In some ways disease does not exist until we agree that it does-by perceiving, naming, and responding to it. These acts of agreement have during the past century become increasingly central to social as well as medical thought. What is often overlooked, however, is the process of disease definition itself-the fashioning of explanatory "frames" for understanding disease-and the consequence of those definitions, once they are agreed upon, in the lives of individuals, in the making and discussion of social policy, and in the structuring of medical care. More study is needed of the individual experience of disease in time and place, the relation of culture to definition of disease, and the role of the state in defining and responding to disease...