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As this 4th edition of the well-known Manual of Tropical Medicine becomes available, at $18.50 per copy, one cannot but wonder about original versus current objectives of the book. The first edition of the Manual served during and immediately after World War II as a practical, nearly pocket-sized, quick reference for medical officers, and later for medical students as well. There is undoubtedly a continued need for a compact, general reference source on parasitic and certain infectious diseases. But, should we continue to lump under “tropical medicine” an increasing and arbitrary collection of entities? Is the term tropical medicine still useful, or is it becoming obsolete? A narrow definition of the subject might restrict tropical medicine only to parasitic diseases. Relatively few parasitic diseases, however, are confined to the tropics and subtropics. There has been an increasing tendency to regard tropical medicine as embracing those health conditions that are characteristic of tropical regions with poor sanitation.