In Emma, as is not uncommon in Austen, illness both defines characters and drives the plot. Mr. Woodhouse provides a classic portrait of the hypochondriac and a humorous glimpse into the overwrought fears about ordinary life--drafts, gruel, journeys--for such a man. Although Austen mocks Emma's overconfident machinations in other matters, she also offers a realistic picture of the loving patience Emma must draw upon in managing her anxious, often difficult father, a subplot that suggests the challenges many daughters face in caring for elderly, ailing parents at home.

Austen suggests a more pointed critique of psychosomatic illness as selfish, in her portrait of Frank Churchill's wealthy aunt, Lady Churchill, who deploys her hysterical ailments strategically, to keep Frank's interests at home. Frank comments wryly that "her illnesses . . . never occurred but for her own convenience" (232).

Austen also references medical debates over the transmission of disease. Before Emma recognizes Mr. Elton's love for her, she and Mr. Elton discuss a "bad sore-throat" from which Harriet is suffering. Both draw upon medical terms for emphasis. When Emma describes Harriet's condition as "a throat very much inflamed, with a great deal of heat about her, [and] a quick low pulse," Mr. Elton anxiously interrupts, "I hope not of a putrid infectious sort," and Emma misinterprets his fear as a concern for Harriet's, not for her own, health (99). Austen's medical references here underscore her irony, suggesting that even the technical, clinical discourse of medicine can promote misunderstanding instead of the clarity it advertises. In just this way, debates over the communicability of infections like puerperal fever or erysipelas simmered throughout much of the early nineteenth century despite efforts to streamline and standardize medical discourse.

Emma provides marvelous vignettes of the social construct of illness during the early nineteenth century, when the culture of medicine was entering a period of rapid change. It is this kind of interweaving of medical with social significance that invests Austen's work, and early case histories, with such a broad perspective on illness and its meanings. Later in the nineteenth century, the social meaning of illness largely disappears from medical narratives as clinical physicians strove for professional recognition. Emma allows us to reintegrate medical issues like hypochondriacism and infection with their meaning in early-nineteenth-century culture.