Holland’s film was acclaimed for the strong performances of its child actors, its carefully detailed sets, and the spectacular beauty of its location filming in England (particularly the garden, whose evolution is dramatized through DP Roger Deakins’s time-lapse photography segments, which allow the audience to see spring bursting out of the ground and into bloom in a matter of fascinating minutes). As much as Burnett’s theme of self-healing through contact with nature and a positive attitude is problematic, this film represents the social construction of Colin’s illness effectively, developing housekeeper Mrs. Medlock (Maggie Smith) as obsessed with curing Colin through all manner of “modern” technologies such as magnetism and hydrotherapy.

These alterations to the film are effective, as are the scenes that dramatize Mary’s investigation of Colin’s back to locate the mysterious “hump” that he is reported to have. Further, as well as dramatizing the power of the “sick role” that the family and household staff have evolved and supported for Colin, the film shows how Colin’s power as invalid combines with his power as upper-class boy. The domestic staff indulge Colin for fear of his temper, his reputed invalidism, and his father’s displeasure; his class equal, Mary, is the one who rebukes Colin, seeing her own former imperiousness in his bad behavior.

At the same time, Caroline Thompson’s screenplay makes some major and inexplicable changes to the novel that erode its coherence as a study of families and illness. The film eliminates the figure of Dr. Craven, the key character in the novel representing theories of both hereditary illness and hysteria. While the rendering of the Raj (in India and home in England) is beautifully engineered with set designs and a recurrent trope of ivory elephants, the screenplay eliminates the cholera epidemic, changing it to an earthquake. The novel’s enactment of English constructions of India as a sick place is thus removed from the 1993 film, making it less offensive, but also less illuminating as an example of how the stories we tell about sickness are informed by cultural and political fears and desires. The screenplay also makes the two cousins’ dead mothers twin sisters, an evocative concept that is not part of the novel and thus not well supported by the story.

A comparison with the 1949 version directed by Fred Wilcox yields fascinating differences, not only in terms of representing the Cravens'  illnesses/disabilities/treatments, but also in terms of how India and England are represented as sites of illness or health.