Jean Giono's portrait of the horseman on the roof is as much a social portrait of the 1832 Provencal cholera epidemic as it is of the reflections and actions of his Stendhalian protagonist. Cholera is at once background and foreground, a social context and a primary agent of the narrative (see Greimas's actantial theory of narrative). The initial chapter illustrates the interconnection of time, voice and perspective in narrative technique (see Genette's theory of narrative discourse), of medical and non-medical (social, religious) perspectives on contagion, and of different forms of medical expertise (knowledge, experience).

Chapters 1, 2 and 13 highlight medical ethics through the attitudes and actions of four physician-characters, while the book as a whole reflects the social ethics of epidemics. Specific episodes represent the dynamics of scapegoating, rebellion, and familial relationships, including that between Angelo and his mother.

The rich descriptive detail gives the reader a vivid sensorial experience of the time, the region, the epidemic, the illness, and the agonizing deaths of the victims. Read together, Giono's The Horseman on the Roof and Camus' The Plague (see this database), written only four years before, dramatically underscore the diversity and autonomy of literary representation of medical subject matter.