This controversial book-length essay by Susan Sontag explores the way in which the figurative language used to describe diseases such as tuberculosis and cancer has often expressed a psychological judgement on people afflicted with these diseases. In effect, Sontag argues, language has served to blame victims for conditions beyond their control.

Sontag begins with an examination of the metaphors that accumulated around tuberculosis, beginning in the nineteenth century, when a cure was yet to be found. It was believed that those suffering with the disease were literally being "consumed" by a passion that was being driven inward (hence the term "consumption"). The victims were thought to be somehow more sensitive, possessed of a superior sensibility. Sontag describes this phenomenon as "the first widespread example of that distinctively modern activity, promoting the self as an image."

As the ravages of TB began to wane due to advances in medical research, this illness replaced by cancer as the bearer of disease metaphors. The repression of intense emotion is again the source of the malady, according to popular conception, but now it takes the form of the malignant, cancerous tumor. In contrast to the romantic image of TB victims, cancer patients, Sontag claims, are psychologically stereotyped as dull, unfulfilled, bourgeois, and rigid (though these stereotypes have no basis on fact). Sontag quotes lines from Auden—"Childless women get it, / And men when they retire"—as an example of this.

Sontag proposes that the culture should abandon these stigmatizing tropes surrounding illness, which only add to the suffering of its victims, and instead adopt a purified language, which views a disease as only a disease, rather than as evidence of a terribly flawed character.