Beth comes down with scarlet fever and is extremely sick, but at first only Hannah and Dr. Bangs realize that the illness might be life-threatening.
Meg writes letters to her mother, who is still in Washington nursing Mr. March back to health. Meg doesn't tell her mother that Beth is sick.
Jo nurses Beth day and night. Beth gets sicker and sicker, and eventually doesn't recognize her and deliriously tries to play the piano while lying in bed.
Now that Beth is sick and might die, her sisters appreciate everything that she did to make their home pleasant and comfortable. Amy longs to go home and Meg and Jo realize how happy they really were before Beth's illness.
While Beth is conscious and aware of what's going on, she tries to comfort everyone around her. Then, she falls into a feverish, delirious state.
On December 1, after examining Beth, Dr. Bangs says that Mrs. March should be sent for. Jo sends a telegram to her mother.
On her way home, Jo meets Laurie, who has a letter from Mrs. March saying that Mr. March is getting better.
Jo tells Laurie how sick Beth is, and Laurie holds her and comforts her while she cries.
Jo composes herself a little. She tells Laurie that she will miss Beth the most of anyone in the family, because Beth is her conscience.
Laurie says that God won't take Beth yet. Jo isn't so sure.
Laurie brings Jo a glass of wine. (This is a common nineteenth-century behavior – drinking a little wine to steady your nerves. We don't recommend it.)
Laurie tells Jo that he sent Mrs. March a telegram secretly yesterday, asking her to come home because he was worried about Beth. Mrs. March is going to arrive this evening!
Jo is very grateful and hugs Laurie, laughing hysterically.
Laurie explains that he and his grandfather decided it was time that Mrs. March should be informed of Beth's illness, but they didn't want to worry anyone, so Laurie sent the message on his own own.
Jo asks how she can thank Laurie. Laurie says that she should hug him again. Jo refuses and goes downstairs.
Jo tells Hannah and Meg that Marmee will be there that evening. They are excited and relieved, and they make preparations for her arrival.
The doctor comes to look at Beth again and says that her condition will change, for good or ill, by midnight.
Meg, Jo, Hannah, Mr. Laurence, and Laurie wait at Beth's bedside, watching and waiting. Hannah falls asleep. The girls pray to God to save Beth's life.
As Meg and Jo watch, Beth's face does seem to change around the stroke of midnight. They think she is dying.
At two a.m., Jo thinks Beth might actually be dead, and leans closer to kiss her goodbye. She sees that Beth has a better color and is breathing normally! Hannah wakes up and says that Beth's fever has broken and she is going to recover. The doctor arrives and confirms what Hannah has said.
Meg puts a newly-bloomed white rose in a vase beside Beth's bedside. As the girls wait, they hear the bells of a carriage from below, and realize that Mrs. March is home!