The physical ailments depicted in the novel serve to illustrate the spiritual and psychological predicaments of the characters they affect. There is a strong connection between these ailments and food, as sickness is often the result of an undernourished spirit or the intake of something hostile to the digestive system. Specific recipes offer cures for specific conditions, such as the oxtail soup that Chencha prepares for Tita after her breakdown. Tita attempts to prepare special foods to solve Rosaura's digestive disorder, but Rosaura eventually dies, never having been cured of the disorder. Her ailment continues even after her death, as her body continues to emit a smell so terrible that few people attend her funeral. The recovery of Tita and the succumbing of Rosaura speak to the essential element of their characters. While Tita's good heart and strong spirit help her overcome debilitating mental and physical conditions, other characters, such as Rosaura and Mama Elena, die unable to control their illnesses, which symbolize their own bitterness toward life.
The novel is told from the point of view of an unnamed, presumably female descendant of the De La Garza clan. From the first chapter, in which the narrative voice directly addresses the reader, to the final page, on which the reader learns that the novel's recipes have been preserved in a book passed down through generations, the narrator is the guide through this complex and often improbable tale. The narrator structures the novel by dividing the story into "monthly installments," and the recipes that begin each chapter act as anchors to the story.
The presence of a narrator who speaks about the past from a contemporary context allows greater space for the fantastical elements of the novel's magical realism. The reader understands implicitly that the narrator is recounting family lore and consequently does not require the narrator to prove the possibility of such things as pink sweat (whether real or exaggerated), but rather accepts these happenings as a part of the mystical world of the novel.
Finally, as the child of Alex and Esperanza, the narrator, by the very fact of her existence, stands as a testimony to the triumph of Tita's spirit, because the family tradition prohibiting the marriage of the youngest daughter has been successfully abolished.
In a novel so concerned with the human spirit, it is no surprise that the spirits of the dead surface as significant figures. The most important spirit figures are those of Nacha and Mama Elena (the spirit of John Brown's grandmother, Morning Light, plays a lesser role). In life and in death, Nacha and Mama Elena are the two central maternal figures for Tita; Nacha provides nourishment, love, and support, while Mama Elena is an oppressive, abusive force. The reader can view these two, who continue to influence Tita as she develops, as the separate halves of an unreconciled whole, each trying to counteract the will of the other.
Nacha appears when Tita is in need, offering wisdom in the form of advice and recipes. Throughout the novel, whenever Tita voices longing for Nacha's companionship, Nacha appears. She offers crucial support for Tita in her determined struggle for love. Mama Elena, on the other hand, is a constant source of vexation for Tita. Her death seems to grant Tita the right to live her life according to her wishes; however, her spirit surfaces when Tita becomes pregnant with Pedro's child, flouting the familial tradition so important to Mama Elena. Mama Elena's terrifying threats and curses leave Tita feeling completely distraught. When Tita finally stands up to her, the ghost shrinks into a fiery, spinning light and sets fire to Pedro. This violence is a clear illustration of the sheer power of Mama Elena's vengeance; even when seemingly defeated, Mama Elena uses her last ounce of power is used toward the destruction of Tita's love. The counterbalancing forces of these two spirits accompany Tita on a path that eventually leads to Tita's own manifestation in spirit form, at her ecstatic death after making love with Pedro. Finally, Tita's spirit is free and her tumultuous struggle is complete.