Casaubon suspects that Will plans to fool Dorothea into marrying him when she becomes a widow in order to get possession of his wealth. However, Will worships Dorothea for other reasons. He wonders what his devotion means to her. He plans to go to Lowick Church during services in order to catch a glimpse of her, even though it would be an outright defiance of Casaubon's prohibition. He goes nevertheless, but he regrets his impetuous action immediately because Dorothea pales when she sees him.
Dorothea is upset that her husband continues in refusing to speak to Will. His presence in the Church only more strongly marks their alienation. Casaubon's health continues to decline. Later that night, Casaubon asks Dorothea to make a promise. She asks what the promise is. Casaubon thinks her question is a refusal. She asks him to defer the matter until the next morning. In the morning Casaubon takes a walk. Dorothea resolves to promise whatever Casaubon wants and searches for him on the grounds. She finds him seated on a bench and discovers that he has died.
Lydgate experiences problems when he continues to ignore the importance of social relations. He concentrates so strongly on reforming the practice of medicine in Middlemarch that he fails to realize the importance of establishing cordial relationships with his colleagues. His professional life cannot be independent of the web of social relations. His resistance to dispensing drugs threatens the livelihood of the local apothecaries. Ironically, it threatens Lydgate's livelihood as well, because potential patients distrust his treatment, as they are accustomed to receiving drugs.
Lydgate doesn't treat his patients like interesting case studies, but as individual human lives. To him, they represent the virtue of improving medicine. He alleviates human misery, rather than merely curing disease. His vocation doesn't represent an abstract academic pursuit. However, he treats the community of Middlemarch as a passive body on which he can experiment with his reforms. His refusal to recognize the human aspect of the web of multiple social relations entails consequences. His success in difficult cases only goes so far to amend his unpopularity. Lydgate's professional success depends on a combination of professional merit and skilled social networking.
Moreover, Lydgate assumes his professional life will be separate from his married life. Even though he heralds a very modern concept of medicine and science, he entertains old-fashioned ideas about marriage. He expects his wife to be a passive ornament to his life. He also does not realize that his professional success is extremely important for his private married life. The two do not exist independent of one another.
Rosamond's dream is to live an aristocratic lifestyle. The narrow range of possibilities for self-realization available to women is perhaps partly responsible for Rosamond's manipulative nature. She can achieve her dream only through a man. She certainly cannot attempt to earn a fortune on her own, as a man might. She has never received an education that would even prepare her for such a life. Her intelligence and her ability to manage people degenerate into selfish vanity in the stunted environment available to women. There is no other outlet for her ambitions. She directs her ambition for upward social mobility into plans to manipulate her husband into leaving Middlemarch. Conventional gender roles stifle Rosamond's natural ambition, and because of her frustrated ambition, both she and her husband are miserable. Her only outlet for this ambition is her husband. He treats her like an object, and she treats him like an object to be manipulated as a means to fulfill her goals.