Illness experience is articulated through metaphors that are grounded in—and constrained by—both bodily experience and social interaction. The bodily grounding of metaphor is based on the hierarchical elaboration of sensorimotor equivalences. The social grounding of metaphor resides in the pragmatics of language where context and intention are inseparable from meaning. Metaphors allow for inventive play, despite the dual constraints of body and society, by requiring only piecemeal correspondences to the world through ostension. The meaning of metaphors is then to be found not in representation but in presentation—modes of action or ways of life. Clinical examples illustrate how a semantics of metaphor can clarify the tensions between the essential irrationality of illness experience and the biomedical presumption of rationality.