Asiatic cholera, one of humanity’s greatest scourges in the modern period, came to Europe for the first time in the years after 1817, traveling by ship and caravan route from the banks of the Ganges, where it was endemic, to the Persian Gulf, Mesopotamia and Iran, the Caspian Sea and southern Russia, and then—thanks to troop movements occasioned by Russia’s wars against Persia and Turkey in the late 1820s and its suppression of the revolt in Poland in 1830–1831—to the shores of the Baltic Sea. From there its spread westward was swift and devastating, and before the end of 1833 it had ravaged the German states, France, and the British Isles and passed on to Canada, the western and southern parts of the United States, and Mexico.
Statistics for morbidity and mortality in this first great cholera epidemic are unreliable, for there was generally no means of collecting and tabulating them on a large scale, but on the basis of what we have it appears that Russia suffered over 100,000 deaths in 1830–1831 and that, in Germany, Berlin alone had 2,000 deaths out of a population of 230,000, while in France there were 39,000 cases of cholera in Paris, with 18,000 deaths, a mortality rate of 21.8 per thousand of population. In Great Britain, the Black Country was particularly affected, with heavy death rates in towns like Bilston, Manchester, and Liverpool, while Glasgow and Dublin had mortality rates of 15 and 30 to the thousand respectively. In Canada one in every thirteen inhabitants of Montreal died in 1832, and in the United States there were 5,000 cases in New Orleans. Nor was this the end of the matter, for the disease returned in 1848–1849, when there were 668,000 deaths in Russia and heavy losses in Italy and France; in 1854, when there were 5,000 deaths in Liverpool; in 1866–1867; in 1873, when half a million Hungarians died of the disease; in 1884; and in 1892.
Cholera was by no means the greatest of the killer diseases of the nineteenth century; tuberculosis had a far higher incidence and claimed nearly four million victims in England and Wales alone between 1851 and 1910, and typhoid, smallpox, and measles had higher mortality rates. But there is no doubt that its psychological impact was unequaled. William H. McNeill has written that the cholera bacillus produced
violent and dramatic symptoms—diarrhea, vomiting, fever and death—often within a few hours of the first signs of illness. The speed with which cholera killed was profoundly alarming, since perfectly healthy people could never feel safe from sudden death when the infection was anywhere near. In addition, the symptoms were peculiarly horrible: radical dehydration meant that a victim shrank into a wizened caricature of his former self within a few hours, while ruptured capillaries discolored the skin, turning it black and blue. The effect was to make mortality uniquely visible: patterns …