During the mid to late 19th century, Detroit and the American Midwest were the sites of five major cholera epidemics. The first of these, the 1832 outbreak, was of particular significance - an unexpected consequence of the Black Hawk War.

In order to suppress the American Indian uprising then taking place in regions around present-day Illinois, General Winfield Scott had been ordered by President Andrew Jackson to transport his troops from Virginia to the Midwest. While passing through New York State the men were exposed to cholera, and then transmitted the disease to the population of Detroit once they reached that city. As a result, cholera was established as an endemic disease in the upper Midwest. Further outbreaks took place in 1834, 1849, 1854 and 1866, ultimately resulting in the deaths of hundreds of individuals. Only the efforts of local health authorities prevented mortality from reaching the level of that in other cities along the Mississippi.

This book is the story of those outbreaks and the efforts to control them.