During the nineteenth century, cholera raged through the United States several times, and Kentucky had very high fatality rates. In 1833, cholera killed 500 of Lexington’s population in just a few weeks. Foody examines the devastation in Lexington from many angles—environmental, commercial, social and medical. She discusses early altruistic efforts, the black woman behind the white hero, the plight of orphaned children, and societal trends revealed in laws and practices. Despite great medical advances, cholera is still a worldwide killer. Foody explains why and compares it to other threatening global diseases, such as SARS and pandemic flu.