Cholera, a virulent, intestinal disease spread by contaminated water, emerged from South Asia in 1830, devastating the cities of Europe as it moved west. By 1832, it appeared in Canada, and, despite efforts to prevent its arrival, the U.S. didn’t have long to wait. Kelton meticulously documents the disease’s spread across the country and the reaction of those whose communities and families were affected. The medical profession hadn’t yet learned the role of microbes in disease—in this case, Vibrio cholerae—and doctors “reflexively described patients whom they lost as intemperate, filthy, or derelict in calling for medical assistance in time.” Temperance advocates joined in: “In almost if not every case Cholera is the result of intemperance, imprudence in eating vegetables, fruits & neglect of diarrhea,” one Baltimore clergyman wrote. Newspapers blamed the Irish, African Americans, and others stuck in impoverished conditions—never noticing their lack of access to clean water. The medical doctrine of the time, based on purging, bleeding, and opium, did little to help the victims. Cholera took an especially high toll among Indigenous people driven west on the Trail of Tears and among enslaved people marched to the Deep South to be sold to cotton planters, in conditions that encouraged the free spread of the disease. Meanwhile, the wealthy fled the cities at the first sign of the plague, mostly to places with good sanitation. While the subject matter is far from cheerful—especially in light of recent experiences with Covid-19—Kelton brings the words and experiences of those who lived through the pandemic to bring the era to life.