"Dying from cholera--mort de chien, dog's death, or the blue terror--was one of the most ghastly experiences a disease could inflict on a human being. More or less healthy persons going about their ordinary affairs were suddenly struck as if by a hammer blow on the head. The initial shock was followed by vomiting and uncontrolled voiding of rice-water stools which leached the body dry of fluids. When dehydration was reaching a critical stage, cramps convulsed every muscle of the body, causing victims to writhe and scream with pain. Perhaps young and attractive in the morning, by nightfall they had become shriveled wrecks with darkened bluish skin, sunken eyes and protruding teeth. Even worse, until almost the very end, victims might be aware of the terrible things happening to their fecal-stained, dehydrated bodies." (Sheldon Watts, Epidemics and History: Disease, Power, and Imperialism [New Haven: Yale University Press, 1997], p. 173).
Today, if treated soon after the onset of symptoms, nearly 100% of cholera patients survive. During the 19th century, death rates were over 50% (and survivors were often severely damaged for life) because nobody could figure out an effective treatment or even what caused the disease. And what is this amazing treatment? Drinking large quantities of water! Yes, that's right. There are fancy electrolyte-replacement fluids that work even better, but plain water usually gets the job done:
Cholera tended to spread along trade routes, and especially along the path of the British Empire. Cholera broke out in India in 1817, compliments of the British East India Company. It soon made its way into China, and by the 1830s the disease was well known in Chinese medical literature, usually under the name "huoluan" (sudden chaos). Outbreaks of Cholera were especially common in and around the treaty-ports in the periods 1841-59 and again in 1881-96. British and other European observers tended to blame such outbreaks on a lack of "hygiene" among "the Chinese," with "hygiene" typically defined as a state-run, coercive regime of public sanitation designed to reduce foul odors. While certain types of public sanitation might well reduce or eliminate cholera, the obsession with odors led British officials astray back home. Public sewers constructed in the 1840s dumped vast quantities of human waste into rivers. The sewers reduced odors on land, but they actually helped spread cholera and other diseases until the treatment of wastewater became effective later in the century. See Steven Johnson, The Ghost Map: The Story of London’s Most Terrifying Epidemic—and How It Changed Science, Cities, and the Modern World (New York: Riverhead Books, 2006) for more details.
Above: a suburb of Hangzhou, China, after a cholera epidemic passed through the area (late Qing).
Below, public health posers from China ca. 1940s - early 1950s. They explain the causes of cholera, symptoms, and measures to treat and prevent it. The second poster highlights inoculations, avoidance of impure ("raw") water, and avoidance of impure food as the major steps in prevention.