Nathan R. Smith M.D.
Professor of Surgery in the University of Maryland.
May his usefullness be prolonged and his present reputation unsullied for many years to come.
The Cholera. 
We have selected the above as the subject of our dissertation, not with the design or vanity of adding anything new, but on account of its dreaded power and present proximity to us. Since the days of Pandora, whom dareing curiosity and prying disposition led to open the fatal present containing the thousands of ills, to which flesh is heir; no disease simple or compound has, in so short time, caused so much destruction among the human family.
It comes upon us, not as disease in its general form and expected from age, time, season or locality, but at one time noiselessly like a thief in the night;  again boldly and fearlessly like the warhorse to battle; and again as the
As capricious in will as independent in taste; we find it suddenly raising its Gorgon head in the midst of some devoted people, tarrying with them for a while, and then as suddenly departing wheresoever it wills. Pausing for awhile as if for breath or repose, or from satiety; we findpassing over plains, valleys, mountains, rivers, and even old ocean herself, devastating all in its way, fearing no law obeying no rule. We generally find its presence in places where its power can be most severely felt, in crowded cities and populous districts; dwelling so long as it wills, but never departing, until, like Medusa of old, it leaves many a monument of stone to mark where its path has been. But may not some modern M.D. arise; like Perseus of old and discovering through the mirror of science its deformities, with the sword of Esculapius destroy its powerEurope in the year 1817  Breaking out in one of the provinces of India, it first appeared slow in its progress, remaining on its native soil as if to perfect its power before attacking the world. From this as its centre it seems to have gradually encircled all the surrounding countries, until it had grasped the whole of Asia.
Pausing for a few years seemingly in a survey of its conquests and buying its destructive tribute upon its miserable subjects; not content with its power, and ambitious of travel, we find it fairly journeying through EuropeLondon and Paris yielding to its its sway; and in the same year it made its omnipotent bow in the land of Freedom.  After journeying through this country, makeing partial returns for the space of two years, it left us to feed upon the vain hope of eternal freedom from  its power. Deluded by this and lulled into security by its absence for 14 years, we had ceased to know it except by name. After that lapse of time, it has again suddenly and without an admonition placed its foot upon our shores, and stretching forth its powerful arm has in a few weeks, transmitted its influence fromNew-York to New-Orleans, where it is now rageing with extreme violence.  As regards the nature of this disease, Physicians disagree in many points; some considering it as a pure gastro-enteritis; others rejecting this idea in part and advanceing the opinion, that there is a specific cause, capable by its direct action of produceing the phenomena of this disease. In support of the first, it is advanced that the phenomena have their root in this affection, or how could we account for the burning sense of heat in the stomach? The antecedent nausea, vomiting & diarrhea, and the undeniable evidences of positive inflammation after reaction? How explain? that indigestible substances and active or acrid cathartics brought on the
On the other hand it is admitted that there is a partial inflammation of the gastro-intestinal-mucous-membrane, but not of sufficient intensity to indicate is as the basis of this disease. They alledge, that no one familiar with inflammation of this membrane sufficient to cause death, can account for its ready submission to the mildest remedies. Admitting an inflammation of this membrane and its tendency to the secretions of that organ; they still deny it power of produceing the phenomena, alledgeing that the injection after death was venous, that the matter exuded was the fibrinous and albuminous portion of the blood, that it was not confined to that organ, but was found in the mucous many cases when the alimentary canal was least affected, and on the other hand collapse takeing
We will not worry your patience farther with all we might learn and write of its Diagnosis, Prognosis, Treatment and Autopoic appearances, feeling that it would not only be an imputation of ignorance to yourselves, but a
As regards its being contagious or non-contagious; after a study of all the opinions advanced on both sides, we are in favor of the latter doctrine, which is the one generally held by the medical profession of this country and of Europe.
In conclusion, we will remark, that thus far we have escaped the ravages of this modern Hydra, as if it feared to attack us; but should it come, may each of you prove a modern Hercules, and wielding the knotty club of Medicine, crush its detested and fearful head, and with the actual cautery of science, sear and seal its power forever?
1. Edwin Lafayette Dusenbery's essay on cholera was written as a requirement for receiving his MD degree in March 1849 from the Medical Department of the University of Maryland: "Every candidate must deposit with the Dean of the Faculty, at such time as may be specified, a thesis, of his own composition, on some subject connected with medical science, and satisfy the Faculty, by appearing before them in a private examination, of his fitness for receiving the degree of Doctor of Medicine" (University of Maryland 19).
The original manuscript of Dusenbery's essay on cholera is housed in the Historical and Special Collections Department, Health Sciences and Human Services Library, University of Maryland. It is written on 12 sheets of lined paper measuring 18 ½ cm by 24 ½ cm and bound together with other essays by members of his graduating class.
Cholera is caused by a bacterium, vibrio cholerae, that lives in contaminated food or water and causes vomiting, diarrhea, and overwhelming dehydration. The organism was unknown until 1883, when German scientist Robert Koch (1843–1910) first isolated it. Koch received a Nobel Prize in medicine in 1905 for his work on cholera and the theory that disease is caused by such organisms ("Cholera").
2. I Thessalonians 5: 2: "For yourselves know perfectly that the day of the Lord so cometh as a thief in the night."
3. Dusenbery wrote the second 1 of 1817 on top of an unrecovered character. A cholera epidemic along the coast of India, near the mouth of the Ganges River, was one of the first documented, in 1817 ("Cholera").
4. Scientists believe that cholera, which lives in estuarine environments, was inadvertently transported from India in the bilge water of ships, which was dumped in European harbors, contaminating them as well. The French transported cholera to Montreal, from where it spread to New York, site of a major cholera outbreak in 1832 ("Cholera").
6. A second major cholera epidemic in the United States occurred in the late spring and summer of 1849, taking the lives of President James Knox Polk and tens of thousands of Americans, including hundreds of prospectors headed for the gold fields of California. President Zachary Taylor declared August 3, 1849, a national day of "Fasting, Humiliation, and Prayer" (see Rosenberg). In Baltimore, where Dusenbery lived, the outbreak was largely confined to the Baltimore Almshouse, where 155 (of 669) residents, mostly men, were affected, and 86 victims died (Bramucci).