The world of medicine in 1830s America would hardly be recognizable to Americans today. Medical professionals for the most part rejected the notion that diseases were singular biological entities: their source might be in the mind, in the climate, in the morals they followed or defied — or in a volatile mixture of some or all of these factors. The prominence of such ideas helps explain how individuals were able to attach social meanings to cholera that supported their own preexisting system of beliefs.

The majority of physicians in the 1830s did not believe that cholera was contagious. The only disease proven to be contagious in their experience was smallpox, which seemingly shared no similarities with cholera. Physicians believed, for the most part, that cholera was an atmospheric malaise, a change in the air that combined with other, already existent elements of an individual's makeup. How this malaise traveled from one locale to another, no one was quite able to explain. But such reasoning did, in the minds of contemporary medical men, help explain how cholera could ravage different — and usually poor — parts of a city simultaneously. Contagionism as a medical theory was frowned upon; invoking it could disrupt the social order, and it threatened the moral superiority of those who used disease’s prevalence among the poor as a pretense for proselytizing.

The reaction of many New Yorkers when cholera struck suggests that the dominant medical theories of the day did not convince everyone — many lay observers believed the disease was contagious. Those who could fled the city in search of more hospitable "atmospheres." Nurses were notoriously hard to employ during the outbreak, and owners of buildings across the city refused to lease their spaces for use as cholera hospitals for fear of contamination.

Most doctors, bolstered by the belief that they would be uninfected by the disease, worked extremely hard to ease the suffering of cholera victims. Limited by the state of medical knowledge and the unrefined tools of their trade, doctors traveled from “cholera nest” to “cholera nest,” employing any number of procedures they hoped would put patients on the road to recovery. The most common treatment was the ingestion of calomel (mercury chloride), which was applied in heavy doses as a purgative. Laudanum, an opiate, eased the pain of patients, while bleeding--a universal remedy--was thought to cleanse victims of impurities. Other treatments for the symptoms included various enemas ranging from tobacco smoke to saline, as well as strategically placed corks. Several physicians themselves fell victim to cholera in 1832, perhaps unknowingly infecting themselves with their methods of treatment.

Due to a lack of understanding, medical knowledge could do little to limit the impact of cholera in 1832 beyond easing the suffering of some of its victims. Despite these limitations, dozens of medical studies of the epidemic appeared in the months following the outbreak, deepening the overall knowledge of symptoms and how the disease ran its course.