"the fourth great Cholera"

Cholera originated in India and first spread widely in 1817, during what is considered the first global cholera pandemic.  The disease was carried by merchants and British soldiers and sailors as far as China and Japan, from where cholera gained its reputation as an oriental disease.

The disease first arrived in Europe and London during the second global pandemic (1829-1851). The disease spread rapidly and was nearly always fatal: 10,000 people died in London alone in the outbreak of 1853-4.  It was during this outbreak that a London doctor, John Snow, discovered that cholera was spread by contaminated water.  Despite this significant discovery, there have been four further global cholera pandemics.