The big health menace today is AIDS; a century and a half ago it was cholera. And while some Americans in 1990 moralistically contend that AIDS is divine retribution for the sinful, promiscuous lives of sufferers, in 1832 many felt that way about cholera.

Like AIDS, cholera was deadly, but much faster in onset and duration. Victims experienced severe cramping, diarrhea, vomiting and dehydration. Then came discoloration of the face and extremities, and often death within 24 hours. "To see individuals well in the morning & buried before night, retiring apparently well & dead in the morning," read one diary account, "is something which is appalling to the boldest heart."

Cholera became front-page news during the 1832 epidemic that seemed synonymous with Eastern and Midwestern cities. Appearing in the summer, the disease claimed 800 lives in Baltimore within weeks. In Philadelphia, 900 died, New York lost 3,500 citizens, New Orleans 6,000. All could lay claim to the degeneracy that some Americans believed was critical to cholera's spread.

Only the District of Columbia's sparse population spared it; 15 souls perished.

Of course, the cholera germ, we know in retrospect, sprang not from promiscuous city folk but from contaminated water supplies. The poor in the city had the worst water and sewer facilities, and the mass infection was taken as confirmation of their virtueless lives. And if a respectable resident contracted the disease, then gossip confirmed that he harbored a clandestine vice.

Cholera victims suffered not only the ravages of disease but the absence of those expected to help the ill. Many hospitals had no nurses, except for visitors who volunteered to help, and in Boston and Philadelphia, it was the Sisters of Charity who took care of nearly all who were stricken. Doctors sometimes moved to other locations to avoid contact with cholera patients.

Many Americans believed the only way to deal with cholera was to try to prevent it: That meant a day of prayer and fasting, preferably on a national basis.

President Andrew Jackson, however, refused to call such a day on the ground that it would be "transcending the limits prescribed by the Constitution for the President."

Jackson's position led to his vilification by numerous newspapers in the East. A typical editorial, on July 16, 1832, contended there was no place for the pious in Jackson's Washington, but "the rabble are courted and applauded, the vicious promoted to office, and the cry which is chanted in their Bacchanalian and nightly revels, is in time of emergency and dread gravely echoed from places of power."

Not surprisingly, the governors of Maryland and Pennsylvania did proclaim a prayer day, as did the leaders of 10 other states.

Also lending support to the view that sin and disease went hand in hand was Sylvester Graham (1794-1851), a New Englander widely acclaimed in the East for a dietary and sexual regimen in which the key word was restraint. Graham, who served as an agent of the Pennsylvania Temperance Society, wrote extensively on the matter of good health, of which a major feature was chastity:

"Remember, my young friends, the end of your organization! Recollect that the final cause of your organs of reproduction -- the propagation of your species -- requires but seldom the exercise of their function! and remember that the higher capabilities of man qualify him for more exalted and exalting pleasures than lie within the precincts of sensual enjoyment! and remember, also, that by all we go beyond the real wants of nature in the indulgence of our appetites, we debase our intellectual and moral powers, increase the carnal influences over our mental and moral facilities, and circumscribe our field of rational acquisition and ennobling pleasures."

The cholera epidemic of 1832 burned itself out within two years, leading observers to cease their admonitions. But an 1833 survey of more than 100 American physicians found that only one believed the disease was contagious, a conclusion that led religious observers to confirm their view of God's retribution on the licentious. Some ministers, noting a larger attendance at church services, concluded that as Americans repented and became better Christians, cholera seemed to fade.

Of little help during the epidemic was the medical profession, whose cures -- chiefly bleeding and the taking of strong purgatives -- only hastened the weakening and sometimes death of patients. Little wonder that a popular saying read: "Cholera kills, and Doctors slay, and every foe will have its way."

Another epidemic struck in 1849, in which Midwestern cities including St. Louis and Cincinnati suffered the most. Once again, moral strictures were the popular cure, although research at some educational institutions began to suggest otherwise. But not until the late 19th century, when the actual cause of cholera became known, did religion play a lesser role in defining its onset and cure.

Thomas V. DiBacco is a historian at American University.