This chapter shows how the biological, social, and cultural dimensions of the Peruvian cholera outbreak were represented in published accounts. Cholera can alternatively be understood as a well-adapted bacterium, as a symptom of societal collapse, or as a conspiracy against the poor. But first, it is necessary to know something of the history of cholera and of the investigations into its treatment and prevention. The ecological/evolutionary analysis of cholera highlights the impact of changing human demographic, economic, and medical patterns on the bacteria's evolutionary trajectory. The combination of evolutionary theory with the ecological model has also provided insights into the long-term genetic implications for human hosts of exposure to other epidemic agents. The introduction of the ecological/evolutionary model of disease into medical anthropology is traceable to an influential early textbook written by Columbia University anthropologist, Alexander Alland. Alland's use of the adaptation concept and the evolutionary/ecological model is not unique to him or to medical anthropology.