

The exhausted former president seemed to gain new life, but in early June, he fell ill again, by most accounts of cholera. After a visit to his mother in Columbia, Tennessee the Polks settled into his new home, Polk Place in Nashville. A doctor assured him he did not have cholera, and Polk made the final leg, arriving in Nashville on April 2 to a huge reception. Several passengers on the riverboat up the Mississippi died of the disease, and Polk felt so ill that he went ashore for four days, staying in a hotel. Worried about his health, he would have departed the city quickly but was overwhelmed by Louisiana hospitality. A passenger on Polk's riverboat died of it, and it was rumored to be common in New Orleans, but it was too late to change plans.

By the time the Polks reached Alabama, he was suffering from a bad cold, and soon became concerned by reports of cholera. He was touring the American South with his wife in a post-presidency vacation. Polk on June 15, who had just left the office of the presidency a few months earlier.

In Nashville, it would even take the life of James K. But cholera also killed famed fur trader Pierre Chouteau Sr., a member of the wealthy founding family of the city. The worst death rates were in the slums on the north and south ends of present-day downtown, where bodies were buried in ditches. The city established a health board with supreme powers that banned vegetables, burned tar to battle "foul air," and turned schools into hospitals. The toll grew six-fold in May, and on May 17 the business district was destroyed by fire. More than 120 died of cholera in April 1849, the month Mayor James G. The backup was derided as "Kayser's Lake." Fouled drinking water spread the disease.

A plugged sinkhole eventually flooded a low spot at Biddle and 10th streets, northwest of today's Edward Jones Dome. Because building sewers was expensive, city engineer Henry Kayser chose in 1842 the cheaper strategy of diverting wastewater into the honeycomb of limestone caves beneath the city. Louis was a fast-growing city of 75,000, with immigrants arriving by the steamboat-load. It is thought that ships from Ireland likely brought the disease first to New York and then to New Orleans, as many people were afflicted with "gold fever" and had set sail for the Gulf of Mexico with plans to make their way up the Mississippi and Missouri Rivers. In December 1848, New Orleans started reporting a cholera outbreak.
