Nineteenth-century migrants traveling across America suffered from many diseases as they journeyed to new homes in the West. The disease that was most common and caused the highest rate of illness and death was cholera. Historian Robert Carter notes, "It was a disease with which people were . . . familiar, yet it was little understood. It would strike suddenly, with no warning, often killing the victim within hours of the first symptoms. It was so uncontrollable that often entire families, even whole emigrating companies, would be wiped out." While cholera was not always fatal, it brought fear and suffering into the lives of nineteenth-century travelers.