Health.

Immigrants who entered the Trans-Appalachian region in the early nineteenth century hoped to leave behind the disease and contamination that seemed so characteristic of Eastern cities. They expected to find in the West an environment of clean air and water, with limitless opportunities for health and material advancement. However, the process of settling the West changed the environment itself. Migrants brought more than their culture; they also transported bacteria and viruses, and with those came epidemics that wrought turmoil in both white and Native American communities. The fact that most people lived far from medical care in primitive, makeshift conditions added to the dangers of disease. When students think of the American West, they often think of gunfights and ambushes even though more persons died from illness than from violence. Thousands of anonymous, unmarked graves along the great trails and in...