By 1866, the Civil War had ended in the United States, and the country underwent a turbulent period of transformation known as Reconstruction. Presidential and Congressional Reconstruction set the terms for the South’s readmission into the Union, which included among its requirements: oaths of loyalty, inclusion of African Americans in politics, and the creation of the Freedmen’s Bureau. Adding to the social tensions of 1866, was a cholera outbreak throughout much of the United States. Frontier cities like San Antonio, Texas lacked medical institutions and trained physicians (medicine was governed by miasma theory, which held that an unclean environment and bad air led to disease) and caused many people to fear cholera. These circumstances led the citizens of San Antonio to call for a hospital to care for the sick. In 1869, under the leadership of the Sisters of Charity of the Incarnate Word of San Antonio, a hospital was established, and became a central institution in the development of the city.
Vibrio cholerae is the bacteria that causes persistent diarrhea and vomiting anywhere from five hours to a day after infection. The ghastly symptoms of the disease included sunken in faces and bodies, and was usually characterized by a bluish tint of the skin called cyanosis. Cholera is transmitted by contaminated water, which prompted quarantines at the ports of Galveston in 1866. In Austin, a single reported case of cholera on September 19, 1866, was enough to cause nervous excitement throughout the city. The possibility of cholera in Austin nearly halted the proceedings of the Eleventh Texas Legislature, but business continued. The San Antonio Herald published the board of health’s call for improvements throughout the city such as the paving of sidewalks and the placing of gutters along both sides of the street. The responsibility for a clean city resided not only with the local government, but with the citizens who were asked to keep the common areas clear.
In San Antonio, the Catholic Church took the lead in responding to the cholera epidemic and the medical needs of the citizens. Bishop Claude Marie Dubuis had suffered from a cholera infection during the 1849 epidemic while working in the city of Castroville, so it was fitting that under his orders he enlisted three sisters from Lyons, France to come to Galveston, Texas. These three formed the core of the new order who came to be called the Sisters of Charity of the Incarnate Word of San Antonio. When Sisters Madeleine Chollet, Pierre Cinquin, and Agnes Buisson agreed to go to San Antonio, they did so under the expectation that they were to become integrated in the community instead of remaining cloistered.
The Sisters left Galveston by stagecoach in March 1869 and embarked on a three-week journey to San Antonio. In preparation, the people of San Antonio began to add more rooms to the rectory of San Fernando Church, but when the Sisters arrived they found that a fire had consumed their new home. After receiving shelter from the Ursuline Sisters, the Sisters of Charity moved into the combined convent and hospital on October 21, 1869. The first hospital was opened on December 1, and was called Santa Rosa Infirmary. The Sisters provided direct nursing care for the patients that they received in the infirmary.
The Santa Rosa Infirmary was an anchor for the community of San Antonio and surrounding cities. The intention of the Sisters of Charity was to serve all sick patients, “by providing for them healthy rooms, good food and attentive nursing…” Frequently, the Sisters went without dinner so they could afford to care for their patients. Showing that the city was still very much a frontier city, the Sisters acknowledged the number of single men in San Antonio who may need “proper care and nourishment.” In their role with Santa Rosa, the Sisters fulfilled their religious moral role within the Church, as well as their moral gendered role as caregivers in American society. Furthermore, the opening of Santa Rosa to all patients, regardless of race and ability to pay, in San Antonio and its surrounding areas exemplified the stabilizing effect that the hospital had during periods of social instability.
The Santa Rosa Infirmary, established by the Sisters of Charity of the Incarnate Word of San Antonio was far from perfect. Initial funding limited the number of patients that could be admitted, with many having to fill out applications one day in advance. Lack of space meant that “lunatics, incurables, persons afflicted with contagious diseases and persons of ill fame” were not admitted “until a proper place outside of town shall be provided for them.” This seemingly insensitive notice was ultimately a reality of the dearth of funding available for running the hospital. Nevertheless, because of the work that the Sisters of Charity of the Incarnate Word of San Antonio contributed to the community, San Antonio benefited from the continued operation of the hospital, which is today known as the CHRISTUS Santa Rosa Health System.
 David Wootton, Bad Medicine: Doctors Doing Harm since Hippocrates (Oxford: Oxford University Press, 2006), 180, 195.
 “Texas.: A Quarantine Ordered at all Ports.” The New York Times March 10, 1866; Pat Ireland Nixon, A Century of Medicine in San Antonio: The Story of Medicine in Bexar County, Texas (San Antonio: Published Privately, 1936), 132-134; Abbé Emmanuel Henri Domenech, Missionary Adventures in Texas and Mexico. A Personal Narrative of Six Years’ Sojourn in Those Regions. Translated from the French Under the Author’s Superintendence. (London: Longman, Brown, Green, Longmans, and Roberts, 1858), 95-96; Bradley, L. D. [Letter from L. D. Bradley to Minnie Bradley – September 19, 20, and 22, 1866 and September 30 and October 2, 1866], letters, September and October 1866; (texashistory.unt.edu/ark:/67531/metapth619286/m1/4/?q=cholera: accessed April 13, 2017), University of North Texas Libraries, The Portal to Texas History, texashistory.unt.edu; crediting Pearce Museum at Navarro College.
 Sister Margaret Patrice Slattery, Promises to Keep: A History of the Sisters of Charity of the Incarnate Word San Antonio, Texas; Volume 1, Historical Development from 1869 to 1994 (San Antonio: Publisher Unknown, 1998), 4-6; Handbook of Texas Online, Sister Josephine Kennelly, C.C.V.I., “Sisters of Charity of the Incarnate Word, San Antonio,” accessed October 30, 2017,http://www.tshaonline.org/handbook/online/articles/ixs02.
 Handbook of Texas Online, Sister Josephine Kennelly, C.C.V.I., “Sisters of Charity of the Incarnate Word, San Antonio,” accessed October 30, 2017,http://www.tshaonline.org/handbook/online/articles/ixs02; Promises to Keep, 6-7.
 Sister Mary Hilda, C.C.V.I., “History of Santa Rosa Hospital: Santa Rosa Hospital, San Antonio, Texas, 1869-1946” (dissertation, 1946), 12-13; Sister Mary Helena Finck, M.A., “The Congregation of the Sisters of Charity of the Incarnate Word of San Antonio, Texas.: A Brief Account of its Origin and its Work” (dissertation, Catholic University of America, 1925), 51; Susan Reverby, Ordered to Care: The Dilemma of American Nursing, 1850-1945 (Cambridge: Cambridge University Press, 1987), 96.
 Sister Hilda, 13.
Rosenberg, Charles E. The Care of Strangers: The Rise of America’s Hospital System. New York: Basic Books, 1987.
Rosenberg, Charles E. The Cholera Years: The United States in 1832, 1849, and 1866, Second Edition. Chicago: The University of Chicago Press, 1987.