These early boards of health were comprised of the mayor, his council, and a physician or sanitary engineer, whose views were often ignored because they would cost governments funds to implement, thus calling for increased taxes. Thus when an epidemic struck, such as the 1832-34 cholera epidemic in most major American cities, a board of health was quickly formed, it functioned during the emergency, and then dissolved with the return to normalcy. The impact of an epidemic on a city cannot be overstated. This quote from a 1849 St. Louis newspaper illustrated the calamitous conditions caused by an outbreak of cholera in that city.