The garrison had an average strength of 3,670 men.
On 9 June 1837, the first two cases of asiatic cholera appeared among the inmates of the Ospizio dei Vecchi situated below Floriana Barracks, which at the time was occupied by the 92nd Highlanders. On 13 June, 645 paupers were transferred to Fort Ricasoli, in the hope that better ventilation there, would stamp out the epidemic. Cholera spread to the Highlanders on 17 June, and to the Royal Artillery at Upper St Elmo on 19 June. As more Highlanders became infected, the regiment was placed under canvas at Fort Manoel.
Cholera soon appeared in every village within five miles of Valletta. Zabbar, Birkirkara and Qormi had the highest number of deaths, due to the great overcrowding and unhealthy conditions that characterised those casals. Many of the inhabitants fled to Gozo taking the cholera with them. In Gozo there were 804 attacks with 359 deaths.
On 4 July, a notice issued by the Central Committee, which had been appointed to manage the epidemic, invited:
The Maltese members of the medical profession and medical students at large, to visit the Civil Hospital at Strada Cristoforo Valletta, and at the Convent of Saint Philip at Senglea, in order that they may become familiarised with the prevailing disease.
At the height of the Cholera epidemic, the interior of the Hornworks at Floriana was, by order of the Lt General Commanding Troops Malta, appropriated as a burial ground for the military. It remained in occasional use up to the 1840's.
Additional Staff Medical Officers arrived from Gibraltar to work along side their military colleagues. None of the army surgeons became infected.
Out of an average strength of 3,670 men, the garrison had 315 cases and 78 deaths. The Royal Navy had 60 cases with 21 deaths.
Inspector of Hospitals John Frederick Clarke opened the Military Hospital in Lower Merchant Street Valletta to Maltese practitioners, and medical students who had never seen cholera, so as to familiarise themselves with the disease.
The epidemic peaked in mid July and disappeared in early October. It had attacked 7,565 persons (4,462 in the towns, and 3,105 in the villages). There were 3,792 deaths (2,207 in the towns and 1,585 in the villages). Five doctors perished.
Dr Antonio Speranza, was singled out by the Governor for his work during the epidemic. He had been
eminently distinguished by courage and decision under circumstances of no ordinary difficulty. In 1813, Dr Speranza had served in the plague hospital at Fort Manoel and was later appointed First Physician of the Civil Hospital,