In this paper I will seek to provide a new understanding of endemicity of disease in India. Through a study of cholera research in the twentieth century I will argue that disease and its endemicity has to be understood in biological factors as well as within a wider social and economic context. I will discuss the medical efforts at locating the causality of cholera from the nineteenth century in Indian climate, water bodies and human anatomy to show that cholera is no more a biological phenomena than water is an ecological or environmental problem. Both are essentially political and economic questions.