The onset of famine in nineteenth-century India resulted in the breakdown of normal social relations and produced a series of often dysfunctional behavioural responses. Survival strategies like the use of 'famine foods' and migration in search of food and work facilitated the spread of such epidemic diseases as cholera, dysentery, malaria, and smallpox. Although many of these diseases are not normally thought of as having a synergistic relationship with malnutrition and hunger, they were linked to it (as the Madras famine of 1876-78 illustrates) through abnormal social and environmental conditions created by drought and an extreme crisis of substance.