This article originally appeared in the pages of the Gettysburg Times, in January of 2025. It was penned by Wendy Allen of the Lincoln Fellowship of Pennsylvania, in the hopes of sharing the work the Fellowship does.

While working on a Lincoln project, I came across renewed research about Lincoln’s bout with “a mild form of smallpox” while here in Gettysburg.  For this column, I draw upon research conducted by Dr. Armond S. Goldman and Dr. Frank C Schmalstieg Jr. from the University of Texas, Medical Branch, in Galveston, Texas. 

Lincoln was so ill here on November 19th that there is a good chance that if the illness has set in just a few days earlier, he might have declined coming to Gettysburg. 

During the train trip from Washington City to Gettysburg on November 18th, Lincoln remarked that he felt weak. The next morning Lincoln was dizzy but later rode a horse to the site of the dedication ceremony. 

Edward Everett began his two-hour keynote address. After its conclusion and a short musical interlude, Lincoln stood to give his address. John Hay, Lincoln’s assistant secretary, noted that Lincoln’s face had ‘a ghastly color’ and he appeared ‘sad, mournful, almost haggard’. Scarcely glancing at his notes, he delivered the Address with a strong voice to a quiet audience.

After the ceremony he looked ‘gloomy and listless’. When Lincoln boarded train for home, he was feverish and weak, suffering from a severe headache. At the White House, he had fever, malaise, exhaustion and pains in the head and back. Information was not released to the press, but rumors circulated that the President was very ill and perhaps dying. There is evidence that those near Lincoln feared that he would die. Hay recorded in his diary on November 26, “The President quite unwell.” William Stoddard wrote that he, Hay, and John Nicolay, Lincoln’s secretary, engaged in “mournful consultations over the idea that all the country would go to ruin if Abraham Lincoln should die.” 

The high fever, profound weakness, general malaise, severe headaches and back pains continued. A scarlet rash appeared over his body on the fourth day of the illness. Lincoln’s physician, Dr Stone, diagnosed the illness as a cold, later as ‘bilious fever’ and then as scarlatina (scarlet fever). Small widely scattered blisters appeared after five days. Dr. Washington Chew Van Bibber from Baltimore was asked by Dr. Stone to see the President. Van Bibber changed the diagnosis to a mild form of smallpox. 

So, did Lincoln have a mild form of small pox? Researchers point out that what became known as mild smallpox or Variola Minor, did not appear in the U.S. until late in the 19th century, so this could not have been the disease that Lincoln had. Could he have had a weakened case of the deadly form of smallpox from either receiving a vaccination or if he already had the disease? It is not known if Lincoln had ever been immunized against smallpox, but with Lincoln’s recorded symptoms and the duration of the disease, today’s medical researchers assert that his illness was full-fledged smallpox.  

By mid-December, some 25 days after the onset of the illness, he felt well enough to work for several hours.  By mid-January, 1864, he was under-weight but had recovered much of his normal stamina. This is one of those historical outcomes that had a profound effect on the course of the United States.