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In Their Own Words
Lincoln Was Sick at Gettysburg. It May Explain His Greatest Speech
An LDI Fellow Argues Smallpox Forced Lincoln’s Brevity—and Changed History
Print:
This op-ed originally appeared in PennLive on June 19, 2026.
As a physician, I read the historical record of November 19, 1863, and see something that most historians have overlooked: a man in the early grip of smallpox who stood, likely dizzy, febrile and wracked, before 15,000 people at Gettysburg and delivered 272 words before dissolving back into his chair.
By the time Abraham Lincoln boarded the train back to Washington, he could barely remain upright. He would be dangerously ill for the next three weeks.
Lincoln was almost certainly in the prodromal stage of smallpox: the two- to four-day window before the rash appears, when the virus is already spreading through the body and the host has no idea yet what is coming. This stage produces high fever, severe headache, and a prostrating, bone-deep malaise that makes sustained physical effort nearly impossible. The full eruption would declare itself only after he returned to Washington.
And yet the standard histories of the Gettysburg Address treat his physical condition as a colorful footnote, if they mention it at all, before moving on to the rhetorical analysis: the three-part structure, the Periclean echoes, the biblical cadences, the genius of compression.
This November marks the 163rd anniversary of that speech. We are still getting it wrong.
Read the full op-ed here.
Author
Rebecca Arden Harris, MD, MSc
Assistant Professor, Family Medicine and Community Health, Perelman School of Medicine
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