As Abraham Lincoln rose to give the Gettysburg Address on November 19, 1863, his face had a “sad, mournful, almost haggard” expression according to Clark E. Carr, a member of National Cemetery Commission. Reciting the speech eloquently and without difficulty, no one – including Lincoln – realized at the time that he was in the early stages of a smallpox infection.
On the train back to Washington that evening, Lincoln became feverish, weak, and troubled by a headache. His personal servant, William B. Johnson, applied a wet towel to the president’s face to help allay the fever and pain. Back in Washington, Lincoln’s sickness progressed. He had a high fever, severe headaches with back pain, and profound weakness. On the fourth day of illness, a scarlet rash appeared on his body. Lincoln’s physician, Dr. Robert K. Stone, first thought the president had scarlatina (scarlet fever), but when small, widely scattered blisters appeared the next day, he became more concerned.