James Buchanan suffered from dysentery on a couple occasions at the National Hotel. Once, Buchanan and many dinner guests fell ill – assumed to be caused by either drowning rats in the cooking water or frozen pipes causing sewage back up to food preparation areas. One of Buchanan’s favorite nephews attended and died from dysentery.

On the eve of his inauguration Buchanan wanted to show confidence in the hotel and held his pre-inauguration party at the National Hotel (owned by a friend and supporter of Buchanan) where he and several guests again became ill (one guest died).  The question has been raised whether his judgment was impaired while he prepared his inaugural address.