The illnesses of United States presidents have long been a subject of interest to both scholars and the American public. One particular area that has generated considerable study is the management of information surrounding such illnesses. An extensive literature has developed around efforts by the White House to conceal, downplay, or ignore presidential maladies. This literature has largely focused on the period from the Gilded Age to the present, accepting the widespread view that such efforts did not occur until the second half of the nineteenth century. This article examines four antebellum episodes in which the American public was not fully informed about the health of their leaders: James Madison's near‐fatal bout of “bilious fever” (1813), the final illnesses of William Henry Harrison (1841) and Zachary Taylor (1850), and Franklin Pierce's alcohol‐induced psychiatric decompensation after the death of his son (1853). Rather than a modern‐day phenomenon, this article argues that such deception is an ingrained and timeworn feature of the American political tradition.