Governor of Kentucky
Returning to Louisville, Blackburn was fêted at the Galt House hotel. For weeks, receptions were held in his honor, gifts of appreciation poured in from across the state and region, and he was hailed as the "Hero of Hickman". It was against this backdrop that he resumed his gubernatorial campaign in November 1878. Two other men also sought the Democratic gubernatorial nomination: Lieutenant Governor John C. Underwood and former Congressman Thomas Laurens Jones. Before the yellow fever outbreak, Underwood had been the favorite, but public sentiment had turned in Blackburn's favor after his service to the people of Hickman. Underwood questioned whether Blackburn's medical background had adequately prepared him to be the state's chief executive; he also mounted a failed legal challenge that claimed Blackburn had not met the constitutional state residency requirement of seven years. In late March 1879, however, Underwood determined that he would not be able to overcome the "avalanche" of support for Blackburn and withdrew his candidacy. At the May 1 Democratic nominating convention, Blackburn was nominated by an overwhelming majority—935 delegates to the convention voted for him compared to just 22 for Jones.
Due to ill health, Blackburn could not take an active part in the campaign. He sought relief from his ailments at Crab Orchard Springs, while much of the campaign oratory was delivered on his behalf by fellow Democrats Boyd Winchester, Parker Watkins Hardin, W. C. P. Breckinridge, and others. Republicans, who had nominated Walter Evans, had fewer speakers with which to canvass the state, and were at a decided disadvantage. Democrats attacked the administrations of Republican Presidents Ulysses S. Grant and Rutherford B. Hayes, cited the alleged abuses perpetrated in the South by Carpetbaggers and Scalawags, and leveled charges that Republicans favored capitalists over the state's working class. Republican orators, led by William O'Connell Bradley, charged Democrats with financial extravagance, citing a $3 million surplus in the state treasury in 1865 compared with a $1 million debt in 1878. Bradley claimed that Democrats had maintained their power in the state through gerrymandering election districts. He cited poor conditions at the state penitentiary and inadequate funding of public education as evidence of Democratic mismanagement of the state.
In late May 1879, the Republican-leaning Cincinnati Gazette reported on Blackburn's alleged plot to infect northern cities with yellow fever during the Civil War, apparently the first time the incident had been reported in Kentucky. The newspaper formed a special department for the sole purpose of investigating the claims against Blackburn and published a daily column in which it related the department's findings. In the wake of the Gazette's investigation, other Northern newspapers, including the Canton Repository, Cleveland Herald, and Philadelphia Press, derided Kentuckians for even considering the election of Blackburn (who they nicknamed "Dr. Blackvomit"). The scandal gained more traction nationally than in Kentucky. Blackburn did not respond to the accusations, and Kentucky Republicans barely made mention of it, knowing that the northern press in general and the Cincinnati Gazette in particular were widely distrusted in the state. Kentucky newspaper editor Henry Watterson opined that most Kentuckians already knew about Blackburn's Civil War activities and either explicitly approved of them or were apathetic about events that had occurred a decade and a half earlier.
In the general election, Blackburn defeated Evans by a vote of 125,790 (56%) to 81,882 (36%), the largest Democratic margin of victory in a decade. Greenback Party candidate C. W. Cook garnered 18,954 votes, approximately 8 percent of the total votes cast. These votes came mainly at the expense of Blackburn and the Democrats. Until the election of Ernie Fletcher in 2003, Blackburn would be the only physician elected governor of Kentucky.
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