The immediate cause of Wilson's incapacitation was the physical strain of the public speaking tour he undertook to obtain support for ratification of the Covenant of the League of Nations. In Pueblo, Colorado, on September 25, 1919[108] he collapsed.[109]
Then, on October 2, 1919, he suffered a serious stroke that almost totally incapacitated him, leaving him paralyzed on his left side and blind in his left eye.[110] He was confined to bed for weeks, sequestered from nearly everyone but his wife and his physician, Dr. Cary Grayson.[111] For at least a few months, he used a wheelchair. Later, he could walk only with the assistance of a cane. The full extent of his disability was kept from the public until after his death on February 3, 1924.
With few exceptions, Wilson was kept out of the presence of Vice President Thomas R. Marshall, his cabinet and Congressional visitors to the White House for the remainder of his term. His wife, Edith, served as his steward, selecting issues for his attention and delegating other issues to his cabinet heads. Eventually, Wilson did resume his attendance at cabinet meetings, but his input there was perfunctory at best.[112] This was one of the most serious cases of presidential disability in American history and was later cited as an argument for the 25th Amendment