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Historians disagree as to the strength of the evidence against Blackburn, and many of the federal and Confederate records relating to the case have been lost.
Writing in the journal America's Civil War, U. S. Navy physician J. D. Haines notes that the Confederate agents who testified against Blackburn were of dubious reputation.
Hyams in particular received immunity from prosecution and was paid for his testimony.
Haines also points out that Blackburn's previous reputation as a humanitarian was ignored ; in the hysteria following Lincoln's assassination, conspiracy theories abounded and Northerners were inclined to believe the worst about anyone with Confederate sympathies.
The New York Times vilified Blackburn as " The Yellow Fever Fiend " and " a hideous devil ".
Historian Edward Steers concedes that the evidence against Blackburn was circumstantial, but in his book Blood on the Moon, he contends that enough evidence survives not only to prove Blackburn's involvement in the plot, but to show that high-ranking Confederate officials up to and including President Jefferson Davis were aware of, condoned, and financed it.
If true, Blackburn's plot would have represented one of the earliest attempts at biological warfare.

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