Part 13 (1/2)

I have availed myself of the permission implied in the subjoined letter of Sir Williae extracts from his account of Mr

Motley's condition while under his medical care In his earlier years he had often cos connected with the respiration” referred to by this very distinguished physician I do not remember any other habitual trouble to which he was subject

74 BROOK STREET, GROSVENOR SQUARE, W

February 13, 1878

MY DEAR SIR,--I send the notes of Mr Motley's last illness, as I proeneral readers, but you will make such exception as you require The medical details may interest your professional friends Mr Motley's case was a striking illustration that the renal disease of so-called Bright's disease er and antecedent change in the blood-vessels in other parts than the kidneyI am, my dear sir,

Yours very truly, WILLIAM W GULL

To OLIVER WENDELL HOLMES, ESQ

I first saw Mr Motley, I believe, about the year 1870, on account of sos connected with the respiration At that tiood, and all he co of oppression about the chest There were no physical signs of anything abnormal, and the symptoms quite passed away in the course of time, and with the use of simple antispasmodic remedies, such as camphor and the like This was lad to have the opportunity ofhis acquaintance I rely said thather hero, Henri IV, a perfect character, and the earnestness hich he replied 'au serieux,' I assure you I have fairly recorded the facts After this date I did not see Mr Motley for soht attacks of haee in the lung tissue resulted So early as this I noticed that there were signs of coree and extent of its ih at that tiood deal arrested ht I could perceive in the occurrence of the haes of vascular degeneration

In August, 1873, occurred the remarkable seizure, from the effects of which Mr Motley never recovered I did not see him in the attack, but was informed, as far as I can remember, that he was on a casual visit at a friend's house at luncheon (or it ely excited, but not quite unconsciousI believed at the time, and do so still, that there was some capillary apoplexy of the convolutions The attack was attended with soht side, and altered sensation, and ever after there was a want of freedoait and in the use of the arm of that side To my inquiries from time to time how the arm was, the patient would always flex and extend it freely, but nearly always used the expression, ”There is a bedevil was not much, if at all, altered

In December, 1873, Mr Motley went byletter at the ti there:--

[This letter, every word of which was of value to the practitioner as to have charge of the patient, relates ive extracts from it]

December 29, 1873

MY DEAR DR FRANK,--My friend Mr Motley, the historian and late American Minister, whose name and fame no doubt you know very well, has by , and I have proive you some account of his case To me it is one of special interest, and personally, as respects the subject of it, of painful interest I have known Mr Motley for some time, but he consulted me for the present condition about midsummer

If I have fory of the case, I believe the s in several parts of the vascular area, lung, brain, and kidneys With this view I have suggested a change of cli diet, etc; and it is to be hoped, and I trust expected, that by great attention to the conditions of hygiene, internal and external, the progress of degeneration oes on, increasing evidence of renal change, but this is rather a coincidence and consequence than a cause, though no doubt when the renal change has reached a certain point, it becomes in its oay a factor of other lesions I have troubled you at this length because y of these cases, and because no case can, on personal grounds, e our attention

Yours very truly, WILLIAM W GULL

During the spring of 1874, whilst at Cannes, Mr Motley had a sharp attack of nephritis, attended with fever; but on returning to England in July there was no ie in the health The weakness of the side continued, and the inability to undertake any ns of cardiac hypertrophy wereof the year 1875 I wrote as follows:--

February 20, 1875

MY DEAR Mr MOTLEY,--The examination I have just made appears to indicate that the main conditions of your health are o, and would therefore be so far in favor of your going to Around of my doubt has lain in the possibility of such a trip further disordering the circulation Of this, I hope, there is now less risk

On the 4th of June, 1875, I received the following letter:--

CALVERLY PARK HOTEL, TUNBRIDGE WELLS, June 4, 1875

MY DEAR SIR WILLIAM,--I have been absent fro time, but am to be there on the 9th and 10th Could I make an appointment with you for either of those days? I a for America Our departure is fixed for the 19th of this month I have not been worse than usual of late I think er, and it is almost impossible for me not to make my visit to America this summer, unless you should absolutely prohibit it If neither of those days should suit you, could you kindly suggest another day?

I hope, however, you can spare et asair as I can Will you kindly name the hour when I may call on you, and address me at this hotel Excuse this slovenly note in pencil, but it fatigues -table with pen and ink

Always most sincerely yours, My dear Sir William, J L MOTLEY

On Mr Motley's return froht, rather better in general health than when he left England