bjoined letter
of Sir William Gull to make large extracts from his account of Mr.
Motley's condition while under his medical care. In his earlier years he
had often complained to me of those "nervous feelings 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
promised. They are too technical for general 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 may supervene as part and
parcel of a larger and antecedent change in the blood-vessels in other
parts than the kidney. . . . I 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 some nervous feelings connected with the respiration. At that
time his general health was good, and all he complained of was
occasionally a feeling 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 my first interview
with Mr. Motley, and I was naturally glad to have the opportunity of
making his acquaintance. I remember that in our conversation I
jokingly said that my wife could hardly forgive him for not making
her hero, Henri IV., a perfect character, and the earnestness with
which he replied 'au serieux,' I assure you I have fairly recorded
the facts. After this date I did not see Mr. Motley for some time.
He had three slight attacks of haemoptysis in the autumn of 1872,
but no physical signs of change in the lung tissue resulted. So
early as this I noticed that there were signs of commencing
thickening in the heart, as shown by the degree and extent of its
impulse. The condition of his health, though at that time not very
obviously failing, a good deal arrested my attention, as I thought I
could perceive in the occurrence of the haemoptysis, and in the
cardiac hypertrophy, the early beginni