ngs 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 might have been
dinner), when he suddenly became strangely excited, but not quite
unconscious. . . . I believed at the time, and do so still, that
there was some capillary apoplexy of the convolutions. The attack
was attended with some hemiplegic weakness on the right side, and
altered sensation, and ever after there was a want of freedom and
ease both in the gait 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 bedevilment in it;" though the handwriting
was not much, if at all, altered.

In December, 1873, Mr. Motley went by my advice to Cannes. I wrote
the following letter at the time to my friend Dr. Frank, who was
practising there:--

[This letter, every word of which was of value to the
practitioner who was to have charge of the patient, relates
many of the facts given above, and I shall therefore only give
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 my advice come to Cannes for the winter and spring, and I
have promised him to give 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 formed a correct opinion of the pathology of the
case, I believe the smaller vessels are degenerating in several
parts of the vascular area, lung, brain, and kidneys. With this
view I have suggested a change of climate, a nourishing 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 may be retarded. I have no doubt you will find, as
time goes on, increasing evidence of renal change, but this is
rather a coincidence and consequence