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Innkeeper Nathaniel Dwight is angry with Elihu Ashley for 2 reasons: he believes Ashley has infected his young granddaughter with smallpox and he wants to be paid back for the money he has had to spend for her medical care. Ashley, who was serving as a doctor in Worthington, Massachusetts, after his training in Deerfield, has recently had a vaccination for smallpox and has stopped at Dwight's inn in Belchertown, Massachusetts, where he has left his coat. When he tries to get the coat, the landlord accuses him of infecting the building and causing the illness of his granddaughter. The tone of the letter shows the fear of smallpox and how widespread it was among the population at a time when shots were new.