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[fol. 6] Sir Heretofore to speake to Dr. Sloane on the part of the afflicted poor, was to my knowledge the same thing as addressing to what was Courteous Gentle, affable, mild, et. And as I can form no less Idea Sir Hans I crave leave without farther apology or preamble to say before him the case of a poor an afflicted with a Fistula suppos’d in Ano. And though my ignorance in Anatomie. and surgerie is such as not to comprehend the common Terms in the practice of either, which renders it impossible I should give a rationale of the matter, or of the process hitherto ineffectualy pursu’d; I shall yet hope to shew it in such a light, You may thence conclude whether a cure be practicable. The object or Patient is about 30 years old, married, has children, His Trade shoemaking, a busines which requires sitting. How long the infirmity hath attended I can’t tle; but about two years ago, on applying to a Physician, he after other previous means at length prescrib’d a salivation, which the Patient underwent, and as thought with succes, being easie for some months; but it return’d. Probably the method was right, and might have been effectual, had due care bin taken, which upon asking some Questions, I find was not (not indeed was it likely unles the Physician had order’d some intelligent person to attend the operation; for both the man and his wife are I think incapable of forming true notions of the consequents of oversights in such cases) by which means this which for aught I know might have cured him, may have done him hurt. All things consider’d tis next an impossibility it can ever be otherwise with this poor man in this place, and in his circumstances. The grievance as hinted is interiour, how far within, I can’t tell, likely not far; neither can I say whether its situation be on the more loose, (I presume there may be such kind of distinctions, though I know not how to expres ’em) or more fixt parts. But wherever situate, hence proceeds a kind of […], which shall run for a month or 6 weeks, and the discontinue for the same space of time or longer; more time being I suppose requir’d to saturate than for evacuating In the flux tis more and less painful, and is says he, sometimes accompany’d with so odious a smel as scarce tolerable. In the evacuation he can’t work, or ev’n sit with any comfort; yet is rarely sick, and as seldom wants a good stomach. Upon asking whether he could not sit easie supposing the seat he workt on were cut through in form of a common convenience answer’d, he had ty’d, and in that case the parts appear very odly, e.g. as though a large hole, big big [sic] as the bunghole of a […] perforated into his entrails, through which the […] with such force and chilnes, as blown with a Bellow. I wish I knew how to give a more dear and particular account. To cure this man is doubtles a good work; but as […] instances which I have partly describ’d it appears to me utterly impossible it can be effected here for these reasons reasons rec’d last, possibly in want of experienc’d, and thence sufficiently skillful anatomists and surgeons. Next in absence of good genuine and perfect Drugs or Medicines, in which I have good great reason to doubt these parts defective Lastly, in want of what seems equaly necessary, e.g. A regular and due attendance. All which in this place, tis likely he will ever find defective. Nor can these defects I conceive, be any where in England so compleatly supply’d as in the London Hospitals. Over all which, as I presume you have a general if not an immediat influence, so I pray, I may prevail with You to make us of it in some one of ’em, on the part of this poor creature, otherwise as far as I can see, destitute of all humane help or comfort. And in case of a favourable return, if tis not too much trouble, by next post, which I hint in respect to the poor Man, directed to me at Acworth near Pontfract Yorkshire, Fennybridge Bag. I shall furnish him with as much mony as sufficient to bring him on foot to London (for he walks pretty well) there to attend Your disposal of him by the name of Benjamin Clarke. And if need be, with a Certificate sign’d by the Minister as well as my self. I now crave leave to say, That though You have not for many years seen me, ’tis possible you may yet remember there was formerly, both at Sir Godfrey Copley’s and at the late Duke of Newcastle’s, one under the name of Your most obedient humble servant Nat Barwell Sept. 4th. [1]731. P.S. Some People have lately told me, that this Fellow’s mother was thought to have had the Pox I believe he never heard of it himself, and I care not mention it to him. Whether true, I can’t tell, tho’ it seems necessary I should hint it to You. It may be scandal; but if otherwise, possibly his blood and juices are thence affected. But his children, and I believe they are his own, (and one of them about two years old) appear very healthy, as doth his wife, and for himself, I believe him stricktly virtuous in that particular.