Dr. S. E. McCollum used this ledger to document the treatments he administered and the payment he received while working as a physician in Mount Vernon, Tennessee between 1875 and 1892. The book's pages have come unbound and the paper is brittle, but most of the information is quite legible. It begins with most of an alphabetical index and goes on to approximately 200 pages of family accounts, including a page for the poor house. Payments were made in food (including molasses, potatoes, and oats), labor (including chopping corn and shoe repair), or money.