Medical casebook of Peter S. Townsend, who at this period maintained a practice on Church Street, near Barclay Street, in lower Manhattan. There are about 30 entries, but many of these are follow-up visits to the same patients. Each entry is in narrative form and does not follow a prescribed pattern. Townsend usually includes age, occupation, and address of the patient, symptoms of the case, and his treatment, including medications prescribed. Many of the patients are relatives of Townsend, but he also treated several employees of the nearby Astor House hotel.