Manuscript records open a window to past events and cultures, often serving as a source of information the like of which is not available in printed form. An examination and analysis of three rural New York State physician's case record books, maintained during the nineteenth century, provides insight not only into the evolution practice of medicine, but also serves to highlight the differences between rural and urban routines.

Case records produced during the first half of the nineteenth century, such as those of David Hanford, who practiced between 1816 and 1844, and Jonathan Johnson, who left records of his medical practice dating from 1827-1829, demonstrate aggressive plans of treatment. These two physicians were representative of the time in which they practiced, as they frequently applied techniques of bleeding, and prescribed copious quantities of pharmaceuticals. George M. Teeple, whose case records cover the period from 1847-1872, was much less aggressive in his application for medical therapeutics. He preferred to rely on the power of nature.

These medical records, when compared not only to each other, but also to published accounts or urban practices, define rural medical practice.