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Notes local doctors' favorable thoughts on setting up practice as a physician in Nottaway. Muses on buying Dr. Agnew's "stand." Comments on his travels and meetings with local officials, notes a large funeral, and reflects on the doctors of the area. Records advice about how to set up a successful practice and the challenges he would face.

Discusses debts, selling medicinal pills, and gaining a deep understanding of a disease’s nature in order to cure it. Suspects Marcus is suffering from bronchitis, commenting on the biology of the respiratory tract, Marcus’s symptoms, and prescribing medicine “not so much…according to the name as according to the nature & symptoms present.” Notes possible remedies to attempt and their effects.. Mentions Dr. Tully’s writings on bloodroot. Remarks on the difference between chronic and acute illnesses and discusses bowel movements and the information they provide about the liver. Recommends he cease studying and take up physical employment, particularly agriculture. Notes the health benefits of western countries and the positive impact of their mother nursing him.

Sending small mollusk shells from Fiji and Peru, in return for shells recently sent to her. Comments on other shell collectors. Gives news of General Miller, John Gibaut, and Rev. J. U. Thompson. Promises to send a list of pastors of Salem's Second Unitarian Church.

Acknowledges receipt of a pamphlet on natural history. Constructing a microscope to view Bacillaria and aid his botanical studies. Includes a small sketch of his design for the microscope lenses. Comments on their exchange of plant specimens.

Bill for groceries and medicine. Includes an 1855 tax receipt for the sums Huntington is to distribute to Columbus, New York, after collecting taxes.

J.D. is staying in Boston, where she is being treated for back and stomach ailments. Describes her water treatments, medicine, price of services, etc. The medical boarding house is quite full. Notes that one "female assistant" fell ill with rheumatic fever and was removed to a "thompsonian," possibly for herbal treatment.

Thoughts and advice on leaving home for college. Describes life as a medical student, the use of cadavers, and the merits of dissection. Notes taking a friend to an anatomy lecture on the brain and his reaction to the dissected cadaver.

Unable to illustrate Reeve’s book for lack of time and unwillingness to risk his reputation if his work did not meet his usual standards. Proposes that he do only some figures.

Notes the economic depression and his uncertainty of being able to collect payments from patients. Unhappy with Richmond and thinks of moving, as charlatans do well in the area. Is preparing two students to attend dentistry school, possibly the Baltimore College of Dental Surgery. Believes the dentistry college needs better publicity. Has difficulty incorporating "the Virginia Society," due to local intransigence.

Handwritten Phrenological Analysis accompanied by a printed and filled in Phrenological Chart created specifically for Lee’s use. Indicates that Richardson has an active and durable temperament and that he is physically active, ambitious, cunning, benevolent and generous, vigilant, hopeful, honest, and that he has a good memory. "No particular love of taking life, nor aversion when it is necessary." Chart includes an illustration of a head with the various sections of the skull labeled with numbers or symbols. Below Is a list of each numbered organ along with the feelings and intellectual faculties associated with each. A scale is provided for "showing the size of the Organs," with 1 being the lowest ("Idiotic") and 10 being the highest ("Very Large"). The four temperaments are also listed out, and Lee gave Richardson a score of 1 for sanguine and nervous, 2 for bilious, and 0 for lymphatic. Section for "inferences" at the bottom of the chart, with Lee’s handwritten notes.