The Thomas Henry Howard Manuscript Account Book is filled with names of patients and the services performed and the payment received for each entry before, during, and after the Civil War. Dr. Howard's entries include the names of his patients, date of services and fees charged together with short descriptions of medical services rendered. Services included visits and medicines, "cupping", "strenthening plaster", dressing wounds, attending pregnant women - "attending wife in parturition", delivery of children "Tending wife in childbirth", Tobacco, and cutting gums. Medical treatment was also administered to local slaves as when Dr. Howard charged Fleming Howery $2.00 "For medical attendance on Negroe child of James Ferguson estate". Post-war African-American patients are noted by the addition of the word "colored" in parenthesis after their names.