Volume entitled "Practical remarks" containing notes on medical reading and the patient accounts of Dr. James Skelton Gilliam of Petersburg, VA. The 12 pages of notes primarily relate to fever and the diseases of tropical climates. There are quotes from Huxham, Lind, Lomnius, Pringle, Sydenham, and van Swieten.

The remainder of the volume contains Gilliam's patient accounts. Entries are inconsistent but always include the patient name and the treatment rendered (often simply described as "of a visit"). Prescriptions and fees are sometimes listed, but dates are rarely given.