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Medical Practice Ledger

Identifier: SC MS 0369

Scope and Contents

Each page is headed with the name of a client and date. In the early years it is an alphabetical listing and chronological. On the reuse of the ledger from the early 1870s onward the list is more chronological with names seemingly written in a hurry. In the entries from 1856-57 beneath the names are the types of merchandise, commodities and costs associated with the client. The entries from 1871-75 onward list mostly medical services interspersed with auction notations, merchandise, produce, sawing wood, cash, medicine as scattered entries only in chronological order. Women were able to establish their own accounts but it is presumed that they were widows whose husbands previously had accounts. Very untidy bookkeeping, possibly a barter system was used, although in many cases there is the distinct notation for Cash paid for services or the valued acceptance of commodities for services rendered.


  • Creation: 1856 - 1904


Access Restrictions

Access Restrictions: Collection housed remotely. Users need to contact 24 hours in advance.

Use Restrictions

Collection is open for research.

Copyright Notice

Please inquire about copyright information.

Biographical / Historical

On the inside of the ledger’s cover is written Benjamin Kauffman, Shiremanstown in an elaborate handwriting. In the 1886 History of Cumberland County, Pennsylvania by Beers is a biography of a Benjamin Kauffman, retired farmer of South Middletown Township born 1805 in Boiling Springs (only a few miles from Shiremanstown), Pennsylvania who died 1889. He was the son of Christian and Maria (Miller) Kauffman of Lancaster County. In 1828 he married Martha Bassler[also listed as Bossler], a daughter of Jacob Bassler of Lancaster. In 1834 they moved to Cumberland County. Of this marriage there were eleven children - seven lived to maturity. Their third child was named Benjamin had married but was deceased by 1886. Possibly he enlisted in the Union Army in 1861 at Mountville, Pa. in Company K 45 P.V. was captured in 1863 and died either in Andersonville Prison 1864 or Libby Prison before the end of the Civil War. It is uncertain which Benjamin Kauffman made this ledger. Searching the Genealogy and History of the Kauffman-Coffman Families of North America 1584-1937 compiled by Charles Fahs Kauffman and published in 1940 resulted in several persons named Benjamin Kauffman none directly associated with Shiremanstown or as a medical person but most were in either Cumberland County, Dauphin County or Lancaster across the Susquehanna River. Although not from the marriage of Benjamin and Martha (Bassler) Kauffman, the number of persons named Benjamin Kauffman listed within the time frame of the ledger are: Benjamin Kauffman (1810-1863) Dillsburg, Pa.; Benjamin N. Kauffman (1811-1888) a weaver in Landisville, Pa.; Benjamin Kauffman (1814-1890) in Cumberland County; Benjamin Franklin Kauffman (1818-1859) at Lancaster, Pa.; Benjamin M. Kauffman (1824-1896) farmer in Cumberland County; another Benjamin Franklin Kauffman (1835-1902) soldier, farmer Osborn, Ohio; Benjamin Kauffman (1836-1908) New Wilmington, Pa. Among the names of physicians registered in 1879 with the Cumberland County Prothonotary’s Office is a John Kauffman. Page 96 of this ledger has a heading “Medical accounts of R. W. Rop” (uncertain spelling but can be safely assumed to be Ross) with a date of 1874 but there are many spelling variations existing for Rop such as: Roop, Ross, Ruff, Rupp or Rops. The name of a Robert W. Ross of Shepherdstown exists in the History of Cumberland County - Physicians registered with the Prothonotary Office at Carlisle, Pa. There are a few little notes tucked in among the pages that clearly spell the doctor’s name as R. W. Ross previously noted as listed in the 1879 register of the Prothonotary Office at Carlisle, Pa. In the Nineteenth Century, the rural doctor visited their patients in the patient’s home making many visits in a day among the villages in the countryside performing an assortment of services. The country doctor practice included a diversity of services even veterinary and dentistry. These visits were noted in a daybook with the notations subsequently entered into a ledger. The ledgers are a list of charges issued to patients for medical services as debits (Dr) and payments or credits (Cr). The charges were mostly generalized entries as “visit & medicine.” Physicians typically kept accounts using single-entry bookkeeping which is the case in this ledger. The name of the patient, usually male, was at the head of the page with notes occasionally made as to members [wife and or children, etc] of the male’s family treated within the context of the entries. Usually if a woman’s name is listed it is a good chance she was a widow. Sometimes the Nineteenth Century country doctor was paid in cash but often they were paid “in kind” with whatever the patient had to hand which is also evident in this ledger. The medical practice had an aim to be a profitable business so payment was accepted in whatever form available to the patient. On Page 96 of Ledger is the heading Medical accounts of R. W./Rop/Rupp, Roop, Ross? with the date of 1874. Subsequently from Page 96 there is no longer any mention of the 1856 or 1857 mercantile entries. The years noted are then from 1871-1904. The handwriting becomes a scrawl and ink is very faint. There are several small notes tucked in among the pages which remain in the ledger where they were found. Some of these notes spell out R. W. Ross Dr. The last note is a receipt dated 1904 made by a John C. Hart to Mrs. Mary E. Ross and pinned to the last blank page in the Ledger. Although the ledger begins with the beautifully written name of Benjamin Kauffman, Shiremanstown, it should be assumed that the major part of the ledger deals with the medical practice of Dr. Robert W. Ross of Shepherdstown, Cumberland County, Pennsylvania.


0.5 Linear Feet (1 ledger, 32 cm)

Language of Materials



A nineteenth-century ledger illustrating the transactions of a combined mercantile and medical practice in Cumberland County (Pa.). The most of the ledger deals with costs of medical services and the mercantile goods available to the farming residents.


The arrangement is chronological beginning with entries from 1856 extending to 1893. The early entries from 1856-1857 have elaborate calligraphy style headings of each client at the head of pages 2-95; for the subsequent pages 96-239 the headings are a different hand, not neatly written; however this same type of scrawling handwriting also appears on the earlier pages beneath a line drawn across the pages to differentiate the entries between those ending in 1857 and those beginning 1871 - this style of entry ends on page 95. All subsequent pages after page 96 which has the heading “Medical accounts of R. W. Rop” (spelling shortcut for Roop, Ross,Rupp) in the ledger are then dated from 1871 to 1893 with a note pinned to the last page dated 1904. Among the several notes included among the pages of the ledger are a few that lead to verification that the medical name is of a Dr. Robert W. Ross from Shepherdstown, Cumberland County, Pennsylvania who is listed with the Prothonotary’s Office of Cumberland County located in Carlisle, Pennsylvania. In the front of the ledger is an Index of clients’ names written in a scrawling hand. It appears that during the late 1850s and the 1860s the ledger was little used but then used again from 1871 to 1893. It is possible that the Civil War interrupted the use of this Ledger. Within these entries are an assortment of entries of merchandise, auction dealings, and medical services especially obstetrical, pills, syrup. Most of the clients listed lived in Cumberland County, York County, Carlisle and Harrisburg, Pennsylvania. Tucked in among the pages are small paper notes which gave clues regarding the name of Dr. Robert W. Ross as creator of a large portion of this ledger. This ledger is a typical example of a country doctor’s ledger but is unique because of the early mercantile listings. The ledger was clearly repurposed and used by two different enterprises.

Acquisition Information

Purchase, February 2019.

Related Materials

Special Collections has a number of rural area ledgers: William Kern Account Book, Thomas Arner Estate.

Eleanor Nothelfer.
Description rules
Describing Archives: A Content Standard
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Lehigh University Library and Technology Services.

Repository Details

Part of the Lehigh University Special Collections Repository

Lehigh University
Linderman Library
30 Library Drive
Bethlehem PA 18045 USA
610-758-6091 (Fax)