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Dr. Harmaunus Smith lived and practiced in the area of Hamilton, Ontario, from 1818 until 1872. His account books are extant from 1826 through 1867; these books give considerable data on the fiscal aspects of Smith’s practice but little information on its clinical details. Analyzing these data, and including further information on heads of households obtained from census and assessment reports, reveals that Smith earned only a very modest income from his practice, being paid only a fraction of what he charged. His fees remained the same or fell over the duration of his practice. His well-to-do patients seem neither to have used his services more, nor to have been any more likely to pay their bills, than those less well off.

The Economic Status of the Practice of Dr. Harmaunus Smith in Wentworth County, Ontario, 1826-67