From the earliest days there was work for the scarce physicians in the Genesee Country. What few there were went about setting fractured limbs, stitching up slashes and cuts, mending broken heads, assisting at difficult confinements, lancing boils and carbuncles, and doing what they could for various other complaints.

However there was little any doctor knew that could help those settlers stricken with "ague" and the raging high temperatures and chills of "Genesee fever." Early travelers through the country often reported the prevalence of settlers suffering from the deadly fever. Indeed, Genesee fever (not recognized at the time as a form of malaria) took an indiscriminate toll among the pioneers. It came to be correctly associated with low lying watery areas — but for the wrong reason. The fever was supposed to come from decaying vegetation in such locations; in fact, like other forms of malaria, it was transmitted mosquitoes.

In the early years of a settlement, there were no doctors, but as hamlets and villages grew, the doctor became, after the minister, the community's most prominent person.

The Physician's Office, c.1840, is from South Valley, N.Y.