The lecture notes are set out across 167 folios, having writing on both the recto and verso, with the original pagination pp.1-333 and an additional 5 folios at the end containing the index and 4 at the beginning with the title etc. Although not indicated on the manuscript itself we know the volume to have been allocated the reference Q 1023 viz. the Manchester Medical Society's 1890 library catalogue. The first page bears the inscription 'James Barlow, chirurgus, Blackburn'.
The index in the rear indicates that the following subjects are dealt with in the manuscript: introduction, tumours [neoplasms], erysipelas, oedema, scirrhous tumour, wounds, contus'd wounds [contusions], simple fractures, compound fractures [fractures, open], wounds of the scalp, injuries of the dura mater, fractures of the cranium [skull], perforating the cranium, extravasation of fluids, commotion of the brain and caries of the skull, fistula lachrymalis [lacrimal fistula], cataract, polypus narium [nasal polyps], hare-lip [cleft lip], diseases of the thorax, scirrhous and cancerous breasts [breast neoplasms], hydrops thoracis & empyema, wounds of the abdomen, dropsy & operation of the paracentesis, diseases of the bladder, symptoms of the stone in the bladder, sounding, lithotomy, lateral operation, diseases of the urethra, diseases of the anus, aneurysm, and amputations.