The notes taken down into this small bound pocket note-book of 131 handwritten pages are believed to have formed part of the Guy's lecture series - 'Elements in the Practice of Physic'. One of the early pages bears the inscription 'John Bethell, Lincoln's Inn Field' but it isn't clear if this was the same individual who took the notes or someone who subsequently owned them.

The volume may be particularly important in that the contents significantly pre-date - when compared - the first edition of the published version of Saunders' lectures in 1780. Based upon differing formulations for remedies included in the notes and changes in topics covered, it is believed that the notes may have been taken down circa 1775 or possibly earlier. They are believed to pre-date the manuscript lecture notes held at the Wellcome Library (1780-1782) and the Heritage Library of the Royal College of Physicians (1782). Other Saunders' lecture notes at the Royal College of Surgeons were taken down in 1784, and those at the Royal Society of Medicine dating from 1795.

Section headings and formulations for remedies contained in 'Elements in the Practice of Physic' include: Of the Inflammatory Fever; Of the Nervous Fever; Of Intermittent Fevers; Of the Malignant Angina; Of the Inflammation of the Intestines; Of the Rheumatism; Of the Measles; Of the Dropsy; Of Indigestion; Of the Epilepsy; Of the Tetanus; Of Insanity; Of Women During the Time They Are With Child and After Delivery; and, Diseases of Young Children.