Beginning with an account of the settlement of Halifax, Marble documents the care taken by the Lords of Trade and Plantations to provide proper food and health care during the settlers' passage across the Atlantic in May and June of 1749. He chronicles the rendezvous of regiments and ships in Halifax between 1755 and 1763, examining the two smallpox epidemics which followed their arrival. He deals with the treatment of the poor in Nova Scotia between the Seven Years War and the American Revolution, showing that many in this group were camp followers who had been abandoned by regiments that had left Halifax. Financial resources previously directed towards providing medical services for citizens had to be redirected to feed, clothe, and shelter such individuals. A third smallpox epidemic struck Nova Scotia in 1775-76 and, as Marble demonstrates, prevented the Americans from attacking Halifax. He examines the initial unsuccessful attempt to regulate the practice of medicine in Nova Scotia and explores the reasons the region lagged behind Lower Canada and the American colonies in this regard.
Marble covers all aspects of health care, including hospitals, the training and practices of physicians and surgeons, the use of patent medicines, and the various types of medical and surgical treatments. As well, he has made a thorough study of individual patients through their wills, diaries, and personal letters.