The quest for timely medical literature was a concern for elite as well as rural physicians in the United States, as evidenced by comments from Drs. Benjamin Rush of Philadelphia; Benjamin Vaughan of Hallowell, Maine; and Lyman Spalding of Portsmouth, New Hampshire. It was the focus of an 1800 correspondence about the new cowpox (vaccination) between Barker and John G. Coffin of Boston who, in 1823, would found and edit the Boston Medical Intelligencer, precursor to the Boston Medical and Surgical Journal, now the New England Journal of Medicine; smallpox inoculation is also discussed. Topics include obtaining and sharing medical books and journals, the importance of both personal correspondence and newspapers for dissemination of medical information, problems with and for booksellers, medical nationalism, and publishing by subscription.