It is a book that can be bought to help Lieutenant Markland deal with the situation at Bitter Springs during the quest Bitter Springs Infirmary Blues. It is a Miscellaneous item, and cannot be used or read.
It can only be bought or stolen from Blake at the Crimson Caravan Company. To steal it, it can be found shelf to the right of Blake, behind two ammunition containers and above a shelf containing three first aid boxes. It can be purchased or stolen at any time but cannot be removed from the player's inventory until given to the Lieutenant.