A discussion of the art historical research, scientific analysis, and conservation treatment of Patch Picture fpr Dr. Physick, an early 19th century American trompe l'oeil gouache painting on paper. The art historical research investigated the history, iconography, and past attribution of the painting. The scientific analysis included pigment identification using x-ray fluorescence, solubility testing of the binder, and fiber identiflcation. The treatment involved removal of the painting from a masonite panel using a solvent vapor chamber, consolidation of flaking paint with methyl cellulose, and a dry lining with japanese paper and wheat starch paste.