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Rush writes that deaths from fever are decreasing, and he will soon end his engagement with city hospital. He outlines activities in the family, and their preparations for her return the following week. The signature to this letter has been excised.

Rush informs Julia that he has been thinking more of the children than he has in weeks and describes a dream he has had about her. He inquires after the new baby. He plans to ride out to the countryside to repair his health and later reports feeling stronger. He lists the conditions of those among their acquaintances.

Rush challenges Julia to be patient regarding a return to town. He repeats the history of his relationship with his detractors, then returns to praising her as a "great woman" for never asking him to leave the city during the outbreak.

Rush provides a detailed account of his sister's death, describing also the invaluable support she provided to him. He notes that there is a want of cash in the city, and that provisions are costly, and prices high. He adds that many of the committee men who sought to help the poor have now died. He hopes for a change in the weather. The close of the letter is missing.

Rush points out that he has received no letters from Julia. He gains strength but must eat often to avoid becoming "weak and fainty." His patients now hand him a glass of milk or crust of bread as they would hand another a glass of wine. He adds that their servant, Marcus, has been very faithful and that his mother is well, but complains of the high cost of housekeeping.

Rush points out that Julia's letters are now delayed at the Post Office by 2 or 3 days, but her recent letter brought him comfort. He says that he cannot think of the family or the children, but lives in the moment, making himself useful to others. His sister has been buried, and he plans to plant medicinal plants at her grave; his mother is fully recovered.

Rush announces he is contemplating moving into a new house before her return and considers a few locations. He adds that his day no grave was opened in the Quaker graveyard and their were no admissions or deaths in the Bush Hill hospital.

Rush has taken measures to purify their house. He points to a new clamor regarding his assertion that yellow fever has been operating in the city. He has been asked to prove that assertion.

Rush states that he would rejoice at news of the birth of his niece if he could, but he feels as though he will never feel joy again. The mortality this day is worse than ever. He believes it is now unsafe for her to receive articles of clothing from their house. Also, he would prefer to borrow money from her brother than from a bank at the moment.

Rush announces that his final apprentice, John Coxe, has died and that his sister is very ill. There is some rain in the city. He reports that Dr. Wistar has published an account of his recovery that is calculated to undermine Rush's treatments.