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Rush writes to Thornton regarding his opposition to capital punishment, and encloses copies of a his pamphlet on the matter, of which Thronton had approved. Rush also discusses his birthplace, Byberry, where Thornton resides.

Rush thanks Dr. Bostock for his essay on respiration, saying he will read it with interest and awaits Bostock's future work on the topic. The rest of the letter relates to Rush's English ancestry and friendship with Bostock's father.

Rush thanks Bostock for his article "Analysis of Animal Fluides," then provides requested anecdotes regarding Bostock's father. Rush comments upon treatment for pulmonary consumption and the use of bloodletting in parturition and pregnancy.

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 writes regarding shipment arrangements for materials Julia has requested. He notes that a new tenant has taken possession of their farm. He inquires regarding Julia's health, they comments on the difficulty of separation from her. Rush's signature has been removed from the letter.

Rush writes that he expects their friend, Dr. Hall, to marry soon. He also writes of his activities with his boys. More particularly, his son John accompanied him on rounds at the hospital and showed no emotion while witnessing an operation. Rush also described in detail their visit to a mentally disturbed patient. He is pleased that John has expressed a desire to become a physician.

Rush writes about solitude, and how he misses having his wife and family to impart his thoughts and ideas to immediately.

Rush writes that he wishes to share his reading of Paley's moral philosophy with her, because he would enjoy it more that way and it would better qualify her to educate their children. He describes a gathering where he provided beer to a group of laborers, and how affectionate one of them was to his dog, including a reflection of "infinite love which follows the human species." He then comments that their leaving a local congregation has finally been noticed. The signature line for this letter has been excised.

Rush explains his plans for travel to Princeton, and the minor ailments he has been suffering. He then describes how he visited a patient who was having a fit of colic, only find she was actually in labor. He expects the affair to give him some trouble, but has neither the constitution nor time to practice midwifery. He rejoices in hearing of the fall of the French monarchy, and expects that it will lead to the removal of all the kings in Europe. A later note was added stating that the letter's signature was given to an autograph seeker.

Rush writes of their exchange of letters, and mentions both of their sons, along with the grandson of President Washington, who is ill with a fever and is being attended by doctors Shippen and Kuhn. He also successfully treats a woman with a locked jaw. He announces his plan to open an African Church, and describes the resulting excitement in the free black community.