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Rush notes that the fever has been said to become more mild, but that is not the case, especially if his treatment has not been used. He adds that besides combatting the fever, he has to contend with the "prejudices, fears, & falsehoods" of his fellow physicians. He adds that all are tinged with infection, now. Even his own eyes are tinged a yellow color.

Rush refers to the tremendous opposition fellow physicians have given him regarding his cures, and Dr. Kuhn's publications have done the most harm. Rush announces that he has used his methods to cure his own attack of the fever.

Rush states that he is sending his assistants out to his patients, and will now visit the most serious cases. He updates her on those in the neighborhood who have not survived.

Rush seeks to reassure his wife that he is fully recovered and well cared for. He notes the numbers of those who oppose his treatments that have now left the city. He adds that it is cold, and that he hopes this will check the fever.

Rush describes how he has been forced to limit the number of patients he sees, and the reactions of those whose treatment he declines. He also describes how many of those who become infected are abandoned. He mentions that there is fear of famine in the city.

Rush says that distress increases in Philadelphia, and names several friends and one doctor who have died.

Rush announces that he is well, but has a sore throat from his treatment. He saw 25 patients by carriage; then 25 more, mostly poor people, at home, but was still forced to turn away 38 others. Their house continues as a hospital. He says that his professional detractors are increasing their persecution of him.

Rush enumerates the close family friends that are ill or have died, and notes that only one doctor who continues to follow his treatment.

Rush announces that his pupil, Johnny Stall, has died. He mentions that citizens universally exhibit symptoms of the fever, but that the poor suffer the most. He hopes the weather will change.

Rush announces that another of his assistants, Alston, has died. He admits to extreme weakness, but otherwise is in good health. He points out that bleeders, doctors, apothecaries, and nurses are becoming scarce, as are the medical necessities used to treat the fever.