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The diary records Rush's travel, accompanied by a servant and via horses, between the outskirts of Philadelphia and Carlisle, Pennsylvania, for an initial meeting with the trustees of Dickinson College. During the meeting the Trustees selected Dr. Charles Nisbet to serve as the College's first president. Rush described the taverns and other travel lodges at which he stopped, along with Tavern staff and other patrons, the quality of the food and drink, along with conversations he witnessed or took part in. Discussion often centered on the topics of the Constitution, paper money, as well as Dickinson College. Rush also described the results of a rapid Spring thaw on the Susquehanna River, the unusually cold weather, the scenery, and the presence whiskey stills in Irish settlements and their impact on their communities.

Contains primarily Benjamin Rush's records of his expenses, including tax and bond payments, rental property fees, classes and dance lessons for family members, as well as money lent or advanced, accounts paid, cash received, and income from boarders. Rush noted the wide variety of areas where his money was spent, from postage and travel, to clothing and shoes, to household provisions and stores, along with medicines purchased. In addition, Rush created accounts for servants when they arrived, and noted their wages and any increased wages, advances, or loans; cloth, clothing, and shoes provided; with occasional notes on their personal and work habits and work history, and when they exited his service or married. Several of the comments have been redacted, along with a few pages of the account book. Finally, Rush made a few brief commonplace notes randomly in the volume, providing a "style sheet" for description of pulses, outlining a few prescriptions for patients, describing the weather, listing inventories of his furniture and linens, recording a few recipes, and in 1783, noting the news of possible peace with England.

Includes statements and receipts for medicines, advice, consultations, and sundries. In one case, Rush collected a fee on behalf of another physician. Julia Stockton Rush also served as collector, along with her husband. Includes a receipt from Richard Henderson in Leesburg, Va., for payment on the account of Mr. Carter, who had been a patient in Rush's care (see Letters series).