Jefferson discusses vaccinations in Philadelphia, the impact of his sending a message rather than making a speech at the opening of Congress, the political implications of suppressing taxes, and his desire to live a long, healthy, and useful life.
Jefferson notes that he has appointed Dr. Waterhouse to the Marine hospital in Boston, in return for his introducing vaccinations to the country, and describes the political fallout from the appointment. He plans to send his 15-year-old grandson to be with Rush in the Fall. He mentions Dr. Rose, and the impact on an embargo on relations with Europe.
Pickering notes that he sent Yellow Fever medicine developed by Dr. Conrad G. Bölke to the Board of Health, but is only now sending along copies of his letters from Bölke and the United States consul at Hamburg, Joseph Pitcairn, with instructions regarding the medicine's use.
Pickering details how the family is no longer able to care for William. He has decided to send William to Rush's hospital in Philadelphia, where he will not be able to escape and might recover. He adds that another son, George, is potentially manifesting the same symptoms as William.
Pickering writes regarding his plans for caring for his mentally disturbed son, William, thanking Dr. Rush for his advice. In a postscript, he asks Rush if he should talk to his son about his derangement when he is rational in order to have his cooperation in effecting a cure.