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Rush expresses amazement that he remains uninfected by the fever, for he has seen over 100 patients on this date, and 40 people were buried. He states that he does not forget to treat the poor "remembering my dream in the Autumn of 1780." Many doctors have adopted his treatment, but several oppose it, as they oppose his treatment for lockjaw. He remarks that more of the French exiles have come down with the fever. He is now using bloodletting as a tool, since the weather is cooler.

Rush notes that the efficacy of his cures is now proven, and that his directions for treating and preventing the disease will be published in the newspapers. He adds that he is in surprisingly good health, since his meals now consist only of milk and vegetables, and water.

Rush writes that he is preparing for the "awful duties of the day," as yesterday exceeded any of the preceding days in distress and death, and two more physicians are ill.

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.