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Rush records the benefits of using Kinepox over variolation to inoculate against smallpox.

Rush replies to a requested consult regarding a severe case of hemorrhoids or other bowel problem. He proposes that if the patient is willing to visit Philadelphia, the problem can be treated surgically.

Rush's draft letter acknowledges receipt of his certificate of membership in the Royal Academy of Medicine in Madrid, and laments the general lack of appreciation one experiences at the end of a career.

Rush writes an unsolicited recommendation for Dr. James Mease to serve as head of the Office of Purveyor for the army's medical department.

Rush congratulates Jones on his decision to leave Congress, and records his own regrets regarding public service, with particular regard to the funding system and the banks. He now believes American citizens "unfit for and undeserving of liberty."

Rush's brief note to his wife following her departure, enclosing 10 dollars and providing information on the family's health.

Rush recommends Dr. James Finley to McHenry, and requests that he visit Finley's patients with him. He adds that he is forced into a military retirement by Dr. Shippen's friends, but takes pleasure in McHenry's service. Finally, he comments on the alliance with France.

Rush states that he is never indifferent to any thing relating to America, and that the basis for America's freedom is broad, but is in danger from a tedious and expensive war, and from "the ignorance, indolence, and avarice of too many of our Whigs." He follows with questions regarding the country's finances, then notes that he has ordered a court-martial of Dr. Shippen, for whom he will serve as prosecutor. A postscript discusses two bills before Congress.

Rush notes that his pupil is better, and that he is using profuse sweating as part of his treatment for the fever. A later note was appended to the letter stating that Mrs. Rush allowed the signature to be cut away for an autograph.

Rush comments on commerce and the work of physicians, and on Philadelphia physicians opposed to use of mercury and bloodletting.