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Rush discusses his appointment to the Army, the support of doctors Shippen and Brower for that appointment, his concerns about the medical system and the numbers of deaths the army has experienced, dispatches that have arrived from France, and that John Adams is on his way there.

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.

Washington acknowledges the receipt of Rush's letter, and regrets the defects of the medical department, as Rush and Gov. Livingston have described them. Washington reports that he has taken measures to have the hospitals inspected and considered regulations regarding them. Includes a separate invitation for Rush to dine with the ?Washington.

McHenry details reforms required within the Army's medical department and makes recommendations for restructuring of general and regimental hospitals, controlling fraud in the commissaries, increasing the numbers of nurses and surgeons, and improving the distribution of medicine.

Greene writes of his support for Rush's recommendations regarding best methods for preserving the health of the Army. He suggests they print a pamphlet on the topic, to make adoption of the recommendations more likely. He comments on Congress' regulation of hospitals.