Collections : [David M. Rubenstein Rare Book and Manuscript Library]

Rush notes that the fever has increased more in one week than it had in three weeks in 1793 and 1797. He had made plans to leave in 7-10 days when the U. S. Mint was closed, but by the end of the letter announces more immediate plans to remove to Sydenham, which has been prepared for the family and servants. Their son John is arriving via his ship in New Castle. A note was appended to the letter in 1848, saying that the close of the letter was cut out for an autograph seeker.

Rush reports that he was driven to Rosehill to visit their son, Ben, and also met neighbors. He figures that two-fifths of all those sent to Bush Hill hospital have died, because his remedies were not used.

Rush relates how he misses Julia, then describes the activities of their boys. He notes that the weather has been uncommonly cool, which has damaged crops. There has also been an outbreak of yellow fever in the city, but he expects it to be checked by the cool weather. He points out that the "ejection of Mr. Erskine's convention with our government by the British Court" has caused outrage in the city.

Rush updates Julia on the alarming spread of the fever. He reports that the College of Physicians has met to consult on how to stop the spread of disease and to draw up instructions for that purpose. These directions will be handed to the mayor. He asks her to stay in New Jersey with the children, and to pray for his protection, although he takes all precautions possible. He plans to confine his boys to the house for their protection.

Rush states that the boys are so apprehensive about contracting the fever from his clothes that he has decided to send them to Trenton. He asks her to have them read something useful, because he is worried about possible habits of idleness. He notes that the directions from the College of Physicians are to be published tomorrow, but worries that the fever will not subside before October's heavy rains and frost. His postscript provides instructions on how to protect the boys.

Rush notes that both boys have headaches, but are travelling regardless. He reports on the fever in their neighborhood, listing who has died or left town.

Rush provides a detailed account of the yellow fever epidemic, describing its varied presentation among individuals. He notes that the violence of the fever has caused Philadelphians to mistake it for plague. He points out that common remedies have all failed, but he consults with Dr. Caspar Wistar regarding treatments.

Rush reports that the fever declines daily and that he expects she will be able to return to the city by mid-November. He rode out for the first time in weeks, and found more people in the streets, and those more cheerful. He adds that he is feeling stronger daily.

Rush notes that rain and cold weather have not decreased cases of the fever; 700 have died since 11 October, and 3400 since 1 August. He feels the distress of others all the more because he cannot assist them now. He has discovered further evidence that his sister gave her life to save his. Finally, he notes that his publications are still saving lives.

Rush reports that his practice has fallen off. Disease has left their district and it is well known that he is too weak to see patients. His pupils attend to the poor. He describes his financial situation, then notes how few friends he now has among medical brethren, and how that impacts his future career, since he now cannot consult or operate with them.