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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 enumerates the close family friends that are ill or have died, and notes that only one doctor who continues to follow his treatment.

Rush announces that his final apprentice, John Coxe, has died and that his sister is very ill. There is some rain in the city. He reports that Dr. Wistar has published an account of his recovery that is calculated to undermine Rush's treatments.

Rush reports that his sister is in grave danger and that, by popular demand, physicians have been forced to adopt his treatment for the fever.

Rush writes that he has seen 100 patients, and that he now saves almost all those he sees within the first day. He notes that some doctors rail against the cure he uses, several of them publishing false information, even though they generally have not visited patients with the fever. He chronicles the fate of several doctors that have contracted the disease. He notes that some of his friends are ashamed to see him once they fall ill. He admonishes her once more to watch the boys closely for signs of infection, for the fever will lie dormant 1 to 16 days following contraction.

Rush notes that his cure is working, but there is a pause in new cases, and that fatalities are now among the poor without access to doctors or respectable people being treated by quacks. He states that if the fever breaks out in Princeton, he will send his assistant John Cox to execute his cure. Once again he documents the health status of his fellow physicians, although he records a rumor that some doctors have ceased seeing patients at all. He then discusses the various treatments that have been used for the fever. In a postscript, he adds that Africans in the city have proven immune to the disease.

Rush notes that John arrived, and they are now at Sydenham. He also reports that he has sold the Chapel farm for $2,500. He describes a new remedy he has developed for yellow fever. The signature has been excised from this letter.

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 only one person has been buried today in the Quaker graveyard, when 5-17 have been regular. He complains of fever treatments used by French physicians.