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Rush points out that many people are returning to town; he hopes not too soon, for there are still many who are ill or dying. The rest of the letter is regarding his professional feud with Dr. Wistar over treatment for the fever. Rush is especially offended because Wistar had originally assented to the efficacy of Rush's treatment, then changed his mind.

Rush states that he receives many inquiries each day from country practitioners, and there is a high cost personally and in postage to answering each letter, so he is publishing an account of the fever, including preventatives and remedies. He reports that he is seeing 40-50 patients a day, and notes the progress in the cases.

Rush reports that he has had a relapse of the fever, but is still seeing patients as he can. He adds that the poor, children, and servants have been hardest hit by the fever. Nursing wages are now $4 a day. The signature for the letter has been excised.

Rush announces that the publication about the fever has been well received by the citizens. He updates Julia on the condition of several patients.

Rush states that he would rejoice at news of the birth of his niece if he could, but he feels as though he will never feel joy again. The mortality this day is worse than ever. He believes it is now unsafe for her to receive articles of clothing from their house. Also, he would prefer to borrow money from her brother than from a bank at the moment.

Rush reports that the women who waited before sending for him to treat their fever have now died. His meals are now public, and he describes his diet. He notes that some doctors have been adding bark and laudanum to his new remedies. He plans to publish to expose their ignorance.

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.