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Rush says that distress increases in Philadelphia, and names several friends and one doctor who have died.

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 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 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 pupil, Johnny Stall, has died. He mentions that citizens universally exhibit symptoms of the fever, but that the poor suffer the most. He hopes the weather will change.

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 has discovered that a letter containing charges against him has been circulating among physicians. He plans to obtain a copy and publish it. He is inquiring after a house.

Rush has taken measures to purify their house. He points to a new clamor regarding his assertion that yellow fever has been operating in the city. He has been asked to prove that assertion.

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 records that his case load is increasing, as is his fatigue, but that many of those he treats are out of danger. He reports on the progress of the epidemic in their neighborhood.