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Rush writes that deaths from fever are decreasing, and he will soon end his engagement with city hospital. He outlines activities in the family, and their preparations for her return the following week. The signature to this letter has been excised.

Rush rejoices in Read's recovery and safe return to South Carolina and sends greetings to Read's family. He outlines family news, including that Julia has given birth to another girl and Mrs. Boudinott has spent the winter. He adds that the women humanize their friend, Dr. Ramsay, in preparation for his finding a wife.

Rush thanks Dr. Bostock for his essay on respiration, saying he will read it with interest and awaits Bostock's future work on the topic. The rest of the letter relates to Rush's English ancestry and friendship with Bostock's father.

Rush thanks Bostock for his article "Analysis of Animal Fluides," then provides requested anecdotes regarding Bostock's father. Rush comments upon treatment for pulmonary consumption and the use of bloodletting in parturition and pregnancy.

Rush informs Julia that he has been thinking more of the children than he has in weeks and describes a dream he has had about her. He inquires after the new baby. He plans to ride out to the countryside to repair his health and later reports feeling stronger. He lists the conditions of those among their acquaintances.

Rush writes that he expects their friend, Dr. Hall, to marry soon. He also writes of his activities with his boys. More particularly, his son John accompanied him on rounds at the hospital and showed no emotion while witnessing an operation. Rush also described in detail their visit to a mentally disturbed patient. He is pleased that John has expressed a desire to become a physician.

Rush writes about solitude, and how he misses having his wife and family to impart his thoughts and ideas to immediately.

Rush writes that he wishes to share his reading of Paley's moral philosophy with her, because he would enjoy it more that way and it would better qualify her to educate their children. He describes a gathering where he provided beer to a group of laborers, and how affectionate one of them was to his dog, including a reflection of "infinite love which follows the human species." He then comments that their leaving a local congregation has finally been noticed. The signature line for this letter has been excised.

Rush takes Julia to task for permitting their son John to have a gun against his expressed wishes. Rush believes John's character is not the correct one for gun ownership, because he lacks gentleness and compassion. Rush requests that Julia not override his dissent, and strengthen their parenting as a result. He announces that he has taken their son Richard to see patients. He is reading John Newton's Cardiphonia. He also is planning to develop a cure for the consumptive cough.

Rush points out that he is too weak and busy to ride out to her at Rosehill, but she may come in to town, or he will ride out to spend the next day with her.