Rush outlines how the family spent July 4th for Julia, then discusses possible successors to University of Pennsylvania chemist, James Woodhouse. Letter includes a poem by William Rush to his mother.
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 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 writes to his son regarding his education. He expects him to study Latin and arithmetic, and stresses that he needs to pay more attention to his spelling.