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Pickering notes that he sent Yellow Fever medicine developed by Dr. Conrad G. Bölke to the Board of Health, but is only now sending along copies of his letters from Bölke and the United States consul at Hamburg, Joseph Pitcairn, with instructions regarding the medicine's use.

Pickering details how the family is no longer able to care for William. He has decided to send William to Rush's hospital in Philadelphia, where he will not be able to escape and might recover. He adds that another son, George, is potentially manifesting the same symptoms as William.

Pickering describes symptoms for which he would like Rush's treatment advice. Includes Rush's own notes regarding two prescriptions he advised.