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Rush congratulates the unnamed recipient on his recent appointment in the army, and makes note of the support of France and Spain in America's revolutionary cause, along with other Mediterranean countries. He mentions that the army expects to check any advance of General Howe into Philadelphia, whose appearance would cause a panic. He notes that his opposition to Pennsylvania's current government has cost him his seat in Congress, but that he had planned to join the army in any case.

Rush discusses his appointment to the Army, the support of doctors Shippen and Brower for that appointment, his concerns about the medical system and the numbers of deaths the army has experienced, dispatches that have arrived from France, and that John Adams is on his way there.

Rush states that he is never indifferent to any thing relating to America, and that the basis for America's freedom is broad, but is in danger from a tedious and expensive war, and from "the ignorance, indolence, and avarice of too many of our Whigs." He follows with questions regarding the country's finances, then notes that he has ordered a court-martial of Dr. Shippen, for whom he will serve as prosecutor. A postscript discusses two bills before Congress.

Rush recommends Dr. James Finley to McHenry, and requests that he visit Finley's patients with him. He adds that he is forced into a military retirement by Dr. Shippen's friends, but takes pleasure in McHenry's service. Finally, he comments on the alliance with France.

Rush relays his plans to visit Julia. A postscript instructs her how to protect herself and the babies from contracting a fever.

Rush writes regarding the health of Julia's uncle's family, one of whom is suffering from a stomach disorder. He also notes that Julia's father's health is deteriorating. Her father will accompany him upon his return, to be placed under another physician's care. He requests that Julia have his assistants call upon the parents of children Rush inoculated before his departure, with instructions for their care. He describes the trial of a Dr. Shippen. He mentions that the letter was written in company, in General Green[e?]'s office.

Rush writes regarding shipment arrangements for materials Julia has requested. He notes that a new tenant has taken possession of their farm. He inquires regarding Julia's health, they comments on the difficulty of separation from her. Rush's signature has been removed from the letter.

Note by Rush requesting that no more books be lent to Mr. Dick on Dr. Rush's account, but permitting the bearer of the note to borrow any books required.

Rush congratulates Greene on his successes in North Carolina, then recommends that he move from Rhode Island to South Carolina, which is more active in manners and government and would suit him better. He then comments upon the country's need for Confederation and for a national character built upon something more than resentment of Great Britain.

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.