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Rush announces that Dr. Sproat has died, adding, "It is truly distressing to think of the desolation which has followed the footsteps of this man, and of all the Doctors who use Bark- Wine- Laudanum, and hot, or cold Baths in this disorder. It is much more inflammatory than a common Pleurisy, & who ever thought of using those remedies in that disease?" He notes the health of other doctors, and reports that he is now employed again by Mr. Hammond, who had been persuaded against Rush's treatment. He ends noting that Julia's sister has written to urge him to leave the city, a move he feels would be "unwise, and perhaps sinful."

Rush details several patients' responses to treatment, or lack thereof, and includes consideration of the impact of psychological influences on recovery. He notes that the days grow colder, but they need rain. He has returned to his notes on yellow fever taken during his apprenticeship in 1762.

Rush reports that the fever declines daily and that he expects she will be able to return to the city by mid-November. He rode out for the first time in weeks, and found more people in the streets, and those more cheerful. He adds that he is feeling stronger daily.

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 reports that his practice has fallen off. Disease has left their district and it is well known that he is too weak to see patients. His pupils attend to the poor. He describes his financial situation, then notes how few friends he now has among medical brethren, and how that impacts his future career, since he now cannot consult or operate with them.

Rush reports that only one person has been buried today in the Quaker graveyard, when 5-17 have been regular. He complains of fever treatments used by French physicians.

Rush announces he is contemplating moving into a new house before her return and considers a few locations. He adds that his day no grave was opened in the Quaker graveyard and their were no admissions or deaths in the Bush Hill hospital.

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.

In this letter to his sister, Rachel, Rush provides details of their sister Rebecca's death, his grief, and the state of their mother's health.

Rush records a visit from physicians who have quietly sought to prove the effectiveness of his mercury treatment by using it to treat the poor. He asks Julia to join him in reading Psalm 103 and praising God for his protection. He expects to take charge of the hospital shortly.

Rush notes the health of several doctors and points out that St. Paul's Church has offered prayers twice a week since the fever began. He is not seeing patients, but is spending his time reading and making notes on the epidemic. He describes his melancholy when he contemplates the state of the city and those he has lost.

Rush points out that many people are returning to town; he hopes not too soon, for there are still many who are ill or dying. The rest of the letter is regarding his professional feud with Dr. Wistar over treatment for the fever. Rush is especially offended because Wistar had originally assented to the efficacy of Rush's treatment, then changed his mind.

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 reports that he was driven to Rosehill to visit their son, Ben, and also met neighbors. He figures that two-fifths of all those sent to Bush Hill hospital have died, because his remedies were not used.

Rush outlines their full affection for each other, and makes tentative plans to visit Julia. The closing for the letter has been excised.

Rush challenges Julia to be patient regarding a return to town. He repeats the history of his relationship with his detractors, then returns to praising her as a "great woman" for never asking him to leave the city during the outbreak.

Rush reports having received various letters and items from London, including a medical book. He states that he has had no cases of yellow fever in two days. He uses the rest of the letter to recount fully his second attack of the fever, beginning October 10th. He writes that he expects her return the coming week.

Rush outlines the work that will keep him from visiting Julia, after all. He points out that there have been four deaths from fever, so unless there is a frost, she should not return to Philadelphia on the date they agreed upon. He repeats more of the "slander" against him.

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.

Rush writes most likely to Dr. Basil G. Middleton, (c. 1740-1818), a former surgeon with Virginia forces in the Revolutionary War, now living in London. Rush discusses personal and medical matters, touching on College of Philadelphia medical school classes and enrollment, and comments on the unconcluded treaty with England and the American political system.

Rush announces that yellow fever has broken out throughout the city, but there have been no measures yet to exterminate the disease. Their son Richard plans to move a mattress and books to their farm. Rush notes that a Mr. Thomas has left Philadelphia forever as a result of his debts, and has ruined many young men in the meantime. In a postscript, Rush points out that Capt. Mitchell of the American Army has the fever. Rush is considering leaving and is urging his patients to leave. Rush's signature has been excised.

Rush notes that the fever has increased more in one week than it had in three weeks in 1793 and 1797. He had made plans to leave in 7-10 days when the U. S. Mint was closed, but by the end of the letter announces more immediate plans to remove to Sydenham, which has been prepared for the family and servants. Their son John is arriving via his ship in New Castle. A note was appended to the letter in 1848, saying that the close of the letter was cut out for an autograph seeker.

Rush notes that John arrived, and they are now at Sydenham. He also reports that he has sold the Chapel farm for $2,500. He describes a new remedy he has developed for yellow fever. The signature has been excised from this letter.

Rush points out that though staying in the country helps him forget all that is going on around him, he cannot forget the poor, sick, and dying in the city. Three more persons were admitted to the hospital this day than were admitted in 1793.

Rush notes that his pupil is better, and that he is using profuse sweating as part of his treatment for the fever. A later note was appended to the letter stating that Mrs. Rush allowed the signature to be cut away for an autograph.

Rush reports that despite being exposed to the fever daily for two months, he is still healthy. However, he has "felt, mourned, and wept" until he could no longer do so. He reports that poor people chase him down in the street, and that he carries medicine with him in order to do all he can to help them. Free blacks and servants form a large percentage of his patients.

Rush recounts all the improvements he has made for her at Sydenham. He will begin sending the family from town with the warm weather in May or June.

Rush comments on commerce and the work of physicians, and on Philadelphia physicians opposed to use of mercury and bloodletting.

Rush writes a brief note to inform Julia that a friend has failed, physically.

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 makes treatment recommendations for an undisclosed ailment.

Rush records the benefits of using Kinepox over variolation to inoculate against smallpox.

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.

Copy of a letter Rush composed to Jefferson regarding appointments Jefferson has made, as well as the impact of yellow fever epidemics on commerce with Europe.

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 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 describes his parting with their son, James, and announces that Dr. Coxe has been appointed Professor of Chemistry. Includes a letter from Samuel Rush to his mother.

Rush relates how he misses Julia, then describes the activities of their boys. He notes that the weather has been uncommonly cool, which has damaged crops. There has also been an outbreak of yellow fever in the city, but he expects it to be checked by the cool weather. He points out that the "ejection of Mr. Erskine's convention with our government by the British Court" has caused outrage in the city.

Rush writes regarding a Mr. Carter's debts, particularly regarding his coffin and grave.

Rush writes a more detailed letter regarding Mr. Carter's debts and ill treatment of Carter, who was insane, by his family. Includes a statement of charges certified by the hospital's steward. Letter features an additional written comment made by Henderson or someone in his firm.

Rush replies to a requested consult regarding a severe case of hemorrhoids or other bowel problem. He proposes that if the patient is willing to visit Philadelphia, the problem can be treated surgically.

Rush congratulates Jones on his decision to leave Congress, and records his own regrets regarding public service, with particular regard to the funding system and the banks. He now believes American citizens "unfit for and undeserving of liberty."

Rush writes his memories of John Rodgers, the patriarch of Presbyterianism in the United States. Rodger's had been his boyhood friend at Dr. Finley's school in Maryland. In 1777, Rush had taken care of Rodger's son in Kingston following a battle.

Rush writes an unsolicited recommendation for Dr. James Mease to serve as head of the Office of Purveyor for the army's medical department.

Rush's draft letter acknowledges receipt of his certificate of membership in the Royal Academy of Medicine in Madrid, and laments the general lack of appreciation one experiences at the end of a career.

Rush's copy of a letter to Hosack on the origin of the fortifications and other Native ruins in different parts of the country.

Rush's copy of a letter assuring the Baron he has read all of the medical segments of Van Sach's letters from Surinam, regarding the origins of infectious disease, including yellow fever and influenza. He commends Van Sach on his plans for preventing fevers in Surinam.

Rush's copy of a letter he wrote regarding his memories of Dr. William Cullen.

The diary records Rush's travel, accompanied by a servant and via horses, between the outskirts of Philadelphia and Carlisle, Pennsylvania, for an initial meeting with the trustees of Dickinson College. During the meeting the Trustees selected Dr. Charles Nisbet to serve as the College's first president. Rush described the taverns and other travel lodges at which he stopped, along with Tavern staff and other patrons, the quality of the food and drink, along with conversations he witnessed or took part in. Discussion often centered on the topics of the Constitution, paper money, as well as Dickinson College. Rush also described the results of a rapid Spring thaw on the Susquehanna River, the unusually cold weather, the scenery, and the presence whiskey stills in Irish settlements and their impact on their communities.

In the casebook, Rush provided brief histories for his treatment of about 75 individuals. Entries generally included the year, patient's name, presented medical issue, dates of treatment, prescriptions applied, pulses noted, and the progression or resolution of the problem. Rheumatism was the most common complaint, along with dropsy (edema), pneumonia, diarrhea, and mania. Among the other illnesses listed were palsy (paralysis), fever, typhus, epilepsy, consumption, scurvy, hydrothorax, swelled spleen, and hysteria.