&<%'£■■ M fA '''$M& UNITED STATES OF AMERICA WASHINGTON, D. C. GPO 16—67244-1 "DOCTOR DANIEL DRAKE'S REPORT TRTOtoT^lTmT&tra. S3 Published, originally, in the Western Journal of Medical and Physical Sciences, EDITED Bt DANIEL DRAKE, M. D. Former Professor of Theory and Practice of Medicine in Transylvania University* Jate Professor of the Medical School of Philadelphia ; Surgeon of the Cincinnati Eye Infirmary; Memher ofthe Philadelphia Vcademy of Natural Sciences: of trie American Philosophical society, and of the Royal Wernerian Society of Nat- ural History, Edinburgh, &c. &c. The Mineral Springs of Kentucky and Ohio, especially ofthe former, are numerous and considerably diversified in their coraposi'ion and quali- ties. They are but little known to the profession, even of those States; who, in general, are, therefore, un&ble to direct their patients to a proper choice. Having visited most of them, (though not with the means ofan ac- curate analysis, nor for a sufficient lenjzthof time to observe all their ef- fects) I propose, in this paper, to give a brief notice of those which consti- tute our principal Watering Places. The countries on each side of the Ohio River, present an identity in the a^e of their rocks,hut considerable variety in their composition. They are a^ secondary, and disposed in horizontal strata. The predominant rocks are grey lime-stone, abounding in organic remains; and sand-stone, alterna- ted with shivers and slate clay. The calcareous formation presents con- siderable variety in its geological character, as well as in its chemical composition. Springs are subterr^rfean streams, supplied chiefly by the rains which percolate through the rocks over which they fail; and which, in their meanderings, dissolve such soluble matters as mav be in their way; and hence the diversity, in quality, tf the mineral waters, in the region of which I have spoken. Throushou^almost every part of it, the common sprint and well water, is hard—in 'other words, is impregnated with the carbonate and sulphate of lime, the muriate of soda, and other saline sub- s'-inces. When anv one or more of these, or other ingredients, are present to a certain degree, the water is no longer regarded as fit for culinary pur- poses- but pronounced medicinal, and resorted to by the valetudinary — In their selcction^lhey are too often governed by considerations of conven- ience, or act in almost total ignorance of the relative effects ot different Borings.. Thus fhev often suffer injury, when they expect to receive beneat A mistaken choice "in the watering place, is not however, the only cinseot ^appointment. The conduct of the patient while there, and the exposure* 2 to which he is subjected, contribute »reut!v to an unfavnrab'e res>;l». Tffr.co? it is ov no m '.ins on' o urnou, t<> see in i i is who i e 1 r h >m • hi ii »;>i , r rC in di-co'im.iemfMH, if noi despair. For the infirm to derive a('vii^c from die use of mineral waters, several circumstances must he aitended ti., 1. [t is necessary that the spring should be well chosen, in other words adapted to the case ofthe patient. 27 That it shou d be in a heathy situation; or one, at least, as exempt as possible from the causes which induced the disease which is to l>e <■ ocd. 3. That the malady should be curable,• or, if not curable, susceptible of pali'tion. 4. That it should not be of such a kind as to be aggravated by exorcise. 5. That the patient should be comi'n tabiy l.dgod, inadry and airy apart- ment, instead of being confined in a sroail cabin or room, close upon the ground floor, surrounded by high weeds and grass, in a damp valley, as is too often the case. 6. rrhat be should not participate in the dissipation, whi< h is so eom- rronlv pracised by those who visit watering p aces f r amusement only. 7. That he_should I e exceedi-igh temperate and sitnp'e in his diet.—. Mineral waters of almost every kind, sharpen the appetile, sometimes to a morbid degree, and the majority of patients suppose, or pretend to suppose, that while, at a mineral spring, they may indulge thr-mselves with impuni- ty. Thus, in numerous instances,the beneficial effects of the water, arc more than countervailed, by errors and excesses in diet. 8. That be should visit the watering place between the 15th or 20th of Mav, 'ind the same peifod in September. The proper (ime).in this country, is the fo.ir months preceding the -autumnal equinox; though, on the whole, it is better and safer to limit the re?idence to the 'hroe summer months.— The first half of Mav is almost a'wavs too conl and rainy to be comfortable; and most wateriiifr places too m eh infested with fevers after the first of September, to justify a longersojourn at them.. These ore given, however, lis general *ules, to which there are exceptions. 6. That the patient should remain longer than is usual. Of all men, the Anglo-American is, perhaps, the mosf impatient. He arrives at a watering place, and like a thirsty animal, obedient only to his sensations, proceed? to drench i.imself. In three . ' s he is, perhaps, worse than when he arrived; and, in a week, he deci >■*, that the wlfters can do him no good, falls into displeasure with every thin"' n' out loy. and repairs to another spring, or returns home in regret, at his uspW-^V penditure of strength and money. In most cases, mineral waters sbou«ld be drunk moderately and perse- veringly. Their specific effects, in many instances, are not perceived, nor, indeed, produced tor some time. Their first impression, on many invalids, is unfavorable; but, bv continuing them, the constitution, at lenafh, be- comes reconciled to their action, and is ultimately strei■pihened by it. 10. That in journeying to the waterim? place, he should pro eed with deliberation, and not in a feeling of anxiety to reach the fountain upon which his imagination i* turned, subject himself to lona d:vv thein at. masse. There are physicians who estimate the value of their interference, >-y the bulk end number of their boluses; and any spring, notabs lutely impregnated vvi'h arsenic, would prove a foun- tain of health to all whom it might extricate from such keeping. These stricture-, apparency severe,are directed against the practice in chronic diseases, on \ ; but it is generally for them that mineral waters are pre- scribed. Ilaviug premised these general remarks, on the use and abuse of mineral waters, I shall proceed to speak, in detail, of some ofthe principal watering places in the West. Harrodshurg Springs.—The town of Harrodshurg. one of the oldest in Kentucky, is sit »' lime-stone, much of which is oi a fi.ie grain, and impregnated with magnesia. All the springs afford water, essentially of thesame composition; though the proprietors are accustomed to speak of them, as presenting some variety in their qualities and effects. None of the veins are large. Thev have no gaseous impregnation, and consequm !y, do not sparkle. Their temperature is that of other springs, not more copious, in thesame latitude—tbout 58 deg-ees of Fahrenheit. The water from one of diem, on the laud of Doct. Graham, has been ex- amined, with some care, by Or. Best and myseif. The fid lowing is a state- met of the experiments made,and the results obtained; which, although not so rigorous and comprehensive, as to constitute a perfect analysis, will convey a correct general idea ofthe composition of all the fountains. EXPERIMENTS. 1. Prussiate of potash and infusion of galls produced a slight discolouration, both before and after boiling. 2. Nitric acid occasioned no change, nor effervesence. i 3. Oxalic -acid produced au obvious and diffused whiteness, which appeared slowly, and the same effect occurred after boiling. 4. \cetate of lead threw down a copious white presipitate, soluble in nitric acid. 5. Nitrate of silver produced the same kind of precipitate, soluble in the same a- cid, find also, in ammonia. 6. The carbonate of ammonia caused a slight whiteness; and, upon the addition of the phosphate of soda, a copious white precipitate ensued. 7. One thousand grains of the water, evaporated, left ;i residuum of dry white matter, which, when apparently deprived of its water of crystallization, weighed jwelve grains Dunn: the evaporation a slight pellicle formed on the surface. 8. \ portion of tins residuum afforded an eCcrvesceuce with several acids, and was wholly saluble, in dilute muriatic acid. 9. Of this effervescent portion, nearly the whole was found to be soluble in sul. phunc acid. The remainder was probably lime; which, united with the sulphu- ric acid, would remain undissolved ■ From this solution, the addition of carbonate of ammonia and phosphate of soda, threw down a copious white precipitate. 10. One thousand grains of the. water were evaporated to one half. Lime water was then added, which piod.uced a turbjdness. The liquor was filtrated. Oxa- lic acrd was then added to it, and occasioned a precipitate. Tt was filtrated again and concentrated still further. Acetate of Barytes was then added, (not in excess) and produced a copious white precipitate. The solution was finally evaporated to dryness,' and heat enough applied to decompose and drive off the acetic aeid.— The residuum, dissolved in water, changed the vegetable blues to greeu. COtfCMJSTONS. This water, it would seem, from the foregoing experiments, contains the folio ing salts: 1. Sulphate magnesia, in large quantities. This is the characteristic ingredient- 's. Carbonate of magnesia,in af small quantity. 3. Sulphate of soda, "v ( do. 4. Sulphate of Lime, do. 5. Carbonareor Lime, in minute do. t) Iron (probably in the itatc of a sulphate) a trace,. 5 7- A minute quantity of sulphuretted hydrogen, as I ascertained by ex- periments, made at the springitself. From this analysis, it appears that the waters ofthe Larrodslurg Springs, bear some resemblance, in the materials which they bold in solu- tion, to tha celebrated Seid I itz fountain of Bohemia. Their predominant ingredient, is sulphate of magnesia, or Epsom salt; though ihe other matters which they contain, especially ihe sulphate of iron, small as it is in quanti- ty, may contribute to their beneficial efrects. I an not in possession ofthe facts, necessary to a full expose of their therapeutick powers; but that these are so great as justly to place them at the head of ail the known mineral springs, in the stales bordering on the Ohio river, 1 have no doubt. The cases to which they are, in a peculiar manner, adapted are chron- ic inflammations, and obstructions in the abdominal viscera. Thus, they are, eminently serviceable, in such cases of dvsuepsia, as are attended with subacute gastritis; in almost every kind of hepatic disorder, except when rhe liver is indurated, ajd consequently, incurable; and in constipation, so constant an attendant on diseases of the stomach and liver. They are al- most equally beneficial, in chronic inflammations of many other parts of the system—especially ofthe serous and fibrous membranes. In tonic dropsies, in rheumatism, and in various affections of the periosteum from febrile metastases, from syphilis and from mereurv, they have often effected a cure, when other means had failed. In several urinary disorders they have done equal good. In chronic diseases of the skin, they have, also, been foand useful, w'lenthe t-atieiit has been subjected to a regimen, that has determined them to the suriace. In pulmonary complaints, thev have been found servicible; but not in the same degree, as in disorders of the abd miual organs; and their use in the maladies requires discrimination. In chronic pleurisy, and the early stages of subacute bronchitis, they have performed cures; but in vomica, tubercular suppurations, and hepatization ofthe pulmonary tissue, they are injurious; and, if persevered in, may even prove fatal. When they have rendered occasional assistance in these affec- tions, it was chiefly by correcting a morbid condition of the digestive func- tions, so often associated with them. In sick headache they occasionally, do good; but many cases of that obstinate maiady, are attended with such an enervated condition ofthe nervous system, that their sedative operation becomes prejudicial. In headaches, dependent, buvvever, on a phlogistic diathesis, they are salutar-, • Finally, in opthalmia, during the stages of acute and subacute inflammation—as long as depletives and sedatives are indicated—diey may be relied upon as an efficient remedy. It would be superfluous to cite other ex-mples of their efficacy. The principle upon which they should ba prescribed is obvious. Reducing the power ofthe heart, and acting as a diuretic, cathartic and sudorific, they are adopted to almost every case of inflammatory disease; while they are, contraindicated, in most orgtnic Iaesions, in exhausted states of the svs-em from profuse discharge of every kind; anemia all cases of broken up and ruined constitution. Of temperaments, the*8an^uineous and bilious heai- 6 them best: to the nervous and prd\cenatic they are generally useless,not unfreq tently oiF-.nSiv-, i 1 1 s>m Mines al-nost oeruieious. I have aire vly ; 1 h m el oieir >n >du* on>'r in . Til 21c influence on ihe circdalion is, I believe, invariably that of a refrigorant and'^eAtive.— Their action >n die kiI ieys is, in genual, thai of a pnverful di.ireiic, in which the vvaer itself, no doubt, performs an important, 'hough not an ex- clusive part. Iii the majority of persons, they, also, operate on the bowels', as a hydragnguecathartic; but those who are strongly inclined to consti- paii, they should be taken, cbictlv at night; the patient lyinn in bed, with Ihe surface of his bod\ 1 loseiv, but thiuo,-covered, in these cases, two s^iall matters require attention; fo- wl1 iiout un observance of them, the desirec effect cannot always be obtain ed: 1. The forehead of the patient should be covered with a slip of flannel,as directed b\ Sydenham, when sweating is the object. 2. He should be left al >ne, or, at least, not be allowed to talk or read. If the w iters be taken war 11 or hot, their sudorific effect will, in most cases, be greater, ibati if taken cold. Lastly when all these means are unavail- ing, an nubile—i'-r example, the pulvis Doveri—thould be employed, and will in genera;, be su cess tub It is a common remark, diat these waters do not oppress the stomach.— This is not owing to the presence of carbonic acid gas, or any other aeriform iluij; but to their passing the pylorus, or being drunk up by the veins of the stomach, very soon after they are r .'nnk- intr I have known it likewise beneficial in cold Phlegmatic habits : attended with swelled legs, and incases of enlarged spleen from' tedious intermittrxt frver»; Signed, »' • IvU(ji c.iv.^. A nlnin simple diet, as observed by Dr. Prnke, is be=t for all prions afflicted, and more particularly with dispepsia. Au observance of the health, vigour and 8 ai.uost perfect exemption, ,1'rorn disease of Waggoner?, Huntsmen and lavage", whose diet is roegti and generally scant, will suffice to point out the proper com ?e to he observed in regard to diet. Kegulir rest, early rising, and as much exerci-e a^ possible should be observed No one wtfo wishes for health should sleep on feather- in warm weather . One who lies buried m feathers, and sweating through a hot summer night will rise languid, with coated toi:;,-neand disordered stomach—this is more particularly th? case with persons using the water, which causes a free perspi- ration. This perspirable matter, instead of passing oh from the body Ireely, and a constant fnesh accession of vital air-aJJ$>wedT as designe: by nature, it is confin- ed about the person, and breathed with the exhalations of the lungs, over and over again. All the secretions and exhalations of the body are thrown off as not uiilv useless but injurious, and should not be taken into it again. It has been observed that woodsmen and such as live in the open air, enjoy health, and if is not so much from rough living as from h rd iving, and Lreathing a fresh and vital air. Hard iodging has the same effect as exercise. It diverts or translates'morbid excitement from the organ diseased to the muscles aad the surface. This is the secret why many persons can sleep sitting up or leaning down upon chairs or a settee, who, the moment they touch their bed are deserted byslcep and pas*miserable and restless nights. Where there is neither exercise nor hard lying to divert excitement, the sensorial power or excitability accumulates upon the diseased organ like the con- sentrated and burning rajrs brought to a locus. Lying ii the open air upon the ground, or upon a board or plank, would cure.mauv. diseases that resist all medical skill. The visiter should go to the spring in the morning, and if possible, take as much of the water pure anc" fresh as it issue? from the bowels of the earth, as will serve for the 24 hours. If enough can hp'dranlc before breakfast to procure one or two free evacuations through the day, the stomach should be left undisturbed till the following morning. In very costive habits when such quantity cannot be taken at once, it may also be used before etirineranri supper. Persons who expect relief, or even any sensible relief, from a few drafts of the water, or any other earthly Tcmedy will be disappointed. Nothing short of supernatural agency is going to revolutionize the system in a few days. In many cases it requires months or years to effect it safely and successfully. As wll might the child, desirous of adult size, expect to pass from youth to manhood by a few hearty diets or stuffings-of the stom- ach ; ami yet how many presume to pass in I men , lispair without a single ration- al effort. It is firmness, fortitude, and perseverance, that overcomes diseases a-- •vell as ether difficulties of life. 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