ration proceeding from cavities, should be sent to a distant place; and a long journey should be still more sedulously avoided if there is much diarrhoea. The latter symptom is generally aggravated by the journey, and the patient is besides unable to take the Red Sulphur water in sufficient quantities to produce any sensible effects; for the quantity, rathan the quality of the water, tends to increase the discharge from the bowels. It is under certain circumstances desirable for invalids in the last stages of pulmonary disease to leave their accustomed air, and seek for a restoration of strength, if not an entire recovery; but these persons should seek a nearer retreat, and one exempt from the fatigues of a mountain journey.

The explanations which are given of the mode in which the water of the Red Sulphur Spring acts in relieving phthisis, do not seem to me to be well founded. It is thought that it has a direct power of diminishing the frequency of the pulse, It is true that this result does follow in a certain proportion of cases; but on a careful examination of many patients who took the water, I found that this effect did not occur at the beginning of many of the cases. It is true that when the irritation of the disease was to a certain extent subdued, the pulse became less frequent; but this did not appear to result from any peculiar action of the water. Its first action was that of a sedative, perhaps more nearly resembling minute doses of hydrocyanic acid than any thing else. It caused a tendency to sleep in nearly every patient, and in some gave rise to considerable headache, and a disagreeable sensation of fulness, which lasted for a few days. The water passed off by the kidneys, producing little effect on the bowels or the skin. It may, however, be readily determined to the surface by proper attention to warmth.

The quantity of water taken is very various; in former times it was much more freely drank than at present; invalids now rarely take more than eight tumblers, about three pints, in a day. But if the water does not produce a permanently disagreeable effect upon the alimentary canal, it may be properly taken in much larger doses, say from ten to twenty glasses of the kind usually employed at the spring. But while taking the water the invalid should take constant and regular exercise; this precaution is one always to be observed when using mineral waters, but certainly by no class of patients more faithfully than those disposed to phthisis. Yet simple and obvious as is this rule of hygiene, the patients have of late been singularly negligent in this matter, and

often limit their exercises to an occasional game at ninepins, and a quiet stroll about the grounds. The water should be taken in divided quantities before each meal, but especially before breakfast. Thus, if the allowance be eight glasses, three of them should be taken before breakfast, in the space of an hour or two; two before dinner, allowing the same period for it; one before supper, and two in the evening. But between every glass, as much exercise as practicable without producing fatigue, should be taken if the weather be fine. If the morning should be cool, it is proper either to exercise within doors, or in the piazzas, which, at the Red Sulphur, extend several hundred feet in length.

Much of the benefit of mineral water depends upon the facility with which it is absorbed, and, as it were diffused throughout the system: this diffusion is greatly promoted by vigorous exercise, which prevents the unpleasant sensation of a load or fulness at the stomach, that often occurs under different circumstances, Exercise is more necessary while taking a water like that of Red Sulphur, which contains but a very small proportion of saline matter, and depends for its action chiefly upon its gaseous elements, which are less readily determined towards a particular organ.

The red deposit which gives name to the spring is less copious this year than usual; in fact, it is scarcely a deposit; a portion of sulphur is combined with a peculiar organic substance, apparently some variety of the cryptogamous plants. The spring has been carefully cleared out, and the sides for the deposition of the plant may have been removed. Some of the old visiters to the spring fancy that the strength of its waters has been impaired by the copious rains of the summer, but this opinion does not obtain amongst others.

The action of the water is certainly that of a mild alterative, as well as sedative, and it is useful not merely in cases of commencing phthisis, but of many sub-acute inflammations of the mucous membranes. Indeed, in pulmonary disease the water is apparently most beneficial in the stages of the diseases in which there is a slight irritation, sufficient to cause some feverishness, but not to give rise to very acute symptoms. The acute forms of phthisis are usually aggravated by a residence at the Red Sulphur; at least this was my experience during the present summer; but this aggravation manifestly depends more on the irritation of the journey and peculiarities of climate, than on any action of the water. The therapeutic rule, that much exercise, or excitement of any kind, is injurious in acute phthisis, always holds good.

The disorders of the mucous membranes in which this water is the most useful, are chronic inflammations of the stomach and bowels, especially the varieties which are sub-acute from the beginning: when the case is one of chronic dysentery following the acute form of the disease, the good effects of the water seem to me more problematical; but of this I have no personal experience. In chronic irritation of the urinary passages a like good effect has often been noticed; I recommended it in cases of this kind, but was not able from my own experience to confirm the results which have been previously observed. In these diseases the water acts medicinally by its alterative virtues; in the functional diseases of the heart the action of the water is more complex, and is partly derived from its alterative, and partly from its sedative qualities. An interesting case of this kind occurred to me: a young gentleman, a student of the University of Virginia, was affected with a disease of the heart, chiefly symptomatic, and dependent upon nervous derangement and dyspepsia, but in part connected with a real enlargement of this organ. After remaining some time at the White Sulphur without benefit, he resorted to the Red Sulphur,—and after taking the waters for a few days with the usual precautions, his symptoms rapidly declined. A single case of this kind is of no value, but the general experience is decidly favorable to the effects of the water in this form of disease.

A mild mineral water like the Red Sulphur, which contains, it is believed, but little more active ingredients than sulphuretted hydrogen and nitrogen gas, must derive much of its virtue from the temperature and quantity of the water. The medicinal ingredients act probably quite as effectually by the direction which they give to the water, as by the remedial properties peculiar to themselves.-Medical Examiner, Aug. 15th, 1840.

THE WESTERN JOURNAL.

Vol. II.-No. X.

LOUISVILLE, OCTOBER 1, 1840.

LANCASTER MEDICAL INSTITUTE.

We regard every association for professional improvement, as entitled to commendation. Under this feeling, we have already noticed two or three in the sister States of Kentucky and Ohio; and propose to make known to our readers, all with which we may happen to become acquainted. On a late visit to Lancaster, in the latter State, we had the pleasure of learning something of a society, composed of its respectable physicians, which is manifestly exerting a beneficial influence on the character of the profession in that place. We have prefixed its title to this article. Its President, is Dr. JAMES WHITE, Vice President, Dr. G. W. BOERSTLER, Secretary, Dr. M. Z. KREIDER, and Treasurer, Dr. H. H. WAITE.

The primary object of this Institute, is "the advancement of medical science among its members." To this end, it holds semimonthly meetings in November, December, January, February and March, and monthly meetings, during the remainder of the year. At each meeting, a topic is selected for discussion at the next. It is expected that all interesting clinical cases will be reported to

the Institute, and the members are furthermore invited to read essays, on the subjects they may investigate, either in medicine or the auxiliary sciences. At the end of his annual term of service it is the duty of the President to deliver a scientific discourse. All these productions are subjected to discussion. It is a further object to regulate the intercourse, and promote the harmony of its members: also to subscribe for Medical Journals.

Now, if the physicians of every country town in the Valley of the Mississippi, were thus to unite, it would unquestionably give an immediate impulse to the profession. They would all be made abler, happier, and more respectable. And why should they not thus unite? Why not resolve to apply their shoulders to the wheels of their profession, and in a spirit of noble emulation, give it a long push, a strong push and a push all together? This would certainly be preferable to the push-pin employments, in which so many of us push away the hours not devoted to the sick; and although, at first the new custom might make us feel a little awkward, it would soon grow into a habit, of which no one would be ashamed.

D.

DOVER'S POWDER MODIFIED.

Dr. Townsend, of Wheeling, has sent to Dr. Drake a note, in which he recommends two new ingredients in the formula for this popular compound—nitrate of potash and the powdered root of the sanguinaria Canadensis. Many of our brethren in the West, have long been accustomed to substitute the former of these articles for the sulphate of potash, but have not dispensed with the Ipecacuanha. Here is the Doctor's recipe: Opium and the powdered root of the sanguinaria, each one grain, nitrate of potash eight grains, mixed intimately by trituration. This preparation he has used, instead of the officinal, since the year 1816. The following are his pharmaceutic and practical remarks concerning it:

“It is said in our Dispensatories that the only use of the sulphate of potash is, to reduce the opium to an impalpable powder by the hardness of its crystals. I dry the opium and then pulverize it until it all passes through a fine seive. This enables me to use the nitrate of potash, which is a diuretic salt of long established value, and always admissible when the Dover's powder is proper.