The Cacapon River ( ; meaning Medicine Waters), located in the Appalachian Mountains of West Virginia's Eastern Panhandle region, is an shallow river known for its fishing, boating, wildlife, hunting, and wilderness scenery. As part of the Potomac River watershed, it is an American Heritage River. The Cacapon River Watershed is made up of three major river segments and many smaller stream watersheds. The headwaters of the Cacapon River, known as the Lost River, is long and receives water from a watershed covering . The largest tributary of the Cacapon is the North River, which drains , an area comparable to that of the Lost River. Overall, the Cacapon River watershed includes the Lost and North River watersheds, and those of many smaller streams for a total of . The Cacapon watershed is itself part of the Chesapeake Bay watershed. In recent years the Cacapon River and its watershed have become threatened by development, and industrial and agricultural growth. Concern about these issues led to the establishment of the Cacapon Institute in 1985 (originally known as the Pine Cabin Run Ecological Laboratory). Course Emergence to Hampshire County line The Cacapon River emerges from underground in a gap in Sandy Ridge (1683 feet/513 m) west of Wardensville. It is actually the reemergence of the Lost River, which sinks into an underground channel east of McCauley near the entrance to Camp Pinnacle. From its emergence, the Cacapon River creates a horseshoe bend shaped gap through Sandy Ridge and flows east paralleling West Virginia Route 55/West Virginia Route 259 to its north. At Wardensville, the river is joined by Trout Run and then curves northeastward where it meanders through an expansive valley plain. Here, it is fed by Slate Rock Run and then Moores Run further north. Waites Run, a tributary draining some of the western slopes of Great North Mountain enters the Cacapon River near the bridge on Rt. 55, north of Wardensville. Shortly after its confluence with Sine Run, the Cacapon River continues north into Hampshire County. Hampshire County line to Yellow Spring From the county line, the river is bounded to its east by the George Washington National Forest and to its west by Baker Mountain (2024 feet/617 m). Throughout this stretch, the Cacapon River is also joined by sections of the old Winchester and Western Railroad grade. It continues its meandering course northeastward, flowing past the community of Intermont