N..^. .M.C*********** i/ * / ' DR. JOHN ESTEN COOKE. S'CJi [From the Church Review and Ecclesiastical Register for July, 1856.] DR, JOHN ESTEN COOKE. We have long been anxious to discharge a sacred duty which we owe to the Church and to the memory of one of her most devoted sons—the late John Esten Cooke, M. D. Dr. Cooke was one of the most remarkable men of our day. With great powers of observation and application, there was com- bined in him a logical force unsurpassed and hardly equaled, by any of his contemporaries in Church or State. The greater part of his life was spent in the active practice of his arduous and engrossing profession, and in the composition of some of the ablest works that have ever illustrated and enlarged the science of medicine. Long after he had passed the meridian of life, and while he was in the full practice of his profession, and engaged with all the earnestness and enthusiasm of his character in teaching this noble science to others, he was led, by an apparent accident, but by a real Providence, to examine the history and constitution of the Christian Church. The absorbing interest of the theme at once enlisted all his powers. With unparalleled industry and intense concentration of mind, he gave himself up to the enquiry. In a few months he accu- mulated and thoroughly digested the lore which ordinary theo- logians require a lifetime to obtain. The remarkable publica- tions in which he exhibited the results of his great mind, ope- rating upon this mass of erudition, placed him at once in the front rank of the theological writers of his age and country. For many years after this, he continued to be the enthusiastic student and the successful teacher of both these two great departments of human learning—Medicine and Theology. It is due to the Church and to the world, that the memory of such a man should not die. John Esten Cooke was born in Boston, Mass., on the 2nd of March, 1783, while his parents were on a visit to that city His father, Dr. Stephen Cooke, and his mother, Catharine Esten were natives of the island of Bermuda, " connected " 8^s Mr. Caswall, "with 8ome distinguished families in En- gland. Ihey continued to reside in Bermuda until 1791 In that year they removed to Alexandria, in Virginia and not long afterwards to Loudon County, Va., near Lelsbur'g. Thev had eight children, six sons and two daughters. One of the bom, John R. Cooke, attained to considerable eminence at he Dr. John Esten Cooke. 3 bar ; and another, St. George Cooke, is still serving with dis- tinguished reputation in the army of the United States. John Esten Cooke, the eldest son, received the degree of Doctor of Medicine, from the University of Pennsylvania, and commenced the practice of his profession in Warrenton, Fau- quier County, Va. In 1821, he removed to Winchester, then the chief town of the " Great Valley of Virginia." In this rich and beautiful valley flows the Shenandoah to its junction with the Potomac, having the Blue Ridge on the East, and the Alleghany mountains on the West. Dr. Cooke remained in this place in the active practice, and in the enthusiastic study, of his profession, until 1827. Here he published an Essay on Fever, which excited very great attention, and soon afterwards the first volume of his great work on Pathology and Thera- peutics. In 1827, Dr. Cooke was elected to the Chair of the Theory and Practice of Medicine in the University of Transylvania ; and, accepting that office, removed the same year with his family to Lexington, Ky. His career as a Professor in that school, was one great and almost unexampled triumph. Although troubled with a slight impediment of speech, the earnestness of his manner, the depth of his convictions, the singleness of his purpose, the sim- plicity and comprehensiveness of his views, and the evident in- tensity of his devotion to truth, made him the most interesting of lecturers. His system of Pathology, and the practice found- ed thereon, very soon obtained an unquestioned ascendency, and almost universal acceptance, in the West and Southwest. The simplicity of that system, and the consequent facility with which it could be abused by inexperienced and unskillful physicians, and even by unprofessional persons, are probably the causes in part of the rapid decline of the system in profes- sional favor, about the time that Dr. Cooke ceased to be its public teacher and expounder. Another, and the principal cause for this result, is the fact that the current literature of the Medical profession in this country, comes from London, Edin- burgh, and Paris. That a Medical system, proposing itself as true and substan- tial, and implying of course that preceding systems had been visionary and shadowy, and therefore entitled to take the place of them all, and to keep it, had originated with a country Doctor in the Valley of Virginia, or with a Professor in a backwoods college at Lexington, Ky., was an idea which the profession at large would not entertain. So the influence of Dr. Cooke's lectures and writings was confined to the West. The magnates of the profession in the great Eastern cities and 4 Dr. John Eden Cooke. [July, colleges, paid little or no attention to this new sj stem, and still continued to look for knowledge and instruction to European centres of intelligence. < Soon after his removal to Lexington, Dr. Cooke published the second volume of his treatise on Pathology and Therapeu- tics. Of this remarkable effort of genius and# labor, we of course express our own opinion in saying, that it is unsurpassed by the profoundest works in Law, Theology, or Medicine, for its large array of facts, and for its close and impenetrable logic. In 1828, Dr. Cooke, in conjunction with Dr. Charles W. Short, Professor of Materia Medica and Medical Botany in the same University, commenced the publication of " The Transyl- vania Journal of Medicine and the Associate Sciences." All the early volumes of this Journal are enriched by the labors of Dr. Cooke. He contributed to it a succession of valuable papers on many of the most important practical questions connected with his profession. Speaking of these papers, the Editor of the Western Journal of Medicine and Surgery, said in 1854, " Honesty of purpose marks everything which has emanated from the pen of Dr. Cooke. It is visible in every page of his voluminous writings. He sought truth, and truth only. He never contended for victory, but for principle. * * * * * His works are models of a clear, direct, simple style." Dr. Yandell very beautifully adds, " It has been remarked, that few men can be trusted to write their own biographies. Dr. Cooke is one of the few who, without any detriment to his fame, might have performed that delicate work. He would have written his life with all the honesty that he lived it—with perfect im- partiality, keeping nothing back through a weak vanity, and exaggerating nothing." (West. Journal of M. and S., Oct., 1854.) The Medical views of Dr. Cooke, so ably and perseveringly maintained, were subjected to a severe but triumphant test by the Cholera which desolated Lexington in 1833. Dr. C. was in Philadelphia at the time of its terrific access. He hurried to the scene of danger as fast as the conveyances of the day would admit, and threw himself into the conflict with his wonted energy and decision. He considered Cholera as be- longing to the class of Malarious diseases, and treated it as such, but with a vigor of administration proportioned to the frightful violence of the malady. In a paper published in the Transylvania Journal of Med., he gives a history of each case, and demonstrates, as far as complete success could do it the soundness of his views, and the propriety of his treatment. It was during this most active period of his active life that Dr. Cooke was called upon to turn his great powers to another 1856.] Br. John Esten Cooke. 5 and very different field of research. For many years previous to 1829, he had been a zealous and devoted member of the Methodist Communion. The causes that induced him to aban- don this connection, and to attach himself to the Protestant Episcopal Church, are fully stated by himself in the introduc- tion to his Essay on " The Invalidity of Presbyterian Ordina- tion." The extract we give is long, but it will well repay perusal. " When a man who has, for eighteen years of his life, taken an active part in the concerns of a religious society, and pro- moted its interests with all his power, leaves it and attaches himself to another, a decent respect for their opinion, as well as a proper regard for his own character for consistency and up- rightness, renders it not improper that he should state the rea- sons which induced him to make the change. This I propose to do in the following pages. " Those who know me intirrately, know that I have ever em- braced the truth when convinced I had discovered it, with little regard for the consequences that might follow. Having had the truths of the Christian religion impressed upon my mind by the unwearied care of a most affectionate mother, I occasion- ally had serious reflections on the subject, although in general by far too indifferent to it, until about nineteen years ago. In the summer of 1810, I met with a pamphlet called the ' Star in the East,' .by Dr. Buchanan, giving an account, among other things, of the discovery of a Christian Church in Ilindoo- stan, secluded from all the world, which derived its origin from the Apostles themselves. This narrative produced a very strong impression on my mind, and, as I had been for some months more thoughtful than common on the subject of relig- ion, I determined to investigate the evidence on which the doctrines of the Christian religion rest. Shortly after, a book- peddler passed through the village, and I purchased a Bible with Canne's marginal references, and Bishop Porteus' Eviden- ces of the Christian Revelation. " I had always been in the habit of requiring strong evidence upon every subject, and never yielding assent to any thing that was not supported by it. 1 sat down, therefore, to the reading of Porteus with the determination narrowly to examine and weigh every argument. " The result was a strong impression made on my mind by the first perusal, during which no quotations from the Scripture were examined, the interest excited by the force of the argu- ment being too great to allow stopping to examine them. Ihe book was read, however, very attentively a second time, with careful examinations of the quotations of Scripture, and the 6 Dr. John Esten Cooke. [July, result was a thorough conviction of the truth of the Christian Revelation; immediately on expressing which to myself, with an audible voice, I felt my mind drawn out in a feeling of grat- itude and love to that Saviour who had died that I might live— the first I had experienced, and not to be forgotten while life and recollection shall continue. The first reading of this book was in September or October, 1810. It had such an effect on my mind as to lead me to regular private devotion. The sec- ond reading was about Christmas. " Between the middle and end of January, I heard my friend Mr. Yidings, to whom I was then an entire stranger, preach for the first time, and again on the Sunday following, and was so much pleased that on the Sunday week after I became a member of the Methodist Society, which I then considered the purest Church as to doctrine. In that society I have continued ever since, in general, well satisfied ; and among its members, but particularly the preachers of the Baltimore Annual Conference, I have many valued friends. These I would not offend, I would not appear to slight, for any thing less than conscience' sake. That I have, until within the last eight weeks, taken an active part in promoting the welfare of the society which I have left, is well known to some of them, and was not long ago evinced in the part I took in the establishment of a religious paper to be published by the Methodist Society. "Soon after that time a volume of sermons by the Rev. Dr. Chapman, for which I had subscribed, was brought home, and for some days no attention was paid to it. At a leisure mo- ment curiosity led me to look into it, when I found the manner and style so striking, and the subject so new to me, that I de- termined to read the book. I had heard that the Church de- nied the^ validity of Presbyterian ordination ; but had never thought it worth while to inquire into a claim at first sight ap- parently^ extravagant. I was determined to see what could be said in support of such pretensions. I read carefully the first seven sermons, by which I was most forcibly struck. The language chaste, the style perspicuous, I was carried along without labor, and comprehended without the slightest effort. Ihe manner of handling the subject was strikingly moderate, and as charitable as any man could reasonably desire. Sup- porting the doctrine of the invalidity of ordination by Presby- ters, and the validity by Episcopal ordination alone, the author proceeds m maintaining the argument, without uncharitable reflections; and when he condemns, does it in the mildest lan- guage, and often or always with expressions of good opinion of the motives of the opposite party. If there is any thing offen- wve to any one, in the book, it is a quotation—and quotations 1856.] Dr. John Esten Cooke. 7 a man is bound to state as they are stated by the author from whom they are taken. To do otherwise, to change language, to curtail, to omit material expressions, without informing the reader, is to act corruptly, and is so esteemed by all men of letters, and justly so. " The argument itself is exceedingly strong, and in the lan- guage of a gentleman of this place in conversation with me, it is the best array of the question, perhaps, anywhere to be found in the same compass. " The strength of the direct argument for the doctrine, and of that indirect one, growing out of the evil consequences of schism, or division from the Church, contained in some of the following sermons, is such, that I was compelled to say to my- self, if these facts are so, this doctrine is the truth. Uneasi- ness now sprung up in my mind. The question arose, what if it be true ? Can you leave your friends, your intimate asso- ciates in what has engaged so much of your attention, your ef- forts, your ardent desires for eighteen years, and go to a people who, prejudice whispered, are no people? The answer of con- science was, if it be the truth, embrace it, and leave the conse- quences to Him, who revealed His will to man for his guidance. " The question now was, is this doctrine true ? To determine this without delay, I sought information from ministers of the principal denominations involved in the doubt as to the validi- ty of Presbyterian ordination, viz: the Presbyterians, the Me- thodists, and Baptists. With one consent they all referred me to Miller's Letters oh this subject. This book I immediately ob- tained. Emory and Bangs were also mentioned, and were like- wise obtained. " Meeting Dr. Chapman in the street, I inquired of him also what were the standard works on this controversy. He also mentioned Miller, and stated that Bowden had answered him. He also mentioned Lord King, (by whom John Wesley was in- fluenced,) and Slater's Original Draught, in answer to King, as well as Potter on Church Government, and Hooker's work. '' 1 immediately commenced reading Miller with great atten- tion, read over and over the arguments respecting the order of the Church in the time of the Apostles and for centuries afterwards, with his quotations from such of the Fathers as could be procur- ed conveniently; and with regard to those which I had not, I was enabled to form a very good idea from comparing him with Bowden. Thus, if he quoted a passage from an author which I had not the means of consulting, Bowden was examined to see what reply was made; if admitted by him, it could not be questioned; if not admitted, Miller's reply to Bowden's answer was exam- ined ; and if necessary, Bowden's rejoinder to Miller's reply. 8 Dr. John Esten Cooke. [July, So that from the two works of each, it was not a difficult mat- ter, with care, to make out what was agreed to by both these able disputants, and what was asserted, but, when answered, not maintained in the reply, and therefore given up; in short, it was not difficult to get at the truth. " The result of the whole investigation, after six weeks' close inquiry, was a thorough conviction of the truth of the doctrine that Presbyterian ordination is unauthorized by scripture, and therefore entirely invalid. " In order that those of my friends and others into whose hands this pamphlet falls, without having it in their power to consult the books above mentioned, may be able to judge of the valid- ity of the reasons on which rests the conclusion I have come to, I propose to make some remarks on the argument of Dr. Mil- ler, the statements he has advanced, and the manner in which he has answered the arguments of the Episcopal writers; and close with a condensed statement of facts showing the invalid- ity of Presbyterian ordination." The statement of some further circumstances attending this conversion will be interesting, as eminently characteristic of the man. Dr. Cooke had only subscribed to the volume con- taining Chapman's Sermons as a matter of courtesy to a col- league, Dr. Chapman being one of the Professors in Transylva- nia University. After the book had been sent to his house, Dr. Cooke remarked to his family and to some friends at din- ner, how strange it was that so intelligent and good a man as Dr. Chapman snould entertain, and attempt to propagate, the narrow-minded notions which he had heard were in his book. On the following Sunday, between breakfast and Church time, he took this book from the parlor table where it had first been placed, and began to read it. By the time the family were ready to go to Church he had become intensely interested in the book. He saw that there was a real question raised in it which he was bound to determine. He permitted his family therefore to go alone, while he continued his examination of the argument which was to control his future religious position. The doubt once planted in his mind as to the ministerial au- thority of those to whose jurisdiction he had heretofore sub- mitted, he could take no rest until the doubt was resolved. The Library of the University, rich in many old books, and the private libraries of Lexington, were diligently ransacked. The examination was begun and prosecuted with all the ardor of a strong and enthusiastic nature. Only four hours were allowed for sleep; one hour was given to the accustomed lec- ture to the Medical Class; the shortest possible time to meals ; 1856.] Dr. John Esten Cooke. 9 and all the rest of the twenty-four, with all the concentration of his great powers, devoted to the absorbing enquiry upon which he had entered. To relieve the brain from the effects of this intense and un- remitted application, and to keep his mind in its highest state of free and vigorous action, he several times bled himself dur- ing the six weeks of this remarkable investigation. At the end of that time his conviction was complete, and the materials of that conviction, soon afterwards embodied into the Essay above mentioned, were accumulated, and ready for present and future use. He immediately connected himself with the Episcopal Church, and neither he nor his family ever after at- tended any other form of worship. # The first duty required of Dr. Cooke, was to satisfy the pub- lic mind, greatly excited by his conversion, as to the grounds of it. For this purpose he published one of the most powerful and conclusive arguments ever produced upon the question of Church government—the Essay on the Invalidity of Presby- terian Ordination. This masterly work made a deep impres- sion upon the public, and upon the Church. It was immedi- ately republished in New York, and scattered in various forms over the country. Dr. Miller, or some friend of his, attempted a reply in the Princeton Review. But this was met by a crushing rejoinder from Dr. Cooke, which damaged yet more the cause which the Review had tried to defend. With all the force and enthusiasm of his character Dr. Cooke now applied himself to raise up the Church in Kentucky, from her fallen and desolate condition. The consecration of a Bish- op for the Diocese in 1832, the establishment of a Theological Seminary at Lexington in 1834, the attraction to the same place of a body of learned and distinguished Ministers of the Chuich —among whom may be mentioned the Rev. Dr. Coit, the two Leacocks, the Rev. Henry Caswall, and the Rev. B. O. Peers— attest the earnestness and enthusiasm with which he gave him- self to this genial work. As Professor of the History and Polity of the Church in the Theological Seminary, and as a member of the Standing Com- mittee of the Diocese, Dr. Cooke employed the whole force of his character and genius in aid of the rising fortunes of the Church. He very soon accumulated one of the best private theological libraries in this country, the greater part of which has since passed into the hands of the Bishop of Louisiana. As a Delegate to the General Convention, which assembled in Philadelphia, in 1835, Dr. Cooke startled from their quiet conservatism the members of that body, by introducing a reso- 10 Dr. John Esten Cooke. [July, lution providing for the immediate election and consecration of a Bishop for each State and Territory in the United States, in which there was no Bishop. This sweeping, thorough, and admirable proposition was afterwards whittled down by the cautions policy of the Convention to the election oi two Mis- sionary Bishops for the West. And of these only one was ac- tually consecrated. Thus again the Church was found lagging far behind her duty and her calling. Another effort which he made, in conjunction with the able theologians then gathered at Lexington, to advance the cause of the Church in Kentucky, was the establishment ot a reli- gious paper called the Church Advocate. For sometime Dr. Cooke edited this paper himself, but subsequently committed that work to the Rev. Henry Caswall. It is well known that this early dawn of the Church's pros- perity in Kentucky, was soon and sadly overcast. To inquire into the causes of this sudden eclipse of so bright a promise would be an ungrateful and a painful task. To bring up again the memory of old troubles, of criminations and recriminations, between men who were all anxious to do good, but who par- took of the common infirmities of human nature, could be of no possible service to the Church. Better let it all be for- gotten. One practical conclusion may perhaps be profitably drawn. The effort then made for the extension of the Church in Ken- tucky, involved too much centralization. The large ecclesias- tical force concentrated at Lexington, was utterly dispropor- tioned to the condition and strength of the Diocese. It was an enormous head without a body. If Dr. Cooke and his fellow Churchmen could have brought from the East a band of itine- rant preachers, and sent them, with the Bishop at their head, through the State, gathering up and organizing into congre- gations the Episcopal families which were thickly scattered over the whole country, the result would have been very dif- ferent. At that time the traditional regard and love for the Episco- pal Church, which the educated class of emigrants from Vir- ginia brought with them, had not yet ceased. The old dust- covered Prayer-books were still in many a house ; and out of those Prayer-books some of the older persons had been taught the catechism in their childhood. This was the feeling which built up the Church at Lexington, and at Louisville. In these places, the principal towns of the State, the old Church influence was found to be strong enough to support a stationed minister as soon as the trial was made. In other parts of the State this 1856.] Dr. John Esten Cooke. 11 influence was diffused over too large a space to be reached ef- fectually in any other way than by a mission embracing a large district, every prominent point in the district being served by the same Minister. This was the system by which the # Church was so rapidly resuscitated in Virginia, the old home of the fathers of these Kentuckians. When the venerable Richard Channing Moore, with his lofty and subduing elo- quence, sounded the rallying cry throughout the Eastern coun- ties of the Old Dominion, a glad and grateful response came up from every neighborhood, and the Church was at once re- established in the hearts of the people. Unhappily this policy was not pursued in Kentucky, and the consequence is that we still mourn, and will probably long be compelled to mourn, over the deplorable weakness of the Church in this Diocese. All that can possibly be said in censure of Dr. Cooke, in re- gard to the unhappy condition of the Diocese, which so soon followed its too sudden prosperity, may also be used in his vin- dication, viz: that he enacted the part which belonged to the sternness of his character, to his intense devotion to truth, and to his uncompromising spirit. To these severer traits of char- acter in him, and in some of his compeers, may possibly be attributed, in part, the disasters which ensued. More pliabili- ty, and a larger allowance for human infirmity than these gen- tlemen possessed or exercised, would seem, from the result of this case, to be necessary to the successful conduct of affairs. Certain it is, that to look for perfection in men, and to stop the wheels of government until it can be found, will render any government and any society impracticable. Disappointed and disheartened by the course which things had taken, Dr. Cooke threw up all his ecclesiastical appoint- ments, but remained to the last a devout, earnest, honest, and simple-hearted Christian, passionately devoted to the cause of Christ and the Church. Dr. Cooke remained for ten years in Lexington, earnestly laboring in the two departments of human knowledge to which he devoted his whole powers, medical science, and Christian truth. A noble champion he was in both fields, and worthy to be held in ever-during remembrance. About the close of this period, the admirable position, and the rapid growth of Louisville, induced the majority of the Professors in Transylvania to look to that City as the most eligible place in the Western country for the establishment of a great Medical School. Accordingly, in 1837, Dr. Cooke re- moved from Lexington to Louisville, and united with Drs. Caldwell, Yandell, and Shorty in founding the Medical Insti- 12 Dr. John Esten Cooke. [July. tute of that city; now known as the Medical Department of the University of Louisville. He continued to teach in this school until its prosperity was placed beyond the reach of ques- tion, or of Western competition. In 1844, Dr. Cooke resigned his professorship and retired to Woodlawn, a beautiful farm in the neighborhood of Louisville. A few years later, in 1848, he purchased a large unimproved estate on the bank of the Ohio river, about thirty miles above Louisville, where his restless energies were employed in the in- appropriate labors, for him, of the farmer and the pioneer. The wild beauties of nature, which he intensely enjoyed, the love of his family, and the consolations of religion, were here his solace and delight. For many years he had been subject, upon exposure, to vio- lent attacks of inflammation of the lungs. These he had often removed by the prompt application of his own vigorous treat- ment. These attacks became so frequent under the exposure incident to his new mode of life on the Ohio, that his strong constitution gradually gave way; and on the 19th of October, 1853, in the 71st year of his age, he breathed his last, with a firm trust in the mercy of the Saviour whom he had loved and served for the greater part of a long life. While on his death bed, for many weeks, and until within a few hours of his death, the Greek Testament was his constant companion. AJ1 day long, and every day, he pored over its sacred pages with critical attention and with devout affection. His mind retained its power and freshness to the last, and to the last he was, as he had ever been, the single hearted worshiper of truth. Truth and Love he found embodied in the Word of the Al- mighty, and on that his soul rested, in life and in death, with satisfied delight. There were two marked features of Dr. Cooke's character which precluded his ever attaining to vulgar popularity ; and which must be allowed to have diminished greatly his capacity for iisefulness. These were his indifference to public opinion and his stern intolerance of error and flippancy. He threw his great truths before the world, and used no further care to commend or introduce them. He took it for granted that every man would be as devout a worshiper of Truth as himself and he was at very little pains to conceal his contempt for those who seemed to care more for everything else than for truth. Ibis disposition created for him many enemies, and was one cause ot his prematura withdrawal from public employments. It is no bad illustration of the character of both to mention that Dr. Cooke admired beyond any man of his time a rising 1856.] Dr. John Esten Cooke. 13 statesman of Kentucky, the Hon. Garrett Davis. Their per- sonal acquaintance was very slight, but congeniality of mind and character excited this admiration. Dr. Cooke loved and honored Davis, because Davis loved and honored truth more than place and power and popularity ; and was utterly fear- less and regardless of consequences in his advocacy of truth. Not very long before his death the Doctor was introduced to Davis in the Court House yard, at Paris, Ky. Not attending particularly to the name, the introduction passed as such things usually do. A moment after he learned to whom he had been speaking. Instantly he sought for Davis in the crowd, and grasping again his hand, told him that he was the man of all others he wanted to see—the man who was never afraid to speak the truth. Stern, and sometimes even harsh, in his intercourse with the world, Dr. Cooke was gentle, tender, and childlike in his reli- gious affections, in the domestic circle, and in social intercourse with the friends he loved. With these last he was ever the warm hearted, genial companion. Without reserve he unbo- somed himself to them, and enjoyed beyond most men the pleasures of conversation—the delightful interchange of thought and feeling. It was deeply affecting to see that strong old man passionately weeping at bidding adieu to the Christian Minister, who, from time to time, celebrated at his secluded home on the Ohio the solemn offices of religion. The profound religious sensibility of this great man, so learned, so powerful in intellect, and so strong in all the elements of true manhood, is a withering re- buke to the vulgar irreligion of the vain, the trifling, and the ignorant. Dr. Cooke frequently, in the last year of his life, expressed a wish to prepare a Popular Manual for the benefit of several large classes of sufferers, setting forth the method by which he had been accustomed to relieve them, and the principles of that method. It will be an appropriate tribute to the memory of this good man to present, especially to the Clergy, his ration- ale of the invalid state into which they are so liable to fall, and the means of preventing or relieving it. The account is drawn up with especial reference to the Clergy, but it is equally ap- plicable to all who are similarly affected, and especially to the whole army of dyspeptics of every class and profession. The following is a brief statement of its principles and reasonings, and which in this place deserves to be presented to the reader. 14 Dr. John Esten Cooke. [July, All general disease is an approximation, more or less remote, to death. In death the arteries are diminished, the extremities shriveled, and a great portion of the blood engorged in the right side of the heart and in the great venous cavities of the body. The chill which precedes a fever furnishes an instance of a rapid approach to this state. The pallor, the coldness, the shrunken extremities, the diminished arterial action, presen t a very ominous counterfeit semblance of death ; and unless that condition is changed there would soon be no counterfeit, but the reality. Fever is the result of the vital force repelling with urgent violence the insidious mischief, the creeping death. Unless the fever supervene, death must ensue. All the appa- rent symptoms of a chill indicate that a large portion of the blood is engorged in the right side of the heart, and in the great venous trunks. But everything that diminishes the force of the circulation tends, in its degree, to produce this same result. For if the blood is not sent with sufficient force through the lungs to be purified and oxygenated, and is not then sent to the extremities of the system to be used, it must necessarily accumulate as black, impure blood, in the vena cava and in the other large receptacles of venous blood. This process once begun, per- petuates and reproduces itself in two ways: 1st, The venous receptacles become enlarged and weakened, making it more difficult for the blood to be returned to the heart. 2d, The less the blood is oxygenated the less can it stimulate the heart to action. In old age the circulating force gradually decreases— more and more of the blood is retained in the venous system—giving rise to the stiffness, aches, and pains of age, and as this process gradually goes on, death must inevitably at last ensue. Most general chronic affections are just an an- ticipation of this state. Whatever diminishes the force of the circulation below the standard of health, accumulates the impure, black blood in the great venous cavities—that is, in the vena cava,—in the vena porta or great vein of the liver, and in all the contiguous venous trunks. Such an engorgement affects the whole of the abdominal viscera and the brain alike—for the jugular veins are as closely connected with the vena cava as any of the veins of the trunk. In autumnal fevers these veins are suddenlv and perilously engorged, giving rise to the various symptoms"char- acteristic of that class of diseases. These symptoms indicate that the brain, and all the abdominal viscera are disturbed and more or less interrupted in the performance of their functions. When the force of the circulation is impaired in a much less 1856.] Dr. John Esten Cooke. 15 degree, but frequently, and under the influence of causes con- tinually operating, the same engorgement takes place in a pro- portionate degree, and insensibly increases, the parts adapting themselves gradually and without much immediate disturbance, to this abnormal state, until some chronic disease is firmly es- tablished. The most common chronic affection proceeding from this cause, is dyspepsia, with its concurrent train of ills. Among these are nervousness, vertigo, tremors, palpitation of the heart, constipation, diarrhoea, sour or fetid eructations, water-brash, heartburn, general debility, and low spirits. These symptoms do not all appear together or in the same per- son, but occur indifferently, according to circumstances and to peculiarities of constitution. They all proceed from the same cause, the unnatural turgescence of the venous system of the parts affected with impure blood; thus hindering, or entirely preventing, according to the degree of the evil, the performance of the healthy functions of those parts. Now let us see how this state gradually creeps upon a clergy- man in the active discharge of his duties. 1. Sedentary habits diminish the force of the circulation, as has always been known, although the mode of the action of this cause has been most clearly explained by Liebig. 2. Intense mental action is sure to be followed by a marked diminution in the circulating force. Mental action is far more exhausting than physical action. 3. All excitement above the normal point requires by a self-adjust- ing law of the economy, a correspondent depression or diminu- tion of force. If this period of depressed vital force could be passed in the quiescent state which is plainly indicated, the healthy standard would gradually be reassumed. If, on the contrary, the system is called upon while in this state for re- newed exertions, the evil will be aggravated, and a cause of permanent disease established. The clergyman, beyond any other class of the community, is subject to all these causes of weakened circulation. The sedentary habits and intense men- tal action of his calling are shared by all students. The higtf excitement of his Sunday work, recurring at regular weekly intervals, is peculiar to himself. Lawyers are usually exhausted at the end of a term, but then comes a long season of repose and relaxation, and the occasions in which a lawyer is called upon to exert his utmost powers, are rare. The ordinary routine of cases ruffles but little the equable flow of his mind, his spirits, and his temper. But a clergyman is called upon every Sun- day at the least, to spend four hours in a state of the highest excitement, in the performance of one of the most arduous, re- sponsible, and difficult of human actions. The corresponding 16 Dr. John Esten Cooke. [July. depression is inevitable. And this result is greatly aggravated by that mysterious tendency of the human system to conform itself to a weekly cycle. After a habit of the body has once been established, the weekly return of the accustomed period will sometimes bring on the condition, even without the usual exciting cause, much more will it increase the action of that cause. Under the influence of these combined circumstances, the force of the circulation is weakened every week in the case of every clergyman engaged in active duty. Of course there is a corresponding accumulation of impure blood in the great veins of the brain and of the abdominal viscera. At first this is so slight as to attract little or no attention. But the contin- ued operation of the same causes for a series of years, gradually enlarges and diminishes the strength and tone of the venous receptacles. They become permanently distended with an ac- cumulation of the impure venous blood. The exercise of Sun- day now produces, for tho next day or two, headache, a sense of extreme weariness, and good-for-nothingness. Presently dys- pepsia, with more or fewer of its accustomed train of ills, sets in. The first remedy for these accumulating ills usually ap- plied is a resort to stimulants. " A little wine for thy sto- mach's sake," is the advice of the friend, and the prescription of the physician, fortified by the supposed authority of Holy Writ. The immediate result seems to sanction the judicious- ness of the advice. The system is forced up by this adventi- tious aid to the healthy standard, and the disagreeable symp- toms are driven off by the removal of their cause—the venous congestion, i. e. the fever, thus artificially produced, has the same effect as the fever which follows a chill. But this stimulus has been applied to a system already jaded. To continue the same effects, the artificial stimulus must be continually in- creased. Each present relief is accompanied with a more rapid waste of the vital force by which the circulation is carried on and the organic functions performed. The comfortable feel- ings of each day are purchased by a corresponding relaxation, and consequent engorgement of the venous system at night. Hence, the discomfort and the disagreeable taste in the mouth with which the sufferer awakes in the morning. At last no amount of stimulus consistent with sobriety will answer the pur- pose, and we have tiie broken down minister—the confirmed valetudinarian. A summer at the Springs, acting most happily upon the mind and body together, enables him to go a while longer. When again, if he is sick, or is the Rector of a rich and liberal congregation, a year's travel in Europe and Asia almost restores him to the feelings and to the elasticity of youth. 1856.] Dr. John Esten Cooke. 17 The modus operandi of these health restoring processes is ap- parent. ^ 1. The remote causes of disease—the sedentary habit, the anxiety, the intellectual exertion, and the mental excite- ment, are all removed. 2. All mineral springs of any reputa- tion possess a gentle cathartic power, which acting constantly, and without irritation, for eight or ten weeks, gradually re- moves the venous congestion, by direct action upon the vena porta, the great vein of the liver. 3. All the surrounding circumstances are favorable to a maintenance of the whole system, mind and body, in a normal state. The alterative effect of a sea voyage, and all the accompaniments of foreign travel, oroduce the same result. But how is this train of evils to be prevented, or their ap- proach retarded ? The young men who are principally con- cerned in this question will hardly regard the subject with sufficient seriousness to heed the answer. That answer is, 1. Obey the law of the Sabbath, that law which requires a day in every week of rest and relaxation from accustomed pursuits. 2. Submit to the pathological law which requires that the sys- tem over-strained on Sunday, shall be allowed to recover its tone on Monday, by sleep, and rest, and abstinence from food, and pleasant recreation. The transfer by the Clergy of the weekly abstinence from Friday to Monday is very important. For when the stomach is in that state of in- cipient disease which I have described, to call upon it to per- form the active function of digestion upon three full meals is most injurious. All these rules apply to the cure as well as to the prevention of disease. Unfortunately, there is but one of them, abstinence, which the clergyman can absolutely com- mand. But when the valetudinarian state has begun, or is established, how is a cure to be effected, and a comfortable degree of health and energy maintained? Dr. Cooke should be hailed as a benefactor by the Clergy and by the whole mighty army of dyspeptics, not only for pointing out the cause of their suffer- ings, but for indicating the remedy. The great remedial agent, in addition to the hygienic rules already mentioned, is the long continued use of any medicine which will operate directly upon the liver, and discharge the impure contents of the engorged vena porta. But it is essential that this should be done gradually and gently. Active purging produces great disturbance of the whole system, weakens the circulation, and thereby increases the disease. So, any medi- cine which acts upon the mucous membrane of the bowels, and produces watery discharges, increases the debility, and thereby IS Dr. John Esten Cooke. [July, aggravates the diseased condition. The disease has been grad- ually formed. It can only be as gradually removed. We must imitate for the dyspeptic at home, as cheaply as possible, the condition of things which he would find at an expensive watering place. There is a class of medicines which operate more immediately upon the liver. The most important of these are Calomel, Aloes, Rhubarb, Colocynth, and Epsom Salts in minute doses. Any of these, or various combinations of the first four, may be used so as to produce at least one and not more than two discharges from the bowels every day. As soon as these medicines begin to operate effectually, those dis- charges will be dark colored—sometimes nearly black—being principally the disordered secretion of the liver, mingled with the impure and almost unchanged contents of the engorged vena porta. From the day that these discharges are established, relief begins to be felt. Such are the close and intimate rela- tions between the venous trunks, that, to relieve one of its su- perfluous load, is to relieve them all. The brain and the heart, and all the digestive organs, participate in the change. There is a feeling as if a small part of an oppressive load had been taken off. The judicious use of these medicines will produce these same dark colored dejections, and the sensible feeling of relief, just as long as the diseased state—the venous conges- tion—lasts. This may be two, four, six, or twelve months, ac- cording to the inveteracy and previous duration of the diseased condition. As the cure progresses, the discharges become lighter, and when they assume the natural color produced by the yellow bile of a healthy person, the cure is completed, and all the symptoms of disease are at an end. In speaking of Epsom Salts as acting on the liver, it must be recollected that it only operates in this beneficial way, when used in minute doses, and in minute subdivision, just as we find it in the Epsom Springs which have attained a high reputation for health restoring properties. In doses of the common size the ac- tion of this medicine would be very injurious in the class of cases now under consideration. A teaspoonful dissolved in three tumblers of water, one half to be drunk on going to bed at night, and the other on rising in the morning, will be about the proper mode of using it. But this dose must be increased or dimin- ished, so as to produce the effect already indicated. A less effect will not do—a greater will be hurtful. We have used for this purpose the salts evaporated from the water of the Crab Orchard Springs in Kentucky. All alcoholic stimu- lants must be carefully avoided by the dyspeptic, before and after his cure. As the disease will always be more liable 1856.] Br. John Esten Cooke. 19 to recur than to be engendered in the first instance, he must be a watchful guardian of his own condition, and whenever the state of the system requires it resort, for a day or two, or as long as is necessary, to the same means of relief. Some physicians try to discredit this system, and to sustain the fashionable empiricism of the day, by insisting that these remedies produce the dark colored discharges simply by chemical changes which they effect. There are two sufficient answers to this. 1. The substances mentioned are not capable of producing such effects by chemical changes. 2. They pro- duce these effects just so long as there is the alleged disease to be removed, and no longer. These are the principles by which Dr. Cooke offers health to the Clergy, and to all dyspeptics. The further elucidation of these principles, and their application to other forms of disease, must be left to the student of his works, and to the wisdom of the profession he adorned. Whenever the members of that learned profession will turn to the forgotten works of this great man, they will find there the materials, which, with the pre- sent vastly enlarged knowledge of therapeutic agents, may enable them to build up a firm, deep, and impregnable philos- ophy of Medicine. I