H. A. COTTELL, M. D. 
Reprint from 
American Practitioner and News 
for March 20, 1886. Gsuhetigs op CQedigine: 
$ddtjes$ 
IN THE 
MEDICAL DEPARTMENT OF THE UNIVERSITY OF 
LOUISVILLE, 1880. 
H. A. COTTELL, M. D., 
PROFESSOR OF MEDICAL CHEMISTRY AND MICROSCOPY IN THE UNIVERSITY. 
LOUISVILLE, KY. 
PRINTED BY JOHN P. MORTON AND COMPANY 
1886 ESTHETICS OF MEDICINE. 
The life of the physician, that of the soldier 
during the hard campaign excepted, is the 
most trying of human callings. 
He is the servant of servants, and the only 
laborer whose hours of work and of rest are 
not laid down upon the circle of the dial. If 
he be young, he must await the tedious com- 
ing of business with chastened patience and 
hungry solicitude. If he be old, and have 
failed to garner a goodly harvest of things 
material, he must spend his days of failing 
strength in bitter contest with want and fam- 
ine; and with all the odds against him, since 
the profession to which he has devoted his life 
will have so consumed him in mind and body 
as to leave him scarcely a resource that may 
be utilized in practice, craft, or trade for 
further support. 4 
Esthetics of Medicine. 
If he be of middle age, he must work with 
tireless energy, and carry a cheerful heart, a 
clear head, and a steady hand under the weight 
of grave responsibilities. Like Hannibal, he 
must allow “no toil to fatigue him bodily, or 
depress his spirits. Heat and cold he must 
bear alike ; his rule as to food and drink must 
be set by natural appetite, not pleasure. His 
times of sleeping and waking must not depend 
on its being day or night; such hours as remain 
after his work is finished he may give to repose.” 
If he be married, his family must suffer neg- 
lect; if he forswear the happiness of domestic 
life, there is great danger that the public will 
forswear him ; if he essay to keep abreast with 
the progress of his profession by reading and 
study, he must con his books at precarious in- 
tervals, with eye to the clock and ear to the 
bell, or neglect appointments and lose caste with 
his clientele; if he fail to read and study, he 
must soon fall behind in the race for honor and 
emolument; if he be endowed with uncommon 
talent or genius, and seek fame in the line of 
original research, he will find this rule incom- Esthetics of Medicine. 
5 
patible with the demands of a successful prac- 
tice, and must either relinquish his cherished 
schemes, or follow them under the ban of pov- 
erty, if he be not counted crack-brained and 
visionary. If he have a taste for the fine arts, 
and acquire skill in letters, music, -or painting, 
he must keep his achievements here a sacred 
secret, since, if known as an amateur in art, he 
will soon be counted an amateur in medicine 
to his lasting professional hurt. If he bring 
business principles into his practice, charging 
fees commensurate with the worth of his work, 
and collecting them promptly, he will be 
esteemed hard and grasping. If he make 
small bills, and bide with patience the time 
of tardy payers, his service, like his fee, will 
be rated low, and, again falling sick, the un- 
grateful patient will ignore*’him for some pro- 
fessional neighbor more worldly-wise than he. 
Like Ulysses of old, he must steer the frail 
bark of his destiny adown the narrow strait 
that flows ’twixt Scylla and Charybdis, fam- 
ine on the one hand and consuming toil on 
the other! 6 
Esthetics of Medicine. 
I have set in shadow the way of the life 
which you have chosen, and to which I now 
welcome you; but only as the painter lays in 
somber tints the ground-work of his picture. 
If my design miscarry not, the canvas will 
soon show brighter colors, with views of hill 
and valley, lake and river, field and forest, 
rill and fountain, and a flood of sunlight over 
all. 
It is clear that when viewed superficially as 
a laborer at his work, the physician does seem 
to lead a hard, unenviable life, and certain that 
any other calling of equal or approximate dig- 
nity gives promise of greater attainment in 
what the world calls success and happiness than 
is possible in medicine. But it is of easy dem- 
onstration that to him who holds medicine as a 
sacred calling and flbeys her high behests with 
an eye single to her beauty, and a mind to 
meditate her deeper lessons, she reveals un- 
failing sources of true wealth and happiness. 
Having espoused medicine, the student soon 
discovers within his legitimate province treas- 
ures of knowledge, science, and art, which no Esthetics of Medicine. 
7 
human effort or capacity may exhaust or appro- 
priate. The first essay is perhaps discouraging 
and seemingly without promise. The study of 
the human frame is a wearisome task. Dry 
bones are an abomination to the tyro in anat- 
omy; but as he comes to know more of the sub- 
ject, his interest grows apace. He notes the per- 
fect fitness of each bone for its peculiar office, 
in size, structure and form ; its graceful curves 
for the breaking of shock, and the deep-laid 
devices by which it is given strength with- 
out clumsiness and amplitude without undue 
weight. Here are areas for muscular attach- 
ment, so disposed that muscle may aid or an- 
tagonize muscle in exact measure, pointing to 
precision, grace, and perfect equilibrium. 
These, and far more than these, are weighed 
with an eye to their nice significance, until 
the skeleton entire stands before his admiring 
gaze, like some stately ruin, wherein every 
foundation stone, every column, arch, and arch- 
itrave bears testimony to beauty and use in 
the Maker’s mind. 
He sees channels cut through bone or laid 8 
Esthetics of Medicine. 
in flesh for artery, vein, nerve, and lymph 
vessel, and contemplates the beautiful adapta- 
tion of the heart, the lungs, and the digestive 
organs, each to its appropriate end ; and then, 
that all may be nourished and directed in 
their appointed work, he sees intricate but per- 
fect systems of vessels and nerves bringing 
every part of the organism into vital communi- 
cation with the centers of force tmd nutrition. 
Looking deeper, he perceives that these many 
organs, however variant in form and function, 
are all composed of one simple anatomical ele- 
ment, the cell; and that of the countless myri- 
ads of these cells which make up the body as 
a whole, each is endowed with life and set to 
the performance of its own predestined office. 
And musing on this matchless mechanism and 
its marvelous adaptation to its grand purpose, 
interest mounts to enthusiasm, while the words 
of the Psalmist, “I am fearfully and wonder- 
fully made,” come to his mind with all the 
force and beauty of their divine import. 
Pursuing his investigation further, physiol- 
ogy bids him contemplate the functions of the Esthetics of Medicine. 
9 
economy, and wonder is lost in bewildering 
delight. Pervading all, and governing each 
organ, each cell, is that subtle essence, that 
mystery of mysteries, life. It flows into mat- 
ter, seemingly inert, and lo, all is motion! 
Atom and molecule own new affinities and 
wake to higher work; each tiny cell springs 
into being at the touch divine, and like a new 
created world enters upon its ordered cycle of 
growth, maturity, and decay; each finished or- 
gan obeys the magic mandate and asserts its pre- 
ordained function; each system owns its heaven 
appointed hest, and all in rhythmic order, each 
for itself and yet for all, make up the harmony 
of the perfect whole—as many instruments 
together in the orchestra of varying timbre, 
range, and power, each sweetly answering its 
player’s touch, through the appointed score 
and to the measure of the leader’s beat, sound 
out the phrases of some noble symphony. 
Now he contemplates the brain (the organ of 
the mind) and its inexplicable phenomena. 
How regal are its functions, receptive, con- 
servative, creative! attentive to every appeal 10 
Esthetics of Medicine. 
of its own little world, but alive to the won- 
ders of the great world as well; open to the 
perception of its ineffable beauty and busy 
with the solution of its intricate problems ; the 
meeting place of earth and heaven, the debata- 
ble ground whereon none may set the line 
which shows where the functions of matter 
end and the offices of spirit begin. And as 
he meditates the wondrous theme, to him how 
apt, how true, and how truly inspired are the 
apostle’s words: “ Ye are the temple of the 
living God.” 
Or, turning to the senses whereby the man 
takes cognizance of the surrounding universe, 
let the student consider the organs of sight and 
hearing, those exquisite mechanisms through 
which impressions of color, form, and sound 
are made upon the brain, which, shaped and 
blended in the artist’s soul, who knows the 
secret of their deeper harmonies, are bodied 
forth in poetry, sculpture, painting, and mu- 
sic. It has been said, with truth and poetry, of 
things wonderful and beautiful in nature—man, 
beast, bird, insect, flower, and crystal—that Esthetics of Medicine. 
11 
they are the thoughts of God; but none the 
less truly so are poems, statues, pictures, songs, 
and symphonies, thoughts of the Omniscient 
One in sublime expression through the medium 
of him who stands erect in his Maker’s own 
image. 
Chemistry ministers to the esthetic sense in 
every test, and the microscope opens to his 
view a world of dainty beauties; while both 
alike suggest to the student conceits for the 
fancy and themes for exalted thought. 
The first admonishes him ever of the reign 
of law, and that matter obeys the inflexible 
mandates of a power impersonal and cold, 
from the infinitely great to the infinitely small, 
from world to atom, from the starry systems 
of space to the molecules of the water-drop. 
The light, soft, white precipitates, and color 
changes in the test-tube or on the tile, suggest 
the fleecy skirts of the summer clouds, or the 
feathery fall of the winter’s snow, or bring to 
mind that trick of Nature’s thaumaturgy which 
decks the trees with green in spring-time, the 
flowers with rainbow hues in summer, and leaf 12 
Esthetics of Medicine. 
and fruit with gorgeous dyes in the mellow 
autumn. 
One must wade through a sea of fallen leaves 
in the wood, after the heavy frosts of autumn, 
to form any conception of their vast numbers 
as they grew upon the trees; and when the 
student reflects that from the time of its putting 
forth till its maturity, each leaf is a little phy- 
sio-chemical laboratory wherein life and light 
are working out countless subtle processes, 
whose end is to serve the creature needs of 
man and adorn his world with beauty, he may 
take comfort in the thought that though our 
first parents were driven forth from Eden to 
labor for their bread, the seeds of the trees 
and the plants of Paradise must have been 
wafted abroad over the earth by the winds 
in blessing, and that still “the Sovereign 
Planter frames all things to man’s delight- 
ful use.” 
If time hang heavy on his hands, the young 
physician may now and then find solace in 
the charming revelations of the spectroscope. 
In our day decorative art, in the making of Esthetics of Medicine. 
13 
books, stationery, and cards for the exchange 
of friendly greetings, has reached a stage of 
high development, if not perfection. This 
fact bears graceful testimony to the rapidly- 
growing culture and taste of o.ur people, and 
shows how naturally things promotive of hap- 
piness associate themselves with things beauti- 
ful. It is fit that our poems, the gems of 
thought, should have exquisite setting in de- 
sign and color at the artist’s hand, and that the 
flowers should adorn with heaven-born tints 
our messages of love ; but with what a sense of 
the divine appointment of wisdom and beauty 
does the chemist read the pencilings of light, 
the handwriting of God, upon the spectroscopic 
page. Here are unfolded not a few of the 
deep-laid secrets of nature in things near and 
far; here are the signatures of the elements of 
earth and air ; here are the hieroglyphics of the 
stars ; here planet and sun, in our own magnif- 
icent system, and fixed star and nebula, from 
out the infinite depths of space, declare the na- 
ture and state of their elements, and “ repeat 
the story of their birth,” while light, the mes- 14 
Esthetics of Medicine. 
senger by which this revelation comes, makes 
known the mystery of color, and tells us how 
the rose and lily are arrayed; how the “ iris 
changes on the burnished dove;” how “morn, 
with rosy hand, unbars the gates of lightand 
how the sinking sun doth set the rainbow in 
the passing shower, or, setting, paint the fleecy 
clouds with red and purple and gold and all 
the soft dissolving tints that twilight owns. 
A popular esthetic writer has prophesied the 
coming of a new art, wherein light, in color, 
shall be made by harmony, rhythm, and mod- 
ulation to stir the emotions through the eye, as 
does sound in music through the ear. If the 
“insubstantial pageant” of this dream shall 
ever pass before our wondering eyes, it will 
be under the wave of the magic wand of 
chemistry. 
How kingly is the estate of the astronomer, 
as he scans through the telescope the shining 
orbs of the infinite abyss, and hears, as they 
move in rhythmic order round the central soul, 
the far-off music of the spheres ! With what a 
perception of the divine harmony of things, and Esthetics of Medicine. 
15 
the majesty of the Creator, does he contem- 
plate star after star and system after system, 
as they, revolving, sweep their mighty curves 
at the order*of eternal destiny, till he is lost 
in the infinitely great ! 
We may well envy him his supreme delight; 
hut the microscope, now an instrument es- 
sential to the physician’s calling, unfolds to 
his view a universe no less marvelous and 
beautiful. Here he may pass from low to 
lower forms of the Creator’s handiwork until 
lost in the infinitely small. Here are the same 
evidences of wisdom in the adaptation of means 
to ends, the same nicety of adjustment in little 
life to the conditions of its environment as that 
which insures the survival of the fittest in the 
fauna and flora of the greater world, with a 
perfection of finish which ministers unceasingly 
to the sense of order and the love of beauty. 
In the great world there are blended with, or 
offsetting the fair features of nature, things 
rude and unsightly; in this little world every 
thing is beautiful. From the faultless facet 
and mathematically-correct angle of the tiniest 16 
Esthetics of Medicine. 
crystal to the elaborate and exquisitely wrought 
designs in the diatom ; from the headed mi- 
crobe of zymotic disease to the luxuriant forest 
of mold-fungi; from the dainty*striations of 
muscular fiber to the extravagant decorations 
of the insect, there is nothing that does not 
show the touch of an infinite artist delighted 
with his work. 
Although not exact or shapely in all her pro- 
portions, medicine may be said to hold among 
her sister sciences princely rank. She levies 
tribute from each and all that it may be 
melted anew in her crucible, stamped with her 
image and superscription, and distributed for 
the common good. In acquiring his education 
the physician necessarily gains some knowledge 
of collateral branches of science. Geology is 
one of these, and botany comes closer home. 
To those of you especially whose choice shall 
be a country life, these charming studies will 
afford abundant opportunity for healthful di- 
version and culture. 
Carlyle has well said that “we see in 
any line of investigation no more than what Esthetics of Medicine. 
17 
we bring the eye to see.” It is impossi- 
ble that you should have passed through 
the scientific training essential to your call- 
ing without having acquired a fund of knowl- 
edge, not strictly medical, which with culture 
and a little technical study will enable you 
to read in the book of nature lessons of life 
and death too deep for the conning of the unin- 
structed swain, while all your finer senses wake 
to the beautiful and joy with ravishment. Like 
Shakespeare you may find sermons in stones; 
with Wordsworth your inward eye may per- 
ceive the deeper truths of nature, while your 
heart is “dancing with the daffodils;” like 
Burns you may eloquently discourse the prob- 
lem of life with the mountain daisy ; like Bry- 
ant you may learn the lesson of immortality 
while gazing into the mild blue eye of autumn’s 
latest, loveliest flower, the fringed gentian. Nor 
should you fail to add to your capacity for hap- 
piness and usefulness by converse with the poets, 
and hearing when opportunity offers, if you 
may not study, the works of the great masters 
in music. From the dear society of these 18 
Esthetics of Medicine. 
sweet singers you will make the daily rounds 
of duty with your soul vibrating to the rhythm 
of pure thought and your heart attuned to 
moving melody, a better doctor and a better 
man. 
How the tedium of the physician’s long ride 
may be lightened, or his weary watch by the 
bed of suffering shortened, by delightful trains 
of thought and fancy, inspired through some 
noble verse or melting melody, called into mem- 
ory by some passing scene or incident! If he 
ride by day, a panorama of delightful land- 
scape goes circling past him, while he alone 
seems fixed and motionless. The sky shapes 
figures to his fancy in the sailing clouds, or re- 
freshes his vision with the soft light of its azure 
depths. The rippling laughter of the stream 
greets him at every bridge and ford, the birds 
sing carols from meadow, bush, and brake, 
the winds make music in every wood and field, 
while in all and through all he may hear, if 
he will only listen, an anthem of praise to God 
and good will to men. If, robbed of natural 
rest, he go forth by night at the call of suffer- Esthetics of Medicine. 
19 
ing, the moon unveils her lovely face and, 
throwing over hill, dale, meadow, and stream 
her magic light, sets to his vision scenes more 
beautiful and forms more fair than ever met 
the poet’s eye in realms of elf or fairy. Or, 
if she shine not, the stars will shower their 
myriad twinkling beams upon him, and gently 
woo his thoughts from earth to heaven. He 
may feel, like Job, the sweet influence of the 
Pleiades, or muse like Homer on the Bear 
Who wheels on high his circling course, 
With watchful eye upon Orion fixed, 
And takes no part in the ocean’s baths. • 
Or, if the season fit, the earth may hold his 
thought with charms no less enticing. He 
sees “the glow-worm golden in a dell of 
dew,” and myriad fire-flies twinkling in the 
meadow grass—a moon in miniature, a mimic 
constellation on the earth—and as he asks, with 
Milton, 
What if earth be but the shadow of Heaven, and 
things therein, 
Each to the other like more than on Earth is 
thought, 20 
Esthetics of Medicine. 
the scene becomes religion and the earth holy 
ground ; for not alone upon the inspired page, 
hut through all nature God reveals himself to 
man. 
But anon the whippoorwill from out the deep 
recesses of the grove sings her sad song; the 
mocking-bird awakes the solemn echoes of the 
glen; the night wind, like some unhappy 
ghost escaped her prison-house, wails in his ear 
with mournful cadence and the spirit of melan- 
choly steals in upon his musings. The inces- 
sant whir of insects in the trees strikes discord 
with thh moaning wind, and brings to mind the 
weary round of duty, the noisy contentions, the 
groans of our sin-cursed, suffering race, whose 
common heritage of disease and death calls him 
to a life of irksome toil and harrowing experi- 
ences. And now black clouds come trooping o’er 
his head, the stars are in eclipse, the tempest 
howls about his ears, and the pitiless rain beats 
in upon him, making him miserable in body 
and mind. But he remembers that his is a mis- 
sion of mercy, and the inner spirit whispers cour- 
age as he pursues his dark and difficult way. Esthetics of Medicine. 
21 
The appointed place is reached, the sufferer 
relieved, and as he reads gratitude in the eye, 
or hears it from the lips, and meditates upon 
the sweet beneficence of his chosen calling, he 
finds himself already well upon the way of 
reconcilement with fate. 
The storm has passed, and, turning home- 
ward, he beholds in the east the roseate hues 
of promised day. The sky grows brighter and 
the clouds put on their many-tinted robes of 
light; more radiantly beautiful the changing 
colors grow with every flying moment, till the 
sun springs from his couch of burnished gold 
and “flames in the forehead of the morning 
sky.” Courage is restored, peace pervades his 
spirit, and happiness returns. The smile of 
morning is all the sweeter by contrast with the 
frown of night, and, bending himself to duty 
with a keener sense of its sacred require- 
ments and privileges, he lays the lesson to his 
heart. 
But it may be suggested that the legitimate 
demands of medicine must be the doctor’s first 
and chief concern, and that he who does his 22 
Esthetics of Medicine. 
duty by his patients and himself will find the 
way in which I have ordered his walk to hap- 
piness a by and forbidden path. ’Tis true that 
the long and weary rides of the physician may 
be fitly lightened and shortened by meditation 
upon the great themes of pathology and thera- 
peutics ; but “man shall not live by bread alone,” 
and he who, failing to perceive the relativity 
of all knowledge, shall restrict his musings 
solely to things of the shop, will face the great 
problems of medicine and surgery without that 
mental grasp which is essential to their proper 
solution, if he do not in time dismiss them alto- 
gether from his mind. His diagnosis will too 
often be made by guess, and his therapeutics 
follow the rut of blind routine. Having failed 
to learn the true lesson of life in the inspired 
pages of Nature’s book, he will read the great 
works in medicine (if he read at all) to little 
purpose, while his ministrations to the sick will 
fail of that inspiring sympathy which wins the 
patient’s trusting confidence—a powerful adju- 
vant to his prescriptions and an earnest of 
future calls. Esthetics of Medicine. 
23 
The most successful contributors to medical 
science and its classic authors are and have 
ever been men who have rounded out their 
mental proportions by general knowledge and 
large culture. 
But while I have laid the foundation of your 
success in culture, and the ten thousand sources 
of happiness which it opens to your view in the 
contemplation of the known in medicine, na- 
ture, and art, I would not have you unmindful 
of the beauty and worth of hypothesis and 
theory. By this I do not mean that you shall 
hold truce with those wild vagaries which too 
often pass muster under these names; but 
that you shall now and then give exercise to 
that imperial faculty, the reason, in the care- 
ful following of some healthful sequence of 
thought, from its simple beginnings in familiar 
fact, onward and upward to the utmost border 
of the known, and knowing where you stand 
have courage to take another step. It may not 
be your privilege, like the great author of the 
Philosophy of Clothes, to “ plant new stand- 
ards, or found new habitable colonies, in the 24 
Esthetics of Medicine. 
immeasurable circumambient realm of noth- 
ingness and night,” but the exercise will give 
health and vigor to the mind and invest the 
familiar facts of science with new features of 
beauty. 
Theory and hypothesis have done quite as 
much for the advancement of science as the ob- 
servation and annotation of facts. They are 
the chief foundation stones in the building of 
all our grand generalizations. 
I trust that I have, in some measure, made 
good my promise to replace with brighter col- 
ors the dark outlines of my sketch of the doc- 
tor’s life, and to throw upon the picture a 
flood of Heaven’s own sunlight. But while 
the sketch was none too dark for the con- 
templation of him who would enter the pro- 
fession with motives of sordid gain, the picture 
which I leave with you sets forth in no ad- 
equate manner the wealth of beauty that shall 
be revealed to him who espouses medicine with 
heart and head accorded to the work, and as- 
pirations worthy of his noble calling. 
When Ulysses landed upon the iEoean isle, Esthetics of Medicine. 
25 
he sent a band of his followers to the fair halls 
of Circe of the braided tresses. The artful 
goddess threw open her shining doors, wel- 
comed them warmly, and feasted them royally, 
but soon bringing them under the spell of her 
enchantments, transformed them into swine, 
drove them into the styes and made fast the 
door. If, under my view, the fair goddess, 
whose domain you have just entered, may seem 
to have dubbed you beasts for her service or 
diversion, take heart, for Circe in good time un- 
barred the door, and called forth the hapless 
prisoners; when, lo ! under her magic touch 
each swine became a man again, but now more 
youthful and comely in outward seeming and 
stronger than before; and feasting them for 
many days with flesh and honey-hearted wine, 
she sent them with blessings upon their way. 
In coming into the realm of medicine, you 
may at first fancy that you have been put under 
the spell of a cruel enchantress, who dooms 
you to tasks irksome and grievous, if she does 
not transform you into beasts; but ere long 
you shall see, if you serve her faithfully, that 26 
Esthetics of Medicine. 
her service, though trying, grows lighter in the 
doing, while, under the guiding of her magic 
hand, the moral, intellectual, and spiritual man 
in you is ever renewing his youth, acquiring 
beauty, and gaining substantial strength.