The Medical 
Millennium. 
The Doctorate Address of the Medical 
Department of the University of Louis- 
ville, Session of 1894-95. / 
/ 
By H. A. COTTELL, M.D. 
Professor of Medical ChemistfyJand Microscopy and Clini- 
cal Diseases of the Nervous System in the University. 
Reprinted, from the American Practitioner and News, 
April 6, 1895. 
LOUISVILLE: 
John P. Morton & Company. 
1895 The Medical Millennium. 
The Doctorate Address of the Medical Department of the 
University of Louisville, Session of 1894-95. 
BY H. A. COTTELL, M. D. 
Professor of Medical Chemistry and Microscopy and Clinical Diseases of the Nervous System in the 
University. 
I love the young. They are the “heirs of all the ages.” They are 
the delight of the present and the hope of the future. Civilization and 
society are to-day what they are because of the advent of the young. 
How wonderful, how beautiful, is the complete life ! It comes in like 
the morning, fresh and fair, in garments rosy and golden. It waxes to 
noontide in robes agleam with the full, white light of day, and it gently 
wanes to its setting in vesture of mellow, dissolving tints. 
As the world goes, young men are naturally divided into three 
classes—they who float, they who retrograde, and they who advance. 
Like drift upon the river, some move upon the surface of affairs. What 
their fathers were, if it be easy, they are content to be. They float 
their little distance adown the stream of time, obedient to every cur- 
rent, the sport of every eddying whirl, and should their lives develop 
any thing of note it is incidental or accidental. 
Like meteors pulled from their course by Earth’s superior attrac- 
tion, others become the slaves of passion and animalism, and, as 
meteors take fire when they traverse the earth’s atmosphere, so these 
scintillate as they disintegrate in the downward plunge to death. 
Like earnest travelers, others set out upon the doubtful journey of 
life. They wish for something better than they have known, and they 
push into the unknown with courage, with strength, and with patience. 
They know full well the difficulties and dangers of the way; the dreary 
forests, the stony paths, the barren wastes, the steep ascents, the hidden 
pitfalls, the yawning chasms, the raging torrents, and the thundering 
avalanches which must be traversed, overcome, avoided, or escaped. 
But yonder is the mountain of their hope, fair in the purple distance, 2 
The Medical Millennium. 
and here and there along the way are the footmarks or the blazemarks 
which show that others have made the journey, and on the mountain 
is the temple of success, perhaps of fame. So the travelers toil on, 
and in toiling become telling factors in the affairs of men. 
Gentlemen of the graduating class, with these last I rank you, and 
bid you full welcome to the profession of medicine. You have joined an 
army more noble than any which followed Hannibal, Alexander, Caesar, 
Napoleon, or Wellington; than any which ever wasted or defended 
a country, for your office is to save life, not to destroy it; to keep the 
“temple and the tower” in peace, not to cast them to the ground. 
And now, looking down the vista of your long future, let each one 
of you try to see himself moving there as he would like to be seen. If 
you go there masked, or as the player of a part, the sham may work, 
but not for long; for “ life is real, life is earnest,” and as your object is, 
so will your movements be. One sees himself pursuing wealth, another 
sees himself following fame, but each must see a man not afraid of work 
nor discouraged by reverses. 
How many doctors are rich? Few, indeed; and these few as a rule 
have secured the treasure at the hymeneal altar. As for fame, it is far 
more difficult to gain than wealth; for Fame is a maiden more coy and 
more indifferent to the addresses and protestations of her lovers than 
any heiress who ever wasted her goodly treasures upon a fortune-hunt- 
ing doctor. 
The physician who aspires to eminence among his contemporaries 
may attain it if he be healthful and strong enough to win it by inces- 
sant labor through long and doubtful and discouraging years. But 
eminence in his own day gives him no hold upon real or posthumous 
fame. Says Carlyle: “ It is good to understand that no popularity and 
open-mouthed wonder of all the world, continued even for a long series 
of years, can make a man great. . . . Popularity is as a blaze of illu- 
mination, or alas! of conflagration, kindled round a man, showing what 
is in him, not putting the smallest item more into him, often abstracting 
much from him, conflagrating the poor man himself into ashes and caput 
mortuum. And then, by the nature of it, such popularity is transient. 
Your series of years quite unexpectedly, sometimes almost on a sudden, 
terminates; for the stupidity of men, especially of men congregated in 
masses round any object, is extreme. What illuminations and confla- 
grations have kindled themselves as if new heavenly suns had risen, 
which proved only to be tar barrels and terrestrial locks of straw! The Medical Millennium. 
3 
Profane princesses cried out, ‘One God, one Farinelli!’ and whither 
now have they and Farinelli danced ? ” So wrote the philosopher of 
Craigenputtock of what were once called great artists and literati, and 
the same may be said, but alas! with greater force, of what are called 
great physicians and surgeons, 
Let us consider some of the greater names in our profession and 
note if there be not many of whom you have never heard. Aesculapius 
was a demigod in pre-Homeric and Homeric times, and a myth in 
later classic and sub-classic days. Of the Asclepiades, Machaon and 
Podalirius owe their places in the files of time to the fact that Homer 
mentions them in his poems. Machaon extracted arrows, sucked the 
wounds, and spread upon them the “healing medicaments.” He was 
in high esteem among the Greek heroes at the siege of Troy, and his 
skill in surgery was made the point of a moral by the aged Nestor in 
the famous lines: 
“A wise physician, skilled our wounds to heal, 
Is more than armies to the public weal.” 
Podalirius had his fame much augmented by a lucky accident. 
Being cast on the shores of Caria at the close of the Trojan war, and 
being presented to the king, whose daughter was sick, he conceived the 
brilliant idea of bleeding her. The princess survived the treatment, 
and Podalirius secured her hand in marriage, with a rich grant of land. 
Thus he is named in history as the inventor of phlebotomy, and seems 
to be the first doctor who proved a successful fortune-hunter among the 
fair. Machaon and Podalirius are euphonious names in the history of 
early medicine; but they are doubtfully genuine, and it can not be 
proved that they left behind them any thing of permanent value. 
Hippocrates is really a great name; a mighty pinnacle standing 
sublime and sunset-flushed among long ranges of hills and lesser 
mountains. He had, however, the royal privilege of writing the first 
treatise on the healing art, and therefore he would have been called 
the father of medicine and esteemed great, even if he had been a man 
of small intellect instead of the genius that in truth he was. But 
to-day, while his teachings are a gulf-stream in the sea of medical 
thought, his writings are little known. Few physicians can read his 
works in Greek, and fewer care to possess them in vernacular translations. 
Celsus, the Latin physician, closes the classic era of medical literature, 
and Dioscorides begins the Christian era. They were great men, indeed, 
but notable mostly in the fact that nobody now reads their works. 
•SlC, 4 
The Medical Millennium. 
Galen, the last great physician of antiquity, wrote many volumes, 
which save his name from oblivion. Indeed, he founded a school in 
medicine. But his classic books lie unread of this progressive age and 
moulder in musty libraries. A scholar and a brilliant professor in 
medicine, who often mentioned in his lectures the name and teachings 
of Galen, did not know that he was born in Pergamus, and that he 
wrote his works in Greek. 
From the beginning of the eighth century of the Christian era till 
the beginning of the nineteenth century the list of great names is very 
long. Their writings and their teachings are interesting to the med- 
ical historian and antiquarian. But the most that can be said of most 
of them is that Fame, like the Royal High Executioner in “ Mikado,” 
“ has got them on her list,” and if she should lop off their pseudo- 
immortal heads, “ they never would be missed.” Let us march a few 
of the more distinguished of these worthies out of the shadows, and 
note how many of them are slight acquaintances, strangers, or names 
and nothing more : Paulus Backtishwah, Ishak Ben Solieman, 
Howell, Avicenna, Arnold, John of Gaddesden, Rabelais, Paracelsus, 
Ambroise Pard, Servetus, Vesalius, Valsalva, Fallopius, Harvey, Sir 
Thomas Browne, Malpighi, Lower, Leeuwenhoek, Swammerdam, Nuck, 
Boerhaave, Santorini, Morgagni, Havers, Cullen, Pott, Louis, Meckel, 
John Hunter, Scarpa, Ed. Jenner, Hahnemann, Abernethy, Larry, Aber- 
crombie, Laennec, Bright, Addison, Sir Charles Bell, Velpeau, Graves, 
Duchenne, and following these the host of original workers who, after 
the idol-breaking of the French Revolution and the intellectual awaken- 
ing which ushered in the century of grace wherein we live, have placed 
medicine upon a scientific basis and made their names familiar as 
household words. 
To conserve their fame not a few have had the good luck to have their 
names attached to certain anatomical organs or diseases which they 
first described or discovered, and, as Dr. Holmes has put it, “ the name 
goes rattling down the ages with the disease or the discovery like a tin 
pan tied to a dog’s tail.” And thus the tin pans labeled Bright, Addi- 
son, Pott, Bell, Graves, Basedow, Duchenne, Meniere, etc., get scoured 
into new luster with every diagnosis of the diseases which bear them. 
The student of anatomy is not likely to forget Vesalius after noting 
that his foramen in the sphenoid bone is not large enough to hold a pin 
whereon to hang the label that keeps the discoverer’s name in remem- 
brance. He can never pull open the only valve in the brain, but forsooth The Medical Millennium. 
5 
he must pull up with it the name of Vieussens from memory’s vasty 
deep. Nor will he be unmindful of Hugier or Havers after a sail in 
fancy through the canals whose vapors keep their names from desicca- 
tion in the cells of memory. At the same time he wishes that Nuck 
had been giveji an overdose of nux vomica before he found the 
canal which the most careful dissection generally fails to reveal. He 
knows not whether Arnold was a Benedict or not, but he wishes he 
had been enough of a traitor to Science to have left untraced the 
auricular branch of the pneumogastric nerve. And he would feign 
that Jacobson had been a daughter and trained to simple domestic 
duties instead of the man-child who developed into the minute dis- 
sector who traced out the little thread-like nerve that makes the tym- 
panum a drum to sound his fame adown the ages. He prefers the 
current jellies of bacteriological culture media to that which makes the 
name of Wharton a film upon the mnemonic cells of his cultured brain. 
The love-lorn student can never meditate upon the subtle mysteries 
of the human heart without recalling the great name of Valsalva. He 
wonders if the crimson-flooded sinuses in his fair one’s heart are holding 
his memory with such a fealty as the heart of every subject in the dis- 
secting-room must hold the memory of the great anatomist. If she 
prove untrue, he deems the dereliction due to the baneful influences of 
the fatal tubercle, and as passion’s tempests Lower the name of Soem- 
mering grows green in memory as he fixes with jealous eyes his yellow 
spots upon the hated visage of his successful rival. 
The name of Henle he holds in sweet recollection when he reflects 
upon the service that the loops have afforded him in threading the 
renal labyrinth. But he doubts the truth of the Scottish proverb that 
“it takes many a Meckel to make a muckle’’ in contemplating the 
complexities of the sphenopalatine ganglion. He drinks to the health 
of all the immortal host of anatomists in liquors more stimulating and 
refreshing than that of Morgagni, and, wishing that Scarpa had angled for 
trout instead of anatomico-surgical spaces, he calls into service the long, 
external respiratory nerve for a full breath and a big sigh of relief as 
the Bell is rung which drops the curtain upon his anatomical studies. 
The truly great names in the list, if greatness is to be measured by the 
far-reaching worth of their discoveries, are Harvey, Hunter, and Jenner. 
The first discovered the circulation of the blood, the second made 
surgery a science, and the third unearthed vaccinia, whereby he ren- 
dered harmless the most fatal and loathsome of epidemic diseases. 6 
The Medical Millennium. 
Servetus was also a great man. He discovered tlie minor or pulmonary 
circulation, and his fame should have rivaled Harvey’s; but, alas! for 
human endeavor, the chief claim to notoriety that Servetus seems to 
hold to-day is the honor of having been burned for a heretic when John 
Calvin ruled Geneva. In our time may be added to these great names 
those of Virchow, Graefe, Charcot, Lister, Pasteur, and Koch; and they, 
with that ancient pinnacle, Hippocrates, shall stand high and resplen- 
dent in the light of truth when the hills and the lesser mountains of 
names and fames medical lie leveled by the hand of Time. 
Be ambitious, young man! Aspire to be great; but forget not that 
the lust for fame is vanity, and that he who follows after fame need not 
be disappointed if, too late to retrace his steps, he finds himself in the 
bogs, and not upon the shining heights of life, with a will-o’-the-wisp 
vanishing into thin air under his nervous grasp. 
Since wealth is fickle and fame is vain, what shall the young doctor 
place before him as the worthy object of his life-long endeavor? The 
cause of a common humanity. For an honest man, however humble, 
striving to do his work in the world, will ever be an object of affection- 
ate regard to him who meditates deeply upon the mystery of life. 
Says Huxley: “We live in a world which is full of ignorance and 
misery, and the plain duty of each and of all of us is to try to make the 
little corner he can influence somewhat less miserable and somewhat 
less ignorant than it was before he entered it.” 
In this era of our worky-day world every thing seems to be giving 
way to business and the things that make for gain. The poets are little 
read, art finds but slim support, and science would have as poor a show 
as it had in the days of the Borgias or of the Spanish Inquisition if it 
were not that men have found out how to make it contribute directly 
to material prosperity. 
This is the age of mechanical achievement, of steam and electricity, 
of telephones, phonographs, and kinetiscopes. Never was the inventive 
genius of man, in things which make for wealth, at such high tide as 
now. The devices, the inventions for saving man labor and making 
him rich are marvelous in our eyes, and will be the wonder of the com- 
ing ages. But are we not too rapidly exhausting the resources of the 
world? The noble forests, “God’s first temples,” where our fathers 
worshiped God and first pronounced the creed of liberty, are going, 
and will soon be no more. The streams which once drove our saws 
and turned our millstones and spindles are too weak to compete with The Medical Millennium. 
7 
our mighty steam-engines, and waste their force as they wander 
seaward. The wind besieges the hills or blows over the meadow 
sweeps in vain, no fans inviting it to become what it is willing to be, 
the servant of man. The mighty pulses of the sea are wasted in beat- 
ing the sands and rocks of the shores, while the coal measures of the 
earth are plundered daily of the millions of tons required to feed the 
hungry furnaces of the factories and mills of industry over the civilized 
world. But when we reflect that the best boilers and engines ever con- 
structed waste at least 70 per cent of the force disengaged by the oxida- 
tion of the coal in their furnaces, and that on an average the waste is 
from 95 to 97 per cent, we may well pause and consider if our boasted 
material progress is not, after all, like a blazing pine torch, brilliant, 
indeed, but brilliant only because of its rapid destruction. 
In this are we not robbing posterity? For, certain as this waste 
of power goes on for a few centuries, the coming man will have to 
find new sources of kinetic energy or go back to the simple devices of 
primitive civilization. And after all does our boasted material progress 
mean real progress for man ? Are not the rich only made richer thereby 
and the poor poorer? Are not men of this day dividing into two 
classes, the rich master and his laboring slave ? He who does not see 
this has but to reflect upon the doings of the labor organizations and 
the recent strikes, the occasional puffs of smoke, the low mutterings 
of subterranean thunder, and the earth tremblings, which seem to 
presage a tremendous volcanic upheaval. 
But great upheavals may make new continents. Out of compost grow 
fair fruits and flowers. Through fermentation of the blood of the grape 
cometh the mellow wine. The golden age of science has been ushered 
in, and the prophetic eye can see in the dappled east the rosy flush which 
betokens the dawning of the medical millennium. For side by side with 
this material progress is the advancement of your profession. Instru- 
ments of precision have been put in the doctor’s hands which make pos- 
sible diagnoses and surgical operations never dreamed of by our fathers. 
In addition to this medicine has made such advances through recent 
discoveries in bacteriology and in serum therapeutics, and has acquired 
such facilities in hygiene and in prophylaxis, that epidemics are getting 
to be things of the past, while the list of preventable diseases is won- 
derfully extended. Yellow fever respects the mandates of quarantine, 
and cholera and the plague do knock in vain at Hygeia’s sevenfold-bolted 
doors, while those subtler sporadic diseases that prey on individual vie- 8 
The Medical Millennium. 
tims here and there have had wrung from them the secret of their 
power, and must sooner or later surrender unconditionally to science. 
Diphtheria, that fell destroyer of young life, has, like the Sphinx of 
Thebes, at last encountered an CEdipus who can guess her riddle, and 
must soon submit to chains, if not to death. And consumption, more 
dreadful and more dreaded than the Gorgonian Medusa, has been 
tracked to her dark, secret hiding place, and must be slain. 
Upon the walls of the oldest church in a neighboring city is a tablet 
bearing this melancholy inscription : “In memory of James Wade, who 
died on the 7th day of October, a. d. 1795; Nicholas Everett Wade, who 
died on the 31st of November, a. d. 1795; Sarah Everett Wade, who died 
on the 18th day of December, A. d. 1795; Stephen Wade, who died on 
the 22d day of December, A. d. 1795 ; Noah Wade, who died on the 20th 
day of October, A. d. 1806, children of David E. and Mary Wade; also 
Mary Wade, consort of David E. Wade, who died on the 28th day of 
April, a. d. 1811.” 
It does not take a seer to read in these solemn lines the doings of 
tuberculosis a hundred years ago. It is a history repeating itself in the 
memories of us all till hope grows weak and the heart sick. Can we 
not go back a century and weep with that mother who, like Niobe, saw 
her children slain by arrows more deadly than those of Artemis or 
Apollo. The consort of her young life and love gone many years 
before, chased into the shadows by the same destroying demon, and 
the children which love had seemingly left to be the stay and comfort 
of her advancing years, withering one by one, like roses blight-smitten 
when the buds gave fairest promise of fragrance, bloom, and beauty. 
In vain were tears and cries and prayers; in vain were drugs, charms, 
amulets, and simples; in vain was her journey to the wilderness upon 
the banks of the beautiful Ohio. No priest could placate with sacrifices 
the angry god. The decree had gone forth, and the fair victims, each 
in his turn, were pitilessly slain. 
Such comfort as religion and poetry could give, this mother had; 
but we know too well that she went broken-hearted to the grave. 
There are many such death-wasted and disease-blighted families to-day, 
but science speaks to them words of good cheer. She shall pluck 
the arrows from the quiver of the implacable destroyer, and say to 
the fond mother there shall be no more weeping Niobes because of the 
ravages of consumption, “in Rama” no more “lamentations and weep- 
ing and great mourning, Rachel weeping for her children, and refusing 
to be comforted because they are not.” Medical science has mastered The Medical Millennium. 
9 
the problem of eliminating phthisis from the causes of death, where, 
like a fury on a mountain of skulls, it stares the statistician out of 
countenance and issues death warrants for more victims than are slain 
by all the wars, pestilences, and famines of the earth combined. That 
tuberculosis can be stamped off the face of the earth is a hygienic 
possibility, and when mankind shall become as much in earnest in 
securing health as in securing wealth it will be done. 
The great problems in medicine to-day are hygienic, not therapeutic, 
though therapeutics seems to be getting the better of diphtheria. The 
most desirable thing in the affairs of man is, first, the making of people 
healthy, and, second, the making of them happy. The dyspeptic Puri- 
tanism which whines over the necessity of suffering as a means of 
grace can have no place in a superstition-free and scientifically-enlight- 
ened philosophy. What we want, and what hygiene is yet to give us, 
are comfortable homes for all mankind, aseptic alike of the germs of 
zymotic disease and of the taints of the common vices, where noble 
and healthful men, noble because they are strong and healthful, and 
sweet and beautiful and healthful women, beautiful and sweet because 
they are healthful, shall rear their little families of disease-unblighted 
children, happy because healthful, and giving promise of future attain- 
ment in the good, the beautiful, and the true, promises which shall not 
be broken because hygienic medicine has made the keeping of such 
promises possible. 
The classic Greeks well understood the necessity of hygiene, but, as 
they had no science to solve the problems for them, their methods were 
often cruel and at best only partially effective. They destroyed the 
sickly and weakling children by exposing them in the forests, where 
they died of starvation or became the prey of wild beasts. For those 
that were considered fit to survive they prescribed temperance in diet 
and the most invigorating physical culture. The result was a race of 
men and women the like of whom the world had never before seen, nor 
since has seen. A walk through Attica, or Peloponnesus, or down the 
lovely vale of Helicon, in the palmy days of Greece (could he have 
been there), would have brought the blush of shame to the cheek of 
any modern lover of his kind; shame at the thought of what man is 
in comparison with what he could be. Noble and strong and beautiful 
men and women were seen on every side, and with this physical per- 
fection went hand in hand a mental strength that needed only the sweet- 
ening and restraining influences of a true religion to have made them The Medical Millennium. 
as strong and as beautiful in morals as they were in body and in mind. 
What they did in war let Marathon and Salamis and Thebes and Ther- 
mopylae attest. What they did in literature and in art the world ever 
since has been trying to do, but alas ! in vain. But, having no science 
to guide them, cholera, yellow fever, and the plague blew out of the 
Levant the breath of death upon them, and phthisis and other diseases 
invaded their fair ranks. 
Hygiene is the glory of modern medicine, and her glory will brighten 
with the age that the centuries shall put upon her. Not only shall pre- 
ventable diseases cease to be, but many affections now deemed inevita- 
ble must also cease to be. For the time shall come when all victims of 
hereditary disease shall be barred by statutory law from reproducing 
their kind. Of course it will be said that such legislation would put an 
embargo upon personal liberty; but if this were true the embargo would 
be off in a few generations, to the lasting good of the human race. Nor 
is it too much to hope that, under the scientific enlightenment which 
must come in the onward march of truth, the victims of hereditary 
disease will rise into fuller and higher liberty and refuse to be the 
mediums of the descent of disease to coming generations. 
You will not live to see the millennium which I have attempted to 
describe, but you may do much by your work and teaching and influ- 
ence among men to hasten the glorious dawning. For in the higher 
reading of the law of the survival of the fittest these seemingly utopian 
ideas are scientific truths, and that they will be fully realized no doctor 
with faith in medicine and faith in the final triumph of good can for a 
moment doubt. 
When Fielding’s traveler from this world to the next had gone some 
distance through hell he expressed to his guide surprise that he had 
seen no physicians there. The guide gave him a knowing look and 
told him not to go too fast. Said he: “Hell appears just now to be 
without doctors because they are all over in the City of Diseases hold- 
ing a convention for the purpose of devising some way of purging the 
soul of its immortality.” The doctor in the flesh may be laughed at 
to-day by the satirist as indulging in utopian visions of disarming dis- 
ease and extracting the sting of death, while in fact disease rages on 
every hand and the undertaker has enough to do. 
The most poetic hygienic dreamer knows full well that diseases of 
degeneration will always be, and that “all that live must die, passing 
through nature to eternity.” But he knows also, as no one else can The Medical Millennium. 
know, that in the fullness of time, under the fuller knowledge to come, 
every infectious and contagious disease will cease to be. To further 
“this consummation” is distinctly the duty of every young man who 
espouses medicine. Keats, telling what the poet should be, says: 
“’Tis a man who with a man 
Is equal, be he king 
Or poorest of the begger clan, 
Or any other wondrous thing 
A man may be ’twixt ape and Plato.” 
To the good physician the meanest and weakest and worst member 
of the human family is a brother, whose sufferings must be assuaged 
or mitigated, whose vices must be corrected if possible, and whose soul 
must be started on the upward journey to the higher spiritual spheres. 
You may go in and out among the rich, but if you are worthy of your 
calling much of your life will be passed among the poor, whose heart- 
full thanks, with your own sense of duty done, will be your only but 
sufficient reward. 
With such a heritage as medicine gives you, and such incentives to 
work as it holds out to you, consider well, young man, what you shall 
do. What part are you to take in the mighty work ? Will you turn 
your profession into a mere means for acquiring money, thus making it 
a business simply ? Will you angle for popularity or fame ? Or will 
you hold the office as one of priestly function, and, planting yourself 
upon a broad philanthropy, resolve to do your full duty to medicine 
and to mankind, be the result wealth and fame or poverty and a name 
unknown ? 
The young physician who makes this vow and is faithful thereto 
goes forth into a world of sin, ignorance, and suffering the noblest of 
missionaries and a ministering spirit of archangelic dignity. “Gedenke 
zu leben,” said the great Goethe. “Yes, ‘think of living.’ Thy life, 
wert thou ‘ the pitifullest of all the sons of earth,’ is no idle dream, but a 
solemn reality. It is thy own; it is all thou hast to front eternity with. 
Work, then, . . .—‘like a star, unhasting, yet unresting.’” 
Louisville;.