Removed from Virginia in 1827 to fill the chair of the Theory and Practice of Medicine in Transylvania University, which had just been vacated by Doctor Drake. He had already acquired a high reputation as a practitioner of medicine; he had published an able essay on autumnal fever in the _Medical Recorder_ for 1824, and had in the same year produced the first volume of his very remarkable _Treatise on Pathology and Therapeutics_, the second volume of which he published in Lexington in 1828. The promised third volume, which was to complete the work, never appeared. He remained in Transylvania Medical School until 1837, when, under the leadership of Doctor Caldwell, he with Doctor Yandell, removed to Louisville to engage in originating a new medical college, the "_Louisville Medical Institute_." In this and in its successor, the "_Medical Department of the Louisville University_," he remained until a few years before his death, which occurred on his farm on the Ohio River above Louisville, October 19, 1853, in the seventy-first year of his age. [Illustration: DOCTOR JOHN ESTEN COOKE. From a Photograph.] Doctor Cooke was in many respects a remarkable man, who acquired a widespread reputation in this country, especially in the Mississippi Valley. His fame was mainly built on his celebrated theory of the universal origin of disease, which was, that disease was caused by cold or malaria. That especially it commenced in weakened action of the heart, resulting in _congestion of the vena cava_, its branches and capillary distribution, and that fever was but the reaction of the vital force to overcome this condition, which unrelieved would result in death. According to him, all autumnal and malarial fevers were but variations of one diseased condition, and even those fearful scourges the plague, cholera, yellow fever, dysentery, etc., were simply varied forms and conditions of congestion of the _vena cava_. To destroy this many-headed hydra--while he would use cold water to reduce too great febrile excitement and even sometimes give antimonial wine[50]--his main reliance was on blood-letting and cholagogue purgatives, as he believed it was by increasing the secretion of the liver and causing it to pour out consistent "black bile" that the venous congestion was to be relieved and the patient cured. Amongst all these remedies calomel was his chief reliance, and was given by him in doses not measured by the balance but by the effect they produced; so that in the latter days of practice--notably during the epidemic of cholera in Lexington in 1833--he absolutely resorted to tablespoonful doses of this mercurial, repeated _pro re nata_; actually giving about _one pound_ in one day to a young patient, without fatal result.