434 THE CURSE OF LEARNING.-DEATHS UNDER ANAESTHETICS.

no doubt selected the Composite Battalion for Ashanti,and Lord Roberts took care to have the troops accompany-ing him on the march to Kandahar mainly composed ofmatured men and not striplings. But we must, after all,take our soldiers when we can get them, and we can onlyrecruit them young. After they have been fed and trained,and have served some few years in the army, they makefine soldiers and have always given an uncommonly goodaccount of themselves. A soldier is probably of the

greatest value between twenty-five and thirty-five yearsof age, when the fullest measure of air can be changedin the lungs, and he should in any case be over twenty-one years of age before he is fitted to undertake the

frequently prolonged physical exertion required of himin the field. Circumstanced as this country is, the menserving with the colours must be mainly composed of

young and immature soldiers ; but then we are not in thisrespect a bit different from other countries and armies.If nations were content with small armies it might beotherwise, but so long as things are as they are we musthave a short-service system. In the event of our beingengaged in a big war, circumstances will be different to whatthey have been hitherto ; the reserve force which will thenbe added to the army will consist of physically maturedmen. The introduction of a short-service system with theother changes which have taken place of late years seem tous to have been essentially necessary, and, notwithstandingall that has been urged against it, no one has been able topoint out any scheme that is better and at the same timepracticable. -

THE CURSE OF LEARNING.

THE -Edinbitrg7b Medical Journal for January continues thevaluable series of papers by Dr. W. Ireland upon MentalAffections in Children, and the subject treated of in thissection is the overstrain of examination and the enormousand useless amount of subjects children and all examineesare required to know. We commented last week upon a

paper recently set in chemistry at the University of Londonto candidates for the M.B. degree, a paper which took nextto no heed of the medical side of chemistry, and we believethe same evil is paramount in most places. An examinerthinks only of his own special subject. The whole system ofteaching is wrong. Take, for example, the London SchoolBoard, a body founded for the purpose of "elementaryeducation." This sapient body’s idea of elementary educa-tion is to teach thirty-six distinct subjects, among which wemay mention botany, experimental science, physics, physio-logy, natural philosophy, object lessons, suitable occupa-tion (!), social economy, and domestic ditto. We do not

suppose that any unfortunate child is taught all the

thirty-six subjects, but the facts above stated show

very well what is the idea of the modern educationist"

(to use his own abominable term) as to what is meant

by elementary. To quote Dr. Ireland : "This inordinatedesire for examining and being examined is not confined tothe medical profession ; it pervades well-nigh all branches oflearning. In my opinion it has already inflicted enduringinjury to many of the studious class in our population, andis likely to go on helping to increase the tendency toexhaustion and irritability of the nervous system....... Thestamp of talent is put upon the back of heavy diligence andthe knowledge certified is of an unhealthy and evanescentcharacter." Every medical man knows how the strain ofexaminations affects school children, Board and otherwise,and we have no hesitation in saying that the results attainedare in no way commensurate with the expense and troubleincurred. Every householder knows what the average modernworkman is like. Here and there one finds an intelligentman, and bodies like the Guild of Handicraft in the Mile-

end-road turn out craftsmen who take a pride in theirwork and do it well; but what shall we say of the averagegas-fitter, carpenter, or electric-bell man ? 2 These apply nocommon sense nor do they think. Recently we sent fora workman to fix a lead and push to an electric bell.He came and went away. On trying the bell it would notring. We examined the connexion and found he had putboth wires of the lead on to one terminal of the wires con-necting the battery to the bell. It had never entered intohis head to try if the bell would ring before he went away.This is the result of modern education. Children are taughta smattering of everything and learn nothing. Elementaryschools ought to teach nothing but reading, writing, arith-metic, swimming, cookery, and needlework. The religiousquestion is outside our province, and the other thirty subjectshad best be relegated to Astolfo’s limbo at the other side ofthe moon.

DEATHS UNDER ANÆSTHETICS.

A MARRIED woman aged fifty-one years was admitted intothe Birmingham Hospital for Women on Dec. 31st, 1895,suffering from an enormous ovarian tumour of very rapidgrowth. She was seen by Mr. Christopher Martin, the

surgeon to the hospital, on Jan. lst, 1896. Both legs werecedematons and there was albumin in the urine. The heartwas displaced upwards and to the left. The pulse was rapid(136) and feeble. No murmurs could be detected. She wasin a very exhausted condition and a most unfavourable casefor operation, but it was obvious that her only chance lay inovariotomy. On the 3rd she was prepared for the operation.An ounce of brandy was given to her, and the anaesthetic (amixture of ether, two parts, and chloroform, one part) was ad-ministered with Clover’s inhaler by the sister in charge underMr. Martin’s supervision. In about five minutes the patientbegan to show signs of cardiac failure and the administrationwas at once stopped. Her pulse could be felt at the wrist, but itwas slow (60) and feeble. Her breathing became embarrassedand her lips bluish. It was decided to postpone the operationand she was lifted back to bed. She continued to fail, herpulse became weaker, and her breathing finally ceased. All

the usual restorative measures (including artificial respira-tion) were applied, but without avail. Dr. Kauffmann, whomade the necropsy, found, in addition to a very large adherentovarian tumour, that the heart was in a condition of marked" brown atrophy," and that there were signs of old pleurisyon the left side. She evidently died from a combination ofcauses : (1) her exhausted state ; (2) the degenerationof the cardiac muscle ; (3) the mechanical pressure of thetumour on the heart; and (4) (only to a limited extent)from the anaesthetic. It seems to us most irregular thatunder any circumstances the grave responsibility of givingan anaesthetic should be relegated to a " sister in charge."Under the circumstances of the case given above the irregu-larity becomes even more serious. The patient was clearlyin a very precarious condition, requiring a most carefuland experienced medical man’s attention for the successfulproduction of chloroform narcosis, and yet she was com-mitted to the necessarily irresponsible nurse. Unless theaccount which has reached us is inexact we cannot feel

satisfied that Mr. Martin’s supervision makes the case

less irregular ; and it is transparently plain that a mancannot give his undivided attention to the performanceof ovariotomy and the administration of an anaesthetic.The second point is the employment of a closed inhaler,such as Clover’s, for the administration of a mixture

containing chloroform of the strength of 1 in 3. This pro-ceeding is to court disaster even in skilled hands. The

practice adopted cannot be deprecated too strongly. Wehave also received particulars of a death under chloroform

which occurred in St. Bartholomew’s Hospital. The patient,