1358 THE BATEMAN APPEAL.

small, varying from 0 to 01 per 100,000, but in thepresence of any stronger acid, as in many moorlandwaters, the quantity taken up may even exceed0-5 per 100,000, its amount depending upon the free.acid present. With such acid waters copper dissolvesin amounts which may be dangerous to health, and intime also the life of thin copper pipes may be affected.Copper pipes of suitable thickness for non-acid watersare now cheaper than lead pipes of correspondingstrength, a point which is dwelt upon in the pamphlet,but it is obvious that however slight the action of thewater on the metal there will be a tendency in timeto reduce the thickness and the pressure resistance ofthe pipes. It is, however, argued that the naturaltendency of the action of a water on copper piping isto form a microscopical film and thus to slow down.Laboratory experiments confirm this alleged tendencyfor the rate of action to decrease, but not with allclasses of water.

The Ministry of Health in their Model Specificationfor Copper Pipes recommended pipes a little strongerthan those suggested by the Council, and until suchpipes have had an extended trial the Ministry’sproposals would be the safer to accept. In any caseit is certain that copper is much less readily oxidisedand much less dangerous to health than lead. Copper-so far as we are aware is not cumulative in the system.Dr. Thresh came to the conclusion that if any water.did not take up more than one-tenth of a grain of themetal after being in contact therewith for 24 hoursthere would be no danger to health. In actual usewater would rarely stand in contact with the metalpipes for more than eight to ten hours, hence it wouldnot take up this quantity. In all cases water whichhas stood for the night in any metal pipe should berun to waste in the morning. The water whichafterwards passes will thus have been in contact withthe metal for a much shorter time and will containvery little if any copper in solution or suspension.The remarks on tin-coated lead pipes are worth noting.Common tin coatings, alloyed with lead, it is stated,.are as dangerous as lead itself. Copper with a coatingof 50-50 tin and lead was found to surrender as

dangerous an amount of lead to a plumbo-solventwater as did lead itself. Unless, therefore, pure tincoating is insisted upon and supplied, tinning is a snare.In the experiments quoted, copper of a high degree ofpurity was used and the results only apply to pipesmade of such metal ; the copper used in waterservices should therefore comply with the specificationquoted in the pamphlet.We are not concerned with the many other advan-

tages claimed by the Copper and Brass Extended Use- Council as the result of the substitution of copper forlead or iron. The report has been compiled with such,care that the conclusions are likely to inspire confidence.

THE ASSESSMENT OF IMPROVEMENT INHEARING.

MEDICINE suffers under the disability that it is notan exact science ; in statistics referring to the resultsof any form of treatment we frequently have to becontent with such expressions as " better " or " worse,"" improved," and " in statu quo," and we seldom havean exact scale by which to measure the degree ofimprovement or its opposite. But occasionally anopportunity occurs for making more accurate measure-ments of results. In THE LANCET for May 2n.dthere appeared a description by Mr. C. M. R. Balbiof the audiometer, an electrical instrument designedto produce sounds of a frequency ranging through thelength of the audible scale, the amplitude of which canbe varied in intensity and accurately measured. Withan intelligent subject the limits of audition for a toneof any frequency can be measured and plotted on achart. In our next issue, that for May 9th, Mr.George C. Cathcart described the results of his treat-ment of chronic progressive deafness by the electro-phonoide, an instrument, also electrical, whichproduces sounds of any required pitch and intensity,

and which appears to give beneficial results by causingvibration of the tympanic membrane, vaso-dilatationof the vessels, and stimulation of the nerve-endings hithe organ of Corti. Mr. Cathcart made the definitestatement that of 100 cases of chronic progressivedeafness, examined and considered incurable by otherotologists, 68 per cent. have been improved aftertreatment by this instrument ; but such a result doesnot appear to have been obtained by others, and theopinion has been expressed that this good result isin part due to the effect of suggestion. This wouldnow seem to be the opportunity to use both instru-ments in conjunction, and to test the actuality of theresults of treatment by an exact measurement of thehearing, plotting out on charts the auditory field ina number of cases before and after treatment.

A MATTER OF PRINCIPLE.

Dr. Olive Langmead recently resigned her post aspart-time officer for maternity and child welfare underthe Bethnal Green Borough Council. For a numberof years she had been using two brands of dried milkfor infants who required to be artificially fed. ThePublic Health Committee of the Council passed aresolution that these brands were to be discontinuedin favour of another, and Dr. Langmead sent in herresignation on the ground (1) that she could notundertake responsibility for the health of infants ifobliged to use a brand of milk with which she wasunfamiliar; and (2) that she could not accept dictationfrom a lay committee upon medical matters. We havegone carefully into the circumstances attending herresignation and are satisfied that it was in accordancewith the ethical principles which govern medicalpractice. Contrary to popular belief, these are framedfor the safeguarding of the public, and Dr. Langmead’saction is justified by her estimate of her publicresponsibility.

THE BATEMAN APPEAL.

As already explained in THE LANCET, it has beenfelt that material assistance ought to be offered toDr. Bateman to meet the legal expenses of his suc-cessful appeal and to make good the deficiency in hisprofessional income. Accordingly the Bateman Fundhas been opened and lists of contributions haveappeared in recent issues. We have receivedadditional contributions as follows :-

.e s. d.Already received and acknowledged 482 16 0Messrs. Amery Parkes and Co., Solicitors 5 5 0Dr. Agnes Savill........ 2 2 0W. M. 2 0 0Thomas Laird ........ 1 0 0

- .í::493 3 0

Remittances should be forwarded to the Managerof THE LANCET, 423, Strand, ’V.C.2, and madepayable to the " Bateman Fund Account."

ROYAL COMMISSION ON NATIONAL HEALTH INSUR-ANCE.—The thirty-second meeting of the Commission washeld at the Home Office, Whitehall, on June 18th, LordLawrence of Kingsgate in the chair. Evidence as to thesupply of medicines, drugs, and appliances under the insurancescheme was submitted by the Retail Pharmacists Union,represented by Mr. A. R. Melhuish and Mr. G. A. Mallinson ;and by the Incorporated Society of Pharmacy and DrugStore Proprietors, represented by Mr. W. Huntrods andMr. A. Hutchinson. Thereafter, Sir Cooper Perry and Dr.James Mennel, representing the Chartered Society of Massageand Medical Gymnastics, gave evidence on the question ofincluding massage and medical gymnastics in the insurancescheme ; and evidence as to dental benefit was given ofbehalf of the Ivory Cross by Mr. W. F. Mellersh, Mr. C.Davis, Mr. H. D. Grant, Mr. John Hall, and Miss A. E.Fletcher. The Commission announce that proof copies ofthe oral evidence and the relative statements submitted atthe meeting of May 28th, 1925, may now be obtained fromH.M. Stationery Office (2s. 3d.).