Principles of Microeconomics 7Th Edition Gregory Mankiw Test Bank Full Chapter PDF

Principles of Microeconomics 7th Edition
Gregory Mankiw Test Bank

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Elasticity and Its Application
Multiple Choice – Section 00: Introduction
1. In general, elasticity is a measure of

a. the extent to which advances in technology are adopted by producers.
b. the extent to which a market is competitive.
c. how firms’ profits respond to changes in market prices.
d. how much buyers and sellers respond to changes in market conditions.
ANSWER: d
POINTS: 1
DIFFICULTY: Difficulty: Easy
LEARNING OBJECTIVES: ECON.MANK.15.22 - LO: 5-0
NATIONAL STANDARDS: United States - BUSPROG: Analytic
TOPICS: DISC: Elasticity
KEYWORDS: BLOOM'S: Knowledge
2. Elasticity is
a. a measure of how much buyers and sellers respond to changes in market conditions.
© 2015 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.
1098 Elasticity and Its Application
b. the study of how the allocation of resources affects economic well-being.

c. the maximum amount that a buyer will pay for a good.
d. the value of everything a seller must give up to produce a good.
ANSWER: a
POINTS: 1
Elasticity and Its Application 1099
3. When studying how some event or policy affects a market, elasticity provides information on the
a. equity effects on the market by identifying the winners and losers.
b. magnitude of the effect on the market.
c. speed of adjustment of the market in response to the event or policy.
d. number of market participants who are directly affected by the event or policy.
ANSWER: b
POINTS: 1
DIFFICULTY: Difficulty: Moderate
KEYWORDS: BLOOM'S: Comprehension
4. When studying how some event or policy affects a market, elasticity provides information on the
a. change in the costs of production.
b. tradeoff between equality and efficiency.
c. effect on the budget deficit or surplus.
d. direction and magnitude of the effect.
ANSWER: d
POINTS: 1
NOTES: r
5. How does the concept of elasticity allow us to improve upon our understanding of supply and
demand?
a. Elasticity allows us to analyze supply and demand with greater precision than would be the case
in the absence of the elasticity concept.
b. Elasticity provides us with a better rationale for statements such as “an increase in x will lead to
a decrease in y” than we would have in the absence of the elasticity concept.
c. Without elasticity, we would not be able to address the direction in which price is likely to move
in response to a surplus or a shortage.
d. Without elasticity, it is very difficult to assess the degree of competition within a market.
ANSWER: a
POINTS: 1
6. When consumers face rising gasoline prices, they typically

a. reduce their quantity demanded more in the long run than in the short run.
b. reduce their quantity demanded more in the short run than in the long run.
c. do not reduce their quantity demanded in the short run or the long run.
d. increase their quantity demanded in the short run but reduce their quantity demanded in the long
run.
ANSWER: a
POINTS: 1
Price Elasticity of Demand
KEYWORDS: BLOOM'S: Application
7. A 10 percent increase in gasoline prices reduces gasoline consumption by about

a. 6 percent after one year and 2.5 percent after five years.
b. 2.5 percent after one year and 6 percent after five years.
c. 10 percent after one year and 20 percent after five years.
d. 0 percent after one year and 1 percent after five years.
ANSWER: b
POINTS: 1
8. Which of the following statements about the consumers’ responses to rising gasoline prices is
correct?
a. About 10 percent of the long-run reduction in quantity demanded arises because people drive
less and about 90 percent arises because they switch to more fuel-efficient cars.
b. About 90 percent of the long-run reduction in quantity demanded arises because people drive
less and about 10 percent arises because they switch to more fuel-efficient cars.
c. About half of the long-run reduction in quantity demanded arises because people drive less and
about half arises because they switch to more fuel-efficient cars.
d. Because gasoline is a necessity, consumers do not decrease their quantity demanded in either
the short run or the long run.
ANSWER: c
POINTS: 1
Multiple Choice – Section 01: The Elasticity of Demand
1. The price elasticity of demand measures how much

a. quantity demanded responds to a change in price.
b. quantity demanded responds to a change in income.
c. price responds to a change in demand.
d. demand responds to a change in supply.
ANSWER: a
POINTS: 1
2. The price elasticity of demand measures

a. buyers’ responsiveness to a change in the price of a good.
b. the extent to which demand increases as additional buyers enter the market.
c. how much more of a good consumers will demand when incomes rise.
d. the movement along a supply curve when there is a change in demand.
ANSWER: a
POINTS: 1
3. The price elasticity of demand for a good measures the willingness of

a. consumers to buy less of the good as price rises.
b. consumers to avoid monopolistic markets in favor of competitive markets.
c. firms to produce more of a good as price rises.
d. firms to respond to the tastes of consumers.
ANSWER: a
POINTS: 1
4. Which of the following statements about the price elasticity of demand is correct?
a. The price elasticity of demand for a good measures the willingness of buyers of the good to buy
less of the good as its price increases.
b. Price elasticity of demand reflects the many economic, psychological, and social forces that
shape consumer tastes.
c. Other things equal, if good x has close substitutes and good y does not have close substitutes,
then the demand for good x will be more elastic than the demand for good y.
d. All of the above are correct.
ANSWER: d
POINTS: 1
5. Demand is said to be price elastic if

a. the price of the good responds substantially to changes in demand.
b. demand shifts substantially when income or the expected future price of the good changes.
c. buyers do not respond much to changes in the price of the good.
d. buyers respond substantially to changes in the price of the good.
ANSWER: d
POINTS: 1
6. Demand is said to be inelastic if

a. buyers respond substantially to changes in the price of the good.
b. demand shifts only slightly when the price of the good changes.
c. the quantity demanded changes only slightly when the price of the good changes.
d. the price of the good responds only slightly to changes in demand.
ANSWER: c
POINTS: 1
7. If demand is price inelastic, then

a. buyers do not respond much to a change in price.
b. buyers respond substantially to a change in price, but the response is very slow.
c. buyers do not alter their quantities demanded much in response to advertising, fads, or general
changes in tastes.
d. the demand curve is very flat.
ANSWER: a
POINTS: 1
8. If the quantity demanded of a certain good responds only slightly to a change in the price of the
good, then the
a. demand for the good is said to be elastic.
b. demand for the good is said to be inelastic.
c. law of demand does not apply to the good.
d. demand curve for the good shifts only slightly in response to a change in price.
ANSWER: b
POINTS: 1
9. When quantity demanded responds strongly to changes in price, demand is said to be

a. fluid.
b. elastic.
c. dynamic.
d. highly variable.
ANSWER: b
POINTS: 1
10. Demand is said to be inelastic if the

a. quantity demanded changes proportionately more than price.
b. price changes proportionately more than income.
c. quantity demanded changes proportionately less than price.
d. quantity demanded changes proportionately the same as price.
ANSWER: c
POINTS: 1
11. Demand is elastic if the price elasticity of demand is

a. less than 1.
b. equal to 1.
c. equal to 0.
d. greater than 1.
ANSWER: d
POINTS: 1
12. Demand is inelastic if the price elasticity of demand is

a. less than 1.
b. equal to 1.
c. greater than 1.
d. equal to 0.
ANSWER: a
POINTS: 1
13. Which of the following is not a determinant of the price elasticity of demand for a good?
a. the time horizon
b. the steepness or flatness of the supply curve for the good
c. the definition of the market for the good
d. the availability of substitutes for the good
ANSWER: b
POINTS: 1
14. The smaller the price elasticity of demand, the

a. more likely the product is a luxury.
b. smaller the responsiveness of quantity demanded to a change in price.
c. more substitutes the product has.
d. greater the responsiveness of quantity demanded to a change in price.
ANSWER: b
POINTS: 1
NOTES: r
15. Whether a good is a luxury or necessity depends on the

a. price of the good.
b. preferences of the buyer.
c. intrinsic properties of the good.
d. scarcity of the good.
ANSWER: b
POINTS: 1
16. Goods with many close substitutes tend to have

a. more elastic demands.
b. less elastic demands.
c. price elasticities of demand that are unit elastic.
d. income elasticities of demand that are negative.
ANSWER: a
POINTS: 1
17. For a good that is a luxury, demand

a. tends to be inelastic.
b. tends to be elastic.
c. has unit elasticity.
d. cannot be represented by a demand curve in the usual way.
ANSWER: b
POINTS: 1
18. For a good that is a necessity, demand

a. tends to be inelastic.
b. tends to be elastic.
c. has unit elasticity.
d. cannot be represented by a demand curve in the usual way.
ANSWER: a
POINTS: 1
19. A good will have a more elastic demand, the

a. greater the availability of close substitutes.
b. more broad the definition of the market.
c. shorter the period of time.
d. more it is regarded as a necessity.
ANSWER: a
POINTS: 1
20. The value of the price elasticity of demand for a good will be relatively large when
a. there are no good substitutes available for the good.
b. the time period in question is relatively short.
c. the good is a luxury rather than a necessity.
d. All of the above are correct.
ANSWER: c
POINTS: 1
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the brain at this period of life leads to an early death, while children
affected with partial atrophy may continue to live, though almost
always in a state of idiocy. The forms mostly observed in children are
unilateral or bilateral atrophy of the cerebrum, partial or almost entire
absence of the cerebellum, imperfect development of the large
cerebral ganglia, and slight partial atrophy of the medulla oblongata.
The large commissures as well as the crura cerebri are very seldom
found atrophied.
The most frequent and, from a practical point of view, the most
important of these forms is the unilateral atrophy of the cerebrum, for
the reason that in a mild form it is to a certain degree consistent with
the mental and physical development of the child. It is mostly found
on the left side. In some cases the atrophy extends evenly
throughout the hemisphere, while in others it affects more or less
one or the other lobe. The loss in the bulk of the hemisphere may
amount to only a slight diminution, or to as much as to one-half of
the normal size. Its thickness above the ventricle may be reduced to
a few millimeters; in some cases even the membranes of the brain
may lie in contact with the ependyma. The ventricle of the atrophied
hemisphere is almost always enlarged. The convolutions of the
cerebrum are very narrow, sometimes quite indistinct. One or both of
the corpora striata also are generally found atrophied. In many cases
even the atrophy extends to one of the crura cerebri and to the
pyramid of the same side, and to the anterior and lateral columns of
the spinal cord on the opposite side. Frequently, one or the other
lateral half of the cerebellum also is found affected. The condition of
the substance of the cerebrum is nearly the same as in the senile
atrophy of the brain to be described hereafter. The skull is mostly
thickened on the side of the atrophy, and frequently asymmetrical.
SYMPTOMS.—In most cases the mental capacity is below the normal

standard, and frequently borders on or represents a state of idiocy.
The temperament of the patient is generally irritable and very
excitable. The most prominent symptom is an incomplete paralysis
on the side opposite to the atrophied hemisphere, which is the more
pronounced the more the corpus striatum, thalamus opticus, and
crus cerebri are involved. Frequently, there are contractures of the
flexor and pronator muscles of both extremities, particularly of the
upper; the muscles of the trunk remain free; sometimes one or the
other half of the face is also paralyzed. Epileptic convulsions also are
frequently present. Blindness and deafness, with a defective sense
of smell and a blunted sensibility of the paralyzed limbs, as well as
neuralgia of the latter, and headache, have also been observed.
CAUSES.—Besides the causes already mentioned, atrophy of the

brain occurring in children after birth may be induced by injuries of
the head, inflammation of the enveloping membranes, of the
ependyma, or of the substance of the brain itself.
TREATMENT.—Atrophy of the brain in children is perhaps, in the

majority of cases, incurable; it is therefore only in the milder cases
that the patient may be benefited by treatment. Electricity and
gymnastic exercises have been recommended. At any rate, it must
be pursued in a very systematic manner, and based upon the
principles established and practised by the late E. Seguin of New
York in his Physiological School for Weak-minded Children,
consisting in improving the mind, first by training the child to the use
of his limbs by means of light mechanical work, etc.
2. Atrophy of the Fully-developed Brain.
In the brain of the adult the atrophy may be partial or total,

symmetrical or asymmetrical, in the same sense as before used in
connection with the atrophy of the brain of children. It may, further,
be stationary, when the atrophying process remains limited to the
part where it originated; or, progressive, when it extends to other
parts of the brain. Generally, partial, asymmetrical, and stationary
atrophy is due to certain accidental pathological processes,
producing a destruction or loss of portions of the substance of the
brain, such as apoplexy, softening, etc., by which the nutrition of the
neighboring parts becomes disturbed. Total, symmetrical, and
progressive atrophy, on the other hand, actually depends upon
certain constitutional disturbances of the nutritive process in general,
such as chronic alcoholic intoxication, etc.
CAUSES.—As already mentioned, the causes of atrophy of the brain

in the adult may be direct or indirect. The former are generally
represented by certain pathological processes which directly affect
the substance of the brain, as, for instance, apoplectic hemorrhagic
effusions into the brain-substance, thrombosis or embolism of the
cerebral arteries, encephalitis, chronic serous effusions into the
ventricles, inflammation and œdema of the pia mater, etc. To the
latter or indirect causes, which affect the organ by disturbing or
lowering the nutrition of its substance, belong the retrogressive
processes of old age or of insanity; the introduction into the system
of certain noxious substances, such as lead or alcohol; furthermore,
certain wasting diseases, such as phthisis, Bright's disease, etc.
PATHOLOGICAL ANATOMY.—The cerebrum particularly is found

diminished in volume. While the convolutions are thinner than
normal, their intervening sulci are broader. The white substance
presents a dirty-white color, and is abnormally dense and tough,
especially near the ventricles. The latter are enlarged and filled with
serum; their ependyma is thickened and frequently covered with
granulations. The cortical layer appears of a dirty, rusty-brown or
yellow color, is pale, soft, or hard, and frequently is found to adhere
to the pia mater. In very pronounced cases the white substance is
almost as tough as leather, and contracts upon section, especially in
the convolutions; its cut surface is rendered concave. Sometimes the
surface of the convolutions, after the removal of the pia mater,
appears finely shrivelled. The dura mater is often found thickened
and adhering to the skull. The space created in the cavity of the
cranium by the atrophy of the brain is filled by serous effusions into
the tissue of the pia mater, the subarachnoidal space, arachnoid sac,
and ventricles.
The histological changes associated with atrophy of the brain differ

in the different forms. In cases of partial atrophy caused by
hemorrhages, etc. the destructive process generally embraces all
the tissues at first, while the secondary degenerations particularly
affect the nervous elements. In total atrophy the pathological process
appears to commence in the connective tissue, and to involve the
nervous elements subsequently; though in a number of cases,
especially of senile atrophy, the nervous elements appear to be
primarily affected. The blood-vessels also undergo certain changes,
giving rise to the contraction of the brain-substance.
SYMPTOMS.—In partial atrophy of the brain the primary symptoms

resemble those which characterize the particular destructive process
to which the atrophy is due. The most prominent are the symptoms
of motor disturbance, which are always semilateral and correspond
to the extent and seat of the lesion; frequently they remain
stationary. The sensibility of the paralyzed parts is but slightly
diminished, and the mind generally undisturbed. But when the
effects of the original lesion extend, in the form of a secondary
degeneration of the nervous elements, to neighboring parts, or even
to the other hemisphere, the cerebral functions may become
secondarily disturbed.
In senile atrophy of the brain, which represents the most simple form
of total atrophy of this organ, the first symptoms frequently appear
toward the end of some intercurrent disease. They consist in a very
slow and gradually increasing derangement of the cerebral functions,
associated with a general loss of innervation, manifesting itself by
talkative wanderings of the mind, restless sleep, hallucinations,
foolish activity, attacks of tremor senilis, etc. The intellectual
functions diminish and the memory is lost. The physical forces also
gradually sink, the tremor senilis increases, and the patient, no more
able to walk, becomes confined to bed. Finally, a relaxation of the
sphincters takes place, and death is produced by the disturbance of
the automatic functions of deglutition and respiration.
Total atrophy of the brain, when due to an extensive meningitis or to

a general disturbance of the nutrition, as is met with in drunkards,
may finally lead to a condition known as general paralysis of the
insane. This disease, however, will be found treated elsewhere in
this work.
TREATMENT.—There is no special treatment for atrophy of the brain;

all that can be done is to palliate and combat the symptoms as they
arise.
HYPERTROPHY OF THE BRAIN.
INTRODUCTION.—Notwithstanding the numerous measurings and

weighings of human brains made in the course of time by different
investigators, no absolute standard measure or weight has as yet
been established by which we can accurately determine a
pathological increase or decrease in the size and weight of this
organ. The want of such a standard is principally due to the
difference generally existing in the dimensions and weights of even a
certain number of brains taken from individuals belonging to the
same race or nation. The same difficulties are met with in the
attempt at establishing a rule by which to measure the mental
capacity of a certain brain, for the question has as yet not been
solved whether this capacity depends upon the quantity or quality of
the brain-substance. In speaking of hypertrophy of the brain,
therefore, we must keep in mind that a large brain must not be
considered hypertrophied unless there exists a disproportion
between its size and that of the cavity from which it was removed; in
other words, when its growth or hypertrophy meets a resistance at
the inner walls of the cranial cavity. According to Virchow, a further
distinction must be made between the increase (hyperplasia) of the
nervous elements themselves and that of the supporting connective
tissue, the neuroglia. To the latter condition particularly corresponds
the peculiar doughy consistence of the white substance of
hypertrophied brains.
ETIOLOGY.—Hypertrophy of the brain is sometimes congenital, and
then associated with dwarfishness and a defective development of
the cranium. Generally, however, it is an extra-uterine affection,
originating mostly during infancy and childhood, though it is also met
with at the age of puberty, and even in adult life. The male sex is
more predisposed to the affection than the female. When
hypertrophy of the brain occurs during infancy, it is almost always
associated with an excessive development of the lymphatic glands,
with a defective involution of the thymus gland, and with rachitis, but
generally without cachexia. No special exciting cause can be
assigned to the affection during youth or adult age, though it has
been stated that during these periods of life the disease may
supervene upon tubercle or carcinoma of the brain. Repeated active
or passive congestion (Rokitanski, Andral), as well as the
introduction of lead into the system, has also been supposed to
incite the disease.
PATHOLOGICAL ANATOMY.—Directly after the removal of the vault of the

cranium, and on cutting through the dura mater, the brain, as if
liberated from pressure, is observed to swell out to such a degree as
to render the replacement of the removed skull-cap impossible. The
enveloping membranes are found closely adapted to one another
and to the brain; they are very thin, bloodless, and dry, and their
vessels are empty and pressed flat. The hemispheres of the
cerebrum are large, and their convolutions, mutually pressing
against one another, are flattened at their surfaces, so that the
intervening sulci are hardly recognizable. After the removal of the
brain from the skull the abnormal dimensions of the cerebrum
present a remarkable contrast to the normal size of the cerebellum,
pons, and medulla oblongata, which also appear flat and broad from
pressure. When a horizontal section is made through the
hemispheres of the cerebrum and a little above the corpus callosum,
the centrum ovale appears unusually large. The cavities of the
ventricles are very narrow, their walls touching one another. There is
no serum in the pia mater or in the ventricles. The substance of the
brain is pale, bloodless, and dry. The white substance, upon which
the hypertrophy particularly depends, is of a doughy consistence,
comparable to the boiled white of an egg or cheese, whilst the gray
substance is so pale as to be hardly distinguishable from the former.
The condition of the skull is, according to Rokitanski,1 as follows: In

cases in which the hypertrophy of the brain has advanced to a high
degree, and in which the sutures of the skull are united, the bones of
the cranium are found thinner and their inner table roughened by
absorption. This is especially the case in the bones which form the
vault of the cranium. The holes or other deficiencies found at the
base of the cranium in the plates of the frontal, ethmoid, and
sphenoid bones are not entirely due to the absorbing process, but
rather to the thinness of these bones. In infants the cavity of the
cranium enlarges in proportion to the hypertrophy of its contents; the
head then resembles in form so much that of hydrocephalus that it
may lead to errors in diagnosis. In some cases in which the disease
rapidly develops to a high degree there is observed on the infant's
skull a loosening and separation of the sutures of the cranial vault,
with red coloration and suffusion of their cartilages.
1 Lehrbuch der Pathologischen Anatomie, 3d ed., 1855, vol. ii. p. 431.
SYMPTOMS.—There is a gradually increasing muscular weakness,

manifesting itself especially in the lower extremities, and giving rise
to an unsteady, stumbling gait and frequent falling, caused perhaps
by the excessive weight of the head, and also an inability of securely
grasping objects. Besides these disturbances of motion, epileptic
spasms appear, at first light in degree and at long intervals, but
becoming later on in the course of the disease more frequent and
severe. Continuous or intermittent attacks of headache almost
always accompany the disease, and, furthermore, vertigo, tinnitus
aurium, photophobia, and dimness of sight with dilatation of the
pupil; general sensation also becomes blunted, but without ever
amounting to anæsthesia. In a number of cases there is no
disturbance of the psychical functions, though in others symptoms of
mental excitement amounting even to delirium have been observed.
Most frequently the intelligence sinks from the beginning of the
disease, to end in complete idiocy. The pulse also has been
observed to fall considerably during the last stage.
The COURSE of the disease is, according to Andral and Hasse,2

almost always chronic, and if an acute development of the affection
has been spoken of, it may be supposed that the latter has
commenced a considerable time previous to the manifestation of the
symptoms during the last stage. Andral divides the disease into two
stages, of which the first is chronic and frequently latent, whilst the
other is more acute and leads to a rapid fatal termination. In most
cases death is caused by such intercurrent affections as give rise to
irritation and hyperæmia of the brain, and thus increase the already
abnormal pressure upon this organ.
2 “Krankheiten des Nervensystems,” 2d ed., 1869, in Handbuch der Speciellen
Pathologie und Therapie, edited by R. Virchow, vol. iv. 1st div., p. 578.
DIAGNOSIS, PROGNOSIS, AND TREATMENT.—It has already been

mentioned that errors in diagnosis may very easily be committed on
account of the great resemblance in the form of the head in cases of
hypertrophy of the brain and of hydrocephalus, though it has been
stated that in the former affection convulsions, in the form of epileptic
spasms, predominate, to be followed during the last stage by
symptoms of depression; whilst in hydrocephalus the symptoms of
depression manifest themselves from the beginning of the disease,
and, moreover, the rachitic deformities are more prominently shown
in the form of a chicken-breast. A positive diagnosis can only be
made by the autopsy.
There are no remarks to be made on the prognosis and treatment of

hypertrophy of the brain.
SYPHILITIC AFFECTIONS OF THE NERVE-
CENTRES.
BY H. C. WOOD, M.D., LL.D.
Introduction.
Syphilitic affections of the nerve-centres are best studied by

separating those of the spinal cord from those of the cerebrum, and
in the present article this natural division of the subject is adopted.
Further, cerebral syphilis in its most characteristic or gummatous
form usually attacks the brain-membranes, or perhaps in some
cases the perivascular sheaths of the vessels, and only secondarily
affects the tissue of the brain itself. The question of the occurrence
of specific disease of the brain-cortex is so important that it shall
have a separate discussion. It is perfectly well proven that with or
without other brain lesion the vessels of the brain may undergo an
atheromatous degeneration as the direct result of a syphilitic
dyscrasia; but such disease links itself on the one hand with the
subject of syphilitic disease of the general vascular system, and on
the other hand with cerebral apoplexies, softenings, and other
degenerations. Moreover, the space here allotted to brain syphilis is
very insufficient. I, therefore, shall not enter upon the further
discussion of syphilitic degeneration of the brain-vessels. The
etiology of brain and spinal syphilis is best discussed under one
heading.
GENERAL ETIOLOGY.—We do not know why in any individual case
syphilis selects one portion of the nervous centres rather than
another for attack; indeed, it is only rarely that any exciting cause
can be discovered.
It is not unnatural to expect that any agency which is capable of

exciting an inflammation of a nerve-centre may, when present in a
syphilitic person, provoke a specific disease of such centre. Thus,
thermic fever is a very common cause of chronic meningitis, and in
the Journ. de Méd. et Chir. (Paris, 1879, p. 191) a case is reported in
which cerebral syphilis followed a sunstroke; I have myself seen one
similar instance, and in Roberts's case of precocious cerebral
syphilis (see p. 804) the first convulsion came whilst the man was
fishing on a very hot day, and may have been precipitated by the
exposure.
Blows and other traumatisms would be expected to figure largely as

exciting causes of nervous syphilis, but they, in fact, are only rarely
present. I have seen one or two cases of specific brain disease
attributed to violence by the patient, and several cases of possibly
specific spinal disease—one in which a poliomyelitis followed a fall
on the ice; one in which, after a fall from a cart and marked spinal
concussion, a local myelitis developed;1 and one of a general
myelitis following an injury by a horse. The only records of such
cases are those of Broadbent2 and those collected by Heubner.3
1 Univers. Hosp. Dispen. Service-Book, x., 1875, p. 58.
2 Lond. Lancet, 1876, ii. p. 741.
3 Ziemssen's Encyclopædia, xii. 301.
Various authorities attach much influence to over-study and other

forms of cerebral strain in exciting brain syphilis. Engelstedt is stated
to have reported cases having such etiological relations, and
Fournier4 affirms that he has especially seen the disease in
professional men and other persons habitually exercising their brains
to excess. Neither in private nor public practice have I met with an
instance where over-brainwork could be considered a distinct
etiological factor, whilst I have seen some hundreds of cases from
amongst the laboring classes, in whom the intellectual faculties are
chiefly dormant.
4 La Syphilis du Cerveau.
The drift of the evidence in medical literature is so pronounced, and

so in accord with my own experience, that I believe it may be
positively affirmed that in the vast majority of cases of nervous
syphilis no exciting cause can be found.
Inherited syphilis seems to be less prone than the acquired diathesis

to attack the nervous system, but is certainly capable of so acting.
As early as 1779, Joseph Glenck5 reported a case of a girl, six years
old, cured by a mercurial course of an epilepsy of three years'
standing and of other manifestations of hereditary syphilis. Graefe
found gummatous tumors in the cerebrum of a child nearly two years
old.6 O. Huebner7 details the occurrence of pachymeningitis
hæmorrhagica in a syphilitic infant under a year old. Hans Chiari8
reports a case in which very pronounced syphilitic degeneration of
the brain-vessels was found in a child fourteen months old. Both
Barlow9 and T. S. Dowse10 report cases of nerve syphilis in male
infants of fifteen months. For other similar cases the reader is
referred to an article by J. Parrott,11 and to a paper by M. E.
Troisier.12
5 Doctrina de Morbis Venereis, Vienna.
6 Arch. f. Ophthalm., Bd. i. Erst Abth.
7 Virchow's Archiv, Bd. lxxxiv. 269.
8 Wien. Med. Wochenschrift, xxxi. 1881, 17.
9 Lond. Patholog. Soc. Trans., 1877.

10 The Brain and its Diseases, vol. i. p. 76.
11 Archiv. de Physiologie, 1871-72, p. 319; also to his “Leçons sur le Syphilis hered.,”
Progrès méd., 1877 and 1878.
12 Arch. de Tocologie, x. 411.
Recorded cases prove decisively that even after puberty specific

nervous affections may primarily attack the unfortunate offspring.
Thus, Nettleship reports13 the development of a cerebral gumma in a
girl of ten years, and J. A.. Ormerod14 of a tumor of the median nerve
(probably gummatous) in a woman of twenty-three, both the subjects
of inherited syphilis. Thomas S. Dowse15 details a case of cerebral
gumma at the age of ten years, and Samuel Wilks16 one of epilepsy,
from inherited taint, in a boy of fourteen. J. Hughlings-Jackson
reports17 paraplegia with epilepsy in a boy of eight, hemiplegia in a
girl of eighteen, and hemiplegia in a woman of twenty-two;18 the
nervous affection in each case being associated with or dependent
upon inherited syphilis. E. Mendel reports19 a case of a child who
had inherited syphilis, and developed in her fifteenth year a maniacal
attack with hallucinations. I have seen cerebral syphilis occur at
twenty-one years of age as the first evident outbreak of the inherited
disorder.
13 Trans. Lond. Path. Soc., xxxii. 13.
14 Ibid., p. 14.
15 Loc. cit., p. 71.
16 Lectures on Dis. of Nerv. Syst., Philada., 1878, p. 333.
17 Journ. Ment. and Nerv. Diseases, 1875, p. 516.
18 Brit. Med. Journal, May 18, 1872.
19 Archiv f. Psychiatrie, Bd. i. 313.

When a nervous affection develops first at a comparatively late
period, and no very apparent evidences of the inherited taint are
present, there is great danger of the case being misunderstood;
indeed, in some instances an immediate diagnosis may be scarcely
possible. It is probable that in most of the reported recoveries from
alleged tubercular meningitis the disease has been syphilitic.
Some time since I saw, in an orphan of fourteen, a chronic basal

meningitis, and in the absence of any history and of any evidences
of syphilis gave the fatal prognosis of tubercular disease; but, to my
astonishment, under the long-continued and free use of iodide of
potassium complete recovery occurred. Another child, reported by a
very good practitioner as cured of tubercular meningitis, and
afterward for a long time under my own care, I believe suffered from
hereditary syphilis. Cases of this character have also been reported
by F. Dreyfous.20
20 Revue mensuelle des Malad. des Enfants, 1883, i. 497; see also Gaz. hébdom.
Sci. méd. de Montpellier, 1883, v. 89.
It is of course very important to diagnose between a tubercular

meningitis and one due to hereditary syphilis. Without a history
certainty is not possible, but a general indefiniteness of symptoms
and slowness of progression should arouse suspicion, especially if
the absence of the pulse-retardation indicated that the vault rather
than the base of the cranium was involved.
The relation of inherited syphilis to various nervous affections not

distinctly specific cannot yet be determined. Arrested development,
and the consequent epilepsy, idiocy,21 early brain sclerosis, are
probably sometimes due to the inheritance; and the cases collected
by E. Mendel22 show that chronic hydrocephalus is frequently of
specific origin.23
21 See Brain, vol. vii. 409.
22 Archiv f. Psychiatrie, Bd. i. 309.

23 See, also, Virchow's Archiv, Bd. xxxviii. p. 129.
Another very important question connected with the etiology of these

disorders is as to the time of their development. Nervous diseases
following acquired syphilitic infection certainly belong to the
advanced stages of the disorder. Huebner reports24 a case in which
thirty years elapsed between the contraction of the chancre and the
nervous explosion. I have seen a similar period of thirty years.
Fournier reports intervals of twenty-five years, and thinks from the
third to the tenth year is the period of maximum frequency of nervous
accidents.
24 Ziemssen's Encyclopædia, xii. 298, New York ed.
The fact that nervous syphilis may occur many years after the
cessation of all apparent evidences of the diathesis is of great
practical importance, especially as the nervous system is more
prone to be attacked when the secondaries have been very light
than when the earlier manifestations have been severe. I have
repeatedly seen nervous syphilis in persons whose secondaries
have been so slight as to have been entirely overlooked or forgotten,
and who honestly asserted that they never had had syphilis,
although they acknowledged to gonorrhœa or to repeated exposure,
and confessed that their asserted exemption was due to good
fortune rather than to chastity.
The following citations prove that this experience is not peculiar.

Dowse25 says: “Often have I had patients totally ignorant of having at
any time acquired or experienced the signs or symptoms of syphilis
in its primary and secondary stages, yet the sequelæ have been
made manifest in many ways, particularly in many of the obscure
diseases of the nervous system.” Buzzard26 reports a case of
nervous syphilis where the patient was unconscious of the previous
existence of a chancre or of any secondaries. Rinecker also calls
attention27 to the frequency of nervous syphilis in persons who afford
no distinct history of secondary symptoms.
25 The Brain and its Diseases, London, 1879, vol. i. p. 7.
26 Syphilitic Nervous Affections, London, 1874, p. 80.
27 Archiv f. Psychiatrie, vii. p. 241.
Although syphilis is prone to attack the nervous system many years

after infection, it would be a fatal mistake to suppose that nervous
disease may not rapidly follow the chancre. What is the minimum
possible intermediate period we do not know, but it is certainly very
brief, as is shown by the following cases of this so-called precocious
nervous syphilis. Alfrik Ljunggrén of Stockholm reports28 the case of
H. R——, who had a rapidly-healed chancre in March, followed in
May of the same year by a severe headache, mental confusion, and
giddiness. Early in July H. R—— had an epileptic attack, but was
finally cured by active antisyphilitic treatment. Although the history is
not explicit, the nervous symptoms appear to have preceded the
development of distinct secondaries other than rheumatic pains.
28 Archiv f. Dermatol. u. Syphilis, 1870, ii. p. 155.
Davaine is said29 to have seen paralysis of the portio dura “a month

after the first symptoms of constitutional syphilis.” E. Leyden30 found
advanced specific degeneration of the cerebral arteries in a man
who had contracted syphilis one year previously. R. W. Taylor details
a case in which epilepsy occurred five months after the infection.31 In
the case of M. X——, reported by Ad. Schwarz,32 headache came on
the fortieth day after the appearance of the primary sore, and a
hemiplegia upon the forty-sixth day. S. L——33 had a paralytic stroke
without prodromes six months after the chancre. A. P. L——34 had an
apoplectic attack seven months after the chancre; A. S——, one five
months after her chancre. In a case which recently occurred in the
practice of A. Sydney Roberts of this city the chancre appeared after
a period of incubation of twenty-six days, and two months and eight
days subsequent to this came the first fit; eight days after the first the
second convulsion occurred, with a distinct aura, which preceded by
some minutes the unconsciousness. An interesting observation in
this connection is that of Ern. Gaucher35 of a spinal syphilis occurring
six months after the appearance of a chancre.
29 Buzzard, Syphilitic Nervous Affections, London, 1874.
30 Zeitschrift f. klin. Med., Bd. v. 165.
31 Journ. Nervous and Mental Dis., 1876, p. 38.
32 De l'Hémiplegia syphilitique Prêcoce, Inaug. Diss., Paris, 1880.
33 Ibid.
34 Ibid.
35 Revue de Méd., 1882, ii. 678.
This citation of cases might be much extended, but is sufficient to

show that nervous syphilis occurs not very rarely within six months
after infection, and may be present in two months.
Gummatous Brain Syphilis.
CLINICAL HISTORY.—Brain syphilis of the type now under

consideration may declare itself with great suddenness. An
apoplectic attack, a convulsive paroxysm, a violent mania, or a
paralytic stroke may be the first detected evidence of the disease. In
most of these cases the coming storm ought to have been foreseen,
and to a greater or less degree averted. The onset of cerebral
syphilis is, however, generally more gradual, the symptoms coming
on slowly and successively. Proper treatment, instituted at an early
stage, is usually successful, so that a careful study of these
prodromes is most important. They are generally such as denote
cerebral disturbance, and, although they should excite suspicion, are
not diagnostic, except as occurring in connection with a specific
history or under suspicious circumstances.
Headache, slight failure of memory, unwonted slowness of speech,

general lassitude, and especially lack of willingness to mental
exertion, sleeplessness or excessive somnolence, attacks of
momentary giddiness, vertiginous feelings when straining at stool,
yelling or in any way disturbing the cerebral circulation, alteration of
disposition,—any of these, and, a fortiori, several of them, occurring
in a syphilitic subject, should be the immediate signal of alarm, and
lead to the examination of the optic discs, for in some cases the eye-
ground will be found altered even during the prodromic stage. Of
course if choked disc be found the diagnosis becomes practically
fixed, but the absence of choked disc is no proof that the patient is
free from cerebral syphilis. In regard to the individual prodromic
symptoms, my own experience does not lend especial importance to
any one of them, although, perhaps, headache is the most common.
There is one symptom which may occur during the prodromic stage
of cerebral syphilis, but is more frequent at a later stage—a symptom
which is not absolutely characteristic of the disease, but which, when
it occurs in a person who is not hysterical, should give rise to the
strongest suspicion. I refer to the occurrence of repeated, partial,
passing palsies. A momentary weakness of one arm, a slight
drawing of the face disappearing in a few hours, a temporary
dragging of the toe, a partial aphasia which appears and disappears,
a squint which to-morrow leaves no trace, may be due to a non-
specific brain tumor, to miliary cerebral aneurisms, or to some other
non-specific affection; but in the great majority of cases where such
phenomena occur repeatedly the patient is suffering from syphilis or
hysteria.
The first type or variety of the fully-formed syphilitic meningeal

disease to which attention is here directed is that of an acute
meningitis. I am much inclined to doubt whether an acute syphilitic
meningitis can ever develop as a primary lesion—whether it must not
always be preceded by a chronic meningitis or by the formation of a
gummatous tumor; but it is very certain that acute meningitis may
develop when there have been no apparent symptoms, and may
therefore seem to be abrupt in its onset. Some years ago I saw, in
consultation, a man who in the midst of apparent health was
attacked by violent meningeal convulsions, with distinct evidences of
acute meningitis. He was apparently saved from death by very
heroic venesection, but after his return to consciousness developed
very rapidly a partial specific hemiplegia, showing that a latent
gumma had probably preceded the acute attack. On the other hand,
an acute attack is liable at any time to supervene upon a chronic
syphilitic meningitis. At the University Hospital dispensary I once
diagnosed chronic cerebral syphilis in a patient who the next day
was seized with violent delirium, with convulsions and typical
evidences of acute meningitis, and died four or five days afterward.
At the autopsy an acute meningitis was found to have been
engrafted on a chronic specific lesion of a similar character. In the
case reported by Gamel,36 in which intense headache, fever, and
delirium came on abruptly in an old syphilitic subject and ended in
general palsy and death, the symptoms were found to depend upon
an acute meningitis secondary to a large gumma.
36 Tumeurs gommeuses du Cerveau, Inaug. Diss., Montpellier, 1875.
In this connection may well be cited the observation of Molinier37 in

which violent delirium, convulsions, and coma occurred suddenly. A
very curious case is reported by D. A. Zambaco38 in which attacks
simulating acute meningitis occurring in a man with a cerebral
gummatous tumor appear to have been malarial. In such a case the
diagnosis of a malarial paroxysm could only be made out by the
presence of the cold stage, the transient nature of the attack, its
going off with a sweat, its periodical recurrence, and the therapeutic
effect on it of quinine.
37 Revue méd. de Toulouse, xiv. 1880, 341.
38 Des Affections nerveuses-syphilitiques, Paris, 1862, p. 485.
In the cases of chronic brain syphilis which have come under my

observation, most usually after a greater or less continuance of
prodromes such as have been mentioned, epileptic attacks have
occurred with a hemiplegia, or a monoplegia, which is almost
invariably incomplete and usually progressive; very frequently
diplopia is manifested before the epilepsy, and on careful
examination is found to be due to weakness of some of the ocular
muscles. Not rarely oculo-motor palsy is an early and pronounced
symptom, and a marked paralytic squint is very common. Along with
the development of these symptoms there is almost always distinct
failure of the general health and progressive intellectual
deterioration, as shown by loss of memory, failure of the power to fix
the attention, mental bewilderment, and perhaps aphasia. If the case
convalesce under treatment, the amelioration is gradual, the patient
travelling slowly up the road he has come down. If the case end
fatally, it is usually by a gradual sinking into complete paralysis, or
the patient is carried off by an acute inflammatory exacerbation, or,
as in two of my cases, amelioration may be rapidly occurring and a
very violent epileptic fit produce a sudden fatal asphyxia. Death from
brain-softening around the tumor is not infrequent, but a fatal
apoplectic hemorrhage is rare.
The clinical varieties of cerebral meningeal syphilis are so

polymorphic and kaleidoscopic that it is almost impossible to reduce
them to order for descriptive purposes. Fournier separates them into
the cephalic, congestive, epileptic, aphasic, mental, and paralytic,
but scarcely facilitates description by so doing. Heubner makes the
following types:
"1. Psychical disturbances, with epilepsy, incomplete paralysis

(seldom of the cranial nerves), and a final comatose condition,
usually of short duration.
"2. Genuine apoplectic attacks with succeeding hemiplegia, in

connection with peculiar somnolent conditions, occurring in
often-repeated episodes; frequently phenomena of unilateral
irritation, and generally at the same time paralyses of the
cerebral nerves.
"3. Course of the cerebral disease similar to paralytica

dementia.”
In regard to these types, the latter seems to me clear and well

defined, but contains those cases which I shall discuss under the
head of Cortical Disease.
Meningeal syphilis as seen in this country does not conform rigidly
with the other asserted types, although there is this much of
agreement, that when the epilepsy is pronounced the basal cranial
nerves are not usually paralyzed, the reason of this being that
epilepsy is especially produced when the gummatous change is in
the ventricles or on the upper cortex. In basal affections the
epileptoid spells, if they occur at all, are usually of the form of petit
mal; but this rule is general, not absolute. The apoplectic somnolent
form of cerebral syphilis, for some reason, is rare in this city, and it
seems necessary to add to those of Heubner's a fourth type to which
a large proportion of our cases conform. This type I would
characterize as follows:
4. Psychical disturbance without complete epileptic convulsions,

associated with palsy of the basal nerves and often with partial
hemiplegia.
The most satisfactory way of approaching this subject is, however, to

study the important symptoms in severalty, rather than to attempt to
group them into recognizable varieties of the disease; and this
method I shall here adopt.
Headache is the most constant and usually the earliest symptom of

meningeal syphilis; but it may be absent, especially when the lesion
is located in the reflexions of the meninges which dip into the
ventricles, or when the basal gumma is small and not surrounded
with much inflammation. The length of time it may continue without
the development of other distinct symptoms is remarkable. In one
case39 at the University Dispensary the patient affirmed that he had
had it for four years before other causes of complaint appeared. It
sometimes disappears when other manifestations develop. It varies
almost indefinitely in its type, but is, except in very rare cases, at
least so far paroxysmal as to be subject to pronounced
exacerbations. In most instances it is entirely paroxysmal; and a
curious circumstance is, that very often these paroxysms may occur
only at long intervals: such distant paroxysms are usually very
severe, and are often accompanied by dizziness, sick stomach,

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Elasticity and Its Application

Multiple Choice – Section 00: Introduction

1. In general, elasticity is a measure of

b. the study of how the allocation of resources affects economic well-being.

6. When consumers face rising gasoline prices, they typically

7. A 10 percent increase in gasoline prices reduces gasoline consumption by about

Multiple Choice – Section 01: The Elasticity of Demand

1. The price elasticity of demand measures how much

2. The price elasticity of demand measures

3. The price elasticity of demand for a good measures the willingness of

5. Demand is said to be price elastic if

6. Demand is said to be inelastic if

7. If demand is price inelastic, then

9. When quantity demanded responds strongly to changes in price, demand is said to be

10. Demand is said to be inelastic if the

11. Demand is elastic if the price elasticity of demand is

12. Demand is inelastic if the price elasticity of demand is

14. The smaller the price elasticity of demand, the

15. Whether a good is a luxury or necessity depends on the

16. Goods with many close substitutes tend to have

17. For a good that is a luxury, demand

18. For a good that is a necessity, demand

19. A good will have a more elastic demand, the

SYMPTOMS.—In most cases the mental capacity is below the normal

CAUSES.—Besides the causes already mentioned, atrophy of the

TREATMENT.—Atrophy of the brain in children is perhaps, in the

2. Atrophy of the Fully-developed Brain.

In the brain of the adult the atrophy may be partial or total,

CAUSES.—As already mentioned, the causes of atrophy of the brain

PATHOLOGICAL ANATOMY.—The cerebrum particularly is found

The histological changes associated with atrophy of the brain differ

SYMPTOMS.—In partial atrophy of the brain the primary symptoms

Total atrophy of the brain, when due to an extensive meningitis or to

TREATMENT.—There is no special treatment for atrophy of the brain;

HYPERTROPHY OF THE BRAIN.

INTRODUCTION.—Notwithstanding the numerous measurings and

PATHOLOGICAL ANATOMY.—Directly after the removal of the vault of the

The condition of the skull is, according to Rokitanski,1 as follows: In

SYMPTOMS.—There is a gradually increasing muscular weakness,

The COURSE of the disease is, according to Andral and Hasse,2

DIAGNOSIS, PROGNOSIS, AND TREATMENT.—It has already been

There are no remarks to be made on the prognosis and treatment of

BY H. C. WOOD, M.D., LL.D.

Syphilitic affections of the nerve-centres are best studied by

It is not unnatural to expect that any agency which is capable of

Blows and other traumatisms would be expected to figure largely as

2 Lond. Lancet, 1876, ii. p. 741.

3 Ziemssen's Encyclopædia, xii. 301.

Various authorities attach much influence to over-study and other

The drift of the evidence in medical literature is so pronounced, and

Inherited syphilis seems to be less prone than the acquired diathesis

6 Arch. f. Ophthalm., Bd. i. Erst Abth.

7 Virchow's Archiv, Bd. lxxxiv. 269.

8 Wien. Med. Wochenschrift, xxxi. 1881, 17.

9 Lond. Patholog. Soc. Trans., 1877.

12 Arch. de Tocologie, x. 411.

Recorded cases prove decisively that even after puberty specific

15 Loc. cit., p. 71.

16 Lectures on Dis. of Nerv. Syst., Philada., 1878, p. 333.