Microeconomics 9Th Edition Colander Solutions Manual Full Chapter PDF

Chapter 05 - Using Supply and Demand
Solution Manual for Microeconomics 9th Edition

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Chapter 5 Using Supply and Demand
Questions and Exercises
1. If price and quantity both rose, the simplest cause would be a shift of the demand
curve to the right.
2. If price fell and quantity remained constant, a possible cause would be a shift out
to the right of the supply curve and a shift of the demand curve in to the left.
Another possibility would be a shift of the demand curve in to the left with a
vertical supply curve.
3. Computer pricing of roads could end bottlenecks and rush hour congestion by
means of price rationing. Currently, at zero price, at certain times the quantity
demanded greatly exceeds the quantity supplied, resulting in congestion. Raising
prices during those times could eliminate excess demand and reduce the congestion.
This technological change will spread out congestions over wider geographic areas
and over the day as individuals with more flexibility with respect to route and
timing will choose to demand less of the current high-demand route at rush hour.
4. a. This would represent a shift in demand to the left, assuming that the decline in
Cookie Monster’s popularity represents a decline in the popularity of cookies.
The price and quantity of cookies would probably fall, as shown in the
accompanying graph.
5-1
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b. This is represented by a shift in demand for bread (high in carbohydrates) to the

left. Equilibrium price and quantity fall, as the graph shows. (Note: This is the
same graph used for part a.)
5. a. Both the shift in demand to the right and the shift of supply to the left lead to a
higher equilibrium price of oil. The effect on equilibrium is indeterminate.
Although the shift in demand to the right would lead to a rise in equilibrium
quantity, the shift in supply to the left would reduce it. Whether equilibrium
quantity rises or falls depends on the relative size of the shifts. The
accompanying graph shows no effect on equilibrium quantity and a significant
increase in equilibrium price.
b. The increase in the oil production of Libya back to its original level shifted supply
to the right, reducing the price of oil and increasing the equilibrium quantity, as is
shown in the accompanying graph.
5-2
whole or part.
6. a. This represents a shift of the supply curve to the left because the offended decide
not to supply organs, increasing the legal price significantly and perhaps reducing
the equilibrium quantity to a quantity that is below the amount currently provided
at zero cost. This is shown in the accompanying graph.
b. How responsive quantity supplied is to price affects the slope of the supply curve.
If quantity supplied is very responsive to price, the equilibrium price might be
quite low and legalizing organ sales would have significant benefits to society. In
fact, the authors of the study estimate the equilibrium price of kidneys to be less
than $1,000. In the accompanying graph, S1 is much more responsive to price than
is S0.
5-3
whole or part.
7. A drought in Australia shifted the supply curve for rice to the left. The equilibrium
price rose from $0.12 to $0.24 a pound, and quantity fell, as the accompanying
graph shows.
8. See the accompanying graph. A price ceiling of PC below equilibrium price will
cause a shortage shown by the difference between QD and QS
9. As you can see in the accompanying graph, the rent controls create a situation in
which demanders are willing to pay much more than the controlled price and
much more than the equilibrium price. These payments are sometimes known as
key money. In this graph, landlords are willing to supply QS at the current
5-4
whole or part.
controlled rent, PC. Consumers are willing to pay up to PB for the quantity QS.
Key money can be an amount up to the difference between PB and PC.
10. See the accompanying graph. A price floor of PF above the equilibrium price will
cause a surplus shown by the difference between QS and QD.
11. A minimum wage is a price floor. A Pmin above the equilibrium wage will result in
the quantity of laborers looking for work increasing to QS and the quantity of
employers looking to hire decreasing to QD. The difference between the two is a
measure of the number of the unemployed.
12. a. A $4 per-unit tax on suppliers shifts the supply curve up by $4, which is shown as
a shift in the supply curve from S0 to S1. The equilibrium price will rise by $4 only
if the demand curve is perfectly vertical. In the case of a vertical demand curve,
quantity would not change. Otherwise, the equilibrium price rises by less than $4
and the equilibrium quantity falls, as shown in the accompanying graph. In this
example, the price increases by less than $4 to P1 and quantity declines to Q1. The
price that suppliers receive falls to P2.
5-5
whole or part.
b. A $4 per unit tax on consumers shifts the demand curve down by $4, which is
shown as a shift down in the demand curve from D0 to D1. The equilibrium price
will fall by $4 only if the supply curve is perfectly vertical. In the case of a vertical
supply curve, quantity would not change. Otherwise, the equilibrium price falls by
less than $4 to P1 and the equilibrium quantity falls Q1, as shown in the
accompanying graph. The price paid by consumers, including the tax, is P2.
c. The unit tax on the consumers and suppliers has the same effect on both equilibrium
quantity and price. It doesn't matter who pays the tax.
13. a. The quantity supplied and the quantity demanded equal each other when the price
is $1.00. The equilibrium price is $1.00, and the equilibrium quantity is 150 units.
5-6
whole or part.
b. The tax shifts the supply curve up by $0.75 from S0 to S1. The equilibrium price
(the price consumers pay) is $1.50, and the equilibrium quantity is 125. Suppliers
receive the equilibrium price minus the tax, or $0.75.
c. The tax shifts the demand curve down by $0.75 from D0 to D1. The equilibrium
price (the price producers receive) is $0.75, and the equilibrium quantity is 125.
Consumers pay ($0.75 + $0.75).
d. It doesn't matter upon whom the tax is levied. The result is the same.
5-7
whole or part.
14. A quota places a quantity restriction on imports. Consumers are willing to pay a
higher price for the lower quantity (QQ) than the equilibrium price without a quota.
Therefore, quotas lead to higher import prices, as shown in the accompanying
graph.
15. a. See the accompanying graph.
b. There is excess demand of 300.

c. The maximum a person is willing to pay is $50.
d. If Pawnee keeps the number of licenses, it must charge $50. If it eliminates the
quantity restriction, it will charge $30 and sell 300.
16. Public post-secondary education is an example of a third-party-payer market

because it is heavily subsidized by state government and, in most cases, a
student’s parents. Those consuming the good, students, do not pay the entire cost
of the education they receive. This probably leads to greater expenditures on
post-secondary education than would be the case if students had to pay the entire
cost of their education.
17. a. Equilibrium price is $6, and equilibrium quantity is 300.

b. In a third-party-payer system in which the consumer pays $2, quantity demanded
will be 900. Suppliers require payment of $14 to supply that quantity.
5-8
whole or part.
c. Total spending in a is $1,800. Total spending in b is $12,600.
5-9
whole or part.
Questions from Alternative Perspectives
1. Austrian
I might decide to hire my friends or to hire those with whom I like to work, such
as those from a preferred ethnic group or sex. Is doing so fair? Fairness is a
judgment question, and judgments differ. From most people’s perspective, such
methods are not fair. The problem is that wage controls set an equal base wage
level but leave open possibilities for other inequalities. Rather than helping the
least skilled end of the labor pool, it prices them out of the market, increasing
their unemployment and promoting other forms of discrimination. Austrians
believe that these market distortions are not good for society and prefer little or no
government intervention.
2. Feminist
There are probably a number of reasons why women are paid less than men. Part
of the pay gap may be explained by differences in work experience, education,
on-the-job training, and work interruptions for women. Economists typically
measure discrimination as a residual: the part of the pay gap that remains
“unexplained” after accounting for these factors. The second part of the question
is a judgment question, and judgments differ. A law that requires firms to pay
equal wages to those with comparable skills may be difficult to implement. How
would the skills be assessed? Others argue that the assessment itself would add
costs to a firm’s production and increase product prices. However, if the reason
for the pay gap is discrimination, the law can change values and make it more
costly to discriminate. Since discrimination necessarily implies that hiring is on
the basis of something other than productivity, reducing discrimination may
promote efficiency. Feminists generally support such laws.
3. Institutionalist
a. We can see cultural evolution through history; the appendix to Chapter 3 can be
used to trace the cultural evolution of the market system. Here it is important to
stress that religious values and social relationships had to evolve to accommodate
the needs of the new forms of economic organization that emerged. Markets
change overnight and increasingly require rapid adaptation by individuals, which
can cause shocks to social relationships. One might question the long-term
(in)stability caused by market evolution. The outcomes of biological evolution are
driven by natural selection: those organisms with traits that give them a
competitive edge in the competition for limited energy propagate; others
disappear. In this context, the only purpose is to reproduce successfully. Some
economists believe that the purpose of cultural evolution is betterment of the
human condition for all.
5-10
whole or part.
b. In the U.S. market, evolution has elevated living standards for everyone relative
to those of, say, 1775. We see access to fresh fruits and vegetables year-round,
many diseases have been eliminated, and life spans have increased greatly. Yet
we are social beings who are aware of our social position. One may be well fed
but still feel socially destitute because one’s relative level of welfare is many
magnitudes below that of others. In this sense, market evolution has failed to
contribute to betterment.
4. Religious
What is appropriate depends on one's normative judgments, and most normative

systems see taking undue advantage of someone in a crisis as wrong. Early
economists examined a concept that they called the "just price," which is the price
that should be charged in various situations. There are many interpretations of
what the just price should be; one is that it should be close to the normal market
price that would be charged. During emergencies such as floods or hurricanes,
most people believe that "price gouging" is inappropriate, and there are social
pressures and laws against it.
5. Radical
a. Today’s rent controls are designed to be less invasive than the ones described in
the book, and thus they do not have the strong effects described there. They still
have some effects, and the policy question is whether the income redistribution
effects they have are sufficiently desirable to warrant the costs of the policies.
b. This is a judgment question; economics can tell one about what the costs and
benefits of a mechanism are, not about what is an appropriate mechanism.
c. This again is a judgment question that requires an integration of normative issues
into the analysis. Most mainstream economists would argue that it is better to deal
with the underlying income distribution issues rather than with specific ones and
that one must consider the problems of government intervention. Radical
economists would argue that although mainstream economists talk about
"underlying issues," they seldom deal with those problems.
5-11
whole or part.
Issues to Ponder
1. a. Airways have value because they produce revenue and there are only a limited
number of airways in the industry.
b. Television networks have incentives to produce high-definition television only to
the extent that they would receive more revenue for using extra bandwidth.
2. a. The supply curve is vertical at 10,000 tickets. We know there is an excess demand
at $130 because there is a secondary market for scalped tickets at a higher price.
The accompanying graph shows excess demand of QD – 10,000.
b. The people represented by QD – 10,000 will make offers to scalpers for any
amount above $130 up to the equilibrium price (if there had been a market) of
$2,000. The accompanying graph shows the range of $200 to $2,000.
c. If scalping became legalized, more people would be willing to sell their tickets
because there would be no risk of being arrested and fined. The shift of the
supply curve for resold tickets to the right will reduce the secondary-market price
of Final Four tickets.
5-12
whole or part.
3. a. A weakly enforced antiscalping law would add an additional cost to those selling
scalped tickets and push up the resale cost of tickets to include the expected cost
of being caught, which would be fairly small with weak enforcement. In the
accompanying graph, this shifts the supply curve from S0 to S1, raising the
equilibrium price slightly from P0 to P1. (Note: This assumes that only selling, not
buying, is illegal.)
b. A strongly enforced antiscalping law (against suppliers) would push up prices far
more as the cost of supply rose and the supply curve shifted to the left. If
enforcement were sufficiently strong, a two-tier price system would emerge with
a low legal price at P0 and another very high price, P2.
4. a. Boards often exist to benefit the consumer but also to benefit those who currently
produce. Often those who are currently certified attempt to limit the number of
new certifications to limit the supply and thus boost the price they receive.
b. Possible changes include eliminating the board of certification, limiting its
regulation to only those skills which it addresses directly, and requiring continual
recertification so that the skills of those already certified reflect the current
demand for skills in that market.
c. A political difficulty with implementing these changes is that a relatively small
group of those currently certified will be hurt and will lobby hard for the status
quo. Those currently certified may have more “clout” with the board if the board
is composed of certified hairdressers. The benefits of the changes are also large,
but they are spread out over large groups of consumers, with each consumer
benefiting very little. Therefore, it will be easier for the small group whose benefit
per individual is large to organize.
5. a. The Oregon health plan includes a prioritized list of medical services that
determine whether a service is covered. The list is based on comparative benefit
to those covered. Those services which have the highest net benefit are ranked
highest. Those with a lower net benefit are not covered.
b. Economists should not oppose the Oregon plan because it involves rationing. The
market involves rationing through the price mechanism. Economists might oppose
the Oregon plan because in general they support the market as the least-cost
5-13
whole or part.
method of providing goods and services. Economists are open to the argument
that the market may not distribute goods and services in the way that society
wants, which may require government intervention.
c. In the market, the interaction of demand and supply determines the equilibrium
price and the quantity that is bought and sold. Those who are able to pay the
equilibrium price are the ones who receive the health care. The Oregon plan uses
a benefit-ranking system rather than price as the rationing mechanism.
6. a. Frequent-flier programs allow companies to lower their effective prices without

lowering their reported prices. Companies also use them to get business travelers
to choose their airlines. Such programs are an example of a third-party-payer
system: The business traveler gets the benefit (frequent-flier miles), and his or her
business pays for the current flight.
b. Other examples include points that hotels give to travelers and bonus checks
based on charges that Discover gives those who use its credit card.
c. Firms probably do not monitor these programs because it would be too costly to
do so.
7. a. An import quota will increase the price of imported sugar. The accompanying graph
shows how a higher imported sugar price increases the price domestic producers
can charge and increase the quantity they can supply to the market. For example, at
world price P0, domestic consumers demand the quantity E–B from importers and
quantity B from domestic producers. After a quota represented by quantity D minus
C is imposed, the import price is P1. Domestic consumers demand the quantity D–
C from importers and quantity C from domestic producers.
b. The government could have imposed a tariff on imported sugar. This would also
have raised the price of imported sugar.
c. A minimum required import level of 1.25 million will limit the ability of the
United States to support domestic sugar prices. The increase in quantity supplied
will put downward pressure on sugar prices.
5-14
whole or part.
8. a. As shown in the accompanying graph, the controlled price (PC) is below

equilibrium. At this price, the quantity of apartments demanded (QD) exceeds the
quantity of apartments supplied (QS). Since there are more apartments demanded
than supplied at this price, apartments are hard to find.
b. Since at the existing quantity supplied, Qs, demanders would be willing to pay PB,
there is a strong incentive to make side payments to existing tenants to acquire an
apartment. At PB, more tenants are willing to supply their apartments than at Pc,
and so a side payment can induce a tenant to give up his or her apartment. This is
one form of rationing. When market price rationing does not take place, some
other form of rationing must replace it.
c. Eliminating rent controls most likely would allow the market price of apartments
to increase and eliminate side payments. The quantity supplied will rise until it
equals the quantity demanded at the market price. The price–quantity combination
is (PE, QE) in the graph. However, if there are few additional apartments available
to be rented (the supply curve is almost vertical), price will increase dramatically
and quantity supplied will rise only slightly.
d. The political appeal of rent control is that it benefits those who currently rent
apartments. Apartment renters who live in rent-controlled apartments are more
likely to vote, and this is why it is maintained. There are other possible reasons as
well.
9. a. The government subsidy of mohair provided an enormous incentive for those who
were allowed to sell mohair to sell large quantities at a lower price than otherwise.
The elimination of this subsidy shifted the supply curve to the left (shown in the
accompanying graph as a shift from Ssubsidy to S no subsidy, increasing the market
price for mohair from P0 to P1 and decreasing the quantity demanded and
supplied from Q0 to Q1.
5-15
whole or part.
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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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Chapter 05 - Using Supply and Demand

Solution Manual for Microeconomics 9th Edition

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Chapter 5 Using Supply and Demand

Questions and Exercises

b. This is represented by a shift in demand for bread (high in carbohydrates) to the

15. a. See the accompanying graph.

b. There is excess demand of 300.

16. Public post-secondary education is an example of a third-party-payer market

17. a. Equilibrium price is $6, and equilibrium quantity is 300.

c. Total spending in a is $1,800. Total spending in b is $12,600.

Questions from Alternative Perspectives

What is appropriate depends on one's normative judgments, and most normative

6. a. Frequent-flier programs allow companies to lower their effective prices without

8. a. As shown in the accompanying graph, the controlled price (PC) is below

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.

17 Journ. Ment. and Nerv. Diseases, 1875, p. 516.

18 Brit. Med. Journal, May 18, 1872.

19 Archiv f. Psychiatrie, Bd. i. 313.

Some time since I saw, in an orphan of fourteen, a chronic basal

It is of course very important to diagnose between a tubercular

The relation of inherited syphilis to various nervous affections not

22 Archiv f. Psychiatrie, Bd. i. 309.

Another very important question connected with the etiology of these

The following citations prove that this experience is not peculiar.

27 Archiv f. Psychiatrie, vii. p. 241.

Although syphilis is prone to attack the nervous system many years