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Strategic Management: A Competitive Advantage Approach, 14e (David)
Chapter 6 Strategy Analysis and Choice
1) An organization's present strategies, objectives and mission provide a basis for generating and
evaluating feasible alternative strategies, coupled with the external and internal audit
information.
Answer: TRUE
Diff: 1 Page Ref: 172
Objective: 6.01 Describe a three-stage framework for choosing among alternative strategies.
Learning Outcome: Define corporate strategy and identify its key elements
2) Alternative strategies don't come out of the blue; they are derived from the firm's vision,
mission, and objectives.
Answer: TRUE
Learning Outcome: Discuss the functions of vision statements, mission statements, and long-
term corporate objectives
3) It is vital that strategists always consider all feasible alternatives that could benefit the firm.
Answer: FALSE
4) The first stage of the strategy-formulation framework is the input stage, and it is directly
followed by the decision stage.
Answer: FALSE
5) Stage 2 in the strategy-formulation framework involves the Quantitative Strategic Planning

Matrix.
Answer: FALSE
6) The Strengths-Weaknesses-Opportunities-Threats (SWOT) Matrix, the Strategic Position and

Action Evaluation (SPACE) Matrix, the Boston Consulting Group (BCG) Matrix, the Internal-
External (IE) Matrix, and the Grand Strategy Matrix are included in stage two of the strategy-
formulation framework.
Answer: TRUE
1
Copyright © 2013 Pearson Education, Inc. publishing as Prentice Hall
7) Good intuitive judgment is always needed to determine appropriate weights and ratings in the
input stage matrices.
Answer: TRUE
Objective: 6.04 Discuss the role of intuition in strategic analysis and choice.
8) When completing the matching stage of the strategy-formulation framework, the SWOT
Matrix needs to be completed before the SPACE Matrix.
Answer: FALSE
9) The purpose of matching key factors is to generate feasible alternative strategies.

Answer: TRUE
10) Strengths-opportunities strategies are based on using a firm's internal strengths to take
advantage of external opportunities.
Answer: TRUE
Objective: 6.02 Explain how to develop a SWOT Matrix, SPACE Matrix, BCG Matrix, IE
Matrix, and QSPM.
11) A SWOT Matrix is composed of four cells for the four types of strategies it creates.
Answer: FALSE
Matrix, and QSPM.
12) One of the steps of the SWOT Matrix is to list the firm's key external opportunities.
Answer: TRUE
Matrix, and QSPM.
2
13) The SWOT matrix is widely used as an organizational tool and, if used appropriately, does
not have any limitations.
Answer: FALSE
Matrix, and QSPM.
14) The most important determinants of an organization's overall strategic position are
considered to be the two internal dimensions, financial position (FP) and competitive position
(CP), and the two external dimensions, industry position (IP) and stability position (SP).
Answer: TRUE
Matrix, and QSPM.
15) The four strategies of the SPACE Matrix are aggressive, conservative, offensive and
defensive.
Answer: FALSE
Matrix, and QSPM.
16) Market penetration can be classified as either a conservative, aggressive, or competitive

strategy.
Answer: TRUE
Matrix, and QSPM.
17) The SP and CP dimension variables in a SPACE Matrix are assigned a numerical value
ranging from -1 (best) to -7 (worst).
Answer: TRUE
Matrix, and QSPM.
3
18) Conservative strategies in a SPACE Matrix most often include product development, market
development, market penetration and related diversification.
Answer: TRUE
Matrix, and QSPM.
19) The firm should pursue conservative strategies if the coordinates of a SPACE directional
vector are (-1, +4).
Answer: TRUE
AACSB: Analytic Skills
Matrix, and QSPM.
20) A firm should pursue defensive strategies if the coordinates of a SPACE directional vector
are (+2, +3).
Answer: FALSE
Matrix, and QSPM.
21) The firm should pursue aggressive strategies if the coordinates of a SPACE directional
vector are (+5, +4).
Answer: TRUE
Matrix, and QSPM.
22) Relative market share position is given on the x-axis of the BCG Matrix.
Answer: TRUE
Matrix, and QSPM.
Learning Outcome: Define strategic management and identify its basic concepts
4
23) The midpoint on the x-axis of a BCG Matrix is typically set at 0.05.
Answer: FALSE
Matrix, and QSPM.
24) The size of the circle in a BCG Matrix corresponds to the proportion of corporate revenue
generated by that business unit.
Answer: TRUE
Matrix, and QSPM.
25) In a BCG Matrix the pie slice indicates the proportion of corporate profits generated by that
division.
Answer: TRUE
Matrix, and QSPM.
26) Stars, Question Marks, Cash Cows, and Dogs are the four quadrants exhibited by the SPACE
Matrix.
Answer: TRUE
Diff: 1 Page Ref: 184-185
Matrix, and QSPM.
27) Cash Cows represent the organization's best long-run opportunities for growth and
profitability.
Answer: FALSE
Matrix, and QSPM.
28) The major benefit of the BCG Matrix is that it draws attention to the cash flow, investment
characteristics, and needs of an organization's various divisions.
Answer: TRUE
Matrix, and QSPM.
5
29) Viewing every business as either a Star, Cash Cow, Dog, or Question Mark is an
oversimplification.
Answer: TRUE
Matrix, and QSPM.
30) The BCG Matrix does not reflect whether or not various divisions or their industries are
growing over time.
Answer: TRUE
Matrix, and QSPM.
31) Having no temporal qualities, the BCG Matrix is a snapshot of an organization at a given
point in time.
Answer: TRUE
Matrix, and QSPM.
32) Both IE and BCG Matrices are called portfolio matrices.

Answer: TRUE
Matrix, and QSPM.
33) The BCG Matrix requires more information about the divisions than the IE Matrix.
Answer: FALSE
34) On the x-axis of the IE Matrix, an internal factor evaluation score of 2.5 represents a weak
internal position.
Answer: FALSE
Matrix, and QSPM.
6
35) The IE Matrix can be divided into three major regions that have different strategy
implications: grow and build, hold and maintain, and harvest or divest.
Answer: TRUE
Matrix, and QSPM.
36) The Grand Strategy Matrix is based on two evaluative dimensions, market share and market
growth.
Answer: FALSE
Matrix, and QSPM.
37) According to the Grand Strategy Matrix, when a Quadrant I firm is too heavily committed to
a single product, then related diversification may reduce the risks associated with a narrow
product line.
Answer: TRUE
Matrix, and QSPM.
38) According to the Grand Strategy Matrix, Quadrant III organizations compete in rapid-growth
industries and have weak competitive positions.
Answer: FALSE
Matrix, and QSPM.
39) To objectively evaluate feasible alternative strategies identified in Stage 2, the QSPM uses
input information derived from Stage 1.
Answer: TRUE
Matrix, and QSPM.
40) Step 1 of a QSPM assigns weights to each key external and internal factor.
Answer: FALSE
Matrix, and QSPM.
7
41) Total attractiveness scores are defined as the sum of the attractiveness scores in a given
column of the QSPM and are computed in the second step of the QSPM.
Answer: FALSE
Matrix, and QSPM.
42) A positive feature of QSPM is that sets of strategies can be examined sequentially or
simultaneously.
Answer: TRUE
Matrix, and QSPM.
43) One positive feature of QSPM is that it does not require intuitive judgments and educated
assumptions.
Answer: FALSE
44) Culture includes the set of shared values, beliefs, attitudes, customs, norms, personalities,
heroes, and heroines that describe a firm.
Answer: TRUE
AACSB: Multicultural and Diversity Understanding
Objective: 6.05 Discuss the role of organizational culture in strategic analysis and choice.
45) Strategy changes may be highly effective and productive if a supportive culture does not
exist.
Answer: FALSE
46) Whenever two firms merge, it becomes especially important to evaluate and consider
culture-strategies linkages.
Answer: TRUE
8
47) Successful strategists minimize their own political exposure on issues that are highly
controversial and in circumstances where opposition from major power centers is likely.
Answer: TRUE
48) The tactic of focusing on higher-order issues involves recognizing that it is often possible to
achieve similar results using different means or paths.
Answer: FALSE
Objective: 6.03 Identify important behavioral, political, ethical, and social responsibility
considerations in strategy analysis and choice.
49) Shifting focus from specific issues to more general ones may increase strategists' options for
gaining organizational commitment.
Answer: TRUE
50) The trend in the U.S. is toward larger boards, with an average of 18 members being the
norm.
Answer: FALSE
Objective: 6.06 Discuss the role of a board of directors in choosing among alternative strategies.
Learning Outcome: Describe modern corporate governance practices
51) Today boards of directors are composed mostly of outsiders who are becoming more
involved in an organization's strategic management.
Answer: TRUE
52) The Sarbanes-Oxley Act put an end to the "country-club" atmosphere of most boards and has
shifted power from CEOs to directors.
Answer: TRUE
53) Strategy analysis and choice largely involves making ________ decisions based on
________ information.
A) long-term; short-term
9
B) subjective; objective
C) short-term; long-term
D) subjective; short-term
E) objective; subjective
Answer: B
54) Which stage in the strategy-formulation framework focuses on generating feasible alternative
strategies?
A) Input
B) Output
C) Decision
D) Throughput
E) Matching
Answer: E
55) Which stage of the strategy-formulation framework involves the Quantitative Strategic
Planning Matrix?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
E) Stage 5
Answer: C
56) Which strategy-formulation technique reveals the relative attractiveness of alternative

strategies and thus provides an objective basis for selecting specific strategies?
A) SWOT
B) SPACE
C) QSPM
D) IFE
E) CPM
Answer: C
57) Each of the nine techniques included in the strategy formulation framework rely on the use
of
10
A) strictly factual data.
B) luck.
C) financial formulas and statistics.
D) intuition and analysis.
E) synergy.
Answer: D
58) Which stage of the strategy-formulation framework includes an Internal-Factor Evaluation

Matrix and a Competitive Profile Matrix?
A) Input
B) Matching
C) Decision
D) Penetration
E) Research
Answer: A
Learning Outcome: Compare and contrast different business-level strategies
59) Which stage of the strategy-formulation framework contains the Internal-Factor Evaluation
Matrix?
A) Input stage
B) Analysis stage
C) Matching stage
D) Decision stage
E) Output stage
Answer: A
60) The match an organization makes between its internal resources and skills and the
opportunities and risks created by its external factors can be defined as
A) input.
B) concept formulation.
C) strategy.
D) SWOT.
E) weakness.
Answer: C
61) Which section of the SWOT Matrix involves matching internal strengths with external
11
opportunities?
A) The WT cell
B) The SW cell
C) The WO cell
D) The ST cell
E) The SO cell
Answer: E
Matrix, and QSPM.
62) Which strategies aim at improving internal weaknesses by taking advantage of external
opportunities?
A) SO
B) WO
C) SW
D) ST
E) WT
Answer: B
Matrix, and QSPM.
63) Which strategies use a firm's strengths to avoid or reduce the impact of external threats?
A) SO
B) WO
C) SW
D) ST
E) WT
Answer: D
Matrix, and QSPM.
12
64) Which strategies are defensive tactics directed at reducing internal weaknesses and avoiding
external threats?
A) SO
B) WO
C) SW
D) ST
E) WT
Answer: E
Matrix, and QSPM.
65) How many cells are in a SWOT Matrix?

A) Two
B) Four
C) Six
D) Eight
E) Nine
Answer: E
Matrix, and QSPM.
66) Which of the following is NOT one of the steps involved in constructing a SWOT Matrix?
A) List the firm's key external threats.
B) Match internal strengths with external opportunities, and record the resultant SO strategies in
the appropriate cell.
C) Match internal weaknesses with external threats, and record the resultant WT strategies.
D) List the firm's external weaknesses.
E) List the firm's external opportunities.
Answer: D
Matrix, and QSPM.
13
67) Which of the following is a limitation associated with a SWOT Matrix?
A) Viewing every business as a Star, Cash Cow, Dog, or Question Mark is an oversimplification.
B) Many businesses fall right in the middle of the matrix.
C) It is a static assessment in time.
D) Other variables besides relative market share position and industry growth rate in sales need
to be considered.
E) The matrix does not reflect whether or not various divisions or their industry are growing over
time.
Answer: C
Matrix, and QSPM.
68) Which of these is NOT a SPACE Matrix quadrant?

A) Aggressive
B) Defensive
C) Competitive
D) Offensive
E) Conservative
Answer: D
Matrix, and QSPM.
69) What type of strategy would divestiture be classified as?

A) Aggressive
B) Defensive
C) Competitive
D) Offensive
E) Conservative
Answer: B
Matrix, and QSPM.
14
70) The two internal dimensions represented on the axes of the SPACE Matrix are
A) stability position and industry position.
B) industry position and internationalization.
C) internationalization and competitive position.
D) competitive position and financial position.
E) financial position and stability position.
Answer: D
Matrix, and QSPM.
71) What are the two external dimensions of the SPACE Matrix?
A) Stability position and industry position
B) Stability position and competitive position
C) Industry position and competitive position
D) Competitive position and financial position
E) Financial position and industry position
Answer: A
Matrix, and QSPM.
72) The two positive-rated dimensions on the SPACE Matrix are

A) FP and CP.
B) CP and SP.
C) FP and IP.
D) IP and SP.
E) FP and SP.
Answer: C
Matrix, and QSPM.
15
73) What type of strategies would you recommend when a firm's SPACE Matrix directional
vector has the coordinates (-2, +3)?
A) Aggressive
B) Conservative
C) Competitive
D) Defensive
E) Integrative
Answer: B
Matrix, and QSPM.
74) In the SPACE analysis, what does a (+6, +3) strategy profile portray?
A) A strong industry position
B) An unstable environment
C) A stable environment
D) A weak industry position
E) A weak financial position
Answer: A
Matrix, and QSPM.
75) The BCG Matrix is designed specifically to enhance which type of firm's efforts to formulate
strategies?
A) Companies with more than one division
B) Large companies
C) Companies with annual sales greater than $1 million
D) Companies with annual sales of less than $1 million
E) All companies
Answer: A
Matrix, and QSPM.
16
76) In the BCG Matrix, which element represents the industry growth rate in sales, measured in
percentage terms?
A) x-axis
B) y-axis
C) first quadrant
D) second quadrant
E) third quadrant
Answer: B
Matrix, and QSPM.
77) In the BCG Matrix, how would a division with a low relative market share position in a high
growth industry be described?
A) Question Mark
B) Cash Cow
C) Star
D) Stuck-in-the-middle
E) Dog
Answer: A
Matrix, and QSPM.
78) In the BCG Matrix, when a division of an organization has a high relative market share and
is in a fast-growing industry, it is called a
A) Star.
B) Cash Cow.
C) Cat.
D) Question Mark.
E) Dog.
Answer: A
Matrix, and QSPM.
17
79) In the BCG Matrix, a division with a high relative market share position in a low-growth
industry can be described as a
A) Star.
B) Cash Cow.
C) Question Mark.
D) Dog.
E) Failure.
Answer: B
Matrix, and QSPM.
80) In the BCG Matrix, which strategy would be most appropriate for a division classified as a
Dog?
A) Market penetration
B) Market development
C) Product development
D) Retrenchment
E) Forward integration
Answer: D
Matrix, and QSPM.
81) Forward integration would be an appropriate strategy for which of the following types of
divisions in the BCG Matrix?
A) Dogs
B) Failures
C) Question Marks
D) Cat
E) Star
Answer: E
Matrix, and QSPM.
18
82) In the BCG Matrix, a division that has a low relative market share position and competes in a
slow-growth industry is referred to as a
A) Dog.
B) Question Mark.
C) Star.
D) Cash Cow.
E) Cowboy.
Answer: A
Matrix, and QSPM.
83) All of the following are limitations of the BCG Matrix EXCEPT
A) Viewing every business as a star, cash cow, dog or question mark can be an
oversimplification.
B) The Matrix requires at least three years worth of data.
C) The Matrix does not reflect divisional or industry growth over time.
D) The Matrix does not allow a company to be classified as somewhere in between two
categories.
E) Variables such as size of market and competitive advantages are not considered in the Matrix.
Answer: B
Matrix, and QSPM.
84) Which of the following analytical tools consists of a nine-cell matrix?

A) BCG Matrix
B) Competitive Profile Matrix
C) SPACE Matrix
D) Grand Strategy Matrix
E) Internal-External Matrix
Answer: E
Matrix, and QSPM.
19
85) What analytical tool has four quadrants based on two dimensions: competitive position and
market growth?
A) Competitive Profile Matrix
B) Internal-External Matrix
C) SPACE Matrix
E) QSPM
Answer: D
Matrix, and QSPM.
86) Firms located in which quadrant of the Grand Strategy Matrix are in an excellent strategic
position?
A) I
B) II
C) III
D) IV
E) V
Answer: A
Matrix, and QSPM.
87) According to the Grand Strategy Matrix, which strategy is recommended for a firm with
rapid market growth and a strong competitive position?
A) Market penetration
B) Unrelated diversification
C) Joint venture
D) Retrenchment
E) Liquidation
Answer: A
Matrix, and QSPM.
20
88) For companies located in Quadrant III of the Grand Strategy Matrix, the first strategy
recommended is
A) extensive cost and asset reduction.
B) asset expansion.
C) employee expansion.
D) immediate liquidation of assets.
E) divestiture.
Answer: A
Matrix, and QSPM.
89) Although Quadrant ________ companies are growing, according to the Grand Strategy
Matrix they are unable to compete effectively, and they need to determine why the firm's current
approach is ineffective and how the company can best change to improve its competitiveness.
A) I
B) II
C) III
D) IV
E) V
Answer: B
Matrix, and QSPM.
90) According to the Grand Strategy Matrix, organizations in which quadrant have a strong
competitive position but are in a slow-growth industry?
A) I
B) II
C) III
D) IV
E) V
Answer: D
Matrix, and QSPM.
21
91) Which matrix is included in the decision stage of the strategy formulation framework?
A) Internal Factor Evaluation Matrix
B) Quantitative Strategic Planning Matrix
C) Boston Consulting Group Matrix
E) Strategic Position and Action Evaluation Matrix
Answer: B
Matrix, and QSPM.
92) The top row of a QSPM consists of alternative strategies derived from all of the following
EXCEPT
A) Grand Strategy Matrix.
B) BCG Matrix.
C) SPACE Matrix.
D) CPM Matrix
E) IE Matrix.
Answer: D
Matrix, and QSPM.
93) Which analytical tool determines the relative attractiveness of various strategies based on the
extent to which key external and internal critical success factors are capitalized upon or
improved?
A) BCG Matrix
B) SPACE Matrix
C) SWOT Matrix
D) IE Matrix
E) QSPM
Answer: E
Matrix, and QSPM.
22
94) Which of the following is the first step in developing a QSPM?
A) Compute the Total Attractiveness Scores.
B) Examine the Stage 2 matrices and identify alternative strategies the organization should
consider implementing.
C) Assign weights to each key external and internal factor.
D) Determine the Attractiveness Scores.
E) Make a list of the firm's key external opportunities/threats and internal strengths/weaknesses
in the left column of the QSPM.
Answer: E
Matrix, and QSPM.
95) What term is defined as the product of multiplying the weights by the Attractiveness Scores
in each row of the QSPM?
A) Total Attractiveness Scores
B) Sum Total Scores
C) Weighted Scores
D) Total Weighted Scores
E) Factors
Answer: A
Matrix, and QSPM.
96) What is the highest number of strategies that can be examined at one time with the QSPM?
A) 1
B) 2
C) 5
D) 10
E) There is no limit.
Answer: E
Matrix, and QSPM.
23
97) Which of these is a limitation of QSPM?
A) Only a few strategies can be evaluated simultaneously.
B) It is prohibitively expensive.
C) It requires intuitive judgments and educated assumptions.
D) Sets of strategies must be examined in reverse order.
E) It requires equal participation from the entire organization.
Answer: C
Matrix, and QSPM.
98) ________ includes the set of shared values, beliefs, attitudes, customs, norms, personalities,
heroes and heroines that describe a firm.
A) Strategy
B) Culture
C) Mission
D) Objectives
E) QSPM
Answer: B
99) What tactic involves shifting focus from specific issues to more general ones?
A) Equifinality
B) Focus on Higher-Order Issues
C) Generalization
D) Satisfying
E) None of the above
Answer: C
24
100) Which tactic emphasizes that a successful outcome is more important than imposing the
method of achieving it?
A) Generalization
B) Satisfying
C) Focus on higher-order issues
D) Equifinality
E) Specialization
Answer: D
101) The act of oversight and direction for an organization is referred to as

A) corporate lawmaking.
B) centralized control.
C) organizational direction.
D) establishing norms.
E) governance.
Answer: E
102) Today, boards of directors are composed mostly of

A) outsiders.
B) management.
C) union members.
D) company employees.
E) company stockholders.
Answer: A
25
103) All of the following are principles of good organizational governance, as established by
Business Week, EXCEPT
A) Each director attends at least 75 percent of all meetings.
B) The audit, compensation and nominating committees are made up solely of outside directors.
C) Each director owns a large equity stake in the company, excluding stock options.
D) At least three directors are current or former company executives.
E) The CEO is not also the Chairperson of the Board.
Answer: D
104) Explain the concept of matching in the strategy formulation framework. Give at least three
examples of matching.
Answer: Matching external and internal critical success factors is the key to effectively
generating feasible alternative strategies. See Table 6-1 for examples of matching.
105) If you construct a SPACE Matrix and the directional vector points to the lower left
quadrant, what type of strategies would you recommend? Give several examples.
Answer: If the directional vector points to the lower-left quadrant of the SPACE Matrix,
students should suggest defensive strategies. Defensive strategies include retrenchment,
divestiture, liquidation, and related diversification.
Matrix, and QSPM.
106) Give five coordinates of a SPACE Matrix directional vector that would suggest
conservative strategies to be most appropriate.
Answer: Student answers will vary. However, five examples they may suggest are (-1, 1), (-2,
2), (-3, 3), (-4, 4), and (-5, 5). Any pair of coordinates with a negative x-coordinate and a positive
y-coordinate is correct.
Matrix, and QSPM.
26
107) In a BCG Matrix, all divisions are classified as either Question Marks, Stars, Cash Cows, or
Dogs. Define each of these terms.
Answer: Question Marks have a low relative market share position, yet they compete in a high-
growth industry. Stars represent the organization's best long-run opportunities for growth and
profitability. Cash Cows have a high relative market share position but compete in a low-growth
industry. Dogs have a low relative market share position and compete in a slow- or no-market-
growth industry.
Matrix, and QSPM.
108) Compare and contrast the IE Matrix with the BCG Matrix.
Answer: The IE Matrix is similar to the BCG Matrix in that both tools involve plotting
organizational divisions in a schematic diagram. Also, the size of each circle represents the
percentage sales contribution of each division, and pie slices reveal the percentage profit
contribution of each division in both the BCG and IE Matrix.
Some important differences between the IE Matrix and the BCG Matrix include: 1) different
axes; 2) the IE Matrix requires more information about the divisions than the BCG Matrix; and
3) the strategic implications of each matrix are different.
Matrix, and QSPM.
109) Explain the benefits and limitations of developing a Boston Consulting Group Matrix.
Answer: The major benefit of the BCG Matrix is that it draws attention to the cash flow,
investment characteristics, and needs of an organization's various divisions.
The BCG Matrix has some limitations: 1) Viewing every business as either a Star, Cash Cow,
Dog or Question Mark is an oversimplification; many businesses fall right in the middle of the
BCG Matrix and thus are not easily classified; 2) the BCG Matrix does not reflect whether or not
various divisions or their industries are growing over time; that is, the matrix has no temporal
qualities, but rather it is a snapshot of an organization at a given point in time; and 3) other
variables besides relative market share position and industry growth rate in sales are important in
making strategic decisions about various divisions.
Matrix, and QSPM.
27
110) Using a Grand Strategy Matrix approach, what strategies are recommended for a firm that is
a weak competitor in a slow-growing market? Elaborate on what these strategies could mean for
a college or university.
Answer: A firm that is a weak competitor in a slow-growing market would be located in
Quadrant III. Quadrant III strategies include retrenchment, related diversification, unrelated
diversification, divestiture, and liquidation.
Student answers will vary when elaborating on what these strategies could mean for a college or
university. However, students should mention that the college or university could possibly have
to be closed. Faculty and/or staff might have to be greatly reduced, which could lead to unhappy
students in very large classes.
Matrix, and QSPM.
111) Describe the positive features and limitations of QSPM.

Answer: There are three positive features of QSPM: 1) Sets of strategies can be examined
sequentially or simultaneously; 2) there is no limit to the number of strategies that can be
evaluated or the number of sets of strategies that can be examined at once using the QSPM; and
3) the last positive feature is that it requires strategists to integrate pertinent external and internal
factors into the decision process.
The QSPM is not without some limitations: 1) It always requires intuitive judgments and
educated assumptions; 2) The ratings and attractiveness scores require judgmental decisions,
even though they should be based on objective information; and 3) it can be only as good as the
prerequisite information and matching analyses upon which it is based.
Matrix, and QSPM.
28
112) Describe the tactics that have been used by politicians that can also aid strategists.
Answer: Equifinality–It is often possible to achieve similar results using different means or
paths. Strategists should recognize that achieving a successful outcome is more important than
imposing the method of achieving it. It may be possible to generate new alternatives that give
equal results but with far greater potential for gaining commitment.
Satisfying–Achieving satisfactory results with an acceptable strategy is far better than failing to
achieve optimal results with an unpopular strategy.
Generalization–Shifting focus from specific issues to more general ones may increase strategists'
options for gaining organizational commitment.
Focus on Higher-Order Issues–By raising an issue to a higher level, many short-term interests
can be postponed in favor of long-term interests. For instance, by focusing on issues of survival,
the auto and steel industries were able to persuade unions to make concessions on wage
increases.
Provide Political Access on Important Issues–Strategy and policy decisions with significant
negative consequences for middle managers will motivate intervention behavior from them. If
middle managers do not have an opportunity to take a position on such decisions in appropriate
political forums, they are capable of successfully resisting the decisions after they are made.
Providing such political access provides strategists with information that otherwise might not be
available and that could be useful in managing intervention behavior.
113) Discuss the appropriate role of a board of directors in an organization.

Answer: Some principles are: No more than two directors are current or former company
executives. The audit, compensation and nominating committees are made up solely of outside
directors. Each director owns a large equity stake in the company, excluding stock options. Each
director attends at least 75 percent of all meetings. The board meets regularly without
management present and evaluates its own performance annually. The CEO is not also the
Chairperson of the Board. Stock options are considered a corporate expense. There are no
interlocking directorships (where a director or CEO sits on another director's board).
29
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child who has scarcely coughed at all during his waking hours.
Witness the voiding of urine in the bed by nervous children during
the early hours of sleep. Witness the phenomena of night-terrors,
which always occur at the time of night when sleep should be most
tranquil.
It appears, therefore, that the harmonious activity of all parts of the

nervous system is indispensable to the highest exercise of the
conscious mind. Healthy intellectual life is the perfectly-balanced
outcome of the complex polygon of forces which has its seat within
the brain. But the suppression of certain lines of this polygon does
not suppress life, nor does it necessarily destroy consciousness. It
only occasions a redistribution of force and a proportionate
narrowing of the stream of related ideas. Since the suppression just
mentioned is not an absolute quantity, but a variable factor, the
polygon of forces in the brain and the corresponding succession of
ideas in consciousness must necessarily be in a state of continual
change. Accordingly, our dreams are as variable as the clouds that
drift upon the currents of the air. As on a hot day in summer, when
the steady equatorial draught has ceased to guide the wind, we may
observe all manner of local tides in the masses of vapor which arise
from the earth, so in sleep, when the guiding influence of the senses
is withdrawn from the brain, the ideas that still arise are chiefly
dependent upon its automatic and reflex action for their origin and
association. Undisturbed by impulses from the external world, the
brain seems then more sensitive to impressions that originate within
the body. An overloaded stomach, an enfeebled heart, a turgid
sexual apparatus, or an irritable nervous ganglion may become the
source of irregular and uncompensated movements which may
invade the cerebral cortex, and may there set in motion a whole
battery of mechanisms whose influence upon consciousness would
be quite unnoticed were the external senses in full operation.
Night-Terrors.
The preceding argument will render it easy to comprehend the
phenomena of night-terrors. These are commonly observed in young
children of a highly nervous temperament before the conclusion of
their second dentition. The subjects of the disorder are generally of
neurotic descent. Insanity, hysteria, neurasthenia, epilepsy, chorea,
and nervous dyspepsia are often discovered among their near
relatives. Not infrequently they have been or will become themselves
choreic.
The attack is often preceded by symptoms of indigestion, but it may

result simply from the commotion of a brain wearied by the
excitement and effort of the previous day. The little patient starts up
out of an apparently sound sleep crying with alarm, calling for his
mother, and staring wildly with every possible expression of terror.
Sometimes he springs from his couch and runs headlong into a
corner or seeks to hide under the bed, as if escaping from some
frightful object. The eyes are open, tears flow, perspiration covers
the skin, there is the greatest excitement, and the little one,
convulsively clinging to its parent, will not be quieted. Only after
fifteen or twenty minutes, as tranquillity gradually returns, does the
child seem to recover the power of recognizing his friends. Presently,
however, he lies down and falls quickly asleep, waking in the
morning without the slightest recollection of the unpleasant event.
Such paroxysms occur during the early part of the night, one or two
hours after the child has been put to bed, just at the time when,
according to the previously-quoted experiments of Kohlschütter,
sleep is passing from its maximum intensity to a lesser degree of
depth. This, then, is the time when the controlling power of the
sensory apparatus over other portions of the nervous system has
already reached its minimum. The spinal centres and those
intracranial ganglia which do not share in the full measure of this
repose are therefore in a condition of relative exaltation.
Disturbances of internal organs consequently produce inordinate
excitement of these waking portions of the nervous apparatus. The
morbid quality of this excitement is attested both by the history of the
patient and by the fact that it does not arouse the whole brain. The
distribution of motion in the cerebrum is impeded, so that certain
portions of the organ remain asleep while other regions are thrown
into a state of tumultuous uproar. Disconnection of these different
organs of the nervous system, by withdrawing particular portions
from the inhibitory influence of the remaining parts, gives opportunity
for violent explosions of nervous force analogous to the convulsions
of a headless fowl or to the course of an epileptic paroxysm. Now, in
sleep, in somnambulism, in hypnotism, in delirium, in certain stages
of intoxication with alcohol or with narcotics, such ungearing of the
different nervous ganglia is more or less completely effected. In
narcotic and anæsthetic sleep besides the disassociation of ganglia
there is paresis of the nervous molecules; hence the phenomena
soon merge into insensibility and coma. But in natural sleep, in
somnambulism, or in hypnotism there is no toxic paresis; hence the
dissociated portions of the brain and nervous system, if aroused, are
in a physiological condition to dispense great stores of force. Hence
the vividness of certain dreams and the astonishing vigor of
particular nervous functions in somnambulism and hypnotism.
Somnambulism.
The phenomena of night-terrors constitute merely a special form of

somnambulism, a condition of which the mechanism, so far as the
present state of cerebral physiology will permit, has been already
suggested. The affection should not be ranked by itself as a
particular variety of disease, but should rather be considered a
violent perturbation in the cerebral organs of a neurotic subject
during the period of sleep. In ordinary dreaming the muscular
apparatus usually remains passive, even though the dream be a
nightmare or an incubus of the most terrifying character. But when
the desires and the emotions are powerfully addressed by the
dream, a certain amount of muscular movement may ensue, as
when a dog barks in his sleep, or when a child laughs upon his
nurse's lap, or when a weary soldier marches on though
overpowered by sleep. One night, when parched with thirst during a
voyage at sea,9 I saw in sleep a sparkling fountain, by the side of
which appeared a young girl holding out a cup of cold water.
Awakened by the excitement, I found myself sitting up in bed with my
right arm extended in the direction of the tantalizing vision: my dream
had merged itself in action. In like manner, the victim of night-terrors
not only moves his body, but gives vocal expression of his feeling of
apprehension and alarm. In like manner, projecting his dream into
action, a sleep-walker may arise from his bed; he climbs out of the
window and descends to the ground, executing all manner of
complicated and dangerous movements; he walks long distances,
and finally returns to his couch without waking. In the morning no
recollection of the event of the night survives. Again, the movement
may be less locomotive in its character. The intellectual faculties
chiefly may be aroused, and then only such movements are
executed as may be necessary to give expression to the mental
process.
9 A proclivity to dreaming has often been remarked among the consequences of
partial starvation.
Such, then, are the principal characteristics of somnambulism, a

state in which dreams are supplemented by more or less complete
and appropriate action, ordinarily without subsequent recollection of
either dream or action.
The somnambulistic dream generally occurs during or soon after the

period of deepest sleep, when the influences of the external world
are largely suppressed. Released from the control of its sensory
portion, the remainder of the brain awakes and becomes aroused to
a condition of functional exaltation. No longer distracted by the
recollection of the special senses, the attention is concentrated upon
the hallucinations which constitute the dream. In the simpler forms of
noctambulism only the automatic locomotive apparatus is awakened,
and the sleeper moves in accordance with the impressions derived
from habit aided by exaltation of the muscular sense. But in some of
the more complicated cases a certain amount of special sensibility
seems to exist. The patient is capable of exercising just that amount
of sensation which is necessary to accomplish his purpose, though
blind and deaf and insensible to every other impression. The more
complete the waking of the organs of sense, the closer the
resemblance to the condition of ecstasy in which cerebral exaltation
is the prominent feature. Accordingly, it sometimes happens that the
somnambulist can recall the events of his paroxysm.10 In such cases
the power of recollection is due to the same conditions that control
the recollection of our ordinary dreams. We remember very
imperfectly, if at all, the dreams that occur during sound sleep, but
the visions with which sleep sometimes commences (hypnagogic
hallucinations) and those that occupy the period of morning slumber
are very easily reviewed in memory, because they are associated
with impressions directly derived from the partially-waking organs of
sense. Such dreams are therefore chiefly recalled through their
association with the train of our waking thoughts. But the dreams of
somnambulism and the dreams of night-terrors, and all other visions
during profound sleep, are as completely as possible cut off from all
connection with the mental activities which arise directly from the
action of the senses. By reason of such isolation the ordinary
association of ideas affords no help to the memory, and the dream
remains in the limbo of oblivion.
10 A. Bertrand, Traité du Somnambulisme, p. 80.
Alfred Maury expresses the opinion11 that the principal cause of

forgetfulness of the events of somnambulism consists in the
exhaustion of the cerebral elements through the intensity of the
excitement to which they are subjected during the paroxysm.
Doubtless this in certain cases may contribute to the loss of memory,
but it should be remembered that the excitement may be relative
rather than absolute. Certain elements wake while others are asleep,
and the waking cells may be aroused to a degree far in excess of
what is usual during the sleep of the brain without attaining to the
level of their diurnal activity. The mind, undisturbed by external
impressions, gives its attention to the activity of these waking
organs, and a dream with all its consequences, somnambulic or
otherwise, is the result. In other words, the plane of consciousness,
so to speak, is lowered during sleep to the level of these molecular
vibrations. But when the whole brain is again awakened after sleep
the residual vibrations of those elements which yielded the physical
basis of the dream, and which, had they occurred during the waking
state, might have persisted with energy sufficient to furnish a
groundwork for recollection of the ideas which they had originally
suggested, are no longer sufficiently energetic to be felt in
consciousness. Recollection of mental states thus generated must
necessarily be impossible so long as the mind is dependent upon the
brain as its register of events. Sometimes, however, the
somnambulist, who while awake had forgotten all the incidents of his
somnambulic experience, can remember in a subsequent paroxysm
all that occurred during the preceding attack. Facts of this kind have
been observed in the waking life of certain hysterical persons,12 but
the apparent interruptions of their personality attach to the waking
state, while in ordinary somnambulism it is only in sleep that the
alternations of memory and forgetfulness occur. A similar recollection
of previous visions is sometimes experienced in dreams, showing
the close relation that subsists between the dreams of sleep and of
somnambulism. The bond of association between these events thus
isolated in time must be sought in a renewal of like conditions of the
brain during the successive periods of somnambulic exaltation. We
must suppose that the molecules which were in a state of functional
excitement during the first paroxysm are again aroused in like
manner after a period of waking quiescence. If, during sleep, their
movements, though of an exalted character, have only just sufficed
to arouse consciousness in the form of a dream, it would not be
probable that during the phase of comparative inactivity which
supervenes when the whole brain is awake their residual motion
could disturb the sphere of consciousness. Hence the time occupied
by their somnambulic vigor must remain a blank in memory during
the waking state. But when the original state of exaltation has been
reproduced by a second period of disorder, if the same molecular
movements be in any way renewed, the conditions of memory are
fulfilled; consciousness is once more aroused as before, and the
patient remembers the dream or the events of the previous attack.
11 Le Sommeil et les Rêves, p. 226.
12 Annales Medico-psychologiques, 5e Série, t. xvi. p. 5, 1876.
Artificial Somnambulism, or Hypnotism.
The phenomena which have now been passed in review are of

apparently spontaneous origin during the ordinary period of sleep.
But from the remotest antiquity it has been known that certain
persons may be thrown into an artificial sleep which closely
resembles the condition of the somnambulist. During the persistence
of this state certain portions of the nervous system become utterly
insensible to external impressions, while other portions acquire an
exalted degree of sensibility. The subject of the experiment can then
by special methods be placed in such relations with other waking
individuals that his surviving sensations, mental processes, and
physical actions shall be no longer regulated by his own volition, but
by the will of another. Such susceptibility is not common to all
persons. About 20 per cent. of the ordinary population is, by some
observers, considered capable of experiencing this condition.
Heidenhain,13 experimenting upon a class of medical students, found
only one in twelve who was thus susceptible. Charcot, whose field of
observation covers the inmates of the Salpêtrière Hospital, finds the
best exemplars of the hypnotic state among the hystero-epileptic
females in that asylum. To these experimenters we are largely
indebted for the most extended scientific observation of the
phenomena of hypnotism, giving precision and publicity to the
knowledge of facts which, though equally well known within a narrow
circle of investigation14 during the earlier decades of the present
century, have been compelled to await the development of cerebral
physiology before their full significance could become apparent to
the mass of the medical profession.
13 Animal Magnetism: Physiological Observations, by Rudolph Heidenhain.
14 Braid, Neuro-hypnology considered in Relation with Animal Magnetism, London,
1843.
The antecedent condition most favorable to the production of the

hypnotic state is a highly unstable constitution of the nervous
system. For this reason the larger number of qualified subjects is
furnished by the female sex, especially by those who possess the
hysterical temperament. Frequent repetition of hypnotic exercises
renders the subject still more susceptible. Heidenhain was at first
inclined to believe that such experiences were not prejudicial to the
health of the subject, but the observation of Harting in the University
of Utrecht, and of Milne-Edwards in Paris,15 have demonstrated
danger to the health of animals subjected to similar experiments. It is
easy to discover, in the various clinical narratives published by
Charcot and his pupils,16 evidence that hysterical patients often
manifest considerable exhaustion after hypnotic exhibitions;
consequently, it cannot be admitted that the practice is devoid of risk
to the health of the individual.
15 Lancet, July 29, 1882, p. 164.
16 Paul Richer, L'hystéro-Epilepsie, Paris, 1881; Le Progrès médical, 1881-82.
Numerous methods of inducing the hypnotic state have been

employed by different experimenters. The greater number consist in
modifications of the sensory impulses derived from the periphery of
the body. Gentle pressure upon the closed eyelids; convergence of
the axes of the eyeballs upon some object nearer than the proper
focal distance of the eyes; fatigue of the retina by gazing upon any
brilliant or luminous object; monotonous excitation or sudden
surprise of the auditory nerve; various impressions through gentle
friction or pressure upon different regions of the body,—all these are
capable of inducing hypnotic sleep. An appeal to the imagination, or
even the mere attempt to abnegate the possibility of vigorous
thought by confining the attention to the most trivial of things,
sometimes suffices to produce the desired phenomenon. Thus,
Heidenhain put one of his students to sleep at a distance by merely
informing him beforehand that at a certain hour he would hypnotize
him in his absence. The state of ecstatic meditation into which the
monks of Mount Athos plunged themselves by the practice of
omphaloscopy affords an illustration of the hypnotic effects of
concentrated attention.
The duration of hypnotic sleep is exceedingly variable, but if left to

himself the patient usually wakes spontaneously, without recollection
of anything that has happened. If it be desirable to awaken him
before the natural termination of the paroxysm, consciousness can
be restored by almost any sudden and energetic appeal to the
senses, such as an electric shock, a sudden illumination of the eye
with vivid light, or a sharp puff of air upon the face.
According to Charcot,17 three principal types may be remarked

among the hysterical subjects upon whom he experimented: (1) the
cataleptic, (2) the lethargic, and (3) the somnambulic. Of these, the
first may be developed primarily by any abrupt and powerful
impression upon an organ of sense, as a bright light or a loud noise
(gong). Fixing the eyes upon some object may produce the same
result. Dumontpallier, for example, has reported the case of a young
woman18 who accidentally hypnotized herself by gazing at her own
image in the mirror before which she was dressing her hair. The
cataleptic state may also be secondarily induced by merely opening
the eyes of a patient in whom a condition of hypnotic lethargy has
been previously developed. If only one eye is thus opened, the
corresponding side of the body alone becomes cataleptic. Closing
the eyes causes the disappearance of this symptom, with complete
restoration of the purely lethargic state. During the cataleptic
condition the several tendinous reflexes disappear, neuro-muscular
hyperexcitability ceases; the skin becomes insensible, but the
special senses, particularly those of sight and hearing, maintain a
partial activity. In this state the senses may become avenues of
suggestion for the production of muscular movements, but if left to
themselves the limbs remain motionless.
17 Le Progrès médical, Feb. 18, 1882, p. 124.
18 Ibid., March 25, 1882, p. 223.

The lethargic state may be induced by simply closing the eyes of the
patient or by causing him to fix his gaze upon some definite object.
The paroxysm begins with a deep inspiration causing a peculiar
laryngeal sound, followed by the appearance of a little foam on the
lips. The eyelids are either wholly or partially closed, and are in a
state of continual tremulous motion. The eyeballs are generally
turned upward and inward. The muscles are completely relaxed. The
tendinous reflexes are exaggerated; pressure over a muscle or upon
a nerve arouses a peculiar contraction of synergic muscles and of
groups of muscles which are supplied by the excited nerve-trunk.
The facial muscles, however, do not thus become contractured: they
merely contract during the application of the stimulus. If the lethargic
patient be rendered cataleptic by opening the eyes, these
contractions persist even after awaking, and they can only be
dispelled by renewing the lethargic state before resorting to pressure
upon the antagonistic muscles—a process by which the contractures
peculiar to this species of lethargy may always be annulled. By the
approach of a magnet to a contractured limb the phenomenon may
be completely transferred to the corresponding muscles upon the
opposite side of the body. If upon a limb of a lethargic patient who
has been rendered cataleptic by opening the eyes an Esmarch's
band be applied, pressure over the bloodless muscles excites no
contracture until the band is removed. A contracture is then
developed, and it may even be transferred to the opposite limb by
the approach of a magnet. To this phenomenon has been applied the
term latent contracture.
The extraordinary muscular excitability manifested by these

hysterical hypnotics is further illustrated by an observation recorded
by Dumontpallier.19 If one end of a caoutchouc tube one centimeter
in diameter and five or six meters in length be applied over a muscle
in the leg, and if the other end be in like manner connected with a
watch, every movement of the second hand will be followed by a
slight contraction in the muscle. The same result follows connection
with the wire of a telephone, and if a microphone be introduced into
the circuit the incidence of a ray of artificial light upon the instrument,
or even its glancing reflection from the eye, will arouse a responsive
muscular contraction. Charcot has sometimes observed muscular
contractions upon the opposite side of the body when a mild galvanic
current was applied to the parietal surface of the head. During the
manifestation of muscular hyperexcitability there is complete
analgesia, but the senses of sight and hearing seem to preserve
some degree of activity. The patient, however, does not manifest any
susceptibility to influence by suggestion.
19 Ibid., Jan. 14, 1882, p. 25.
The somnambulic state may be directly induced by fixed attention

with the eyes, by feeble and monotonous excitation of the senses,
and by various other methods of an analogous character. This forms
the most common variety of the hypnotic condition. It may very easily
supervene during either the lethargic or the cataleptic state as a
consequence of pressure or gentle friction upon the top of the head.
Thus, Heidenhain caused muscular paralysis by rubbing the scalp.
Unilateral friction of the same surface produced paralysis of the
opposite side of the body without notable affection of consciousness.
The eye and the eyelids behave as in the lethargic state. The patient
seems asleep, but there is less muscular relaxation than in hypnotic
lethargy. There is no exaggeration of the tendinous reflexes, and
muscular hyperexcitability is absent. But by lightly touching or
breathing upon the surface of a limb its muscles may be thrown into
a condition of rigidity which differs from the contracture of the
lethargic state in the fact that it does not yield to excitation of the
antagonistic muscles, though yielding readily to a sudden repetition
of the same form of excitement by which it was originally produced.
From the immobility of the cataleptic state it also differs by a greater
degree of resistance to passive motion. Though analgesia may be
perfectly developed in this state, there is generally an exalted
condition of certain forms of cutaneous sensibility and of the
muscular sense. Strange perversions of other special senses are
sometimes remarked. Cohn20 discovered that a patient who was
naturally color-blind “when unilaterally hypnotized was able to
distinguish colors which were otherwise undistinguishable.”
Conversely, when the cataleptic state is induced the eye becomes
incapable of discerning colors. Spasm of accommodation is also
present, and is one of the earliest demonstrable symptoms of the
hypnotic condition.
20 Brain, vol. iii. p. 394.
These remarkable exaggerations and perversions of special

sensibility have been the cause of much scepticism on the one hand
regarding the verity of the phenomena of hypnotism, and of much
credulity on the other, extending even to a belief in the existence of
supernatural and miraculous gifts. But when the fact is once
comprehended that in this capacity for uncommon feats of vision,
hearing, touch, etc. we observe merely the exaggeration of a
process which occurs in every act of attention, the miraculous
semblance of the phenomena disappears. Attention implies an
increase of activity in certain portions of the brain, with diminution of
the function in the remainder of the organ. In the wild excitement of a
cavalry charge the soldier feels not the sabre cut which will fill his
consciousness with pain so soon as his attention is released from
the fetters imposed by the more engrossing events of the combat.
So in the somnambulic sleep those parts of the brain which remain
awake perform their functions with a vigor that is enhanced by a
concentration of cerebral energy in certain restricted portions of an
organ that, by reason of its naturally excessive instability, had been
previously fitted for the liberation of an inordinate amount of
molecular motion. Hence the slightest suggestion of sense may
suffice for the most extraordinary perception. Such persons see
through their eyelids and hear at a surprising distance. The memory
of past events, the recollection of long-forgotten words and thoughts,
supplies in this state an abundance of materials out of which an
exalted imagination may construct the most astonishing scenes. By
this method of combination are produced those remarkable oratorical
utterances which by the ignorant have been so widely attributed to
the supervision of guiding spirits from another world. In this condition
the essential characteristics of the mind of the so-called medium
become the real guides of his mental processes. Hence the infinite
variety and contrariety of the utterances of such declaimers.
Among other consequences of this exalted susceptibility of the
waking portions of the brain may be noticed the effect of suggestions
by others upon the mind of the somnambulist. Numerous examples
scattered through the literature of the subject21 illustrate the manner
in which the course of our ordinary dreams may be thus directed.
The hypnotic dream is far more easily modified.22 The simplest
manifestations of such influence are exhibited in movements in
obedience to the command of the hypnotizer. Next in rank are those
more complicated actions that are effected by excitement of the
imitative faculties of the subject. Every suggested movement that
can be in any way perceived by the patient will be at once
reproduced. Various emotions and passions may thus be aroused by
simply placing the sleeper in the appropriately suggestive attitudes.
Under the influence of a pregnant idea intruded upon the mind of the
patient the subsequent association of ideas will suffice for the
evolution of a complicated series of hallucinations, as in the case of
a young woman, who on being directed to put out her tongue
immediately began to feel sensations of uneasiness in her stomach,
followed by nausea and attempts at vomiting, accompanied by the
impression of being on shipboard. In the lowest grades of the
hypnotic state consciousness may remain, and the subsequent
recollection of the events of the paroxysm may be quite persistent. In
such cases illusions that were produced by suggestions from other
minds generally survive in memory and become the causes of
serious delusion. Witness the manner in which susceptible
individuals, partially hypnotized in a so-called spiritual circle, believe
in the reality of the illusions which have occupied their senses during
a séance.
21 Carpenter's Physiology, 8th ed., p. 765; Le Sommeil et les Rêves, par L.-F. Alfred
Maury, 4th ed., p. 153 et seq.
22 Loc. cit., p. 357.
A higher degree of insensibility to ordinary impressions is necessary

to the production of the phenomena of passive obedience and of
automatic imitation. It is probable that the degree of sensory
hyperæsthesia which enables certain hypnotic patients to read the
thoughts of others belongs rather to the first than to the last of these
classes. This capacity is usually associated with preservation of
consciousness and memory, and is, essentially, a mere exaggeration
of that power which all possess in greater or less degree. Numerous
well-authenticated examples of a surprising manifestation of this
faculty have been recorded, so that the possibility of its existence no
longer admits of doubt.23 In all cases it has been remarked that the
hypnotic mediums can only respond correctly to questions for which
the true answer is present in the mind of the questioner. For all other
interrogations the replies are delivered purely under the influence of
random suggestion. In certain of these cases the pathway of
communication lies through actual physical contact, as in ordinary
mind-reading, where the insensible molecular oscillations of the
muscular elements of one individual serve to guide the movements
of another. But more frequently the transmission of ideas is effected
through the eyes. With these organs the table-rapper or the
planchette-writer reads the unspoken words of the questioner in a
manner very like, yet vastly more deliberate than, that by which deaf-
mutes now learn to interpret the movements of the lips of persons
with whom they converse. This fact is well illustrated by the
experience of Maury24 in an interview with a celebrated table-rapper,
who without the slightest hesitation made known to him the age,
name, and date of death of a brother whom he had lost. She also
gave the same information regarding his father, and related the
names of other persons upon whom he had fixed his attention. But if
he turned away his face or concealed his eyes, so that the woman
could no longer watch their expression, her responses ceased to be
of any value.
23 Luther V. Bell, Two Dissertations on what are termed the Spiritual Phenomena,
read at the meetings of the Association of Medical Superintendents of American
Insane Hospitals at Washington and Boston in 1854 and 1855.
24 Le Sommeil et les Rêves, 4th ed., p. 361.

In these partial developments of the hypnotic state it is worthy of
note that the phenomena of sleep are so few and so comparatively
insignificant that they are usually overlooked. Hence the veil of
mystery which has so often obscured the interpretation of such
cases. Careful observation, however, will always detect some
characteristic departure from the normal standard—some loss of
balance between the different parts of the nervous system—by
means of which the true relations of each example may be
determined.
TREATMENT.—A large proportion of the phenomena of somnambulism

and hypnotism depend rather upon an originally irritable organization
than upon a specially diseased condition of the nervous system.
Their treatment, therefore, frequently resolves itself into the
management of hysteria or of cerebrasthenia. But if the
manifestations of somnambulism develop for the first time in a
person advanced in years, who has previously enjoyed good health
and a sound mind, it should be regarded as an omen of grave
import, signifying the imminence of organic cerebral disease. Though
the meaning of such incidents is less sinister in early life, they reveal
an ill-balanced state of the nervous system and an imperfect process
of nutrition in the growing body. Such children are the frequent
victims of night-terrors, the form of disorder most commonly evolved
by their somnambulistic proclivities. The treatment of night-terrors
should therefore be chiefly directed to the invigoration of the general
health of the patient. Indigestion and malnutrition are among the
most prominent antecedents, and they should constitute the principal
objects of therapeutical attention. Constipation is usually present.
This may be relieved by the use of compound rhubarb powder or any
other gently stimulating laxative. Digestion should be aided with
pepsin as soon as the catarrhal condition of the alimentary canal, so
uniformly present, has been measurably improved. Cod-liver oil or its
substitutes should be administered for a long period of time. If the
nocturnal paroxysms be frequently renewed, it may be well to
employ the bromides, either with or without chloral hydrate; but as a
general rule it is better to rely upon hygienic and restorative
treatment, rather than upon any form of merely hypnotic medication.
INSOMNIA.
The departures from the course of natural sleep which have been
thus considered are not so much the direct consequence of acute
disease as the result of structural deviation from the normal type of
the nervous system. We must now briefly review the strictly
pathological modifications to which sleep is liable.
Lithæmic Insomnia.
Among those who indulge freely in the pleasures of the table a form
of insomnia is not uncommon. Originating at first in mere overloading
of the stomach, and consisting in a direct irritation of the brain
through the medium of the intervening nervous apparatus,
sleeplessness finally becomes a symptom of more serious mischief.
The tissues become charged with nitrogenous waste, and a
lithæmic25 or gouty condition is established. Such patients are
wakeful, or if they sleep their slumbers are imperfect and
unrefreshing.26 Grinding of the teeth,27 noticed by Graves during the
sleep of the gouty, is a symptom indicative of a highly irritable
condition of important ganglia at the base of the brain. These
symptoms are sometimes associated with turgidity of the superficial
vessels of the head, indicating imperfect function of the circulatory
organs, with a tendency to accumulation of the blood in the venous
channels of the body. The sleep of such partially-asphyxiated
patients is fitful, irregular, and akin to stupor. Occurring in the
subjects of periodical gout, these disturbances of sleep become
increasingly serious as the paroxysm is approached, until loss of
sleep and the unrefreshing character of such slumber as may be
obtained become important factors among the causes of failing
health.
25 DaCosta, “Nervous Symptoms of Lithæmia,” Am. Journ. Med. Sci., Oct., 1881.
26 Dyce Duckworth, “Insomnia in Persons of Gouty Disposition,” Brain, July, 1881.
27 Trousseau, Clinical Medicine, Am. ed., vol. iv. p. 362.
For all such patients a proper recognition of the cause of their

disorder is essential. This must be corrected by measures
appropriate to the treatment of the gouty diathesis. Since the
condition of the cerebral tissues is a state of irritation caused by the
presence of excrementitious substances, such hypnotic remedies
must be selected as will not interfere with the defecation of those
tissues. Bromide of potassium, valerian, scutellaria, hyoscyamus,
hops, and cannabis indica are useful, together with all that class of
drugs which quiet the brain without hindering the process of
excretion. Chloral hydrate often produces an excellent result, but
care should be taken to prevent its habitual use.
Febrile Insomnia.
Closely related with the sleeplessness of lithæmia are the

disturbances of repose which attend the evolution of the various
specific fevers. In many cases the condition varies all the way from
stupor to delirium. Excessive somnolence, such as often ushers in
the fever, is an indication for evacuant treatment. Cerebral
excitement calls for remedies like the bromides and chloral hydrate,
which do not interfere with elimination. If pain, like headache or
backache, be a symptom demanding attention, the addition of
morphia in small doses forms a valuable reinforcement for the
hypnotic mixture; but, as a general rule, opiates should be used with
a sparing hand. The various resources of hydrotherapy are often
invaluable when wakefulness results from the cutaneous irritability of
the eruptive fevers. During the later stages of a protracted illness the
occurrence of insomnia should direct attention to the nutrition of the
patient. Wakefulness is then the symptom of an irritable weakness of
the brain, demanding remedies which delay the process of
disassimilation. The failing power of the heart requires attention, and
diffusible nutriment must be given to convey the elements needful for
restoration of the exhausted brain. These indications are most
perfectly answered by the associated administration of opiates with
alcohol, milk, and beef-juice in small and frequent doses.
Insomnia from Exhaustion.
Cerebral exhaustion is a not uncommon cause of wakefulness in

cases uncomplicated with fever. It is usually the result of chronic
conditions of ill-health and depression, such as are often
encountered as the result of various cachexias or of dyspepsia, with
or without the abuse of alcohol, tea, coffee, or tobacco. Overwork,
debilitating discharges, pregnancy, parturition, mental anxiety,
depressing emotions, chronic heart disease, and incipient insanity
are fruitful causes of the exhaustion which produces this most
distressing form of insomnia. In such cases the cessation of healthy
nutrition leads to a condition of excessive instability in the cerebral
tissues. The oxygen which they receive from the blood is not stored
with any degree of permanence, but tends to pass directly into stable
combinations with the oxidizable elements of the brain.
Consciousness is thus continually aroused. The state of such a
patient presents a very close analogy to the condition of the victim of
diabetes whose liver refuses to retain its glycogen. The inordinate
discharge of sugar into the blood not only exhausts the tissues of the
liver, but also excites other organs—notably the kidneys—to
excessive and unwholesome activity. In somewhat similar fashion,
the failure of the brain to assimilate and to retain oxygen leads to an
abnormal intramolecular oxidation, which excites an excessive and
unwholesome activity on the part of the Ego in another region—
namely, in the field of consciousness. Such wakefulness might justly
be termed a psychical diabetes.
This variety of insomnia has frequently been ascribed to cerebral

anæmia occurring as a part of a general spanæmia. But this
universal impoverishment of the blood, though a sufficient cause of
the morbid instability, the irritable weakness, of the cortical tissues,
does not necessarily imply a comparatively bloodless condition of
the brain. Unequal circulation and local hyperæmia in different
organs of the body are no unusual consequences of the anæmic
state. Slight disturbances suffice to arouse the brain of such a
patient. The vaso-motor apparatus shares in the general irritability,
permitting blood to inundate the cortical substance almost without
provocation. The unstable protoplasm is only imperfectly renovated,
usually at the expense of the other tissues of the body. The weary
patient, busying himself with an unwilling review of the events of the
day, tosses long upon his couch before he can secure the approach
of “tired Nature's sweet restorer, balmy sleep.” When at length he
yields, his slumbers are brief, and the latter part of the night is but a
repetition of the earlier vigil.
Such patients need a very radical course of general treatment. A

complete change of habits should be effected. A long vacation in the
country, or, best of all, a protracted voyage in a sailing vessel, is
desirable. Hot foot-baths, with cold affusion upon the head, and
warm sponge-baths, or even the full bath in tepid water, at bedtime,
are of great service as means of tranquillizing the nervous system.
The indications for medicinal treatment, besides attention to the
predisposing cachexia, are twofold—to calm and to nourish the
enfeebled nervous substance. Opiates calm, but do not nourish—
they hinder the process of nutrition; hence the sufferer wakes
unrefreshed by the sleep which they procure, and is soon in a
condition worse than ever. The same objection lies against the
continuous use of the bromides. But alcohol and its hypnotic
derivatives (chloral, paraldehyde, etc.) not only calm the excitable
brain, but they also furnish to the tissues a certain amount of
diffusible nutriment which suffices to steady the brain until a change
of occupation, with rest and wholesome food, can produce a
complete restoration of its normal stability. To this effect of alcohol
must be ascribed its value as an hypnotic in the wakefulness of old
people who cannot sleep without a preliminary nightcap. A moderate
draught of hot toddy in such cases serves to arouse the feeble heart
and to equalize the circulation by the production of a moderate
degree of general vascular dilatation. The sugar and water afford an
easily assimilated food, while the alcohol benumbs the cortical
protoplasm to a degree which favors the cessation of conscious
perception. If administered in excessive doses, it is not sleep but
anæsthetic intoxication which follows. If this condition be unduly
repeated, the phenomena of chronic alcoholism supervene, with all
the horrible forms of insomnia that accompany cerebral starvation
and delirium tremens. Non-alcoholic nerve-stimulants and tonics,
with careful administration of easily-digested food, are then more
than ever needed to overcome the neurasthenic wakefulness.
Insomnia from Active Cerebral Congestion.
Still another form of sleeplessness is often experienced as a result of

actual inflammation in some portion of the body, either involving the
intracranial contents directly or reacting upon the brain through the
medium of its circulation. In such cases many of the symptoms of
acute inflammation are present. The head aches, the temples throb,
the face and eyes are suffused with blood, the temperature is
considerably increased. The senses become exalted, ideas pursue a
tumultuous course, there may be actual delirium. These
disturbances are due to an active hyperæmia of the brain. The
substance of the cortex becomes hyperexcitable, and the ordinary
incitements of sense produce an exaggerated effect in
consciousness. The patient does not sleep, and he feels no need of
sleep, because the nutrition of the brain is sustained at the expense
of the remainder of the wasting body. The most speedy and effectual
relief in such cases is obtained through a diminution of the current of
blood in the brain. Moderate compression of the carotid arteries has

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Strategic Management Concepts and Cases 14th Edition

5) Stage 2 in the strategy-formulation framework involves the Quantitative Strategic Planning

6) The Strengths-Weaknesses-Opportunities-Threats (SWOT) Matrix, the Strategic Position and

9) The purpose of matching key factors is to generate feasible alternative strategies.

16) Market penetration can be classified as either a conservative, aggressive, or competitive

32) Both IE and BCG Matrices are called portfolio matrices.

56) Which strategy-formulation technique reveals the relative attractiveness of alternative

58) Which stage of the strategy-formulation framework includes an Internal-Factor Evaluation

65) How many cells are in a SWOT Matrix?

68) Which of these is NOT a SPACE Matrix quadrant?

69) What type of strategy would divestiture be classified as?

72) The two positive-rated dimensions on the SPACE Matrix are

84) Which of the following analytical tools consists of a nine-cell matrix?

101) The act of oversight and direction for an organization is referred to as

102) Today, boards of directors are composed mostly of

111) Describe the positive features and limitations of QSPM.

113) Discuss the appropriate role of a board of directors in an organization.

It appears, therefore, that the harmonious activity of all parts of the

The attack is often preceded by symptoms of indigestion, but it may

The phenomena of night-terrors constitute merely a special form of

Such, then, are the principal characteristics of somnambulism, a

The somnambulistic dream generally occurs during or soon after the

Alfred Maury expresses the opinion11 that the principal cause of

12 Annales Medico-psychologiques, 5e Série, t. xvi. p. 5, 1876.

Artificial Somnambulism, or Hypnotism.

The phenomena which have now been passed in review are of

The antecedent condition most favorable to the production of the

16 Paul Richer, L'hystéro-Epilepsie, Paris, 1881; Le Progrès médical, 1881-82.

Numerous methods of inducing the hypnotic state have been

The duration of hypnotic sleep is exceedingly variable, but if left to

According to Charcot,17 three principal types may be remarked

18 Ibid., March 25, 1882, p. 223.

The extraordinary muscular excitability manifested by these

The somnambulic state may be directly induced by fixed attention

These remarkable exaggerations and perversions of special

22 Loc. cit., p. 357.

A higher degree of insensibility to ordinary impressions is necessary

24 Le Sommeil et les Rêves, 4th ed., p. 361.

TREATMENT.—A large proportion of the phenomena of somnambulism

26 Dyce Duckworth, “Insomnia in Persons of Gouty Disposition,” Brain, July, 1881.

27 Trousseau, Clinical Medicine, Am. ed., vol. iv. p. 362.

For all such patients a proper recognition of the cause of their

Closely related with the sleeplessness of lithæmia are the

Insomnia from Exhaustion.

Cerebral exhaustion is a not uncommon cause of wakefulness in

This variety of insomnia has frequently been ascribed to cerebral

Such patients need a very radical course of general treatment. A

Insomnia from Active Cerebral Congestion.

Still another form of sleeplessness is often experienced as a result of

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