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DRURY
COLIN Management and
Cost Accounting
11
ELEVENTH
EDITION
Australia ● Brazil ● Canada ● Mexico ● Singapore ● United Kingdom ● United States
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Management and Cost Accounting, © 2021, Colin Drury
11th Edition WCN: 02-300
Colin Drury ALL RIGHTS RESERVED. No part of this work may be reproduced,
transmitted, stored, distributed or used in any form or by any means,
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British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library.
978-1-4737-7361-5
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Printed in China by RR Donnelley

Print Number: 01 Print Year: 2020
BRIEF CONTENTS
PART ONE PART FOUR

Introduction to management and Information for planning, control and
cost accounting 2 performance measurement 380
1 Introduction to management accounting 4 15 The budgeting process 382
2 An introduction to cost terms and 16 Management control systems 419
concepts 26 17 Standard costing and variance
analysis 1 450
18 Standard costing and variance analysis 2:
PART TWO
further aspects 488
Cost accumulation for inventory 19 Divisional financial performance
valuation and profit measurement 48 measures 513
3 Cost assignment 50 20 Transfer pricing in divisionalized
4 Accounting entries for a job costing companies 545
system 88
5 Process costing 111 PART FIVE
6 Joint and by-product costing 138
Strategic performance and cost
7 Income effects of alternative cost
management, value creation and
accumulation systems 156
challenges for the future 580
21 Strategic performance management 582
PART THREE
22 Strategic cost management and value
Information for decision-making 176
creation 616
8 Cost–volume–profit analysis 178 23 Challenges for the future 658
9 Measuring relevant costs and revenues for
decision-making 204
PART SIX
10 Pricing decisions and profitability
analysis 238
Addendum: The application
11 Activity-based costing 265 of quantitative methods to
12 Decision-making under conditions of risk management accounting 686
and uncertainty 297 24 Cost estimation and cost behaviour 688
13 Capital investment decisions: appraisal 25 Quantitative models for the planning and
methods 320 control of inventories 712
14 Capital investment decisions: the impact 26 The application of linear programming to
of capital rationing, taxation, inflation and management accounting 733
risk 351
iii
CONTENTS
In Memoriam IX Incremental and marginal costs 38

Preface X The cost and management accounting
About the authors XVI information system 39
Acknowledgements XVII
PART TWO
PART ONE Cost accumulation for
Introduction to management inventory valuation and
and cost accounting 2 profit measurement 48
1 Introduction to management 3 Cost assignment 50
accounting 4 Assignment of direct and indirect costs 51
The users of accounting information 5 Different costs for different purposes 52
Differences between management accounting Cost–benefit issues and cost systems
and financial accounting 6 design 53
The decision-making, planning and control Assigning direct costs to cost objects 54
process 6 Plant-wide (blanket) overhead rates 54
The impact of the changing business The two-stage allocation process 55
environment on management accounting 10 An illustration of the two-stage process for a
Focus on customer satisfaction and new traditional costing system 57
management approaches 16 An illustration of the two-stage process for an
Functions of management accounting 18 abc system 62
Summary of the contents of this book 20 Extracting relevant costs for
Guidelines for using this book 20 decision-making 66
Budgeted overhead rates 67
Under- and over-recovery of overheads 68
2 An introduction to cost terms and Non-manufacturing overheads 69
concepts 26 Cost assignment in non-manufacturing
organizations 70
Cost objects 26
The indirect cost assignment process 72
Manufacturing, merchandising and service
Appendix 3.1: Inter-service department
organizations 27
reallocations 74
Direct and indirect costs 27
Period and product costs 30
4 Accounting entries for a job
Cost behaviour 32
Relevant and irrelevant costs and revenues 35
costing system 88
Avoidable and unavoidable costs 36 Materials recording procedure 89
Sunk costs 36 Pricing the issues of materials 90
Opportunity costs 37 Control accounts 91
iv
CONTENTS v
Recording the purchase of raw materials 92 PART THREE

Recording the issue of materials 94
Information for
Accounting procedure for labour costs 95
Accounting procedure for manufacturing decision-making 176
overheads 97
Non-manufacturing overheads 98 8 Cost–volume–profit analysis 178
Accounting procedures for jobs completed and Curvilinear cvp relationships 179
products sold 98 Linear CVP relationships 180
Costing profit and loss account 99 A numerical approach to CVP analysis 182
Job-order costing in service organizations 99 The contribution margin ratio 183
Interlocking accounting 99 Relevant range 184
Accounting entries for a just-in-time Margin of safety 186
manufacturing system 101 Constructing the break-even or cvp chart 186
Alternative presentation of CVP analysis 187
5 Process costing 111 Multi-product CVP analysis 189
Operating leverage 191
Flow of production and costs in a process CVP analysis assumptions and limitations 192
costing system 112 The impact of information technology 195
Process costing when all output is fully
complete 113
9 Measuring relevant costs and
Process costing with ending work in progress
revenues for decision-making 204
partially complete 118
Beginning and ending work in progress of Identifying relevant costs and revenues 205
uncompleted units 121 Importance of qualitative/non-financial
Partially completed output and losses in factors 205
process 126 Special pricing decisions 206
Process costing in service organizations 126 Product mix decisions when capacity
Batch/operating costing 126 constraints exist 210
Appendix 5.1: Losses in process and partially Replacement of equipment – the irrelevance of
completed units 128 past costs 213
Outsourcing and make-or-buy decisions 214
6 Joint and by-product costing 138 Discontinuation decisions 218
Determining the relevant costs of direct
Joint products and by-products 139
materials 220
Methods of allocating joint costs 139
Determining the relevant costs of direct
Irrelevance of joint cost allocations for
labour 220
decision-making 145
Appendix 9.1: The theory of constraints and
Accounting for by-products 146
throughput accounting 222
7 Income effects of alternative
cost accumulation systems 156 10 Pricing decisions and
profitability analysis 238
External and internal reporting 157
Variable costing 159 The role of cost information in pricing
Absorption costing 160 decisions 239
Variable costing and absorption costing: a A price-setting firm facing short-run pricing
comparison of their impact on profit 161 decisions 239
Some arguments in support of variable A price-setting firm facing long-run pricing
costing 162 decisions 240
Some arguments in support of absorption A price-taking firm facing short-run product mix
costing 164 decisions 244
Alternative denominator-level measures 165 A price-taking firm facing long-run product mix
Appendix 7.1: Derivation of the profit decisions 245
function for an absorption costing Surveys of practice relating to pricing
system 168 decisions 247
vi CONTENTS
Limitations of cost-plus pricing 247 Payback method 334

Reasons for using cost-plus pricing 248 Accounting rate of return 338
Pricing policies 248 The effect of performance measurement on
Customer profitability analysis 250 capital investment decisions 339
Appendix 10.1: Calculating optimal selling Qualitative factors 340
prices using differential calculus 255
14 Capital investment decisions:
11 Activity-based costing 265 the impact of capital rationing,
taxation, inflation and risk 351
The need for a cost accumulation system in
generating relevant cost information for Capital rationing 351
decision-making 266 Taxation and investment decisions 353
Types of cost system 267 The effect of inflation on capital
A comparison of traditional and abc investment appraisal 356
systems 267 Calculating risk-adjusted discount rates 358
The emergence of abc systems 269 Risk-adjusted discount rates and the weighted
Volume-based and non-volume-based cost average cost of capital 362
drivers 270 Sensitivity analysis 363
Designing abc systems 273 Initiation, authorization and review of projects 365
Activity hierarchies 275
ABC profitability analysis 277
Cost versus benefits considerations 279 PART FOUR
Time-driven abc 280 Information for planning,
Resource consumption models and unused
control and performance
capacity 283
Periodic review of an abc database 285 measurement 380
Abc cost management applications 285
15 The budgeting process 382
12 Decision-making under The strategic planning, budgeting and control
conditions of risk and process 383
uncertainty 297 The multiple functions of budgets 386
Conflicting roles of budgets 387
Risk and uncertainty 298
The budget period 387
Probability distributions and expected value 300
Administration of the budgeting process 388
Measuring the amount of risk 301
Stages in the budgeting process 389
Attitudes to risk by individuals 302
A detailed illustration 391
Decision tree analysis 304
Computerized budgeting 400
Buying perfect and imperfect information 306
Activity-based budgeting 401
Maximin, maximax and regret criteria 307
The budgeting process in non-profit-making
Risk reduction and diversification 308
organizations 403
13 Capital investment decisions: Zero-based budgeting 404
Criticisms of budgeting 406
appraisal methods 320
The opportunity cost of an investment 322
16 Management
Compounding and discounting 323
control systems 419
The concept of net present value 325
Calculating net present values 326 Control at different organizational levels 420
The internal rate of return 328 Different types of control mechanism 420
Relevant cash flows 331 Feedback and feed-forward controls 422
Timing of cash flows 331 Harmful side-effects of controls 423
Comparison of net present value and internal Management accounting control systems 424
rate of return 332 Responsibility centres 425
Techniques that ignore the time value of The nature of management accounting
money 334 control systems 427
CONTENTS vii
The controllability principle 428 Distinguishing between the managerial and

Setting performance targets and determining economic performance of the division 518
how challenging they should be 432 Alternative divisional profit measures 518
Determining how much influence managers Surveys of practice 519
should have in setting targets 433 Return on investment 520
Different approaches that managers use to Residual income 521
evaluate budgetees’ performance 434 Economic value added (EVA(TM)) 522
Contingency theory 435 An illustration of the calculation of EVA(TM) 523
Alternative uses of management accounting Determining which assets should be included
information 436 in the investment base 526
The impact of depreciation 527
The effect of performance measurement on
17 Standard costing and variance
capital investment decisions 528
analysis 1 450
Addressing the dysfunctional consequences
Operation of a standard costing system 451 of short-term financial performance
Establishing cost standards 453 measures 530
Purposes of standard costing 457
A summary of variance analysis for a variable 20 Transfer pricing in divisionalized
costing system 458 companies 545
Material variances 458
Purpose of transfer pricing 546
Labour variances 463
Alternative transfer pricing methods 547
Variable overhead variances 464
Market-based transfer prices 548
A generic routine approach to variance
Cost plus a mark-up transfer price 549
analysis for variable costs 465
Marginal/variable cost transfer prices 551
Fixed overhead expenditure or spending
Full cost transfer prices without a
variance 466
mark-up 552
Sales variances 466
Negotiated transfer prices 552
Reconciling budgeted profit and actual profit 469
Marginal/variable cost plus opportunity cost
Standard absorption costing 470
transfer prices 553
Reconciliation of budgeted and actual profit for
Comparison of cost-based transfer pricing
a standard absorption costing system 474
methods 554
Appendix 17.1: A generic routine approach to
Proposals for resolving transfer pricing
variance analysis 477
conflicts 555
Domestic transfer pricing
18 Standard costing and variance recommendations 558
analysis 2: further aspects 488 International transfer pricing 559
Appendix 20.1: Economic theory of transfer
Recording standard costs in the accounts 488
pricing 563
Direct materials mix and yield variances 493
Sales mix and sales quantity variances 497
Distinguishing between planning and operating Part Five
variances 498 Strategic performance and
The investigation of variances 500
The role of standard costing when ABC has
cost management, value
been implemented 501 creation and challenges for
the future 580
19 Divisional financial performance
measures 513 21 Strategic performance
management 582
Divisional organizational structures 514
Advantages and disadvantages of The performance management framework 583
divisionalization 515 Strategy and strategic positioning 583
Prerequisites for successful Performance measurement and performance
divisionalization 516 management systems 585
viii CONTENTS
Alternative performance management Relevant range and non-linear cost

frameworks 585 functions 697
The balanced scorecard 585 A summary of the steps involved in estimating
Linking performance evaluation with the cost functions 698
balanced scorecard 596 Cost estimation when the learning effect is
Benefits and limitations of the balanced present 699
scorecard approach 597 Estimating incremented hours and incremental
cost 702
22 Strategic cost management and Appendix 24.1: Multiple regression
value creation 616 analysis 704
Cost management and the value chain 617 25 Quantitative models for
Life cycle cost management 620
the planning and control of
Target costing 621
inventories 712
Kaizen costing 626
Activity-based management 627 Why do firms hold inventories? 713
Benchmarking 631 Relevant costs for quantitative models under
Business process reengineering 632 conditions of certainty 713
Just-in-time systems 632 Determining the economic order
Quality cost management 638 quantity 714
Assumptions of the eoq formula 716
23 Challenges for the future 658 Application of the eoq model in determining
the optimum batch size for a production
A brief historical review of run 717
management accounting 659 Quantity discounts 718
Globalization and management accounting Determining when to place the order 719
practices 660 Uncertainty and safety stocks 719
Environmental and sustainability issues 661 The use of probability theory for determining
Focus on ethical behaviour 666 safety stocks 720
Information technology and Control of inventory through
digitalization 668 classification 722
Intellectual capital and the knowledge-based Other factors influencing the choice of order
economy 673 quantity 723
Integrated reporting 675 Materials requirement planning 724
Implications for management accounting 676 Just-in-time (jit) purchasing arrangements 724
26 The application of linear

Part six programming to management
Addendum: The application accounting 733
of quantitative methods to Linear programming 734
management accounting 686 Graphical method 735
Simplex method 740
Uses of linear programming 743
24 Cost estimation
and cost behaviour 688
Bibliography 754
General principles applying to estimating cost Glossary 764
functions 689 Appendices 775
Cost estimation methods 690 Answers to review problems 777
Tests of reliability 696 Index 861
In Memoriam
Emeritus Professor Colin Drury (1944–2019)
S adly, Professor Colin Drury passed away in 2019 after a short illness. At the time of his passing, Colin
had already made plans for the content of the 11th edition of his bestselling textbook. Therefore,
in discussion with Colin’s family, Cengage brought on board a new and highly experienced contributing
author for the 11th edition, Professor Mike Tayles, to bring Colin’s initial plans and drafts to conclusion.
For several decades, Colin had been known for his textbooks, especially Management and Cost
Accounting, by almost anyone who wanted a thorough understanding of the subject. Colin was often
complimented on the comprehensive nature and clarity of his writing. This was probably attributable to
his previous practical experience, but also to the thorough and uncomplicated manner in which he tack-
led all his work. He managed to navigate successfully between the academic and practitioners’ study of
management accounting and as a result of his rigour and authority, his textbook became recommended
reading in management accounting by the professional accounting bodies as well as in many universi-
ties across the UK, Europe and beyond. From as early as the third edition it was regarded as ‘Europe’s
Bestselling Management Accounting Textbook’. The ACCA Students’ Newsletter noted: ‘Drury’s book
can be recommended, without reservation, to all accounting students.’
Colin also served on the Research Committee of CIMA and worked on the CIMA Official
Management Accounting Terminology. Colin was quick to include the most up-to-date research findings
into the latest editions of his textbooks and therefore helped turn research into practice. The areas of his
own research interests emphasized current practice, hence, he helped to bring management accounting
practice into research. Shortly after Colin’s retirement, to acknowledge his achievements, the British
Accounting and Finance Association bestowed upon him a Lifetime Achievement Award, which he
richly deserved.
Colin’s legacy will live on through this award and through his extensive contributions to books and
journals – Cengage thanks him for all his dedication over the past decades, and for his family’s support
in enabling the 11th edition to reach fruition.
All at Cengage
ix
PREFACE
F undamentally, this new 11th edition updates and builds upon the foundation in Management and
Cost Accounting which Colin so successfully established. Colin and I first started to teach together
40 years ago and commenced our research collaboration in 1990 with research into contemporary man-
agement accounting practices. I enjoyed collaborating with Colin, producing A Survey of Management
Accounting Practices in UK Manufacturing Companies (ACCA) and Cost System Design and Profitability
Analysis in UK Companies (CIMA) in addition to various journal articles. Colin was a pleasure to work
with, he had a clear passion for this work, but for someone so renowned in the academic accounting
community he was very modest about his achievements. There was always a humility in the way he
went about all of his academic endeavours. Although our careers ultimately followed different paths, we
maintained contact and so I am privileged to make a small contribution to this highly successful text-
book which for over three decades and ten editions, has been at the forefront of helping students learn
the key concepts and processes in management and cost accounting.
The aim of the 11th edition of this book is to explain the principles involved in designing and evalu-
ating management and cost accounting information systems. Management accounting systems accu-
mulate, classify, summarize and report information that will assist employees within an organization in
their decision-making, planning, control and performance measurement activities. A cost accounting
system is concerned with accumulating costs for inventory valuation to meet external financial account-
ing and internal monthly or quarterly profit measurement requirements. As the title suggests, this book
is concerned with both management and cost accounting, but with emphasis placed on the former.
A large number of cost and management accounting textbooks have been published. Many of these
books contain a detailed description of accounting techniques without any discussion of the principles
involved in evaluating management and cost accounting systems. Such books often lack a conceptual
framework and ignore the considerable amount of research conducted in management accounting in
the past three decades. At the other extreme, some books focus entirely on a conceptual framework of
management accounting with an emphasis on developing normative models of what ought to be. These
books pay little attention to accounting techniques. The objective has been to produce a book that falls
within these two extremes.
The target audience for this book is undergraduate students who are pursuing a one-year or two-year
management accounting course, and students who are preparing for the management and cost account-
ing examinations of professional accountancy bodies at an intermediate or advanced professional level.
It will also be of use to postgraduate and higher national diploma students who are studying manage-
ment and cost accounting for the first time. An introductory course in financial accounting is not a
prerequisite, although many students will have undertaken such a course.
PREFACE xi
STRUCTURE AND PLAN OF THE BOOK

A major theme of this book continues to be different financial information for different management
purposes and how to explain this to students. The framework used in this book highlights that there are
three ways of constructing management accounting information:
1. The first is cost accounting with its emphasis on producing product (or service) costs for allo-
cating costs between cost of goods sold and inventories to meet external and internal financial
accounting inventory valuation and profit measurement requirements.
2. The second is the notion of decision-relevant costs with the emphasis on providing relevant
information to help managers to make good decisions.
3. The third is responsibility accounting and performance measurement that focuses on both
financial and non-financial information; in particular, the assignment of costs and revenues to
responsibility centres.
These are captured in Figure 0.1 and throughout the book we remind the reader of this distinction and
point out where different examples of management and cost accounting information are – or are not –
suited to particular circumstances.
FIGURE 0.1
The management
accounting system
structure of this Introduction to management and cost
book accounting – Part 1
Cost accumulation
for inventory
valuation and profit
measurement –
Part 2
Information for
planning, control Information for
and performance decision-making –
measurement – Part 3
Part 4
The application of quantitative Strategic performance

methods to management and cost management,
accounting – Part 6 value creation and
challenges for the future –
Part 5
The book is divided into six parts. Part One consists of two chapters and provides an introduction to
management and cost accounting, its terminology and a framework for studying the remaining chap-
ters. The following three parts reflect the three different ways of constructing accounting information.
Part Two comprises five chapters and is entitled ‘Cost accumulation for inventory valuation and profit
measurement’. This part focuses on assigning costs to products, to separate the costs incurred during a
period between costs of goods sold and the closing inventory valuation for internal and external profit
xii PREFACE
measurement. The extent to which product costs accumulated for inventory valuation and profit mea-
surement should be adjusted for meeting decision-making, cost control and performance measurement
requirements is also briefly considered. Part Three consists of seven chapters and is entitled ‘Informa-
tion for decision-making’. Here the focus is on measuring and identifying those costs that are relevant
for different types of decision. The title of Part Four is ‘Information for planning, control and perfor-
mance measurement’. It consists of six chapters and concentrates on the process of translating goals and
objectives into specific activities and the resources that are required, via the short-term (budgeting) and
long-term planning processes. In addition, the management control systems that organizations use are
described and the role that management accounting control systems play within the overall control pro-
cess is examined. The emphasis here is on the accounting process as a means of providing information
to help managers control the activities for which they are responsible. Performance measurement and
evaluation within different segments of the organization is also examined. Part Five consists of three
chapters and is entitled ‘Strategic performance and cost management, value creation and challenges for
the future’. The first chapter focuses on strategic performance management, the second on strategic cost
management and value creation. The third chapter concentrates on the emerging issues that are likely to
have an impact on management accounting and considers some potential future developments in man-
agement accounting. Part Six consists of three chapters and is entitled ‘ADDENDUM: The application
of quantitative methods to management accounting’. This part can be incorporated flexibly depending
on the wishes of the instructor.
In devising a framework around the three methods of constructing financial information, there is
a risk that the student will not appreciate that the three categories use many common elements, that
they overlap (see Figure 0.1) and that they constitute a single overall management accounting system,
rather than three independent systems. Steps have been taken to minimize this risk in each part by
emphasizing why financial information for one purpose should or should not be adjusted for another
purpose. In short, each part of the book is not presented in isolation and an integrative approach has
been taken.
A frequent consideration in a book of this type is how much the application of quantitative tech-
niques should be integrated with the appropriate topics or if it should be considered separately. Quan-
titative techniques have been integrated whenever they are an essential part of a chapter, but otherwise
they are presented separately in Part Six. This approach allows for maximum flexibility. Instructors
wishing to integrate ‘quantitative techniques’ with particular earlier chapters may do so by assigning
readings from Part Six, while those who wish to concentrate on more ‘discursive’ material will not be
distracted by having to exclude the relevant quantitative portions of chapters.
CHANGES IN THE CONTENT OF THE 11TH EDITION

Feedback in relation to structure and content of the previous editions has been extremely favourable
and therefore no major changes have been made to the structure. The major objective in preparing the
11th edition has been to continue to produce an accessible text and to incorporate appropriate recent
developments in the management accounting literature. The content and expression was thoroughly
reviewed as well as the opportunity to rewrite or improve the presentation and explanation of the mate-
rial. Greater attention has been given to emerging issues such as environmental and sustainability issues,
ethical considerations, the knowledge-based economy, IT and digitalization.
We have also included a new ‘employability skills’ section at the end of each chapter, given the
increasing emphasis on teaching employability skills. Comprehensive solutions to all these questions
can be downloaded from the companion website to this title.
In addition, substantial updates have been made to the end-of-chapter assessment material that con-
tains the solutions in a separate section at the end of the book. Finally, most of the ‘Real World Views’
that provide examples of the practical application of management accounting have been updated or
replaced by more recent examples that provide better illustrations of the practical applications. Sug-
gested outline solutions to the answers to the questions accompanying the ‘Real World Views’ have been
added to the Instructor’s Manual accompanying this book.
PREFACE xiii
LEARNING NOTES
The scale and scope of management accounting is always expanding. It is inevitable that not all
instructors will use all chapters of this book in their teaching programmes. In order to meet the differ-
ent requirements of lecturers, different course curricula and to retain the book at a manageable size,
various topics have been included as learning notes that can be accessed by students and lecturers in
the digital support resources accompanying this book. The learning notes tend to include the more
complex issues that often do not feature as part of the content of other management accounting text-
books, but which, over the years, have remained topics of relevance and interest. All learning notes are
appropriately referenced within the text. For example, at appropriate points within specific chapters
the reader’s attention is drawn to the fact that, for a particular topic, more complex issues exist and that
a discussion of these issues can be found by referring to a specific learning note in the digital resources
accompanying this book.
CASE STUDIES
Over 30 case studies are available in the digital support resources for this book. Both lecturers and stu-
dents can download these case studies from the book’s companion website. Teaching notes for the case
studies are only available for instructors to download. The cases generally cover the content of several
chapters and contain questions to which there is no ideal answer. They are intended to encourage inde-
pendent thought and initiative and to apply the content of this book in particular contexts. Case studies
are also intended to develop critical thinking and analytical skills.
HIGHLIGHTING OF ADVANCED READING SECTIONS

One of the major advantages of this book, highlighted in feedback, has been the comprehensive treat-
ment of management accounting. Throughout the book there are sections that have been identified
as advanced reading. Instructors and students can decide whether or not some of the more advanced
material is essential for their course. These advanced reading sections have been highlighted using a
vertical coloured line. They should be read in detail only when the remaining parts of the chapter have
been fully understood.
INTERNATIONAL FOCUS
The book is an established text in many different countries throughout the world. As a result, a more
international focus has been adopted. A major feature is the presentation of boxed exhibits of surveys
and practical applications of management accounting in companies in many different countries, par-
ticularly on the European mainland. Most of the assessment material includes questions set by the UK
professional accountancy bodies. These questions are appropriate for worldwide use, and users who
are not familiar with the requirements of the UK professional accountancy bodies should note that
many of the advanced-level questions also contain the beneficial features described above for case study
assignments.
RECOMMENDED READING
A separate section at the end of most chapters provides advice on key articles or books which you
are recommended to read if you wish to pursue topics and issues in more depth. Many of the refer-
ences are the original work of writers who have played a major role in the development of management
xiv PREFACE
accounting. The contribution of such writers is often reflected in this book but there is frequently no
substitute for reading the original work of the authors. The detailed references are presented in the bib-
liography towards the end of the book.
ASSESSMENT MATERIAL
Throughout the text, illustrations have been kept relatively simple. You can check understanding of
each chapter by answering the review questions. Each question is followed by page numbers within
parentheses that indicate where in the text the answers to specific questions can be found. In addition,
more complex review problems are set at the end of each chapter to enable students to pursue certain
topics in more depth. Each question is graded according to the level of difficulty. Questions graded
‘Basic’ are appropriate for a first-year course and normally take less than 20 minutes to complete. Ques-
tions graded ‘Intermediate’ are also appropriate for a first-year course but take about 30–45 minutes
to complete, whereas questions graded ‘Advanced’ are normally appropriate for a second-year course
or the final stages of the professional accountancy examinations. Fully worked solutions to the review
problems not prefixed by the term ‘IM’ (Instructor’s Manual) are provided in a separate section at the
end of the book.
This book is part of an integrated educational package. A Student Manual offers additional review
problems with fully worked solutions. Students are strongly recommended to purchase the Student
Manual, which complements this book. In addition, the Instructor’s Manual provides suggested solu-
tions to the questions at the end of each chapter that are prefixed by the term ‘IM’. The solutions to these
questions are not available to students. The Instructor’s Manual can be downloaded free by lecturers.
Also available to lecturers is a Cognero test bank offering 1,800+ questions and answers tailored to the
content of the book, for use in classroom assessment.
The form of assessment in both academic and professional accounting is evolving, which is reflected
in the use of objective test (OT), multiple-choice or drag-and-drop-based short problems. Periodically,
use is made of larger questions or case studies (sometimes pre-distributed) which are cross-functional
containing contextual material.
Candidates are advised that the graded questions in this book are still an ideal way to prepare for
both these styles of assessment. The reasons are:
●● OT questions: candidates need to understand the whole process of any calculation, decision or
action in order to understand the particular part being examined in any shorter OT question.
●● Case studies: candidates may be faced with a case study (at any level), which contains the detail
or results of a comprehensive calculation. They may be required to understand, adapt, perhaps
critique, such a calculation and use it to make judgements and recommendations.
Candidates can only make a correct judgement in response to either situation if they understand the
overall problem and how any one part fits with the whole process. This will be guided by making attempts
at a combination of basic, intermediate and advanced questions which appear at the end of each chapter.
I hear and I forget, I see and I remember, I do and I understand.
Chinese proverb
ALTERNATIVE COURSE SEQUENCES

Although conceived and developed as a unified whole, the book can be tailored to the individual
requirements of a course and to the preferences of the individual reader. For a discussion of the alterna-
tive sequencing of the chapters see ‘Guidelines for using this book’ in Chapter 1.
PREFACE xv
SUPPLEMENTARY MATERIAL
The 11th edition of the print Student Manual helps you work through the text and is available from all
good bookshops (ISBN 978-1-4737-7362-2).
The 11th edition of Colin Drury’s Management and Cost Accounting text is accompanied by the fol-
lowing dedicated digital support resources:
●● Dedicated instructor resources only available to instructors, who can register for access either at
login.cengage.com or by speaking to their local Cengage learning consultant.
●● Cengage MindTap, an online learning solution that allows lecturers to easily customize and
combine learning tools such as readings, interactive content and assessment activities to create
a personalized learning path for students, including Aplia. Lecturers can add or remove existing
content within the learning path or add their own content in order to deliver a seamless student
experience that aligns exactly with the way they teach their course.
DEDICATED INSTRUCTOR RESOURCES

This includes the following resources for lecturers:
●● Instructor’s Manual which includes answers to ‘IM Review problems’ in the text
●● Online test bank which provides over 1,800 questions and answers
●● PowerPoint slides to use in your teaching
●● Teaching notes to accompany the case studies
●● Downloadable figures and tables from the book to use in your teaching.
Mike Tayles, Emeritus Professor Accounting and Finance, University of Hull
ABOUT THE AUTHORS
Colin Drury
Colin Drury was at Huddersfield University from 1970 until his retirement in 2004, when he was
awarded the title of Emeritus Professor. For the last 35 years, Colin had been at the forefront of helping
students learn the key concepts and processes in management and cost accounting through his bestsell-
ing textbooks, which have been widely recommended by the main professional accounting bodies for
their examinations. He was an active researcher throughout his career and his research had been pub-
lished in around 100 professional and academic journals.
In recognition for his contribution to accounting education and research, Drury was given a Lifetime
Achievement Award by the British Accounting Association in 2009.
Colin’s flagship title Management and Cost Accounting was first published over 35 years ago and is
now in its 11th edition. It established itself as one of the leading management accounting textbooks in
EMEA. It is known, not just for its rigour and authority, but particularly for Colin’s down-to-earth style
that reflected his background as a practising accountant before his involvement in academia.
Mike Tayles
Mike Tayles holds the Emeritus Chair in Accounting and Finance at The University of Hull. During his
career, he has been the Head of Management Accounting and Programme Director of various Degree Pro-
grammes as well as a Visiting Professor at various universities internationally. He has been an Examiner/
Lead Marker for both the ACCA and CIMA.
Mike is a chartered management accountant with a first degree in mathematics and economics and a
doctorate in contemporary management accounting practices. He has worked in various manufactur-
ing industries, holding such positions as group management accountant and financial controller.
Mike’s research interests include management accounting practices, cost system design, activity-
based cost management and developments in strategic management accounting, including quality and
intellectual capital. He has presented papers at national and international conferences, and published
articles in professional and international academic journals and research reports. He has consulting
and research experience in both manufacturing and service businesses.
xvi
ACKNOWLEDGEMENTS
T he authors are indebted to many individuals for their ideas and assistance in preparing this and
previous editions of the book. In particular, we would like to thank the following who have provided
material for inclusion in the text and the dedicated digital support resources or who have commented
on this and earlier editions of the book:
Alicia Gazely, Nottingham Trent University, UK
Anh Nguyen, ICHEC, Belgium
Annie van der Merwe, University of Johannesburg, South Africa
Anthony Atkinson, University of Waterloo, Canada
Antony Head, Sheffield Hallam University, UK
Ben Ukaegbu, London Metropolitan University, UK
Bjarni Frimann Karlsson, University of Iceland, Iceland
Carsten Rohde, Copenhagen Business School, Denmark
Cathy Knowles, Oxford Brookes University, UK
Charlotte Wilson, University of Hull, UK
Christopher Coles, Glasgow University, UK
Clare Guthrie, Manchester Metropolitan University, UK
Corinna Schwarze, University of Stellenbosch, South Africa
Dan Otzen, Copenhagen Business School, Denmark
David MacKerrell, Bromley College, UK
David Russell, De Montfort University, UK
Dermot O’Leary, Athlone Institute of Technology, Ireland
Deryl Northcott, Auckland University of Technology, New Zealand
Dinah-Ann Rogers, Manchester Metropolitan University, UK
F.J.C. Benade, UNISA, South Africa
Falconer Mitchell, University of Edinburgh, UK
Fanus Nortje, UNISA, South Africa
Finland Joset Jordaan-Marais, University of Johannesburg, South Africa
Francois Steyn, University of Stellenbosch, South Africa
Gary Owen, University of Greenwich, UK
Gordian Bowa, Polytechnic of Namibia, Africa
Graham Parker, Kingston University, UK
xvii
xviii ACKNOWLEDGEMENTS
Hadiza Said, University of Hull, UK

Hugh McBride, GMIT, Ireland
Ian G. Fisher, John Moores University, UK
Ian Herbert, Loughborough University, UK
Igbekele Sunday Osinubi, University of East London, UK
James S. Reece, University of Michigan, USA
Jayne Ducker, Sheffield Hallam University, UK
Jim Stockton, University of Chester, UK
Joanne Monkman, CIMA, UK
Jodie Moll, University of Manchester, UK
John Currie, National University of Ireland, Galway, Ireland
John Fletcher, Middlesex University, UK
John Innes, University of Dundee, UK
John Joyce, Sheffield Hallam University, UK
John Perrin, University of Exeter, UK
John Shank, The Amos Tuck School of Business, Dartmouth College, UK
Jonathan Rooks, London South Bank University, UK
Jose Manuel de Matos Carvalho, ISCA de Coimbra, Portugal
Jukka Pellinen, University of Jyväskylä, Finland
Julia Smith, University of Wales Cardiff, UK
Katlijn Haesebrouck, Maastricht University, NL
Keith Best, University of Huddersfield, UK
Khaled Hussainey, Stirling University, UK
Kirsten Kininmonth, University of Glasgow, UK
Lewis Gordon, University of Liverpool, UK
Lin Fitzgerald, Loughborough University, UK
Louise McAlinden, ACCA, UK
Martin Quinn, Queen’s University Belfast, Ireland
Melissa McGill, University of Johannesburg, South Africa
Michael Tapiwa Mubaiwa, Manchester Metropolitan University, UK
Michel Lebas, HEC Paris, France
Mike Johnson, University of Dundee, UK
Mubina Musa, Manchester Metropolitan University, UK
Nick Best, Astranti Financial Training, UK
Obert Matarirano, University of Forth Hare, South Africa
Paul Collier, University of Exeter, UK
Peter Clarke, University College Dublin, Ireland
Peter Cleary, University College Cork, Ireland
Peter Nordgaard, Copenhagen Business School, Denmark
Richard Andrews, University of Hull, UK
Richard Grey, University of Strathclyde, UK
Richard M.S. Wilson, Loughborough University Business School, UK
Robin Roslender, Heriot-Watt University, UK
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cords of three dogs, and in each instance produced changes which
he interpreted as comparable to the myelitis of human pathology. But
the inflammation thus provoked was not of the cord-substance alone;
it also involved the membranes, and the inflammatory foci were in
several instances purulent. Now, pus never85 forms in ordinary
myelitis. An abscess of the cord never occurs where a septic agency
can be excluded. In six dogs whose spinal cords I wounded in the
dorsal and lumbar regions by aseptic methods, and who survived
from two to seven days, I never found purulent or indeed any active
inflammatory process, as that term is ordinarily understood, but
exactly such passive and necrotic or reactive changes as occur in
the acute myelitis of human pathology.
83 Klinik der Rückenmarkskrankheiten, ii. p. 115.
84 Cited by Leyden.
85 In the textbooks and encylopædias, without an exception, the statement that pus
may be a product of myelitis is made. This is true of traumatic cases and of such
depending on septic and zymotic causes alone. I am unable to find a single carefully
observed case of the occurrence of pus in simple myelitis in the literature.
Owing to the advance of clinical and anatomical knowledge made

within the past fifteen years many forms of spinal disease classed
with the inflammations have been recognized as distinct pathological
entities, no longer to be confounded with simple acute myelitis,
ordinarily so called. Special forms of acute spinal paralysis, notably
acute poliomyelitis anterior of children and the corresponding chronic
affection among adults, have become separated in this way, and are
accordingly treated of in separate parts of this volume.86
86 For other and practical reasons the traumatic and compression forms of myelitis
are also assigned a separate place.
Some dispute exists as to the propriety of making a distinction

between acute and chronic myelitis, since an acute myelitis, if the
initial attack be recovered from with life, presents a similar condition
clinically as chronic myelitis; and this quiescent or slowly-progressing
condition may extend over many years. The term acute with
reference to inflammation of the spinal cord refers only to the active
period of the disease. Just as an embolic softening of the brain is an
acute affection, but may be followed by a chronic paralysis or
aphasia, so the acute myelitic process may be followed by a chronic
paraplegia. It is improper to call the latter a chronic myelitis. It is
merely a protracted symptomatic sequel of the acute process. The
latter is distinguished from chronic myelitis both clinically (by the
rapidity of its onset) and anatomically (by the early dissolution of
nerve-elements in the focus of disease). Limited in this sense, acute
myelitis, excluding the special clinical forms already adverted to, is
rather a rare disease.
MORBID ANATOMY.—The most recognizable change noted in an acute

myelitic focus is one of consistency: the spinal substance is
softened. In some cases the softening is so slight that the observer
may doubt whether he has a pathological or cadaveric softening to
deal with, the dorsal cord, which is most apt to be the site of an
acute transverse myelitis, being precisely the part which is most apt
to show the latter change even in fairly well-preserved bodies. In
extreme cases the softening may be so intense that the cord-
substance, completely fluidified, runs out of the meningeal sac,
leaving the latter a collapsed membranous cylinder to mark the place
where the cord once was. Where the cord-substance is sufficiently
firm to permit of sections being made through it, the normal outline of
the gray and white substance is found obliterated, either presenting
the appearance as if the gray and white matter had been stirred up
together or of a more uniform color-change. The color may be either
white, reddish, yellowish, or chocolate-like. It depends upon the
participation of the blood-vessels in the change. If there be much
hyperæmia, there will be developed what is known as red softening;
if there be much extravasation and commingling of blood with the
diffluent cord-tissue, a chocolate color will mark the diseased area;
and similarly one and the same focus may present different tints in
different parts according to the age and intensity of the process and
the more or less advanced retrogressive metamorphosis of the
extravasated fluid. As already stated, the purulent form of softening
or abscess does not occur in ordinary myelitis.
There is considerable variation in the extent of the affected areas of

acute myelitis. In the typical and severe transverse form the whole
thickness of the cord may be disorganized, and the disorganization
may extend in the length of the cord, so as to involve the level of exit
of from two to five pairs of nerves. In less furibund cases the area of
absolute softening is confined to the gray substance and its
immediate neighborhood, the submeningeal white substance being
but slightly affected or escaping. Sometimes several foci of intense
softening are scattered through a short length of the cord and
connected by less severely involved areas of softening or œdema.
Leyden distinguishes three types of distribution—the transverse, the
longitudinal, and the disseminated insular or multiple form. He
includes under the longitudinal type the so-called central softening of
Albert, but undoubtedly many cases of syringo-myelia have passed
under this designation. The submeningeal form of softening which,
with Ollivier, he states to occur in association with spinal meningitis,
must be a very rare affection, as it is difficult to find a well-
established case recorded. The longitudinal form shows the same
predilection for the gray substance which the acute myelitic process
generally does, but I have seen a finely demarcated fascicular
myelitis limited to the lateral column in a paretic negro. In this case
the pyramid tract and the contiguous area in front of it were so
intensely softened that for a length of twelve centimeters a hollow
canal ran through the cord in the place previously occupied by the
diseased substance. In recent cases of myelitis the diseased area is
usually found surrounded by a transition zone in which, the morbid
change gradually becoming less intense, the consistency is firmer,
and which merges into that of the normal cord. In cases where death
occurs after a few weeks a more abrupt demarcation is usually
found; this is due to the reactive changes occurring in the
neighborhood. The connective tissue becomes firmer, and thus the
softening centre becomes surrounded by a sclerosing capsule.
Ultimately, the centre undergoes complete disintegration and
absorption, and a cavity is left behind filled with a clear fluid; in short,
a cyst surrounded by a firm capsule represents the residua of
disease. In cases where the softening at the centre of the focus does
not proceed so rapidly nor reach so high a degree as to result in
liquefaction, the less vulnerable elements, the blood-vessels and
supporting tissues, survive the death of the ganglionic and
conducting substance; the connective elements hypertrophy, and
thus a firm sclerotic patch is formed, indicating the location of the
previously softened field.
It seems to be generally admitted, with Hayem, that the blood found

exuded in the hemorrhagic form of myelitis does not necessarily
indicate an active determination, but is rather, like some forms of so-
called red softening of the brain, the result of capillary rupture or
necrosis in the midst of the disintegrated tissue, now rendered
incapable of supporting the vessels. The existence of a purely white
form of myelitic softening shows that a textural change is the primary
occurrence, and that the participation of hyperæmia or congestion is
not an essential feature of myelitis. The assumption of an initial
inflammatory congestion is made rather on theoretical grounds than
on the basis of observation. It is simply incredible that, as Ross87
claims, white softening should be a third stage, preceded by red and
yellow softening as a first and a second stage! How the extravasated
blood, which pathologists generally allow to leave long-lasting traces,
manages to disappear, and how blood-vessels in the midst of
necrotic or œdematous surroundings suddenly acquire such
contractile energy as to produce a total emptying of their contents
while the perishable nerve-elements remain behind, are problems
which should be solved before attempting to assign to a condition
which is often found to be a primary phase of myelitis the position of
a late and regressive stage. Erb admits that red softening, to which
he also assigns the position of a first stage, is very rarely seen, only
traumatic and rapidly fatal cases of central myelitis offering
opportunities of examining it. None of the various forms of exudation
claimed to occur at this period under the names of vitreous, colloid,
or hyaline deposit have been confirmed in any recently well-studied
case.88 The great mass of authorities, however, still agree in
regarding the minute changes of the initial stage of myelitis to
correspond to those of ordinary inflammation. The vessels are
described as injected, the adventitial spaces as crowded with the
formed elements of the blood, and the vascular walls and the
neuroglia infiltrated with granule-cells and fatty granular matter. By
some, inflammatory changes of the neuroglia are described, but I am
unable to find a single case in which these were determined in early
fatal cases. As far as our observation goes, the hypertrophy of the
neuroglia is a later occurrence.
87 A Treatise on Diseases of the Nervous System, 1882, vol. ii. p. 280. The author
states no authority, nor does he advance his own observations in support of this
statement.
88 Baumgarten's case of hyaline exudation, Archiv der Heilkunde, vol. xvii. 276, was
an infectious myelitis and associated with anthrax.
As to the nervous elements themselves, they are always found

affected. The nerve-cells appear inflated, their processes fragile,
sometimes suddenly swollen in their course, at others very thin and
brittle. Multiplication of the nuclei of the large multipolar cells has
been described. It must be an unusual occurrence, as it has been
confirmed by but a few of the numerous observers who have
examined into this question. The protoplasm of the nervous
elements loses its normal striation and fine molecular granulation; it
becomes either coarsely granular or hyaline. The axis-cylinders, both
in their intracinereal and their intramyelinic course, show changes
similar to those of the cell-processes in the gray matter. Particularly
frequent are swellings in their course, the diameter of the cylinder
being so much increased as to almost equal that of the myelin tube.
This increase in diameter is regarded as an inflammatory swelling by
some, as secondary to disturbed nutrition by others; it precedes
disintegration: the substance becomes granular, fragile, and in the
end dissolves. In the mean time the myelin loses its continuity,
irregular segments of it fusing into round and oval masses.89
89 Many of the bodies represented as granule and colloidal cells are in reality round
spheres of myelin, whose resemblance to a nucleated cell is sometimes heightened
by their occasional inclusion of a fragment of an axis-cylinder which has not yet lost
its power of imbibing carmine and other dyes. Where softening has proceeded
farthest, there the spherical and other forms of myelin are found crowding the field,
and mingled with them are blood-corpuscles, fragments of blood-pigment, granular
detritus, and bodies known as fatty granular cells. A number of bodies of very different
origin have received this name, some of them, like the fragments of myelin alluded to,
not even meriting the name of cells. Others, however, are veritable formed histological
elements, either leucocytes or cellular ingredients of the neuroglia, which, having fed
on the products of myelin disintegration, have become enlarged and coarsely
granular. The longer the duration of the process the more numerous are these bodies,
showing that they are not the coarse and essential factor of the inflammation, but an
accompaniment, subserving some conservative process, inasmuch as they either
remove effete material or contribute to the permanent organization of the cicatricial or
atrophic tissue.
The period now reached by the morbid process may be regarded as

a sort of interregnum. The necrotic tissues have not yet disappeared
on the one hand, the products of inflammation have not yet
organized themselves on the other. It is in this period that the
ganglionic elements are described as undergoing certain changes in
outline and in appearance. Above all, one change has interested
observers, which, consisting in the development of what appear to
be spherical vacuoles in the interior of the cell, is termed
vacuolization. I can compare it to nothing so nearly as to the
appearance which is produced by the formation of gas-bubbles in a
putrefying albumen or other semifluid substance.
This vacuolization of ganglion-cells is now regarded as a cadaveric

change. It is not agreed, as yet, whether its occurrence in myelitis is
so frequent as to suggest its ante-mortem occurrence as a veritable
feature of the disease. I have been struck by this change in the
neighborhood of wounds artificially produced in dogs, even in the
fresh specimen. It must be remembered, however, that under these
circumstances, the nutrition of the cell being destroyed and exposure
to the macerating effect of the cerebro-spinal and pathologically
exuded fluids occurring, a cadaveric change may take place intra
vitam.
The influence of phosphorus and alkaloid as well as metallic poisons
on the cord has been experimentally studied by a number of
observers. Unfortunately, Popow, Tschisch, and Danillo—who
described as characteristic a resulting change in the staining
reaction of the cells, the development of vacuoli in them, and an
atrophy of their processes—had not made a sufficient number of
examinations of normal cords under like methods of preparation to
recognize which of these deviations is without the physiological
confines. Kreyssig90 demonstrated the existence of all these
conditions in the cords of perfectly healthy animals preserved in
chromic acid;91 and Schultze confirms him, and expresses a
surprise, which must be shared by all reflecting investigators, that
poisons of so widely different a character should have an identical
effect on the cord-substance, as is claimed by the writers named.
90 Virchow's Archiv, cii.
91 He attributes the remarkable difference in staining of nerve-cells of the same

ganglionic group and in the same section to the sudden transferral of the hardened
specimens to strong alcohol, which seems to be the custom in some German
laboratories. He claims that uniformity in staining is effected if the specimen be
transferred from the chromic preparation to weak alcohol, then to stronger, and thus
by gradual increase of the strength to strong spirit. Possibly, instead of approximating
the real structural indications by this method, Kreyssig may obliterate them. In
specimens which alcohol is not permitted to touch before staining is completed, very
deeply and very lightly stained cells will be found almost side by side. The shorter the
hardening process, the more perfect the staining method, the more likely are these
differences to be found. It is reasonable to assume that the difference in dye-
absorbing power indicates slight differences in the cell-protoplasm, marking the
nutritive state of the latter and occurring within physiological limits.
If life be prolonged and the conservative processes assert

themselves, the disintegrated material disappears, and as the white
color of the greater area of the cord was due to the myelin, and the
latter has now become destroyed within the diseased area, the latter
presents a grayish color. This phase is often termed gray softening.
The consistency is, however, much firmer than in the previous stage.
Trabeculæ of connective tissue form, enclosing in their meshes a
large number of neuroglia-nuclei and sometimes spaces filled with
fluid. According as condensation and retraction or rarefication
preponderate the process will terminate either in the formation of a
sclerotic focus or of a cyst. Occasionally an irregular spongy tissue
containing several small cysts results.
Charcot claims that a restitution of anatomical continuity, and

therefore of physiological potentiality, may occur in a myelitic cicatrix.
But the experiments of Kahler92 and Homén93 prove that when a
nerve-tract is once destroyed within the spinal cord all hope of
restoring that tract in structure, and thus to restore its functions, is at
an end. Unlike the fibres of the peripheral nerves, those of the spinal
cord and brain do not seem capable of regeneration.94 If a
restoration of function is to occur at all, it must occur through other
channels than those destroyed—in other words, by vicarious action.
92 Prager medizinische Wochenschrift, 1884, No. 31.
93 Contribution expérimentale à la Pathologie et à l'Anatomie pathologique de la

moelle épinière, Helsingfors, 1885, abstracted in Centralblatt für die medizinisches
Wochenschriften, 1886, No. 16.
94 According to the first observer, this is probably due to structural differences. The
extramedullary fibres have a sheath and annular constrictions which are absent in the
intramedullary.
In a large number of cases myelitis is a limited affection; that is, its

ravages remain confined to the area originally involved. But
occasionally the morbid process involves the next segments above
or below, extending with specially great rapidity through the anterior
gray horns. Exceptionally, the entire cord may thus become the site
of a generalized myelitis. There is one segment of the cord which
may be regarded as possessing an acquired vulnerability when a
myelitic focus is in its neighborhood, and that is the lower end. It
seems that while the results of a transverse myelitis in the middle
dorsal cord may remain stationary for ten or more years, those of a
transverse myelitis at the upper lumbar level do not; on the contrary,
the entire cord below the lesion appears to be doomed to undergo
the same degeneration by contiguity. This is the only occurrence
which seems to deserve the name of a descending myelitis: an
ascending extension is more frequently noted in other parts of the
cord, but the frequency of both the so-called ascending and
descending types has been unduly magnified by the inclusion of the
secondary degenerations, which are constant sequelæ of all
complete destructive transverse lesions of the cord, but which are
rather passive phenomena, and probably influence the clinical
progress of the case but little, except under such conditions as are
potent in that chronic form of myelitis which underlies tabes dorsalis.
CLINICAL HISTORY.—The symptoms of acute myelitis usually

correspond to those of any more or less completely transverse lesion
of the cord, and accordingly vary with the altitude of the upper level
of the lesion. In a general way, they may be stated as consisting of—
First, paralysis of movement in the parts supplied from the nerves

given off below the level of the lesion. The reason for this can be
easily recognized in those cases where the pyramid tract, which
conveys voluntary impulses centrifugally, is interrupted by the
softening.
Second, paralysis of sensation in the parts supplied by the same

nerves. This is equally explained by the pathological interruption of
the centripetal impressions normally conveyed brainward.
Third, alterations in the nutrition of the parts supplied by the nerves

arising in the affected level.
Fourth, abolition of those reflexes which are translated in the level of

the lesion.
Speaking crudely, then, the symptoms of a transverse myelitis fall

into two natural groups. The one which includes the first and second
categories enumerated are symptoms due to interruption of cerebral
functions; the other, which comprises the last two categories, being
due to abolition or perversion of spinal functions. There is a third
group comprising certain constitutional symptoms.
Aside from those variations due to the distribution, extent, and

intensity of the lesion there are others which depend on the rapidity
of its invasion. There are three types in this respect—the
apoplectiform, the ordinary acute, and the subacute. The term
apoplectiform has been used in two different senses, one being
clinical, and referring to the rapidity of onset of the symptoms; the
other anatomical, and referring to the nature of the lesion. It is,
however, doubtful if a distinction in the latter sense is practically
valuable. The presence of a blood-clot in a myelitic focus is itself
secondary to the softening, and the intensity and rapidity of the
process must have shown itself in the development of the latter.95
The term ought, therefore, to be used in a clinical sense only.
95 I am able to recall but a single case in which, even clinically speaking, a primary
hemorrhage into the cord-substance was plausible. In this instance a sudden arrest of
menstruation had occurred nearly simultaneously with a combined strain and
exposure in a young girl.
The constitutional symptoms of acute myelitis—which, however, are

often absent—are its most distinctive features in one sense.
Disorders of motion and sensation and perversions of nutrition are
signs common to all destructive affections of the cord, whether of a
traumatic, neoplastic, or a chronic inflammatory character. But fever,
headache, and delirium,96 associated with gastric and visceral
disturbances of acute development, are not found to be initial and
intrinsic symptoms with them as with acute myelitis. In their absence
the mode of onset is characteristic. A high degree of paralysis, motor
or sensory, is developed with a rapidity unequalled in any chronic
affection of the cord. Sometimes there is a prodromal period in which
formication, numbness, and disorders of movement are observed in
the same part of the body which are destined to become paralyzed
at a later stage of the malady. Within a few hours, days, or at most
weeks, complete paraplegia may become developed. The prodromal
symptoms may include any form of disturbed sensation. Lancinating
pains, tingling, a feeling of the limbs falling asleep, peculiar and
indescribable sensations attending the acts of micturition and
defecation or of placing the feet violently on the ground, are
common. Occasionally they are found in one limb only, although
motor and sensory paralysis may ultimately occupy the symmetrical
member as completely as the one first involved. In some cases it has
been noted that the patient is unable to lie down, or, if lying, to
occupy the dorsal recumbent position. This feature has been utilized
to support the theory of an initial congestion, which is supposed to
be relieved or aggravated according as the cord is kept elevated or
depressed.
96 These symptoms are to be regarded as actual parts of the myelitic symptoms only
when they accompany the prodromal or initial periods. The later complications,
uræmia and septicæmia, the latter arising from pyelitis, cystitis, or decubitus, often
lead to constitutional disturbance which is not due to the myelitis as such.
In most cases of transverse myelitis, when the anterior cornua are

destructively involved, we possess in the electrical tests valuable
and unerring means of determining the altitude and extent of the
lesion. Whenever we find the atrophy of a paralyzed muscle
accompanied by qualitative electrical changes in myelitis, we must
conclude that the cell-group from which that muscle receives its
nerve-supply is destructively involved.97 These changes are
particularly well demonstrable when the cervical or lumbar
enlargements are affected. They are not as readily ascertainable in
the case of a transverse myelitis in the upper dorsal region, on
account of the situation of the muscles supplied by the upper dorsal
nerves, and the consequent difficulty of application of the necessary
tests.
97 The proposition, originally, I believe, made by myself, that there are distinct cell-
groups in the spinal cord which are constant with certain animal species, and
correspond in relative development to ventral, dorsal, and appendicular muscular
groups (“Architecture and Mechanism of the Brain,” Journal of Nervous and Mental
Diseases, April, 1880), appears to be confirmed in a general way by the researches
and cases of Edinger, Kahler-Pick, Dejerine-Major, Genzmer, Von Monakow, Sahli,
Prévost-David, F. Schultze, Remak, and Parrot-Joffroy; for the knowledge of the first
and last of which I am indebted to the review of the subject by Starr (“Localization of
the Functions of the Spinal Cord,” American Journal of Neurology and Psychiatry,
August, 1883).
The disturbance of the deep reflexes with very few exceptions

affects the same peripheries as are represented in the destroyed
and impaired gray nuclei. Thus, if the lower part of the lumbar
enlargement be affected, the reflexes of the Achilles tendon and the
gluteal muscles will disappear; if the upper lumbar enlargement, the
knee-jerk disappears.98 Disease of the lower part of the cervical
enlargement is in like manner associated with absence of the wrist-
tendon reflexes, while the disappearance of the elbow-tendon reflex
suggests a higher involvement at the levels of the fifth and sixth
cervical nerve-roots.
98 The disappearance of the knee-jerk and similar reflexes was originally supposed to
be a phenomenon exclusively pertaining to spinal disease and to a destructive lesion
anywhere in the track of the centripetal and centrifugal nerves connected with that
segment of the cord in which the reflex is supposed to be translated. But aside from a
number of physiological observations99 which prove that cerebral conditions may
influence the intensity of the jerk, there are pathological ones which show that it may
be permanently abolished in disease of the pons and cerebellum, and temporarily
abolished or diminished immediately after capsular and ventricular hemorrhage. The
associated symptoms in the former case, and the history of the onset and total
hemiplegia in the latter, serve to distinguish them from destructive spinal lesions
should the occasion for discriminating between them ever arise; which is not likely.
99 S. Weir Mitchell and M. J. Lewis found that voluntary effort increases the jerk at
first, but if continued diminishes its excursiveness (The Medical News, 1886, Feb.
13th and 20th).
In complete transverse acute myelitis of the cervical region high

fever is a constant symptom. In unilateral myelitis of this region
flushing of the face and unilateral sweating are produced, together
with iridoplegia, sometimes preceded by dilatation, owing to initial
irritation and succeeding paralysis of the sympathetic branches
originating at this level of the cord.
Just as the disturbed reflexes and the belt sensations enable us to
distinguish at what levels of the cord the myelitis is situated, so the
distribution of the motor and sensory paralysis affords corroborative
evidence of such location and additional proof of its extent and
intensity.
Transverse myelitis at and above the level of origin of the phrenic

nerve is almost immediately fatal, through its interference with the
innervations required in respiration. In the upper part of the cervical
enlargement it produces complete paraplegia of motion and
sensation in the trunk and all four extremities. In the lowest part of
the cervical enlargement it produces paralysis of the same parts, but
the serratus magnus and scapular muscles escape. The nuclei of
origin of the muscles moving the upper extremity are situated so that
those which are farthest removed from the axis of the body when the
arms are extended are situated lowest in the cord. The sensory
paralysis is distributed in harmony with the motor paralysis; that is,
when there is paralysis of motion in the hand and forearm the
anæsthesia or subjective numbness is also in the hand and forearm.
The same correspondence is not found in affections of the lumbar
enlargement, for anæsthesia of the gluteal region accompanies
paralysis of the crural muscles when the lesion is low down at the
level of the lower lumbar and upper sacral nerves. The distribution of
the anæsthesia, in other words, is not by segments of the limb, but
by surfaces. The gluteal, posterior femoral, gastrocnemial, and outer
pedal surfaces are affected together with the muscles moving the
foot, while the thigh and inner side of the leg and foot become
anæsthetic, with lesion of the upper part of the lumbar enlargement
accompanying paralysis of the quadriceps and deep muscles. It is
not difficult to understand this discrepancy when we bear in mind the
different plan of distribution followed by the brachial plexus as
compared with the lumbar and sacral plexuses. It is not, in my
experience, found that the anæsthesia affects that surface which
covers the part moved by the paralyzed muscle; which is
characteristic of associated paralysis and anæsthesia from cortical
disease.
One of the most dreaded occurrences in acute myelitis is the
malignant bed-sore. The ordinary decubitus which results from the
protracted sojourn of the patient in bed, coupled with the prominence
of his trochanters and sacrum resulting from general or atrophic
emaciation, is also common, but is comparatively benign and easy to
prevent or to manage when established. The malignant bed-sore, on
the other hand, is a spontaneous occurrence, due to the same
obscure but undeniable trophic influences exerted for good by the
normal and for evil by the diseased nerve-centres, which play so
large a part in the symptomatology of tabes dorsalis. It cannot be
avoided; it is not due to pressure alone, or, as some have claimed, to
the macerating influence of the dribbling and decomposing urine.
The development of this lesion is exceedingly rapid, and it may be
regarded as a sort of local gangrene. The skin shows a livid color;
vesicles appear, then burst; the part becomes denuded; and within a
few days a deep ulcer with a dark border and base appears,
discharging a sanious fluid. The subsequent history is that of a rapid
extension and destruction of the neighboring tissues, even down to
the bone, and if situated over the sacrum opening into the spinal
canal through the necrotic arches of the sacral vertebra, thus leading
either to general septicæmia or to putrid infection of the spinal
meningeal sac. Occasionally, gangrenous spots coexist on other
parts of the body, notably the lower extremities, where neither
pressure nor maceration can be accused of playing a part, proving
that the process is primarily due to the spinal affection.
Acute central myelitis, as described by Dujardin-Beaumetz, Hayem,

Hallopeau, and Erb, usually runs its course very rapidly. Indeed, all
of these observers speak of it as the most violent and quickly fatal
variety of spinal inflammation. I have, however, seen one case with
T. A. McBride at the Presbyterian Hospital in which all the
characteristic symptoms of acute central myelitis were markedly
developed and present in their characteristic groupings, and yet the
patient had been suffering from progressing symptoms of myelitis for
one year and a half before that time.100 Usually, complete
anæsthesia and paralysis of the lower half of the body occur in this
form. But the most characteristic feature is a rapidly progressive
atrophy not only of the paralyzed muscles, but also of some which
are still partially under the dominion of the will. With this there is
extreme vesical and rectal trouble, the sphincters being paralyzed.
As a rule, the deep and superficial reflexes are destroyed—they are
always diminished—and trophic disturbances of a malignant type,
such as acute decubitus, joint-changes, and œdema, are common.
The paraplegia is characterized by the flaccid condition of the limbs;
the contractures and spastic symptoms found with other forms of
myelitis are entirely absent, and qualitative electrical changes,
beginning with disappearance of farado-muscular contractility, are
found in the atrophying muscles. There are marked constitutional
symptoms with this form; the tendency to an ascent of the process
and successive involvement of one segment after another of the
gray matter is great, and a fatal issue, as far as known, is inevitable.
100 At the time the patient had undergone such a profound change in appearance that
I failed to remember him, and it was only by accident I learned that I had seen him in
private consultation with his family attendent, F. A. McGuire, a year previous. On the
latter occasion I had made the diagnosis of subacute myelitis chiefly limited to the
posterior columns; there were ataxia, both static and locomotor, slight incontinence,
belt sensation, and ocular symptoms, with abolition of the deep reflexes in the lower
limbs.
DIAGNOSIS.—The principles governing the determination of the

affected region of the cord in acute myelitis are exactly the same as
those detailed in the later sections on Chronic Myelitis or Sclerosis,
the acuteness of the onset, and the relapses which sometimes
occur, and the predominance of irritative spasms—which, however,
is an inconstant criterion—serving to distinguish between the acute
and chronic form of spinal inflammation. In the present state of our
knowledge it is impossible to always differentiate between acute
central myelitis and syringo-myelus—a condition in which the
formation of a periendymal neoplasm, and its subsequent breaking
down in the axis of the cord, lead to the formation of a tubular
cavity.101 The neoplasm in this instance is classified among the
gliomatous new formations. The symptoms depend, exactly as do
those of myelitis, on the distribution of the destructive lesion. In some
cases the posterior cornua and columns are chiefly involved, and
extreme anæsthesia is found; in others the anterior columns are
affected, and the symptoms of a poliomyelitis or an imperfect
transverse myelitis may be imitated.102
101 This cavity, unlike that of hydro-myelus, is not a dilatation of the central canal, but,
lying to one side of it, is excavated in the cord-substance.
102 Repeated fractures have been noted in cases marked by profound analgesia. It is
believed that they are not always due to trophic changes, but may be the result of
muscular action, exaggerated on account of the patient's inability to gauge his efforts.
Still, in the majority of cases the presence of positive trophic disturbances of the skin
seems to indicate the probability of some textural change facilitating the fracture.
As a rule, the sensory disturbance in syringo-myelus is out of

proportion to the muscular atrophy developed; that is, it involves a
far more extensive province. It is usually of a peculiar character:
some forms of sensation are involved but slightly, or even escape,
and others may be nearly destroyed. Commonly, it is the pain and
temperature-sense which suffer most, while the cutaneous space
and pressure, as well as the muscular sense, are not materially
disturbed. These peculiarities are not commonly found in cases of
myelitis, and when present, and particularly when the paralytic or
sensory affections involve all four extremities alike, they suggest the
existence of syringo-myelus. As yet we are unable to make more
than a probable diagnosis between the two diseases.
DURATION AND PROGNOSIS.—The duration of the disease varies.

Cases of the apoplectiform variety are mentioned, in which the
process reached its height in a few minutes, or where the patient,
having retired in good health the night before, awoke finding himself
paralyzed in the lower half of his body. Death may terminate such a
case in a few days or weeks. In another class of cases, complicated
by serious involvement of the bladder, the fatal termination is often
precipitated by putrid cystitis, pyelitis, or uræmic poisoning, and even
in cases which have passed the dangers of the early period in safety
these ominous complications may develop with the usual result
many years after the beginning of the illness. In a number of cases
the first period, that in which the morbid process becomes
developed, is followed by one of comparative quiescence, in which
the paralyses of sensation and motion then established remain
stationary for months and years. A number of authors, Erb, Leyden,
Strümpell, and Ross, speak of such a case as one in which chronic
myelitis has followed an acute myelitis. It seems improper to use the
terms acute or chronic in this way. As it is generally understood that
the term acute applies to myelitis in which disintegration of the
nerve-elements predominates over interstitial proliferation, and in
which the secondary sclerosis is rather like the cicatrix of an acute
inflammation and necrosis, it should not be confounded at any
period, no matter how similar the clinical signs may be, with a
process which is essentially an interstitial one from the start. If
chronic amaurosis results from an acute glaucoma, we do not
change the latter designation to chronic glaucoma.
In cases where the symptoms at the acme indicate rather an

involvement of the peripheral than the central paths of the cord, and
in which an incomplete motor and sensory paralysis develops, the
patients often regain a considerable amount of motor power and
sensation, so that they may reach a good age, suffering at most from
a paresis of some one muscle or muscular group, occasional bladder
trouble, and pains. It has been laid down as a rule that where
paraplegia and other signs remain stationary for years, there is no
hope of even partial recovery. The following remarkable and well-
attested case proves that this rule is not without exceptions:
Isidor K——, æt. forty-four years, worker in tobacco. After over-

exertion in the fall of the year 1879 he had numbness, tingling,
dorsal pain, and paresis rapidly developed, which induced him to
consult the physicians at the clinic of the University of the City of
New York. After some slight improvement a relapse occurred, and
several others followed, usually provoked by over-exertion, till he
became completely paraplegic. He was, according to his account,
several times exhibited to a medical class by William A. Hammond,
and remembers that this authority spoke of a possible ascent of the
affection and ensuing involvement of the arms. His bladder was at
no time seriously disturbed. For four years and three months he was
totally paraplegic; his lower extremities were without life; and for the
greater part of the time he could not move his toes. The limbs were
cold and pale, but underwent little atrophy. The only exercise
obtained during this time was in a roller carriage. His sexual power
was abolished throughout the whole four years and over. Nothing
can be learned as to his reflexes in this period.103 The paralysis of
sensation was as complete as that of motion, and the lower limbs
never perspired. The arms remained free. There was a dorsal belt
sensation.
103 Hammond has no notes of the case, having discontinued the clinic, and Ludwig
Weiss, the physician in charge, saw him only occasionally in behalf of a benefit
society.
On July 23, 1884, shortly before mid-day, while lying on the bed, in
which he had lain a helpless cripple for over four years, except when
lifted into the roller carriage, he felt a sudden rush of warmth.
Surprised at this first sensation he had felt for years in limbs which
had been quasi-foreign appendages, he raised up the bed-clothes
and saw that they changed color. There was some tingling for about
three minutes, and a perspiration broke out in the affected members.
With this he found he could move his feet: half alarmed, half exulting,
he sent for his physician, L. Weiss, who found that the patient could
stand and walk with considerable freedom. I was then consulted, and
found the patient presenting a picture of incomplete transverse
myelitis. He could walk, turn about, stand with closed eyes with slight
swaying, and his knee-phenomenon was of short excursiveness, but
exceedingly spasmodic, and this symmetrically so. He was carefully
watched, and against the advice of his physician engaged in
peddling cigars, and subsequently took a position as attendant at the
pauper asylum on Ward's Island. Here he was on his feet fully twelve
hours a day, and his motion, which had continued improving until it
was to all practical intents and purposes normal, aside from a slight
stiffness, again became impaired, and a joint trouble in the
metacarpo-phalangeal articulation of the right little toe, which had
troubled him a week after his partial recovery, recurred.104 On
January 15th of the present year I again examined him. His knee-
phenomenon was greatly exaggerated, cutaneous sensations
scarcely impaired, gait paraparetic, but he could walk great
distances, and claimed to suffer less from the exertion than from the
tenderness accompanying the joint trouble referred to. There had,
therefore, occurred, without any assignable cause—for the patient
was not under treatment for a year or more before the event—an
almost instantaneous restoration of sensation, locomotion, and
sexual power; all of which faculties, notwithstanding the infraction of
every medical direction given, remained established for two years,
with prospects of so continuing a longer period.
104 This was a trophic joint trouble.
TREATMENT.—Most of the therapeutic propositions relating to the

treatment of the acute myelitic process are based on the theory that
it is of a congestive character or associated with congestion.
Accordingly, the internal administration of such drugs as ergotin,
which diminish the calibre of the blood-vessels, and local measures,
such as depletion, wet cupping, and counter-irritation, intended to act
in the same way by derivation, are unanimously recommended by
authorities. The suggestion of Hammond, that the patient occupy a
ventral or lateral, and not the dorsal, position, is based on, and
entirely consistent with, this same view. It is difficult to say what
effect is attributable to these measures. Remarkable spontaneous
changes—retrogressions as well as advances of the morbid process
—occur equally under expectant as under active treatment. I have
never seen any improvement in the active phase of simple myelitis
which I felt confident I could attribute to any special remedy
employed with a view of acting directly on the morbid process.
Indeed, improvement has been claimed by Jewell as a result of the
use of strychnia—a drug which under the very dogmas governing the
orthodox treatment of the disease might be expected to do positive
damage.105
105 Jewell gives very large doses of this alkaloid. L. C. Gray, in a discussion held
before the American Neurological Association, cited numerous observations directly
conflicting with those of Jewell. I cannot, in view of a recent observation in a typical
case of acute anterior poliomyelitis, in which by accident the toxic effects of strychnia
were obtained, consider this dispute as at all settled. In direct connection with the
toxic symptoms the abolished patellar jerk returned in an exaggerated form; motion
also returned, and rapid improvement ensued.
In relapses of acute myelitis which had been brought on by chilling of

the feet I have obtained good results by derivation to the lower
extremities, and on many grounds think that the morbid process in
the cord, if it can be affected at all, can be affected by treating the
periphery where the symptoms are noted more readily than by
applying the cautery or bleeding over the proven site of the disease.
Exposure of the dorsal region to cold has not yet been noted as a
cause of acute myelitis, whereas such exposure of the lower
extremities is a frequent one. This seems to show that the spinal
cord is more vulnerable to influences affecting its nervous
distribution than to those which are topographically nearer. If this is
true as regards morbid influences, it may be urged that it is plausible
as regards remedial influences if these are to drive out the disease
tendency by the same door it entered.
Rest is imperative during the active progress of the disease. It may

be stated as a canon that the earlier the patient takes to his bed, and
the more thoroughly he obeys the injunction to attempt no motion of
the affected members, the better, cæteris paribus, will the result
obtained be. Countless cases are on record where a relapse was
directly traceable to a walk undertaken prematurely or carried farther
than was wise. As convalescence or partial restitution advances,
gradually increasing exercise is to be attempted, not waiting for the
danger-signal of a tired feeling to discontinue it; for that feeling,
developed, means positive harm already done. It is therefore
necessary to allow the returning function to be utilized only within
small limits at first, and extending them slowly.
In all cases of severe myelitis where the formation of bed-sores is to

be apprehended the water-bed should be employed. Owing to the
low temperature which the rubber sac constituting it has, it is

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PART ONE PART FOUR

In Memoriam IX Incremental and marginal costs 38

Recording the purchase of raw materials 92 PART THREE

Limitations of cost-plus pricing 247 Payback method 334

The controllability principle 428 Distinguishing between the managerial and

Alternative performance management Relevant range and non-linear cost

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Mike Tayles, Emeritus Professor Accounting and Finance, University of Hull

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Owing to the advance of clinical and anatomical knowledge made

Some dispute exists as to the propriety of making a distinction

MORBID ANATOMY.—The most recognizable change noted in an acute

There is considerable variation in the extent of the affected areas of

It seems to be generally admitted, with Hayem, that the blood found

As to the nervous elements themselves, they are always found

The period now reached by the morbid process may be regarded as

This vacuolization of ganglion-cells is now regarded as a cadaveric

91 He attributes the remarkable difference in staining of nerve-cells of the same

If life be prolonged and the conservative processes assert

Charcot claims that a restitution of anatomical continuity, and

93 Contribution expérimentale à la Pathologie et à l'Anatomie pathologique de la

In a large number of cases myelitis is a limited affection; that is, its

CLINICAL HISTORY.—The symptoms of acute myelitis usually

First, paralysis of movement in the parts supplied from the nerves

Second, paralysis of sensation in the parts supplied by the same

Third, alterations in the nutrition of the parts supplied by the nerves

Fourth, abolition of those reflexes which are translated in the level of

Speaking crudely, then, the symptoms of a transverse myelitis fall

Aside from those variations due to the distribution, extent, and

The constitutional symptoms of acute myelitis—which, however, are

In most cases of transverse myelitis, when the anterior cornua are

The disturbance of the deep reflexes with very few exceptions

In complete transverse acute myelitis of the cervical region high

Transverse myelitis at and above the level of origin of the phrenic

Acute central myelitis, as described by Dujardin-Beaumetz, Hayem,

DIAGNOSIS.—The principles governing the determination of the

As a rule, the sensory disturbance in syringo-myelus is out of

DURATION AND PROGNOSIS.—The duration of the disease varies.

In cases where the symptoms at the acme indicate rather an

Isidor K——, æt. forty-four years, worker in tobacco. After over-