Vera-guth Symptom

VERA-GUTH SYMPTOM, PHENOMENON in the development of endophlebitis; on the other hand, when infection spreads from surrounding tissues (i.e., in periphlebitis), the thin venous wall may be involved throughout its thickness before reactive proliferation of the intima or significant thrombosis can occur. In both cases, nodules form on the inner lining of the V., which can reach very considerable sizes here. Due to the growth of specific granulations and thrombotic deposits on their free surface, these intimal nodules sometimes take the appearance of polyps, which most often have the shape of an elongated and flattened pear, the narrow stalk of which is attached to the inner lining, the broad end is directed along the blood flow, and one of the flattened sides is pressed against the vessel wall. The central parts of such a polyp are usually softened and contain a large number of bacilli. If the softening reaches the surface, all contents of the polyp empty into the bloodstream, causing hematogenous generalization. The favorite site for the development of polypous tubercles is the larger branches of the pulmonary V. - 2. Actinomycotic granulations and abscesses can also spread to the walls of V., leading to their destruction and sometimes to generalization of the process. -3. Syphilitic lesions of V. are characteristic of all stages of this disease, but give a picture that is not very characteristic. In general terms, they come down to: in fresh foci - to proliferations (sometimes very significant) of the inner lining with subsequent thrombosis and to the appearance of infiltrates of varying density, mainly from lymphoid and plasma cells, in the other layers of the wall; in old ones - to thickening and scar or hyaline transformation of all layers, often with complete disappearance of the lumen. Somewhat more characteristic is the syphilitic phlebitis of the secondary period, described by Hoffmann as a special form, which sometimes affects a considerable length, mainly large V. of the lower, less often upper, extremities. The vein is transformed into a dense cylindrical cord with nodular thickenings, apparently located in the area of the valves. Histologically, this involves numerous small-cell and plasma infiltrates in the adventitia and media, with proliferation of local cells, and extensive (especially in the area of the mentioned nodular thickenings) proliferations of the intima containing a large number of giant cells of Langhans type. These proliferations, together with thrombus, usually completely or almost completely fill the vessel lumen. The 'chronic obliterative endophlebitis of the liver V.' described by Chiari as a special pathological form also apparently can have, at least in some cases, a syphilitic origin. - 4. Finally, many authors point to the possibility of proliferation of specific granulations in the walls of V. in leprosy (both inside the 'tuberculous nodules' and in their immediate vicinity). - As tumors developing from elements of blood vessels, leiomyomas, angiomas (mostly of cavernous type), angiosarcomas and endotheliomas are described.

M. Skvortsov.

VERA-GUTH SYMPTOM, PHENOMENON (Vera-guth). The V. symptom, observed in depression, consists in the formation of a skin fold on the upper eyelid, at the border of its inner third, due to the upward and backward traction of the skin. The Vera-guth phenomenon consists in changes in the galvanic conductivity of the skin under the influence of psychological processes; it is detected when the human body is included in a galvanic circuit by means of a galvanometer introduced into the same circuit. Oscillations of the current ('action current') under the influence of psychological processes can be detected and graphically depicted by means of photography (string or mirror galvanometer). The oscillations of the current are completely independent of the will of the subject being examined and correspond to the strength of the affect associated with the irritation. This method makes it possible to judge the mental processes of the mentally ill. With its help, one can prove the significant influence of psychological processes on the activity of the sweat glands.