i2o THE MICROSCOPE. 



"PEAR GRIT" AS A CAUSE OF ANAL IRRITATION. 



BY DR. J. T. ROTHROCK, PHILADELPHIA. 



OR three successive summers mv attention has been called to a 



F 



case for which I can find no exact parallel in our medical 

 literature, and as it presents some marked features, is, perhaps, 

 worthy to place before the medical public; especially as the 

 diagnosis is easy, the treatment merely abstinence from the offend- 

 ing cause, and because, further, it may give a clue to many other 

 cases with like symptoms. 



The patient, a middle-aged, strung, active man, very fond of 

 fruit, each summer was taken with what he first supposed a "fit of 

 piles." There was excessive pain on defecation, tenesmus, flat- 

 tened feces, and a more or less copious discharge of blood At one 

 time the pain was so severe and so distinctly localized as to lead to 

 the suspicion of fissure or ulcer of the anus. 



The periodical return of these attacks was suggestive, and in- 

 duced an examination for cause. 



Among the fruits quite too freely indulged in by the sufferer 

 were pears. This at once suggested the inquiry as to whether the 

 "grit" that all, even the best pears, contained, might not have to do 

 with the trouble. On mention being made, it at once brought to 

 mind the fact that on the paper used in the closet there were small 

 white hard bodies, never larger than the head of a pin. 



Examination by the microscope revealed the fact that in the 

 feces there were quantities of bodies like those shown in the figure 

 — clearly the so-called sclerenchyma, or stone cells, of vegetable 

 histologists. This furnished the clue to the treatment, which was 

 simply to abstain from the pears, a cure always following. 



An idea of the hardness of these cells may be gained from the 

 statement that they are of exactly the same material and hardness 

 as the shell of the hickory nut. 



One may readily understand from this, and from the numerous 

 sharp angles a cluster of these cells show, that lodged in the folds 

 of the mucous membrane at the verge of the anus, even if it were 

 not in an inflamed condition, it would speedily become so, and that, 

 to an inflamed or ulcerated membrane it would soon prove an in- 

 tolerable source of distress. 



There is this further consideration in connection with other like 



