CONSTIPATION. — Lat., constipalis (from constipare, to pack together).
Definition.—Prolonged retention of faeces in the alimentary canal; retarded defecation; a symptom resulting from a variety of morbid conditions of the in testines, and not a distinct disease. The strictly-natural law governing intestinal evacuations in man requires one, and sometimes two, discharges every twenty four hours.
Symptoms.—The symptoms produced by habitual constipation vary much in different cases. Many persons appear to enjoy fair health with an evacuation only once in two or three days. A smaller number continue well with only an evac uation once a week; one woman came under my- observation who claimed to have had no ffecal discharge from the bowels for thirty days, and yet had been attending to her household duties all the time, with only a sense of fullness in the abdomen and some dizziness in her head.
Case of Hindoo male, aged 50 years, 5 feet 6 inches high, who has been, since his 30th year, in the habit of passing stools once in six months or so, and even then only two or three hard scybala are passed. But every eight months the man gets a severe attack of fever, preceded by rigors, and then he passes, to his entire relief, sometimes consciously and at others in an unconscious state, enortuous quantities of black, semisolid, feculent matter, whith has evidently been ac etunulating in his intestines all the while.
Notwithstanding all this, the man looks well and healthy. He suffers very little from this except a slight loss of appetite and energy. His abdomen is not bloated, but feels hard on pressure. He does not complain of flatulence; passes urine freely; and sleeps well. S. Kotayya Naidie (Indian :Med. Rep., -.May I, '90).
In a large majority of persons, how ever, constipation causes a sense of full ness, lassitude, mental depression, or dull pain in the head, with some impairment of digestion, all of which symptoms are temporarily removed by a free movement of the bowels. In some cases after re
tention of the intestinal contents from three to five days, a spontaneous diar rhcea supervenes for a single day, after which the constipation returns as before. In many other cases, protracted constipa tion leads to a violent attack of head ache every week or ten days, accom panied by extreme nausea or vomiting for a day, during which the bowels are evacu ated, and the next day the patient re turns to his ordinary duties, though pale and impaired in strength.
Most of the dyspeptic conditions, dila tion of the stomach, etc., are really cases of constipation, and this may mechan ically tend to produce hremorrhoids, hernias, vesico-uterine tumors, hyper troplty of the prostate, etc. Germain See (Med. Rec., Feb. 3, '94).
Hysteria in the female and hypochon dria in the male, or even conditions bor dering on insanity, may be the result of constipation. Staple (Amer. Med.-Surg. Bull., Aug. 15, '94).
In many cases the middle and posterior part of the tongue is covered with a light coat and the urine is deeper color and Tess in quantity than natural; the appe tite is variable. Sometimes the colon is distended with gases, with slight ten derness on pressure and irregular peri staltic movements. In such cases the operation of physic is liable to be accom panied by pains across the abdomen and tenesmus, and sonic mucus may be evacu ated with the faeces. Such symptoms in dicate congestion or inflammation in the mucous membrane of the rectum, which is sufficient, in some cases, to cause fre quent slimy discharges, while the ascend ing and transverse colons remain filled with compact ffeces.
Many cases of constipation are treated unsatisfactorily with medicine when the real cause is in the rectum. The pres ence of thickening of the skin and mucous membrane, irritable ulcer or fis- I sure, fistula, or limmorrhoids frequently interfere with the treatment instituted. W. M. Beach (Pittsburgh Med. Rev., June, '95).