Various classifications have been made by different authors on the subject of constipation. We find in the Compendium the following :
1. Constipation resulting from the presence of foreign bodies obstructing the intestinal canal.
2. Constipation from structural lesions of the intestine, which may either diminish the calibre or furnish a cavity for the collection of the faecal matters.
3. Constipation from compression, strangulation or invagination of the intestine.
4. Constipation from absence of a faecal residue.
5. Constipation resulting from excessive contractility of certain portions of the intestinal tube.
6. Constipation from inertia of the intestinal membranes.
7. Constipation from alteration of the products of exhalation and secretion which are thrown upon the surface of the intestinal tube.
M. Villemin divides this condition into five divisions.
1. Constipation from anaesthesia of the rectal mucous membrane;
2. From muscular paralysis;
3. From muscular spasm;
4. From induration of the stools;
5. From mechanical obstruction.
According to M. Martineau, constipation may be the consequence :
1. Of a trouble arising in the contractile tissue of the intestine or in the abdominal muscles;
2. Of an alteration in the secretions of the intestines themselves or of the glands connected with the intestinal tract;
3. Finally of a mechanical obstruction to the free course of the faecal matter.
Kallenbach indicates as immediate causes of the constipation, the following pathological states :
1. Atony of the intestinal canal, especially of the lower portion;
2. An irritative state of the intestinal canal, due to nervous troubles, or rheumatic and inflammatory irritation;
3. Haemorrhoids;
4. Organic diseases of the liver;
5. Stenosis and disorganization in the intestinal canal.
Noack gives :
1. Inertia of the intestines;
2. Alteration of the intestinal mucous secretion;
3. Contraction of the muscular fibres;
4. Irritation or congestion of the intestines;
5. Haemorrhoids.
We will not discuss here the merits or defects of these various classifications. It is a question of very complex pathogenesis and we do not believe it is possible to establish a classification so exact as to defy all criticism.