There is such a general failure on the part of physicians to realize the importance of the small epigastric hernia, with an even greater failure to recognize the hernia itself, that I wish to report a typical instance with operation, and to speak briefly of six other patients operated on in this base hospital. I shall also call attention to four other cases which either came to my attention elsewhere or were cases in which diagnosis was made and operation performed by surgeons who had, in their work here, come to recognize the importance of these trivial-appearing hernias in causing obscure abdominal symptoms.
Let us say in the beginning that there is no lack of textbook description of the hernia. Berger1 found 137 in 10,000 individuals (120 males and seventeen females); Macready found thirty-eight cases of epigastric hernia to 19,341 cases of inguinal and femoral hernia, but he obviously overlooked