To the Editor:—
I have developed a useful procedure, not published as a physical observation in standard textbooks.Often mothers come in with a report of groin swelling, typical of inguinal hernias, but because the child cannot cooperate with straining or coughing, it is impossible to demonstrate the hernia in the office.I have found the following procedure useful: the child is stripped nude, and stood up on the examining table (or held up, if it is a small infant), and the full surface of the hand is placed over the abdomen. The abdomen is pumped in and out with gentle, small, frequent strokes ( as in pumping up an air mattress), and the fluid is pumped down into the hernia sac. This maneuver, without fail, demonstrates the hernia to its fullest extent, the size being limited by the fullness of the sac. This pumping is so effective that I have