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JAMA. 1916;LXVI(20):1534-1535. doi:10.1001/jama.1916.02580460010003.
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A defect in the abdominal parietes preventing closure of the umbilical canal results in what is known as a congenital opening. Only when there is protrusion do we regard it as a hernia. It is a somewhat common occurrence to find the opening at the navel unobliterated. The defect is at the opening for the omphalomesenteric duct and the urachus. In the majority of instances, no injury results from this non-closure. Increased abdominal pressure, coughing, lifting, straining at stool, etc., often lead to an umbilical hernia, which I do not wish to consider here.

This umbilical opening may at first be very small — so small as to escape the notice of the examining physician, and later assume large dimensions. It is always congenital in origin.

All these patients have symptoms of nervous dyspepsia due to increased irritability of the autonomic nervous system. They are often free from distressing symptoms


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