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To the Editor:
—Epigastric hernia is more common than the meager references to it would lead one to suppose. The reason is failure in diagnosis; for unless one is particularly on the lookout for it, one can easily miss it and attribute the symptoms to something totally different. Not every epigastric hernia will necessarily produce symptoms, but a small one may cause a wide variety simulating the condition set forth by Friedenwald and Morrison (The Journal, Oct. 30, 1926, p. 1466).During the last three years I have seen about a score of such cases. The diagnosis has been made in almost every case by a certain procedure of palpation and, if indicated, confirmed by laboratory and roentgen-ray tests, which, of course, were negative. A clue to the condition may often be obtained from the history, especially when the symptoms are associated with pain which has no relation to food
Warden HFW. A TEST PROCEDURE FOR THE EASY DIAGNOSIS OF EPIGASTRIC HERNIA. JAMA. 1927;89(1):49-50. doi:10.1001/jama.1927.02690010049030