RESUMEN
Four cases considered to be cases of hiatus are described. They led the author to read up some of the recent literature. The symptoms complained of were perhaps confusing until the possibility of hiatus hernia was considered, when a new light was shed on the diagnostic problem. Once diagnosed, simple medical treatment can in many cases produce very satisfactory results.The condition is rare, but not all that rare.The symptoms which presented were broadly, in case one, retro-sternal discomfort, occasional heartburn, and tiredness; in case two, retro-sternal pain, and pain in the arms, difficulty in swallowing and tiredness; (he had been treated for ten months as angina of effort); in case three there were confusing dyspeptic symptoms, pain in the epigastrium and upper abdomen, flatulence, heartburn and occasional vomiting; (these symptoms varied somewhat in their pattern from time to time).; in case four the symptoms were, retro-sternal pain, flatulence, occasional heartburn, loss of appetite, and "a block of air" in the chest when lying down at night. Cases two and three may well have had complications, for in number two there were changes in the E.C.G., and in number three a complicating peptic ulcer or peptic ulcer diathesis was not impossible. Hiatus hernia is a condition to be kept in mind by general practitioners, physicians and surgeons, in all cases presenting with retro-sternal discomfort, heartburn, dyspepsia, and on occasions, anaemia, with perhaps melaena. I am indebted to Dr. Kyaw Aung for his enthusias-tic co-operation, so freely given. I have also to thank Dr. Tha Din for his opinion on the X-ray and for his stimulating help in discussion.