This study covers 605 direct inguinal hernias, none of which had been operated on previously.1 Included were all direct hernias in patients admitted to the wards at St. Luke's Hospital, New York, from 1926 to 1935 inclusive, and all repairs of direct inguinal hernias from 1916 to 1925 inclusive, subsequently observed for nine months or longer. Of the 605 hernias, 565 were repaired. Among the latter, 458 were followed for nine months or longer. Sixty-eight recurrences were discovered, giving a recurrence rate of 14.8 per cent. The average follow-up time was thirty-three and two-tenths months. The average time after operation at which the recurrences were discovered was twenty-six months. These direct hernias comprised 13.6 per cent of all hernias and 16.6 per cent of all inguinal hernias included in the study as outlined in the foregoing paragraph. ETIOLOGIC FACTORS Onset (Age at Which Hernias Were First Noted). —Only 2