In matters of wealth it is accepted practice in society to make decisions early: to take advice from several, often opposing, sources of information and then to make financial decisions which are quite independent of either. It is also accepted practice to make provisions for the future, and to update one's financial picture on a regular basis. Then too, the changing face of health care and the speed at which current health knowledge and techniques are being superseded means that no establishment, however worthy, can incorporate them into its structure quickly enough. It is both the strength and weakness of establishments, such as the medical establishment, that they are cautious in adopting new procedure.

One common problem in the intestinal tract that is confused by people who have "heart pain" is a disorder called hiatal hernia, or a diaphragmatic hernia. This is a condition in which a small part of the stomach is able to slide up into the chest through an opening in the diaphragm. The diaphragm is the muscular structure that separates the and lungs from the organs of the abdomen. The esophagus, the tube that carried food from the mouth to the stomach, passes through a hole in the diaphragm. When a person has a diaphragmatic hernia, this normal hole is larger than it is supposed to be, and when he lies down, part of the stomach slides up into his chest. This occurs only when the person is lying down, because when he is sitting or standing, gravity pulls the stomach down low in the abdomen. If a person has from this problem, one is usually a feeling of pressure or general discomfort in the upper abdomen or the lower chest. Sometimes this hernia can produce severe pain.

The clue to the diagnosis of the hernia is that usually the pain starts sometime after the person has gone to bed after a large meal. The sooner he goes to bed after a meal, the more likely he is to experience discomfort. Furthermore, most patients find that they get relief from the pain if they sit up in bed, or better yet, if they get up and walk around. On assuming a more upright position, the stomach returns to its normal position and the pain disappears. The diagnosis of this condition is confirmed by an x-ray of the upper intestinal tract.