The object of this paper is to call attention to the pulmonary signs associated with moderate and large pericardial effusions. Although Pins,1 in 1889, described these signs in "A New Symptom of Pericarditis," and Curschmann,2 in 1907, wrote a classic article demonstrating the anatomic reasons for their occurrence, it has not been generally recognized that the effusion itself is responsible for the production of striking physical signs in the lower part of the chest posteriorly. In 1926, Conner3 called attention to the work of previous investigators and presented his views of the clinical and anatomic considerations of pericardial effusion.
For many years the pulmonary signs found in children with rheumatic heart disease at Bellevue Hospital were discussed, and various diagnoses—usually of compression of the lung, pneumonia, pleural effusion or pulmonary infarction—made. It is now believed that pericardial effusion is the correct interpretation of the signs that I