Pericarditis occurs frequently as part of a rheumatic carditis in children and is evidence of a severe and general inflammation of the heart. Probably there is always some accumulation of fluid, even when there is not enough to be demonstrable by clinical methods. In some cases the amount is large enough to cause symptoms and great discomfort, or even danger to life in a child who is already very ill from the infection itself.
In 1931, I called attention1 to the papers of Curschmann2 and Conner.3 Curschmann demonstrated the anatomic points to be considered in the diagnosis of pericardial effusion and the reasons for the signs frequently found over the lower part of the left side of the chest posteriorly. Conner, from a study of thirty-four cases, was convinced of the accuracy of Curschmann's reasoning and on the basis of these facts agreed that the posterior site