. Archives of physical medicine and rehabilitation . opic examina-tion about as frequently in markedlydilated hearts as when there was alarge effusion. In pericardial effu-sions the cardiohepatic angle wassometimes acute, sometimes obtuse, andsometimes obliterated. He found thisto be equally true in markedly di-lated hearts. The angle is more aptto be obliterated if the patient is ex-amined in the upright position. Hefound an obliteration in the normaloutline of the various chambers of theheart in nearly all cases; also that thedulness lies higher toward the sternalnotch and is wider at the ba
. Archives of physical medicine and rehabilitation . opic examina-tion about as frequently in markedlydilated hearts as when there was alarge effusion. In pericardial effu-sions the cardiohepatic angle wassometimes acute, sometimes obtuse, andsometimes obliterated. He found thisto be equally true in markedly di-lated hearts. The angle is more aptto be obliterated if the patient is ex-amined in the upright position. Hefound an obliteration in the normaloutline of the various chambers of theheart in nearly all cases; also that thedulness lies higher toward the sternalnotch and is wider at the base whenthe patient is in the prone position. Hewas unable to see the outline of theheart shadow within the pericardiumin any case. We have studied rather carefullysixteen cases of pericarditis with effu-sion. 1 he diagnosis was in fourteenof these checked by necropsy or peri-cardial tapping. In twelve casesthere was 200 or more present,and in ten of these the x-ray showeddefinite indications of fluid within thepericardium. Ol the h\e cases not. KlK. 1 A, liu.\ .iK^d l:. IlTii tontilllltlH. B, After removal of 500 of fluidmoval of another 500 Complete recovery. im folk0, After re Klg. ;;—L;n-K. Patient recovered. Hemoval of .lOO 352 PERICARDITIS WITH EFFUSION—HODGES diagnosed by the x-ray, four were inpneumonia patients where the amountof fluid was less than 200 Inthese, plates were made only with ihepatient in the supine position andshowed no definite change in theheart or mediastinal shadow. The fifthpatient had a very large empyema onthe left side. Unless there were def-inite contraindications, examinationsafter inspiration and expiration weremade with the patient in the erect,supine, and prone positions. The con-stant findings were ( I ) a general in-crease in the width of the cardiacoutline, (2) a widening of the medi-astinal shadow which changed withchange in position of the patient, (3)a straightening out of the curves ofthe left bord
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