To the Editor:—
In a recent article (Shipley, A. M.: Pericarditis, The Journal, September 25, p. 1017) the author states that "in late cases with a large effusion, anterior drainage may not be effective" and that Truesdale, Heuer, Loucks, Moore and I have reported a "posterolateral approach, as far as the pericardium is concerned, by resection of the seventh rib near the midaxillary line."It is true that I discussed this approach in a paper read before the Western Surgical Association Dec. 9, 1932, but only to condemn it. I said that in the largest type of effusions the fluid could be readily reached in this manner but that the prompt expansion of the lung would quickly obstruct the drainage, while in the smaller effusions such drainage could not be effected without going directly through lung tissue (Suppurative Pericarditis: Description of a Case in Which Drainage Was Made Through a