[Physical therapy of lymphedema: Montpellier's experience]. / Physiothérapie des lymphoedèmes: l'expérience de Montpellier.

Authors have presented their experience for treatment of lymphedema during 5 consecutive days. After intensive phase of treatment at hospital, specific therapy is described to maintain results. Complex decongestive physiotherapy includes manual lymphatic drainage and bandage which are modified with original methods every day if necessary.

[Manual lymphatic drainage]. / Drainage lymphatique manuel.

Manual physiotherapy of lymphoedema is the best treatment for chronic venous and lymphatic stasis of the lower limbs. It consists in handlings of the limb for the appeal and the resorption of the lymph but it cannot be used alone. It must be associated with other techniques: defibrosing, skin care, compressive bandages, muscular exercise. Contensive and compressive bandagings prolong the action of lymphatic drainage. The main indication of manual physiotherapy is primary or secondary lymphoedema but also chronic venous disease, and in some selected cases acute venous thrombosis and traumatic or post-traumatic pains.

[History of the treatment of varices]. / Aperçu historique du traitement des varices.

Diseases of the vein and particularly varicose veins have been recognized since antiquity. The Ebers papyrus, dated 1550 b.c., mentions serpent-shaped dilatation of the lower limbs. The Acropolis tablet of the IVth century b.c. concerning Dr Amynos allows us to visualize an enlarged lower limb clearly showing a varicosity. From 460-377 b.c., Hippocrates noted that a loose tourniquet leads to haemorrhages but that when the tourniquet is tight gangrene ensues and finally that standing up can exaggerate leg ulcerations. Of course much progress has been made since Hippocrates. The school at Alexandria, with Herophilus and Erasistrates speak of vascular ligatures. Their work was unfortunately lost in the fire of the Alexandria library in 391 a.d. Galien himself described varicose vein ligatures in 200 a.d. Leonardo de Vinci's magnificent anatomic studies of veins are widely known. In 1525, Ambroise Paré described leg bandaging for ulcers beginning from the foot up to the knee. In 1585, Fabrice d'Acquapendente described venous valves. In 1676, Wiseman invented the first supportive stockings made of leather and in 1854, Unna described in Vienna the supportive boot which now carries his name. Shortly thereafter new medical and surgical techniques were developed for the treatment of varicose veins. Pravaz, in 1860, invented a syringe which now carries his name and initiated sclerotherapy. At the end of the XIXth century, Trendelenburg performed the first ligatures of the greater saphenous veins. In 1905, and 1906, Keller and Mayo performed the first ablation of the greater saphenous vein and in 1906, Carrel reported the first venous transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

[ A comparative lympho-scintigraphic evaluation of manual lymphatic drainage and pressotherapy in edema of the arm following treatment of a breast tumor]. / Evaluation comparative lymphoscintigraphique du drainage lympathique manuel et de la pressothérapie sur l'oedème du membre supérieur secondaire au traitement d'une tumeur mammaire.

Manual lymphatic drainage (MLD) and pressure-therapy are part of the therapeutical gears used in physiotherapy for reducing edema. The solution to the problem of the reduction fo lymphedema of the extremities rests with the evacuation of the liquid phase and the resorption of the stagnant proteins in the interstitial compartment not being collected by the lymphatic system. The injection of a 99 Technetium-labelled colloid substance provides a functional approach to the problem of lymphatic stasis.