8.1 Absolute Contraindications
8.1.1 Malignant Tumors
8.1.2 Acute Inflammation
8.1.3 Erysipelas
8.1.4 Thrombosis
8.1.5 Cardiac Decompensation
8.2 Relative Contraindications
8.2.1 Treated Cancer
8.2.2 Precancerous Stages of the Skin, Nevus
8.2.3 Chronic Inflammation
8.2.4 Thyroid Function Disorders
8.2.5 Bronchial Asthma
8.2.6 Hypotonia and Dysautonomia (Autonomic dystonia)
8.2.7 Granulomas
9 Basic Considerations in Actual Practice
9.1 Combining Manual Lymph Drainage with other Procedures
9.1.1 Combining with Measures that Promote Circulation
9.1.2 The Influence of Temperature
9.1.3 The Influence of Medication
9.1.4 Iontophoresis
9.1.5 Breathing Exercises
9.1.6 Diet
9.2 Calculating Edema Volume by Measuring Circumference
9.3 Support Dressings and Compression Bandages
9.3.1 Technique
9.3.2 Number and Composition of Bandages
9.4 Motion Therapy
9.5 Stress
9.6 Preliminary Examination
9.7 Mechanical Decongestion (Pressotherapy)
9.8 Treatment Side-Effects
9.9 Skin Care
10.1 Lubricants
10.2 Post-Treatment Rest
10.3 Treatment Times
11 The Strokes and their Criteria
Foreword
In the spring of 1936, Dr. Emil and Estrid Vodder presented, in Paris, their [Manual Lymph Drainage] for the first time. The occasion was a large-scale health convention, Sante et Beaute [Health and Beauty], which was received with great interest. In the journal Sante pour tous [Health for Everyone], Dr. Vodder first published the basis and the experiences which had - intuitively - led to the development of this new massage technique. The operating mechanism was accurately described in accordance with the then current state of medical knowledge. While he and his wife continued to work with their [manual lymph drainage] and to gather further experience, it was not until the mid-fifties - probably due to wartime influence - that some physicians became interested in Vodder's new massage technique.
Vodder's Manual Lymph Drainage is today an indispensable part of physiotherapy. Although at first it was primarily applied, along with bandaging and movement therapy, to treat edema of the larger extremities, the indications list has since been extended, a step at a time; numerous indications for which Dr. Vodder had used lymph drainage in therapy now enrich the therapeutic palette of possibilities.
The doctoral head of the Dr. Vodder School at Walchsee has written the book you now hold in your hands, intended for use in the teaching of Manual Lymph Drainage. It will be a significant aid to his students in learning the material. What Vodder has placed in our hands we now pass on to the next generation of teachers and students. I wish this book all the best on its way.
Walchsee, October 1995
Dr. Ingrid Kurz
Part I: Theory
Introduction
The human lymphatic system is one of many purification systems. However, one should not view its functions in isolation - which caution applies, by the way, to all organ systems, since man is far too complex a system for that. The high degree of specialization in the individual branches of medicine tends to obscure and impede comprehensive insights and understandings. The individual organs are interlinked by numerous regulatory cycles and control mechanisms. A holistic understanding of the human system is a prerequisite to correct understanding of the way that Manual Lymph Drainage works.
Man is both a closed and an open system. The skin is by no means a rigid barrier to the outside world: in the first place, the human body takes in too much via this organ; in the second place, too much is transported to the outside via the skin. From another viewpoint, however, the skin really is a clear demarcation boundary, as is shown by a partial alteration of the laws of gravity inside the human organism.
Lymphology, the study of the lymphatic system, is dedicated to researching the lymphatic vessel system and its connections with the other organs. Mastery of the technique of Manual Lymph Drainage, and success in its application, demands basic knowledge in certain areas of histology, anatomy, physiology and pathology.
The goal of Manual Lymph Drainage is to get bodily fluids flowing -either because they have become blocked for any number of reasons, or simply to accelerate the flow. Manual Lymph Drainage attempts to eliminate waste products from connective tissue and to improve the metabolic situation. Congestive conditions can be cleared up with this technique. This therapeutic result can even be improved and preserved by additional physical treatment methods.
Manual Lymph Drainage first works on the lymphatic vessel system mechanically; these mechanical stimuli then have a direct effect on the autonomic nervous system. When lymph drainage is properly applied, relaxation and a pleasant lassitude is induced; with Manual Lymph Drainage, we achieve a sympathicolytic effect in the vessel region, and the hypertonia of the patient's entire system is reduced, which has a calming (sympathicolytic) effect.
In certain areas, Manual Lymph Drainage works to stimulate the immune system, since the transport of immunocompetent cell systems is accelerated.
Manual Lymph Drainage's focus is on the connective tissue, which, according to Pischinger, should be considered to be a complete organ in its own right. It should not be viewed merely as a highway from blood vessel to cell; it is, rather, a cell-milieu system - which means, that each side depends on the other in equal and reciprocal partnership. This is reinforced by the nerve supply in every organ. [1]
Manual Lymph Drainage is above all about clinical practice, and so this book can only impart theoretical fundamentals.