The patient is placed in the supine position with the head supported on a pillow and the limb(s) raised. Half-sitting, half-lying is a compromise position which may be used if there is some difficulty in Iying (eg pulmonarv problems). Venous flow is stimulated by raising the legs.

We don't use any emollient or oil, nothing should come between the therapist's hand and the skin of the patient. The skin of the patient is mobilised by the moving hand of the therapist in order to stimulate the resorption of the liquid excess via lymphatic and venous vessels ( 1, 2 ).
The main difference in the response of the lymphatic and venous draining networks is the fact that the increased lymphatic activity caused bv manual stimulation continues even after the manual drainage has stopped.

Every treatment by MLD has to be specific to the needs of the individual patient. The guidelines above are the foundations for proper treatment. The course of the treatment will depend on the specific reaction of the patient and the response of the oedema. There is one absolute rule which must not be broken - the movement and touch must alwavs be very superficial and extremely soft ( I0 ).

Usuallv MLD will be just a part of the treatment given for oedema. Our research has demonstrated that MLT stimulates the resorption of proteins ( 1 ).