[Treatment of upper limb lymphedema after mastectomy with escine and levo-thyroxine]

Lymphoedema of the upper limb is the most serious and most crippling complication of mastectomy. An account is given of the factors possibly responsible, and a classification of the different forms is proposed. When fibrosis has set in, treatment is followed by very disappointing results, being at best able to bring about a partial, but transitory reduction in limb volume and consistency. Reference is also made to results obtained in 70 cases with two substances, 1-thyroxine and escine (somatoline), applied by massotherapy in postural drainage, ionophoresis, and pressotherapy, according to the requirements of each case. The results were distinctly satisfactory, though the outstanding fact was the maintenance of the response throughout many follow-up controls. It is felt, therefore, that somatoline can be usefully given in cyclic form, both in cases treated in an early stage, and also in all patients were lymphoedema is a likely risk after mastectomy.