Applied Anatomy of the Lymphatics
F. P. Millard, D.O.
Evelyn R. Bush, D. O., Louisville, Ky.

    The two great functions, respiration and circulation, are made more active through the physiological effect of exercise.  It is impossible for any of the organic functions of the body to be separated from the result of the work of the muscles.  The increased frequency of the pulse rate, and hence the quickened blood current during exertion, is the result of muscular contraction  It is observable that every organ during activity has a greater amount of lymph bathing its tissues, than during a quiescent state.

    As we study and analyze the results of exercise, we are forced to realize that the daily regular and frequent repetition of muscular movements cause an increased activity in the venous, arterial and lymphatic system, thus relieving the tissues of congestion, and bathing them in nutrition, and by these changes improve and protect the system from various disorders.

    The same fact is observable in the lungs--by exercise the improved circulation results in greater power, i.e., greater regularity and control in performing movements, greater development and strength.

    The heart also gains by well-directed regular exercise.  It becomes less excitable upon exertion.  The beginner in exercise shows various disturbances upon the slightest movements, but not so the one who has had training regularly.  The improved heart action furnishes a better flow of lymph to its ultimate destination.

    The man who accustoms his body to regular work improves his organs, just as a laborer can do better work with better tools.  The man who systematically trains his body gets better work out of it and better service for humanity.

    Man is restricted by mental intensity and muscular restraint.  This restraint interferes with and defeats Nature.  She not only cannot express herself through such a tense, high-keyed instrument, but such restraint causes great waste of nerve energy and also interferes with flow of lymph.  To get rid of this nerve tension use relaxing, resting movements.

    Daily invigorating and relaxing exercises are necessary to promote the onward flow of lymph towards its final discharge into the blood.  Apparatus is unnecessary; no special clothing is required; exercise taken nude before a mirror is best.  Ten minutes in morning and fifteen or twenty at night, after the form of exercise is learned and old habits broken.

    We should consider exercise a part of our daily routine, same as we do washing the teeth, combing the hair, bathing, etc.

    The thread-worn remark, “I haven’t time” no longer holds.  Efficiency is the commander.  It takes no more time to stand correctly than it does to “slump-on-one-hip.”  It is not a question of time as of learning relative values.  Cause and effect in the body is the law.  It is impossible to be structurally abnormal and physiologically normal.

    Would an aeroplane pilot try to run a plane by any laws other than those necessary to the perfection of the invention?  He knows the infinite amount of trouble he would incur if he did not first become informed as to the laws of the machine he is to run.  Yet how about the human machine?  Frequently all law is disregarded.  The FIRST LAW of all machines--balance, equilibium, harmony, adjustment--is often forgotten.  The human machine, if out of balance, will not run perfectly any more than any other machine.

    From our osteopathic point of view, one of the most important causes of disease is the maladjustment of the bones of the skeleton.  Hence, if the framework is wrong, all else is wrong, the circulation in the veins, arteries and lymphatics being among the first to suffer.

    The body poise is mechanically correct if the ankles, hips and spine are correct.  When the spine is in correct position, all other parts, the trunk, chest, neck, head and shoulders, are in correct positions.  There is such close coordination between all parts of the body that if even one is out of place then one or all other parts will suffer.

    The phase of readjustment which I will discuss will be muscular.  The keynote of our profession is normality of bony structure.  In our eagerness to perfect alignment we sometimes forget to recognize the importance of muscular tonicity; we sometimes forget that the “vis-a-tergo” of the power from behind is necessary to the onward flow of lymph.  We sometimes forget that the maintenance of normal bony structure is due to the strength of the ligaments and muscles.

    The different parts of the body can only be kept in condition by performing the different functions normal to them.  The muscles in performing their functions not only improve their own quality and tone and keep the normal bony alignment, but they improve the health and strength of the entire system, including brain, nerves, heart, lungs, pelvic organs, etc., through the effect produced upon the respiration, the venous, arterial and lymphatic circulation and digestion.

    All of our muscular work should be based upon scientific principles and in perfect harmony with natural laws.

    People frequently say, “I believe in exercise but I am too old; my muscles are too stiff” never realizing they are lessening their chances of life by this very inactivity.  As all the tissues receive their food through the lymph, then sluggish lymph means lessened circulation, hence shorter life.  Physical education should not be limited to the period of youth.  Indeed, those who begin to feel the weight of years, or rather the crippling effect of bad physical habits, need the help that can be derived from rational exercises even more than do the young.

    By regaining lost flexibility and youth, and learning to economically use his nerve force, it is possible for many a person past his prime to make his more advanced age his best years physically. One cannot be too old to exercise.  So long as we abide in our bodies, we should strengthen them by daily exercise as much as by daily food.  Muscles that are called stiff are usually either tense or weak.  Muscles that are not duly exercised lose their shape, their firmness and their strength, due largely to the lymph in the lymph spaces not being sufficiently stimulated through pressure by muscular contraction. Nowhere else does this muscular degeracy so rapidly steal away our health and our efficiency as in the waist muscles.  The abundance of lymphatics in this region arrest the necessity for muscular activity.  A person is years older or younger in appearance, health and efficiency acording to the tone and health of these muscles.  We might truly say, we are healthy in proportion to the normality of our lymph flow.  To avail oneself of the opportunity of exercise is each person’s own responsibility.

    We must change our habits of life; we must change our style of dressing.  Great strides forward have been made in woman’s dress lately, and soon we will wear clothing of such a character as to leave the body unhampered and unrestricted.

    If the corset were a necessity for the maintenance of health for women, according to the Divine Plan, the Lord in His omnipotent wisdom would have given us one with which to start life’s journey.  There is no more excuse for women to wear corsets than men, primarily, but the style of dress and lack of physical education have been responsible for the weak abdominal muscles that sometimes demand artificial support.

    In the measuring of man, where do we stand physically?  Where do we stand in physical efficiency?  Just what is our balance on the ledger of life?  We are beginning to appreciate the vital importance of knowing the physical examiner’s report.  Why consider brains and training of other kinds and neglect the body?




    We know mathematics but we do NOT know that in order to have health, we must have a normal lymphatic system; that the lymph vessel has its origin within the tissues, and carrying, as it does, the nutriment to nearly every cell and tissue in the body, it must be kept normally active; that the normal flow of lymph is essential and that the “lymph movement” is largely due to muscular activity.

    It matters not what the occupation, the habits, the conditions, the environment of the individual, it is the BALANCE between the receipt and expenditure of VITAL FORCE which constitutes perfect health.

    We can only maintain our normal physical standard of excellence and efficiency by delibert and adequate care.

    The body must be developed with the same care and thoroughness as the mind, if it is to stand the stress and strain of life and measure up to one hundred per cent efficiency.

    The highest aim of education is to liberate the mind and spirit--to set them free.  This means that the body, the medium through which we reveal the intelligence and fine spirit within, must be MADE and KEPT plastic and obedient.

    We must learn to despise the pitiful restrictions which we have allowed fashion to put upon us.  We must do away with all restrictions of the foot, waist and throat before natural symmetry of the body can be regained and preserved.  We must learn to admire the body with all its natural spontaneous power and pliability, its capacity for action, its instinctive unhampered ease.

    Activity is life.  Inactivity is disease and death.  There is nothing in this wonderful world of ours quite so wonderful, nothing quite so beautiful as a perfect man or woman physically.  And whether you consider it from an aesthetic standpoint, or that of the greatest utility, there is no consideration of human life quite so significant, so important or so desirable.

    It does not seem, therefore, that any well-chosen care we can bestow on physical education can be unimportant or undignified, or that any element of culture is more needful than the perfecting of our bodily fitness and growing vigor.

    We American women do not ask our men to be reputable citizens ONLY, but to be admirable and creditable examples of physical manhood as well.

    By a systematic stimulation causing a thorough and complete drainage of the lymphatics, a vital resistance in the body is built up and maintained, which will protect it and prevent infections of various kinds.


    In health we should take all around activity which will insure normal lymphatic drainage.  This spells Protection and Prevention, for health depends upon an even control of all parts.

    With the installing of modern heating plants in homes, the indoor clothing has been modified.  Bodily habits and activities must adjust themselves to the changed conditions which the last decades have brought, if health is to be maintained.

    The necessity for increased activity is due to the various efficiency devices, which have replaced muscle activity.  The world demands brain -- not brawn -- to handle its problems.  Health demands brawn as well as brain.  As the various occupations do not furnish sufficient opportunity for the best development of the body, exercises, intelligently prescribed and conscientiously taken, just supply this deficiency.  It is as important to study HOW to maintain th greatest bodily resistance, how to keep the body immune to the various ills which attack it, as to study disease itself.

    There are practically few diseases which cannot be benefitted by exercise, either passive or resistive.  The laity and many physicians as well, are in the habit of thinking of exercise only in its strenuous forms, just as they are thinking of Osteopathy as a vigorous form of treatment and suitable only for the robust.

    It is a question of the intelligence of the physician who prescribes exercise on one hand, and the skill of the physician in giving the adjustive technique on the other.  It is knowledge, ability, and judgment, not force, that is needed.

    The kind of exercises, both in quality and quantity, needed for the growing individual, as well as the adult, in various stages of physical development, is a problem that faces the physician daily.  The understanding of the theory of the different systems of gymnastics; the ability to get cooperation from the gymnastic instructor, who carries out the physician’s directions just as the nurse does in carrying out the physician’s instructions; the ability of the physician to demonstrate in his own body the same normality of structure as he professes to produce in the patient, are all problems to meet.

    The average gymnastic instructor who is able to display well-developed muscles, do stunts on apparatus which appall the untrained; the nurse whose experience has given her a great amount of skill, frequently handicaps the physician.  Both, often disastrously, presuppose their ability embraces the knowledge of pathology and symptomatology of disease which characterize the broader work of the physician.  If the physician would train his own body to normality of posture, of muscular control; if he would acquire some of the skill of a nurse in handling a patient, he would get better cooperation and the patient would profit.  There is a certain contention among the gymnasts, nurses and physicians.  Each must know his relative place, recognizing that all are necessary to the goal of Health.  Emerson says: “How can I hear what you SAY, when what you ARE is forever thundering in my ears?”

    When we consider that the bones of the body would fall apart if it were not for the ligaments and muscles, that the accuracy with which the bony, articular, adjacent surfaces fit depends upon the strength of these ligaments and muscles, there is left only the necessity for maintaining the normal strength of these tissues.  It is not a question of “shall we exercise,” but “we MUST exercise.”




    Due to the progress of civilization, so many of the opportunities for muscular exercise have been taken away that it will now become a part of our course of study how to conscientiously exercise enough to keep the organism to its standard of vital resistance.  So many of the occupational diseases are due to this very lack of proper attention being paid to this phase of life, i.e., to the need of all around exercise.

    The longer hours in school for children, thus lessening the activity normal to them; the ever-increasing modern devices which are labor-saving, thus cutting down the opportunity for muscular activity so necessary to the normal body; the increased demands for mental concentration to accomplish more in shorter time, which means further expenditure of nerve force; the lessened amount of sunshine and the quantity of fresh air, are all changes due to city development.  Beginning with the tot kept in school for at least five hours of the day, to the factory worker, the bookkeeper, the stenographer, and to the various forms of ever-increasing sedentary life -- forgetting that exercise is ever fundamental to growth and health -- is a situation which handicaps the efforts of physicians of all schools today.

    Exercises should be in line with the natural functions of the body.  There are methods in climbing, methods in jumping, methods in running and walking, so it ever is in exercise -- the method used is all important.

    The following exercises are planned so as to promote and restore normal lymphatic circulation, thus increasing nutrition and improving the general health:

    An exercise for strengthening abdominal muscles and accelerating lymph flow through the abdomen, is done with a weight.  Lie on the back, put as heavy weight (a book will do) as can be lifted easily upon abdomen and raise abdomen up and down.  (Plate 35).  Increase weight in proportion to increase of strength of muscles.  The back remains on the table constantly.

    A simple but excellent exercise for strengthening abdominal muscles (Plate 36) is to lie on back, place book or other weight across legs at ankles, raise feet, holding legs stiff.  This strengthens leg muscles also.

    For increasing rib action use same weight on chest (Plate 37) raise and lower in the same manner.

    For loosening muscles of the spine the following is most excellent (Plate 38).  Place the clasped hands at the occiput and with strong pressure force the chin to the neck.  Begin rolling the head and trunk forward and downward as though you could roll the body into a ball.  Continue the rolling movement as far as possible until you have gained a decided stretch on the sciatic nerve or make the head touch the leg (Plate 39),   returning to normal position slowly, breathing constantly.

    This exercise (Plate 40) is for the abdomen, back and ribs and is very far-reaching in its effects: Sit upon a stool, and bend the body backward until the head is near the floor.  Then rise slowly to a sitting position.  The feet may be kept on the floor by putting toes under a chair or a strap attached to the floor for the purpose.

    Clasp hands at back of neck, (Plate 4l), stride forward on left foot, bend body forward until chest is on thigh.  A comprehensive and effective movement that can be varied in several ways to take in all parts of the body.  A good variation is to extend hands above head instead of clasping in back of neck, and take same movement as described.

    Breathing may be considered the most important of all the functions of the body.  All other functions depend upon it.  Man may exist some time without eating, a shorter time without drinking, but without breathing his existence may be measured by minutes.  The majority of women do the upper chest breathing only.  The majority of men do the lower mid-chest breathing.  I will take up with you the different areas, the upper, mid-chest and diaphragmatic, and how to gain control of them and the freeing of the ribs, which is essential to normal breathing:

    The patient will lie on the table, on the back, knees flexed.  Take an ordinary breath and exhale.  After taking a breath, lift the chest wall, thus drawing in the abdomen.  Do this to the count of l; to the count of 2 lift the adomen.  This will draw in the chest.  Alternate rapidly to the count of 1-2, 1-2, 1-2.  In this way you will get an internal abdominal massage better than anyone can give you.  Every organ, every particle of tissue within is lifted and vibrated by this movement.  Extreme tenderness may be felt at first.  Do it slowly but more rapidly as you become more skillful and gain in control.  To make it more difficult, take a deep breath abdominally -- I say abdominally in order to make it clearer.  Muscularly distend the abdomen as far as possible.  Then take the exercises as above described with the count of 1-2.  Placing the hands in front of the lower ribs in the diaphragmatic area, say the word “Yawn,” drawing in the breath and feeling the distention in the diaphragmatic area only.  This will be quite difficult to get and will never be done perfectly unless you stand on the balls of the feet with the chest well lifted and abdomen drawn in.  Place hands on sides in diaphragmatic area and repeat “Yawn,” getting lateral movement in the ribs.

    Place the hands in the mid chest, laterally, taking in the breath and forcing the ribs out.  Hold the diaphragmatic and mid breath taken and feel the upper part.  Try these different areas by placing your hands upon them separately until you have gained control and until you can breathe in any part separately; then combine.

    Roll over on to shoulders and head, support the hips with hands, elbows resting upon the floor (Plate 42).  Alternate leg movement, similar to riding a bicycle.  This exercise can be varied by flexing both knees down to chest; straighten and flex several times.  Also try to touch floor over head.  Alternate feet and do it with both feet together.

    Plate 43.  Bend the body at right angles to legs.  Bend the right knee (if unable to keep straight) and touch the floor in front of right toes, at same time extend left arm upward and backward.  Alternate same movement with left.

    Plate 44.  Bend body sidewise keeping it in same line as when erect and with right hand touch outside of leg as near knee as possible.  Flex left arm at elbow having closed hand high in axilla.  Alternate movement with opposite side.


    Assume squatting position as shown in Plate 45 with clasped hands well back between legs; rise to erect position with hands extended overhead; bend backward from the waist, lifting and rounding out chest as shown in Plate 46.

    Great attention should be paid to the vasomotor hygiene.  Much of life depends upon the proper functioning of this system.  Muscular activity, the control of the emotions, are both dependent upon it for their well being.

    The insane asylums furnish us with many examples of perverted emotions due to the lack of a proper circulation to the various organs.  Over-wrought emotions, wild delusions, vivid hallucinations, are not often found among those whose muscles are firm and vigorous.

    The health of the vasomotor system depends largely upon proper muscular exercise.  The cold hands and feet of the student are often due to this lack of exercise.  Other irregularities occur when the system is not kept in proper tone.

    The circulation of the lymph is of the greatest importance and is chiefly carried on by muscular contraction.  The lymph spaces are squeezed by the pressure and the fluid is forced onward.  Exercise hastens this circulation.

    All respiratory movements assist in drawing the lymph onward, as they assist the blood current to move more evenly and normally toward the heart.  It is quite probable that the muscular fibres in the walls of the lymphatics themselves have a rhythmical contraction.  The contractions of the muscular fibres of the villi apear to further the chyle movement from the lacteals into the valvular lymphatics.  As the lymph vessels gradually unite into the larger ones, an increased pressure must result, thus further assisting in its onward flow.

    There are nearly seven hundred lymph nodes in the body.  The greater number lie in the chest and belly cavities, with a few in the neck, face and limbs, but some in nearly every part of the body.

    All tissues of the body derive their nutrient material from and excrete their waste products into the lymph.  The oxygen and food absorbed into the blood pass through the capillary walls into the lymph, bathing all tissues.

    Knowing this, effective exercises can be planned which will function for each part.