Medical data is for informational purposes only.

You should always consult your family physician, or one of our referral doctors prior to treatment.
rope and is so highly recognized in the medical field that doctors
now commonly prescribe these treatments which are used in hos-
pitals and reimbursed by Social Security. This work is facilitated
by physiotherapists, chiropractors, nurses and bodyworkers.
Concisely we can say that the three main actions of lym-
phatic drainage are:
1) Stimulation of body fluid circulation. It activates lymph
function and lymph circulation. Indirectly stimulate the blood cir-
® culation of the Body (enhance blood capillaries resorption, increase
Dr Chikly’s pulsation of capillaries, activate venous circulation, . . .).
LYMPH DRAINAGE THERAPYTM 2) Stimulation of the immune system: the passage of
Copyright (C) 1996 - Bruno Chikly, M.D. and UI Publishing lymph in the lymph nodes stimulate the immune system (the hu-
By permission of author published by the Arthritis Trust of moral as much as well as the cellular immunity). The stimulation
America®/The Rheumatoid Disease Foundation, of lymph circulation activate antigen/antibody presentation and
7376 Walker Road, Fairview, Tn 37062 immune reactions.
3) Nervous sytem: stimulate the parasympathetic nervous
Bruno Chikly, M.D., Laureat of the Medical Faculty of Paris, system (relaxation effect, antispastic effects -- muscle tonus -- ,
Member of the International Society of Lymphology (I.S.L.) is a etc). The constant stimulation of the C-fiber mechanoreceptors has
inhibitory effects (analgesic -anti-pain-action).
graduate of the medical school at Saint Antoine Hospital in France,
where his internship in general medicine included training in en- LYMPHATIC & ENERGETIC DRAINAGE is an original method
docrinology, surgery, neurology and psychiatry. Dr. Chikly also of LYMPHATIC DRAINAGE developed by a French physician, Dr. Bruno
Chikly. Today, lymphatic drainage has reached a new level of ef-
holds a degree in psychology at the master’s level. Further areas
of training and education consist of 10-years of study in Oriental fectiveness and efficiency. The enhancements we have made to the
medicine, including acupuncture and osteopathy, including original Vodder technique is by incorporating the most advanced
scientific data on lymphology with whole-body healing values and
CranioSacral Therapy, Visceral Manipulation, Spinal release,
Mechanical link, Muscle energy among others. direct listening techniques. As in CranioSacral Therapy, we can
His doctoral thesis addressing the lymphatic system, its his- easily develop and teach the skills to identify the very specific
rhythm, then direction and quality of the lymphatic flow. Dr. Chikly
torical evolution and the manual lymphatic drainage technique was
awarded the Medal of the Medical Faculty of Paris, VI, a presti- was the first in the world to make this breakthrough. The method,
gious acknowledgment for in-depth work and scientific presenta- Lymph Drainage Therapy (LDT), offers patients a myriad of ben-
efits. Advance practitioner can really assess their patients (lym-
tion.
Lymph Drainage Therapy workshops on the body and face, phatic mapping), monitor their work and check the result of their
along with self-drainage techniques, currently are taught in France, work at the end of the session. If needed (lymphedema, surgery,
obstruction), they can finally find the best alternate pathways to
Belgium, Switzerland, Sweden, Israel, Tunisia, Canada, Brazil and
the United States. For more information on workshops, Upledger reroute the lymph flow to a healthy area of the body.
Institute at 1-800-233-5880. The manual manoeuvres employed are very subtle (e.g.
cranio-sacral movements). The work is done with flat hands using
TABLE OF CONTENTS all fingers to simulate aquatic, wave-like movements, which en-
Introduction ables the practitioner to deeply listen to the rhythm of the body
History of Lymph Discovery and Lymphatic Drainage fluids. A heightened awareness opens one’s ability to attune to the
The Water Element and the Liquids of the Body. exact pressure and rhythm necessary to enter into the flow of the
Circulation, Blood and Lymphatic Vessels (Physiology) lympathic system.
Lymph Vessels, Lymph Nodes THE LYMPH : AN “ELIXIR OF LIFE”
Lymph Circulation Lymph in its flow actually takes away the toxins, the
Comparison Lymph system/Blood system germs, and the large molecules that the venous system can’t regain.
Composition of Lymph It can, in particular, remove “trapped proteins” and fat molecules
Functions of the Lymphatic System in the tissues.
Indications and Applications of Lymph Drainage Finally as it passes through the lymphatic nodes, small
Annex: Dr Chikly’s resume centers of filtration, it also manages our immune defenses. Lymph
INTRODUCTION leaves the waste and germs in the lymphatic nodes, and transports
LYMPH DRAINAGE THERAPY TM lymphocytes, specialized white corpuscles that produce antibod-
A NEW CONCEPTION OF LYMPHATIC DRAINAGE ies.
LYMPHATIC DRAINAGE is a specialized massage tech- It is easy to understand, therefore, its importance for the
nique designed to activate and cleanse the human fluid system. strength of our immune system, the state of our tissues and our
Because the lymphatic system itself is responsible for optimum general well-being.
functioning of the water circulation and immune system, LYM- However, the lymphatic flow can stagnate or even stop
PHATIC & ENERGETIC DRAINAGE is a key to maximizing our abil-
for many reasons such as fatigue, stress, emotional shock, lack of
ity to rejuvenate and to establish resistance to stress and dis- physical activity, certain food additives, etc. . . If the lymphatic
ease. (Also see “Lymphatic Detoxification,” www.arthritistrust.org.) circulation slows down, the supplying and regeneration of cells is
LYMPHATIC DRAINAGE was initially developed in Europe poorly carried out. Consequently, toxins accumulate, hastening the
in 1932 by Dr. E . Vodder. By the late 60’s it established the cred- aging process and opening the gates to various physical problems.
ibility necessary to be taken seriously by the medical profession. We use our hands to aid in Nature’s work assisting the
Dr. Johannes Askonk, a prominent German physician, then suc- recirculation of the lymphatic flow.The wave-like movements of
cessfully tested 20,000 patients in hospitals in order to verify its the fingers restimulate the contractile movements of the lympatic
credibility, measure its efficiency and find its indications and channels.
counter-indications. HISTORY OF LYMPH DISCOVERY
Today this technique is widely spread throughout Eu- AND LYMPHATIC DRAINAGE
It is most likely that throughout history the medical field

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 Medical data is for informational purposes only. You should always consult your family physician, or one of our referral doctors prior to treatment.
was unable to recognize the lymphatic system because of the trans- THE WATER ELEMENT
parency of the lymph and the difficulty to even see the lymphatic AND
vessels when dissections were done. The ancient peoples of China, THE LIQUIDS IN THE BODY
Sumeria, Babylon, Egypt, and India may have had vague ideas of I) THE LIQUID ENVIRONMENT OF THE ORGANISM
the lymph circulation of the body. As we know it today, they were LIFE IS UNTHINKABLE WITHOUT WATER. It is the most abun-
far from understanding the lymphatic system as a specific entity. dant element of living beings. We have learned that through evolu-
The Greeks witnessed some lymph vessels, primarily the tion animals left the water to become mammals. They developed a
ones in the intestines because they carry a more visible milky-like respiratory tract, and from there it seems we became a “dry” spe-
lymph (chyliferous vessels) and probably the “thoracic duct”, the cies. Yet the gasses that we breath are transported in water, and
largest lymphatic vessel. Even though Hippocrates (460-377 B.C.), communication throughout the cells is also done through water. It
describes a lymphatic temperament, we really have to wait until is then interesting to realize that OUR OWN CELLS IN FACT NEVER LEFT
the anatomists of the l7th century before the first substantial scien- THE WATER!
tific discoveries concerning the lymphatic system were made. Coming in contact with lymph is to connect with the liq-
• In 1622, Gaspard Asselli (1581-1626), an Italian phy- uid dimension of the organism. Many civilizations have symboli-
sician, discovered the “milky veins” of a dog after digestion. This cally associated the water element with different aspects of life: the
is documented as the first historical discovery of the lymphatic ves- subconscious, the moon, woman, emotion, the inner child, purity,
sels. love. Like our own subconscious or our inner child, we can easily
We can note that shortly afterwards in England, 1628, deny or overlook our own water element. Our society specifically
William Harvey published his discoveries about the systemic blood doesn’t acknowledge the water element nor does it encourage aware-
circulation. ness of the more subtle aspects of ourselves. Through Lymph Drain-
• In 1650-51, John Pecquet (1622-1674) from Dieppe, age Therapy we will try to come in contact again with these dimen-
France, described, the lymphatic duct, the largest lymphatic vessel sions of our body and look towards integrating more sides of our-
of the body,” and its unique beginning in the “Cysterna Chyli” or selves.
“Pecquet’s cystern”. CIRCULATION,
• Olauf Rudbeck (1630-1708) was a scientific genius BLOOD AND LYMPHATIC VESSELS
from Sweden (Uppsala). He was the first anatomist to see and con- The lymphatic system belongs to the circulatory appara-
sider the lymphatic as a complete and specific system in the human tus which provides one way for the blood to leave the heart, the
body that could be compared to the venous circulation. He can be arterial system, and two ways for it to return: the venous and lym-
referred to as the first man who truly discovered the lymphatic sys- phatic pathways. THE LYMPHATIC SYSTEM IS THEREFORE
tem, and understood it as a whole system. ANOTHER PATHWAY BACK TO THE HEART, PARALLEL TO
• Alexander of Winiwarter (1848-1910), a surgeon from THE VEINAL SYSTEM.
Belgium, was the first physician to introduce an effective protocol Lymph is an intermediary liquid, between the blood and
using manual techniques (heavy pressure) in hospitals for draining tissues. It is, therefore, the real interior environment in which the
lymphedemas. cells are immersed. This is where these cells both receive their nu-
• F.P. Millard, Canadian osteopath, founder and presi- tritive substances and reject any damaging toxins.
dent of the International Lymphatic Society, editor of a quarterly Part of the constituents of the blood will go out of the
journal published by the Lymphatic Research Society, proposed a blood capillaries to join the surrounding tissues, passing through
new osteopathic technique of “diagnosing various diesease by pal- the interstitial environment (interstitium), the “interstices between
pating lymphatic glands.” In Applied Anatomy of the Lymphatics, each cell”. The liquid that is filtered from the blood capillaries, will
1922, he used the term “lymphatic drainage,” and suggested differ- further be reabsorbed accordingly:
ent lymphatic drainage techniques to affect the lymphatic flow. • From 80 to 98% by the small veins emerging from the
• Emil Vodder (1896-1986), a Danish massage practi- blood capillaries.
tioner, and doctor in philosophy (1928), had further intuition, an • From 2 to approximately 20% by the small initial lym-
inspired insight, to drain the lymph of one of his patients that suf- phatic capillaries.
fered from chronic sinusitis and diffuse acne. This took place be- If the body did not “reuse” the 2 to 20% of the liquid, a
tween 1932 and 1936 in Cannes, French Riviera, in his large part of which the venous system cannot recover, the body
physiotherapeutical institute. He further developed, for the first time, would probably develop systemic edemas (swellings) because of
a precise manual technique for lymph drainage. the protein loss, and ultimately the organism would probably die in
Initially, he began to reveal and demonstrate this tech- 24 to 48 hours.
nique in cosmetogical congresses throughout Europe (beginning In effect the lymphatic system fine tunes the drainage of
with Paris, 1936). Emil and Astrid Vodder, his wife, gave the de- the interstitium (connective tissue) and thus constitutes a sort of
nomination Manual Lymph Drainage to the technique: it is like “overflow,” which evacuates the water and excess substances in the
“draining the marsh” (of chronic sinusitis). interstitial environment.
Because he was not an M.D. or a physical therapist, but a The initial lymph capillaries which originates in almost
massage therapist, he had a difficult time to authenticate his new every tissue of the organism, are at their beginning “feather fine”.
technique. At that time his work was not accepted by the scientists They will slowly increase in size moving into big lymphatic col-
because they were afraid that the bacteria and toxins would spread lectors, and will eventually join the major venous circulation, just
from the lymph nodes and vessels throughout the body. before reaching the heart, behind the clavicles. SO REMEMBER THE
It was not until1967 that the German physician, Johannes LYMPH CIRCULATION ENDS IN THE SYSTEMIC BLOOD CIRCULATION JUST BE-
Asdonk, scientifically tested the technique in his clinic on 20,000 FORE THE HEART.
patients and established its medical effects, its indications and its The lymphatic system meanwhile transports large pro-
countra-indications. Today in Europe, the technique is commonly teins, foreign bodies and pathogenic agents (germs, toxins etc.) in
used in hospitals, this work is prescribed by M.D.’s and is reim- its pathway through the lymphatic nodes which acts as an active
bursed by national insurance. purification center. The nodes break down and destroy those par-
Bruno Chikly, M.D., France, was the first to recognize ticles, so they can eventually be flushed out of the body through
the specific rhythm of the lymphatic flow and teach how to attune the eliminatory tract.
with it manually (Lymph Drainage Therapy). LYMPH VESSELS, LYMPH NODES.
I) Location of the lymphatic system:

2
 Medical data is for informational purposes only. You should always consult your family physician, or one of our referral doctors prior to treatment.
The lymphatic system is present everywhere in the or- vessels or minute “anastomosis” (“watersheds”). This structure will
ganism except where there is no vascularisation: be used in advance levels to drain the lymph flow in a specific
• The epithelial tissues (spleen, bone marrow, epidermis direction or another.
etc.). 3. Pre-collectors:
• The cartilaginous tissues They have the same structure as the lymph capillaries,
• The cornea and the lens of the eye but are larger vessels that have additionally, conjunctive and elastic
Further exceptions include the following tissues that are layers. They slowly acquire valves to help them carry the lymph to
drained indirectly: the big collectors. These valves consist of two parts (“bicuspid”
• The placenta valves) and are located between two lymphangions (or muscular
• The labyrinth of the inner ear units). Lymphangions and valves give the lymphatic vessels the
• The central nervous system (?) characteristic appearance of a pearl necklace, sometime called
II) Organisation of the Lymphatic pathways: “monoliform” shape.
Lymph is the liquid contained in the lymphatic vessels. 4. Lymph collectors:
Remember that before entering the initial lymph capillaries, this These are large vessels that carry the lymph to the lymph
liquid is called the “interstitial liquid” (in the “interstice” between nodes. The superficial collectors, above the fascias, drain about
the cells) or the pre-lymphatic liquid. 70% of the lymph of the body. They are very often located through-
1. The Pre-lymphatic pathways: out fatty tissues. The biggest collector of the body is the “thoracic
The interstitial liquid flows in the interstitium (intersti- duct” that usually terminates in the left brachio-cephalic vein.
tial tissue) through non-organized pathways, sometimes called the 5. Lymph trunks/lymph ducts (thoracic duct):
“tissue canals”. They are like the spontaneous waterways that wa- They are the biggest lymph collectors of the body.
ter naturally carves out in a field in rainy weather. They are unorga- 6. Lymph Nodes:
nized and unstructured pathways, that are different from real ves- LYMPH PASSES THROUGH THE LYMPHATIC NODES
sels which are closed units. This interstitial liquid is slowly “drain- WHICH ARE LINKED TO THE IMMUNE SYSTEM.
ing” to the lymphatic capillaries. The state of the connective tissue The Greek word “ganglion” (node) means little tumor.
can be jelly-like (jel.) or more liquid, in a soluble state (sol.).The For a longer time, this word referred to different anatomical struc-
property of the connective to become more jel. or sol. is called tures of the lymphatic system or to the nervous system. The first
thyxotrophy. It determines the amount of fluid trapped in the ground precise microscopic studies of the nodes were not done until the
substance (Jel.) or free to circulate (sol.). L.D.T. specific 19th Century.
manoeuvres will help the natural drainage of the pre-lymphatic Nodes are covered by a dense connective tissue, the cap-
pathways and slowly transform the “jel.” constitution of the loose sule. These densifications extend into the nodes and are called tra-
connective tissue in a more “sol.“ state. beculae.
2. Lymphatic capillaries (or initial lymphatics): The collectors conjunct in large numbers in the convex
Lymphatic capillaries, made of a single layer of flat cells, region of the nodes. We call these vessels the “afferent” lymph
are 4 to 6 times bigger than the blood capillaries. They are fragile vessels. Lymph usually leaves the node through one, sometimes
vessels, one cell thick, with collagen fibers connecting them to the two or three vessels, from the concave region of the node. They are
surrounding environment. They form a tight “spider net” covering the “efferent” vessels. This region of the node contains a slight
most of the body organs. depression and is called “the hilum” of the node.
Unlike the closed-loop of the blood circulation the lym- Nodes usually have the shape of a bean (kidney-shape),
phatic circulation is a one-way structure beginning with the lymph but may have all kinds of different shapes, some being round, oval,
capillaries. oblong. A normal, healthy size can range from 1 to 25 mm (from
In the embryo, the lymphatic capillaries develop within the head of a pin to the size of a cherry pit).
the pre-lymphatic pathways. The nodes are formed in the embryo during the second
The lymph vessels “grow” specifically within the sur- month of the intra-uterine life. They grow and achieve maturity in
rounding interstitial tissue and inherently stay firmly connected by puberty.
its many microfibrils called the “anchoring filaments” (Leak fi- We can count from 400 up to 1,000 nodes in the human
bers, or Casley-Smith fibers, first observed in 1935 by Pullinger body. More than one-half are located in the abdomen alone. Many
and Florey). These fibers are attached from the tissue to the lymph nodes are also located in the region of the neck (the cervical re-
capillary cells. They help the lymph capillaries to widely open if gion). The main groups of nodes can be found in the major articu-
there is too much fluid pressure in the connective tissue, or, for lation folds of the body, excluding the crease of the wrists. By put-
example, when we move the tissue manually with the external ting yourself in the embryo position you are able to protect them,
manoeuvres of Lymph Drainage Therapy. except for the ones in the malleolar region, the mythologic weak
After the pre lymphatic liquid enters the lymph capillary point of Achilles.
the flat cells of the wall of the lymph capillary close, working as Lymph nodes are part of the lymphoid system. This sys-
flap valves, and the liquid becomes lymph. tem is comprised of the various organs that are part of the immune
As the connections between the lymph capillary cells system. We separate the primary and secondary lymphoid organs.
are very loose, some fluid (mainly water and small molecular weight The primary lymphoid organs include bone marrow and thymus.
solutes) can usually escape through the minuscule spaces between The secondary lymphoid organs include lymph nodes, spleen, ap-
the cells. Proteins (macro molecules) on the contrary, never get out pendix, tonsils, adenoids, M.A.L.T. (mucosals associated lymphoid
of the lymph vessels, they are too large. In this way proteins even- tissue present in the small and large intestines, the oral cavities. . .
tually become more and more concentrated as they travel through .). Their function is to defend the body against aggressive agents
the lymphatic apparatus. The concentration of the interstitial liquid entering the body or to destroy accumulated wastes.
and the lymph is therefore slightly different at the beginning. Lymph nodes have various specific functions:
The initial capillaries form a very tight, web-like net- • They are filtration and purification stations for the
work without valves everywhere under the dermo-epidermic junc- lymph circulation.
tion. The lymph collected in these capillaries gathers in the pre- • They capture and destroy toxins of the body. During
collectors. We can note that at the main lines between territories, inflammation the lymph nodes can become enlarged and painful.
where the lymph circulation divides into two opposite directions When they trap cancer cells in order to destroy nodes can be sources
(medial center line, “belt” line), we can find a specific network of of secondary growth localization (metastasis) for the cancer

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 Medical data is for informational purposes only. You should always consult your family physician, or one of our referral doctors prior to treatment.
• They concentrate the lymph, reabsorbing about 40% measure and when you take it (before or after digestion).
of the liquids present in the The lymphatic load can comprise: lipids (fat), glucids,
lymph. proteins, enzymes, urea, minerals, hormones, some dissolved gases
• They produce lymphocytes and monocytes. The pro- (nitrogen, carbon dioxide), cells (lymphocytes, macrophage), tox-
duction of lymphocytes is increased when the flow of lymph is ins, bacteria, viruses, very few extruded red corpuscles, body waste,
increased through the nodes. It indicates manual techniques like pieces of cell debris, maybe some cancerous cells, etc.).
L.D.T. increase the production of lymphocytes. LYMPH CAN BE DIAGRAMMATICALLY COM-
Lymph nodes ”offer 100 times more resistance to lymph PARED TO BLOOD, WITHOUT ITS RED CORPUSCLES AND
flow than the whole rest of the system put together” (Casley-Smith). WITHOUT ITS PLATELETS.
LYMPH CIRCULATION Its protein content is lower and its osmotic pressure is
There are approximately 6 to 10 liters of lymph in the slightly higher than in plasma, its viscosity a little less.
body, compared to 3.5 to 5 liters of blood. 1) Water and colloid:
About 1.5 to 2 liters of lymph per day circulate throughout the Lymph contains more water than blood (plasma). There
whole body. Efficient activation of the lymphatic circulation can is 96% water in lymph compared to just over 90% in the plasma.
increase this number to 10-30 liters per day. But lymph contains less water than the cerebro-spinal-fluid (CSF)
The lymphatic muscular units contract in humans at a surrounding the brain (98.5% of water).
rate of about 10 cm/min or 3 in/min (Olszewski & Engeset 1979). This water is filtered from the plasma of the blood and
The overall pulse rate in lymph can be 1 to 30/min. has almost the same composition as the interstitial liquid.
We usually separate two lymphatic circulations: 2) Proteins:
• The superficial lymphatic circulation, just under the Lymph has variable composition of proteins (albumin,
dermo-epidermic junction (about 70% of lymph flow). This circu- globulin, fibrinogen), from 10 to 60 grams per liter.
lation is not directly stimulated by exercise. The lymphatic system has a very important function. It
• The deep circulation of the muscles, below the fascia, can help recirculate proteins. The large proteins are not supposed
and the very deep circulation of the viscera (Grupp 1984), which is to leak from the blood circulation, but actually, 0.1% of them do
activated by muscles contractions. leak from the blood circulation every hour. At the end of the day
COMPOSITION OF LYMPH that makes about 100 grams of lost protein in the tissue, almost
The lymph is a transparent, alkaline liquid, usually vis- half of the quantity of protein circulating in the blood (Witte, 1977).
cous. It can be whitish and gelatinous in the intestinal tract when As we said, if not recovered massive swelling and death could oc-
lymph is filled with the fat assimilated in the digestion. The lymph cur within 24 hours.
in the intestines has a specific milky aspect and has been called by The lymphatic system is the only system of the body that
the Greeks the “Chyle”. These abdominal vessels are easier to ob- can recuperate these proteins and help them to come back to the
serve, and permitted the first discoveries of the lymphatic vessels. heart through the lymphatic system. This is what we call the “anti-
That is why they were primarily referred to as the ”milky veins” or swelling function” of the lymph. This effect is possible because of
the “white vessels” of the body. the very special structure of the lymph capillaries. The very broad
The composition of the lymph is called the “lymphatic space between lymph capillary cells, prompts the sucking effect of
“load”. The lymphatic load varies depending on which tissue you the lymphatic contractions.

COMPARISON LYMPH / BLOOD SYSTEM:

LYMPH - LYMPH CAPILLARIES BLOOD - BLOOD CAPILLARIES

Embryology (development): Embryology: formed with all the
within the surrounding tissues circulatory apparatus.
One-way vessels Closed loop circulation system
Superficial circulation (70%) Deep circulation, under fascia
(about 60%)
Transparent, white liquid, no red corpuscles Red liquid: red corpuscles
Slow rhythm (1.5-4 liter/day) Quick rhythm (80,000 liter/day)
When drained circulation increases
up to 10-20 liters/day
Big spaces between capillaries, Small opening (“windows”)
5-6 times bigger than vein openings
Can recuperate proteins, “toxic-trapped Can’t recuperate “trapped-proteins”.
proteins”, fat, etc., on a greater scale than blood
Muscles help to circulate: lymphangions Heart pump for circulation
are controlled by sympathetic and
parasympathetic reflex system
400-1000 nodes filter the liquid No nodes (the spleen an equivalent?)
85% of lymphocytes 20-40% of lymphocytes
Can be activated with light touch Deeper touch to activate veins
Connects to surrounding tissue through
“anchoring filaments”. Sliding the skin
helps to open lymph cell junctions

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 Medical data is for informational purposes only. You should always consult your family physician, or one of our referral doctors prior to treatment.
The lymph is the only system of the organism that can thymus for the T. lymphocytes. Later on they leave the venous cir-
recuperate “trapped proteins” accumulated around the cells sourc- culation and circulate throughout the arteries, veins, body tissues,
ing from poor physical activity, oxygenation and diet, excess of lymph vessels and nodes, lymphoid organs. While they circulate,
toxicity, stress, aging, etc. lymphocytes make contact with antigen in order to destroy or elimi-
3) Lipids of lymph nate them from the body.
Lymph recuperates the fat absorbed during digestion in The secondary lymphoid organs are organs that comprise
the intestinal tract. On the average we find 10 grams of lipids per a large number of lymphocytes that have migrated from the pri-
liter after meals. They are mainly free fatty acids and lipoproteins. mary lymphoid organs. They are:
4) Cells: Lymph nodes
The number of free cells in the lymphatic flow can vary Spleen
considerably and multiply when they go through lymph nodes or Tonsils (the paired palatine tonsils, lingual tonsil, tubal
when infectious tissues are present in the body. tonsil, nasal tonsils)/Adenoids (pharyngeal tonsil or Luschka’s ton-
In lymph we can find the following cells: sil).
• A) Lymphocytes (85%): They comprise 85% of the Appendix vermiform
cells in the lymph versus 20 - 40% of the cells in the “red blood”. M.A.L.T. (Mucosal Associated Lymphoid Tissue): Peter’s
Altogether, the human body holds trillions of lymphocytes in the patches (in the submucosa of the distal ileum)
blood, lymph, and tissues. MAIN DOCUMENTED FUNCTIONS
We can describe two kinds of lymphocytes: OF THE LYMPHATIC SYSTEM
• 1) B lymphocytes: They produce anti-bodies 1) Absorbs excess fluid, macromolecules (proteins), elec-
and are responsible for the circulating immune response (“Humoral trolytes, toxins, foreign substances (debris..) from the interstitial
immunity”). When an aggressor (“antigen”) enters and circulates compartments (tissue space around the cells). This role is of a regular
through the body, B-lymphocytes protect the body and respond by cleansing of tissue, and also of removal of waste and cells after
producing specific “antibodies” (immunoglobulin chains) that are acute conditions (injury, necrosis . . .). Through this process the
produced in modified B lymphocytes that are called “plasma cells” lymphatic system maintains optimal functioning and retains the
(“plasmocytes”). A specific “memory” for this microbe (memory integrity of the connective tissue,
cell) stays in the body 6 to 20 years after the first immune contact. 2) Recovers back to the blood, substances that have es-
• 2) T lymphocytes: They are responsible for caped from the blood compartment to the tissues.
the “cellular” immune response. When the “antigen” (aggressor) 3) Removes and carries these substances back to the blood
has entered a cell (“infected cell”) the T lymphocytes are activated circulation, usually after passing through one or more lymph nodes.
to destroy the foreign agent. T-lymphocytes stay about 30 minutes Helps process these substances in the little filtration units
in the blood circulation, about 5-6 hours in the spleen and 20 hours that are the lymphatic nodes.
in the lymphatic system.. 4) Regulates the fluid volume and pressure in a tissue.
• B) Macrophage (13 -15%): 5) Helps transport immuno-competent cells (lymphocytes
Issued from Monocytes cells, they manage the defense . .) and other substances (hormones. . .) throughout the body. May
of body tissues. Contrary to lymphocytes, they attack any agent play an important role in the localization of infection in the body.
considered an aggressor to the body (“the Self”) without discrimi- 6) By this means helps generate more immuno-compe-
nation and without any specific memory. tent cells in the lymph nodes.
• C) Other cells : we can find in the lymph: 7) Carries food components (fatty acids) absorbed from
1) Dead cells, migrative cells (from cancer), foreign waste the small intestines to the blood circulation.
cells... MAIN ACTIONS OF LYMPHATIC DRAINAGE
2) In case of body inflammation cells from different parts 1) Liquid/blood: Activates lymph function and lymph cir-
of the body come in the lymph: mastocytes, granulocytes, few red culation. Indirectly stimulates the liquid circulation of the body
globules, platelets... (enhance blood capillaries resorption, increase pulsation of capil-
5) Other substances: laries, activate venous circulation, . . .).
Fibrinogen permits the lymph to lightly coagulate. There 2) Immune system: the passage of lymph in the lymph
is less fibrinogen in lymph (0.55 g/l) than in the blood, (1 - 2.5 g/l). nodes stimulates the immune system (the humoral as much as well
Substances like toxic agents, colorant, dust, food preser- as the cellular immunity). The stimulation of lymph circulation
vatives, etc. activates antigen/antibody reactions.
THE LYMPHOID ORGANS 3) Nervous system: stimulates the parasympathetic ner-
AND vous system (relaxation effect) inhibits various (analgesic action -
THE IMMUNE SYSTEM - anti-pain --, antispastic effects -- muscle tonus -- , etc).
The immune system is the system that protects the body INDICATIONS AND APPLICATIONS
from substances that are foreign or interpreted as foreign substances OF LYMPH DRAINAGE THERAPY
(antigen), no longer identified as “Self”. DON’T FORGET THAT BY LAW ANY DISEASE MUST BE DIAGNOSED
The lymphoid organs are organs mainly responsible for BY AN M.D.
thr immune response. They produce or contain a large number of All the necessary studies have not been done yet, nor
lymphocyte cells in a specialized form of reticular connective tis- have all applications of Lymphatic Drainage been discovered. There
sue. is an unending list of indications that still need to be explored. The
The lymphoid organs are separated in “primary lymphoid following are the most common disorders treated, and some are
organs” and “secondary lymphoid organs”. various ailments that showed response in therapists’ daily practice.
The primary lymphoid organs are the bone marrow and They are not all scientifically proven indications of lymphatic drain-
the thymus. age. They are only reference points for those that don’t have expe-
The bone marrow produces and further help mature (“dif- riences of the lymph drainage. Every case has to be considered
ferentiate”) the B lymphocytes. specifically.
The thymus is the place where migrates undifferentiated Angiology (Blood vessels)/Cardiology/Phlebology (veins)/
lymphocytes to mature T lymphocytes. Lymphology:
Lymphocytes are primarily formed in the bone marrow • Edema (swelling or “dropsy”) is an excessive accumu-
and get to mature in the marrow for the B. lymphocytes and in the lation of fluid (hydro-colloid) in the interstitium. Lymphedema is

5
 Medical data is for informational purposes only. You should always consult your family physician, or one of our referral doctors prior to treatment.
an edema that is a result of impaired removal of lymph from the Gastro-enterology (Stomach): chronic constipation; irritable bowel
interstitium. It is an accumulation of protein-rich fluid in the tis- syndrome, chronic colitis; ulcerative colitis, Crohn’s disease; en-
sues that may develop into fibrosis. Yet it is a poorly understood teropathy, coeliac disease; diverticulosis; food intoxication; chronic
disease in medicine. gastritis, stress ulcers; chronic pancreatic insufficiency, chronic
a) Lymphostatic edema (high protein edemas): is one of pancreatitis
the main medical indications of lymphatic drainage. General: stress; fatigue; chronic fatigue syndrome (CFS), Epstein
Lymphostatic edema = deficit in lymphatic transport ca- Barr syndrome; chronic fatigue syndrome (CFS).
pacity. In lymphostatic edemas the lymphatic vessels themself are A very common disorder, yet not clearly defined. It has
not properly working. It is a decreased ability to remove fluid from worn various names: HHV6 syndrome (Human Herpes Virus 6);
the extracellular compartment. These edemas are also described as epidemic neuromyasthenia, Iceland disease, chronic mononucleo-
Low Output Failure or low volume mechanical insufficiency). sis, chronic teast syndrome, myalgic encephalomyelitis, etc.; auto-
There are various lymphostatic edemas: nomic dystonia; chronic pain; sleeping disorders; snoring; detoxi-
Primary lymphedema (congenital origin) fication (fasting, dieting, tobacco, substance dependency); toxic
Secondary lymphedema (anatomical obliteration): chemical poisoning; jetlag (pressure in airplane), edemas within
• Post-surgery lymphedema: post-mastectomy the plane; alcohol hangover
lymphedema, post-hysterectomy lymphedema, Gerontology (older people): L.D.T. is a very good technique to use
post-prostatectomy, post-biopsy, etc. with elderly people, because of its profound effects on tissue re-
• Metastatic lymphedema generation and oxygenation, deep cleansing of the body, as well as
• Post-infectious, (parasites/filariasis, tubercu- its immune system stimulation, stress release, and health mainte-
losis, etc.) nance. You can apply L.D.T. for almost every indication with eld-
• Post-radiations lymphedemas erly people because of its gentleness and harmlessness. L.D.T. be
• Post-trauma, burns used as a home family practice. Just be careful of the reaction of
• Post-medications, silica dust, etc. your patient in the 3-4 initial treatments. Give shorter sessions and
• CVI: post-phlebitic, etc. evaluate; cerebral degeneration, memory loss...
b) Lymphodynamic edema = overproduction of lymph Gynecology: Menstruation; PMS, painful or haemorragic menstrua-
or High Output Failure, is when normal or increase in capacity of tion; breast pain or swollen breasts (from menstruation, oestro-
normal lymphatics is overwhelmed by an excessive burden of in- progestatif pill, pregnancy); pregnancy; “stretch marks (belly,
tercellular fluid. The lymph vessels are functionning correctly (are breasts): “striata gravidarium” “cutis striata lymphostatica”. About
still “dynamic”) but they can’t handle the excessive stagnant liquid 50% of them can usually be alleviated. It is a very long process and
in the connective tissue. The excess fluid present in the connective the results will be better if the drainage begins in early stages; swol-
tissue is a burden beyond the transportation capacity of the lym- len legs; varicose veins; breast feeding; breasts’ soreness, cracks or
phatic system. For example: defective kidney or heart function, fissures in the puerperal period (prevention or treatment; help scar-
blockage in the venous system, low protein edema, etc. ing process, anti-infectious); fibrocystic mastopathy (cysts forma-
Edemas of different origins can be also treated, for ex- tion in the breast); Infertility
ample: “dermatologic” edemas, e.g. chronic eczema; pediatric ede- Infectious disease:
mas; Traumatic edemas: torn muscles, sprain articulation, joint dis- (also check Dermatology, General, Ophtalmology, Pneumology)
locations, knee edemas after meniscus and ligament lesions, ten- You can apply it to Pediatric (children) or Gerontology
dinitis, tendinosynovitis, fracture (before, in and after the cast), (elderly people). (Be cautious to do short sessions first to avoid
haematomas, “ski thumb” injury. . . . Reduction of edema helps an inflammatory reactions); chronic amygdalitis, pharyngitis, tonsil-
early, less painful mobilization or prepares the patient’s tissue be- litis, laryngitis, rhinitis, otitis, syringitis; chronic sinusitis fronta-
fore applying plaster; post-infectious edemas (ORL, odontologic lis: do neck, face, especially nose and cheeks, you can finish with
,etc.); pre-menstrual edemas, cyclic-idiopathic edema; gynecologic Intra-oral treatment if there is no sign of fever at all (be careful of
edemas; “neurologic” edemas (neuralgia, facial paresia, multiple meningitis with fever. Don’t work with lymph drainage, and espe-
sclerosis, etc.) cially not inside the mouth); chronic sinusitis maxillaris; allergic
Edemas associated with Rhumatism or Auto-Immune nasal catarrh; HIV positive, AIDS: Be very careful, check with an
diseases: arthrosis, polyarthric, PSH, etc.: Nephrologic edema M.D. The reactions can be different depending of the state of the
(nephrotic edema), Lipedema disease. Improve quality of life, can stimulate immune system in
Edemas of veno-lymphatic conditions: we can drain from previous states. Recent studies suggest that as many as 2 billions of
the first early stages of venous diseases to varicose veins, post throm- lymphocytes (CD 4) are produced every day to replace the losses
botic leg edema, hypodermitis to the late chronicle complications induced by the virus.
like venous ulcer. Always keep in mind the terrible contra-indica- Neurology (Nerves): headaches; migraine; post trauma symptoms:
tion of acute phlebitis; arteritic ulcer, and other type of ulcer (dia- headaches, vertigo. . . .; cerebrovascular accident (stroke), hemiple-
betes mellitus ulcer); arterial hypertension (high blood pressure); gia, chronic ischemic syndrome, apoplexia, various encephalopa-
arteritis, intermittent claudication (intermittent limping); Raynaud’s thies. . . . concussion (commotio cerebri, commotio spinalis); spi-
disease nal injuries; cerebral spastic infantile (cerebral palsy, Little’s dis-
Dentistry, orthodontic: tooth pain; post-tooth extraction (for the ease); neuralgia facial, intercostal neuralgia, herpes zoster neural-
pain, the edema, the haematoma, the scar, etc.); tooth realignment; gia, etc.; trigeminal neuralgia; facial paralysis; Parkinson disease,
root canal, orthodontic surgery; gingivopathy (gum disease); paro- choreic disorders: sometime diminution of the trembling. . .; mul-
dontitis tiple sclerosis (MS): If the disease cannot be cured with Lymph
Dermatology (skin): acne vulgaris; rosacea; seborrhea; chronic and Drainage, some patients really appreciate the results of the tech-
allergic eczema (avoid the area at the beginning to avoid inflamma- nique especially for their legs. It seems after some studies that the
tory or allergic reactions); Peri-oral dermatitis (from cortisone treat- crisis becomes shorter and the remissions of M.S. longer with
ments); chloasma; some pigmentation spots. Lymph Drainage. The action of the drainage might work on the
Esthetic: wrinkles (lymph drainage hydrates the skin, nurtures auto-aggressive T lymphocytes that cross the blood-brain barrier
wrinkles, removes toxins, regenerates skin tissue, tonifies skin, re- in M.S.; vertigo; memory disorder; peripheral nerve disorders/cra-
laxes facial muscles. . . .); skin complexion; erythrosis; telangiecta- nial nerve disorders: facial nerve paralysis, trigeminal neuralgia,
sia; hematosis; “bags” under the eyes; hair loss; adiposis, cellulite; Bell’s Palsy. . . ; myopathy, muscular dystrophy or atrophy; spinal
breasts ptosis (sagging breasts.) poliomyelitis (edemas); epilepsy

6
 Medical data is for informational purposes only. You should always consult your family physician, or one of our referral doctors prior to treatment.
Ophtalmology: Visual acuity: many clients said their sight became
much better after the sessions; scotoma; chronic dacryocystitis (in-
fection of the lachrymal sac), blepharitis (inflammation of the eye-
lid margins); chronic glaucoma; chronic edema of the eyelids; retina
detachment
Orthopedy (Bones-Surgery): trauma; hematoma; sprain; disloca-
tion, luxation; ligaments and meniscus pathologies; fracture; post
fracture or post-sprain symptoms: pain, discomfort etc.
Osteopathic/Chiropractic: (Also check Orthopedy, Rheumatology,
Sport); neck pain, whiplash; lower back pain, lumbago, lumbalgia.
. . ; sciatica: there are many different etiologies (origins) of sci-
atica. It is not the best indication of Lymphatic Drainage, but in
some cases it really helped patients. Maybe it is the anti-edematous
action around the “nerve” and the anti-pain action that makes it
work.
Otorhinolaringology - ORL (Nose-Throat-Ear): peridontal disease;
tinnitis: tinkling, ringing or buzzing in the ear; vertigo; Meniere’s
disease; asialie-hyposialie; Sjrogren’s syndrome (dry eyes and
mouth syndrome): tremor
Pediatrics (Children): All quoted diseases can be applied to chil-
dren. Be especially careful not to enhance fever in a child.
Pneumology (Lungs) Allergology: chronic bronchitis, emphysemal
bronchitis; bronchial asthma; emphysema; post-pleuritic disorders;
silicosis: pneumoconiosis resulting from inhalation of silica (quartz)
dust; cystic fibrosis: (mucoviscidosis); hay fever
Rheumatology (Bones-Articulation), musculoskeletal and connec-
tive tissue disorder: Lymph drainage can effectively alleviate the
edemas of many rheumatologic ailments after signs of acute in-
flammation have disappeared; arthrosis (neck, shoulders, hips,
knees. . . .), polyarthrosis deformans; rheumatoid arthritis, juvenile
rheumatoid arthritis, polyarthritis; ankylosing spondylitis
(ankylopoietic spondylarthritis); gout, chondrocalcinosis
(pseudogout); psoriasic arthritis: psoriasis associated with arthri-
tis; allergic arthropathies, endocrine arthropathies, diabetic arthro-
pathies, etc; lupus erythematosus; scleroderma; polymyositis and
dermatomyositis; osteoporosis; lumbago, lumbalgia; Sudeck’s at-
rophy (traumatic osteoporosis, algoneurodystrophy or “shoulder-
arm” syndrome); fibrositis syndrome: bursitis, tendinitis, tenosyno-
vitis, tendoperiostosis, etc; tennis elbow (lateral humeral epicondyli-
tis), etc.; carpal tunnel syndrome; Dupuytren’s contracture; spas-
modic torticollis; noctural paraesthetic brachialgia; fibromyalgia
syndrome (FS): it is today maybe the third most common rheu-
matic disease.
Sport: To improve the conditions of muscles before and after a
sport event (waste and acid lactic in the tissue); muscle spasms;
Sport trauma: any edemas, haematomas (be sure that any bleeding
has stopped); sprains, dislocations, etc.; muscle cramps or pain;
ligament and meniscal lesions; fractures (under cast, after the cast);
scars/fibrosis
Surgery: Pre-surgery: prepare the tissue for the intervention, drain
the tissue clear the lymph ways before the post-surgery edema;
post-surgery: scars-fibrosis (help scaring process, anti-pain, anti-
infectious, etc. . .) Some effects against hypertrophic or keloides
scars; for any surgery taking off major lymph nodes (post-mastec-
tomy, post-prostatectomy, post-hysterectomy, post-ovariectomy,
post-nephrectomy, ORL surgery, tumor removal. . .); post-plebitis
and post thrombotic surgery; post-trauma surgery; limb amputa-
tion; prosthetic surgery; skin transplant; burns; oral surgery, face
surgery, face-lifting, ear lifting. . .; vein stripping
Veterinarian
Lymph drainage can also be applied to animals.