Dr. Ralf Oettmeier, Alpstein Clinic AG, Gais, Switzerland, www.alpstein-clinic.ch
Although its importance and presence, our lymphatic system is neglected by conventional medicine. It not only forms the drainage and evacuation system, but together with the immune cells and primary and secondary lymphatic organs it is the main carrier of our immunocompetence. In the context of milieu medicine, the understanding of lymphatic disease is of great practical relevance. After targeted diagnostics, it is important to develop an individualized treatment that paves the way for the organism's ability to regulate and heal itself.
The main components of our lymphatic system
The Latin word "lympha" means "clear water" and describes the plasma-like appearance of the lymph fluid. The protein content is between 1-5% depending on the region. Around 2 liters of new lymph are formed every day. About 25% of our body water is in the lymph. Figure 1 shows the main components of the lymphatic system.
Figure 1: Main components of the lymphatic system
1. Webinar as part of the SANUM conference 2020
The lymph accumulates within the periphery of the organs and tissue in very permeable lymph capillaries, which are approximately 100 µm in diameter and have a wall thickness of only 0.1 µm. These flow into so-called lymph collectors, which are thicker and, similar to the leg veins, also have valves. In the abdominal cavity, the lymph is collected in the cisterna chyli and then flows upwards over large lymphatic trunks (ducts) to finally open into the large vena cava behind the collarbones. Thus there is a direct integration of the lymph into the blood vessel system. The cycle is open and thus also transports a large amount of metabolic products that have to be excreted into the blood (which we can possibly see in vital blood microscopy).
Figure 2: Reticulated interaction of the lymph capillaries (Source: lumenlearning.com)
While the flow in the large lymphatic vessels is transported to the center by the suction effect of the large vena cava, in the periphery, this depends on the build-up of colloid osmotic pressure. This flow depends crucially on the supply of electrolytes and protein. For example, if there is a lack of protein, the absorption of lymph becomes slow, which can lead to massive edema.
Between 600 and 700 lymph nodes with a size of 2 to 20 mm are placed between the lymphatic channels. They form the home and maturation site of the lymph cells and are particularly concentrated on the trunk of the body. The most important lymph nodes that are accessible for an examination are located on the side of the neck and above the collarbones (= upper lymphatic belt), in the armpits and in the inguinal region (= lower lymphatic belt).
Figure 3: Structure and histology of a lymph node (Source: lumenlearning.com)
The most important lymph cells are those of the B and T series. The B lymphocytes are the main component of the adaptive immune system and, as activated plasma cells, produce various types of antibodies. These immunoglobulins are the product of an antigen-antibody reaction against foreign particles and pathogens of all kinds. The germinal centers of the B cells are lymph nodes, spleen and intestinal wall. 15% of the immunoglobulins (Ig) produced are of type A and are located on the surface of the mucous membrane (IgA). In fresh infections, IgM appear after 1-2 weeks, which disappear again after an average of 6 weeks and are replaced by IgG, which represent about 75% of the serum antibodies, beginning with the third week after a new infection. Immunoglobulins are used in serological diagnosis of pathogens. The term "T-lymphocyte" refers to the thymus as its center of maturation. These immune cells organize the cell-mediated or cellular immune defense and have a number of subgroups. In the laboratory test "lymphocyte subpopulation determination", for example, one can differentiate into T helper cells, T regulator cells (formerly suppressor cells), natural killer cells (NK cells) or cytotoxic T cells. All processes are controlled by immunological messenger substances, so-called lymphokines or cytokines. The process of a specific immune defense against viruses, parasites, fungi, cancer cells and special bacteria (Borellia, Lues, leprosy) is highly complex and is shown in Figure 4. The macrophages (= phagocytes) play a key role here, absorbing foreign substances, metabolic waste and pathogens, crushing them and then presenting them to the lymph cells as antigens. As with the lymphocytes, the macrophages can have a beneficial (pro-) or inhibitory (anti-) effect on inflammation and tumors, depending on the number of cytokines present.
Figure 4: The defense chain against microbes in detail
The thymus behind the breastbone is the largest in relation to our body size when we are born and then experiences a reduction and increase in fat tissue in the course of life. Nevertheless, it is one of the most important immune organs, as being the maturation center of T lymphocytes and, if weakness develops, it is jointly responsible for all age-related diseases, immune deficiency and cancer (Fig. 5.).
Figure 5: Structure and histology of the thymus (Source: lumenlearning.com)
The spleen is located in the left upper abdomen behind the costal arch and represents an oversized lymph node with a primary filter function (Fig. 6). In other words, the spleen is the quality manager of the blood. Deformed and older blood cells are filtered out and signal substances are released to the bone marrow to stimulate new production. As a result of an accident, one can lose the spleen with severe trauma but still live quite well. But this requires a good lifestyle and constant stimulation of drainage and detoxification. The vital blood in the dark field microscope of splenectomized patients is impressive: one finds a high number of deformed erythrocytes.
Figure 6: Structure and histology of the thymus (Source: lumenlearning.com)
The red bone marrow is a key element of the lymphatic system. The bone marrow and thymus make up the primary lymphoid tissues involved in the production and early selection of lymphocytes.
Secondary lymphatic organs with a high density of lymph cells (so-called follicles) are the tonsils in the mouth and throat, the appendix (the tonsils of the abdomen), the Peyer's plaques of the intestinal mucosa and Copper's star cells in the liver.
The lymph centers of the mucosa-associated lymph tissue (= MALT) play an extremely important role in ensuring a controlled demarcation of the “inside” from the “outside world” and should be emphasized. The following illustration shows in a simplified way the interplay between lymph cells, lymph follicles and lymph capillaries under the intestinal mucosa. The quality of the mucosa, its mucous layer and the bacterial flora above it is of crucial importance in order to prevent inflammation or the permeability of the intestinal mucosa (= leaky gut).
Figure 7: Complex regulation of the immune defense in the intestinal mucosa (Copyright Springer link)
Physiologically, in addition to its drainage and transport function, the lymph is also of great importance as an immune organ and for maintaining natural tissue tension (= tugor). In addition, the lymph, together with the extracellular space, forms the largest landfill for substances subject to excretion (often called "slag").
Diseases of the lymphatic system
The best known is the lymphedema, which is primarily caused by disruption of the lymph flow. This can be provoked by mechanical obstruction of the lymphatic system (e.g. after removal of lymph nodes, as a result of radiation, by parasites), lack of protein (hunger edema) and as a result of injury and inflammation.
An inflammation of the lymph vessels is called lymphangitis. This inflammation of the blood vessels lying under the skin, which is popularly incorrectly referred to as "blood poisoning", often occurs in injuries with wound infection and can form a red line on the extremities. A special form are the erysipelas caused by streptococci, which marks an area of inflamed and painful reddening. In a broader sense, neurodermatitis (in the case of superinfection) and cellulitis are also counted as capillary lymphangitis.
Of course, as reactions in the area of inflammation, lymph nodes can also enlarge and become painful. This is an expression of increased immune reaction and cell proliferation and decreases in parallel with the healing of the inflammation. Especially in the throat and neck area of children, benign lymph node swellings can be found and detected for years. It is important to differentiate the mostly painless, clear lymphomas. These tend to appear in the region of the upper or lower lymphatic belt and can mean Hodgkin's or non-Hodgkin's disease. If these patients are suspected, they should be referred to further haemato-oncological diagnostics. Finally, the number of lymphocytes can also increase pathologically in the sense of leukemia. A distinction is made between acute and chronic as well as B-cell, T-cell leukemia and plasmacytomas. These are noticeable in the hemogram during differentiation and should urgently be clarified hematologically.
We also consider fibromyalgia (= soft tissue rheumatism) to be an ostensibly lymphatic disease. Patients with fibromyalgia subcutaneously show a pathological microcirculation, especially of the lymphatic vessels, show high serological titers of various viruses and often also foods, and are prone to deposits in the intercellular space (1).
Lymph as a reservoir for metabolic waste / "slag dump"
Every day our cells produce metabolic products that are subject to excretion. In addition, there are decay products of cells (e.g. about 1.2 million granulocytes decay per second, preferably in tissue), pathogen fragments and the mostly protein-rich loads from the intestine collected by the lymph. In addition to being transported solely through the lymph, these waste materials are also taken up and broken up by macrophages and granulocytes. The following figure shows this course impressively, observed in vital blood microscopy (Fig. 8).
Figure 8: Amorphous symplast (slag deposition) in fresh blood (left) and surrounded by granulocytes with resorption beginning after 3 hours (right)
Therapeutic interventions for the lymphatic system and its components
Based on holistic diagnostics, there are a number of therapeutic approaches to improve the lymphatic system, immune competence and the lymphatic organs. The most important measures that have proven themselves in practice are:
Correction of milieu deviations in the acid-base balance (after blood gas analysis),
Compensation of oxidative stress with appropriate antioxidants and amino acids,
Dietary change to base-rich, natural untreated food, protein reduction to 1 gram per kilogram of body weight, reduction of sugar, gluten grain and cow's milk (products),
Treatment of interference fields with neural therapy and instruments of biological dentistry,
Elimination and detoxification of toxic weight bearing with metals and / or organic toxins (after prior analysis),
Special injections (i.c., s.c.) into the main points of the upper or lower lymphatic girdle with Procaine and additives such as Lymphomyosotis (HEEL), Selenokehl (SANUM) and Thymokehl (SANUM),
Lymph drainage of the extremities and abdomen in case of visible edema,
Improvement of blood flow after isopathic diagnosis with the classic means according to Prof. Enderlein (Mucokehl, Mucedokehl, Mucor rac. Comp., Nigersan) and the associated organic acids,
For inflammatory swellings and after injuries, proteolytic enzyme therapy (e.g. Wobenzym®, Bromelain, Wobe-Mugos®)
Homeopathic complex remedies for the lymph (Lymphomyosotis (HEEL), Lymphdiaral (Pascoe), Lympholact (Pflüger)),
Intestinal structuring and stimulation of the protective intestinal flora with pre- and probiotics, use of enzyme drinks to stimulate the lactic acid milieu,
Isopathic intestinal structuring with Notakehl, Fortakehl, Mucor rac. Comp (Sankombi), Folliculi lymphatici (Rebas),
Immune modulation with SANUM immune agents (especially Utilin, Utilin S, Recarcin, Bovisan),
In the event of severe exposure to lymphotropic pathogens (EBV, CMV, Toxoplasma), possibly microimmunotherapy and Artemisia annua,
for the spleen:
Homeopathy: Ceanothus, Grindelia, Ranunculus bulb., Spleenimmunosyx
Schüssler salts: No. 2, 4, 7, 9
for the thymus:
Anthoposophy: Thymus / Merc. (Fa. Wala)
Spagyric: Thymus vulgaris comp. (Fa. Spagyros)
SANUM: THYMOKEHL D6 Kps
Holistic physical and manual procedures such as lymph drainage, foot reflex zone treatment, osteopathy, myoreflex treatment, special massages, biomechanical stimulation therapy (BMS),
Whole-body hyperthermia and active fever therapy in the case of proven immunodeficiency and for active prevention in high-risk patients,
Lots of exercise and activity ("If you rest, you rust")
In the case of stubborn edema and a tendency to swell: compression and support stockings, bandaging.
The right options should of course be selected for each patient and milieu regulation and movement should always be included.
ORF S et al: Abnormalities of microcirculation in patients with fibromyalgia (D), Arthritis Res Ther 2005,7
BROWN, D.: Immune System Module 1: Anatomy of the Lymphatic and Immune Systems. (2015) https://cnx.org/contents/XuVQoXkr@1/Immune-System-Module-1-Anatomy-of-the-Lymphatic-and-Immune-Systems
Alpstein Clinic AG,
Dorfplatz 5, CH-9056