Following the teachings of A. T. Still, Frederic P. Millard, DO, began his research into the lymphatic system in the early years of the 20th century.
52 Through the 1940s, he published numerous articles related to pathologic processes in the lymphatic system.
52-63 Dr Millard also founded the International Lymphatic Research Society in Kirksville, Mo, and served as the society's president. In 1922, he published
Applied Anatomy of the Lymphatics,54 the first osteopathic medical book examining only the lymphatic system (
Figures 3 and
4).
In an article published in 1920 titled “New method of diagnosing various diseases by palpating lymphatic glands,”
53 Dr Millard described major points of lymph node palpation for specific clinical diagnostics based on lymphatic, osseous, fascial, and nerve lesional findings. His recommended treatments typically took 5 to 10 minutes to complete.
53
Dr Millard explained, “We want to assist the student by demonstrating that in any pathological condition there is invariably a relative lymphatic disturbance, and try to show how adjustment will assist the body in clearing up the retardation or obstruction.”
55 In 1923, Dr Millard wrote, “The time will come... when every organic disease will be considered in association with lymphatic blockage.”
60
In 1929, William Otis Galbreath, DO, developed a simple lymphatic technique using mandibular manipulation in a pumping fashion to help open and close the eustachian tube, thereby allowing “the ear to drain accumulated fluid more effectively.”
64 Promising research has recently supported the efficacy of the Galbreath technique in treating children for otitis media.
64,65
Frank D. Chapman, DO, and his wife, Ada Hinckley Chapman, DO—both graduates of ASO—made important contributions to research on the lymphatics during the 1930s. In 1937, Dr Ada Hinckley Chapman and Charles Owens, DO, wrote the book
An Endocrine Interpretation of Chapman's Reflex, which described a system of reflex points first used by Dr Frank Chapman.
66 Drs Chapman and Owens described these reflex points as predictable fascial tissue abnormalities that reflect visceral dysfunction or pathology. In the book's introduction, Dr Frank Chapman explained, “It seemed to me that the lymphatic system had much more profound influence on bodily functions than it had been given credit for.”
66 He added, “my special plea is on behalf of the lymphatic aspects of disease, which I regard of paramount importance whether they originated in bony lesions, infections, toxins, or other cause.”
66
In the foreword to the Chapman and Owens book, Fred Mitchell, Sr, DO, noted that the reflex points were “clinically useful in three principle ways: (1) for diagnosis; (2) for influencing the motion of fluids, mostly lymph; and (3) for influencing visceral function.”
66 He also explained that the surface changes of Chapman's reflex can be found in the deep fascia as “gangliform contractions” located at specific points of the body and related to fixed organs.
66 Unfortunately, to this day, biopsies of the identified areas have not correlated with the specific pathologic changes associated with Chapman's reflex points.
67
Another graduate of ASO, William Garner Sutherland, DO,
68,69,70 became most famous over the course of his long career for his cranial concept, which was based on his belief that the bony cranium was capable of motion.
68 Although Dr Sutherland focused mainly on cerebrospinal fluid in his research, he also developed some original OM techniques for the lymphatic system. For example, Dr Sutherland's views on the possible effect on the lymphatics of his soft tissue/fascia techniques were described by H.A. Lippincott, DO,
69 “The fasciae envelop, separate, protect, and support the various structures. Not the least important of their functions is to encourage and direct the movement of tissue fluids and to promote the flow of lymph through its channels.”
In one of the many lectures he delivered during the 1940s and 1950s, Dr Sutherland
70 described the following lymphatic technique:
Another osteopathic physician who pursued greater understanding of lymphatic treatments was Gordon J. Zink, DO,
71 professor at the Des Moines University, College of Osteopathic Medicine and Surgery in Iowa. Dr Zink, who was affectionately nicknamed “the lymphomaniac,” developed lymphatic techniques to increase diaphragmatic motion and stimulate reflex on the lymphatic system. He also promoted direct “milking” techniques for the lymphatics. He suggested, for example, the use of pectoral traction, applied approximately twice a day for 3 to 5 minutes at a time, rather than lymphatic pumps, which he noted were beneficial but are “also time-consuming and have to be repeated frequently.”
71