Lymph

“ In lymph vessels the cancer cells may merely accumulate so as to fill the lumen and form indurated cords, or they may proliferate and give rise to secondary nodules along the course of the vessels. When the lymphatic network in the skin is diffusely infected, the appearance is either that of a multitude of secondary nodules or of a diffuse thickening, so that the skin comes to resemble coarse leather. ”

“ In nearly every tissue and organ of the body there is a marvelous network of vessels, called the lymphatics. These are busily at work taking up and making over waste fluids or surplus materials derived from the blood and tissues generally. The lymphatics seem to spring from the parts in which they are found, like the rootlets of a plant in the soil. They carry a turbid, slightly yellowish fluid, called lymph, very much like blood without the red corpuscles. The lymph is carried to the lymphatic glands where it undergoes certain changes to fit it for entering the blood. ”

“ This thickening or condensation is the [52] result of what we call effusion of coagulable lymph. It will be rather difficult to explain the process; but lymph is that fluid understood to be the nutritious portion of our sustenance or system, and which is here yielded up by the vessels which absorb it, and which vessels abound, with few exceptions, in every tissue of our body. However, it will suffice to say, that where inflammation takes place, there is an alteration of structure, and that alteration is generally an increase. ”

“ There are two sets of absorbent vessels—the lacteals, which convey the chyle from the alimentary canal to the thoracic duct; and the lymphatics, which take up the lymph from all the other parts of the body and return it into the venous system. There is a right lymphatic duct, about a quarter to a half inch in length, which receives the lymph from the absorbents of the right upper limb, the right side of the head and neck, the right side of the chest, the right lung and the right half of the heart, and the upper surface of the liver. ”

“ To sum up in a few words the present state of our knowledge as to lymph formation we may say that the exchange of water and salts between the blood and the tissues is probably entirely determined by processes of filtration and osmosis. Further, that the physical condition of the capillary cells is frequently altered by many chemical substances, and that in consequence it may permit exudation into the tissue spaces much more freely. In the next place, the flow of lymph from a tissue is not solely determined by the amount of the tissue fluids. ”

“ IT is proved, by a multitude of experiments, that the lymphatics communicate with the blood-vessels. They may be distended by blowing air, or by injecting water or mercury, into an artery: and the lymph, which they carry, is frequently, in a morbid state, found tinged with a mixture of the red globules or crassamentum of the blood. ”

“ Along their course the lymphatics frequently pass through glands,—hard, pinkish bodies of all sizes, from that of a hemp seed to an almond. These glands are often enlarged by disease, and then are easily felt.
The Lymph, which circulates through the lymphatics like blood through the veins, is a thin, colorless liquid, very like the serum. This fluid, probably in great measure an overflow from the blood vessels, is gathered up by the lymphatics, undergoes in the glands some process of preparation not well understood, and is then returned to the circulation. ”

“ In inflammations of a high type, in those occurring on the skin or mucous membranes in which there is an extraordinary increase of nuclei and embryonal cells, and in lymph thrown out in excess at one point, so that its central parts are far from vascular tissue and nourishment, the cell elements undergo a rapid increase and degradation into pus-corpuscles, and its solidified intercellular lymph undergoes granular decay and liquefaction into pus. ”

“ For ourselves, we have scarcely any doubt that the lymph system plays an important part in metabolism, along the lines we have indicated. Sometimes substances are reduced and converted into harmonious material; sometimes products of a definite type are built up. The lymph is, as we have pointed out before, to be considered as a sort of buffer between the cells of the blood and those of the body ”

“ Under the influence of the muscular system comes not only the blood but the lymph. The lymphatics form a subsidiary system of small valved vessels, and drain the tissues of the excess of lymph, which transudes from the capillaries of the organs during functional activity, or in consequence of venous obstruction. The larger lymphatics open into the veins at the root of the neck. It is chiefly by the compressive action of the skeletal and visceral muscles, and the aspirating action of the respiratory pump, that the lymph is propelled onwards. ”

“ The lymph collected from a lymphatic before it has passed through a lymph gland contains a few leucocytes, and though the number of lymphocytes is greater in the lymph after it has flowed through a gland it is never very great. ”

“ The study of their development shows that they grow into the tissue as a closed system of minute tubes, which indicates that in all probability they remain permanently closed. If we trace the lymphatic vessels towards the thorax we find that in some part of their course they terminate in structures known as lymphatic glands. From these again fresh lymphatic vessels arise which carry the fluid towards the main lymph-vessel, the thoracic duct. ”

“ All the ordinary movements of our bodies are economically pressed by Nature into the service of the lymph-flow. As in the veins, the valves of the lymphatics prevent backward movement, and as in the veins the muscles compress the vessels, and common movement thus assists a special end. Even the motions of breathing favor the return of the lymph. For, when we inspire, the pressure in the great veins becomes negative in character, and lymph is thus capable of being sucked into the circulation from the main tube or duct of the lymph-system. ”

“ In continuing his observations Heidenhain next studied the results following the injection of a number of substances into the blood. He found many which on injection gave rise to an increased lymph-flow from the thoracic duct, and arranged them in two classes. As instances of lymphogogues of the first class we may mention extract of mussels, leech extract, peptone, extract of crayfish muscle, extract of strawberries, of raspberries and many other like substances. ”

“ A distinguished pathologist at Vienna, Professor Paltauf, who was the coroner's physician of the city and had a large number of these sudden deaths to investigate, found that in most of the cases one abnormal condition was constantly present. This consisted in an enlargement of the lymph glands all over the body. The lymph glands in the neck were involved, also the tonsils and lymphoid tissue at the back of the throat, the series of lymph glands in the groin, and, finally, there was a hypertrophy of the lymphoid tissue that occurs all along the intestinal tract. ”

“ If an animal is at rest, no lymph flows from the hind limbs. To obtain a sample of limb lymph it is necessary to massage the limb. If, however, the veins to the limb be ligatured, we obtain a flow of lymph. The ligature of course causes a rise of the capillary pressure, and it has been argued that this rise of pressure starts a filtration through the capillary wall and hence a flow of lymph. But the stoppage of the blood-flow also damages the capillary wall and tissue cells by asphyxiation, and the resulting lymph-flow is in all probability the resultant of many complex processes. ”

“ Hence, too, the more abundant exudations of lymph, the centres of which are farthest removed from the healthy tissues and from nourishment, are the most prone to suppuration. That the germs can make their way to such deep-seated exudations in the substance of solid tissues is to be accounted for by their gradual advance through the inflamed and weakened structures from the adjacent skin or mucous membrane, or in some instances by 55reason of their presence in small numbers in the blood. ”

“ Lymphogen contains all the organic minerals in the same proportion in which they are contained in perfect lymph, and if taken as directed, will always restore the lymphatic system and allow it to perform its important function. ”

“ Their structure is the same; the membrane of which they are formed, their valves, the lymph which they contain, the glands thro' which they pass, their direction from smaller tubes to larger, and from these to the blood, differ in nothing from what we observe of the other lymphatics. Their lymph, in the mean time, is without doubt or controversy supplied from the cavity of the intestines ”

“ Most people who are not critically ill need to walk at least 200 yards twice a day, with assistance if necessary, if only to move the lymph through the system. The lymphatic system is a network of ducts and nodes which are distributed throughout the body, with high concentrations of nodes in the neck, chest, arm pits, and groin. ”

“ We also know that many of the bodies of this class act upon the liver in other directions than in exciting an increased lymph production. Thus they may cause an increase in bile secretion, or, as in the case of peptone, the liver cells may be excited to produce a new chemical material, in this instance an antithrombin.
We have now to consider the effect of throwing an organ into activity upon the lymph-flow from the organ. In all cases in which it has been examined it is found that increased activity is accompanied by increased lymph-flow. ”

“ But when I come to examine the distribution of the lymphatics in the different situations in which elephantiasis occurs, I find a difficulty, from a mechanical point of view alone, of explaining how the obstruction which is necessary to produce a complete lymph stasis can occur. Looking again at the illustration of the superficial lymphatics of the leg, at what point in the limb can a single worm be situated so that the lymph-stream would carry the ova so as to obstruct the whole of the superficial inguinal glands? ”

“ Lymph nodes are also a part of our immune system and produce white blood cells to help control invading organisms. When the lymph is overloaded with waste products the ducts and nodes swell, and until the source of the local irritation is removed, are incapable of handling further debris. If left in this condition for years they become so hard they feel like rocks under the skin. Lumps in the armpits or the groin are prime sites for the future development of a cancer. Fasting, massage, and poultices will often soften overloaded lymph nodes and coax them back into operation. ”

“ The glands act as filters, arresting not only inert substances, such as blood pigment circulating in the lymph, but also living elements, such as cancer cells or bacteria. As it passes through a gland the lymph is brought into intimate contact with the leucocytes, and in bacterial infections there is always a struggle between the organisms and the leucocytes, so that the glands may be looked upon as an important line of defence, retarding or preventing the passage of bacteria and their products into the general circulation. ”

“ Termination of inflammation.—Like congestion, inflammation may terminate by resolution. In this case the exuded lymph undergoes chemical change, and the products are absorbed and carried off by the blood vessels and lymphatics, to be thrown out of the body by the kidneys, liver, the glands of the skin, and the other excretory organs. The cells, which have wandered into the neighboring tissues from the blood vessels, gradually disappear or become transformed into fixed cells. Those which are the result of the tissue cells, wakened into active life, follow the same course. ”

“ In the lymph-glands, the Malpighian bodies of the spleen, in the thymus, or the adenoid tissue of the tonsil, of the lymph-elements in the intestines and other regions, colorless cells are constantly being manufactured, and the general belief has been since Hewson's time that the red corpuscles develop in some way or other from these leucocytes. ”

“ The lymphatics far exceed the veins in number and perform a function similar to the veins, gathering waste material from the tissues, also the digested food called chyle, from the stomach and intestines. The lymphatic vessels, also the lacteals which absorb the chyle, all pass through glands, which are extremely numerous, where certain deleterious substances are extracted from the lymph before it is emptied into the blood stream. ”

“ But the lymph and the blood, everything considered, can hardly be looked upon as two separate and distinct liquids. Not only do they supplement each other in their work and possess striking similarities, but each is made in its movements to pass into the vessels occupied by the other, so that they are constantly mixing and mingling. For these and other reasons, they are more properly regarded as two divisions of a single liquid—one which, by adapting itself to different purposes,27 supplies all the conditions of a nutrient fluid for the cells. ”

“ But in some instances, when no lymph is previously effused, and no cyst is formed, the matter is not confined, but pervades the cellular substance extensively, and is generally followed by more or less sloughing of that tissue, and by great constitutional disturbance. This most frequently occurs in patients of a debilitated habit, in whom the incited action has been so slight as not to cause the effusion of lymph, by which nature usually sets bounds to the suppurating process. ”