IN ALL CASES REFER THE PATIENT TO A MEDICAL DOCTOR OR SPECIALIST AND OBTAIN AN OPINION OF WHETHER THE LUMP IS LIKELY TO BE BENIGN OR MALIGNANT. IN PARTICULAR REFER SMALL LUMPS WITHOUT TREATMENT WHERE THERE APPEARS TO BE SWELLING AND NO PAIN.

The lecture commenced thus.. In this passage we look at the protocols and purpose of specialist lymphatic drainage and its use in especially Chi Kung Massage as practiced at the Chi Clinic as well as several other arts.

Firstly we refer to the work ‘Lymphatic drainage of the skin and breast’ written by Uren, Thompson and Howman Giles (1999) as a detailed study of the recent finding in the oncology of the skin and deep tissue of the breast. It appears to be the absolute authority of all the lymph drainage vessels, sentinel nodes and mapping methods.

This is a specialised and detailed book, not commonly referred to outside of specialist clinics. Chapter seven is specific in its findings of the absolute need to drain the mammary ducts by way of the deep lymphatics as separately and quite distinct from the commonly appreciated superficial tissue. The two systems are distinct and show the superficial as draining to the axilla with the deep routes emanating in the subareolar plexus in the medial and lateral aspects. Further, it mentions that the examination of cadavers shows the existence of sub mammary interpectoral nodes. These are well known and extend the whole of each rib

The book fairly acknowledges that some of the research was done on infant cadavers and in the adult breast, some of the ducts disappear. This is a useful work to complement the works of Tortora and Grabowski in the definitions of lymphatic flow.

In his book ‘Zen Shiatsu’, Shizutzo Masunaga describes on pages 89 and 94 the actual application of firm pressure to the breast in order to release toxins. In a later chapter, on p166 he describes the shiatsu of the breast in the case of post natal lactation difficulty. He also describes the older practices of massaging the breast before and after birth to prevent such difficulty. This book is well worth reading for its practical and no-nonsense approach to the well being of the patient.

It is easy to see in this work that the role of the practitioner is to develop and enhance the general well being of the patient by holistic methods and practices.

Dr Yang, Jwing Ming has written some 27 works over the course of many years, from about 1980 to 1989. He is a master of Shaolin White Crane Kung Fu, Wushu and has a masters in engineering, has taught at the Purdue University and the University of Boston. He is widely considered to be authoritative, despite his modest approach. In his book ‘Chinese Qigong massage’ he looks at the flow of chi and stagnation caused by accumulation of fat deposits.

I have read this book many times and others in this series. It is clear that what he does in the context of his clinic is one thing and that the methods should be adapted to the culture and the wish of the patient. Those who are not shy or concerned with social impropriety will get a far better massage than those who are likely to be conservative.

I now refer to the works of Tortora and Grabowski (Second edition). On pages 999-1001 of the 9th edition is a useful overview of the construction of the breast. On page 741 is a good diagram of the internal interstitial nodes of the thorax. On page 738 is schematic of the general lymph ducts of the body but the detail is lacking. However, it does show the absence of medial lymph nodes in the upper medial quadrant. This is in line with the findings of the first book studied above. It does show the adipose fat layers, the superficial layers of the endermis and the location of the lactiferous ducts.

For a better and more detailed view, we turn to Gray’s Anatomy. However, this is purely anatomical and does not profess to look deeply at the physiology or organ function.

As to the breast itself, we find it to be quite simply, an over developed sweat gland that is present in both male and female, requiring stimulus to develop into a mammary gland. It is composed in the female of adipose tissue, fats and is suspended by the Coopers ligament with no muscle to assist it.

In almost all cases of impending menstruation, at a point that is usually 4 days post ovulation, the breast start to swell. They become in many cases, extremely painful and uncomfortable. One usually swells more than the other and the fluid cannot escape due to the restrictions imposed by artificial means, in particular the common use of under-wired bras.

In many cases that present at the clinic, the mammaria might be likened to a bag of marbles hanging from the shoulders. The patient concerned is sometimes suffering from PMT, may be absolutely fearful of cancerous lumps, probably does not feel well and often feels that the prominence of her breasts is attracting unwanted attention. To relieve these symptoms is the singular reason why these methods of breast massage and lymphatic drainage were developed. The practice was common in the years before 1970 and I was introduced to the methods by midwives with whom I was associated whilst I was learning massage methods.

At this clinic, we often see women who are newly pregnant and suffering from morning sickness. In extreme cases, the Western medicine approach can be to artificially abort the fetus. This demonstrates a vast lack of knowledge and a total deficiency of diagnosis or comprehension of treatments available.

For example, I had a woman present in her early thirties with appalling morning sickness and had been told by the consultants that if it did not abate within a few days she must have a termination. She was distraught and anxious but had been recommended here by a friend whom I had also treated for this same condition.

The condition is quite simply that the liver and kidney are overloaded with toxins from the placental toxins and the stomach reacts badly due to the increased level of acidity. The remedy is to apply reflexology to the feet at K1, liver tsubo points on the spine, K24-26 on the chest, St points on the face and chest and then massage the breast to remove the excess lymph where it tends to stagnate.

She immediately felt much better and said so at the time, her colour returned and she drank water. The release of toxins was such that she was able to eat and the following morning there was only the slightest of nausea. It was then that she told me that she was a gynaecological nurse in a local hospital, working on the maternity wards and sent no less than 6 of her friends and pregnant mums to see me. All carried full term.

In every case of my patients becoming pregnant, I continue with full body massages all through the pregnancy. None of them has ever suffered with lower leg oedema or breast pain and all have carried well. They are active to the point of giving birth. Over the last 5 years I have helped about 20 mothers in this way.

One girl in her thirties had two children already and became pregnant with the third. She had regular monthly treatment with me. She came to the martial arts class on a Sunday, had a treatment on the Tuesday and gave birth on the Wednesday of the same week.

During the course of the last 40 years I have worked on over 5,000 individuals most of whom were women. If you are in any doubt as to the nature of the lump, refer for an opinion. Over 90% of those referred are non malignant and a needle biopsy confirms. Mostly these are fats and excess fluids.

In certain cases, and this does happen several times during the course of the year, I teach the woman’s partner or husband to do a limited amount of breast massage and how to relieve the oedema when it is too painful. In every case, the woman has come back to say that it has helped but, it is not the same as when I do it. It is useful if they are going on holiday when the period is due or where the couple is not of sufficient means to afford treatment on a regular basis. Otherwise, the woman is taught self massage but this is very difficult to achieve. One cannot do this at all effectively and it is facile to suggest that this is an alternative to be preferred. Only a man would think to suggest it, not one who has suffered this painful condition and tried it.

Currently, I have over 1,500 patients /  clients and perform about 800-1000 full body massages each year of which 90% of the treatments for females include breast drainage as a usual practice. The practice has wide spread approval among the female clients and many are referred here from local hospitals, western clinics and doctors for the treatment.

Virtually all the clientele is by referral and all clients are made fully aware of the treatments before they are asked to sign a consent form.  It is not compulsory to have any treatment if you do not wish it.  You may ask for a chaperone or for your partner to be present in the room during treatment.

Now let us look at the anatomical precepts that necessitate the touching of the breast during a massage where the lymphatic drainage is not required to the breast tissue. One may also refer to Atlas of Skeletal Muscles by R. J and J Stone c1994, if you can find one now. It is an easy read and quite descriptive.

For an absolute detailed look at these muscles I refer to Travell and Simons, trigger point therapy and Myofascial Pain and Dysfunction. This is the massive work that was completed in 1947 by two of the most prominent practitioners and founders of the now widely adopted clinical application of Trigger Point therapy. It is peculiar that it is commonplace everywhere except in Britain. Of all of my students that come from the fields of medicine and physiotherapy, those that have come from South Africa and New Zealand have studied it. They are now working in hospital environments in London and elsewhere.

I am often dismayed at the total lack of knowledge exhibited by many of those trained in so called Swedish Massage and the protocols of Sports Therapy. The massages that are offered are no more than a quick and very superficial massage of the top layers of skin which is done in the concept of a ‘Health Club’ or massage outlet where the emphasis is on getting as many through the door as possible in the quickest possible time. In my opinion, few are able to offer substantive treatment with a good diagnosis and care of the patient. In fact they positively avoid any condition that may require diagnosis.

To return to the point of examination, all of these above listed muscles are indicated in conditions of stress as well as those of the posterior thoracic regions. They are indicated in conditions of frozen shoulder, restriction of movement of any kind and all require trigger point therapy, acupressure and especially, massage. All carry lymph ducts and channels essential to the function of the muscles and the promotion of movement of interstitial fluids by muscle action.

The pectoralis is especially indicated in those who push wheel chairs, buggies, hold the arms out during work on a computer or driving. It is critical to the well being and posture of the whole thorax and in indicated in the support of the spinal column.

It is absolutely not possible to apply the necessary massage and stretching methods to the muscle without touching the breast. Equally, it is literally impossible to repair damage muscle tissue with the bra in position. There are ways of doing this without cupping the breast but that depends on the individual. There is no way of describing this in words. My students are taught how to do it during the massage classes.

It must be remembered that when you are taught by me, at this clinic you are in a unique situation and that may not be replicated in your own practice.

Moving on now to discuss the general efficacy of a full body massage with lymphatic drainage in the context of Chi Kung massage and sports therapy as administered at my clinic.

The client is made to feel special. The condition is diagnosed very intensively with often, 45 minutes interview prior to treatment. The diagnosis continues throughout the treatment and all subsequent treatments. The first is to establish the patient’s reaction to the massage, the requirement of the client as to modesty and decorum to be observed. Each latter treatment is deeper and more intense as the client gets used to the methods and feels more relaxed.

In the treatment of ME this method is unsurpassed and we have a success rate of 95%. The breast holds toxins and viable virus in stagnant fat cells. Read my paper on ME. It is absolutely critical to drain the fatty breast tissue if you are to remove the toxins from the body. The incidence of ME is over 100 to 1 female and the reason is in the way men store fats around the internal organs and females around the extremities and superficial fat layers.

The effects of these treatments are often unexpected with incredible reports coming back to us of a complete change of lifestyle, attitudes and relaxation. Many who come here for treatment continue as students in the martial arts for their fitness and rehabilitation.

Many who come here, both male and female have been extensively, systematically and without pity the subject of sexual and mental abuse. Many have taken the offender to court and been through the whole gambit of emotional drama. They come here to experience body contact in a trusted situation from one who understands and has sympathy with them. This is almost unique and I am not aware of any other clinic where this happens with such regularity or where the practitioners have such a reputation for this work. There seemed to be many more of us 20 years ago than there are now. Counselling is invariably long winded and I have heard many say that it is unsuccessful.

The ones who come here after such methods tell me of their experiences and the failure to help the condition in any way at all. The fact that someone does not go back is not an indication that they are cured. There is a great stigma attached to such methods.

Many have said that it has helped to get them off a register where they may be seen as a depressive and in need of drugs. By the employment of the methods used at this clinic, they are able to return to some sort of normality in a relatively short period of time. This is how they learn to get their life back and to appreciate that they can trust again. It is often seen as a much more practical approach to the problem and throughout the course of treatment, the patient is always in charge of the progress. This empowerment is critical to the recovery of self confidence and the conduct of the treatment is one of absolute trust with no concept of any sexual intent.

I teach you to listen without comment. I teach you to never judge or criticise. I teach you never to take on board anybody else’s problems. I teach you how to deal with such cases and many of you will go on to train as counsellors, care persons, therapists and mentors.

Those of you who have read my papers on the treatment of vaginismus will appreciate well that the words used, the atmosphere of the clinic itself, the presentation and approach is critical to success in these fields. I do not intend to expand here upon the methods used; that is the subject of another class altogether, for those who specialize in the field.

Remember also that I am one of a very few Western men allowed to work with those of the Muslim faith, both men and women. To get that permission is indicative of the acceptance of the methods used here at this clinic and our approach to all religions and the respect and protocols to be observed. Likewise, I work with those of the Sikh faith and Hindu, Buddhist and Christian alike, having respect for all requirements of religion and persuasion. That you must also learn and for that you will be taught especially as part of another class, by those invited from each religion or persuasion to elucidate wherever possible.

There are many sites that one can visit on the net but few that show any sign of common sense to the subject. There are some good sites, see the attached examples, and they are not utilizing the methods set out by Mr Vodder in America some 40 years ago but the methods used in Italy, Germany and South Africa in particular and written of in works now translated. One of these, and a worthwhile read is ‘’Phlebolymphodoema’ by Cavezzi and Michelini and this is available by way of the internet sales, shown on the extracts. Also look to the College of Physicians and Surgeons for guidelines as to breast examination. There are so many ways of doing this and so few are as effective as the methods that you will learn here.

Never excuse these treatments or try to explain them. It is futile to try to get anyone who has not experienced them to understand. The facts speak for themselves.

Whilst I have attached some examples for consideration, you should do your own research and form your own views as to what procedures you are happy to perform, how you elicit the attitude of the patient, how you explain the reasons before proceeding and how to establish the air of absolute trust necessary for the treatment to begin.

IN ALL CASES REFER THE PATIENT TO A MEDICAL DOCTOR OR SPECIALIST AND OBTAIN AN OPINION OF WHETHER THE LUMP IS LIKELY TO BE BENIGN OR MALIGNANT. IN PARTICULAR REFER SMALL LUMPS WITHOUT TREATMENT WHERE THERE APPEARS TO BE SWELLING AND NO PAIN.

Post script...The lymphatic drainage methods have been found to be particularly effective in the relief of post operative cancer where sections of skin have been taken to replace in other areas or where deep lymphatics have been removed and odema results.  In some cases we have found the lymph ducts have enlarged in adjacent areas to cope with the additional load.  This is possible only  by the creation of ''need'' by application of hydraulic pressure and the body responding positively.  The recovery rate has proven to be quite amazing.  

Clearly, no-one can be cured or put back to how they were before the operation. This merely provides a coping regime where the patient is empowered to help themselves. T