Nature's Vascular Back-Up Plan (Part 3)

By Dale G. Alexander , LMT, MA, PhD

Nature's Vascular Back-Up Plan (Part 3)

By Dale G. Alexander , LMT, MA, PhD

The first article in this series described the clinically based assertion that clearing the common bile duct and assisting the flow of bile and pancreatic juices and enzymes down into the small intestine often enhances the upward flow of venous and lymphatic fluids back to the heart/ lung complex. The second article described the application of the hands-on technique(s) recommended to assist this flow into the small intestine.

The Alternate Route

This article will describe nature's back-up plan for when the progression of inflammatory cycles have advanced to the point that the body activates its ancestral memory to direct the venous flow upward into the superior vena cava by an alternate routing. It is a selection by the Autonomic Nervous System (ANS) that I have empirically observed within clients repeatedly for over 25 years.

The body's efficiency to recycle venous blood back to the heart/lung complex so that its raw materials may be used in the production of new blood is a defining characteristic of our existential success as a species. "Fresh blood is the body's most precious healing resource." However, the return of venous blood and lymphatic fluids from below the diaphragm are especially vulnerable to being slowed, restricted, or blocked in their flow upward.

My clinical experience evidences that inflammatory cycles related to the common bile duct, gall bladder, liver, or pancreas commonly disrupt this recycling efficiency. The good news is that human body has evolved a back-up plan.1 The system it employs are the vessels of the azygos, hemi-azygos, and the accessory hemi-azygos venous system. (See Figure 1).

Learning the Vena Cava

I have the deepest gratitude to the client early in my career who declared that she possessed an anomaly of the inferior vena cava such that her body was required to utilize the architecture of the azygos venous system. Researching this system was done the "old fashioned way" before computers and Google; yet, laid the foundation for the understanding that I now share with you. I have been simply lucky to have had waves of clients over the decades who presented with bizarre and stubbornly chronic somatic profiles who eventually were diagnosed with medical ailments associated with the biliary organs, pancreas, and their ducts.

Thus, when your future clients present with chronic somatic dysfunction, please consider palpating and clearing the common bile duct of any congestion, if possible.2  If the client is exceptionally sensitive to this palpation, encouragement to seek a medical evaluation is indicated.


Returning to the azygos system depicted in Figure 1 and let's first set the context for understanding that when the body's vascular back plan is initiated, we don't receive a memo, no blinker light goes on, and no beep occurs. Your body just shifts in its internal function. This is what happens when one's blood pressure rises to a sustained and unhealthy level.

It does so silently.3 The ANS functions largely below the threshold of our consciousness to maintain our capacity for living.4 Second, some estimate that between 60-70 percent of the total blood volume is circulating in our veins. 5-6 The clinical inference here is that shifting from the inferior vena cava to the smaller tubes of the azygous system will extend the time and reduce the rate of flow of venous blood delivery back to the heart through the superior vena cava.

Third, it is important to recognize that the azygous veins already have a job. They are the extension of the lumbar veins and they also drain the thoracic vertebrae and the intercostal walls of the thoracic cavity.

Fourth, congestion of these veins will eventually provoke pain and are often related to subluxations of the thoracic vertebrae and ribs of the thorax. Consider the frequency of clients presenting with right sided pains along their spine from T8 up through T1-2. Far too often this is suggested to be the result of right-handedness and the activities of that same sided shoulder, arm, and hand. Sometimes it is. Repetitive injury syndromes do occur.

However, my consistent clinical experiences propose a different perspective, especially for clients with chronic somatic profiles. This is the same region where venous blood will find its alternate pathway back to the heart. And, now that you have read this article, please consider asking a few simple questions.

Testing for Hep C

Has anyone in your family had gall stones, kidney stones, or been diagnosed with anomalies (variations) of the liver, gall bladder, or pancreas complex? Have you encouraged all of your clients of the Baby Boomer generation to be tested for Hep C? Your clients' responses will guide you toward possibly encouraging them to see a physcian.

When the azygos vessels become engorged with blood, it should be no surprise people have so much back stiffness and pain. The treatment principle here is that when a client is in pain and their tissues are dense and tense, recognize this as a possible indicator of vascular congestion, especially when this density occurs along the spine from T8 and includes the upper right quadrant of their back, where venous drainage into the superior vena cava occurs.

Also please consider how, in the lower venous system, the blood from the low back is becoming congested as well. Remember, the azygos venous return transports the venous blood from the lumbar veins. Until old blood moves out, new blood can't get in to re-nourish aching and injured tissues.

Congestion, as a result of inflammatory cycles within the pancreato-biliary system figure into a host the somatic problems that clients present to you. Restoring the flow of the vascular river back to the heart is what people hire us to do. They don't realize this, yet this article offers you the knowledge of how nature's vascular back-up plan can figure into the perpetuation of chronic somatic dysfunction, including low back dysfunction. Your prosperity will expand as you embrace these ideas.


  1. Azygos vein, Wikipedia; July 2018.
  2. Alexander D. Streching & Clearing the Common Bile Duct. Massage Today, July 2018.
  3. High Blood Pressure, American Heart Association (; August, 2018.
  4. Functions of the Autonomic Nervous System, Lumen Learning (; August 2018.
  5. Biguria JF. Venous Drainage Anatomy. Medscape, Sep 14, 2017.
  6. Jean Pierre Barral DO, developer of Visceral Manipulation. Techniques described were learned from Dr. Jean Pierre Barral DO. The Barral Institute, 1986-1993.