When looking at the concepts of accumulation and gathering and edema mentioned in Donguibogam from the perspective of modern medicine, you can see that they are very closely connected to the condition called lymphedema. In our body, there is a circulatory system called the lymphatic system that is just as important as the blood circulatory system. The lymphatic system consists of lymphatic vessels spread throughout the body like a net, lymph nodes, and lymph. Put simply, if blood is a highway transporting oxygen and nutrients, the lymphatic system can be called a drainage system and immune surveillance system that collects and processes unnecessary protein, waste, bacteria, and viruses pooling between cells.
What happens if this lymphatic system does not function properly? Just like drainage backing up when a city's pipes are clogged, lymph excessively accumulates between the cells of our body. This is precisely lymphedema. Because it is not merely water pooling, but protein-rich lymph, the skin can gradually harden, undergo fibrosis, and induce a chronic inflammation response. In addition to swollen limbs, it can be accompanied by diverse symptoms including heavy, aching pain, skin discoloration, and an increased risk of infection due to decreased immunity.
The causes of lymphedema can be broadly divided into two types. The first is primary lymphedema, which occurs when there is an anomaly in the lymphatic system from birth, arising when the development of lymphatic vessels or lymph nodes is insufficient or functionally problematic. The second is secondary lymphedema, which occurs when lymph nodes are removed during cancer surgery, when lymphatic vessels are damaged by radiotherapy, or when the normal flow of the lymphatic system is obstructed by infection, trauma, deep vein thrombosis, and similar conditions. In particular, cases where arms or legs swell following surgery for breast cancer or uterine cancer are classic examples of secondary lymphedema.
While modern medicine has clearly elucidated the mechanisms of this lymphedema, it shares much in common with the concept of accumulation and gathering in Donguibogam. While Donguibogam spoke of stagnation of dampness-phlegm caused by spleen-stomach deficiency, modern medicine speaks of the accumulation of lymph caused by damage or hypofunction of the lymphatic system. Both share an essential insight in that they are phenomena appearing when problems arise in the flow and excretion of internal bodily waste. Although lymphedema is a chronic disease that must be approached through management rather than a complete cure once it occurs, early detection and appropriate management can alleviate symptoms and significantly improve quality of life.
