Spring is the season of the Wood element and is characterized by reawakening and outward expansion. It is associated with the Liver and Gallbladder energetic systems, which when balanced are known for Qi that flows smoothly, initiative and good decision-making. Physical associations manifest in the eyes, tendons, ligaments and sinews which are nourished and maintained by the Liver. Just as the expansiveness of Spring can be seen in nature, emotional and physical energies associated with the Liver can be directed outward. Just like a sprout beginning to rise, energy is still fragile and can easily be damaged. Outbursts or projections of excess energy can best be put to good use with activities or projects that can utilize it.
Climactically Spring is associated with wind. The wind which can carry other pathogens also tends to aggravate the wood element. In the body it can cause allergies, itchy skin and pain patterns that tend to move from place to place. Symptoms may present as fever, slight aversion to wind or cold, cough, or mild thirst with burning pain in local areas. Sensitive people should enjoy windy outdoor time in minimal doses.
Injuries may present as:
- Wind: marked by a decrease in range of motion and pain that changes location.
- Heat: local inflammation and/or redness in the joints or extremities, and may be aggravated by heat.
- Damp: fixed and intense pain with a feeling of heaviness, numb skin and muscles that wet conditions may aggravate.
Movement in the Spring
To prevent injuries and improve performance in the Spring, consider the following:
Warm up properly utilizing dynamic stabilization exercises to ensure that postural muscles are activated prior to regular training.
As a stand-alone program or as an adjunct to another endeavor or sport, take advantage of strength training with slower to moderate speed movements. Strength guidelines state using 70%-85% of your estimated 1 repetition maximum, at a moderate to high volume (up to 25 sets when your main activity is weight training), with up to 60 seconds rest between sets. Incorporate this into your program for about four to six weeks to allow ligamentous tissues, which have a poor circulatory system, time to adapt. The nervous system and muscles characteristically adapt more quickly, which is part of the strength continuum but does not take all tissues into consideration. Transitioning into ballistic movements too soon, especially after a lay off due to injury or from sedentary life will predispose a person to further injury. Beginners should spend more of their workout doing stability exercises with a strength component.
As part of a post workout cool down, emphasize static flexibility to bring the body back into a more parasympathetic (normal) state. This will allow tendons to relax and circulation of metabolites in the muscles to move more smoothly.
Proper maintenance such as Tui Na, bodywork, acupuncture and meditative movements assist in recovery from exercise and injuries and boost the immune system.
Spring Time Nutrition
Food that assists in balancing the nature of the Liver and Wood element should nourish, soothe and keep the Liver clean, tonify the Spleen, nourish Yin, & strengthen Yang. Enjoy plenty of young plants, fresh greens, sprouts, and yellow to red veggies nutrient-dense and low in calories. These include tomatoes, loquat, beets, mint, onion, green beans, broccoli, chives and leeks. Flavor meals sparingly with vinaigrettes and pickled foods.
Keep high-calorie, refined, greasy or fried foods, sugars and alcohol that overtax the Liver and Gallbladder to a minimum.
Fasting will over tax the Liver and create more disharmonies in the body. A better way to cleanse the Liver is via sound nutrition, herbs that support Liver function and simply sweating from exercise.
Ju Hua (chrysanthemum) congee: 100g white rice, 50g chrysanthemum.
Soak chrysanthemum separately for 30 minutes. Then combine with rice over heat for 5 minutes. Soothes the Liver and brightens the eyes.
An Chun (‘animal ginseng,’ quail) dish: 100g quail, asparagus 100g, mushrooms 5g, cucumbers 15g, egg whites.
Slice quail and mix with egg whites then sauté. Add asparagus, cucumber & mushrooms later. Sea salt to taste. Nourishes and soothes Liver.
Spring Herbal Considerations
This year has brought much change in the world and continuous perceptions of disharmony which sound nutrition and lifestyle may not relieve quickly. Strong emotions may affect digestion, causing stomach butterflies or bloating, acid regurgitation diarrhea and/or stomach pain. A Chinese formula that has made its way into Western use is called Xiao Yao San or “Free and Easy Wanderer”. This formula profoundly soothes the Liver, thereby reducing the effects of stress on the body and helps prevent digestive symptoms. For those with enteric brains, this is quite a find. (For a thorough diagnosis, consult a Licensed Acupuncturist (L.Ac.)
Climate and physiological change affect the natural tendency of the Liver to spread and grow. By nourishing and maintaining the Wood element, the outward momentum of Spring will segue nicely into the warmer months of Summer.
Read about the coming Summer
Autumn begins at the equinox, where the day and night will seem to be equal in length. During this season harvesting and eliminating can be seen as crops are brought in and leaves change colors and float to the ground. Creatures in nature tend to become more dormant and focused on preserving energy. Yang Qi (warmth, vibrance) goes inward, & Ying Qi (combination of air/ da qi and food qi/ gu qi) starts to grow.
The fall corresponds to the “Metal element,” which has a quality of moving inward and represents the organs of the lungs, the large intestine, and the skin. The Lung and Large Intestine energies affect respiration, digestion, nutrient assimilation, and opening and closing of skin pores. They are also seen as the main organs for cleansing & detoxification. The Lung manifests in the nose and represents an entrance for clean air/ da qi into the body. The Large Intestine is seen as a segway for elimination of unwanted and unnecessary constituents from the body.
The metal elemental energy is associated with processing and grief, letting go of old attachments and emotional baggage. Autumn is a good time to assess what we value and determine what is needed. As we do this we realize who we are without constraints, in effect remaining positive and calm.
The Lungs are strong in the fall, but exercising less than the spring & summer is essential to store yang qi for the winter. This can be optimized by choosing exercises that do not require excessive sweating, focusing more on athletic skills & techniques, and practicing inward-directed movements such as Qi Gong, Tai Qi, Yoga and breathe work. In terms of recovery acupuncture, herbal medicine and tui na (Chinese clinical bodywork), accompanied by the philosophy of going to bed earlier and waking up later applies well in this season.
This is also an excellent time to rejuvenate the lungs and to cleanse and nourish the skin by avoiding extreme dryness.
Potential imbalances can be seen in the immune system/ wei qi, respiratory problems (allergies, shortness of breath & asthma), skin conditions and constipation.
Foods that will help balance the metal element, nourish and protect body fluids/ jin ye, should be warmer, sweeter and slightly sour. But not pungent, acrid or spicy as these can be too dispersing & may cause damage to body fluids.
Here is a general list of foods that can nourish the body during autumn: pears, white fungus, onion, garlic, chive, ginger, turnips, daikon; yellow, orange vegetables like carrots, yams, sweet potatoes; dark leafy greens, such as mustards, kale, chard and spinach; and rice, quinoa, amaranth or oats.
This is an easy recipe that is beneficial to eat at the beginning of autumn or winter:
- 1 pear – peeled, remove seeds
- Fill with 30g Fritillaria bulb/ chuan bei mu (a licensed acupuncturist can provide this)
- Steam 10-15 minutes, cut into 3 equal parts and add local bee honey/ feng mi.
This can also be cut into cubes, added to rice & water to make congee.
As the air becomes cooler and our environments become more still, we can learn from the world around us. Turning towards introspection, and nourishment via breath, food and Oriental Medicine, we can allow an opportunity for conserving strength and a renewal of energies/ Qi.
Irritable Bowel Syndrome (IBS), also known as spastic colitis, is the most frequent gastrointestinal (GI) disorder and accounts of 30 -50% of all referrals to gastroenterologists. In 10-20% of European and American populations it starts in late teens to early twenties occurring more often in women.
IBS is not classified as a disease, but as a syndrome. It is considered a functional GI disorder characterized by a variable combination of chronic and recurrent intestinal symptoms that are not explained by structural or biochemical abnormalities.
Symptoms may occur alone or in combination: abdominal pain or discomfort with altered bowel function; abnormal frequency of bowel movements (BM); typically diarrhea, constipation or both; flatulence, bloating, loss of appetite, nausea, increased mucous production, painful BMs. Cramping, intermittent, lower abdominal pain does not usually occur at night nor interfere with sleep and most symptoms are commonly relieved by defecation.
Additional non-bowel symptoms may include heartburn, chest pain, headaches, fatigue, muscle pain, urologic dysfunction and gynecological symptoms, and often coincide with chronic fatigue syndrome. There is a Mind-Gut interaction where anxiety and/or depression frequently accompany IBS symptoms in varying degrees.
The cause of IBS is not clear. It is felt to be a “dysregulation” of intestinal motor and sensory functions of central nervous system (CNS) origin – thus the psychogenic component. The gut produces 95% of serotonin in the body. If the gut is not functioning optimally this affects mood, thought processes and clarity of mind. There is strong evidence for disruption of balance between non-pathogenic flora and the immune system, while GI infections treated by antibiotics result in a higher chance of acquiring IBS.
Diagnosis follows the Rome III Criteria, which includes abdominal pain for at least three days per month for three months and is characterized by two out of the three following symptoms: pain relieved with a BM; change in frequency of BM; and change in the consistency of BM.
Other causes should be ruled out such as lactose intolerance, drug-induced diarrhea, parasites, food sensitivity (may depend on combination) and food allergies.
Medications include the possible use of tricyclic antidepressants and symptomatic treatment for spasms, constipation and diarrhea. Antibiotics are often improperly prescribed because diarrhea is confused with infection. This leads to other gut problems such as poor gut flora.
Lifestyle: Eliminate offending foods such as common allergens: wheat, dairy, corn and soy. Avoid gas-producing and diarrhea-producing foods: beans, fermentable carbs, sweeteners, hydrogenated fats, brussel sprouts, cabbage, cauliflower, raw onions, grapes, plums, raisins, coffee, garlic, red wine and beer. Increase dietary fiber from non-wheat plant sources for constipation and foods that promote healthy flora in the gut such as beet fiber.
TRADITIONAL CHINESE MEDICINE (TCM) cannot be simplified without losing its essence. It seeks to find and understand the cause. TCM’s advantage in treating functional disease is holism and emphasis on various exterior functional activities of the human body.
TCM can’t live without the Spleen (SP); biomedicine does not consider its importance. In TCM the SP and Stomach (ST) energetic systems are paired. Together they receive food, assimilate it and send it to the rest of the organs and the body to be further processed. The SP ascends energetically while the ST descends. SP dysfunction may result in diarrhea, while ST dysfunction may result in nausea or vomiting.
The Small Intestine (SI) separates pure substances from the un-pure. It has the ability to absorb and distribute nutrients. There are few specific SI syndromes and SI qi deficiency can result in chronic diarrhea. Most SI diseases are referred to as SP problems. The Large Intestine (LI) has the ability to eliminate waste and its dysfunction is constipation.
Causes of IBS in TCM include: irregular diet; emotional stress leading to qi stagnation and affecting the SP and ST; SP deficiency causing anxiety, depression and sleep disturbances; Qi, Blood, Yin or Yang deficiency after chronic disease or after delivery; or overuse of laxatives or purging supplements.
Differentiation follows the basic presentations such as diarrhea-predominant IBS, constipation-predominant IBS with abdominal pain and flatulence, abdominal pain-predominant and alternating between diarrhea and constipation. Subcategories go into further detail and include but are not limited to:
- Excess presenting with abdominal distension and/or pain, red face, scanty and/or red urine, dry smelly mouth; may occur in heavier kids with less BMs due to lack of exercise.
- Deficiency in older patients and weaker constitutions with diminished Yin essence from over-consumption of spicy food and irregular toilet habits. There may be weakness, no power to pass stool, might not be dry, may even be soft; sweaty, pale complexion, shortness of breath and/or fatigue. This is also common in women after giving birth due to blood loss.
- Cold, in chronic conditions and older patients. Stools may not be dry, but difficult to pass or the patient may have no power to pass stool and present with a sallow or pale complexion, cold in the four limbs and lower abdomen and an aversion to cold with clear urine.
Acupuncture and Herbs seek to alleviate symptoms, address the cause and restore balance to the entire person by being highly modifiable based on patient presentation. Some acupuncture points are near areas of discomfort while others are found on distal aspects of the body. Herbs are a way to safely treat the body internally.
Nutritional considerations follow an energetic standpoint that is synonymous with the TCM diagnosis. Foods are recommended that nourish and balance the body without aggravating the gut.
Both Western and Eastern medicine agree it is necessary to address the whole body to alleviate the IBS presentation. After being diagnosed it is imperative that consistent lifestyle changes are made to maintain and prevent reoccurrence of symptoms.
In spring, all creatures take advantage of energy that was stored during the fall and winter months. New growth can be seen moving upward and outward, both emotionally and physically, via the reappearance of plants and animals, as well as our own emerging perspectives on life.
Spring is the season linked to the Wood element, and the Liver and Gall Bladder organ system. The energetic Liver should be soothed, nourished or regulated. Its function according to Oriental Medicine (OM) is to circulate Qi (energy) upward and outward in the body as well as control the other organs. The Wood element is characterized by growth and wind, which tend to be found more often in the spring. Wind can strengthen the Liver, but too much can cause it to overact on the Stomach and Spleen. This can lead to a disharmony that may manifest as stomach upset and/or digestive disturbances, acid regurgitation, and possibly diarrhea. For those that may have overworked themselves the previous season, their immune systems may be compromised.
Spring allergens from grass and trees are blown through the air into our bodies. Theses allergens can affect a person, particularly if they are overstressed by life or emotionally overloaded. This, in turn, will weaken their digestive function and wei qi/immune system. An unbalanced Liver energy may result in mood swings, depression or irritability, and occasional outbursts of emotion.
To assist the Liver Qi to flow, incorporate activities that both enliven and relax the body. Exercise should be calm and fluid. Try breathing exercises, stretching, Qi gong, Tai Qi, light weights, and/or yoga. Joint support is important, as the tendons and ligaments are a manifestation of the Liver energies and is well covered by the aforementioned modalities. Rest and recovery, as for every season, are imperative to good health. In this season, going to bed somewhat later in the evening and waking up earlier are applicable.
Springtime foods should be sweet in flavor to nourish the spleen, with some pungentness (spicy) and warmth to help soothe and regulate the Liver’s functions, such as black sesame, quail or Chinese yams. Include some fresh greens like kale and spinach as well as young plants or sprouts. Foods that help soothe the Liver if it is out of balance include chive, onion, peppermint, beans, sea vegetables, vinegars, lime, & animal liver. Although sour flavored foods are good to have at this time, more is not necessarily better. Foods that clog the Liver, such as processed, sugary foods, excessively fatty and hydrogenated fats, are devoid of life and should be kept to a minimum. Other foods to avoid include salty, cold in temperature, excessive raw foods, or difficult to digest foods, accompanied by a decrease in calories to reduce the load placed on the Liver.
Acupuncture and Tuina should be utilized frequently to boost the immune system, alleviate sinus pressure & headaches associated with allergies, assist in digestion, moderate mood swings, and assist in recovery from exercise.
“In the spring and summer when food is plentiful and humans tend to become lazy and slothful, finger pressure is used to increase digestion, fire and restore vigor.” Qi Bo – Yellow Emperor’s Classic
By incorporating regular self care practices via mindfulness, nutrition, exercise, acupuncture and bodywork, one can best retain and improve their own health during this season of growth.
Read about the coming Summer
In Oriental Medicine (OM) winter is the time to turn inward with meditative thoughts and conserve one’s energy. The winter’s energetic system is found in the Kidneys and manifests physically in the ears, lumbar spine and knees. Positive energy in this season reflects in a calm ability to handle stress with consistent focus and moderate energy throughout the day. Hearing can be more acute in the winter months, but the lower back and knees may experience more discomfort than in other times of the year. Some aspects of the Chinese medicine Kidney energetic can be seen in the biomedical kidney’s water metabolism, adrenal, reproductive and excretory functions . Through self-neglect or from prolonged stressors, people may find themselves anxious, irritable, fatigued and in some ways fearful or insecure. Since the cold slows the flow of blood and warmth to our extremities, activity should maintain continued circulation of the body’s fluids and proper joint relationships, as well as build our resources rather than deplete them.
Beneficial activities include Qi Gong, Tai Chi, low intensity movement or corrective exercises. Pre-workout exercises designed to warm the body up should be done for longer duration than in the hotter times of the year. Outdoor activities should be during the warmer, sunnier parts of the day and kept at a shorter length of time.
The weather can creep into the body and aggravate old injuries, arthritis and other aches and pains. This is especially true for outdoor athletes such as runners, bikers and hikers who spend a lot of time exposed to the elements as well as our aging populations and younger children. Pain patterns manifest in different ways.
- Wind: marked by a decrease in range of motion and pain that changes location.
- Cold: fixed stabbing pain with spasms that does not usually have inflammation, is aggravated by cold and relieved by warmth.
- Damp: fixed and intense pain with a feeling of heaviness, numb skin and muscles that wet conditions may aggravate.
- Heat: not so common in the winter; characterized by local inflammation and/or redness in the joints or extremities, and may be aggravated by heat.
The wind is a carrier of other pathogens such as cold and dampness. Adequate clothing or protection is imperative. The yang parts of the body where most external pathogens enter and cause problems, such as the back and nape, should be covered. Normally our immune system (wei qi) is ample protection but chronic exposure, poor food choices and weaker or overworked constitutions create susceptibility. Enjoy foods that nourish the Kidneys and warm the interior of the body. Choices should include nourishing soups, broths and stocks, moderate spices and congees or porridge.
- Foods that nourish the Kidneys: black beans, grapes, bone broth, eel, quail, walnuts (hu tao ren), black sesame (hei zhi ma), Chinese yam (shan yao), goji berries (gou qi zi), seaweeds: sargassum (hai zao), kelp (kun bu) or other varieties
- Warm foods: lamb, deer, beef, chicken
- Warm spices and herbs: mild peppers, cinnamon, cardamom, nutmeg, ginger (sheng jiang)
- Although salt guides to and nourishes the Kidneys, it is unnecessary to add copious amounts to our modern diets. Instead utilize seaweed, which is rich in iodine, and sea salts for cooking.
- Raw and cold foods make the body weaker by disrupting digestive processes. They include: iced drinks, ice cream, and excessive raw vegetables and fruits.
Overtraining or overworking in the winter will greatly affect your performance in the following season. Be aware of early signs and adjust your activities accordingly. Signs include – but are not limited to – a higher resting heart rate, decreased focus, mental fatigue, insomnia, mood swings, chronic muscle soreness, frequent injuries, delayed recovery, sensitive digestion, and/or unwanted weight loss or gain. Athletes and exercise enthusiasts who continue through the colder months of the year should follow these guidelines.
- Regular acupuncture and tui na treatments restore balance to the body and speed recovery.
- Warm up sufficiently. Include the use of a foam roller and dynamic stretching.
- Avoid prolonged static or deep stretching at the beginning of workouts as this will cool the body down further, increasing the chance of injury.
- Stay hydrated and maintain adequate nutrition. The body sweats less in the cold and relies more on exhalation and urination to expel water and waste, which creates the illusion of hydration.
- Rest and be aware of signs of over-training.
By conserving energy, exercising moderately and eating well you can enjoy the season and ready yourself for a smooth transition and expansion into Spring.
For other articles on winter, see Oriental Medicine Winter.