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Walking the Seasons

Naturopathic Medicine Naturopathic Medicine
Kaneka
 
EuroMedica

How ayurveda’s approach to seasonal medicine can influence naturopathic medicine.

As the global COVID-19 pandemic continues, with new variants continuing to demand practitioners and public to pivot, it is time to return to the roots of our medicine to be of most service in this ever-evolving time. As has been true since time immemorial, natural healers are uniquely positioned to not only help address disease directly, but also to excel at prevention and the dislodging of chronic sequalae. So it behooves the savvy clinician to not only revisit these practices, but also to review the evidence that supports them. In ayurvedic medicine, these foundational treatments, such as managing the diet, using herbal remedies, incorporating sweating, detoxification practices and exercise are further nuanced through observations of what nature is doing. The concept of seasonal alterations layered on top of the individualistic treatments famous to the naturopathic profession may play an important role in disrupting the current COVID cycle.

Ritucharya: Harnessing the Visible Order

In ayurveda, much like in naturopathic medicine, all humans are seen as intrinsically and inextricably linked to nature. In India where ayurveda developed and evolved, the year is divided into two periods, each containing three sub-seasons: Uttarayana, the cold months, which contains three sub-seasons called Sharath, Hemanta and Shishira respectively. Meanwhile, the warm season, known as Dakshinayana, contains the three sub-seasons of Vasanta, Grishma and Varsha. It is important to pay attention to the fact that the ayurvedic scholar-physicians in essence had six seasons, comparative to the modern day concept of four seasons: summer, fall, winter and spring. This is because the nuances in diet, activities and medicines that are best applied change based on these six sub-seasons.

The process by which doctors tailor their medical recommendations to incorporate the best practices of each sub-season is known as Ritucharya. This word literally translates to “season” (Ritu). Interestingly, the origin of the word ritual, stemming from the Latin “ritus” which has origins with the Sanskrit word “rtá” which means “visible order.1 Meanwhile, the word “charya” means guidelines or conduct. Taken together, the term Ritucharya can be thought of as “following the guidelines of the visible order.” This etymology is an important consideration to naturopathic doctors since it alerts the clinician that there is not a strict set of rules, based on specific dates associated with specific seasons or sub-seasons. It means the doctor should respond and tailor treatments against the “visible order” that is to say what the current climate is doing in that region. Too often students who study seasonal living as a medicinal approach can be too adherent to the date and the recommendations classically associated with that date, rather than earnestly responding to nature as it presents itself. Moreover, given the shifts in weather patterns resulting from climate change, accounting for the “visible order” is an important consideration.

Nevertheless, by exploring the classical recommendations for each of the sub-seasons, we can learn how to best adapt our treatments in order to support the body’s natural healing mechanisms, boost the immune system, and protect the valuable resources of the body that are called upon in the face of any pathogen.

Understanding the Dosha System: The Key to Unlocking the Utility of Ritucharya

In order to best harness the different recommendations for the wheel of the year, one must first have a basic understanding of the Dosha system of ayurveda. The three Dosha represent the biologic distillation of the five elements of nature who’s interplay are responsible for the creation of all matter and energy of the universe. These elements are water, air, fire, earth and ether/space. Simply put, these five elements combine into three Dosha which then interact with each other to generate and govern all aspects of living beings. These three Dosha are called: Vata, Pitta and Kapha. Every human alive has all three of these forces within them; however, the beauty we know today as the variety of life, results from the fact that these three Dosha exist in different ratios within all of us. Some have an abundance of one, and less of another. These differences are what ayurvedic doctors, as well as naturopathic doctors (even if they are unaware of it) harness to make tailored recommendations for their patients. One patient may need to focus on hydration and rest while another needs an excess of movement and an avoidance of over-hydration in order to achieve balance and thus allow the body to heal itself.

The Vata aspect of ourselves deals with all the movements of the body, from intracellular exchanges to thoughts bouncing through the mind to the elimination of feces from the colon. It is sensitive to dryness, being composed of the elements air and ether/space, it tends to promote coldness and dryness within the body. As a result, additional coldness and dryness can create an imbalance, damaging the warming and lubricating parts of the body. The Pitta aspect of the body focuses on the transformative processes the body undergoes. It is primarily thought of as digestion, but many other transformative processes occur in the body that are worthy of consideration, such as the transformation of an experience a person has happen to them, the remodeling of a wound, or the transformation of a thought or impulse into literal action in the world. It is comprised of the elements of water and fire and it is sensitive to heat, since it already represents the heating aspect of the body. Lastly, the Kapha aspect of ourselves represents all aspects of structure in the human body: the flesh, fat, bones, cell membranes, and so on. Moreover, it plays a role in all the lubrication of the body. It is comprised of earth and water and as such it is considered cold, oily and damp, with a tendency towards stagnation. By understanding this rudimentary overview of the Dosha system, it starts to become evident how the external forces of the seasons may influence these various aspects of ourselves. Likewise, when recalling that we are all each made up of a unique ratio of these three Dosha, with some being more dominant than others within our own physiology, we begin to understand why different seasons can help or hinder our patients, either reducing their pain or symptoms, or leaving them far more susceptible to infection, inflammation and overall discomfort.

The Six Sub-Seasons

Shishira

Jan. 15-Mar. 15

This is when the dark and cold time of the year begins to respond to the impulse of growth underground. During this time, our digestive fire that transforms our food into lifegiving essence can be impacted if a person has not been protecting it all winter. Moreover, is a person is naturally more Kapha dominant, they will be more likely to be sluggish, resulting weight gain, fatigue and giving up on dietary changes that could help them. Therefore the wisdom is to recommend to patients that they eat warm, well spiced, well cooked foods like stews during this time. Additionally, massaging the body with warm oils, and practicing gentle yoga is appropriate here. Whereas the end of the year in December, it is best to stay home, focus on stillness and quieting the mind, here we see the beginnings of movement, which gentle yoga highlights best. This is still largely a time to stay home or only interact with family and close friends when possible.

Vasanta

Mar. 15-May 15

Vasanta is the time of year that can be quite variable depending on which month and which region a person is in. It is an excellent time for practitioners to practice their awareness of what nature is doing out their window, and how it is impacting each of their patients. During this time, the Kapha energy that had been growing during the winter, should begin to disperse in our patients, and the Pitta aspects of themselves should begin to grow. Because it is a time of great variability, the wisdom is to treat the gut with probiotic and prebiotic foods, to use gently stimulating spices such as cumin, turmeric and fennel as to not overwhelm those with a delicate system with too much heat too soon. Also, honey has been used in ayurveda to scrape away excess Kapha and is excellent to use here. This wisdom holds true to naturopathic doctors as well, as we know that local honey can decrease seasonal allergies that will begin to appear around this time in susceptible individuals. Seasonal allergies can be thought of as a Kapha/Pitta disharmony: the many fluids that the body secrets in response to the pollen are Kapha in nature, as Kapha rules over the moisture of the body, and is in excess from being not properly controlled during the winter months and has now built up, and is easily triggered. The inflammation and redness is caused by Pitta.

Grishma

May 15-July 15

This is the time of early summer where the heat increases, but the humidity has not yet arrived. This is the time to increase fruit juices, with pulp, focus on mineral-rich foods, and enjoy the sweetness of the season. It is also a time of expansion where it is best to enjoy the outdoors with friends and others and bask in the sunshine. Vata is also expanding at this time, so is important to look for patients who’s anxiety may spike at this time, which will sap their strength and energy, leaving them susceptible to disease.

Varsha

July 15-Sept. 15

This is considered the hottest and most humid time of year. The humidity is considered to dampen and drown the digestion, so eating well-cooked and lighter meals is ideal to let the digestion, which is being dampened by nature, rest. As many people go on vacations during this season, consider it a time to gently allow the digestion to take a small vacation as well. Lemon and ginger water is an excellent choice for hydration, as well, and raw foods are to be mostly avoided. While this may seem counter to the heat of the season, raw foods are hard on the digestion, which as mentioned, will be weakened in extreme humidity. If it is dry, such as in Texas, moist or raw foods can be okay in moderation.

Sharath

Sept. 15-Nov. 15

This is the final surge of warmth followed by the descent into the cold. Sharath is the complement to Vasanta in that it is a month of high variability where one day can be quite warm, and the next ice cold. As a result, the doctor must be careful with each patient, looking for their unique responses to this variability and always seeking to provide recommendations that are counter to, i.e. balancing to the symptoms that are being seen. However, one aspect that is universal is that the sunlight in the northern hemisphere is beginning to markedly decline. As a result, it is important to begin the process of nourishing and harmonizing the digestion. As the cold months continue, digestion as well as the fires within, will be relied upon for energy since it will be absent from the environment. Because the Pitta aspect of ourselves is responsible for turning our food into the very essence that gives us life, which then powers our immune systems, the ayurvedic doctor predicts that those who have not eaten correctly for their type or followed the movements of the summer months will not have the resources to stay healthy in the cold months, and so there is an increase in infections across the board. Lastly, as the darkness grows, this is a great time to resume stillness-based meditations to prepare the mind and body for the slowness of winter.

Hemanta

Nov. 15-Jan. 15

This is the time of most stillness. Individuals should be moving with the sunlight the most during this time and sleeping when it is dark. The fires of life are considered at their lowest, and as such it is imperative that individuals protect their own fire within. This is accomplished by not over-exercising and exposing ourselves to the cold: this depletes our energy, which during these months will not replenish as quickly. Ayurveda sees this somewhat slower recovery as natural and normal and should be respected. Stillness meditation should be used daily and individuals should not exert themselves professionally, athletically, or in any real manner. Unfortunately, the end of the year is often filled with parties, deadlines and an increase in responsibilities. As such, we often see all conditions worsen at this time in our patients. Likewise, it explains why so many people give up on their New Year’s resolutions. They simply wasted their resources over-exerting themselves during the time of stillness, and when the season of Shishira comes, and it the time to begin the impulse toward moving, they have little resources to call upon to move toward new goals, powered by the newness of the growth around them in spring.

Conclusions

Being able to apply and harness the approaches of Ritucharya takes time to master. However, as we continue to see patients struggle to stay healthy, to fend off disease, and to feel in tune with their own destinies, it becomes germane to consider this approach as part of a truly holistic treatment plan. By helping patients understanding the push and pull of the seasons, coupled with acknowledging how nature is behaving outdoors and each patient’s unique constitution, we can help them deeply influence their health, change the trajectory of their chronic conditions, and keep them safe and ready for the challenges that surely lie ahead.

Reference:

1 Barbara Boudewijnse, “British Roots of the Concept of Ritual,” in Religion in the Making: The Emergence of the Sciences of Religion (Brill, 1998), p. 278.

Growing up near the Himalayas, Dr. Shailinder Sodhi developed an early interest in ayurvedic plants and herbs, and received his BAMS (bachelor in ayurvedic medicine and surgery) degree from Dayanand Ayurvedic College in Jalandhar, India in 1985. In 1993, he received a naturopathic medicine degree from Bastyr University, as well as a degree in diagnostic ultrasound from Bellevue College. Dr. Sodhi practices naturopathic medicine along with his wife, Dr. Anju Sodhi, and his brother, Dr. Virender Sodhi, at the Ayurvedic and Naturopathic Medical Clinic in Bellevue, WA, which he established in 1989. In addition, Dr. Sodhi serves as president of Ayush Herbs Inc., a manufacturer of high-quality ayurvedic herbal formulas, is an adjunct faculty member at Bastyr and has been published in several natural health magazines.