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#Amlapitta (acid peptic disorder) is prevalent in rainy season because natural accumulation of pitta in rainy season. Indulgence in foods which are incompatible, spoiled, very sour, causing burning sensation in epigastrium cause increase of pitta to produce amlapitta, in persons in whom pitta has already increased.17
 
#Amlapitta (acid peptic disorder) is prevalent in rainy season because natural accumulation of pitta in rainy season. Indulgence in foods which are incompatible, spoiled, very sour, causing burning sensation in epigastrium cause increase of pitta to produce amlapitta, in persons in whom pitta has already increased.17
 
#Shirashula (headache) is a common feature of all types of shiroroga and is of three types:  
 
#Shirashula (headache) is a common feature of all types of shiroroga and is of three types:  
Vatika shiroroga:
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##Vatika shiroroga:
Aggravating factors: Cold season; Rainy season and cloudy days
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*Aggravating factors: Cold season; Rainy season and cloudy days
Relieving factors: Hot season, clear and shiny sky i.e. cloud free days
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*Relieving factors: Hot season, clear and shiny sky i.e. cloud free days
Paittika shiroroga:
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#Paittika shiroroga:
Aggravating factors: Hot season, Intake of hot food
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*Aggravating factors: Hot season, Intake of hot food
Relieving factors: Cold season
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*Relieving factors: Cold season
Kaphaja shiroroga:
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#Kaphaja shiroroga:
Aggravating factors: Vasanta season, cold season
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*Aggravating factors: Vasanta season, cold season
Relieving factors: Hot season
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*Relieving factors: Hot season
6. Shula (pain)
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#Shula (pain)
a. Vatika shula
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##Vatika shula: Vatika shula especially gets exacerbated after digestion of food, in the evening time, at the end of night, during cloudy and rainy days, in cold climate, and due to direct and eastern wind exposure.18,19 It gets relieved by svedana(sudation), abhyanga(oil massage), mardana(massage), unctuous, and hot food items. On the basis of site the vatika shula may be termed as janusandhigata shula (Osteo arthritis of knee), kati shula (low backache), prushthagata vatika shula(backache), and trikagata vatika shula (pain in pelvic bones) etc.
Vatika shula especially gets exacerbated after digestion of food, in the evening time, at the end of night, during cloudy and rainy days, in cold climate, and due to direct and eastern wind exposure.18,19 It gets relieved by svedana(sudation), abhyanga(oil massage), mardana(massage), unctuous, and hot food items.
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##Paittika shula: It gets exacerbated during mid day, mid night, at the time of digestion of food, and during sharad ritu. It gets relieved by cold season, cold and madhura food.20  
On the basis of site the vatika shula may be termed as janusandhigata shula (Osteo arthritis of knee), kati shula (low backache), prushthagata vatika shula(backache), and trikagata vatika shula (pain in pelvic bones) etc.
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##Kaphaja shula: This type of pain gets exacerbated just after intake of food, during early morning, at the beginning of night, and during shishira and vasanta seasons.21
b. Paittika shula  
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#Atisara (diarrhoea): Rituviparyaya (any deviation from seasonal regimen) is the main cause of atisara .22  
            It gets exacerbated during mid day, mid night, at the time of digestion of food, and during sharad ritu. It gets relieved by cold season, cold and madhura food.20  
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#Sheetapitta (urticaria): Exposure to cold air aggravates kapha and vata dosha, and along with pitta cause sheetapitta. It increases during rainy and winter seasons and especially in shishir ritu.23
c. Kaphaja shula
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#Kushtha (skin diseases): The first important cause of kushtha is viruddha anna-pana (intake of antagonistic food), which includes kala viruddha also for e.g. during hot season intake of katu and hot variety of foods and during cold season ruksha (rough) and sheeta (cold) foods are kala viruddha.24  
          This type of pain gets exacerbated just after intake of food, during early morning, at the beginning of night, and during shishira and vasanta seasons.21
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7. Atisara (diarrhoea)  
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===== Effect of seasonal changes on health =====
Rituviparyaya (any deviation from seasonal regimen) is the main cause of atisara .22  
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8. Sheetapitta (urticaria)    
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Exposure to cold air aggravates kapha and vata dosha, and along with pitta cause sheetapitta. It increases during rainy and winter seasons and especially in shishir ritu.23
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9. Kushtha (skin diseases)  
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The first important cause of kushtha is viruddha anna-pana (intake of antagonistic food), which includes kala viruddha also for e.g. during hot season intake of katu and hot variety of foods and during cold season ruksha (rough) and sheeta (cold) foods are kala viruddha.24  
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Effect of seasonal changes on health  
   
Various researches have proved the direct relation of seasonal variation on physiological and pathological changes in body:   
 
Various researches have proved the direct relation of seasonal variation on physiological and pathological changes in body:   
 
Climate change has a profound effect on human health and well-being. The impact of climate change on human well-being goes beyond mortality; even birth rates and sperm counts appear to be affected by meteorological phenomenon.25,26,27  
 
Climate change has a profound effect on human health and well-being. The impact of climate change on human well-being goes beyond mortality; even birth rates and sperm counts appear to be affected by meteorological phenomenon.25,26,27  
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To a great extent, the seasonal changes in the immune system are controlled by changes in the levels of various hormones, particularly melatonin. Serum levels of melatonin were found to be highest in the winter months in both normal individuals and SLE patients.34 There is natural increase in bala (strength/immunity) of individuals during winter i.e. hemanta and shishir ritu.
 
To a great extent, the seasonal changes in the immune system are controlled by changes in the levels of various hormones, particularly melatonin. Serum levels of melatonin were found to be highest in the winter months in both normal individuals and SLE patients.34 There is natural increase in bala (strength/immunity) of individuals during winter i.e. hemanta and shishir ritu.
 
Striking seasonal variations have been demonstrated in the plasma and saliva levels of the glucocorticoid, cortisol, which promotes carbohydrate metabolism. The lowest levels of cortisol were found in healthy individuals during spring and summer, while the highest levels were found during autumn and winter seasons.35  
 
Striking seasonal variations have been demonstrated in the plasma and saliva levels of the glucocorticoid, cortisol, which promotes carbohydrate metabolism. The lowest levels of cortisol were found in healthy individuals during spring and summer, while the highest levels were found during autumn and winter seasons.35  
Agni (digestive power) of individuals is strong during winter i.e. hemanta and shisira ritu, and weakest during grishma and varsha ritu.
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Agni (digestive power) of individuals is strong during winter i.e. hemanta and shisira ritu, and weakest during grishma and varsha ritu.
 
Rheumatic diseases vary in severity by season. The incidence of acute gouty attacks (an inflammatory arthritis) is highest in the spring season.36 Schlesinger N.et al. (2009) explained in his paper “Seasonal Variation of Rheumatic Diseases” that seasonal variation has been shown in a number of rheumatic diseases.37
 
Rheumatic diseases vary in severity by season. The incidence of acute gouty attacks (an inflammatory arthritis) is highest in the spring season.36 Schlesinger N.et al. (2009) explained in his paper “Seasonal Variation of Rheumatic Diseases” that seasonal variation has been shown in a number of rheumatic diseases.37
 
Coronary artery disease shows a winter peak and summer trough in incidence and mortality.38 Leo Sher also proposed that seasonal mood changes may contribute to the increased incidence and mortality of coronary artery disease in winter. Depression is associated with increased incidence, morbidity, and mortality of coronary artery disease.
 
Coronary artery disease shows a winter peak and summer trough in incidence and mortality.38 Leo Sher also proposed that seasonal mood changes may contribute to the increased incidence and mortality of coronary artery disease in winter. Depression is associated with increased incidence, morbidity, and mortality of coronary artery disease.
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This clinical study based on subjective parameters revealed that in patients of group A (treated with modern drug) and in group B (treated with modern drug along with observance of proper ritucarya of different seasons, highly significant improvement was observed in all symptoms. On intergroup comparison (Chi-square test) patients of group B showed significant rate of improvement in many symptoms like dyspnea, wheezing, cough, rhinorrhea, and frequency of attack and duration of attack. Inter group comparison between group A and B (unpaired t test) had shown statistically significant increase in FVC, FEV1 and PEFR of group B cases as compared to the patients of group A at different follow-ups. These finding suggest that ritucarya has a definite additive effect along with standard drug therapy in the treatment of tamaka shasa (bronchial asthma).
 
This clinical study based on subjective parameters revealed that in patients of group A (treated with modern drug) and in group B (treated with modern drug along with observance of proper ritucarya of different seasons, highly significant improvement was observed in all symptoms. On intergroup comparison (Chi-square test) patients of group B showed significant rate of improvement in many symptoms like dyspnea, wheezing, cough, rhinorrhea, and frequency of attack and duration of attack. Inter group comparison between group A and B (unpaired t test) had shown statistically significant increase in FVC, FEV1 and PEFR of group B cases as compared to the patients of group A at different follow-ups. These finding suggest that ritucarya has a definite additive effect along with standard drug therapy in the treatment of tamaka shasa (bronchial asthma).
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References
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=== References ===
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1. Ch.Su. 12
 
1. Ch.Su. 12
 
2. S.Su. 6
 
2. S.Su. 6
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40. Nathani Neeru et al, 2013
 
40. Nathani Neeru et al, 2013
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Glossary  
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=== Glossary ===
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1. Abhya¿ga - rubbing with unctuous substance, inunctions
 
1. Abhya¿ga - rubbing with unctuous substance, inunctions
 
2. AÐana - eating, food
 
2. AÐana - eating, food