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*Mortality rate during heat waves increases with age.30,31 The elderly seem to suffer from impaired physiological responses and often are unable to increase their cardiac output sufficiently during extremely hot weather.32  
 
*Mortality rate during heat waves increases with age.30,31 The elderly seem to suffer from impaired physiological responses and often are unable to increase their cardiac output sufficiently during extremely hot weather.32  
 
*It was noted that men who had taken bath in 15oC water for one-half hour over nine consecutive days before a trip to the Arctic showed less signs of cold-induced stress than non-treated men. It indicates that adaptation to cold temperatures can occur through repeated exposures. 33
 
*It was noted that men who had taken bath in 15oC water for one-half hour over nine consecutive days before a trip to the Arctic showed less signs of cold-induced stress than non-treated men. It indicates that adaptation to cold temperatures can occur through repeated exposures. 33
*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.
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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 ''shishira 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 ''shishira ritu'', and weakest during ''grishma'' and ''varsha ritu.''
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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
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*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.
“Seasonal affective disorder” is a condition where depression in the winter and fall alternate with non-depressive periods in the spring and summer. The degree to which seasonal changes affect mood, energy, sleep, appetite, food preference, or the wish to socialize with other people has been called "seasonality." Recent studies have demonstrated that seasonal mood changes are related to the genetic factors. It means that people may have genetically‐determined sensitivity to seasons.    
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“Seasonal affective disorder” is a condition where depression in the winter and fall alternate with non-depressive periods in the spring and summer. The degree to which seasonal changes affect mood, energy, sleep, appetite, food preference, or the wish to socialize with other people has been called "seasonality." Recent studies have demonstrated that seasonal mood changes are related to the genetic factors. It means that people may have genetically‐determined sensitivity to seasons.  
Jaiswal Rahul et al, 2011, in a clinical survey39 found a significant relation between seasonal variation and prevalence of some diseases viz. jwara (viral fever), amlapitta (acid peptic disorders), tamaka shvasa (bronchial asthma), pratishyaya (rhinitis) and sirashula (pittaja sirashula and ardhavabhedaka migraine). They also observed that there is seasonal variation in the state of agni and bala strength) of the person, as stated by our ancient seers.  
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Jaiswal Rahul et al, 2011, in a clinical survey39 found a significant relation between seasonal variation and prevalence of some diseases viz. ''jwara'' (viral fever), ''amlapitta'' (acid peptic disorders), ''tamaka shvasa'' (bronchial asthma), ''pratishyaya'' (rhinitis) and ''sirashula'' (''pittaja sirashula'' and ''ardhavabhedaka'', migraine). They also observed that there is seasonal variation in the state of agni and bala strength) of the person, as stated by our ancient seers.  
 
*Nathani Neeru et al, 2013, in a clinical research40 found that maximum number of patients of tamaka shvasa (bronchial asthma) were registered in winter seasons (hemanta and sishira), vasanta and varsha. These seasons were the predominant period of asthma attack in majority of cases. In maximum number of cases the attack of tamaka shvasa gets precipitated by intake of kapha and vata vitiating sheeta, guru, madhura and amla rasa predominant ahara like ice-cream, cold drink, cold water, fruit juices, curd, sweets, rice, pickle, salad with lemon etc. in all seasons. Out of 140 cases about half were observing ritucarya occasionally and less number of cases were found to adhere with ritucarya regularly. About two-third cases were bathing with cold water in winters and less number of cases were in the habit of daily head bath.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).
 
*Nathani Neeru et al, 2013, in a clinical research40 found that maximum number of patients of tamaka shvasa (bronchial asthma) were registered in winter seasons (hemanta and sishira), vasanta and varsha. These seasons were the predominant period of asthma attack in majority of cases. In maximum number of cases the attack of tamaka shvasa gets precipitated by intake of kapha and vata vitiating sheeta, guru, madhura and amla rasa predominant ahara like ice-cream, cold drink, cold water, fruit juices, curd, sweets, rice, pickle, salad with lemon etc. in all seasons. Out of 140 cases about half were observing ritucarya occasionally and less number of cases were found to adhere with ritucarya regularly. About two-third cases were bathing with cold water in winters and less number of cases were in the habit of daily head bath.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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