In October, Aunt Zhang, who suffers from osteoarthritis in both knees, is both happy and worried. She is happy that the dry climate in autumn will reduce the symptoms of joint pain, but she is worried that joint pain may worsen in the ensuing winter because of the cold climate. Can I take tonic in autumn and winter? Traditional Chinese medicine emphasizes on taking tonic in autumn and winter, because the human body is in the stage of “collecting” and “hiding” in autumn and winter, so eating tonic food at this time can be better absorbed and utilized. Therefore, Cantonese people are used to taking tonic in autumn and winter. Indeed, patients with immune diseases such as rheumatoid arthritis and systemic lupus erythematosus have a weak constitution and need to take immunosuppressants during treatment, which hurts the body’s vital energy. Such patients can eat more chicken, rabbit, beef and mutton in winter to replenish their qi and blood, together with some Chinese herbs such as Astragalus, Radix Angelicae Sinensis, Radix et Rhizoma Polygonati, Colla Corii Asini, Radix et Rhizoma Shou Wu, Red Date and Cinnamon Meat. The classic recipe from Zhang Zhongjing’s “The Essentials of the Golden Needs”, “Angelica Ginger and Mutton Soup”, is a recipe often recommended by TCM rheumatologists for such patients. At the same time, it is cautioned that not all rheumatism patients are suitable for autumn and winter tonic. For example, some patients belonging to the damp-heat body, if blindly supplementation will aggravate the disease. Experts especially emphasize that patients suffering from gouty arthritis should still maintain a light diet in autumn and winter. In the autumn and winter recipes, the old hot soup, all kinds of hot pot may trigger the acute attack of gout, in addition, at the end of the year and the Chinese New Year festival, the delicious food on the table often makes the rheumatology clinic gout patients a large increase in the number of patients. Therefore, patients with rheumatism should consult a rheumatologist to find out if they can take supplements and how to do so. Is the dry and cold climate suitable for outdoor activities? Some rheumatism patients ask whether outdoor activities will “freeze the joints” in the cold and dry climate of autumn and winter. Chinese medicine emphasizes the balance of yin and yang. In autumn and winter, the body’s yang energy is relatively weak, and blood flow is slow, so appropriate outdoor activities can promote the body’s qi and blood flow and stimulate yang energy. For example, for patients with ankylosing spondylitis, adequate exercise can reduce the pain of the lumbar spine and joints, and maintain the function of the lumbar spine and joints, the most suitable exercise is to swim in a heated pool and outdoor cycling. For patients with osteoporosis, daily sun exposure and outdoor exercise can help with calcium absorption, thereby strengthening bones. However, different diseases have different requirements for outdoor activities. For example, in autumn when the sun is strong, SLE patients should avoid sun exposure because sun exposure may induce vasculitis and photoallergy in SLE, so outdoor activities in the morning and evening are suitable for such patients. Patients with systemic sclerosis and Raynaud’s phenomenon have insufficient blood supply to their extremities, so they must keep their extremities warm in winter and wear back gloves and socks before going outdoors, otherwise they are prone to frostbite of fingers and toes and even local necrosis. Patients with dry syndrome have reduced saliva secretion due to damaged glands, so they must prepare sufficient drinking water before going outdoors. How to deal with the change of disease? The change of climate from hot summer to autumn and winter may cause changes in the patient’s diet and even emotions, which may cause changes in the previously stable condition. Patients with rheumatoid arthritis, for example, may have their joint pain reduced or even disappear temporarily in dry weather; patients with systemic lupus erythematosus may have their vasculitis aggravated or even worsened by cold weather; patients with connective tissue disease combined with pulmonary hypertension may have lung infection and aggravate their disease because they are not adapted to the fast-changing climate. In the face of such changes, patients should not adjust their treatment plans on their own, but should always keep in touch with their primary care physician, and all medication adjustments must be decided by the physician according to their condition. The treatment and rehabilitation of the disease is the joint responsibility of doctors and patients, and it is the common desire of doctors and patients to maintain a high quality of life for patients with rheumatic diseases.