Gout, a common form of arthritis in the west, is associated with elevated blood uric acid levels. The most common clinical symptom is pain and inflammation in the metatarsophalangeal joint of the big toe.

Many patients in the west simply take prescribed painkilling or anti-inflammatory drugs to ease the pain and reduce the swelling without investigating the cause of this disease. This leads to further obstruction and tissue degeneration of the affected joints and organs, and in severe cases, gout can affect the kidneys and cause kidney damage.

In TCM, gout falls into the category of Bi Syndrome: “Bi” means “painful obstruction”. Chinese medicine differentiates the cause of gout, with treatment determined by the patients’ symptoms
Treatment for gout caused by wind, cold and damp will focus on dispersing the wind, warming the cold and eliminating the damp. The patient’s diet must also be altered to achieve the same therapeutic function.

Treatment for gout caused by wind, damp and heat will focus on clearing the heat and eliminating the dampness.
People experiencing chronic gout usually suffer from qi and blood deficiency, liver and kidney deficiency, spleen and kidney yang deficiency.

The primary symptom that manifests with gout caused by wind, cold and damp is prolonged ache in the metatarsophalangeal joint of the big toe. This ache is constant and deep, and in cold, damp, weather or living conditions will develop into pain. Patients also look pale, feel cold, are overweight and generally have aching feet and knees. They can also experience loose bowel movements and aversion to cold, and their abdomens may be distended. Certain foods such as ice cream, iced coffee, cheese, and cold beer aggravate this cold type of gout.

Gout caused by wind, damp and heat produces a sudden, sharp, burning pain in the big toe. The pain can be so intense that the patient may not be able to walk or function. It is aggravated by heat, hot weather, hot greasy food, smoking, coffee and alcohol. Patients with this hot type of gout look hot, feel hot, have rather hot temper, fast pulse rate, constipation and a bitter taste in the mouth. In western medicine, a very strong anti-inflammatory drug is prescribed to control the pain and reduce the swelling; however, this drug produces a number of clinical side effects including liver damage, gastric pain and kidney problems.
Both cold and hot types of gout are characterised by elevated serum uric acid levels either due to the person’s reduced ability to excrete uric acid, or through increased uric acid synthesis from purine metabolism. Aspirin and most diuretics may contribute to this. Alcohol, red meat, organ meat, coffee and stress decrease excretion from the kidney as well as increasing synthesis of uric acid. Bowel toxicity is also a major contributor to gout.

Chinese medicine and modern nutritional medicine can treat and prevent gout very successfully. A number of traditional Chinese herbal formulations, used in China for many centuries, are very effective, but they need to be prescribed by experienced Chinese herbalists. The most common is a traditional decoction called White Tiger And Cinnamon Decoction; this is generally used as a core formula, with practitioners adding more herbs according to the individual patient’s condition.In the west, herbs such as celery seed, guajacum, and Arctium lappa (burdock) are used to treat gout because of their blood-cleansing and anti-inflammatory properties. Supplementation with essential fatty acids, antioxidants and high doses of folic acid (20 milligrams per day) are extremely helpful because they inhibit an enzyme called xanthine oxidase, which is the enzyme that converts xanthine to uric acid in the blood.

Patient with gout must avoid alcohol, coffee, refined and processed foods, and saturated fats, and additionally eat a low-purine diet. Foods with high purine content include yeast (brewer’s and baker’s), shellfish, organ meats, herring, sardines, mackerel and anchovies.