Gout is a rheumatic disease caused by the deposition of uric acid crystals (monosodium urate) in tissues and fluids within the body. It can present itself in a number of ways, though the most common is a recurrent attack of acute inflammatory arthritis (a red, tender, hot, swollen joint). These crystals cause the joint to swell up and become inflamed. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected. Other joints, such as the heels, knees, wrists, and fingers may also be affected. Joint pain usually lasts between 2–4 hours, and during the night. An acute attack of gout will usually subside after five to seven days without treatment. However, 60% of people will have a second attack within a year. Those with gout are at an increased risk of hypertension, diabetes mellitus, metabolic syndrome, and renal and cardiovascular disease. This often accompanies an increased risk of death.
Hyperuricemia is the underlying cause of gout. This can occur for a number of reasons including: diet, genetic predisposition, or under-excretion of urate. Urates are the salts produced in uric acid. Renal under-excretion of uric acid is the primary cause of hyperuricemia consisting of about 90% of cases, while overproduction is the cause in less than 10%. About 10% of people with hyperuricemia develop gout at some point in their lifetimes. The exact cause is unknown. Gout may run in families. It is more common among men, women after menopause, and those who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in their blood. The condition may also develop among people with diabetes, kidney disease, obesity, sickle cell anemia (as well as other anemic conditions), leukemia, and other blood cancers.
There are several medications used to treat hyperuricemia, each with its own side effects. Alkaline drugs, non-steroidal anti-inflammatory drugs, uricosuric drugs use, and drugs that inhibit the production of uric acids may be fast and effective; but will generate various side effects and even liver and kidney toxicity. On the other hand, Chinese medicine and acupuncture is a safer alternative with a reduced risk of toxicity and side effects.
Traditional Chinese medicine believes the disease is the result of greasy foods, which leads to internal pent-up heat and moisture. Wind and cold invades channels and collaterals, blocking the movement of qi and fluids. This causes stasis of moisture and heat that become phlegm which clogs the collaterals, causing swelling and burning pain in the joints. Traditional treatment seeks to clear heat and moisture; disperse phlegm; and remove stagnancy. This will dredge the channels in order to stop pain while facilitating the functions of the Spleen and Kidneys. Patients are advised to avoid extreme fatigue, wind, and cold for the duration of the treatment. Diets and lifestyles should to be controlled, while alcohol and smoking are discouraged.