Gout
Overview
Gout is a metabolic joint disease from elevated uric acid with urate crystal deposition; acute attacks cause sudden redness, swelling, heat, and severe pain, often of the big-toe joint at night; recurrent attacks can produce tophi, joint damage, and kidney stones. Chinese medicine classifies it under bi syndrome ("white-tiger joint wind"): acute attacks are usually damp-heat binding, while chronic/intercritical phases show spleen deficiency with damp turbidity, phlegm-stasis obstruction, or liver-kidney insufficiency. Acute gout requires standard anti-inflammatory and urate-lowering care; TCM is adjunctive.
Pattern differentiation (clinical patterns)
Damp-Heat Binding (Acute)
Sudden red, hot, markedly swollen and cutting joint pain, worse at night with restricted movement, sometimes fever, thirst, dark urine, red tongue with greasy yellow coating, slippery rapid pulse.
Clear heat and drain dampness; unblock collaterals to stop pain.
Phlegm-Stasis Obstruction (Chronic)
Recurrent joint pain with stiffness and deformity or visible tophi/nodules and restricted movement, dark tongue or stasis spots with greasy white coating, fine rough pulse.
Transform phlegm and dispel stasis; unblock collaterals and resolve bi.
Connections
Daily care & prevention
During acute attacks rest, elevate the limb, and hydrate (if no cardiac/renal restriction); take prescribed medication and continue urate-lowering treatment. Long term, limit alcohol (especially beer), sugary drinks, organ meats, rich meat broths, and certain seafood; manage weight and monitor serum uric acid and kidney function. Massage Yanglingquan (GB34), Xuehai (SP10), Yinlingquan (SP9), and Zusanli (ST36) adjunctively—not as a replacement for standard care.
When to seek medical care
Seek care for a first attack, fever or multiple hot swollen joints, severe unrelieved pain, an infected or ulcerated tophus, or concurrent kidney stones or abnormal kidney function. Do not self-use painkillers or steroids long term.