The Treatment of Modern Western - Biblio.nhat-nam.ru

31GOUTFormerly known as “the disease of kings,” gout is caused bydeposits of uric acid crystals in the joints of the hands, wrists,elbows, knees, ankles, and feet, and particularly the big toe.Symptoms include sudden, severe, pain and tenderness alongwith possible redness, warmth, and swelling in the affectedjoints. In 50% of cases, the first attack is characterized byintense pain in the first joint of the big toe. If the attack progresses,fever and chills will appear. Initial gout attacks usuallystrike at night and are preceded by a specific event, suchas excessive consumption of alcohol, trauma, certain drugs,or surgery. Subsequent attacks are common, with mostpatients experiencing another attack within one year.However, seven percent of gout sufferers never have a secondattack. Hyperuricemia leading to uric acid crystal formationis typically caused by either the body’s overproduction of uricacid or the kidney’s inability to eliminate uric acid fastenough. Uric acid may also collect under the skin as tophi orin the urinary tract as kidney stones. Attacks of gout arecommonly precipitated by drinking alcohol, particularlybeer and wine, or overeating rich, fatty foods, such as liver,anchovies, and gravy. In addition, this disease is stronglyassociated with obesity, hypertension, hyperlipidemia, anddiabetes mellitus. This condition affects approximately threeout of every 1,000 adults and is primarily a disease of adultmen, 95% of gout sufferers being males over the age of 30. 1The Western medical diagnosis of gout begins with a physicalexamination and the patient’s medical history in an effortto differentiate this type of arthritis from any other.However, definitive diagnosis depends on finding uric acidcrystals in the joint fluid during an acute attack. Serum uricacid levels may also be tested and are often elevated.Unfortunately, uric acid levels in the blood alone are oftenmisleading and may be transiently normal or even low.Additionally, uric acid levels are often elevated in individualswithout gout. Although there is no cure for gout, colchicinehas been the standard Western medical treatment for thepain of gout since the 1800s. While this drug is very effective,its common side effects when orally administeredinclude nausea, vomiting, and diarrhea. These side effects areuncommon when this drug is administered intravenously.Because of the unpleasant side effects of colchicine, NSAIDshave become the treatment of choice for most acute attacksof gout. For patients with elevated serum uric acid, multipleattacks of gout, and tophi or urolithiasis, uric acid normalizingmedicines such as probenecid and allopurinol may beprescribed. In addition, reducing obesity and eating a properdiet are essential for managing this disease.CHINESE DISEASE CATEGORIZATION: Gout is atype of bi zheng or impediment condition which is specificallycalled tong feng, painful wind, in Chinese medicine. Itmay also be referred to as guan jie wai tong feng, joint externalpainful wind, or tong feng xing guan jie yan, gouty arthritis,in the more modern Chinese medical literature. Othercommon Chinese disease names for gout are guan jie liu feng,joint running wind, and bai hu guan jie liu feng, white tigerjoint running wind.DISEASE CAUSES: Former heaven natural endowment(i.e., sex), unregulated eating and drinking, enduring disease,and possible external contraction of evilsDISEASE MECHANISMS: As a species of impediment,gout is caused by either wind damp cold evils or wind dampheat evils. Damp heat evils are mainly internally engenderedand are usually the result of or are associated with spleendamage due to unregulated eating and drinking. In particular,alcohol and greasy, fatty, thick-flavored foods tend toproduce internal damp heat. Cold and dampness may beeither internally engendered or externally contracted. Forinstance, living in a cold, damp environment may lead towind damp cold impediment. However, the dampness ofwind damp cold impediment may also be due to improper