Housed
in the first metatarsophalangeal joints on some unlucky patients’ there live a
buildup of monosodium urate crystals. These ungrateful house guests cause their
host severe attacks of pain and inflammation in the peripheral joints, commonly
known as gout. Gout is caused by high levels of uric acid in the blood.
Generally, uric acid is filtered out by the Kidneys, however, if the Kidneys
are not filtering properly, or there is too much uric acid in the body then it
will become deposited elsewhere, usually in joints. It is considered to be the
most common form of inflammatory arthritis. People who suffer from gout may
also suffer from kidney stones being that uric acid crystals may deposit there
as well (1).
From a Western perspective, gout has
causative factors that include a high prevalence of uric acid in the blood as
well as a low uric acid renal clearance rate, diets rich in meats, seafood and
other purine rich foods, alcohol consumption, use of diuretics, chronic renal
disease, hypertension, obesity and osteoarthritis. There is also believed to be
a genetic component contributing. Factors that are believed to be preventative
against gout are the consumption of dairy products, coffee, Vitamin C and
increased water consumption. Gout is treated in western medicine with the use
of NSAID’s, corticosteroids, colchicine (all to reduce inflammation) as well as
medicines to reduce the amount of uric acid in the bloodstream (1).
Traditional Chinese Medicine finds gout to have two excess
patterns and two deficiency patterns: Liver Qi Stagnation gout; Damp Heat Joint
Bi; Spleen Qi Deficiency gout; Kidney Deficiency gout. Being that the Liver
governs the tendons, diseases affecting the joints point towards a liver
imbalance. Considering the painful and inflamed nature of the disease, this can
be seen as stagnation of liver qi combining with damp pathogens and producing
heat. Over time the heat will dry out the damp and turn it into a phlegmy
consistency. Bi syndromes are
characterized by pain in the body that is intensified by external pathogens:
wind, damp, heat and cold. Gout is considered to be a Damp Heat Joint Bi
because of its tendency to become worse with the ingestion of alcohol, fried
and fatty foods (3.)
The spleen is the main organ associated with digestion. It
also has a tendency to produce dampness when not functioning properly. The
connection to the spleen can be clearly seen in the inability to digest
purines. The symptoms; inflammation, redness, swelling and pain can be related
to a Damp Heat syndrome that is rooted in a Spleen Qi Deficiency. The
connection with the kidneys is seen in the fact that the uric acid is filtered
through the kidneys. A constitutional, or lifestyle induced kidney deficiency
will prevent them from filtering properly leading to a buildup of uric acid
crystals (3).
Gout can be treated with internal medicine based on the
diagnosis. For the branch (Damp Heat) the formula Juan Bi Tang can be used to
treat the heat Bi with the addition of herbs to drain damp such as Cang Zhu and
Fu Ling. For an underlying Spleen Qi Deficiency, the formula Liu Jun Zi Tang
can be prescribed along with Juan Bi Tang. A pattern of Liver Qi Stagnation
with heat would improve with the formula Dan Zhi Xiao Yao San. A constitutional
Kidney Deficiency can be treated with the formula Er Xian Tang if the
deficiency seems to be affecting Yin and Yang equally. A general point
prescription for gout could include points such as ST36, ST40, SP6, SP9, Ren12,
LI4, LV3 and Master Tang’s Wu Hu 3.
Works Cited
No comments:
Post a Comment