-Dr. P. S. Mamtora (Orthopedic surgeon) & Dr. Vijay H. Vaishnav (Homoeopath)

What is gout?
This is a metabolic disorder. It affects joints and later the kidneys. It is a disorder where the uric acid is not metabolised well. The serum (blood) level of this normal substance is high. The raised levels of uric acid may be due to over production or reduced excretion. The higher levels allow the uric acid crystals to get deposited in and around the joints. This causes severe pain, swelling and redness of that area. The crystals can also get deposited in the kidneys to form uric acid stones

What can precipitate an attack?
Unaccustomed physical stress, mental stress and bouts of alcohol consumption can trigger an acute attack of gout.

What are the symptoms?
There is a sudden, acute onset of severe pain involving any one joint or one side of a joint. The commonest joint is the ball of the great toe. The area suddenly becomes red, painful and swollen. It may be difficult to move the part due to the pain. Occasionally, people mistake it to be due to an injury. However, it is not possible to have such a severe pain due to an injury that one cannot remember definitely.

How does one control the disease?
It frequently needs medicine for good control. There is also a need for good control in the diet to keep the serum uric acid levels within the normal range.

What diet should one follow?
The intake of the following things should be stopped, as they are high in purine rich proteins: alcohol, red meat, fish, sea food, pulses, peas, spinach, cashew nuts. Alcohol should also be avoided. (See also the article- Dietary advice)

Can homoeopathy help?
Homoeopathy is known to control the uric acid diathesis and is also useful in acute attacks. The following drugs are important aids in the treatment of gout:

Lycopodium- This is a drug for chronic gout, with chalky deposits in the joints. It is suited to persons who are mentally keen, but of weak muscular power. Typically, the patient appears emaciated (he is thin and withered), and full of gas. They are apprehensive and afraid to be alone. Though they lack self-confidence, they are haughty and headstrong when sick. There is a pain in the heels as if treading on a pebble. One foot feels hot and the other feels cold. The urine is slow in coming and shows a heavy, red sediment. There may be a backache, which is relieved by passing urine. The right side of the body is peculiarly affected and all the complaints seem to increase in the evening, especially between 4 p.m. and 8 p.m..

Colchicum- This drug has a specific power of relieving the gouty paroxysms but it seems to be more beneficial in chronic affections of these parts. The parts are red, hot, swollen with tearing pains felt more in the night. The parts are sensitive to touch. The patient complains of tearing pains in the joints in hot weather, and stinging during cold. Gout settles in the great toe or in the heel. With the gout the patient also has disorders of the stomach. The smell of food, especially fish, causes nausea and may even cause fainting. There may be an icy coldness felt in the stomach. The urine is dark, brown, black- looks like ink.

Urtica urens- This drug, prepared from the stinging nettle, helps in the elimination of uric acid from the body. The patient has a tendency to gout and stone formations. The joint symptoms are associated with urticaria or alternate with it. The shoulders (deltoid region), wrists and ankles are commonly affected. The patient cannot tolerate touch, water or exposure of the affected parts to cool, moist air and snow air.

Lithium carb- There is a swelling and tenderness of the finger and toe joints, better by hot water. There is a nodular swelling of the joints. The ankles pain on walking. Some of the patients have a headache, acidity, nausea and gnawing pain in the stomach which cease while eating. The urine may deposit a red sand and is turbid, scanty and dark. Joint symptoms are sometimes associated with heart disease.

Ledum- When gout is the result of alcoholism, Ledum should be thought of. The inflammation of the joints begins in the lower limbs and ascends upwards. The ball of the great toe is swollen. It is red, sometimes bluish, and cold to touch. Dipping the part in a bucket of ice cold water relieves the pain. It is generally worse from getting warm in bed. The patient is sensitive to the cold, yet the heat of the bed is intolerable.

Benzoic acid- It cures symptoms of gout associated with a high coloured and offensive urine. The pains are tearing with stitches in the affected joint. Gout seems to settle in the achilles tendon, just above the heel. The symptoms are worse in the open air and from uncovering the affected parts.

A detailed history followed by constitutional treatment by a good and qualified homoeopath is necessary to treat gout. It is not advisable to resort to self-medication for any disease. The above mentioned drugs are just a few of the remedies for gout and are mentioned solely to create awareness about the efficacy of homoeopathy in this disease.