Gout

Question 0

Chinese Name

Answer 0

Tong Feng ~ Painful wind

or

Bi Syndrome

Question 1

Def

Answer 1

Caused by deposits of uric acid crystals in the joints of the hands, elbows, wrists, knees, ankles and feet particularly the big toes.

Question 2

Clinical Features

Answer 2

Sudden severe pain and tenderness along with possible redness
Warmth/swelling in the affected joints
Fever/chills and malaise
Limited ROM in the affected joint or joints

Question 3

Etiology/Pathology

Answer 3

Wind { Cold/Damp/Heat –> Acute { W-C-D and W-D-H

Unregulated eating or drinking –> Sp –> Phlegm Retention

Weak Constitution
Sex —> Consumption of Liv & Kid Yin

Question 4

What time does an attack usually occur?

Answer 4

During the night

Question 5

Basic Points

Answer 5

Ashi
Li 4
Sp 6

Question 6

Severe, acute, fixed, stabbing pain as if being cut by a knife

Answer 6

Qi and Blood Stagnation

Question 7

Enduring joint pain, low back and knee soreness and limpness, worsening of symptoms after activity, lack of joint flexibility, night sweats, dry mouth and throat, tinnitus

Answer 7

Liver and Kidney Yin Def

Question 8

Attacks are severe, acute joint pain which is fixed in one location and worse on exposure to cold, better with warmth, there may be swelling but no visible redness or heat, possible deformation and hardening of the joint with restricted movement

Answer 8

Wind Cold Damp

Question 9

Severe, acute joint aching and pain which is fixed in location and is accompanied by redness, warm and swelling, possible fever, thirst, constipation, yellow scanty urine

Answer 9

Wind Damp Heat

Question 10

Enduring joint pain which sometimes is mild and sometimes its strong, on and off, swelling of joint, restricted movement, dark purple skin in the affected area, stiffness, hardening and deformation of the joint

Answer 10

Phlegm and Stasis Obstructing Network Vessels

Question 11

Wind Cold Damp POT

Answer 11

Dispel wind
Eliminate Dampness
Warm the channels
Free the flow of Qi

Question 12

Wind Damp Heat POT

Answer 12

Clear Heat
Eliminate Dampness
Free the flow of the network vessels to stop pain

Question 13

Qi/Blood Stagnation POT

Answer 13

Quick the blood and Transform stasis

Free the flow of the network vessels to stop pain

Question 14

Phlegm and Stasis Obstructing Network Vessels POT

Answer 14

Transform Phlegm
Dispel Stasis
Free the flow of the network vessels to stop the pain

Question 15

Phlegm and Stasis Obstructing Network Vessels Points

Answer 15

St 40
St 34
Ren 12

Question 16

Liver and Kidney Yin Def POT

Answer 16

Nourish the liver and Kidney Yin

Strengthen and reinforce the sinews and bones

Question 17

Kid and Liver Yin Def Points

Answer 17

K 3

K 7

Question 18

W-D-H Points

Answer 18

Du 14

LI 4/11

Question 19

W-C-D Points

Answer 19

LI 4

Sp 6

Question 20

Qi/Blood Stagnation Points

Answer 20

LI 4

Sp 6

Question 21

3 Stages

Answer 21

early: Non symptomatic stage, could be years

Acute: Arthritis stage, over 100 types of arthritis

Chronic: Deformity
Kidney Disease 10-20%
Tophi - Stone on skin or to kidneys

Question 22

Tx

Answer 22

Based on Location/Pattern

Ashi Points most important --> Lancet or Big thick needle
Sp 2/3
LI 4
Sp 6
St 44
Liv 3

Tophi: Surrounding needle technique

Auricular: sympathetic, shenmen, toe

Herbal Plaster: Not acute and not if skin is broken!

Question 23

Edu

Answer 23

Regulate Diet - no oily/spicy foods
Don't drink alcohol
Drink lots of H2O
Avoid Overwork
Avoid Stress
Avoid Cold

Question 24

What does Tophi mean?

Answer 24

“Stone”

A deposit of uric acid crystals that develop in cartilage tissue, tendons and soft tissues. These usually develop after a patient has suffered from the disease for many years. Deposits also can occur in the kidneys leading to chronic renal failure.