Gout and homeopathy

Gout and Homeopathy:

Definition:

                Gout is the common end point of a group of disorders that produce hyperuricemia. It is marked by transient attacks of acute arthritis initiated by crystallization of urates within and about joints leading eventually to chronic gouty arthritis and the deposition of masses of urates in joints and other sites creating tophi. Tophi represent large aggregates of urate crystals and the surrounding inflammatory reaction (see later). Most, but not all, patients with chronic gout also develop urate nephropathy. A plasma urate level above 7 mg/dl is considered elevated because it exceeds the saturation value for urate at normal body temperature and blood pH.

 Normal uric acid level:

    Male:  2.4-6 mg/dl

    Female: 3.4-7 mg/dl

Types:

 1. Gout tophus or tophi

                  Such gout after the deposition of urates (tophi), forming hard concretion in the ear lobe and in the joints of fingers and toes.

 2. Gout with nodosities (tophi)

                  Gout with appearance of nodes, knots around the small joints of finger. It is also called tophi gout.

 3. Gouty arthritis deformans

                    A gouty disease in which there is inflammation around the joint, inflammation of a joint with deposition of salts in the affected joint. Such deposition causes the muscles to tighten and further can lead to deforming of the joint in one direction or bending of the joint to one side, thus it is called as gouty deformans or arthritis deformans. Generally wrist joint and finger joints are affected and turn to one side.

 Note : Gout causes myalgia (pain in the muscles), stiffness and pain in the joint.

Causes and risk factors:

      Inherited abnormality in uric acid metabolism

     Obesity

     High blood pressure

     Heavy alcohol intake

     Hypothyroidism

     Dehydration  

Pathogenesis:

Clinical symptoms:

     1.   Pain

     2.  swelling of big toe,knee

     3. redness

     4. tenderness

 Investigation:

  Serum uric acid level

  Plain X ray of the joint..

Homeopathic treatment:

Acute condition:

Colchicum autumnale:

                       In the evening fretful, cannot tolerate any annoyance; any external impression, noise, odor, touch or bright light makes him irritable. Toe-joint becomes inflamed, dark-red, hot and intensely painful; he is besides himself with agony. The foot becomes oedematous. Urine scanty and dark-red. The smell of food makes him sick at the stomach. Greatly prostrated.

 Ledum palustre

                      After abuse of alcoholic drinks; pimples on the forehead; face bloated; awakens with a hot, tensive swellings of the toe and foot, with tearing, shooting, grinding pains; cannot bear the least covering or the warmth of the bed; foot becomes oedematous, and yet the urine is copious and frequently passed. Old 

nodes, the sequelae of former attacks, become excessively painful.

 Arnica montana

                     Inflamed joint is shining, red and hard. He dreads the proximity of any one, having a constant fear that they will touch him. pains unbearable during the night; the bed feels too hard.

 Sulphur

                      Especially for drunkards or those who indulge in too rich food and take but little exercise; face blotched red; nose red habitually; as soon as he drops into a sleep the affected limb jerks and arouses him with excruciating pains. Pains are erratic and leave a sensation of numbness. Often indicated.

 Eupatorium perfoliatum

                    In some cases, when the big toe is swollen, the foot oedematous, the urine profuse and the body aches all over as it, the "bones were broken".

 Sabina

              Probably more for women; great toe hot, swollen, paining at night, worse from warmth of bed; high fever.

 Antimonium crudum

                  Especially when the stomach is involved; tongue white, bowels costive; vomiting and retching.

 Bryonia alba

                Joint swollen, tense, not very red; if he raises his head he feels deathly sick; tongue white down the centre; patient unbearably cross.

 Nux vomica

              The patient is irritable, overbearing; leads a sedentary life, and yet eats to excess; habitually costive; face sallow, but often also a flushing of the cheeks; arouses at 3 a.m.  with pains in the great toe. Useful for drunkards.

 Rhus toxicodendron

              After exposure to wet; must move, though it intensifies the pains.

 Benzoicum acidum

                 usually his urine has an offensive odor and deposits a reddish, clouded sediment, but now it is nearly clear and he complains of tearing in the joints; old nodes become painful. As these pains abate, palpitation of the heart sets in, ceasing only when they increase.

 Berberis vulgaris

                 Tearing, burning, stinging pains; patient subject to the formation of biliary calculi; darting sharp pains radiate from the kidneys, usually downward and along the ureters; urine cloudy, grayish, depositing a sediment; fistula in ano.

 Manganum-act. + -c. (old abbr.)

                 Toe or other joints dark-red in spots; tendo Achilles shortened; pains shift, seem to be in the periosteum, and are worse at night.

 China officinalis

              Painful; oversensitive to pain; great weakness; pains worse at night.

 For sub-acute and chronic cases, choose from the following:-

 Causticum

          Nodes on the joints; joints stiff, toes or fingers contracted; pains relieved by the warmth of the bed.

 Guajacum officinale

           Similar to the above and follows it well. Limbs drawn up and curved; worse from motion.

 Colocynthis

           Stiffness of the joints, with boring pains.

Lycopodium clavatum

            Nodes; fingers and toes pain more at night; swelling of the dorsa of the feet; numbness; flatulence; rumbling in the splenic flexure; full feeling after a mouthful or two food; lithic acid deposit in the urine. Must rise often at night to pass water.

 Calcarea carbonica

          Especially when the well-known "lime-constitution" exists. Useful for drunkards, who feel worse at every change of weather. Also, when standing or working in water aggravates the disease.

 Graphites

         Tearing in the toes; awakens at night and springs out of bed suffocating; eating relieves; gastralgia. Fleshy, bloated; nose red; skin rough, herpetic.

 Rhododendron chrysanthum

          Always worse at the approach of a storm, especially of a thunder-storm.

 Staphisagria

            Pain from the eyes to the teeth; eyes burn and feel dry despite the profuse lachrymation; patient weak, exhausted by dissipation; face sallow; eyes sunken

.

 Kalium hydroxydum

              Periosteum affected; distressing pains at night, preventing sleep; limbs contracted; morbus Brightii. Abuse of Mercury.

       

Kalium bichromicum

               Pains in the fingers alternate with gastric ailments.

 Natrium phosphoricum

             Caused pains about the heart, which ceased when pains returned in the toe.

 Lithium carbonicum

             heart affected; worse stooping; tearing down the limbs; urination relieves the heart. Deposits on the valves of the heart; pain from heart to head; burning in the great toe.

 Iodium

               Inveterate nocturnal pains, but not much dwelling of the joints.

 Ammonium phosphoricum

            To remove deposit in the joints.

 Aurum muriaticum

             Gnawing deep in the joints, which were recently inflamed.

Biochemics treatment:

Ferrum phosphoricum

           For the fever and other inflammatory symptoms.

 Natrium sulphuricum

           chief remedy for gout, especially if due to rich food, with bilious symptoms. In acute attack alternate with Ferrum Phos.

 Natrium phosphoricum

            If there is marked acidity, creamy coated tongue, sour smelling sweat, etc. Chronic gout.

. May be alternated with one indicated medicines given below

 Abrot, actea sp, Am phos, Ant c, Apis, Arbutus, Arnica, Bell, Benz ac, Berb v, Bry, Caust, Cim, Colch, Dulc, Elat, Graph, Guaiac, Kali c, Kali iod, Kalm, Led, Lith c, Lyc, Lycopus, Nat m, Nux m, Nux v, Puls, Phododen, Rhus t, Ruta or Sul 30. See their therapeutics under arthritis.

Diet and management:

          purine rich foods like shellfish,organ meats like liver,kidney and brain to be avoided..

dairy product may reduce the pain…

exercise ia must.