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Why is there a lack of effective diagnosis and treatment for gout in medical clinical practice?
Gout is characterized by swelling, pain, joint involvement, recurrent attacks, and the accumulation of urate crystals, forming tophi. The earliest Chinese Traditional Medicine (TCM) understanding of gout (formerly known as "bi syndrome") can be found in the "Questions on Bi Syndrome" in the Huangdi Neijing. It attributes gout to the combined effects of wind, dampness, and cold, forming "bi" (bi). It further categorizes gout into three types: wandering bi, painful bi, and fixed bi. The pain associated with bi syndrome is described as roaming through the joints, resembling a tiger's bite. During the Eastern Han Dynasty, the medical sage Zhang Zhongjing further elaborated on the pathogenesis of gout. In the "Golden Chamber Essentials: Pulse Symptoms and Treatments for Stroke and Lijie Diseases," Zhang Zhongjing wrote that pain in the joints (i.e., gout) and inability to bend or stretch are caused by drinking alcohol and sweating in the face of wind. This coincided with the discovery of a link between alcohol consumption and gout by the renowned Greek physician Galen, who was also a contemporary. This fact demonstrates that ancient Chinese Traditional Medicine (TCM) and Western medicine, originating in Europe, explored the causes of gout simultaneously, and their understanding of the causal conditions was essentially the same.
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2025
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09
Hippocrates (460-370 BC), the ancient Greek physician considered the father of Western medicine, was the first to describe gout, calling it "the disease that makes one unable to walk." He also argued that gout was the arthritis of the rich, while rheumatism was the arthritis of the poor. In his Aphorisms, he explained gout as follows: eunuchs are immune to gout, women only develop it after menopause, gout inflammation subsides within 40 days, gout is more common in spring and autumn, and rich food and wine are associated with its onset. He also proposed the "humoral theory," which laid the early theoretical foundation for the later exploration of hyperuricemia.
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2020
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03
Why is gout considered an ancient human disease?
In Traditional Chinese Medicine, gout is referred to as "bi syndrome," meaning "pain or numbness in the limbs caused by wind, cold, dampness, and other factors." The Yellow Emperor's Classic of Internal Medicine, written during the Warring States Period before the Common Era, states that "overuse of the five internal organs, resulting in imbalance of qi and blood, leads to endogenous bi syndrome (gout)." The term "gout" in Traditional Chinese Medicine first appeared in the Liang Dynasty's "Ming Yi Bie Lu" by Tao Hongjing during the Southern and Northern Dynasties. After the Jin and Yuan Dynasties, monographs by Zhu Danxi and Gong Tingshen provided detailed descriptions of gout.
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2020
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