|Posted on Tuesday, November 25, 2003 - 14:35: |
Hi Dr. Halevi. My name is Phil and I am a registered acupuncturist from L.A. I have a male patient (46 yrs old) suffering from recurrent gout on his toes and the meta tarsal fascia, and ocassionally on his rt. knee. When this happens his knee, or toes, are very swollen and red-purple with extreme pain. My acupuncture does not seem to help him very much and he needs to take NSAIDs in order to relieve the pain and inflammation. Is there a specific technique for the treatment of gout that you can recommend of? Anything beside diet and NSAIDs? - thanks -
BTW, your forum looks great... all the best.
|Posted on Wednesday, November 26, 2003 - 04:04: |
Thanks for your kind words Phil. As for the gout, it usually gives better results with acupuncture than NSAIDs, despite the fact that I see no harm in administering both in order to relieve the patient's suffering as fast as possible. Gout is differentiated in C.M. as a Bi syndrome due to blood stasis and/or toxic blood affecting the joint. It has a component of Dampness as it causes also swollen joints and it bears downward to the lower parts of the body, in most cases. In order to relieve the pain and inflammation in the acute stage, you need to use blood-letting technique at the Well-jing points of the affected toes (or meridians, in case of the knee alone). Beside these points use Li-4/ Liv-3/ B-40 (weizhong) and Li-11 as secondary points. As local points (besides the Jing-well points) use the strongest points in the area of the pain. (Liv-3/ Sp-6/ St-44/ Sp-3...etc.) Needle must be retained for longer periods of time, 30-60 min and manipulated every 10 min in dispersion. In the chronic phase, you may need to differentiate the syndrome properly and treat it (herbs or acupuncture) in between the attacks. Many practitioners make the mistake and treat the syndrome while the patient is in the acute stage, or treat the disease by its Western diagnosis, i.e., excess of uric acid in the blood. I do not speak of diet as I am sure you are aware of its importance. One note though, coffee elimination is of prime importance here, as much as wine, etc. Good luck and keep me posted.
|Posted on Wednesday, January 07, 2004 - 12:27: |
Sorry for the late reply, but I recall studying that gout is considered a damp heat condition, is it not so and if so how it affects the treatment startegy?
|Posted on Thursday, January 08, 2004 - 12:34: |
Hi Phil. Here is a reply I posted sometime ago on another Chinese medicine forum on the net. This post covers your question exactly:
I am afraid I can not agree with you on this Joe. Nobody says gout
is Wind-Cold-Dampness, yet it IS a severe BI-stagnation syndrome. It
is a Blood-stasis kind of Bi. If you analyze the manifestations of
gout, you find extreme local pain with stabbing quality, a deep
purple-black color in the affected joint, swelling and pricking as
well as black blood when you squeeze out a few drops of blood. All
of these signs, as well as usually a very choppy and wiry pulse,
indicate a blood stasis phenomenon. There is another sign indicative
of blood stasis. Most gout sufferers feel somewhat relieved when hot
shower is applied on the gout, whereas damp-heat sufferers usually
feel worse with hot water. If you refer to the cause of gout, you
can see that it is caused by the sedimentation of very sharp uric-
acid microscopic cristals in the joint's connective tissues with the
ligaments and inside the crevices of the joint. This is purely a
microscopic trauma to the joint, a trauma that leads to blood stasis
I know that many schools of acupuncture teach their students what
you have said, but alas, experience and logic must prevail. Also, as
I have said in the link above (
if you treat by acupuncture in the technique of blood-stasis
removing, results are immediate and excellent, which is of course
the final proof to what I argue.
When speaking about the causes of gout, I think that you are wrong
again. People may get gout from different etiologies. Some people
get it from excessive liver Yang Qi or liver Qi stagnation (these
are mostly those who exhibit also hypertension, as few of the
writers here indicated), some patients get to this problem out of K.
Qi deficienecy leading to the down pouring of damp heat (later
evolving into blood stasis), and some, not the majority by all
means, due to spleen syndromes. BTW, I wonder if you know that there
is a considerable number of patients that get into a gout attack
simply by having a blow or impact directly on their knee or toe, and
sometimes even due to the exertion of a specific joint. This further
indicates a blood stasis factor.
|Posted on Friday, February 20, 2004 - 20:37: |
Hi Dr. Halevi;
In your article on Gangrenous diabetic Abscess...
You mention that you instructed your patient to apply a strong green tea dressing to the wound. Why green tea, what was it supposed to do and how does it work.
|Posted on Friday, February 20, 2004 - 22:18: |
Yes, Ted, I have been using green tea dressings in many instances in the past, for various inflammatory disorders, with very good results. In this specific case, the ulceration was wide open, oozing pus and fast developing. The hospital treatment insisted that it must be bandaged all the time after the application of their anti-biotic ointments. This did not relieve the condition a tiny bit, in the contrary, it got worse very rapidly. My strategy was to have it exposed to the air so that it could dry out. Green tea is drying and has an anti bacterial and anti carcinogenic properties, according to quite a number of researches. Thus, the dressing was applied several times a day, each time for half an hour and then removed in order to leave the wound exposed.
|Posted on Monday, February 23, 2004 - 20:25: |
Thank you for your reply.
I too use green tea for stings and rashes, with good results.
|Posted on Wednesday, August 18, 2004 - 22:27: |
why people with gout cant eat red meat and can eat white meat if both have the same level of purines
|Posted on Thursday, August 19, 2004 - 16:23: |
I would suggest a complete meat free diet. In any case, red meat is more difficult to digest and contains more hot energy than white meat. Gout is characterized as a hot, or damp-hot disorder and this is why hot-energy food is contra-indicated. This includes alcoholic beverages as recognized by Western med. but also coffee or pungent food by Ch. med.
|Posted on Monday, March 28, 2005 - 11:39: |
In your homepage reference on gouty arthritis you mention that:
As mentioned above, it is strongly advised to drink plenty of water (at least 12 glasses daily) and refrain from excessive sexual activity, excessive physical exertion and traumatic injuries.
You also say:
Those "researches" that recommend intensive sexual activity for gout sufferers, rely on false researches and false conclusions.
Can you please elaborate on these statements?
|Posted on Tuesday, March 29, 2005 - 17:48: |
Why yes of course, Phil. Excessive sexual activity depletes the kidney Qi (energy) according to Ch.med. We know today that gout is caused mostly due to the inability of the kidneys to excrete uric acid thus causing uricemia (too much uric acid in the blood serum). In view of this, one of our concerns in the management of this disorder, is not to further weaken kidney Qi - or, to try and strengthen (we call it solidify) this kidney Qi. I suppose that researches who claim that their findings show that frequent sexual activity is beneficial in the management of gout, have problem in interpreting the data. I would say that those who are able and can manage an abundant sexual life have a relatively strong kidney Qi and this is why their gout attacks are less often or less acute. just the other way round...
|Posted on Saturday, April 09, 2005 - 11:33: |
Thank you kindly for your reply. Is it also possible that having sex often may drain excessive damp-heat from the kidney?
Can this contribute to a reduction of uric-acid in the system?
|Posted on Sunday, April 10, 2005 - 21:31: |
This is a very nice idea Phil. While Ch. med. literature derfinitely advocates restrain in sexual behavior, it is also aware of the fact that total abstinence may cause stagnation. Stagnation of kidney Qi may turn into damp-heat as you say, thus contributing to damp heat which may take the form of uricemia. Still, there is quite a difference, in view of Ch. med. doctrine, between an excessive sexual behavior (such as recommended in the quoted researches) and a moderate normal sexual conduct. The latter, especially when done in accordance with the seasons cycle, is proper and healthy. Excessive sexual behavior, on the other hand, is depleting the Qi of the kidneys, thus contributing to the weakness which is one factor of the gout etiology.
Clinical experience show that reinforcing kidney Qi by acupuncture while, at the same time, leveling liver functioning and reducing damp heat, may reduce uric acid blood level. Yet, strengthening the kidneys often increase sexual desire and functioning. It is recommended to point out this probability to the patient and warn him not to indulge in excessive sexual activity, lest the treatment objective be in jeopardy.