"Gout, unlike any other disease, kills more rich men than poor, more wise men than simple". Great kings, emperors, general, admirals & philosophers have all died of gout. Gout is a Purine metabolic disorder. It is a disorder in which MUMC (Momo urate monohydrate crystals) deposited around the connective tissue of the synovial joints. Urate crystals form due to the increase level of uric acid in the blood. Gout is also known as Podgra, when it involves joint at the base of big toe. Males are more sufferer than females. The uric acid level increases in males over 20 years of age and in females it increases after menopause. Normally, uric acid dissolves in the blood and passes through the kidneys. But sometimes, when the body produces too much of uric acid (in females more than 6.0 mg/dL & males more than 7.0 mg/dL) or when kidneys are not able to excrete uric acid properly. Then level of the uric acid increases and there is a formation of needle like urate crystals in the joint which causes pain, swelling and inflammation.
According to Ayurveda Gout is known as vata-rakta roga. Vata means (wind), rakta means (blood) and roga means (disease). In this vitiated vata doshas get combined with impure blood (rakta dhatu) and travel throughout the body causes swelling, inflammation and severe pain in the joints. Due to intake of diet consisting of salty, sour, pungent, alkaline, fatty, hot and uncooked articles, moist or dried things, meat of aquatic and marshy animals, oil-cakes, radish, horse gram, black gram, other leguminous vegetables, sesamum paste, sugarcane, curd, sour gruel, vinegars, buttermilk, incompatible food, eating during indigestion, anger, day-sleep, vigils mostly in delicate persons who eat delicious things at pleasure & are not in habit of walking aggravates vata-rakta (Gout). It seats in hands, feet, fingers & all joints. At first it confirms its root in hands & feet. Then spreads over all the body.
Due to subtleness & pervasiveness of vayu, liquidity & flowingness of blood it circulates all over the body through blood vessels. Being obstructed in joints due to zigzag way it gets located there with agitation & in combination with pitta dosha etc. causes respective afflictions. Hence, it produces pain in mostly various joints and as such patient suffers from respective pain very difficult to tolerate.
Synovial joints on the distal end of the first metatarsal phalangeal is affected. There is swelling, arrhythmia, tenderness, extreme pain and this condition is called POGDRA. There are fewer chances that it will affect the large proximal joints in the first attack. In gout there is a formation of the tophi in metacarpal joints, elbow, and knee etc.
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