I Can Hear the Heart's Voice of Traditional Chinese Medicine-Chapter 304 - 134: Flowing Water Does Not Stagnate, Hinged Doors Do Not Decay (Acute Gout Attack) (2)

Chapter 304: Chapter 134: Flowing Water Does Not Stagnate, Hinged Doors Do Not Decay (Acute Gout Attack) (2)

Chen Xinghua inhaled sharply as he walked from the entrance to stand in front of Lu Xuan.

"Dr. Lu... good morning." It was probably Chen Xinghua’s first time here, and he seemed a bit nervous, frequently sucking in cold air, as if enduring some kind of pain.

"Good morning, please have a seat first," Lu Xuan gestured.

With Lu Xuan’s gesture, Chen Xinghua sat down directly, his face looking a bit grim.

Lu Xuan quickly asked, "Brother Chen, what’s wrong? You don’t look too well, constantly inhaling like that. Is there some pain or...?"

Chen Xinghua took another breath and said, "I’ve always had high uric acid. I’ve had it checked before, and the doctor said I was overweight and enjoyed eating seafood and meats, so I should be more restrained with my diet."

"With high uric acid, you definitely need to cut back on seafood and meats, especially seafood and offal. I think you’ve heard these are like a gout package," Lu Xuan nodded. At this point, he roughly guessed why Chen Xinghua was here.

High uric acid, or to put it more seriously—it’s gout.

If it were just high uric acid, Chen Xinghua wouldn’t be drawing cold breaths continuously; he’s clearly enduring some form of pain.

Thinking about the high uric acid he mentioned, it’s likely to be gout nine times out of ten.

Hearing this, Chen Xinghua sighed, "At first, I was quite careful, but over time, I found that apart from the uric acid being a bit high, I didn’t feel unwell, so I didn’t take it seriously. A few friends came over last night, and I had a bit to drink. I don’t know if it was because I was too tired during the day, but in the latter half of the night, the joints in my limbs and the joints in my wrists and toes suddenly became swollen and painfully unbearable.

It’s hard to even stand up. I’m working alone here in Yong City, just living nearby. I’ve heard you’re excellent, so I came to the health center to register before dawn."

Coming to register before dawn, it’s understandable he got the first number.

At the health center, a large part of the numbers is available online, but quite a few are reserved onsite, many of them being very early ones. This is also to accommodate patients who cannot register online.

Some hospitals even leave a number every couple of numbers to be available onsite for emergencies.

At Lu Xuan’s place, most of the time, the first number can only be gotten onsite.

So, in many cases, it’s impossible to get the first number online, unless it’s for doctors with no reputation and not many people registering to see them. Popular doctors with many patients generally have reserved numbers available onsite.

Otherwise, if there weren’t any reserved numbers onsite, the patients would be furious.

The health center clearly considered this situation, and there are quite a few reserved numbers onsite.

These are basically for the convenience of the residents around the health center; after all, they live nearby, making it easier to register early in the morning.

However, for someone like Chen Xinghua, who has difficulty moving, they really can only come before the health center opens, or they might not even get the onsite number.

After all, the ability of the elderly to get up early is not to be doubted.

"Is there anywhere else you feel uncomfortable?"

"I have some restricted movement, and I always feel feverish and chilly. When I came this morning, the guard had to help me because I was moving with difficulty, or I might not have gotten your number."

Lu Xuan nodded, instructing Chen Xinghua to remove his shoes as he put on medical gloves and gently pressed a few points. Chen Xinghua gasped in pain, almost yelling.

"It’s already quite severe. If you’d come sooner, some medication might have brought it down, but now it’s reached the stage of gout, making it much harder to treat."

Chen Xinghua deeply regretted it, "I didn’t know it would be so serious. If I had known, I wouldn’t have had that drink last night."

"It’s not just about that one drink. You should pay attention all the time," Lu Xuan replied irritably.

"See, you satisfied your craving, but you’re the one in pain now, aren’t you?"

Saying this, Lu Xuan couldn’t help but shake his head.

He then took Chen Xinghua’s pulse and checked his tongue.

The tongue was red, the coating was whitish and greasy, and the pulse was fast.

Even without tests, Lu Xuan knew the patient’s blood uric acid was probably alarmingly high.

And it was a typical acute attack.

In Western medicine, gout is a disease caused by purine metabolism disorders, with clinical manifestations of acute or chronic gouty arthritis having recurrent acute attacks, increased blood uric acid concentration, and those with prolonged disease having joint deposits, often leading to joint deformities, possibly accompanied by kidney disease, often complicated with kidney stones, etc.

The clinical manifestation of joint pain starts abruptly, often with sudden unbearable joint pain without activity, or sudden severe pain in the joint at night accompanied by fever and other systemic symptoms. Affected joints most commonly include the big toe and metatarsal-phalangeal joints, followed by the ankle, hand, wrist, knee, elbow, and other joints of the foot.

Particularly, the first metatarsophalangeal joint is most commonly affected. A few hours after the onset of joint pain, the area becomes hypersensitive, with significant redness, swelling, and heat.

In traditional Chinese medicine, gout is classified among the "Li Jie Feng" (cramping wind).

The etiology as mentioned in the "Suwen·Ju Teng Lun" states: "The continuous movement of the meridians is unending; they circulate without rest, and when cold enters the meridians, it causes delay. When qi stagnates outside the vessel, blood is insufficient; when it stagnates inside, qi is obstructed, thus causing sudden pain.

When cold stagnates outside the vessels, the vessel turns cold; coldness leads to shrinkage, shrinkage causes tension, tension pulls on the minor networks, thus causing sudden pain... Cold invading the channels meets residual warm qi causing swelling, leading to unbearable pain and hypersensitivity."

The name "Li Jie Bing" first appeared in the "Essential Prescriptions of the Golden Cabinet Treatment of Wind-Strokes and Arthritis": sweating causes entering the water, like water harming the heart, with continuous sweating causing joint pain, making movement intolerable, attributed to drinking and sweating in the wind."

The "Elbow Emergency Formulas" Volume Three and "Taiping Holy Benevolence Formulas" Volume Twenty-two also explained the causes of "Li Jie" disease: "White Tiger Wind disease results from toxins of wind, cold, heat, and dampness arising due to deficiency, leading to stagnation in the meridians with blood and qi not circulating, accumulating in the joints, or spreading in the limbs, with no external change in skin color, dormant by day and flaring by night causing bone-piercing soreness. Named White Tiger Wind due to symptomatology like a tiger’s bite."

The Yuan Dynasty physician Zhu Danxi, a founding master of the Yin-Nourishing School, detailed the etiology and pathology of gout: "Gout, fundamentally, results from heat in the blood leading to its boiling; subsequent exposure to cold water, standing on wet ground, enjoying the breeze, or resting in gusts results in cold mingling with hot blood.

The resulting coagulation causes pain, worse at night, traveling in the Yin channels. Pain migrates the joints with wind-heat, wind-damp, and blood deficiency."

In summary, gout is recognized by both ancient and modern physicians as related to metabolic imbalances, with causes often linked to obesity, indulgence in purine-rich seafood, high-protein foods, and excessive alcohol consumption.

Typically, individuals with obesity present exterior deficiency with self-sweating, prompted by wind encounter or cold exposure, or immersion in water, leading to stagnant blood and qi in the vessels, precipitating in the joints, especially during nighttime when the body’s metabolism slows, leading to acute joint pain hindering movement.

"Dr. Lu, I’ve heard gout is difficult to cure and can only be managed with painkillers; is that true?" Chen Xinghua couldn’t help but ask.

Ji Xiuwen, standing by and hearing that Chen Xinghua had gout, thought for a moment and asked, "This should be an acute gout attack, right? I think there aren’t any tophi formed yet."

Ji Xiuwen has identified Chen Xinghua’s acute gout attack, which Lu Xuan didn’t doubt; being a top student from Zhijiang University of Traditional Chinese Medicine, he would certainly possess such competencies.

Moreover, Chen Xinghua had clearly outlined his condition, and if they couldn’t deduce from that, years of study might have been in vain.

However, even so, Lu Xuan said, "Indeed, it’s an acute gout attack. Generally, acute gout attacks are easy to treat, but if not handled carefully, it may be mistaken for rheumatism, potentially delaying treatment and leading it into a chronic stage.

If it progresses to that stage, attacks become more frequent, affecting more joints with each occurrence. Post-attack swelling and pain may not fully subside, leading to joint deformation and restriction, and joint enlargement limits movement.

If tophi have formed, it’s mostly in the late stages of the disease. Tophi, usually found around the joint bones, erode bone structure causing deformities and bone damage, and may form hard nodules under subcutaneous tissue near joint bursae, tendon sheaths, and cartilage, which may be mobile, and additionally cause kidney or urinary calculi formation.

As the old saying goes, "Flowing water is never stale, hinges never rust." In the body’s unfaltering rise and fall, frequent indulgence in alcohol, fish, shrimp, rich foods, or obesity with inactivity often lead to gout."