GOUT

Clinical Manifestations
  • Aversion to Wind
  • Mild, or severe chills
  • Fever which may be persistent
  • Uneasiness from fever
  • Spontaneous perspiration
  • Headache
  • Muscle aches and pain
  • Stiff neck and shoulders
  • Nausea
  • Nasal irritation
  • Nasal obstruction
  • Tendency to snore
  • Itchy throat
  • T:  Normal
  • C:  Thin and white
  • P:  Superficial and slow or Moderate and maybe weak
Treatment Principle
  • Create sweat to relieve the Exterior and expel Wind
  • Harmonize Ying and Wei to protect digestion and nourish Wei Qi
Herb Formulas
Points
Clinical Manifestations
  • Wandering joint pain, especially the wrists, elbows, knees and ankles
  • Chills and fever
  • Atrophy above and below the knees
  • Limited movement
  • Paralysis of knees
  • One or both knees swollen, enlarged and painful
  • Stiffness of knees
  • Legs so weak and sore after dysentery that it is difficult to walk
  • Generalized pain and numbness in the legs
  • Hemiplegia
  • Dizziness
  • Neuralgia
  • Paralysis, stiffness, swelling and pain of feet
  • Atrophy of the leg muscles
  • Chest oppression
  • Lumbago
  • Tinnitus
  • T: Pink or Pale and swollen or Red
  • C: Thin white or Greasy white
  • P: Superficial and tense or tight or Deep and thin or Deep and weak or Deep, slow and weak
Treatment Principle
  • Dispel Wind
  • Activate Qi and Blood
  • Tonify Qi and Blood
  • Eliminate Cold-Dampness
  • Tonifies Yang
  • Strengthens the muscles, tendons and bones
Herb Formulas
Points
Clinical Manifestations
  • Joint pain, especially in the wrist, ankle, knee and elbow
  • Muscle pain
  • There may be numbness and heaviness in the limbs
  • The pain is worse with Cold and better with warmth
  • The pain is aggravated by Wind
  • The pain aggravated by Dampness
  • The pain is stabbing
  • Muscle weakness
  • Difficult movement
  • Numbness of the muscles and skin
  • Hemiplegia, especially of the upper limbs
  • The pain alleviated by movement
  • Slight muscle edema
  • Heaviness of the joints
  • Cold joints
  • Aversion to Cold
  • The pain worse at night
  • Local inflammation
  • Migratory pain
  • Deviation of the eyes and mouth
  • Spasm of the limbs
  • T: Slightly purple or purple spots
  • C: Thick and white
  • P: Slippery or Slightly superficial or slightly rough or Slow and Soft or Wiry and tight or Floating and wiry
Treatment Principle
  • Remove Wind-Dampness
  • Eliminate Painful Obstruction
  • Circulate Qi and Blood
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • Painful joint flare ups at night
  • Joints are red, hot, swollen and extremely painful =Damp-Heat caused by Excess Dampness in diet or yang Deficiency caused by over exertion, recurrent infections, trauma or surgeries
  • Predominant location is in the Spleen channel at level of big toe (Damp-Heat or Phlegm-Heat) with frequent relapses at end of spring and fall
  • “Tophi” (chalk stone deposits) form on joints =Phlegm-Cold (governed by the lungs) Uremic Arthropathies= Spleen dysfunction (governs the circulation of fluids in the joints)
  • Uremic Nephropathies= Kidney dysfunction
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Migrating pain in the joints especially the :
    Shoulders
    Elbows
    Knees
    Wrists
    Fingers
    Upper back and neck
  • Multiple joints
  • Pain quality changes
  • May move from soreness to numbness to aching
  • Sensitivity varies
  • Pain often appears abruptly, acutely or paroxysmal and then disappears
  • Limited range of motion
  • Chills and fever
  • Aversion to Wind
  • Symptoms are worse in windy weather
  • Sore throat
  • General body aches
  • Maybe perspiration
  • T: Pink
  • C: Thin and white or Sticky and yellow
  • P: Superficial and moderate
Treatment Principle
  • Eliminate Wind
  • Warm Cold
  • Expel Damp
  • Clear the Channels
Herb Formulas
Points
Clinical Manifestations
  • Numbness and heaviness of the extremities
  • Soreness and fixed pain of joints
  • Stiffness or numbness of the muscles or skin
  • Pain worse on cloudy or rainy days
  • Maybe peripheral or systemic edema
  • Pain is alleviated by pressure and warmth
  • Pain lingers and is recalcitrant to treatment
  • Worse during cloudy or wet weather
  • Limited movement
  • Edema
  • Maybe stifling sensation in chest
  • Maybe anorexia or indigestion
  • Maybe abdominal distention
  • Maybe loose or semi-liquid stools
  • T: Pink or Pale
  • C: Greasy and white
  • P: Slow, moderate and soft
Treatment Principle
  • Expel Damp
  • Clear the channels
Herb Formulas
Points
Clinical Manifestations
  • Excruciating sharp, stabbing joint pain
  • Pain alleviated by warmth and aggravated by Cold
  • Pain with fixed location
  • Few joints are involved
  • The joints cannot be flexed or extended
  • No local redness or Heat
  • Painful area often feels cold to the touch
  • Pain worse at night and better during the day
  • Pain mostly affects low back and lower extremities
  • Pain intense but short lived
  • Pain changes over days or weeks
  • Ankylosis (stiffness) of joint
  • Aversion to Cold
  • Maybe chills with a slight fever
  • Anhidrosis
  • Frequent nocturnal urination
  • T: Pink or Pale
  • C: Thin and white (thicker than for Wind-Bi)
  • P: Superficial and tight or Wiry and tight - maybe slow
Treatment Principle
  • Warm the channels
  • Activate Qi and Blood.
Herb Formulas
Points
Clinical Manifestations
  • Attacks of severe acute joint pain which is fixed in location, worse with Cold and better with warmth
  • Aversion to Wind, Cold and Dampness
  • Stiff and painful muscles and joints
  • Limited movement
  • Pain aggravated by Wind
  • Sensitive to climatic changes
  • Numbness of muscles
  • Pain aggravated by Dampness
  • Cold joints
  • Possible deformation and hardening of the joint with restricted movement
  • Maybe joint swelling without redness or Heat
  • Pain worse at night
  • Low back pain or soreness
  • Lumbago
  • Fatigue
  • Heaviness of the body
  • Heaviness of the muscles
  • Preference for warmth
  • Weak joints
  • Palpitations
  • Pale face
  • Shortness of breath
  • Preference for dry weather
  • T: Pale or Purplish
  • C: Thin, white and greasy
  • P: Thready and weak or Thready and slippery or Deep, slippery and wiry or Soft, moderate and wiry
Treatment Principle
  • Dispel Wind-Cold-Damp
  • Tonify Qi
  • Warm the channels
  • Strengthen the tendons
  • Nourish and Invigorate the Blood
  • Break up Blood Stasis
  • Eliminate Damp
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • High fever accompanied by severe chills and shivering
  • Aversion to Cold
  • Pain worse at night
  • Difficult movement
  • Local inflammation
  • Migratory pain
  • Soreness and pain of the extremities
  • Nasal congestion with sonorous breathing
  • Anhidrosis
  • Pain and stiffness of the head and neck
  • Focal distention and fullness of the chest and diaphragm
  • A productive cough
  • May have numbness and heaviness in the limbs
  • Body aches
  • Nasal obstruction
  • Cough with sputum
  • Stuffy nose
  • Joint pain
  • Pain worse with Cold and better with warmth
  • Pain aggravated by Wind
  • Pain aggravated by Dampness
  • Pain is stabbing
  • Muscle weakness
  • Pain alleviated by movement
  • Slight muscle edema
  • Heaviness of the joints
  • Cold joints
  • Headache
  • Dizziness
  • T: Pale or Slightly purple or Purple spots
  • C: White or thin, white, greasy
  • P: Slippery or Slightly superficial or Superficial and soft or Slightly rough or Slow and Soft or Wiry and tight or Superficial and rapid that is forceless under pressure
Treatment Principle
  • Release the Exterior
  • Augment Qi
  • Remove Wind-Cold-Damp
  • Eliminate Painful Obstruction
  • Circulate Qi and Blood
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • A generalized sensation of heaviness
  • Neck, shoulder, elbow and upper back stiffness
  • Numbness of the extremities
  • Difficulty moving
  • Wandering joint pain, especially in the neck, shoulder, upper back and elbow
  • Upper back spasms
  • Immobility of the joints
  • Wandering joint pain
  • T: Normal
  • C: White
  • P: Moderate or Floating and slow or Slippery or Slow or Superficial and wiry or tight
Treatment Principle
  • Tonify Qi
  • Nourish Blood
  • Dispel Wind
  • Eliminate Dampness
Herb Formulas
Points
Clinical Manifestations
  • Generalized body aches and pains
  • Irritability
  • Heavy sensation in the shoulder and back
  • Discomfort or a constricted sensation in the area of the chest and diaphragm
  • Multiple sores, carbuncles furuncles or abscesses
  • Redness
  • Itching
  • Persistent swelling
  • Chest pain
  • Fever
  • Thirst
  • Aching and painful extremities
  • Aching and painful joints
  • Eczema in the genital area
  • Unbearable swelling and pain of the lower extremities
  • Shoulder stiffness
  • T: Normal
  • C: Greasy and slightly yellow
  • P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight
Treatment Principle
  • Resolve Dampness
  • Clear Heat
  • Disperse Wind
  • Stop pain
  • Activate the Blood
  • Tonify Qi and Blood
Herb Formulas
Points
Clinical Manifestations
  • Severe, acute joint aching and pain
  • The pain is in a fixed location
  • The pain is accompanied by redness, swelling and Heat
  • Irritability
  • Heavy sensation in the shoulder and back
  • Discomfort or a constricted sensation in the area of the chest and diaphragm
  • Multiple sores, carbuncles furuncles or abscesses
  • Itching
  • Persistent swelling
  • Chest pain
  • Fever
  • Thirst
  • Aching and painful extremities
  • Aching and painful joints
  • Eczema in the genital area
  • Unbearable swelling and pain of the lower extremities
  • Shoulder stiffness
  • Constipation
  • Reddish, yellow urine
  • T: Red
  • C: Greasy and yellow
  • P: Slippery, wiry and rapid
Treatment Principle
  • Resolve Dampness
  • Clear Heat
  • Disperse Wind
  • Stop pain
  • Activate the Blood
Herb Formulas
Points
Clinical Manifestations
  • Protracted, incessant cough
  • Expectoration of copious, clear, watery or white Phlegm
  • Short, weak, breathing
  • Asthma
  • Spontaneous sweating
  • Weak voice
  • Reluctance to speak
  • A general air of sadness or melancholy
  • A waxy, pale complexion
  • Rounded or hunched shoulders
  • Four limbs tired
  • Anorexia
  • General lassitude
  • Distention and pain of the epigastrium and abdomen
  • Loose stools
  • Severe cases:
    Frightens easily
  • T: Pale with a thin crack
  • C: White or White and greasy
  • P: Thready and weak or Floating and weak
Treatment Principle
  • Reinforce the Spleen
  • Benefit the Lungs
  • Descend Lung Qi
  • Disperse accumulation
Herb Formulas
  • Wu Ji San
  • Chinese Patent Medicines:
    Su Zi Jiang Qi Wan
    Jiu Fei Su He Wan
Points
Clinical Manifestations
  • Continuous cramping pain in the abdomen
  • Pain is not severe
  • Pain is relieved by pressure
  • Edema of the feet
  • Urinary difficulty
  • Slight edema (primarily of the lower limbs)
  • Symptoms generally occur during pregnancy
  • Pale face
  • Fatigue
  • Heaviness of head
  • Lassitude
  • Lower abdominal pain
  • Dizziness
  • Tinnitus
  • Lumbago
  • Edema
  • Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation
  • Oliguria
  • Palpitations
  • Cold feet
  • Extreme coldness of the hands and feet
  • Vertigo
  • Weakness and numbness of lower back and legs during pregnancy or postpartum
  • Mal position of the fetus
  • Dysmenorrhea
  • Irregular menstruation
  • Right upper quadrant pain
  • Hepatomegaly
  • Anemia
  • Lack of energy
  • Sore back
  • Thirst with no desire to drink
  • T: Pale or pink maybe petechiae on margin
  • C: Thin or Greasy white
  • P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle
  • Strengthen the Spleen and Kidneys
  • Resolve Dampness
Herb Formulas
Points
Clinical Manifestations
  • Irritability
  • Anxiety
  • Palpitations
  • Night sweats
  • Dizziness
  • Vertigo
  • Dry throat and mouth no thirst
  • Fidgeting
  • Insomnia
  • Insomnia due to stress
  • Excessive dreams
  • Lack of energy
  • Weakness and fatigue
  • Weak abdomen
  • Restlessness
  • Sleepiness
  • Light-headedness
  • Impatience
  • T: Pale or Red and dry
  • P: Wiry and rapid or Thready and rapid or Thready and weak or Thready and tight
Treatment Principle
  • Nourish Liver Blood
  • Calm the Shen
  • Clears Heat in Liver
  • Eliminate irritability
Herb Formulas
Points
Clinical Manifestations
  • Enduring joint pain
  • Symptoms worsen after exertion
  • Lack of joint flexibility
  • Facial complexion pale and sallow
  • Both cheeks slightly red
  • Dizziness
  • Dry eyes
  • Blurred vision
  • Spots before the eyes
  • Numbness of limbs
  • Flaccid paralysis (Wei syndrome), weakness
  • Tinnitus
  • Deafness
  • Forgetfulness
  • Low back and knees sore and painful
  • Throat dry and painful
  • Five sole Heat
  • Low-grade fever
  • Night sweats
  • Irritability
  • Insomnia
  • Stools difficult to pass
  • Constipation
  • Men:
    Spermatorrhea
  • Women:
    Irregular menses or
    Scanty menses or
    Amenorrhea
    Vaginal discharge
  • T: Red
  • C: None
  • P: Thready and rapid
Treatment Principle
  • Nourish and Reinforce the Liver and Kidneys
  • Strengthen and reinforce sinews and bones
Herb Formulas
Points
Clinical Manifestations
  • Painful joint flare ups at night
  • Joints are red, hot, swollen and extremely painful =Damp-Heat caused by Excess Dampness in diet or yang Deficiency caused by over exertion, recurrent infections, trauma or surgeries
  • Predominant location is in the Spleen channel at level of big toe (Damp-Heat or Phlegm-Heat) with frequent relapses at end of spring and fall
  • “Tophi” (chalk stone deposits) form on joints = Phlegm-Cold (governed by the lungs) Uremic Arthropathies = Spleen dysfunction (governs the circulation of fluids in the joints)
  • Uremic Nephropathies = Kidney dysfunction
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Pain that is severe, fixed and stabbing or
  • Pains that move around
  • Distention
  • Depression
  • Irritability
  • Pan is worse with pressure
  • Dark complexion
  • Fixed, palpable masses
  • Bleeding with clots
  • Purple lips
  • Purple nails
  • Dry skin
  • Blue, dark or purplish discoloration of skin in small or large areas,
  • Varicose and spider veins
  • Cold hands and feet
  • Tendency to hemorrhage dark blood or clots
  • T: Purple, possible purple or red spots
    Red purple if there is Heat
    Blue purple if there is Cold
  • C: White
  • P: Choppy or Wiry and choppy
  • Note: This pattern often accompanies and complicates other patterns.
Treatment Principle
  • Invigorate the Blood
  • Break up Stagnation
  • Unblock the channels
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • Weakness of the knees
  • Soreness of the lower back
  • Lumbago
  • Atrophy of the leg muscles
  • Lower back weakness
  • Knee pain
  • Difficulty walking
  • Emaciation
  • Impotence
  • Poor memory
  • Dizziness
  • Night sweats
  • Five-sole Heat
  • Aggravation of the pain by Damp weather
  • Pale complexion
  • Profuse urination at night
  • Tinnitus
  • Hair loss
  • Sensation of warmth
  • Thirst
  • Dry skin
  • T: Red or Pale and flabby with teethmarks
  • C: Little or Thin and white
  • P: Thready and weak, especially in the Kidney positions
Treatment Principle
  • Tonify the Liver and Kidneys
  • Strengthen the tendons and bones
  • Eliminate Damp-Heat
  • Tonify Kidney Jing
  • Relieve rheumatic pain
Herb Formulas
Points
Clinical Manifestations
  • Distension and pain before or during menses
  • Burning abdominal pain which precedes or follows the menstrual flow with guarding
  • Soreness and distention of the lower back
  • Pressure makes the pain worse
  • There may be constant lower abdominal pain that worsens with menstruation
  • Hot sensations
  • A feeling of Heat in the abdomen
  • Aversion to Heat
  • Yellow smelly vaginal discharge between periods
  • Dark-red or purple thick Blood with clots
  • Maybe heavy bleeding
  • Maybe dark, scanty, concentrated urine
  • May be a mild fever
  • T: Red
  • C: Yellow and greasy
  • P: Wiry and rapid or slippery and rapid or soft and rapid
Treatment Principle
  • Resolve Dampness
  • Clear Heat
Herb Formulas
Points
Clinical Manifestations
  • Severe, acute joint aching and pain
  • The pain is fixed in location
  • The pain is marked by pronounced swelling and distention of the affected joints
Treatment Principle
  • Eliminate Dampness
  • Discharge turbidity
  • Invigorate the Blood
  • Transform Stasis
Herb Formulas
Points
Clinical Manifestations
  • Ulcerated sores that do not heal on a limb that is dark red
  • Slightly swollen and warm to the touch
  • There may me a rotten smell to the lesion
  • Gangrene of the extremities, especially the fingers and toes with purulent abscess
  • Extreme pain
  • Local inflammation and swelling
  • There may be copious discharge of pus from the ulcers
  • A burning sensation
  • Fever
  • Thirst
  • T: Red
  • C: Normal
  • P: Rapid
Treatment Principle
  • Clear Heat
  • Resolve toxicity
  • Nourish Yin
  • Activate the Blood
  • Alleviate pain
Herb Formulas
Points
Clinical Manifestations
  • Heat and pain in the joints and muscles
  • Severe limitation of movement
  • Fever and shaking chills
  • Lusterless yellow complexion
  • Scanty, dark urine
  • Pain worse on cloudy or rainy days
  • Arthralgia involving one or several joints
  • Local redness and Heat of the extremities
  • Swelling with excruciating pain
  • Pain better during the day and worse at night
  • Numbness of the muscles
  • Thirst
  • Dryness of the mouth
  • Irritability
  • Muscular atrophy
  • Restlessness
  • Anorexia
  • Desire for Cold drinks
  • Loose stools
  • Aversion to Heat
  • Fullness of the chest
  • Pain improved with Cold and worse with Heat
  • Muscular swelling
  • Muscle redness
  • General heaviness
  • T:Red, maybe flabby
  • C: Yellow and greasy
  • P: Slippery and rapid
Treatment Principle
  • Clear Heat
  • Eliminate Dampness
  • Invigorate the collaterals
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • Enduring joint pain which is sometimes mild and sometimes stronger
  • The joint pain does not heal
  • Recurrent attacks of joint swelling
  • Restricted movement
  • Maybe dark, purple skin in the affected area
  • Stiffness, hardening and deformation of the joints
  • Tophi (painless uric acid crystals) under the skin, mainly on the face, ears and joints
  • T: Dark or Purple with possible static spots
  • C: White
  • P: Thready and choppy and/or wiry
Treatment Principle
  • Transform Phlegm
  • Dispel Stasis
  • Unblock the channels
  • Stop pain
Herb Formulas
Points