Gout
This is a clinical condition characterized by an increase in secum uric acid levels and recurrent attacks of arthritis affecting the first metatarsophalangeal joint to start with followed by gradual involvement of other joints.

CAUSES

Common in men above 40 years of age.
Alcohol and rich food can aggravate the condition
Obesity may predispose or aggravate
Trauma, dietary6 excess, acute infection and surgery may precipitate attack.
Multifactorial inheritance of a metabolic error (Purine metabolism) is the basic cause of primary gout in most cases.

SYMPTOMS

In many cases, high uric acid level in blood may persist for years without any clinical symptoms of gout.
Sudden onset of excruciating pain with swelling of the first metatarsophalangeal joint in the middle of the night, awakening the patient from sleep accompanied by fever with chills, anorexia, headache, malaise, etc., may also be present.
Patient becomes restless and tosses about in agony throughout the night.
After the great toe, the insteps, ankles, heels, knees, wrists, finger and elbow are involved in order of frequency.
The inflamed joints are intensely sensitive to touch and in some cases even the bed clothes are unbearable.
Attacks last for one to two days or weeks and then subsides spontaneously.

This is followed by:
Asymptomatic invervals for varying period. Hence, spontaneous remissions and relapses are characteristic features of acute gout.
There may be local venous prominence, cellulites with extremely tender swelling of the affected joints.
There may be itching or scaling of the skin over the affected joints during recovery.


TREATMENT

Try and reduce weight
Avoid diet rich in animal fats
Enough fluid should be taken
Eat more of green vegetables
Avoid alcohol
Restrict fat in diet
Rest in bed during acute attacks do not overwork the joints.
Apply hot or cold compress as desired by the patient.
Physiotherapy and moderate exercise may help.
Symptomatic medicines for palliation of pain.
Constitutional homoeo remedies are needed for correcting the metabolism.