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Case Study

Podagra - Gout
Dr K Raju
'Urt-uren / Calc-flour

Rheumatology is the science or study of Rheumatic disease. Though Gout presents as rheumatic disease, it differs entirely from rheumatism. The causative factor of the disease is the excess of Uric acid in the blood. Uric acid is the end product in the metabolism of first class proteins and is excreted in the urine; it is relatively insoluble and liable to give rise to stones. Gout is a form of metabolic disorder in which sodium biurate is deposited in the cartilage of joints and the ears. Characteristically it involves the MP joint of the big toe which is acutely painful and swollen. It affects males more than females mainly after the age of 40 years, and spares children.

Heredity plays an important role in the causation. Hyperuricemia is the condition, Gout being one of the manifestations. Gout affecting finger, shoulder, and knee joints are called Chiragra, Omagra and Gonagra respectively. An acute stage makes the joints painful, hot and sensitive to touch. Diet restriction consists mainly of high protein diet, red meat and alcohol. ;this is necessary to maintain normal uric acid levels. The cases mentioned below have had attacks of gout and had already been treated without much respite. They were having inflammatory arthropathy. Marked pain and swelling in the small and large joints were like rheumatism.

Case 1: Male 45 yr, Butcher, optimistic, not easily irritable, had malaria five years ago. He had[L] shoulder pain extending to [R] with stiffness of neck and shoulder. Crippled for the past six months with pain and swelling in most small and large joints. He had a habit of supari chewing and mutton eating.
The complaints were agg by rain, getting wet, change of weather and water. The patient came on 19/2/96 with lab report dated 9/1/96 S. Uric acid - 8.6 mg and second blood exam done on 20/3/96 S. Uric acid - 3.4 mg (copies of reports encl.)

Drugs given were Urtica-urens and Mag-phos 6x to relieve pain SOS. Treated for uric acid only which was reduced and the symptoms disappeared enabling the patient to attend to his normal work as usual.

Case 2: Male, 57 yrs, of short stature, ( grocery stores owner), came for the treatment of his both knees and fingers which were swollen and painful during movements. There was cracking sound at rest. He was easily irritable. There was [R] ear deafness with buzzing sound for the past 10 yrs. No H/o otorrhoea, cause unknown.
First investigation was done on 14/2/97 which revealed S. uric acid 7.8 mg. second blood examination was done on 23/6/97 after the homoeopathic treatment which revealed S. uric acid 2.5 mg. (copies of reports encl.)

Case 3: Female 56 yrs., housewife, stature was short. Her both knees and fingers were painful, tender with creaking sound on movements for the past 10 years. She also suffered from cramps of calves during sleep at night. Menopausal since 8 yrs. Easily irritable. Anaemic. First investigation was done on 14/2/1997 which showed S. uric acid 5.8 mg: Second inv. done after treatment on 23/6/97 showed lower level of S. uric acid 3.7 mg (copies of reports encl). The cases 2 and 3 referred above are wife & husband. Dr W Boericke, materia medica, pg. 661, states "Gout and uric acid diathesis favours elimination Urtica-urens: page 150 states "Gouty enlargements of the joints of fingers. Chronic synovitis of knee joint Calc-flour. Urtica-urens 6 before meals, Calc-flour 30 after meals were prescribed for both and continued for 5 months regularly. All the signs and symptoms of gout disappeared. 

For case No 2, "cramps in calves" Mag-phos 30 at bedtime SOS. Patients were advised to avoid red meat, organ meat, high protein diet like soyabean and to take pulses in moderation.