Today we are going to discuss a disease which is a form of arthritis and is called gout. From ancient times, this disease is known as the disease of kings because in ancient times, this disease used to happen to royal people who did not do enough physical work as per their diet. Gout is a disease which is caused due to high protein diets like soft drinks, yeast, oily fish, red meat and alcohol.
To discuss about gout, and to know what it is and how can we get rid of it, we have our expert, Dr. Parmeshwar Arora in our studio. Welcome to the show, Dr, Parmeshwar.
Q. As I have already told our audience, today we are here to discuss a form of arthritis which is called gout. First of all please tell us, what is gout?
As you said, gout is a form of arthritis. It is a condition in which the level of uric acid in our blood rises abnormally. This condition is called hyperuricemia. Whenever the level of uric acid in blood rises, it results into formation of monosodium urate monohydrate (MSU) crystals in the synovial fluid. This causes inflammation in synovial membrane of joints. It often creates swelling and severe pain in joints and this condition of arthritis is called gout. In terms of Ayurveda, it is referred to as ‘vata rakt’ which is observed to be similar to gout, considering their symptoms and origin. If we regularly consume food which is peppery (pungent) or sour in taste, it somehow pollutes our blood. At the same time, if we also aggravatae our vata (air), this results in the origin of a disease called ‘Vata rakt’. As, according to modern science, this disease (gout) starts from the big toe, in Ayurveda also, vata rakt is believed to originate from big toe itself. So, somehow both these diseases seem to be identical or similar. In another words, we can say that gout is referred as vata rakt in Ayurveda. To conclude, gout is a joint disorder wherein pain and swelling is seen in the joints.
Q. As you just said, this disease begins at the big toe? Why is it so?
We have clear reasons for this in Ayurveda. As we see in this case, the blood becomes toxic. As it is the general tendency, it is bit difficult for the toxic blood to remain in circulation. As I believe, since big toe is the most dependent part, it is the one which gets affected first. This toxic blood gets deposited in the big toe and causes inflammation in its synovial membrane. Thus the condition of gout begins. Here’s the answer for your question….it is the toxic blood which creates this condition by getting deposited in the big toe and causing swelling in its membrane.
Q. This was about its start but generally speaking, what could be the other reasons for this condition?
As I feel, here the Ayurveda supersedes the other medicine sciences because the diseases referred in Ayurveda are so self explainatory. They tell us about the reasons for the disease as well as their complete aetiopathogenesis. As we see in this case, gout is called ’vata rakt’ which associates it with simultaneously aggravataed vata and toxicated blood. When we say aggravataed vata disorder, it again involves three aspects namely, diet, lifestyle and psychological disorders. Today, we have adopted a trend of consuming food items which are not freshly cooked. This directly aggravates vata. You can prevent a substance from rotting by temperature control or preservataives, but the food items prepared almost a month ago, cannot be called fresh. It is directly mentioned in shastra that unfresh or precooked food directly aggravate vata in our body. Similarly, too much inclination towards cold things , causes vata disorder. Even, consumption of too much of dry food(which contain little or no liquid) is also a reason for aggravated vata. Apart from this, lifestyle elements like keeping awake during nights, ongoing stress and habit of suppressing the urge to pass urine or stools, also increases the level of vata in our body. This aggravated vata disturbs the entire metabolism of our body. In simpler terms, metabolism refers to a digestion-like process. If you relate it with a life-situation where you are running your gas stove and fan simultaneously, you will see that the flame gets disturbed because of which either the food does not cook properly or even if it gets cooked it takes a huge time. Similarly, when the vayu (air) inside our body is aggravated, it somehow influences the process of digestion or metabolism by making them sluggish and suppressing them . This is how, vata becomes a reason for the origin of ‘vata rakt’.
Q. As you had mentioned, we have gout as the level of uric acid in our blood rises abnormally. Why does the level of uric acid rise?
There are two ways in which the uric acid is produced in our body.
1) Our protein intake. If we increase our protein intake which can be in the form of milk, cottage cheese (or paneer), eggs or pulses etc., then the production of uric acid increases.
2) The cell-breakdown. When the cells in our body break, uric acid is produced. So, for any reasons, if there is a considerable increase in the number of cells, breaking up, the uric acid production also increases. The conditions in which more cells break up could result from starvation, fasting, reduced intake of food due to unavailability of desired food items, trauma, undergoing a surgical process etc.. Coming to psychological reasons, when we are under a lot of mental tension and lead a stressful life, we see that our body gradually becomes weak and the degenerative process of our body speeds up. So, increased cell breakdown due to degeneration or mental trauma also causes rise in uric acid level in our blood by increasing its production.
There can be one more situation where the production of uric acid is normal but there is problem in its excretion through urine or stool. Urine is the prime medium for excretion of uric acid from our body. Thus, gout can also be seen in a patient suffering from a kidney problem i.e. whose renal function is not proper. This is because the uric acid in his body is not being excreted properly.
Apart from this, I would like to name a few medicines which are often being consumed by people e.g. aspirin which is taken by cardiac patients, decreases excretion of uric acid. Diuretic medicines which increase the urination also decrease excretion of uric acid. Similarly, if we start consuming too much alcohol, they increase organic acids in our body and decrease uric acid excretion. Also, anti-tuberculosis medicines decrease excretion of uric acid from our body. Thus, there could be several mediums but the basic thing is that, anything which increases the production or decreases the excretion, is responsible for increase in uric acid level in our body.
Q. Now, when we have understood the causes, what are the solution for them? How can we come out of this problem?
In acute conditions when patients have severe pain, in allopathic medicines, patients are given non-steroidal anti-inflammatory drugs. Considering the pain, it is the preferred option as it temporarily relieves pain and swelling. Patients who repeatedly get such attacks i.e. whose uric acid remains constantly high, regularly consume medicines like allopurinol or colchicines. But, I would like to tell you that this is just a suppressive treatment. I have a hundred doubts about a gout patient receiving a permanent cure in allopathic medicine.
Generally, all gout patients would agree that whenever they get a gout attack, they have to depend upon pain killers and they have to consume medicines like allopurinol or colchicines or Probenecid on regular basis. But if you want to get a permanent solution to the problem of gout then you would once again need to seek the help from Ayurveda and start taking the Ayurvedic medicines. The panchkarma treatment which is a cleansing treatment has a very important role in treatment of gout. According to a shloka mentioned in our shastras, if through medicines we have suppressed an aggravataed dosha (or a toxic condition in this reference) then if the favourable conditions arise again (i.e. if we again start consuming the problem aggravating diet or start leading such a lifestyle), the condition would resurface (i.e. in this reference, uric acid will increase and you would again get a gout attack).
If you want this disease to be cured permanently then you would have to get the cleansing treatment done. This is so because, once the toxicated blood and toxicated vayu (air) is removed out of your body, then the chances of disease occurring again is decreased to a great extent. My recommendation to the gout patient , as an Ayurvedic doctor, is that you should meet an Ayurvedic doctor and get ‘vasti treatment’ done, repeatedly. In ‘vasti treatment’ we use anema to extract vayu out of the body. The patient should also get the ‘virechan’ done. In virechan, we induce diarrhea by making patient consume various medicines. These two treatments are meant to cleanse your body. In addition to this, you will have to take ‘manikya yog’ as 1 gram, ‘kaishore gugul’ as 2 tablets, ‘amrita gugul’ as 2 tablets with ‘manjasthadi qwath’. Regular consumption of these medicines for three months, would most probably give you permanent freedom from the disease of gout.