A Thesis On Homoeopathic Management of Gout

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Introduction

INTRODUCTION

The best medicine I know for rheumatism is to


thank the Lord, it ain’t Gout
Josh Billings_____

India, being one of the developing countries of the world, had


prevalence of wide varieties of communicable diseases, which made
the health authorities to concentrate more on these communicable
diseases. This led to the great decline in the prevalence of
communicable diseases but in turn, made way for the Non
Communicable Diseases (NCD) to rise among the population, to such
an extent that, NCD now, are the most common disease of concern
over the globe. Unhealthy diet and physical inactivity, the two major
global determinants, has enormously affected human health, and has
been the cause of various diseases, both in developed as well as
developing countries. Gout is one such Non Communicable Diseases,
whose prevalence has risen in the past few decades and is one of the
major causes of morbidity, not only in India but, over the world.
Gout is derived from the Latin word “Gutta”, meaning drop, as it
was believed in the past that poison falling in drops into the affected
joints caused Gout. Gout was historically known as "the disease of
kings" or "rich man's disease". Gout is a true crystal deposition
disease. It can be defined as the pathological reaction of the joint or
peri-articular tissues to the presence of monosodium urate
monohydrate (MSUM) crystals, due to alteration in body urate
metabolism. MSUM crystals preferentially deposit in peripheral
connective tissues in and around synovial joints, initially favouring
lower rather than upper limbs and especially targeting the first
metatarsophalangeal and small joints of feet and hands. The major
clinical manifestations are acute synovitis, chronic erosive and
deforming arthritis, tophi, nephrolithiasis, and interstitial nephritis. It
is also associated with increased incidence of hypertension and
cardiovascular disorders.

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Introduction

Globally, the incidence of Gout has increased doubly in last two


decades because of multiple factors like increased longevity, increased
prevalence of hypertension and rampant use of diuretics, more use of
low-dose aspirin, epidemic of obesity and metabolic syndrome, dietary
trends, increased alcohol consumption, increased chronic kidney
disease (CKD) and major organ transplantation with use of
cyclosporine. Dietary causes account for about 12% of Gout, and
include a strong association with the consumption of
alcohol, fructose-sweetened drinks, meat, and seafood, the
consumption of which has increased to a great extent in the modern
world. The incidence of gout varies in population from 0.2 to 3.5 per
1000, with an overall prevalence of 2-26 per 1000.
Incidence of gout in India is not very clear as Original works on
gout are lacking in India. The prevalence is 0.12% as per International
League of Nations Against Rheumatism, Community Oriented
Program for Control of Rheumatic Diseases (ILAR COPCORD) study in
Bhigwan village of India. A study from Vellore revealed that 15.8% of
the affected patients are less than 30 years of age; Urban Indian
population is involved more than the rural population and due to
increased prevalence of metabolic syndrome in younger population,
the first attack of gout occurs a decade earlier to them, and positively
correlated with intelligence, social class, sedentary lifestyles, stress,
overeating, obesity, increased alcohol consumption, and high protein
diet.
Gout is the most common cause of inflammatory arthritis in
men aged more than 40, affecting approximately 1–2% of adult men in
the Western world; they usually present in the form of “podagra”, i.e.
acute onset pain in joint, erythema and swelling of the first
metatarsophalangeal joint. Gout develops in men more than women
(10:1). It is rare in children and premenopausal females.
Gout has a significant impact on a patient’s Quality Of Life in
regards to the severity of pain, deformities, kidney involvement and
other complications. It reduces productivity and increases annual

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Introduction

total healthcare costs, since care of gout absorbs relevant amounts of


healthcare resources. Gout also, has a substantial impact on work
absence and may also negatively impact productivity.
Allopathic treatment of Gout involves use of Non-steroidal anti-
inflammatory medications and Colchicine during acute attacks.
Secondly the treatment is aimed at preventing further crystal
formation. If oral therapy is not effective, the attack can usually be
terminated by intramuscular corticosteroid injections. However, when
used for a longer period of time some of these drugs create
dependency & side effects. Allopathic medicines have tried to help, but
has many drawbacks.
Hahnemann’s unique and well proven scientific theory,
“Homoeopathy” can help those suffering from Gout. He has given us
the information, how to deal with the various stages of sickness; Acute
& chronic and with its subdivisions. With the holistic science,
Homoeopathy, we have been successful not only to relieve the
symptoms but also the cause & thereby restoring the inner harmony
and health. The Homoeopathic Materia Medica presents a great
number of drugs, which can be selected according to the totality of the
case before us, whereby the acute exacerbation can be relieved and
further progress of the disease halted, without any side effects, thus
helping patient in a better way, helping them to lead a life of good
quality.
In the conventional system of medicine, the available treatment
for Gout is merely palliative and having so many adverse effects
whereas Homeopathy with its dynamic, individualistic, holistic &
miasmatic concept can treat patients with gout more effectively &
safely.
In this clinical study my humble effort is to show Homoeopathic
approach and its efficacy in the treatment of Gout through 30 clinical
cases.

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