Gout is a group of diseases caused by disorders of purine metabolism and/or reduced uric acid excretion. The most painful symptom of this disease is the acute attack of single arthritis, mostly severe pain, which seriously affects the patient’s quality of life. Through repeated clinical practice, Prof. Song proposed the theory of “gout is not wind” and emphasized the theory of “internal toxicity” as the cause of the disease, i.e. “internal organs contain toxicity and attack the extremities”. The root cause of the disease is “internal toxicity”. In the treatment, we adopt six methods to clear heat and detoxify, dry dampness and detoxify, invigorate blood and detoxify, detoxify dampness and detoxify, clear heat and detoxify, and benefit qi and detoxify, so that there is a way out of internal toxicity, and the evil will go away and the right will be safe. And in daily life, we emphasize attention to dietary regulation to prevent recurrence of disease. 1, the basic pathogenesis – emphasize that gout is not wind, advocate internal poison caused by the disease, poison has external hidden manifestations. Professor Song believes that the basic pathogenesis of the acute attack of the disease is not caused by external evil, but by the accumulation of heat in the viscera, internal poisonous evil, and the combination of poison and heat, resulting in “heat and poison gas from the viscera, attacking the hands and feet, and the hands and feet are {hot, red, swollen and painful.” In clinical practice, acute attacks of gout mostly occur under exogenous conditions such as full meals, alcoholism, overwork, tight shoes, trauma, etc., and are not caused by cold or humidity. Most of the patients with this disease eat too much alcohol, wine and spices, and their spleen and stomach lose their health, resulting in internal heat and damp-heat toxins in the internal organs. Heat and damp-heat toxins are injected into the bones of the lower limbs and paralyzed in the meridians, or due to the loss of kidney opening and closing, unfavorable Sanjiao, etc., resulting in the inability to expel the toxins from the body, stagnation of Qi and blood clotting, and heat and toxins filling the blood vessels, resulting in pain in the bones like a tiger’s rodent. The heat toxin does not go away for a long time, burning the fluid for phlegm for turbidity, condensing in the skin, meridians, bones and joints are phlegm nuclei, remaining under the skin. In other words, as stated in Chao Yuan Fang’s “Treatise on the Origin of Various Diseases”, “heat and toxicity come from the internal organs and attack the hands and feet, and the hands and feet become painful with heat and redness”, rather than “wind, cold and dampness are mixed and combined to form paralysis” as stated in the Nei Jing. Many physicians are muddled by the three gases of wind, cold and damp, and use drugs to dispel wind and dampness and disperse cold to treat gout, which only treats the symptoms of pain, but not the root cause of its internal toxicity, which can be considered a lack of understanding. The internal toxicity has its external manifestations, such as: (1) red, swollen and hot pain in the joints. The disease is mostly manifested as asymmetric arthritis of the lower extremities, with half of them starting with the first metatarsophalangeal joint. Local pain in the joints is severe and unbearable, with limited movement, dark red skin and local burning. Dampness, heat and toxicity tend to go down, and the joints of the lower extremities are a collection of tendons and collaterals, and the blood flow is sluggish at night, and Yang enters Yin, so the pain is more frequent at night and in the lower extremities. The big toe of the foot is the beginning of the spleen meridian, so the big toe of the foot (the first metatarsal phalangeal joint) is the place where the disease mostly occurs. Dampness, heat and toxicity are caused by blood flow and retention, which cause pain and redness in the joints due to vaporization of Qi and blood and blockage of meridians. (2) Localized scrofula and phlegm nuclei in the joints. If the damp-heat toxin starts to occur, it only hinders the flow of qi and blood, and if it is dispersed in time, the joints can be restored to normal. If the damp-heat toxins steam the Qi and blood, generating phlegm and stasis, it can become tangible from invisible to tangible, and the phlegm nuclei can be seen in the joints. If the tangible stasis blocks the qi and blood, the joint will continue to be painful or even deformed. As stated in Lin Peiqin’s “Treatment of Similar Evidence”, “The hands are bent, the body is full of scrofula, and the swelling is like shedding, gradually leading to destruction, and the pain is like a switch, and cannot be bent or stretched.” (3) Long-term disease and kidney. Heat paralysis for a long time, heat toxicity will follow the meridians and circulatory channels, deep into the internal organs, and the corresponding internal organs paralysis symptoms. As stated in the “Su Wen – paralysis theory”: “five organs are all together, the disease is long and does not go, the internal shed in its cooperation. Therefore, the bone paralysis has not ceased, and the evil is repeatedly felt in the kidney.” The damp-heat poison should be evaporated by the kidney and discharged from the bladder. But the evil of dampness and heat stays in the kidney, which in turn damages the essence of the kidney, so that the kidney loses its division of steam and gasification. Phlegm and blood stasis can also remain in the kidney, becoming a tangible harm. Therefore, when gout occurs repeatedly, it can cause the kidney to decline, resulting in retention of urine and heavy evidence of guangs, which is also what Ye Tiansh said, “Long-term illness and the kidney are very important. In addition, endogenous toxicity also has its own hidden indicators, such as the results of physical and chemical examination in Western medicine can be considered as endogenous toxicity in Chinese medicine. In acute attacks of gout, there may be elevated white blood cells, accelerated blood sedimentation, and elevated blood uric acid, as well as obesity, hypertriglyceridemia, hyperviscosity, and hypertension. Joint puncture or gout stone content examination can be seen within or outside the leukocyte double refractive fine needle-shaped uric acid crystals, recurrent attacker involved joint X-ray shows bone with chisel-like, worm-like, honeycomb-like or cyst-like defects with clear borders, normal or hyperplastic surrounding bone density, it can be considered that the elevated blood uric acid is the source of damp heat and turbidity toxicity. 2, the basic treatment DD pay attention to the method of dispelling poison, advocate the use of six methods together, the creation of effective formulas to dispel poison. Since the basic pathogenesis of this disease is the accumulation of heat in the internal organs and the internal vermin, in the treatment of the disease, Professor Song repeatedly emphasized that the basic treatment of this disease should focus on the method of eliminating toxins. When the toxin is removed and the heat is cleared, the blood vessels are harmonized and the disease is easily cured. In detail, the method of eliminating toxins is divided into six types: clearing heat and detoxifying, drying dampness and detoxifying, invigorating blood and detoxifying, dampness and detoxifying, clearing heat and detoxifying, and benefiting qi and detoxifying. In clinical practice, Prof. Song has developed a basic formula for treating the disease by using the six methods: 9g of cooked rhubarb, 30g of dioscorea Z, 30g of tiger scepter, 6g of leech, 18g of dacquoise leaf, 30g of fu ling, 20g of atractylodes, 9g of cypress, 12g of raw licorice, and 30g of barley, with flexible clinical addition and subtraction, which often works like a rafter. The six methods and formulas are now combined to elaborate. The clearing of heat and detoxification is the use of sweet, cold and sweet drugs to clear and transmit the poisonous evil out, such as the big green leaf; dry damp detoxification is the use of bitter cold drugs to attack dampness, which helps to cut off its source, remove the poisonous evil glue nature, such as Huang Bai, Cang Zhu; blood detoxification is the use of blood drugs to break the blood detoxification, which can make the poisonous evil disintegrate, blood vessels open, which helps to get rid of the poison out, such as leeches, tiger scepter; the benefit of damp detoxification that is to get rid of evil to have a way out, one of the ways out In the urine, urine selection of heat and diuretic drugs to diuretic detoxification, so that the poisonous evil from the front yin out, such as dioscorea, Tu Fu Ling; heat detoxification that is to clear the internal heat poison, through the internal organs, diarrhea of turbid poison, to take the bottom of the kettle, so that heat poison, turbid poison from the stool out, such as cooked rhubarb; benefit qi poison used for a long time because of the poisonous evil, loss of vital energy, deep into the blood veins greasy wet and stagnant poisonous evil, detoxification, detoxification method is difficult to work, need to use Benefit Qi and strengthen the spleen method, slowly to poison out of the poison, in order to make the remaining poison to be purified, the right qi to restore such as raw licorice, barley. 3.Basic care of DD is to abstain from alcohol, meat and seafood, to promote reasonable diet, and to develop measures to prevent recurrence. Professor Song repeatedly stressed that gout patients must avoid alcohol, including white wine, beer, red wine. Alcohol consumption is one of the most important triggers of gout attacks. Modern research has found that ethanol, the main component of alcohol, can increase lactic acid in the body, which can inhibit the excretion of uric acid by the kidney tubules; at the same time, ethanol can also promote purine decomposition, which directly raises blood uric acid; furthermore, alcohol itself can provide purine raw materials, such as beer fermented from malt, which has a very high purine content. Therefore, the best way to prevent gout attacks is to stop drinking alcohol, and to avoid drinking a lot of alcohol if you can’t quit for a while, and avoid alcohol abuse. Secondly, gout patients should abstain from eating foods high in purines, such as sardines, crabs and other kinds of seafood, as well as soybean powder, animal offal and bone marrow. If the disease is mild, you can eat meat, peas, soybeans, pinto beans, spinach and other foods that contain less purines. Those with severe disease should only consume millet, rice, wheat, buckwheat, corn, various vegetables, fruits, seaweed, eggs and milk. Gout patients should also drink more water, preferably more than 3,000 ml per day, to facilitate the discharge of turbid toxins. Obese patients must reduce their calorie intake and lower their body weight, with the aim of reducing the production of internal toxicity to eliminate the root cause of toxicity. Again, Professor Song proposed some effective measures to prevent recurrence of the disease. The main contradiction of gout disease is recurrence, and the main source of recurrence is the increase of blood uric acid, which belongs to the identification of “blood poison” and “turbid poison” from the perspective of Chinese medicine. Clinically, most patients with hyperuricemia have hyperlipidemia, hyperglycemia, hyperviscosemia and fatty liver, which can cause many serious diseases, such as cardiovascular and cerebrovascular lesions. Therefore, even if there are no obvious symptoms and signs during the relative quiescence period, the patient should always use drugs to cool the blood and detoxify the body, to clear the turbidity and cleanse the stomach and intestines, and can take rhubarb tablets, lipid regulating tablets and senna leaves for a long time. Rhubarb tablets should be taken after meals, 4-6 tablets each time, 3 times a day. Senna leaves can be taken as tea for a long time. Meaning in Ge Hong said: “If you want to live forever, the intestines are always clear, and if you want to stay alive, there is no shit in the intestines”.