Gout is a group of diseases caused by disorders of purine metabolism and/or reduced uric acid excretion due to abnormal metabolic functions of the body, or excessive production of uric acid. It is clinically characterized by hyperuricemia, characteristic recurrent acute arthritis, gout stone deposition, and chronic arthritis with gout stones, often involving the heart. Western medicine classifies gout into two major categories: primary and secondary. About 1-2% of primary causes are due to enzyme defects, while most cannot be elucidated. Patients with gout are often associated with hypertension, hyperlipidemia, diabetes, atherosclerosis and coronary artery disease. Secondary is often caused by kidney disease, blood disorders, and chemical drugs. Etiology and pathogenesis: The relationship between gout and the development of hyperuricemia has been an important research challenge. Uric acid is the end product of purine decomposition in humans. Uric acid has two sources, one is from the breakdown of nucleotides in nucleoprotein-rich foods, which is exogenous and accounts for about 20% of uric acid in the body; the other is from the synthesis of amino acids, ribose phosphate and other small molecules in the body and the metabolism of nucleic acid decomposition, which is endogenous and accounts for about 80% of uric acid in the body. The purine bases or purine nucleotides known to Western medicine are derived from the breakdown and metabolism in the liver. The true cause and pathogenesis of gout or hyperuricemia is not known. The names “primary” and “secondary” are not based on science. I believe that although hyperuricemia is an important biochemical marker of gout, the understanding of gout in Western medicine is not clear in the clinical and domestic and foreign literature, and it is not a simple explanation like hyperuricemia. Therefore, it is impossible to study and create new biochemical tests to understand the etiology and pathogenesis. I also propose that, based on the literature and clinical manifestations, the holistic view of Chinese medicine considers gout to be the category of paralysis. The etiology of the disease is based on two major factors. The internal factors are due to the endowment of the body, the loss of liver drainage, the loss of nourishment of the arteries and veins, and the accumulation of stasis over time. The external factors (i.e., causative factors) come from changes in dietary habits and structure as well as environmental conditions, or from pharmacogenic toxic side effects caused by the use of inorganic chemical drugs, or from inorganic chemical drugs or pollution sources that cannot be excreted from the body and are deposited in the organs and veins of the body and develop. It is worth discussing: ① those with hyperuricemia with excessive uric acid production or reduced clearance in renal disease do not show gout symptom attacks. ② Renal lesions are rarely seen in patients with gout. Since androgens can make the phospholipid membranes of cell organelles susceptible to urate crystals and cause a cellular response, but estrogens can make the phospholipid membranes resistant to such crystalline precipitation, gout predominates in men and postmenopausal women. This also illustrates the unknown difference between the hyperuricemia of gout and the hyperuricemia of renal lesions. (iii) In addition to solitary gout disease, it is seen in patients with cardiovascular disease with gout. ④There is a tendency for uric acid to rise with increasing age, indicating a weakened metabolic function due to physical aging and vascular aging. ⑤ After the rapid economic development of Japan after World War II, gout became a prevalent disease in Japan after the exponential increase in protein foods; historically, it was a rare disease in the Chinese nation, but since the late 1980s, the incidence of gout has soared in the more economically developed coastal areas, as well as in large and medium-sized cities with drinking desks or public relations. (6) Filipinos living in the United States have significantly higher levels of uric acid than those living in the Philippines proper. The above issues fully demonstrate that hyperuricemic gout is not caused by kidney disease; it also fully proves that hyperuricemia of gout, from environmental factors, mental factors, changes in diet structure and dietary habits as external causes. Clinical manifestations of gout: The only known gout stones can be deposited anywhere except in the central nervous system, and urate can be deposited in any part of the body. Gout stones form subsequently and expand the urate pool, causing bone erosion and deficiency, as well as leading to fibrosis of the surrounding tissues and stiff deformity of the joints. The most common joints and their vicinity, such as cartilage, bone, mucous capsule and subcutaneous tissue. There are 90% of middle-aged and elderly male patients and 5% of postmenopausal women. The site of attack starts in the ear and thumb joints in more than 70% of patients and gradually involves multiple joints, such as the toes and plantars, ankles, fingers, wrists, elbows, knees, shoulders and hips, and the spine; a few occur in the nasal cartilage, tongue, vocal cords, eyelids, aorta, heart valves, and myocardium. Gout nodules can be as large as an egg or as small as a sesame seed. The pain is often severe like a knife cut or a biting pain that occurs at midnight during rest. The joints and surrounding soft tissues become red, swollen, and hot, and the area cannot tolerate sheeting or vibration. The disease of gout is not a one-day disease. Due to the prevalence of drinking table office in the past 20 years or so, excessive intake of wine, meat and salt, together with a large amount of food containing hormones and pesticides, as well as the pharmacogenic injury from the abuse of antibiotics and chemical hormones, the normal metabolic pattern of the body is altered and the immune function is dysfunctional. Causes gout and aseptic osteonecrosis and the incidence of diabetes, hyperlipidemia, hypertension, hyperuric acid, cardiovascular and cerebrovascular diseases soared, and the incidence of cases in the city tends to be significantly younger. And look at the old retired Red Army and the revolutionary soldiers during the Liberation War, the founding of the country. Due to the hardships they have endured, when they were in office, but also just a rough meal, after leaving the service without the right to greed, to maintain an excellent style of life, open-minded, psychological and physical health, but also a long life. From them, we can reflect that the sky has eyes. It is expected that in the next 10 years, China’s official disease represented by gout, the incidence will become the world’s first. Treatment: (Western medical treatment) Commonly used drugs for the treatment of gout in Western medicine are: colchicine (toxic side effects: significant gastrointestinal irritation, lowering of white blood cells, hair loss, weakness); hydroxybacterium (toxic side effects: triggering gastritis, water and sodium retention, reduction of white blood cells and platelets); anti-inflammatory pain (toxic side effects: triggering gastritis, water and sodium retention, reduction of white blood cells and platelets); non-steroidal anti-inflammatory drugs: such as ibuprofen, (toxic side effects: damage to central nervous system and liver function); prednisone (57 toxic side effects and should be used with caution); probenecid (toxic side effects: fever, rash, gastrointestinal irritation, renal colic and provocation of acute attacks); sulfopiridone (toxic side effects: fever, rash, destruction of gastric mucosa, gastrointestinal ulcers); benzbromarone (toxic side effects: irritation of (gastrointestinal tract, fever, skin rash, renal colic). Surgical scraping is used to remove large gout stones that have ulcerated fistulas. (TCM treatment) Chinese medicine has a wide range of methods for treating gout, and a holistic view of dialectical treatment is the absolute advantage of safety and effectiveness. Gout is a category of paralysis in Chinese medicine. The treatment is based on the basic method of activating blood stasis, activating the channels, eliminating swelling and dispersing knots, and harmonizing the qi and blood of the internal organs. I would like to introduce the effective treatment of “ankylosing spondylitis” to colleagues or patients for reference and use. The two diseases are actually treated by the same mechanism. In fact, the mechanism of treatment for both diseases is to remove stasis and disperse nodules, and to relieve pain. This is the reason for “treating different diseases together”. Shuang Hu Tong Pao Wan” is mainly made up of Blood Fructus, Yuan Hu, Chong Lou, Liu Liu Liu Nuo, Frankincense and Myrrh, patients can prepare and crush each part of this formula by themselves and then put it into capsule number zero. Take 8 capsules 3 times a day. It is usually best to take it continuously for 4 weeks in order to consolidate the effect.