🌿 Folk Prescriptions

"What illness do you have?" "Gout!" "Gout? That’s because your diet isn’t scientific—you’ve developed gout!" "...What should I do?" "You should eat less...and more..."
This is a conversation I overheard between two patients in the waiting room outside the internal medicine clinic.
Is gout truly caused by "eating too well," as one patient claimed?
Gout Overview: Gout has existed since humans appeared on Earth. It was first documented by European physicians around 1270 AD, with the English term "gout" meaning "deposition" or "accumulation." At that time, gout was poorly understood. It was believed that toxic substances deposited in joints and subcutaneous tissues caused arthritis and gout.
Gout, as its name suggests, feels like pain whenever wind blows—yet metaphorically, it strikes suddenly and fades just as fast, hence the name "gout."
Due to many famous historical monarchs and generals suffering from gout, it is also known as the "disease of the wealthy," or "the nobleman’s disease."
During gout attacks, pain spreads rapidly through limbs and joints, resembling tiger bites, hence the name "White Tiger Joint Wind."
With modern lifestyles emphasizing gourmet food and overindulgence, today gout is no longer exclusive to royalty—it affects ordinary people too.
Gout results from genetic or acquired factors causing purine metabolism disorders and sustained elevation of serum uric acid. It is a group of diseases caused by long-term purine metabolism disorders and elevated serum uric acid, leading to tissue damage. Clinical features include hyperuricemia, recurrent acute gouty arthritis, if untreated, prolonged progression, accompanied by complications such as hypertension, hyperlipidemia, coronary heart disease, diabetes, and kidney stones. When renal lesions occur, significant azotemia may appear, progressing to renal failure and uremia. Urolithiasis increases risk of arteriosclerosis and coronary heart disease, seriously threatening gout patients’ lives. Thus, gout is a systemic disease caused by purine metabolism disorders.
Causes of Gout Attacks
Gout usually occurs at night. Why? During the day, physical activity causes fluid accumulation in joint cavities. At night, this fluid is reabsorbed. Since fluid reabsorption exceeds uric acid reabsorption, uric acid concentration rises in joints, triggering attacks.
Production of Uric Acid
Uric acid is a metabolic waste product in our bodies, derived from purines. Purines are categorized as:
Endogenous: Carbon from carbohydrates and nitrogen from purines synthesized internally; cellular breakdown.
Exogenous: From nucleoproteins in food, divisible into plant-based and animal-based sources.
Dietary Classification for Gout
First category: Acute attack phase, 0–25 mg purine/100g. Dairy, eggs, vegetables, fruits, grains, tubers, sea cucumber, jellyfish skin.
Second category: Suitable for those who have had previous attacks, 25–150 mg purine/100g. Chicken breast, fish, tofu, some vegetables and fruits, lean pork.
Third category: Suitable for those without prior attacks. Liver, intestines, mackerel, mullet, sprouted beans, concentrated meat broths, yeast powder, chicken essence.
Three Simple and Effective Dietary Recipes
Coix Seed and Red Date Soup: Use 50 grams of Coix seed and 5 red dates, boil into soup. Drink the soup and eat the seeds and dates. Helps relieve joint pain.
Corn Drink: Use 100 grams of corn or corn silk, roots, and leaves, decoct into tea. Regular consumption helps excrete uric acid.
Walnut Paste: 250 grams of walnut kernels, 100 grams of yam. Soak walnut kernels in cold boiled water with 10 grams of salt for 5 minutes, then microwave for 3 minutes, crush in a blender, mix with roasted yam powder. Take 30 grams each time with warm water. Regular consumption helps strengthen the body and regulate metabolism.
Dietary Considerations for Gout Patients Regarding Purine Content
Gout attacks are often related to overindulgence. Because delicacies are typically high in purines, high-purine foods ultimately break down into high serum uric acid. Thus, adjusting diet composition is crucial for preventing gout attacks. Gout patients should avoid moderate-purine foods and strictly refrain from high-purine foods. This helps lower serum uric acid levels, preventing urate crystal formation and protecting joint tissues.
Generally, diets are classified into high-, moderate-, and low-purine categories.
Low-purine foods (less than 50 mg purine per 100g): Grains—rice, wheat, sorghum, corn, potatoes, sweet potatoes, noodles, macaroni; Eggs—chicken eggs, duck eggs, century eggs; Dairy—milk, cheese, ice cream; Beverages—soda, chocolate, cocoa, coffee, milk powder, fruit juice, tea, honey, gelatin; and various fruits, vegetables, and oils.
Medium-purine foods (50–150 mg purine per 100g): Meats—chicken, pork, beef, lamb, fish, shrimp, crab; Legumes—black beans, mung beans, red beans, kidney beans, peas, green beans, bean curd, tofu, bamboo shoots, golden needle mushrooms, silver ear fungus, peanuts, cashews, sesame seeds.
High-purine foods (150–500 mg purine per 100g): Bean sprouts, soybean sprouts, asparagus, cauliflower, nori, mushrooms, eel, shark, cod, eel, animal organs, clams, dried scallops, mackerel, mussels, oysters, sardines, clam broth, meat broth.
Very high-purine foods (over 500 mg purine per 100g): Dried small fish, eel skin, yeast powder.
Should gout patients eat three meals a day or multiple smaller meals?
Since humans began studying gout, scientists have sought an ideal eating frequency—shifting from three hearty meals to multiple smaller ones. This approach offers numerous benefits: significantly reducing uric acid production and elevation, decreasing daily need for uric acid-lowering medication, and lowering blood cholesterol levels. These benefits likely stem from slow, continuous absorption in the gut, minimizing the duration of "fasting state" and improving uric acid metabolism and regulation.
Additionally, increasing meal frequency while reducing portion size can reduce hunger, thereby lowering total daily energy intake. Research now explores eating 6–8 times daily. Also, medications like allopurinol can slow food absorption, achieving similar effects to small, frequent meals. However, increased meal frequency isn't suitable for everyone. If you maintain good control of serum uric acid and have a healthy weight, this method may not be necessary.
Reminder:
1. Avoid binge eating;
2. Take medication on schedule;
3. Exercise moderately;
4. Attend regular outpatient follow-ups;
5. Moderate exercise for weight loss is urgent!
Dietary Tips for Gout
1. Use minimal oil in cooking; prefer steaming, boiling, braising, or cold-mixed methods.
2. Limit high-fat foods.
3. Drink plenty of water.
4. Avoid alcohol.
Nourishing Soups:
Rheumatic Arthritis Tea Bag
Ingredients:
20 grams of Angelica sinensis slices, 15 grams of Rehmannia glutinosa, 20 grams of Paeonia lactiflora slices, 15 grams of Ligusticum chuanxiong slices, 15 grams of Chicken Blood Vine, 20 grams of Sea Wind Vine, 20 grams of Wide Tendon Vine, 20 grams of Stonevine, 10 grams of Dictamnus dasycarpus slices, 20 grams of Taxillus chinensis, 15 grams of Codonopsis pilosula, 15 grams of Clematis chinensis.
Preparation:
1. Prepare a clay pot for decoction;
2. Wash all ingredients;
3. Add all ingredients to 5 bowls of water, simmer slowly until reduced to 1 bowl;
4. Drink after meals, three times weekly.
Function Explanation:
Activates blood circulation, nourishes blood, dispels wind-dampness, relaxes tendons and meridians, reduces inflammation and relieves pain.
Indications:
Rheumatic arthritis, migratory arthritis, limb numbness.
Ingredient Functions:
Angelica sinensis, Rehmannia glutinosa, Paeonia lactiflora, and Codonopsis pilosula all nourish blood and harmonize blood flow; Chicken Blood Vine, Sea Wind Vine, Wide Tendon Vine, and Stonevine all nourish blood, dispel wind, and relax tendons and meridians; Dictamnus dasycarpus, Taxillus chinensis, and Clematis chinensis all expel wind-dampness and relieve arthralgia. (This is the dosage for one adult.)