Come on, Dr. Wu

Chapter 416 Please Don’t Indulge Him
It sounds so mysterious, it's a disease of affluence, a disease of kings, and a disease of emperors. How did it come about?

Some Western metaphysics believe that gout is caused by the devil biting the foot, while Eastern metaphysics says that ventilation is the gathering of dragon and tiger energy.

However, this is obviously nonsense.

The time when gout was truly understood was probably in 1679. In that year, Leeuwenhoek of the Netherlands observed rod-shaped crystals of sodium urate for the first time under a microscope. However, due to the conditions at the time, this guy had no idea what it was.
Later, people waited and waited, and with the unremitting efforts of many scientists, it was not until 1961 that McCarty and Hollander used a polarized light microscope to directly observe the sodium uric acid crystals in tophi. From then on, people began to understand the relationship between gout and uric acid.

This was also a major advancement in Western medicine's research on ventilation. From then on, ventilation had quantitative standards.

A blood test can be done to determine whether or not a person has gout, and the degree of gout can also be determined by the level of uric acid.

And as time went on, the cause of the appearance of uric acid was discovered.

Purine!

Yes, purine.

This is a microscopic component in the body. Under normal circumstances, purine is excreted through the kidneys and generally does not accumulate. But when there are too many purine substances in the body, everything begins to slowly change.

At this time, uric acid officially appears.

Uric acid appears as a product of purine metabolism. Large amounts of uric acid lead to hyperuricemia. Uric acid is a substance that is slightly soluble in water, but it is not so easy to clear out of the body. When it accumulates too much, it is easy to form crystals. After excessive uric acid forms a large number of crystals, the crystals will be deposited in large joints, causing local inflammatory reactions, and then you can hear a scream: It hurts!
This is the whole process of gout, and the cause of Li Jun’s gout is not difficult to understand now.

When I asked him later, I found out that in order to make money, Li Jun spent most of the day making barbecue. When he was hungry, he would just eat a few skewers. When he was not busy, when friends came over, they would sit down together, open two bottles of beer, and eat a few skewers of barbecue.

Wait until there are more customers before starting to work.

After a long time, the body will naturally react. You should know that barbecue and beer are the foods that are most likely to produce purine products. If seafood is added, it will directly become what people call a gout meal.

Gout belongs to the category of Bi syndrome in traditional Chinese medicine and can be diagnosed based on symptoms, tongue patterns, pulse patterns, and associated diseases.

Wu Xiaofu has been working in surgery all his life. He has removed tophi in the emergency room, but he has never treated gout systematically in the outpatient clinic. However, Wu Xiaofu has read a lot of books, has seen so many patients in the outpatient clinic, and has seen a variety of pulse conditions. Following the books and with other clinical experience to support his diagnosis, he is pretty sure about treating gout.

Traditional Chinese medicine emphasizes observation, auscultation, questioning and palpation. The diagnosis and treatment of all diseases start with observation, and the main thing to observe is the symptoms. An experienced Chinese medicine doctor can basically tell what disease the patient has after just one look at him.

This is clinical experience. After seeing so many patients, I basically memorize what symptoms each patient has and can just look at the symptoms to make a diagnosis.

Just like Li Jun, when Wu Xiaofu looked at his calf just now, he found that he had obvious sudden symptoms of redness, swelling, heat and pain in the joints, which are typical symptoms of ventilation.

Just by looking at this, you can diagnose gout with 50% certainty.

"Come on, stick out your tongue."

While taking his pulse, he asked Li Jun to stick out his tongue.

Tongue is also an important basis for TCM diagnosis, even as important as pulse. A good TCM doctor can determine the cause of the disease by looking at the tongue. The tongue of gout is generally manifested as redness of the tongue, thinning of the tongue coating, or bluish-purple tongue and tortuous sublingual veins.

It is mainly caused by dampness and phlegm in the body, which lead to stagnation of Qi and blood and obstruction of meridians.

Li Jun's tongue turned red and the coating became thinner, which matched the diagnosis of ventilation. The diagnosis went straight to 70%.

Then there is the pulse, which is the most important. Chinese medicine pulse feeling is like Western medicine looking at test results, which is used for the final diagnosis and final decision.

Li Jun's pulse is strong, fast, and beating powerfully. Such a pulse usually indicates heat in the body.

This is exactly the pulse condition of gout, insufficient vital energy and obstruction of blood vessels.

The diagnosis of gout has reached 90%.

When Li Jun was asked again, he was found to have other symptoms such as dry mouth, bitter taste in the mouth, dry and hard stools, red and yellow urine, burning sensation, yellow and greasy tongue coating, slippery and rapid pulse, sore waist and knees, tinnitus, and hearing loss.

These are exactly the physical symptoms that gout can cause. The symptoms such as soreness in the waist and knees, tinnitus, and hearing loss indicate that Li Jun's gout has caused kidney damage. This is not surprising. After gout affects the internal organs, the first organ to be affected is usually the kidneys.

After all, purine must be excreted through the kidneys. It is normal to increase the burden on the kidneys and cause kidney damage if a large amount of purine products is consumed.

In addition to the kidneys, gout may also cause damage to the spleen and heart.

After the spleen is damaged, symptoms such as diarrhea, edema, and bleeding may also appear.

If heart damage occurs, symptoms such as palpitations, chest tightness, and shortness of breath will occur.

After observation, auscultation, questioning and palpation, the diagnosis of gout in the patient can be 99% accurate.

The last point is the habit of traditional Chinese medicine practitioners. No, basically all doctors have this habit, which is to never say anything certain. After all, diseases are discovered by doctors, not created by doctors. It is impossible for doctors to know everything. In case the disease undergoes some changes, it is normal for misdiagnosis and treatment to occur.

"You're ventilating."

"gout!"

Li Jun was shocked when he heard this. "How can I get gout? I'm so thin."

Gout is not a rare disease, Li Jun naturally knew about it. In Li Jun's impression, people who suffer from gout are generally fat people. I heard that it is caused by high uric acid. It is probably because other people are prone to high uric acid. But he is as thin as a bamboo pole, so why does he have gout?

"Who told you that only fat people can get gout? It's just that there are more fat people among the gout patients. It doesn't mean there are no thin people. They can account for at least 20% to 30% of the patients."

There are actually many causes of gout in life.

Of course, patients with hyperlipidemia account for a large category of gout patients. Studies have found that approximately 75% to 84% of gout patients have hypertriglyceridemia, and some have hypercholesterolemia.

Such a large proportion has led many people to mistakenly believe that gout is a disease caused by obesity and that thin people will not get it. This is a big mistake.

If thin people consume too much purine, they may also get gout. Foods with relatively high purine content include seafood, beer, animal offal, and barbecue.

Seafood, beer, and animal offal are the top three, and barbecue is fourth. Of these four, three are what Li Jun eats frequently. Seafood is also indispensable on the barbecue stall. Crayfish, oysters, etc. are now the main types of seafood on Li Jun's barbecue stall.

Hearing Wu Xiaofu say this, Li Jun was also shocked. It was actually like this!
Looking at his wife beside him, he hurriedly said, "Did you hear that? Director Wu said that my illness was caused by eating barbecue. You must not be lazy in the future. You must cook for me every day at mealtime. I can't eat these anymore." After saying that, without waiting for his wife to get angry, Li Jun hurriedly said, "Director Wu, why don't you also take a look at my wife? She also eats barbecue frequently. Every night when I go home, I have to bring her some barbecue skewers. She eats them before she goes to sleep. Look at how fat she is. She is more prone to gout than me."

After saying this, before Wu Xiaofu could say anything else, Li Jun's wife slapped Li Jun on the back of his head, "Who are you calling fat?"

Li Jun's wife is indeed fat. She is less than 1.6 meters tall and weighs about 180 or 190 kilograms.

After calling Li Jun, Li Jun's wife realized that the situation was not right, and hurriedly said to Wu Xiaofu with an apologetic look, "I'm sorry, Director Wu, I'm used to calling you, please don't mind, I apologize."

Wu Xiaofu quickly waved his hands to indicate that everything was fine.

By the way, I took the pulse of Li Jun's wife. She didn't have gout, but her health was not much better even if she didn't have gout. Obesity was really the source of the disease. From this pulse, I found that Li Jun's wife's heart, lungs, liver, and kidneys were not in good condition.

The main reason is obesity.

Not to mention anything else, just this liver, it's absolutely severe fatty liver. If it continues like this, cirrhosis is not impossible.

Wu Xiaofu said whatever he wanted to say. After calling Li Jun, he couldn't call him again.

What Wu Xiaofu said was serious, and Li Jun's wife was also frightened. No matter who she was talking to, she had to listen to the doctor. It seemed that if she didn't lose weight, she would die. She couldn't eat anymore.

In fact, Li Jun’s wife had tried to lose weight several times before, but each time ended in failure.

There was a period of time before, in order to lose weight, Li Jun was not allowed to bring back barbecue. Li Jun was happy to hear that. His wife was actually fine before they got married. Although she was fat, she was only about 130 pounds. But now, as the marriage time gets longer, her weight is increasing day by day.

It's almost 200 yuan. With Li Jun's physique, he could easily break a bone if he was pressed down on the bed.

Li Jun had long wanted his wife to lose weight, but he didn't dare to do so. The slapping in the face was more painful than his gout. When Li Jun heard that his wife wanted to lose weight on her own initiative, he naturally wanted it very much. He really didn't bring the skewers, and then he was slapped in the face again.

"I told you not to bring it, but you didn't? Do you not love me anymore? Aren't you afraid that I'll starve?"

Well, losing weight is just a cover, the real reason is that I want to beat him up.

"Junzi, don't bring any more nonsense back to me. I want to listen to Director Wu and lose weight quickly."

Ah! This!
Li Jun was a little hesitant after hearing these familiar words. He wondered whether he should risk getting beaten up and support his wife in losing weight.

"What? If you dare not obey, I will beat you to death."

Li Jun felt miserable. He was now pushed to the edge of the cliff. He was afraid that he would be severely beaten.

In addition to hyperlipidemia and excessive purine intake, some other groups may also suffer from gout, such as the diabetic group. 0.1% to 09% of diabetic patients suffer from gout. Some people believe that obesity, diabetes, and gout are the triple "killer" in modern society.

Well, that is to say, all three often appear together.

There are also some people who lead irregular lives. With the progress of society and the development of science and technology, online games are updated from time to time. Many people have become addicted to playing games and often play for a whole day, which disrupts their normal biological clocks. An irregular life can easily induce gout.

Of course, it's not just playing games, working overtime and so on are all possible, but it is best to abandon these behaviors that disrupt the biological clock.

Wu Xiaofu prescribed some medicine for Li Jun and Li Jun's wife, one for treating gout and the other for assisting weight loss.

Treating gout does not mean just curing the joint pain, nor does it mean just lowering the uric acid level. These are only treating the symptoms and not the root cause. There is a saying that goes, low back and leg pain should be treated from the kidneys, and high uric acid is a sign of poor kidney function.

So the treatment of gout can be summed up in one sentence: treat the kidneys!

Combined with the four examinations and the eight-category syndrome differentiation, it is actually very easy to lower uric acid with Chinese medicine alone. Just two medicines, coix seed and papaya, are enough, and the effect is not worse than Western medicine. Western medicine such as colchicine used to treat gout, although it works quickly, also mainly reduces uric acid.

Not only can it only treat the symptoms, it also has serious side effects. To be honest, for this kind of chronic disease, Chinese medicine is milder.

If Chinese medicine wants to cure the root cause, it must start with the kidneys.

Therefore, in the prescription prescribed by Wu Xiaofu, the main ingredient is the auxiliary ingredient, and lowering uric acid is only an auxiliary effect, while treating the kidney is the main ingredient.

While taking the medication, you should also pay attention to reducing gout attacks.

This also needs to be explained. Every time gout attacks, not only does it bring pain, it also aggravates the condition and is very unfavorable for treatment.

To reduce gout attacks, the first thing is to stabilize the uric acid level in the body. Taking medicine regularly is the key. People with persistently high uric acid levels need to take acid-lowering drugs regularly to stabilize it. The medicines prescribed by Wu Xiaofu are almost just right, ensuring the effect while not causing too many side effects.

All medicines are poisonous. For some medicines, you still need to pay attention to the side effects.

As long as Li Jun takes his medicine on time and stops his previous bad eating habits, gout will basically not recur.

Some people think that taking medicine is just like taking it. It doesn't matter if you take one more or one less meal a day. It's no big deal to change the time of taking the medicine. At most, if I take it late in the morning, I can just take it later in the evening.

I forgot to eat today, I will just eat more tomorrow.

This is totally wrong! Using the medicine in this way will not only fail to achieve the desired effect, but will also make gout worse.

Because of failure to take medication as prescribed by the doctor, the patient's uric acid level may increase or decrease in a short period of time. Once this happens, uric acid crystals in the joints will fall off.

Once the crystals fall off, white blood cells come on the scene, and that's it, gout strikes.

So don’t take anything for granted, and be sure to follow the doctor’s instructions!
Next, when losing weight, you must avoid losing weight too quickly. When I heard that obesity can cause gout, I thought that I had finally found a motivation to lose weight, and this time I must be serious about it, so I started exercising desperately to lose weight.

In order to lose weight as quickly as possible, some people even started taking diet pills.

My goodness, doing this, even though I lost weight, I actually got gout.

It is the same old story that ketone bodies compete with uric acid for excretion, which increases the blood uric acid level and promotes acute gout attacks. Similarly, there are people who do not know that they have high uric acid levels, but are eager to lose weight by starving themselves, or follow others to lose weight by ketogenic diet or eating meat, which is also very likely to cause gout.

Therefore, if you really want to lose weight, in addition to mastering the correct method, remember to have a physical examination and measure your uric acid level. It is not too late to take action.

(End of this chapter)