The redness, swelling, heat, and pain in the joints are only the tip of the iceberg in gout. Beneath the surface lies a chronically imbalanced metabolic system, overburdened Spleen and Kidney functions, and a network of meridians clogged with "turbid-stasis" pathogens.

Many gout sufferers focus all their attention on pain relief—as long as the pain stops, they are satisfied. But relieving pain only treats the symptoms. The real challenge is: how do you prevent gout from recurring? And how do you fundamentally change the constitution that makes you prone to gout in the first place?

I. Gout Hurts the Joints, but the Disease Lies in the Organ

1. Spleen-Kidney Deficiency: The "Soil" That Nurtures Gout

TCM holds that the root of gout lies in the Spleen and Kidney. The Spleen is the "foundation of acquired constitution," while the Kidney is the "foundation of innate constitution." Together, they govern fluid metabolism and the transformation and distribution of essential nutrients.

• Spleen deficiency weakens its transformative function, preventing water-damp from being properly metabolised, leading to internal accumulation of damp-turbidity.

• Kidney deficiency impairs its qi-transforming function, hindering fluid excretion and allowing damp-turbidity to accumulate further.

A deficiency in both Spleen and Kidney is like hardened, compacted soil—water cannot penetrate, nor can it drain away, eventually resulting in stagnation. This "compacted soil" is the fundamental root cause of recurrent gout attacks.

2. From "Damp-Heat" to "Turbid-Stasis": A Vicious Cycle

In the early stages, gout often manifests as damp-heat accumulation—red, swollen, hot, and painful joints, with a red tongue and yellow, greasy coating. At this point, the condition is predominantly one of excess pathogens. With timely intervention, the damp-heat can be cleared and recovery is possible.

However, if attacks recur repeatedly and linger without resolution, the condition progresses to a more complex stage. Prolonged damp-heat damages qi, blood, and body fluids; phlegm and stasis become mutually entangled, obstructing the meridians; and the Liver, Spleen, and Kidney gradually become deficient, resulting in a complex pattern of mixed deficiency and excess.

At this stage, patients not only experience joint pain but may also present with systemic symptoms such as fatigue, lumbar soreness, and frequent nocturia. Gout is no longer just a "joint problem"—it is a local manifestation of a systemic metabolic disorder.

3. Treatment Based on Syndrome Differentiation: Different Constitutions, Different Approaches

Because the pathogenesis of gout is complex and its patterns diverse, TCM places great emphasis on treatment based on syndrome differentiation.

Even among patients with the same disease:

• In the acute attack phase, with red, swollen, hot, and painful joints, the pattern is damp-heat accumulation, treated by clearing heat and draining dampness.

• In the chronic phase, with cold and painful joints aggravated by cold, the pattern is wind-cold-damp bi, treated by warming the meridians and dispelling cold.

• In long-standing cases with joint stiffness and tophi, the pattern is phlegm-stasis obstruction, treated by resolving phlegm and eliminating stasis.

• In elderly or frail patients with recurrent episodes, the pattern is Spleen-Kidney deficiency, treated by strengthening the Spleen and tonifying the Kidney.

The same disease, in different individuals and at different stages, calls for different treatment approaches. This is the essence of TCM's "one prescription for one person" philosophy.

II. Qiteng Therapy: From "Treating Joints" to "Regulating Constitution"

1. An External Treatment Plan Guided by Holistic Thinking

The core strength of Qiteng Therapy at Qingdao Tiandao Traditional Chinese Medicine Clinic does not lie merely in "rapid pain relief"—although many patients do experience relief after treatment—but in holistic regulation.

Qiteng Therapy does not focus only on the painful joint; instead, it combines whole-body fumigation with targeted baking therapy to coordinate multiple meridians and organ systems. The fumigation phase regulates systemic qi and blood and expels overall damp-turbidity; the targeted baking phase precisely addresses local stasis at the affected sites. Together, they treat both the symptoms and the root cause.

As a classic TCM text states: "The principle of external treatment is the same as that of internal treatment."

Although Qiteng Therapy is an external therapy, its therapeutic logic is entirely consistent with oral medications—both revolve around resolving turbidity, eliminating stasis, unblocking meridians, and regulating the internal organs.

2. "Expelling Pathological Accumulations": A Visible "Detoxification" Process

Qiteng Therapy presents a unique phenomenon during treatment: red papules appear on the patient's skin, which then turn into brown scabs and eventually fall off naturally.

These scabs are not burns or allergic reactions—they are a visible manifestation of internal turbid-stasis pathogens being "driven out" of the body. Calcified deposits, metabolic byproducts, and other "waste toxins" attached to the meridians, blood vessels, fascia, and bone crevices are broken down into microparticles under the action of high-temperature herbs and expelled through the sweat pores.

The greater number of scabs indicates heavier internal stasis; fewer scabs indicate that the body is recovering. This visible therapeutic response allows patients to tangibly perceive the changes occurring in their body.

3. The External Treatment Advantage: No Harm to the Internal Organs

For gout patients who require long-term management, the safety of the treatment modality is of paramount importance.

Oral urate-lowering drugs and anti-inflammatory analgesics, while effective, may impose a burden on the liver, kidneys, and gastrointestinal tract with prolonged use. Qiteng Therapy, as a TCM external treatment, delivers herbal active ingredients directly through the skin to the lesion site, bypassing both the digestive absorption and blood circulation pathways.

This means:

• No gastrointestinal irritation, nausea, or diarrhoea

• No added burden on the liver or kidneys—suitable even for patients with compromised hepatic or renal function

• Suitable for long-term use in chronic patients requiring sustained management

For patients who are unsuitable for surgery due to age or underlying conditions, or who are concerned about medication side effects, Qiteng Therapy offers a conservative treatment alternative.

4. Activating Self-Healing Capacity: Letting the Body Heal Itself

The highest goal of TCM treatment is not to "use drugs to treat disease" but to stimulate the body's innate self-healing power.

Qiteng Therapy creates a favourable internal environment for self-repair by unblocking meridians, expelling pathological accumulations, and improving qi and blood circulation. When the meridians are unobstructed, qi and blood are abundant, and turbid-stasis is resolved, the body's self-healing mechanism is activated—not the drugs "treating" the disease, but the body healing itself.

This is the essence of TCM holistic thinking: not to do what the body should do for itself, but to help the body regain the ability to do what it should do.

III. Some Advice for Gout Sufferers

If you are troubled by recurrent gout attacks, the following points may be worth considering:

First, acknowledge the root cause. Gout is not simply a "diet-induced" illness; it is a manifestation of Spleen-Kidney dysfunction and metabolic imbalance. Dietary control and painkillers alone address only the symptoms, not the root.

Second, value proper syndrome differentiation. Gout at different stages and in different constitutions requires completely different treatment approaches. Blindly following others' prescriptions or taking medication without proper diagnosis is not only ineffective but may also worsen the condition.

Third, pay attention to your overall health. Do not focus solely on uric acid levels and joint pain; observe your systemic state—sleep, energy, digestion, and mood are all signals your body is sending.

Fourth, explore external therapies. For those concerned about medication side effects or unsuitable for surgery, TCM external therapies are worth understanding. Qiteng Therapy, guided by TCM holistic principles and centred on "resolving turbidity, eliminating stasis, and unblocking meridians," has been clinically practised for years and offers a non-surgical, low-side-effect conservative treatment option for gout sufferers.