Because gout is clinically manifested as recurrence of redness, swelling, a burning sensation, pain, and limited flexibility of joints, it is included in the category of bi-syndrome in TCM. As for the pathogenesis, this disease is externally caused by blockage of the meridians following invasion of the body by exogenous pathogenic wind, cold and damp heat; and internally caused by deficient healthy qi, overstrain, or exposure to wind while sweating and the weakened weiqi failing to protect the body from the exogenous pathogenic factors, giving rise to blockage of the meridians and stagnation of qi and blood. In a prolonged case, there may appear blood stasis and phlegm stagnation with the involvement from the meridians to the viscera, then visceral bi-syndrome occurs.

If patients don't get treatment, a gout attack can last for days or even weeks. If patients keep having more attacks, more joints may become affected and the attacks will last longer. If patients have gout attacks for many years, he/she may develop tophi. These are uric acid crystals that form lumps under the skin. Tophi usually form on the toes, fingers, hands and elbows. Patients may also develop kidney disease or kidney stones from uric acid crystals that collect in the urinary tract. Over time, even the bone around a joint may be destroyed by gout.