Gout is a painful type of arthritis commonly felt in a big toe. Gout is caused by a buildup of uric acid in the blood known as hyperuricemia. A gout attack happens when uric acid forms crystals in the joints, causing inflammation and pain. As your uric acid level rises, so does the chance for gout and gout attacks. Over time, these attacks, or flares, can become more severe, last longer, and happen more often. Symptoms and signs of gout in TCM include as follows.

1. Obstruction of Damp Heat in the Meridians   
Chief Manifestations: Redness, swelling, a burning sensation and pain of the joints which is alleviated by cold, tenderness, or fever, constipation, dark yellow urine, yellow and greasy tongue coating, and wiry and rapid or smooth and rapid pulse.

2. Invasion of the Collaterals by Cold and Dampness 
Chief Manifestations: Rigidity and deformity of the joints, limited flexibility, darkish red skin, aversion to cold and cold limbs, darkish tongue with ecchymosis, thin and white coating, deep and thready pulse.

3. Phlegm Stagnation Blending with Blood Stasis
Chief Manifestations: Subcutaneous nodules which are normal-colored, tenderless or ruptured, darkish tongue with occasional ecchymosis, thin and white coating, and deep and smooth pulse.

4. Retained Damp Heat in the Urinary Bladder      
Chief Manifestations: Sandy stones in the urine; difficult, frequent and urgent urination; urethral pain and colicky pain of the loins and abdomen; even hematuria, red tongue with yellow coating, and rapid pulse.

5. Deficiency of Spleen Yang and Kidney Yang 
Chief Manifestations: Short breath, lassitude, loss of appetite, nausea, vomiting, abdominal flatulence, loose stools, sore and weak loins and knees, aversion to cold, cold limbs, edema of the face and lower limbs, pale complexion, pale swollen tongue with white and thin coating, and deep, thready and forceless pulse.