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Goutyart


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Gouty Arthritis
by Anthony di Fabio The Roger Wyburn-Mason and Jack M. Blount Foundation for the Eradication of Rheumatoid Disease AKA The Arthritis Trust of America®, 7376 Walker Road, Fairview, Tn 37062 The Case of Sam Georges
Agatha M. Thrash, M.D. from Uchee Pines Institute, Seale, Alabama de- scribes her patient as a 59-year-old African-American who was a logger by tradeworking a crew of pulpwood men. For several years Sam Georges had had occa-sional minor problems with Gout, usually lasting one or two days. This greatestand present episode had lasted over two weeks.
Sam's shoes had been cut to accomodate his painful feet, where toes were swollen and tender. Dr. Thrash reports that "His uric acid was high at 11.1(normal 3.9-9.0 mg/dl), his blood sugar was borderline, and his blood urea ni-trogen was 41 (normal 6-23). Sam's cholesterol was 275, and triglycerides 224,while his HDL (High Density Lipids) cholesterol was only 28, with blood pres-sure of 218/108 and weight of 286 pounds." Dr. Thrash placed Sam on a very strict diet without animal products -- no meat, milk, eggs, or cheese -- no visible fats such as margarine, butter, mayonaise,fried foods, cooking fats, salad oils and nut butters. He was advised to drink tenglasses of water daily, plus one glass per hour if he had active sweating, andallowed no food between meals, and only two meals a day -- breakfast andlunch. At supper time Sam was allowed a piece of fruit and a slice of bread. Hisfood was to be taken salt free.
In one week Sam's blood pressure dropped to 140/78, and his weight went down to 271 pounds. He said that he could now bend over and tie his own shoesand make them snug, wearing shoes without cutouts for his toes.
"Within three months Sam had lost 25 pounds, his blood pressure was stabilized at 138/72, and pulse at 72. He felt good and happy. At that point hissalt intake was allowed at one-half teaspoon per day, but continuing his fat freediet.
"After 18 months Sam's blood pressure still remained steady, weight con- tinued to come down close to 200 pounds, and Sam had no more episodes ofGouty Arthritis."12 Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
What is Gout?
Gouty Arthritis is a defect in the ability of the body to rid itself of excess uric acid, thus causing uric acid crystals to lodge in the collagen tissue matricesthroughout portions of the body, especially near the joints, or at other locationswhere a supersaturated solution of poorly dissolved uric acid will easily fall outof solution, near cooler portions of the body.
It's possible, but not probable, that those suffering from other forms of arthritis will also suffer from gout, a metabolic deficiency of a nature not com-pletely understood.
"Gouty Arthritis" is the term used, and since the name includes the word "arthritis" many wrongly associate the condition with Rheumatoid Arthritis orOsteoarthritis. (See Arthritis: Osteoarthritis and Rheumatoid Disease Includ-ing Rheumatoid Arthritis; http://www.arthritistrust.org.) Distribution of Gout
As osteoporosis is dominately a woman's disease, Gout is predominately a man's disease, the ratio being about 19 men for 1 women. Ninety-five percent ofGout victims, therefore, are men. The few women who have Gout show signsand symptoms after menopause, so there must surely be a hormonal factor.
The peak age for acute Gout is between 40 and 60 years.
Children are almost never affected.
Gout seems to be inherited, but it doesn't necessarily occur at birth or even a number of years later, but rather often it appears in later life.
While Gout is not the "big" kind of arthritis in numbers, such as Rheuma- toid Arthritis (about six million) and Osteoarthritis (about forty million), it issurely big enough in terms of numbers affected, about one million.
About 30% of those who have Gout have a genetic metabolic deficiency, while about 70% have Gout as a result of another disease or drug intake.
The Nature of Gout
The symptoms of gout are that the big toe joint is most frequently affected, but instep, ankle, knee wrist and elbow are common sites, sometimes even thespine; bouts may vary from days apart to several attacks a year; first attacks maybe in only one joint, lasting for days; later attacks may affect more joints; theremay be joint deformation if unattended; limitation of joint movement is precipi-tated by stress, or wrong diet; sharp, needle-like pain on movement of joints;skin is tense, hot, shiny and dusky red or purplish; systemic reactions may in-clude fever, heart rate increase, and chills and malaise.
Gout is classified into primary and secondary "hyperuricemia;" that is, the condition of excess uric acid in the blood stream.
Primary Gout refers to genetic deficiencies or disorders.
Secondary Gout refers to a gouty condition that follows from another dis- ease, or as the consequence of drug intake.
Up until the 1960s Gout was a terrible disease without much help from the medical profession. One had attacks of fever, chills and excruciating needle-likepains. The Gout victim suffered for weeks at a time and this often meant loss ofwork-time and salary. Eventually the attacks of Gout became more frequent andeventually disabling, with kidney disease, heart disease and many other compli-cations that set in.
Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
Nowadays most Gout victims find the disease simply an inconvenience, as they have available knowledge of how to control it through both diet and the useof at least two medicines.
Gout is viewed as a recurrent acute arthritis of the peripheral joints -- feet, legs, hands, arms, head and neck -- which results from deposits in and about thejoints and tendons of crystals of monosodium urate from a supersaturated solu-tion of uric acid in the blood (hyperuricemic).
Gout may become chronic and deforming. Not everyone with supersatu- rated blood may develop gout, but the greater degree and duration of the super-saturation, the more probability of crystal deposition and of acute attacks ofGout.
Usually an underlying abnormality in the metabolism of a chemical called "purines" is attributed to the Gouty condition, with excessive production of pu-rines and diminished ability to clear uric acid as being the major factors.
Causation Mechanisms for Gout
Although the exact mechanisms for the production of Gout are not entirely understood, many factors may be involved, including decreased urine produc-tion, and other conditions associated with decrease of fluids external to cells,renal disease, dehydration, diabetes, the use of diuretics, starvation, acute alco-hol (ethanol) ingestion, toxemia of pregnancy, and over production of lacticacid.
Damage to nerves from lead poisoning has been suggested as a mechanism The use of various drugs may contribute to Gout, such as pyrazinamide, aspirin (salicylates), ethambutol, diuretics, and nicotonic acid.
A.V. Costantini, M.D.,5,14 who presented a paper involving autoimmune diseases, malignancies, atherosclerosis, hyperlipidemias and Gout, is Head of theWorld Health Organization (WHO), also Collaborating Center for Mycotoxinsin Food Division of Clinical Chemistry, Department of Internal Medicine,School of Medicine, Albert Ludwigs University, Freiburg, Germany, and RetiredClinical Professional Faculty, University of California, School of Medicine, SanFrancisco, California.
Costantini reports the diseases wherein fungal forms of microorganisms have been found. These include the following: atherosclerosis, cancer, AIDS,diabetes mellitus, rheumatoid arthritis, Sjogren's syndrome, systemic lupuserythematosus, gout, Crohn's disease, multiple sclerosis, hyperactivity syn-drome, infertility, psoriasis, cirrhosis, Alzheimer's disease, scleroderma (pro-gressive systemic sclerosis), Raynaud's disease, sarcoidosis, kidney stones,amyloidosis, vasculitis, and Cushing's Disease.
If mycoplasmas are the basis to many of the so-called auto-immune dis- eases, including Gouty Arthritis, then here is another instance where ThomasMcPherson Brown, M.D. and Roger Wyburn-Mason, M.D., Ph.D. have alreadyled the way, Brown in the use of tetracycline (and related antiobiotics) againstmycoplasmas, and Wyburn-Mason in the use of anti-amoebics (also anti-mycoplasmic), as has already been described.
Gus Prosch, Jr., M.D. of Birmingham, Alabama remarks that "I'm not a bit surprised that someone has discovered a mycoplasmic organism as the basis to Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
Gout. Allopurinol is used to lower the uric acid in Gout, but it also kills amoeba-type germs, and possibly weakens mycoplasmic organisms."13 Other researchers have shown that many of the medicines recommended for Rheumatoid Diseases by The Arthritis Trust of America/The RheumatoidDisease Foundation are anti-microbial, viral-static, anti-mycoplasmic, and anti-protozoal, so it is not at all surprising that, where there is a micro-organismicbasis to the disease, such medicines will indeed have an effect on the course ofthe disease.
Possibly what each independent investigator has found represents a cross- section in the life-cycle of pleomorphic (form changing) organisms.6 While medi-cal researchers dally behind, microbiologists have accepted the fact that manymicro-organisms change their form and function depending upon their surround-ing environment. A bacteria can revert shape and function to become amycoplasmic organism, to a yeast/fungus form, to a protozoan form, to a viralstage -- and can revert back again.
Where one investigator sees mycoplasmas, another sees amoebae, another virus, and another bacteria.
When the human body becomes an environmental sanctuary for a particu- lar form of organism, than that form, found associated with the disease, it ap-pears to be the cause of the diseased condition.
Acute Gout Gout attacks are extremely painful, needle-like pains on use of the joint affected. It may start with but one joint in 85% to 90% of first attacks -- appar-ently while in good health -- but over time attacks may include more than onejoint. They will last for variable lengths of time separated by intervals of com-plete relief.
In at least half of first attacks, the site of pain is the first joint of the toes (metatarsophalangeal), while 90% of Gouty patients experience acute attacksin the great toe at some time during the disease.
Next in order of frequency of attacks are the insteps, ankles, heels, knees, wrists, fingers, and elbows.
Commonly the first attacks begin at night. Within hours the affected joint becomes hot, dusky red, and extremely tender. It may progress to resemble abacterial inflammation of the tissues (cellulitis).
Systemic signs may include an increase in the number of leukocytes in the blood, (leukocytosis), fever, and an increase in the red blood corpuscle (erthrocyte)sedimentation rate.
Acute Gouty Arthritis may be the presenting symptom of another under- lying metabolic disorder. An acute attack usually appears without warning, butmay be precipitated by minor trauma, as from minor surgery or ill-fitting shoes,overindulgence in food or alcohol, fatigue, emotional problems, infections, ortreatment with antibiotics, insulin or mercurial diuretics.
Systemic reactions may include fever, heart rate increases (tachycardia), chills, malaise and an increase in leukocytes (leukocytosis) in the blood. Firstattacks may last but a few days. Later, untreated attacks may last for severalweeks. Symptoms and signs may regress. Intervals between bouts vary consid- Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
erably, but tend to become shorter as the disease progresses. Eventually, withouttreatment, several attacks will occur each year.
Interval Gout There is typically a complete remission of symptoms, and then most pa- tients experience a second attack from six months to two years later.
If they are untreated, the attacks will increase in frequency.
Chronic Gout A third stage of Gout is reached after many years. With chronic Gout, hard or gritty (tophaceous) deposits appear in the joint and tendons. Chronic jointsymptoms develop as permanent erosive joint deformity appears. There is limi-tation of motion, often involving multiple joints of the hands, feet, or both.
Rarely is the shoulder, scacroiliac or sternoclavicular joints involved. Some- times the cervical spine may be involved.
Monosodium urate deposits are common in the walls of the sacs surround- ing joints (bursae) and within tendon sheaths. Increasing deposits of monoso-dium urate about the joints, erosion of joints and joint destruction, chronic jointswelling and pain may progress to a crippling disease in which acute attacksdecrease in frequency and severity.
Visible "tophi," deposits of monsodium urate, occur in cartilage, synovial membranes, tendons, and soft tissues, after an average of about 12 years. Tophiare especially visible in the the margin of the ear lobe (pinna), fingers, hands,knees, and feet, and also the ulnar surface of the forearm.
Grotesque deformation of the hands and feet progress rapidly toward crip- Rare Syndromes Rare forms of Gout have been recognized as overproduction of uric acid (Lesch-Nyhan syndrome), self-mutilation, and other neurologic and metabolicdeficiencies.
Associated with Gout can be a number of other diseases, including blood (hematopoietic) diseases, psoriasis, thyroid (myxedema), parathyroid (hypo-and hyperparathyroidism), hypertension, heart (myocardial infarction), kidney(advanced renal diseases), obesity, and several hereditary diseases (Down's syn-drome and glycogen storage disease, Type I).
There can be a sex-linked presence of uric acid in the urine (uricaciduria) with a deficiency of a certain enzyme (hypoxanthine-guaninephosphoribosyltransferase). This is associated with markedly excessive uric acidproduction, a tendency to develop uric acid kidney stones, and severe GoutyArthritis and kidney disease (nephropathy) at an early age.
Usually the characteristics of Gout are so unique as to be easily diagnosed by patient history and examination.
Traditional treatment usually involves (1) use of an anti-inflammatory drug to halt the pain of an acute attack; (2) daily use of a drug, colchicine, to dissolvethe already deposited crystals; (3) use of allopurinol to prevent further deposi-tion of crystals; (4) a maintenance program of preventative therapy, usuallythrough diet control.
Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
Those patients that are intolerant of colchicine may use phenylbutazone or Colchicine is often compounded with probenecid, a chemical that helps inhibit tubular reabsorption of urate, thus increasing the urinary excretion ofuric acid, thereby also decreasing the blood serum urate levels.
Other drugs may also be used to lower the concentration of urate in the blood stream.
One of the advantages of using colchicine is that a gouty condition will usually (90% of the cases) recede within twelve hours of its administration,according to Michael T. Murray, N.D.10 Allopurinol helps to lower uric acid levels by inhibiting its formation. It also inhibits the enzyme responsble for the final conversion of purines into uricacid, xanthine oxidase. According to Dr. Murray, "Allopurinol is best used inGout patients who overproduce, as opposed to underexcrete, uric acid."10 Al-lopurinol, according to researchers, is anti-protozoal, anti-bacterial, viral-static,and also anti-mycoplasmic, which may be a partial explanation of its effective-ness in the treatment of gout.
Although corticosteroids can produce rapid relief from pain, most authori- ties recommend use of other drugs. However, if it is necessary to remove fluidfrom a joint for relief of symptoms, then corticosteroids are often used.
Abundant fluid intake is recommended, also, to combat dehydration and decrease urate precipitation in the kidneys.
Occasionally stronger pain killers are prescribed, when necessary.
It is said that traditional therapy permits patients to live a full and produc- tive life without serious disability, provided diagnosis is prompt and that thepatient accepts the treatment.
The hard, gritty deposits (tophi) can be resolved, joint function improved, and kidney dysfunction can be halted.
If necessary, some limited reconstitution of joint structure is possible via Progressive, untreated kidney dysfunction leads to further gouty deposits, which accelerates the process, thus forming the greatest threat to life.
What's Wrong With Traditional Treatments?
Certainly a person in pain, with increasing joint dysfunction and other or- gan degeneration, will welcome the quick relief offered by palliative treatmentfor pain. The use of colchicine, if tolerated by the patient, and allopurinol, in theabsence of chemical sensitivities which might be peculiar to the gout victim, arealso a welcome relief, for one will eliminate the growing urate crystals, and theother will prevent their re-growth.
Unfortunately 90% of those afflicted may not be able to tolerate colchicine in optimal dosages. According to Michael T. Murray, N.D.10 about "80% of thepatients are unable to tolerate an optimal dose because of gastrointestinal sideeffects such as severe nausea, abdominal cramps, vomiting and/or diarrhea, whichmay precede or coincide with clinical improvement." Colchicine also has other side effects, according to Michael T. Murray, N.D.,10 including possible "allergic reactions, loss of hair, suppression of bonemarrow resulting in low white blood cell counts, anemia, fatigue, abnormal bleed- Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
ing and bruising, peripheral nerve inflammation characterized by numbness,'pins and needles' sensations, pain, weakness in the hands and/or feet, liver dam-age, and inflammation of the colon resulting in bloody diarrhea." So long as the traditional Gout diet does not conflict with other dietary requirements, it is quite useful and should be adhered to, at least during theperiod when one is at risk for this disease.
According to Michael T. Murray, N.D. "It is a well-accepted fact that most cases of gout can be treated effectively with diet alone. However, with the ad-vent of potent drugs like allopurinol, many physicians do not even stress thevalue of diet therapy to their patients." Dr. Murray summarizes the proper di-etary regimen as (1) elimination of alcohol intake; (2) low purine diet; (3) achieve-ment of ideal body weight; (4) liberal consumption of complex carbohydrates; (5) low fat intake; (6) low protein intake; and (6) liberal fluid intake.10 Typical Gouty Arthritis Diet Furnished by John Baron, D.O.3 List 2
Very High
Fairly High
(Careful With These) All Organ Meats* (brain, Beans, Peas, Lentils except those in List 2 sweetbreads, etc.) Brands and Cereals (except whole grain) Salmon (and Lox, Etc.) Fish Roe (including Meats (except Organ Meats* — see list 1) Milk and Milk Products Seafood (Crabs, Oysters SpinachWheatgerm *Organ meats are often used in preparing sausages, luncheon meats and similar products. These "invisible" organ meats can add large amounts of purine to the diet ofthe unwary. "Invisible" organ meats should be avoided just as much as any other purinefood.
No alcoholic beverages!********************************************A suffering gout victim should probably take advantage of all of these traditional treatment forms. Nonetheless, none of them tackle the basic prob-lem, which is this: John Doe did not have gout for many years, and suddenly, for Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
no clearly known medical reason, does have gout. Why? What is there about thebody that is changed, and how can this change be reverted? In other words, again, traditional medicine does not tackle the cause of the presumed metabolic problem.
Anti-Amoebic (Anti-Microbial) Treatments Gus J. Prosch, Jr., M.D.,13 Birmingham, Alabama, reports that some of his Gout patients beneficially respond to The Arthritis Trust of America/TheRheumatoid Disease Foundation anti-amoebic therapies used for other Rheuma-toid Diseases. (See Arthritis: Osteoarthritis and Rheumatoid Disease IncludingRheumatoid Arthritis; Arthritis: Little Known Treatments; http://www.arthritistrust.org.) Anti-Mycoplasmic, Anti-Fungal Treatments According to Dr. Costantini,15 the concept of auto-immune diseases con- tains a fatal flaw, because no successful species can develop a system of defensewhich attacks itself.
Antibodies that are measured in the blood stream and which imply an autoimmune condition are actually antibodies against "ubiquitin," a substancethat is present in many species including that of fungi.
"Gout and hyperuricemia are clinical entities of previously unkown etiology (cause). Fungi/mycotoxins have been ignored as documented cause of bothentities," according to Dr. Constantini. "All of the biochemical findings in gout/hyperuricemia are explainable by fungal production of preformed urates/uratecrystals, oxalate, glutamate, glycosaminoglycan, glycoprotein and hormones." As Gout and hyperuricemia respond to various antifungal treatments, it seems to be established that Gout, along with a number of so-called auto-immunediseases, is based upon a tissue sensitivity to the toxins of fungi and antibodiesagainst a product of the invading mycoplasma, "ubiquitin." It has also been reported that colchicine is a good anti-mycotoxin, which may be one of the reasons why Gouty Arthritis responds to administration ofcolchicine.
As many of the drugs recommended for treating various Rheumatoid Diseases are anti-bacterial, viral-static and anti-fungal, here is more circumstan-tial evidence that the good response to using these drugs with so-called auto-immune diseases, as well as Gouty Arthritis, is based upon infestation by micro-oganisms, possibly including mycoplasmas.
Dr. Costantini reports that Gout responds to griseofulvin, an antifungal antibiotic which has similar action to colchicine. Among the antifungals are alsofound lovastatin, griseofulvin, ketoconazole, neomycin, fibrates, tetracyclineand others, some of which may also be effective against Gout. Use of thesemedicines should be under a health professional's supervision, and care shouldbe taken to replace Lactobacillus acidophilus that will be killed in the intestinaltract.15 (See "Friendly Bacteria," http://www.arthritistrust.org.) According to research work and findings of consultant Professor Schiedl (Germany), and the Instituto Medico Biologico of Tijuana, Mexico, physiciansFiliberto Munoz-Torres and Fernando C. Ramirez del Rio, a mycoplasmicinfection usually results from a focus of infection, such as the gums where either Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
a tooth has been extracted, or where there has been root canal work.
According to George E. Meinig, D.D.S., who reports on the extensive work of dentist Weston Price in Root Canal Coverup, without special precautions tosterilize the dentin tubules after mouth surgery, aerobic bacteria mutate to ananaerobic (live without oxygen) form. They live in and migrate from thethousands of feet of small tubules. These mycoplasmic forms will invade otherorgans and systems to be fought off by our immune systems. When we can nolonger fight off the invasion, we began suffering from "degenerative" diseases,such as gout.
A number of dentists and physicians can apply non-invasive techniques to determine if there is a mycoplasmic focus of infection in the gums, and, if so,others have been trained to sterilize these sources with laser heat and hydrogenperoxide injections after surgery. Many people have recovered spontaneouslyafter such treatment.
*******************************************************The Instituto Medico Biologico can be contacted at 482 W. San Ysidro Blvd., #808, San Ysidro, CA 92173, or, Allen W. Lloyd Building, Paseo, Tijuana406=203, Tijuana, Mexico; call (619) 425-3153.
Root Canal Coverup by George E. Meinig, D.D.S. is available through this Aroma Therapy Herbalist Jeanne Rose of San Francisco, Chairperson for the National As- sociation of Holistic Aromatherapy, suggests in her book Aromatherapy: Appli-cations and Inhalations, that one can soothe the pain of gout with a massage oilcontaining 1 ounce of olive oil and 5 drops of juniper oil, which is massagedinto the joints several times each day.7 Aromatherapist Judith Jackson of Greenwich, Connecticut, author of Scentual Touch: A Personal guide to Aromatherapy, uses a cool foot bath "spiked"with juniper and rosemary essential oils.7 Dr. Caroline M. Shreeve9 reports on the use of 4 drops of essence of juniper on a little brown sugar after every meal, which can be used for all forms ofarthritis. For Gout alone, rub the afflicted joint with olive oil containing 10percent essence of juniper.
Bee Sting Therapy The International Apitherapy Study begun in 1983, has gathered follow-up data on more than 12,000 bee stung patients. It may take up to 1-5 stings to reducethe pain.18 (See Arthritis: Osteoarthritis and Rheumatoid Disease IncludingRheumatoid Arthritis; Arthritis: Little Known Treatments; http://www.arthritistrust.org.) A case of Gout is reported by Paul A. Goldberg, M.P.H., D.C.,19 graduate of Bowling Green State University, Life College, and the University of TexasMedical Center Graduate School of Public Health. Dr. Goldberg holds degreesin preventive medicine, nutrition and chiropractic, and is Professor of ClinicalNutrition, Gastroenterology, and Rheumatology at Life College in Marietta, Geor-gia. He operates The Goldberg Clinic in Marietta, Georgia.
Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
The Case of Jeff Scales Jeff Scales, 41-years-of-age, came to Dr. Goldberg with severe gout so painful that he could not walk at times. Jeff was also troubled by fatigue, highblood pressure, an overweight condition, digestive disorders, and ear and sinusinfections. His Gout was gradually getting worse despite drugs given him byhis physician.
Laboratory tests revealed elevated uric acid, cholesterol and triglyceride levels. He had numerous allergies and a number of mineral imbalances.
Jeff was placed on a liquid diet for detoxification and rest lasting 21 days.
His symptoms initially worsened, and the blood uric acid levels increased. Bythe 10th day the pain began to subside as did the uric acid, cholesterol, andtriglyceride levels. Later Jeff was placed on an elimination diet and givenacupressure along with specific nutrient supplementations.
In 40 days Jeff lost over thirty pounds, with normalization of cholesterol, triglycerides and blood pressure. He reported feeling very well with no morejoint pain and with increased energy. he was able to get off of all high bloodpressure and Gout medications.
Three years later Jeff is still in excellent health. As a bonus, his ear and sinus infections have become a thing of the past.
Michael T. Murray, N.D. suggests weight reduction in obese individuals, using a high-fiber, low-fat diet. Liberal fluid intake is also recommended, as ithelps keep the uric acid diluted, and also promotes its excretion.4 Other Dietary Considerations It's also important that sufficient thyroid5 be produced or available to the metabolism, as it may not be easy or possible to change from acidic to alkalineif the thyroid is insufficient. Other hormone replacement therapies, such asdehydroepiandrosterone, and others might be considered. (See Thyroid Hor-mone Therapy: Cutting the Gordian Knot; http://www.arthritistrust.org.) Enzyme Therapy Enzyme supplementation, along with proper diet, may be important.
Julian Whitaker, M.D., Newport Beach, California, and Dr. Michael T.
Murray, Bellevue, Washington, report that some gout patients find relief byeating a handful of up to one-half pound of cherries each day.7 "Cherries, haw-thorn berries, blueberries, and other dark red-blue berries are rich sources ofcompounds that have been found to favorably affect collagen metabolism andprevent and reduce inflammation of joints."4 One can also juice about four handfuls of pitted cherries with 1/2 cup of strawberries to help neutralize excess uric acid, reports Cherie Calbom, M.S., acertified nutritionist in Kirkland, Washington, and co-author of Juicing for Life.
She also advises using this juice daily to prevent gout attacks.
Other forms of flavonoids may also be of benefit to individuals with Gout.
Dr. Murray suggests that "quercetin may offer significant protection by inhibit-ing uric acid production in a fashion similar to the drug allopurinol, as well asinhibiting the manufacture and release of inflammatory compounds.
"Quercetin is widely found in fruits and vegetables. For best results, 200 to Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
400 milligrams of quercetin should be taken with bromelain between meals, asbromelain is believed to enhance the absorption of quercetin and other medica-tions."10 Dr. Caroline M. Shreeve9 reports on the use of four cupfuls daily made of the following: 1 liter of water, 4 slices of lemon, a pinch of lavender and a pinchof dog's tooth.
Folic Acid Michael T. Murray, N.D. reports that "folic acid has been shown to inhibit xanthine oxidase, the enzyme responsible for producing uric acid." Research,he says, has shown it to be a greater inhibitor than allopurinol, which suggeststhat "pharmacological doses (10 to 50 milligrams/day) may be an effective treat-ment in gout."10 Garlic (Allium sativum) has been used throughout the world for gout and Rheumatism. According to Alternative Medicine: The Definitive Guide, "Stud-ies indicate general benefits from almost any type of garlic, be it raw garlic,dried garlic, garlic oil, or a prepared commercial product. However, odorless orodor-controlled garlic preparations have a high degree of activity and are appro-priate. . "4 A herbal tea long said to be effective with Gouty Arthritis is Kombucha Selection of homeopathic remedies is a function of the individual's physi- cal condition, constitution and personality.
According to Chris Meletis, N.D.
In times of emergency until you see your medical doctor or homeopath, or as a complementary treatment until you feel some relief, Chris Meletis, N.D.7 atthe National College of Naturopathic Medicine in Portland, Oregon, advisesthat for red, hot, swollen joints, try Belladonna 12c every couple of hours.
If the joints are acutely painful and red, use Aconite 12c every few hours.
If the big toe is red and tender, and you also feel irritated and weak, use Colchicum 12c every few hours.
For burning, itching and swelling in the gouty area, use Urtica urens 12c, every few hours.
According to Dr. Schuessler's Biochemistry Dr. Schuessler's Biochemistry8 reports on the use Natrum sulphur as a rem- edy for gout, although in the acute stages alternate it with Ferrum phosphorus. According to Dr. Lockie Dr. Andrew Lockie11 recommends to be taken every 15 minutes for up to 10 doses, the following: Colchicum 6c for a person depressed, irritable, weak, and nauseous and whose affected joints are excruciatingly painful, especially at night or when anattempt is made to move it.
Arnica 30c when joints feel bruised and painful.
Ledum 6c when affected joints are slightly swollen, with a cold feeling in them, and discomfort lessened by cold bathing and increased by movement.
Urtica 30c when affected joints burn and itch.
Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
Benzoic Ac. 6c when symptoms are accompanied by strong-smelling urine.
Lycopodium 6c when one foot is hot, the other is cold, and symptoms worsen from 4 to 8 p.m.
Pulsatilla 6c when pains flit from joint to joint.
Dr. Lockie11 further advises for the ease of pain to "apply a hot compress or ice pack to the affected joint, but do not take aspirin as it may interfere withaction of antigout drugs. . Drink extra fluid (plain water is best, or water witha little sodium bicarbonate in it) to enable your kidneys to excrete as much uricacid as possible." According to Dr. Catherine Russell Dr. Catherine Russell, Guadalajara, Mexico,20 uses a lot of stinging nettle, which she picks and prepares herself during the dry season. She administersstinging nettle extract (96 proof alcohol), a tablespoon 3 X daily. The extract isalso applied locally to Gout inflammation, and "the next day," she reports, "thepatient will feel better." Dr. Russell also may use DMSO (dimethylsulfoxide),and she'll advise a change in diet and lifestyle, more exercise, halting smokingand increasing vitamin C intake.
"If improvement is not forthcoming, I'll use a high potency homeopathic remedy, which usually works unless there is a stubborn genetic factor." John Abruzzo, M.D., professor of medicine and director of the Rheumatol- ogy and Osteoporosis Center at Thomas Jefferson University Hospital in Phila-delphia, Pennsylvania, applies a cold, wet compress directly to the sore area for20 minutes, or he will wrap an ice pack in a plastic bag, placing it over a towelon the skin. He has advised, "Never leave a cold treatment on for more than 20minutes, . ., or you could damage your skin. Gout is comparatively easy to treatif it is recognized early enough. If you let it go for too long, it's much harder toget under control. "7 So, see your doctor as soon as possible.
Agatha Thrash, M.D. and Calvin Thrash, M.D. write that "Large doses of charcoal by mouth -- ten tablets four times a day for ten days -- charcoal bathsand compresses promote a fall in the blood uric acid.
"Mud baths have also been suggested as useful in gout."17*******************************************************Agatha Thrash, M.D., Calvin Thrash, M.D., Home Remedies, Thrash Pub- lications, may be obtained through this Foundation at http://www.arthritistrust.org.
Qigong for Arthritis The balancing or distribution of biolectrical energy to body parts in need can be an important therapy.16 (Qigong for Arthritis by Dr. Jang Jwing-Mingavailable through this Foundation at http://www.arthritistrust.org.
The Case of Harry Turner Harry Turner, 72 years-of-age, is an interesting demonstration of a concept of the Chinese medicine which approaches the cause of the problem (root) asopposed to its symptoms (the branches), according to Roger Jahnke, O.M.D.
Harry had high blood pressure and also suffered from chronic obstructive pulmonary disease. He'd been on drugs for a period longer than 10 years, which Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
had completely eliminated his sex life.
"Following the rule, to treat the root and not the branch, what we did instead of treating Gout or high blood pressure, or chronic obstructive lung disease, wetreated his syndrome, his constitutional syndrome in terms of Chinese medicine,which was the 'yin' of the kidney." ("Yin," in Chinese medicine, means"deficient."16) "What's fascinating about Harry's progress is that without treating Gout or high blood pressure, both of those seemingly unrelated disorders began toresolve, and he no longer needed medicines.
"Harry caught the vision of the value of self-applied, health enhancing methods. He was particularly interested in meditation [which is part of Qigong]." *************************************************See Roger Jahnke, O.M.D., books, Qigong: Awakening and Mastering the Medicine Within, The Self Applied Health Enhancement Methods; tape, DeeperRelaxation for Self Healing, Health Action, 243 Pebble Beach, Santa Barbara,CA 93117; Dr. Yang Jwing-Ming, Arthritis -- The Chinese Way of Healing andPrevention, The Root of Chinese Chi Kung: The Secrets of Chi Kung Training,YMAA Publication Center, 38 Hyde Park Avenue, Jamaica Plain, Massachusetts02130. (Also see http://www.arthritistrust.org.) Michael Murray, N.D. recommends "1.8 grams a day of eicosapentaenoic acid (EPA), 400 to 800 IUs a day of vitamin E, 10 to 40 milligrams a day offolic acid (under a physician's supervision) and quercetin (with bromelain), 124to 250 milligrams three times a day between meals."4 ********************************************************Michael Murray's book Natural Alternatives, is available through William Morrow and Company, Inc., New York, 1994. (Also see http://www.arthritistrust.org.) ******************************************************Julian Whittaker, M.D. recommends drinking lots of water to keep the urine diluted. Ten to 12 glasses of water daily, as also recommended by Dr.
Batmanghelidj (Your Body's Many Cries for Water, available this foundation)will help excrete uric acid and prevent crystals from forming. "Tart cherries,blueberries, and other dark red-blue berries contain anti-inflammatory com-pounds called anthocyanins, which are remarkable in their ability to ease thepain of gout." Dr. Whitaker also recommends flavonoid quercetin to inhibit uric acid pro- duction similar to that involved with prescription drugs. He recommends taking200 to 400 mg of quercetin along with 1,000 to 1,500 mg of the enzyme brome-lain -- to enhance absorption) two to three times daily between meals.
Universal Oral Vaccination Early research with Rheumatoid Arthritis and "Rheumatism," involved sta- phylococcus and streptococcus killed organisms injected as antigens, the suc-cessful results thus strongly supporting the infectious nature of RheumatoidArthritis. As many forms of Rheumatoid Disease seem to have an infectiousand/or allergenic component, such as Ankylosing Spondilitis, Candidiasis, Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
Crohn's disease, Fibrositis, Fibromyalgia, food allergies, rhinitis, and so on,this form of protection may be not just all-inclusive, but also cheap and all-important.
Injecting known, specific allergens or antigens into the cistern (base of teat) of a cow just prior to calving produces protective substances that are cura-tive.
As Dr. Costantini has shown a mycoplasmic basis to Gout, so this form of treatment may be effective. (See "Universal Oral Vaccine," http://www.arthritistrust.org.) 1. The Merck Manual of Diagnosis and Therapy, 16th Edition, Merck, Sharp & Dohme Research Laboratories, Division of Merck & Co., Inc., Rahway, N.J.,1992.
2. Textbook of Internal Medicine, J.B. Lippincott Company, East Washing- ton Square, Philadelphia, PA 19105, 1989.
3. John Baron, D.O., Gouty Arthritis, The Art of Getting Well, The Arthri- tis Trust of America, 7376 Walker Road, Fairview, TN 37062-8141, 1989.
4. Burton Goldberg Group, Alternative Medicine: The Definitive Guide, Future Medicine Publishing Co., Puyallup, WA, 1994.
5. Anthony di Fabio, Thyroid Hormone Therapy: Cutting the Gordian Knot, The Art of Getting Well, The Arthritis Trust of America, 7111 Sweetgum Dr.
SW, Fairview, TN 37062-9384, 1989; a report on the work of Broad Barnes,M.D.
6. Lida Mattman, Ph.D., Cell Wall Deficient Forms: Stealth Pathogens, CRC Press, Inc., 2000 Corporate Blvd., N.W., Boca Raton, Florida, 33431, 1993.
(Also see 3rd edition.) 7. Doug Dollemore, Mark Giuliucci, Jennifer Haigh, Sid Kirchheimer, Jean Callahan, New Choices in Natural Healing, Rodale Press, Inc., Emmaus, Penn-sylvania.
8. J.B. Chapman, Ph.D., J.W. Cogswell, M.D.; revised D.S. Rawson, M.A., Dr. Schuessler's Biochemistry, Thorsons Publishing Group, Rochester, Vermont,1986.
9. Dr. Caroline M. Shreeve, The Alternative Dictionary of Symptoms and Cures, Century Hutchinson Ltd., Brookmount House, 62-65 Chandos Place,Convent Garden, London WC2N 4NW, 1986.
10. Michael T. Murray, N.D., Natural Alternatives, William Morrow and Company, Inc., New York, 1994.
11. Dr. Andrew Lockie, The Family Guide to Homeopathy, Fireside, Rockefeller Center, 1230 Avenue of the Americas, New York, New York 10020,1989.
12. Personal correspondence with Agatha M. Thrash, M.D. November 2, 13. Personal interview with Gus J. Prosch, Jr., November 21, 1995.
14. Personal attendance at a medical conference, where Gary Gordon, M.D.
spoke briefly from the floor, describing Costantini's work.
15. A.V. Constantini, M.D., The Fungal/Mycotoxin Connections: Autoim- Medical data is for informational purposes only. You should always consult your
family doctor or one of our referral physicians.
mune Diseases, Malignanacies, Atherosclerosis, Hyperlipidemias, and Gout,Keynote Speaker, American Academy of Environmental Medicine, Reno, Ne-vada, 1993.
16. Jwing-Ming Yang, Arthritis -- The Chinese Way of Healing and Pre- vention, YMAA Publication Center, Yang's Martial Arts Association (YMAA),38 Hyde Park Avenue, Jamaica Plain, Massachusetts 02130, 1991.
17. Agatha Thrash, M.D., Calvin Thrash, M.D., Home Remedies, Thrash Publications, Rt. 1, Box 273, Seale, Alabama 36875.
18. Dava Sobel, Arthur C. Klein, "Bee Venom," Arthritis: What Works, St.
Martin's Press, 175 Fifth Avenue, New York, NY 10010, 1989; Also see Alter-native Medicine Digest, Future Medicine Publishing, Inc., 5009 Pacific High-way East, Suite 6, Fife, WA 98424.
19. Personal correspondence with Paul A. Goldberg, M.P.H., D.C.
20. Personal interview with Dr. Catherine Russell.
21. Julian Whitaker, M.D., Health & Healing," August 2000, Vol. 10, No.

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UNIVERSITY OF TASMANIA Understanding Applied Pharmacology: Perceptions of undergraduate student nurses Final Report for the SNM HDR Committee Ms Juliet Sondermeyer, Dr Christine Spratt, Dr Christine Armatas and Mr Daniel Goss January 2006 FACULTY OF HEALTH SCIENCE School of Nursing and Midwifery

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ONLINE FIRSTSystematic Review of Early CardiometabolicOutcomes of the First Treated Episode of Psychosis Debra L. Foley, PhD; Katherine I. Morley, PhD Context: The increased mortality associated with schizo- scribing 53 independent studies; 25 studies met inclu- phrenia is largely due to cardiovascular disease. Treat- sion criteria and were retained for detailed review.