Are you experiencing persistent joint pain, swelling, or stiffness? These symptoms could be related to arthritis, a common condition that affects millions of people. While there are many types of arthritis, gout and rheumatoid arthritis (RA) are two of the most prevalent. Understanding the differences between these conditions, their causes, and their treatments is essential for effective management. This blog post will provide a comprehensive guide to understanding both gout and RA, exploring conventional and homeopathic treatment options, and offering practical advice for managing symptoms, designed to empower you with the knowledge you need to take control of your health.
Understanding Gout
Gout is a form of arthritis characterized by sudden and severe attacks of pain, swelling, redness, and tenderness in the joints, most commonly the big toe. This intense discomfort arises from the accumulation of uric acid crystals within the joint. Uric acid is a waste product normally produced by the body during the breakdown of purines, substances found in many foods and body tissues. When the body either produces too much uric acid or cannot eliminate it effectively, it can accumulate in the blood, a condition known as hyperuricemia. This excess uric acid can then form sharp, needle-like crystals in the joints and surrounding tissues, triggering inflammation and intense pain.
Causes and Risk Factors
- Diet: Certain foods, especially those rich in purines, can elevate uric acid levels. High-purine foods include red meat, organ meats (such as liver and kidneys), and certain types of seafood (such as shellfish, herring, and sardines).
- Alcohol Consumption: Excessive alcohol intake, particularly beer and liquor, can also increase uric acid production and hinder its elimination from the body.
- Obesity: Being overweight or obese is linked to higher uric acid levels.
- Genetics: A family history of gout significantly increases the likelihood of developing the condition.
- Other Medical Conditions: Conditions such as high blood pressure, diabetes, kidney disease, and heart disease can impair the body’s ability to process and excrete uric acid, increasing the risk of gout.
Symptoms of Gout
- Gout attacks often come on suddenly and intensely.
- The most common symptoms are severe pain, swelling, redness, and tenderness in the affected joint, most often the big toe.
- The pain can be excruciating and may be accompanied by fever or chills.
- Gout attacks can last from a few days to several weeks, and may become more frequent over time if not managed correctly.
Conventional Treatment for Gout
- Acute Attack Management: The primary goal of treatment during an acute gout attack is to reduce inflammation and control pain.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can be effective in relieving pain and reducing inflammation.
- Corticosteroids, such as prednisone, can also be used to quickly decrease inflammation during severe attacks.
- Colchicine is another medication that can help alleviate pain and inflammation, particularly when taken at the first sign of an attack. The typical dosage for a gout attack is 1.2 mg at the first sign of an attack, followed by 0.6 mg one hour later, with a maximum of 1.8 mg in a one-hour period.
- When taking colchicine, it’s crucial to avoid grapefruit or grapefruit juice, which can increase the risk of side effects.
- Uric Acid Lowering Therapy: For those with frequent gout attacks, uric acid-lowering medications can help reduce uric acid levels in the blood and prevent future attacks.
- Allopurinol is a commonly used medication that blocks the production of uric acid. It is generally well-tolerated and can be started at a low dose (100 mg daily) and increased gradually to achieve a serum uric acid level of 4-5 mg/dl. Regular monitoring of liver function, blood counts, and renal function is essential while on allopurinol.
- Febuxostat is another xanthine oxidase inhibitor that works similarly to allopurinol to reduce uric acid production. It can be effective in patients with mild to moderate renal impairment.
- Pegloticase is a porcine uricase that increases the solubility of uric acid. It is administered intravenously and is used in cases where conventional therapies have not worked. Patients should be pre-medicated with steroids and anti-histamines prior to receiving infusions.
- Probenecid works by increasing the kidney’s ability to clear uric acid from the blood. It is typically used for patients under 60 with normal kidney function and should be used with good oral hydration. Probenecid is contraindicated for patients with renal stones.
- It is important to note that initiating uric acid-lowering therapy can initially trigger a gout flare-up. Therefore, it’s often prescribed alongside prophylactic medications (such as steroids, colchicine, or NSAIDs) to prevent this.
- Lifestyle Changes:
- Dietary Modifications: Limit purine-rich foods and incorporate more vegetables, low-fat proteins, and whole grains into your diet.
- Alcohol Consumption: Reduce or eliminate alcohol, especially beer and liquor.
- Weight Management: Losing weight can significantly reduce uric acid levels.
- Acute Attack Management: The primary goal of treatment during an acute gout attack is to reduce inflammation and control pain.
Understanding Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints. Unlike gout, which is caused by uric acid buildup, RA occurs when the body’s immune system mistakenly attacks the synovium, the lining of the membranes that surround the joints. This attack leads to inflammation, which can cause pain, swelling, stiffness, and eventually, joint damage.
Symptoms of RA
- RA symptoms can vary in intensity and may include:
- Joint pain, swelling, and stiffness, often affecting multiple joints on both sides of the body.
- Fatigue, fever, and loss of appetite.
- Joint deformities if the condition is not managed effectively.
- Stiffness that is worse in the morning or after periods of inactivity.
- RA symptoms can vary in intensity and may include:
Conventional Treatment for RA
- Conventional treatments for RA typically aim to reduce inflammation, relieve pain, and slow down disease progression. These treatments may include:
- Disease-modifying antirheumatic drugs (DMARDs): Medications like methotrexate, sulfasalazine, and hydroxychloroquine are often the first line of treatment to slow disease progression and prevent joint damage.
- Biologic agents: These medications, such as tumor necrosis factor (TNF) inhibitors and interleukin inhibitors, target specific components of the immune system and are often used for patients who do not respond to DMARDs.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These can provide short term relief from pain and inflammation.
- Corticosteroids: Medications like prednisone can help reduce inflammation and pain but are not suitable for long-term use due to potential side effects.
- Physical Therapy: Helps improve joint flexibility and muscle strength, and can also reduce pain.
- Lifestyle Adjustments: Exercise, weight management, and a balanced diet can help manage RA symptoms.
- Conventional treatments for RA typically aim to reduce inflammation, relieve pain, and slow down disease progression. These treatments may include:
Homeopathic Approaches to Gout and RA
Homeopathy, a system of alternative medicine developed in Germany about 200 years ago, uses highly diluted substances to stimulate the body’s self-healing mechanisms. The core principles of homeopathy are “like cures like” and the use of extremely diluted substances. Homeopathic treatments are highly individualized, with practitioners selecting remedies based on the patient’s unique symptoms and overall constitution.
Homeopathic Remedies for Gout
- Several homeopathic remedies are used to address gout, including:
- Benzoic acid: This remedy is often indicated for gout where the urine is offensive, with a strong, repulsive odor and brown color, and for extreme pain in the big toe and swollen knees.
- Antimonium crudum: This is used when gastric symptoms accompany joint pain and inflammation. Patients may experience increased appetite and overeating, with pain in the heels and fingers.
- Sabina: This remedy is considered for women with gout who also experience uterine symptoms, with shooting pain in the toes and heels. The joints may appear swollen, red, and shiny.
- Bryonia: This is considered when the pain is sharp and stitching, and is worsened by movement, but improves with pressure and warmth.
- Ledum palustre: This may be helpful for gout affecting the small joints, especially the ankles and toes, with coldness that improves with cold applications.
- Urtica urens: This is indicated for gout with burning, stinging pains in the joints that worsen with cold and improve with warmth.
- Guaiacum: This is indicated for gout with swelling and stiffness in the joints, especially the knees and ankles, with tearing or shooting pain and possible tophi formation.
- Several homeopathic remedies are used to address gout, including:
Homeopathic Remedies for RA
- Homeopathic practitioners may recommend the following remedies for RA:
- Antimonium Crudum: May be used for arthritis, especially in the finger joints.
- Apis: This remedy is used for joint swelling with redness, inflammation, burning, or stinging. It is made from bee venom and may have anti-inflammatory properties.
- Arnica: This is used for joints that are tender to the touch.
- Caulophyllum: This may be helpful for migrating pain in the small joints of the hands and feet, especially in women.
- Causticum: This is used for RA with joint deformities and weakness, especially with nighttime pain that interferes with sleep.
- Colchicum: This is used for chronic joint pain and inflammation with tearing pain that worsens with cold air, and pain that migrates from one side to another.
- Ledum Palustre: This is used for arthritis that starts in the feet and travels up the body, with joints that feel cold to the touch.
- Pulsatilla: This is indicated for pain that moves unpredictably from one joint to another, and that is worse from warmth.
- Rhus Tox: Made from poison ivy, this remedy is often recommended for pain and stiffness that is worse with rest, and is an anti-inflammatory.
- Homeopathic practitioners may recommend the following remedies for RA:
How to Use Homeopathic Remedies
- Homeopathic remedies are available in various forms, including dissolvable tablets, topicals, and tinctures.
- It’s essential to consult with a qualified homeopathic practitioner to determine the most appropriate remedy and dosage for your specific symptoms.
- Some homeopathic treatments are widely available over-the-counter (OTC), while others are only sold through practitioners or health food stores.
- Homeopathic providers select treatments based on how you describe your pain and which joints are affected.
- Homeopathic treatments should not be used as a replacement for proven treatments for rheumatoid arthritis.
Regulation and Safety of Homeopathic Medicines
- In the United States, homeopathic medicines are regulated by the FDA, but they are not evaluated for safety or effectiveness.
- The FDA requires that homeopathic medicine labels list the conditions they are designed to treat, all ingredients, dilutions, and instructions for safe use.
- In Canada, homeopathic medicines are licensed by the Natural and Non-prescription Health Products Directorate (NNHPD) and are assigned a DIN-HM.
- The NNHPD assesses the safety, efficacy, and quality of homeopathic products before approving them for sale. These products must meet specific standards for strength, quality, purity, and packaging.
- There are concerns about the accuracy of homeopathic product labels. Some products may contain higher doses or ingredients other than those listed on the label. For instance, in 2017, the FDA warned about excessive amounts of belladonna found in some homeopathic teething tablets.
- Homeopathic treatments may sometimes contain heavy metals, such as mercury or iron.
- Always check for FDA warnings regarding specific brands before use.
Lifestyle and Complementary Therapies for Gout and RA
In addition to conventional and homeopathic treatments, lifestyle modifications and complementary therapies can play a crucial role in managing gout and RA symptoms.
Dietary Modifications
- For Gout: Limit consumption of purine-rich foods such as red meat, organ meats, and certain types of seafood.
- For RA: Follow an anti-inflammatory diet, which includes foods such as fish oil, which has been shown to help reduce inflammation.
Exercise
- Regular physical activity can help maintain joint flexibility, reduce pain, and improve overall physical function for both gout and RA.
- Physical therapy can help with pain and stiffness.
Weight Management
- Maintaining a healthy weight is essential for reducing the risk of gout flares and managing RA symptoms.
Stress Management
- Stress can exacerbate symptoms of both gout and RA. Techniques like yoga, meditation, and mindfulness can help reduce stress and anxiety.
Other Complementary Therapies
- Acupuncture may help reduce pain associated with RA.
- Massage can help with relaxation and reduce pain scores in people with RA.
Actionable Advice and Best Practices
Managing gout and RA effectively requires a proactive approach that combines professional medical advice with lifestyle modifications.
Finding Qualified Practitioners:
- Consult with qualified healthcare professionals, including rheumatologists, general practitioners, and homeopathic practitioners.
- For homeopathic treatment, ensure that the practitioner is certified by organizations such as the North American Society of Homeopaths (NASH).
Individualized Treatment Plans:
- Treatment plans should be tailored to each individual’s unique symptoms, medical history, and preferences.
Holistic Approach:
- Combine medical treatments with lifestyle adjustments to achieve the best outcomes.
Medication Management
- Conventional medications for gout include NSAIDs, colchicine, and uric acid-lowering therapies.
- Conventional medications for RA may include DMARDs, biologic agents, and steroids.
- Homeopathic medications are highly diluted substances that aim to stimulate the body’s natural healing processes. Remedies should be selected based on individual symptoms.
Monitoring and Follow-Up:
- Regular check-ups with healthcare providers are essential for monitoring the effectiveness of treatments and making any necessary adjustments.
- For those taking medications like colchicine, advise regular blood tests and liver/kidney function tests.
Label Awareness:
- Be aware of the labeling of homeopathic products, and look for required information including ingredients, dilutions, and instructions for use.
- Check for FDA warnings regarding specific products.
Drug Interactions:
- Always inform healthcare providers about all medications and supplements you are taking, including homeopathic remedies.
When to Seek Medical Advice:
- Consult a healthcare professional if symptoms persist or worsen.
- Never disregard medical advice because of something you read online.
Conclusion
Gout and rheumatoid arthritis are both significant health concerns that can greatly affect your quality of life. Understanding the unique characteristics of each condition, along with their causes, symptoms, and treatment options, is vital for effective management. While conventional medicine offers effective treatments, homeopathic approaches and lifestyle modifications can play a complementary role in alleviating symptoms and improving your overall well-being. By taking an active role in your health, consulting with qualified professionals, and adopting healthy lifestyle habits, you can manage these conditions effectively.
Do you have any experiences with gout or RA, or have you found certain remedies helpful? Share your thoughts and questions in the comments below.
References
Gout– Homeopathic Medicine; Its Use, Indications and Dosage – Google Search
Accessibility Links
St. Luke’s Hospital
Gout Treatment : Medications and Lifestyle Adjustments to …
5 Homeopathic Remedies for Treating Gout Pain
Homoeopathic Management of Gout
DailyMed – GOUT-GONE- antimonium crud , quercus , rhododendron, benzoic ac , silicea , nux vom , ledum , citricidal extract tincture
LABEL RSS
DRUG LABEL INFORMATION
GENERAL PRECAUTIONS
PREGNANCY
INGREDIENTS AND APPEARANCE
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Homeopathy Treatment for Rheumatoid Arthritis
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Gout Treatment : Medications and Lifestyle Adjustments to Lower Uric Acid
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
Evidence for homeopathic medicines – Canada.ca
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
5 Homeopathic Remedies for Treating Gout Pain – By Dr. Ramesh Chander Yadav | Lybrate
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Colchicine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Rhus Toxicodendron: Uses, Efficacy, and More
Arthritis Pain (Homeopathy) – Health Information Library | PeaceHealth
Arthritis Pain (Homeopathy) – Health Information Library | PeaceHealth
Arthritis Pain (Homeopathy) – Health Information Library | PeaceHealth
Arthritis Pain (Homeopathy) – Health Information Library | PeaceHealth
Arthritis Pain (Homeopathy) – Health Information Library | PeaceHealth
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
Homoeopathic Management of Gout
