Gout is a metabolic disease which occurs as a result of pathological reaction of the joint or periarticular tissues due to the presence of Monosodium Urate (MSU) and Monohydrate crystals in the body. MSU crystals mostly deposited in connective tissues in and around joints or in soft tissues like cartilages at various parts of the body. Hyperuricemia is the cardinal abnormality leading to Gout. These days its prevalence is increasing due to changes in life style and therefore it has a noteworthy impact on the working population, their work, productivity and physical function. Gouty arthritis is conventionally managed by analgesics, anti-inflammatory drugs, Glucocorticoids, Uric Acid lowering therapy, Xanthine oxidase inhibitor and Uricosurics drugs. These drugs may be poorly tolerated and dangerous in the elderly and in the presence of renal insufficiency and gastrointestinal disorders. Based on the symptomatology, Gouty Arthritis can be well correlated to Vata-Pitthadhika Vatarakta. Vata and Rakta are the main factors involved in this disease and Sandhi or joints are the main site of manifestation. The patient was treated with Snehana (oleation), Mridu Swedana (mild sudation) followed by Anuvasana Vasti with Sahachar Tail and Niruha with Panchatikta Ksheera Vasthi (enema with medicated milk) in 7 days schedule. Upanaha Sweda (poultice) for 7 days and Samana Aushadhi like Kaishor Guggul, Kokilaksha Kashaya, Poonarnava Guggulu (oral Ayurved drugs) for one month. Substantial clinical improvement was reported in quality of life after 30 days of the treatment. This case report provides guidelines that Gouty arthritis with a very high serum uric acid can be treated as per Vataraktha Chikitsa Siddhanta in Ayurveda.
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