Summary of case history,　Complaint: Left metatarsophalangeal joint swelling and pain for 3 days. Symptoms: Severe pain in the left metatarsophalangeal joint, sudden onset, fixed pain, accompanied by swelling of the left foot back, increased skin temperature, reduced pain when cold, severe heat, bitter mouth, irritability, poor sleep, yellow urine, and dry stool. Specialized physical examination: swelling of the left metatarsophalangeal joint and back of the foot, tenderness (+), high skin temperature on the back of the foot, and limited mobility.,TCM diagnosis,　shizhuo bi (liver spleen damp heat syndrome).,Western medicine diagnosis,　acute gouty arthritis.,Therapeutic methods,　1. Internal administration of traditional Chinese medicine: 20 grams of Jinlingzi, 30 grams of Jinqiancao, 30 grams of Haijinsha, 30 grams of Chicken Neijin, 20 grams of Yujin, 20 grams of Mianbixie, 20 grams of Heishunpian, 15 grams of Weilingxian, 30 grams of Tufu Ling, 30 grams of Zhimu, 20 grams of Coix seed, 30 grams of Huangbai, 10 grams of bran fried Atractylodes macrocephala, 20 grams of vinegar, 30 grams of Yanhusuo, 30 grams of raw gypsum, 30 grams of seven doses of water decoction. Take one dose daily in the morning and evening. 2. External application of traditional Chinese medicine: 20 grams of Shenjin Grass, 20 grams of Tonggu Grass, 20 grams of Jixue Teng, 20 grams of Weiling Immortal, 20 grams of Chuan Niu Xi, 20 grams of Duhuo, 20 grams of Qianghuo, 20 grams of Red Peony, 20 grams of Red Flower, 20 grams of Angelica sinensis, 20 grams of Fangchi, 20 grams of Papaya, 20 grams once a day, apply to the swelling and pain area of the left metatarsophalangeal joint.,Clinical outcomes,　The swelling and pain of the patient's left metatarsophalangeal joint have significantly reduced.