Rubia cordifolia, also known as Indian madder or Manjistha, has a longstanding history of use in traditional Ayurvedic and Chinese medicine, primarily as a blood purifier and anti-inflammatory agent. Its application for gout is derived from these traditional systems, where it is believed to help clear excess "heat" and toxins from the blood, which are thought to underlie inflammatory and metabolic disorders like gout. Gout is characterized by painful joint inflammation due to uric acid crystal deposition, and traditional practitioners have used Rubia cordifolia to mitigate these symptoms by promoting detoxification and reducing inflammation.

Scientifically, there is limited direct evidence supporting the use of Rubia cordifolia specifically for gout. Some in vitro and animal studies indicate that extracts of the plant possess anti-inflammatory and antioxidant properties, which could theoretically be beneficial in gout management. For example, Rubia cordifolia has demonstrated inhibition of certain inflammatory mediators and enzymes, such as cyclooxygenase and xanthine oxidase, the latter being involved in uric acid production. However, these findings are preliminary, and clinical trials in humans targeting gout are lacking.

In summary, the use of Rubia cordifolia for gout is primarily justified by traditional usage, with moderate but indirect scientific rationale based on its general anti-inflammatory effects. Robust clinical studies are needed to confirm its efficacy and safety for gout specifically.