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Doran Martell's Gout?


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Will one of Doran's maesters be able to cure his gout in the Winds of Winter?



Gout sounds like a really painful, uncomfortable thing for anyone to have, and I feel quite sorry for Doran having to suffer through and not be able to walk. He must have a terribly sendentary/unhealthy lifestyle for it to get that out of hand though.



Perhaps he should drink plenty of water, eat lots of fruits and veggies, so the nutrients will cleanse his system of gouty impurities? What is to be done about his gout?


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Umm



He's gonna die and then it won't bug him anymore lol?



Doran is not long for this world and he knows it, hence why he is speeding everything up. Only 2 years past he was able to walk on his own and even sit a horse I think. This is why he told Arianne mostly everything and is putting so much faith in her, so it's good she is beginning to wise up and learn to play the game his way rather than Oberyn's, the latter of whom accomplished very little in terms of Dorne's future and possibly helped doom it by dying and letting his brood wander to do ill.


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It would help if he stopped viewing those fat, ripe blood oranges as a metaphor for himself, House Martell, mortality etc., and ate a couple instead.


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Doran biggest health problem likely isn't gout, but all the other stuff brewing undiagnosed beneath the surface. I wouldn't be surpised if he had high blood pressure, high cholesterol and type 2 diabetes.

He is a ticking time bomb for a good old fashioned myocardial infarction (heart attack).

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Gout's one subject of which I have firsthand knowledge. It's a form of arthritis caused by the body not being able to process "purines", contained in a number of foods. This results in a high concentration of uric acid in the blood, which can crystalize out in a joint, causing extreme discomfort, sometimes to the extent of excruciating pain. Doran's had the condition so long that the joints have incurred permanent damage, so even if he gets the uric acid under control he'll always suffer, though maybe not as badly. Drinking lots of water is an excellent idea because it dilutes the uric acid, making it unlikely to crystalize.


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Gout's one subject of which I have firsthand knowledge. It's a form of arthritis caused by the body not being able to process "purines", contained in a number of foods. This results in a high concentration of uric acid in the blood, which can crystalize out in a joint, causing extreme discomfort, sometimes to the extent of excruciating pain. Doran's had the condition so long that the joints have incurred permanent damage, so even if he gets the uric acid under control he'll always suffer, though maybe not as badly. Drinking lots of water is an excellent idea because it dilutes the uric acid, making it unlikely to crystalize.

So is it because of his diet then, or does it have a natural occurrence, or is it a combination of factors?

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I hear Gout was pretty common among the upper classes of medieval europe, up until the mid 1800s.



I don't think people really exercised back then, and they ate a lot of really rich foods that even rich people today don't eat that much (sheep stomach, peacock, quail boars head etc.) and they drank a sh**t ton of alcohol, since that was one of the few safe things to drink.


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So is it because of his diet then, or does it have a natural occurrence, or is it a combination of factors?

Before I try to awkwardly summarize the Wikipedia article I'll just provide the link to the relevant part: http://en.wikipedia.org/wiki/Gout#Cause

Short answer, it's likely a combination of factors. But then again, this applies to almost every chronic illness - it's a complete misconception that an ailment is solely caused by dietary or lifestyle factors, those may just exasperate a genetic disposition and vice-versa.

As for Doran, I don't see him getting better. He is already rather old, has had gout for a long time, and a very severe case at that (swelling all along his legs and the inability to walk). If he hasn't been successfully treated so far, there seems to be little that can be done. Of course, it could always happen that someone with magical powers or new medical knowledge shows up and heals him, but really, story-wise, what's the point?

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So is it because of his diet then, or does it have a natural occurrence, or is it a combination of factors?

Combination of diet and some individuals' inability to process purines. Alcohol contributes indirectly because it has a diuretic effect, so the blood is more concentrated, but not directly. Red meats, especially game, are among the worst things to eat.

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Before I try to awkwardly summarize the Wikipedia article I'll just provide the link to the relevant part: http://en.wikipedia.org/wiki/Gout#Cause

Short answer, it's likely a combination of factors. But then again, this applies to almost every chronic illness - it's a complete misconception that an ailment is solely caused by dietary or lifestyle factors, those may just exasperate a genetic disposition and vice-versa.

As for Doran, I don't see him getting better. He is already rather old, has had gout for a long time, and a very severe case at that (swelling all along his legs and the inability to walk). If he hasn't been successfully treated so far, there seems to be little that can be done. Of course, it could always happen that someone with magical powers or new medical knowledge shows up and heals him, but really, story-wise, what's the point?

And I think that answers the OP. I don't see Doran eating a bunch of red meat(the Dornish seem to like chicken and peacocks and such, as there doesn't seem to be the flora to support any kind of real game) and if it's not the citrus or spicy food or something like Light a wight described then the problem is probably just Doran's physiology.

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Lead greatly exacerbates any tendency to gout by interfering with the kidneys' ability to excrete uric acid - this is why it was such a problem in early modern Europe, they drank wine that was sweetened with lead compounds (as did the Romans) and used lead in a number of ways of storing and making alcoholic beverages. We don't know much about hown the various vintages and liquors in Westeros are produced, but this could be a factor.


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And I think that answers the OP. I don't see Doran eating a bunch of red meat(the Dornish seem to like chicken and peacocks and such, as there doesn't seem to be the flora to support any kind of real game) and if it's not the citrus or spicy food or something like Light a wight described then the problem is probably just Doran's physiology.

That peacock could be a real contributor. I'd consider it game.

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That peacock could be a real contributor. I'd consider it game.

Ah then definitely it could be so, as I imagine they eat a lot of wild poultry as it's easier to sustain in Dorne than red meat aside from swine, and from what we've seen pigs aren't terribly common in Dorne and certainly not the wild kind.

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I've wondered what he uses to treat it. Plants containing colchicine have been used for thousands of years in the treatment of gout, even if the substance itself wasn't isolated until fairly recently. That would be super helpful in addition to the lifestyle changes. If they aren't using it, I need to write a strongly worded letter to his maester.

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I think his gout will continue to get worse, and he will die when he hears of what happened to Quentyn.





Peacock is very gamey meat. Had it once. Long story.




How was it? I'm interested to know.


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I've wondered what he uses to treat it. Plants containing colchicine have been used for thousands of years in the treatment of gout, even if the substance itself wasn't isolated until fairly recently. That would be super helpful in addition to the lifestyle changes. If they aren't using it, I need to write a strongly worded letter to his maester.

Cherries are very good for it.

My grandmother has it. It stopped for a while and started back up and she was in so much pain so I got her some cherry juice and in two days the pain stopped completely, and it hasn't started up in a while but she continues to drink the cherry juice.

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