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'''Causes'''
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Old-school thinking attributed '''gouch''' to elevated uric acid levels due to [http://gomerblog.com/2015/08/alcohol-abuse/ alcohol], [http://gomerblog.com/2015/01/obesity-epidemic/ red meat], and [http://gomerblog.com/2015/05/protamine-shortage/ seafood], with crystallization at lower temperatures. New-school thinking simply attributes it to the Devil.