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#GOTscience: Reality Check on Gruesome Twists in ‘Game of Thrones’

Image: Lancel in "Game of Thrones"

Lancel Lannister, played by Eugene Simon, bears the mark of a religious seven-pointed star on his forehead in the HBO series "Game of Thrones." Helen Sloan / HBO

This season's episodes of "Game of Thrones," HBO's sex-sword-and-sorcery series, haven't been for the fainthearted: The show's plot twists have included the troubling rape of a sympathetic character, another character being burned alive, one learning to practice euthanasia, at least one suffering a terrible disease, and yet another being set up for what appears to be a head transplant.

The latest show provides further examples of the fictional society of Westeros "going medieval" or even farther back — including fights to the death, torture by flaying and religious extremism. But as gruesome as they may seem, the practices that are worked into the script have some basis in actual history. Here's a reality check on a few of the twists from this week's episode.

‘Game of Thrones’ 101! Surprising facts about the HBO hit 1:59

Mark of faith

One of the characters on the show, Lancel Lannister, has become so religious that he has a seven-pointed star carved into his forehead. Where does that come from?

"Game of Thrones" author George R.R. Martin recently told Entertainment Weekly that he modeled the Faith Militant, the cult that Lancel Lannister joins, after "the medieval Catholic Church, with its own fantasy twist." Although carving crosses into the foreheads of the faithful weren't part of the practice back then, branding with a hot iron was used as a form of punishment for heretics and criminals.

The Middle Ages also brought the phenomenon known as stigmata — that is, the appearance of wounds on the hands and feet, and sometimes in the side, of an ardent believer. Such wounds mirror the accounts of Jesus' wounds in the crucifixion. The scientific study of stigmata has been murky, but the non-supernatural explanations range from psychosomatic bleeding (for example, psychogenic purpuras) to self-mutilation, perhaps inflicted unconsciously while in the throes of a spiritual state.

Skinned alive

What about torture by flaying?

The practice of skinning captives goes back at least to the Assyrians, according to the "History Behind Game of Thrones" blog. A wall relief from the palace of King Sennacherib shows prisoners apparently being flayed alive after the capture of the city of Lachish in 701 B.C.

The practice is recorded in medieval European history as well — most notably to punish the young bowman who killed King Richard the Lionheart in 1199. But death by flaying wasn't nearly as common in 12th-century England as it is in the fictional realm of House Bolton (whose motto is "Our Knives Are Sharp").

Fight to the death

One scene shows fighters battling each other in a gladiator-style game until only one is left alive. Seems like an awful waste of gladiators. Is that the way the Romans did it?

Not usually. Historical accounts suggest that the loser survived the overwhelming majority of gladiatorial fights. If a professional gladiator died in combat, the sponsor of the games often was required to pay compensation to the fighter's manager.

"Keep in mind that the lanista — the owner of the gladiator school — had a sizable investment in these professional fighters," historical novelist James Duffy observes in his roundup of common gladiatorial misconceptions. "If he were to lose half his fighting force in each arena show, he would be out of business very quickly."

Quick, the antidote!

Another scene shows a character coming close to death after being wounded by a poisoned sword, only to be revived instantly after taking a sip of the antidote. Do antidotes work that quickly in real life?

In a word, no.

"Antidotes are not instant; basically they’re playing catchup with the effect of the poison," Deborah Blum, author of "The Poisoner's Handbook," told NBC News in an email. "They tend to work by binding up the agent in the bloodstream (prussian blue to block thallium absorption, for example) or by competing for receptors (the use of ethanol to treat antifreeze poisoning). They do need to be given in reasonable time."

Blum referred to a thallium poisoning case in New Jersey that unfolded back in 2011. A knowledgeable nurse caught on to what was going on — but by the time the antidote was administered, "it was too late," she said. The victim's estranged wife, a chemist, was convicted of murder and sentenced to life in prison.

"Of course you can get a rapid alleviation of symptoms with some treatments — say, oxygen for carbon monoxide poisoning," Blum said. "But there’s nothing that instantly counters a poison that I know, except in fiction."

Got scientific questions about scenes from "Game of Thrones"? Flag them with the Twitter hashtag #GOTscience.