Pestil­lence and infec­tion.

on Grisodate

Griso­date; the med­i­c­i­nal gray salt to which civ­i­liza­tion owes every­thing and all.

With­out its dis­cov­ery, human­i­ty would be much reduced, if not extinct; destroyed by viral epi­demics and the hideous latent plague that waits in the bones of all humans. 

Griso­date is not a real panacea. Its prop­er­ties are antivi­ral and antimy­cotic, but only weak­ly antibi­ot­ic. It staves away flu, plague, hepati­tis, rubel­la, and measles, but not tetanus, syphilis, chlamy­dia, tuber­cu­lo­sis, or any oth­er bac­te­r­i­al infec­tion.

As such, most of the rules pro­vid­ed for dis­eases are for bac­te­r­i­al infec­tions.

Unless not­ed, dis­eases affect humans, rag­men, and mice equal­ly.

exposure and infection

Most dis­eases require you roll Immu­ni­ty that night to resist get­ting sick. When this hap­pens, you may not know that you were exposed or what you are rolling against. If you fail, the Book­keep­er will state you’re are feel­ing sick but will not reveal what you’ve con­tract­ed.

Note: Roll Immu­ni­ty only once per dis­ease come the night, even if you’re exposed mul­ti­ple times—such as by ani­mal attacks.

coughing

Dis­eases can sub­ject you to a num­ber of cough­ing fits per ses­sion. The Book­keep­er should set a series of alarms rep­re­sent­ing when your cough­ing fits strike.

• In per­il, cough­ing con­sumes your next turn (2 actions.) Immu­ni­ty -4 to sti­fle. If suc­cess­ful, you are stag­gered instead.
• In dan­ger, cough­ing risks alert­ing foes. Immu­ni­ty -4 to sti­fle.
• In social inter­ac­tions, cough­ing forces a reac­tion roll with a -1 mod­i­fi­er.

ague

A drain­ing, stub­born blood infec­tion. Long present on the Coast and more stub­born for its age. Caused by an invis­i­ble par­a­site replete in the flag­ging veins of its hosts, ague was once an acute, dead­lier afflic­tion. Mil­len­nia lat­er, it has evolved a milder but more obsti­nate pathog­no­mon­ic char­ac­ter.

Once called “marsh fever,” believed to orig­i­nate in the “mias­ma” of marsh­es and dank forests, ague has since been proven a prod­uct of the mos­qui­tos who live on those wet places. They bloom year­ly in the swamps and marsh­es of the North, mak­ing ague a sea­son­al vis­i­tor. In the South, ague is present in all sea­sons. Qui­nine is tak­en to pre­vent it—often in ton­ics, along­side griso­date.

Lore: Disease/Sorcery -4: Mos­qui­tos and bats are ague’s reser­voir species, but beast­men are its ori­gin. Beast­men were bred immune to ague by their Idran mas­ters, who used their capac­i­ty to spread it as a bio­log­i­cal weapon.

Transmission 

Ague is spread by the bite or scratch of mos­qui­tos, bats, and oth­er car­ri­ers. Three days after expo­sure, roll Immu­ni­ty -4 at night. If you fail, you con­tract ague.

A qui­nine ton­ic makes you immune to ague for 1 day.

Pathology

Ague takes 2 forms, the first of which is most com­mon and least severe. Symp­toms depend on sever­i­ty.

Com­mon ague: You can­not lev­el For­ti­tude, Immu­ni­ty, or Might. You suf­fer recur­ring chills and a low fever. Your Bleed stress­es take dou­ble the usu­al stitch­es to heal. If your Immu­ni­ty low­ers for any rea­son, your ague wors­ens into Pyrex­ic ague.

Pyrex­ic ague: Also known as “liv­er ague.” You have jaun­dice and near-con­tin­u­al fever. You have 1 Pain stress at all times. Once per ses­sion, you suf­fer a parox­ys­mal attack of con­vul­sions, dur­ing which you are use­less. An attack lasts 10 min­utes and caus­es 1d4 Stun stress.

treatment

A “hard ton­ic” is required to treat ague. This revolt­ing solu­tion of qui­nine and griso­date, usu­al­ly a liter, must be drunk all at once. A treat­ment caus­es 1d4 Poi­son stress. One treat­ment should be had per day. After a week, make a Immu­ni­ty roll -4. If you suc­ceed, your ague is cured. A hard ton­ic treat­ment usu­al­ly costs £1.

Bungworms

An unpleas­ant intesti­nal par­a­site spread by impure alco­hol.

Bung­worms orig­i­nate in Plataine, where they breed nat­u­ral­ly in cork tree bark. Said bark should be soaked and pas­teur­ized to kill the worms before export, but not all crops are. Cheap corks—cheap bungs—are espe­cial­ly liable to con­tain worms, and cheap alco­hols tend to be bot­tled with cheap bungs.

So export­ed, the worms trav­el broad­ly. Unde­tect­ed, for they are trans­par­ent, minus­cule, and invis­i­ble in liq­uids. They make it into bot­tles and gin bar­rels Coast­wide, crawl­ing from the bungs into the spir­its, hop­ing to spread as they do in Plataine on the spring rains. Extreme­ly durable, the par­a­sites with­stand strong liquor, griso­date, and stom­ach acid, and so wait in the booze for an unlucky drinker.

Transmission 

Any cheap or low-qual­i­ty spir­its may con­tain bung­worms.

The night after con­tact, roll Immu­ni­ty -4. If you fail, you con­tract bung­worms. If you suc­ceed, you resist the par­a­sites.

Pathology

In the body, bung­worms tra­verse into the intestines, where they bor­row into the epithe­li­um, caus­ing sig­nif­i­cant dys­func­tion and dis­com­fort.

The morn­ing after con­tract­ing bung­worms, suf­fer­ers awak­en to intense, inter­mit­tent abdom­i­nal cramps. A feel­ing of heav­i­ness and bloat­ing coin­cides, accom­pa­ny­ing con­sti­pa­tion, caus­ing +1 Pain stress, an addi­tion­al Pain stress every meal con­sumed, and -2 stitch­es per meal con­sumed.

Every ensu­ing morn­ing, roll Immu­ni­ty -4 to see if the worms die off. A dose of qual­i­ty dewormer grants +2. Suc­cess means you return to nor­mal. Fail­ure means you still have worms.

bansheeism

A degen­er­a­tive ill­ness that trans­forms its vic­tims into howl­ing mad­men. No cure exists once it has tak­en hold. Its ter­mi­nal vic­tims are ban­shees, pitied and dan­ger­ous.

Transmission 

Ban­sheeism is borne on the breath and flu­ids of the infect­ed. It is infa­mous­ly trans­mis­si­ble by ban­shees’ wail­ing, raw cough­ing fits, which emit flu­id and blood from the lungs and stom­ach. The dis­ease is most infec­tious in these fer­al end stages and it is for this danger—combined with the des­per­ate aggres­sion of the infected—that ban­shees are ban­ished to asy­lums.

The night after con­tact, roll Immu­ni­ty -4. If you fail, you con­tract ban­sheeism. If you suc­ceed, you resist con­tract­ing the dis­ease.

Pathology

While you have ban­sheeism at any stage, you can­not die of old age. When you advance through a stage of the ill­ness, all symp­toms remain from the pre­vi­ous stage.

1: incu­ba­tion stage: You can­not lev­el up Intel­lect. Oth­er­wise asymp­to­matic. Roll Immu­ni­ty at the end of every week. If you fail, you advance to the next stage. If you have latent tuber­cu­lo­sis, it becomes active.

2: pro­dro­mal stage: You are mild­ly infec­tious at this stage. You can­not lev­el up Immu­ni­ty. -1 to sleep rolls. 1 pain stress at all times. Con­stant fever. Recur­ring cough. Roll Immu­ni­ty at the end of every week. If you fail, add an addi­tion­al -1 to sleep rolls and +1 Pain until you reach 3 of each. Then, progress to the next stage.

3: acute stage: You are infec­tious. Lose 2 Intel­lect. You have a fre­quent wet cough, con­tain­ing blood. Twice per ses­sion, the Book­keep­er will announce a brief cough­ing fit. You can­not resist it. When you suf­fer a fit, you must roll on the ter­ror chart. Roll Immu­ni­ty at the end of every week. If you fail, lose an addi­tion­al 1 Intel­lect. Progress to the next stage when you reach 0.

4: encephalitic stage: You lose con­trol and become a ban­shee. Cre­ate a new char­ac­ter with +200 XP to spend.

black lung

An expres­sion of plague caused by dust and smoke inhala­tion. Com­mon in chim­neysweeps, masons, char­coal burn­ers, asbestos min­ers, and heavy smok­ers. Inhaled par­ti­cles minute­ly wound the lungs, weak­en­ing immu­ni­ty. Plague blooms with­in, grow­ing bloody black nod­ules in the viti­at­ed flesh.

Lore: Disease/Plague -2: Every­one has plague in their lungs. That’s how it spreads. Buboes among the alve­oli lace res­pi­ra­tion with invis­i­ble spores. Even humans med­icat­ed long-term with griso­date and oth­er­wise “clean” of plague are full of live spores. Wait­ing, patient, for the pro­phy­lac­tic salt to wane.

Etiology

Black lung is a form of of occu­pa­tion­al pneu­mo­co­nio­sis, a dis­ease caused by inhala­tion of dust. It is not con­ta­gious. Dam­age from dust inflames the lungs and exac­er­bates exist­ing plague, which fills the lungs with fibroids and buboes. In autop­sy, suf­fer­ers’ lungs appear entire­ly black, more plague tis­sue than human.

Pathology

After long term expo­sure to inhala­tion haz­ards, roll Immu­ni­ty -4 at night. If you fail, you con­tract black lung (stage 1.)

• Comor­bid­i­ty: If you have ban­sheeism or tuber­cu­lo­sis at time of con­trac­tion, you advance imme­di­ate­ly to stage 2.

Every 6 ses­sions sur­vived, roll to see if your dis­ease pro­gress­es. If you have any Smog stress, roll at -6, not -4.

1: Inflam­ma­tion: Chest tight­ness and a per­sis­tent cough. Once per ses­sion, the Book­keep­er will announce a brief cough­ing fit. You can­not resist it. Immu­ni­ty lev­els cost 4 times the usu­al XP.

2: Sec­tion­al col­o­niza­tion: Severe cough pro­duc­ing blood and black tis­sue. Twice per ses­sion, the Book­keep­er will announce a brief cough­ing fit. You can­not resist it. You can­not lev­elup Immu­ni­ty.

3: Gross col­o­niza­tion: Severe cough. Bloody, chok­ing, and full of dead tis­sue (1-in-4 chance of pro­duc­ing a plague pearl, per.). Thrice per ses­sion, the Book­keep­er will announce a brief cough­ing fit. You can­not resist it. You can­not lev­elup Immu­ni­ty or For­ti­tude.

treatment

Black lung will progress even if you con­sume griso­date ton­ic. A ton­ic steam neb­u­liz­er treat­ment pro­vides +2 to resist pro­gres­sion, as does a brine sauna ses­sion

blight

Blighters are out­casts. Per­sons reduced and dis­tort­ed as much by prej­u­dice as by the numb­ing bac­te­r­i­al infec­tion dis­tort­ing their bod­ies.

Transmission 

Blight is spread by the secre­tions of infect­ed tis­sue. It usu­al­ly begins on the hands, face, or groin. If you touch infect­ed tis­sue, roll Immu­ni­ty -2 that night. If you fail, you have stage I blight at point of con­tact.

Pathology

At start of every ses­sion, roll a d12 for every blight­ed body area: If you get a 12, the blight spreads to an adja­cent body area. If you get a 1, the blight on that area advances by 1 stage.

Stage I: One body area devel­ops gray-black, spongy lesions. It is not yet con­ta­gious. It may be cured with a com­bi­na­tion of expen­sive sul­fa gel and sur­gi­cal debride­ment.

Stage II: The lesions merge, sup­plant­i­ng the area’s skin with a thick, numb gray hide. It weeps lymph and is con­ta­gious unless salved and ban­daged. Hence­forth, wounds here can­not cause Pain stress.

Stage III: Blight tis­sue forms a stiff cas­ing over the body area. The joints are cracked, thin­ly bloody, and smell of used ban­dages. It has an armor val­ue of 3|1.

Stage IV: The area hard­ens, crusts, and dries stone-hard. It has an armor val­ue of 4|2. It is non­in­fec­tious unless cracked open, where­upon it drib­bles foul flu­id. Suf­fer 1 Move­ment penal­ty per 2 Stage IV areas. If you can­not move, you will even­tu­al­ly starve.

Note: Armor worn over stage III or IV blight counts as lay­ered armor.

fat rot

A mor­ti­fy­ing flesh-eat­ing bac­teri­um.

Transmission 

Fat rot is spread by the flu­ids of car­rion eaters, maneaters, and var­ied unclean mon­sters.

The night after expo­sure to fat rot, roll Immu­ni­ty -4: Fail­ure means you are infect­ed. A spot of flesh sen­si­tizes, aching like yanked hair.

Pathology

Fat rot spreads grad­u­al­ly. While you have it, Immu­ni­ty and For­ti­tude lev­els cost dou­ble.

Every night, roll Immu­ni­ty -4. Fail­ure means the rot spreads to a new body area, eat­ing up the adi­pose tis­sue under the skin: Afflict­ed areas sink and red­den, cre­at­ing a spread­ing yel­low-rimmed lesion where the fat has been devoured. Every time it spreads, suf­fer 1 Wound stress and lose 1 For­ti­tude. Wear­ing armor over afflict­ed areas caus­es 1 Pain stress per area cov­ered.

treatment

Sul­fa oint­ment is an effec­tive cure. A tin of it can cure 4 afflict­ed body areas overnight.

Cheap­er treat­ment comes in the form of car­bol­ic acid injec­tions into the void under the lesion. These are painful, caus­ing 1 Pain stress per injec­tion, and are not guar­an­teed to work: Each injec­tion allows you roll Immu­ni­ty to see if the body area is cured of rot. Injec­tions cost 10p per area.

plague

A high­ly trans­mis­si­ble, humanoas­sump­tive fun­gal infec­tion. AKA “black plague” or “black death.” It is con­tin­u­al­ly pan­dem­ic in all human pop­u­la­tions. Its omnipres­ence, inevitabil­i­ty, and gris­ly man­i­fes­ta­tion post-mortem have laden it with potent cul­tur­al weight: It is, or is syn­ony­mous with, death itself. 

Transmission 

Only humans can con­tract plague. It is asymp­to­matic and unrec­og­niz­able (with­out inva­sive surgery) while the host is alive, devel­op­ing with­in mar­row and lung tis­sue. Plague pro­duces fruit­ing bod­ies in the lungs, which dis­perse spores via nat­ur­al res­pi­ra­tion.

Most humans are born with plague. It is large­ly impos­si­ble to avoid infec­tion. 

Pathology

Plague is latent while the host still lives. Post­mortem, it under­takes rapid patho­gen­e­sis, swift­ly assum­ing the cadav­er, con­vert­ing it into an infec­tious agent: a grue.

Grues are vio­lent prop­a­ga­tors pro­grammed to seek out humans and slaugh­ter them. Patho­gen­e­sis begins anew with­in grues’ kills, birthing new grues. Grues are sub­ject to par­tial decom­po­si­tion; resem­bling, in time, black skele­tons, bones stained and held togeth­er by necrot­ic-black plague tis­sue and stud­ded with buboes. 

Only griso­date can treat plague. Tak­en by mouth, it weak­ens latent cas­es, pre­vent­ing plague’s assump­tion of the body after death. If applied as a solu­tion to a grue, it rapid­ly destroys the plague tis­sue ani­mat­ing the skele­ton, killing it swift­ly.

All human char­ac­ters under­go post­mortem patho­gen­e­sis. The Book­keep­er will deter­mine how much time pass­es between death and grue-hood (usu­al­ly 2d12 hours.) A human who con­sumed a dose of grey salt with­in the last week will not become a grue. A human char­ac­ter who con­sumes grey salt every week for six months will see their plague enter remis­sion. Their lung and bone tis­sue will be large­ly free of plague growth, but it will nev­er leave them entire­ly.

Tuberculosis

Known as “con­sump­tion” or “white plague” for the belief that it lies dor­mant in the lungs and bones like real “black” plague. Tuber­cu­lo­sis is com­mon in the gen­er­al pop­u­la­tion. It is often roman­ti­cized in the aris­tos­phere.

Transmission 

While in prox­im­i­ty to a char­ac­ter with tuber­cu­lo­sis, you may gain the White Plague trait for + 10 XP.

Pathology

Latent: No effects. You are asymp­to­matic. While latent, you may opt into the Con­sump­tive trait at any time. 

Active: You have 1 Con­sump­tion stress at all times. You are often pale. You have a per­sis­tent, ebbing cough that pro­duces bloody spu­tum. Once per ses­sion, the Book­keep­er may announce a brief cough­ing fit. After 6 Ses­sions Sur­vived, you may opt into severe tuber­cu­lo­sis in exchange for 100 XP.

Severe: You have all the effects of active tuber­cu­lo­sis, plus: Your For­ti­tude can­not exceed 4 and may be cur­tailed. You are pale and wast­ed. Your cough is often con­vul­sive, and the Book­keep­er may inflict an addi­tion­al cough­ing fit on you per ses­sion for every 2 Con­sump­tion stress you have. Every week, roll Immu­ni­ty. If you fail, you gain 1 Con­sump­tion stress. You can choose to remove a lev­el from any core skill to avoid this stress. With the Surgery skill, a doc­tor may be able to remove some Con­sump­tion stress but at the cost of the Col­lapsed Lung effect (arti­fi­cial pneu­moth­o­rax ther­a­py.) 

splitting sickness

A vir­u­lent skin infec­tion. Invis­i­ble, unno­tice­able, until the night, where­upon it spon­ta­neous­ly splits flesh like over­ripe fruit. Suf­fer­ers awak­en to the wet rip­ping of painful rents, usu­al­ly on the thighs and back. This split­ting is called dormioschi­sis, the prod­uct of a skin-weak­en­ing enzyme emit­ted by bac­te­r­i­al colonies attempt­ing to spread and acquire nutri­ents.

transmission

Split­ting sick­ness is caused by a bac­teri­um (Schin­di­a­sis nox) and spread by touch­ing infect­ed skin or blood. It is trans­mit­ted cross-species by bats, who are immune to its effects. The bac­teri­um can live on sur­faces for sev­er­al hours, mak­ing house­hold objects dan­ger­ous fomites.

After con­tact, roll Immu­ni­ty -2 that night. If you fail, you con­tract split­ting sick­ness.

Pathology

You suf­fer dormioschi­sis every night there­after until cured. If you suc­ceed, your immu­ni­ty defeats the infec­tion.

Dormioschi­sis: Every sleep, roll 1d4-2. You suf­fer a num­ber of mod­er­ate (sever­i­ty 2) slash­ing wounds equal to the result. They usu­al­ly occur on your thighs, back, or abdomen. If the result is 0 or neg­a­tive, you do not split that night and you have a chance to roll Immu­ni­ty -2 to resolve the infec­tion.

Advanced, time-con­sum­ing treat­ment with a micro­scope may allow a doc­tor to pin­point larg­er infec­tion sites and puri­fy them with sul­fa, spar­ing you a night of split­ting. Pack­ing you in a bed of griso­date may achieve the same effect, but it is expen­sive and risks hyper­na­trem­ia.

soot wart

Crops of grim, black­ened car­ci­no­mas orig­i­nat­ing in the groin and armpits and prop­a­gat­ing along the limbs. Com­mon in chim­neysweeps and oth­er sooty pro­fes­sions.

Pathology

You sport painful, raised ker­ati­nous warts on 1d6 body areas. Poten­tial areas include your abdomen and both shoul­ders, upper arms, and thighs. You can­not wear armor on warty loca­tions. If you do, suf­fer 2 Pain stress.

Every month, there is a 1 in 6 chance that the warts spread to anoth­er poten­tial loca­tion. If all loca­tions are warty, you suf­fer a 1 Metas­ta­sis stress instead. It can­not be healed.

syphilis

A wide­spread dis­ease, usu­al­ly sex­u­al­ly trans­mit­ted. Slow to progress, but debil­i­tat­ing in the end. Those born with it are the most unfor­tu­nate. They often enter the world deformed, suf­fer­ing advanced symp­toms.

Pathology

Pri­ma­ry: You have an unsight­ly, pain­less chan­cre (often some­where inti­mate.) It remains for a month or so, weep­ing and infec­tious. 

Sec­ondary: Your skin blis­ters and blooms with chan­cres. Flat, warty papules and nod­ules. They aren’t itchy. Your well­be­ing is dimin­ished, often acute­ly, by fever, malaise, shriv­el­ing, and aches. Your hair may fall out. Peo­ple rec­og­nize your symp­toms, earn­ing you -1 to reac­tion rolls. Your For­ti­tude and Immu­ni­ty can­not exceed 7, com­bined, and may be cur­tailed.

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