Ash Plague/Ichorfect- Siromsja's notes

An excerpt from Siromsja's healer's journal on her first encounter with ash plague

17 Thrihum, 385 kw

Arrived at a small village, very isolated. Took two-and-half moon-phases of travelling through wilderness to reach, next nearest settlement on other side of Direwood. Conducted my usual business. Burnthorn bushes grow nearby, which some children had gotten severe rashes from. Treated them with some spring-salve(light), finishing the previous jar & opening a new one. Two remain in reserve. Expect all to fully recover by morrow. One had developed welts leaking pus & required more treatment. Gave him a moderate healing potion & heather wrap. Should be enough to combat infection, further monitoring required. (Note to self: harvest burnthorn stems & roots before leaving) Sold five doses of minor healing potions. About a third of the batch remains in reserve. Will have to verify I have the ingredients stocked to brew new batch soon.

At the distant edge of the village was a small locked hut. I sensed desperate ailing from within. After inquiring, I was told by the folk that inside was a man with 'ash plague'. This is the first I have heard of this disease. I also was told the following: No one is to approach the hut until time comes to dispose of his body. The illness became apparent recently. The other villagers locked the man in there to die soon, in solitude. They say ash plague is fatal & untreatable. It is uncertain which will kill him first, the disease or starvation. Starvation would apparently be more merciful. I do not abide any of this. Forced isolation of a sick person with no care is deplorable & inhumane. Even more to leave him in a prison of his own filth just to ensure he dies faster. I have decided to take the man on as a patient. I will attempt to rid him of the disease. If it is truly impossible to do so, then I will at least ease his suffering & ensure him a peaceful passing. I am told ash plague is contagious and spreads through contact. Will take necessary precautions & prepare protection before beginning treatment morrow.

18 Thrihum, 385 kw

Met with patient at sunrise. He was agitated when he saw me, afraid of spreading his disease. Was calmed after I explained the purpose of my gloves and mask. Willing to be treated, which is good. Patient was severely dehydrated & malnourished. Provided water & light broth. Observed symptoms of high fever, severe cough, muscle weakness, mind fog, irregular/accelerated heartbeat, mysterious bruises (patient does not recall acquiring), stiff joints, blisters on neck, & extensive dark gray spots around mouth and eyes. According to villagers the spots are what identifies ash plague, as well as a mold-like ichor in the lungs that is coughed up in later stages. No sign of such at present. Word of mouth conflicts on whether or not insect legs and wings are also expelled among the ichor. If that is true, I should consider the possibility ash plague is more a curse than natural illness.

Treated common symptoms first. Addressed fever & gave herb-honeycomb syrup for cough (note to self: seek opportunity to buy more honeycomb- stock low). Cough briefly improved for a few hours. Cleaned interior of hut to minimize risk of additional bacterial infection. Applied salve & heather wrap to blisters, charged warming stones for joints. Patient has difficulty leaving cot to urinate, brought chamberpot closer. I haven't the optimal sanitation items for a fully bedridden patient, may have to improvise.

Burnthorn boy's swelling reduced & rash clearing.

19 Thrihum, 385 kw

Fever persisting. Patient responded well to small dose of major healing potion. Stomach still too weak for food heavier than simple broth, but hydration improving. Have to find way to increase patient's protein intake before giving larger dose of potion. Skin paler than yester & clammy; concerning. Bruising increased, ash spots remain the same. No trace of ichor in phlegm, yet, nor insect parts. Attempted to examine patient's lungs, but he is extremely anxious about magic, even druidic magic, which I suppose he's never thought to differentiate. Apparently these people are very superstitious. Hopefully I can convince him to let go of his prejudice for the sake of his health. Most people's fear of dying tends to outweigh their fear of witches, after all.

20 Thrihum, 385 kw

No change. Patient stubborn about magic, but allowed me to light an incense for his throat & lungs.

21 Thrihum, 385 kw

Patient's fever broke overnight & was more alert today. Told me about his wife and children. His were not among the ones I treated upon arrival. Was able to give him the full dose of strong potion bit by bit over the course of the day along with water & more broth. Warming stones improving mobility as expected, recharge required either morrow or day after. Ash spots increased slightly in size. Patient caved & allowed me to See into his lungs. Could already detect a darkness gathering there, examination confirmed black substance growing on walls of lungs. Appears to be slightly moving- independently of the motion of patient's breathing. Like reaching tendrils, or a mass of crawling bugs. Supportive of theory that ash plague may be of arcane origin, but found no indication of the presence of a crone egg, so it is unlikely to be a direct curse. To study the ichor I will need a sample of it, but as patient has yet to expel any of it I would need to retrieve the sample directly from his lungs. Patient agreed to procedure once promised it is a simple & painless process, though as it involves magic he requested not to know the details & for me to do it while he is unconscious. Given that it will involve sending an animated wooden beetle crawling up and down his throat, that is probably for the best. Will prepare the beetle tonight and collect the sample in the morning.

22 Thrihum, 385 kw

Patient's wife delivered two loaves of fresh bread to the hut today, one for her husband and one for me. She did not come inside. Patient was able to eat some of the bread & cried while doing it. I never know what to do with crying people and felt very awkward, but doubt patient was able to tell. Made him drink more water. Patient was put to sleep for beetle procedure with ease & sample was collected successfully. Fever still kept at bay, but bruises & blisters continue to worsen. Spent most of day studying ichor sample while patient rested. It is unlike anything I have ever seen. Despite not resonating a consciousness of its own, it maintained a strong link to what remained in patient's lungs hours after removal. I wonder if such a connection also exists when portions of the ichor are coughed up, or if it is only because this piece was separated prematurely.

Had some of my share of bread with dinner. It was very good.

23 Thrihum, 385 kw

No change. Still studying ichor sample. It is almost as if it is resisting examination, like it has secrets to protect. I am now certain ash plague is an arcane malady, though I do not know how patient contracted it. No one else in village appears to be infected. Spoke to the villagers again, & learned that ash plague appeared out of nowhere about fifty years ago & ravaged the entire warlands for nearly a decade. It was nondiscriminatory & decimated not just the region's common folk, but soldiers and lords as well. Entire armies were wiped out, coughing up rivers of black muck. The death toll was leagues higher than any other disaster in the warlands' entire remembered history. Which is admittedly limited given the utter lack of education and poor quality of life here, but I have managed to See a fair amount of this region's past myself. I believe what the villagers say. The strangest part is, after the devastation peaked, cases of ash plague rapidly dwindled, and became extremely rare. My theory is that if this is a magically created disease & not a naturally occurring virus, it may have been too deadly for its own good, & burned through its victims faster than it could spread, unable to adapt to survive like other viruses. This would be especially likely if the creator was knowledgeable in dark magic but not medicine. Would like to investigate the history of this plague more, but currently have no leads on its specific source and do not know where to look. There was never anything like this in the north. Perhaps after my work here is done, I could ask around and figure out where in the warlands ash plague first spread from.

Sample has grown within the jar.

24 Thrihum, 385 kw

Ichor within patient's lungs spreading. Ash spots increased in number. Stayed up too late last night dissecting sample and am very tired. Patient slept for most of day. Fever threatening to return but has not yet. Gave another full dose of strong healing potion. It improves his other symptoms and comfort, though seems to have no effect on ichor or spots. Currently dividing main sample into smaller pieces for combatant testing. Have determined a significant amount of ichor's actual substance is broken locust eggs. Off-putting, but not surprising. Locusts are a favoured motif of curse-crafters. Though understandable, their negative reputation is unfortunate. Zarthosian giant locusts are very nutritious, and taste great pan fried with spicy felfel sauce.

Plan to first try banishing wards against malice on the ichor. Morrow, I will offer to cleanse patient's spirit. Hope he will allow it. To be stalked by death like this will put rot in one's soul. I pray for him.

25 Thrihum, 385 kw

Frustrated. Wards stabilize ichor but only temporary and it will not shrink. No change in patient, but I worry about the force of his cough. I fear he may start expelling ichor soon. Time is of the essence. Will perform cleansing ritual for patient whether he wants me to or not. Veniathan feels as distant as ever, even in my deepest meditation, even during asoniathil. Had I still my full power & abilities I would be capable of stronger magic. Father could have healed him, I am sure. Would give anything for his guidance & wisdom right now.

26 Thrihum, 385 kw

Rumours have spread in village that patient was recovering. Had to turn away three children from entering the hut. They were very upset with me for not allowing them to see their father. Did not have it in me to tell them not to get their hopes up, even though I should have. Patient overheard and cried again. This time I asked if there was any way I could comfort him & he asked me to hold his hand. I obviously had my clean gloves on, so I did. He has not had any touch since he became sick, other than my treatment which is a purely functional touch & hardly lingers. I have not had any true touch in a long time, either.

Patient began hacking up small chunks of ichor soon after. I have preserved the substance in separate jars and am comparing it to the earlier sample. Does not appear to contain whole insect parts, has same composition. Second and third sample seem drawn to each other but react poorly to sample one. Not sure what this means.

27 Thrihum, 385 kw

Concentrated applications of Spirit-Light causes new ichor samples to shrink. Patient coughing up larger quantities. Ash spots spreading. Fever returned. Awareness diminishing. Performed cleansing ritual on patient & myself, just in case. Treated patient's chest & throat with Spirit-Light. Impossible to tell yet if effective on burrowed ichor. May be too late. May not be strong enough. Already feel drained from casting it twice in one day, & could not maintain spell for long. It is a very powerful spell. Could never truly master it, even back then.

28 Thrihum, 385 kw

Used Spirit-Light again, really pushing it. Treated fever & cough with more conventional medicine. Burrowed ichor shrank noticeably but not enough. Patient lost movement control of fingers & hands.

Finished bread. It had become a little stale, but still tasted good.

29 Thrihum, 385 kw

Perhaps if I had attempted this treatment sooner, results would be better. Used SP-L again & failed to shrink ichor but it also failed to grow. Doing all I can to ensure patient's comfort. No further change in other symptoms or awareness.

30 Thrihum, 385 kw

No change.

1 Cosod, 385 kw

No change.

2 Cosod, 385 kw

Patient died this morning. Conjured vines to contain body so he may be safely moved for burial. Cleaned sickhut. Informed villagers of passing. His family cried. Did not know what to say. Said nothing. Applied stasis to ichor samples for further study. Will research curse-based diseases more thoroughly & investigate origin of ash plague, which I have decided to call Ichorfect, assuming virus does not have formal name. Should I encounter another case, I will know what to do. Harvested burnthorn. Left village by sunset. Did not attend funeral. Did not feel right to.

Patient's name was Loharr. I will remember him.