Rapid Onset Severe Silicosis

Rapid Onset Severe Silicosis (also known as ROSS) is a condition that sometimes afflicts individuals who have had to breathe dust from the erupting volcanoes in the Katra mountains of northern Punjuki on Magicians' End.
First recorded in the aftermath of the eruption of Mt. Gelzibom in 211 APC, it has recurred at irregular and often thankfully long intervals, corresponding to the times of minor and major volcanic activity, whenever any quantity of this specific kind of dust has been present in the atmosphere.

Causes

The condition is triggered by exposure to dust from volcanic eruptions in the Katra mountains of northern Punjuki. It is not known exactly what it is about breathing this specific dust which induces the pathology relatively rapidly in susceptable individuals. The outcome is by no means a universal response, and whilst it seems to preferentially affect older people and those with pre-existing conditions, there are many documented cases of younger patients suffering from the symptoms.

Symptoms

ROSS is characterised by the same kind of symptoms associated with the better understood disease of "standard" silicosis, but where that chronic condition can take a lifetime to develop, ROSS may occur anytime within three months to three years of a much more limited exposure to the triggering environmental hazard, the breathing of volcanic dust from a specific region within the Katra mountains.
Sufferers might experience any or all of the following symptoms:-

Persistent coughing, sometimes with sputum

Shortness of breath, especially with exertion

Chest pain, fever, and night sweats

Weakness, tiredness, and weight loss

Respiratory failure in severe cases

Treatment

There is little that can be done for sufferers. Treatment options focus on alleviating the symptoms and preventing any further progress of the condition. Cough medicines may be used to reduce the additional stress on the body caused by its futile attempts to expel the dust. Chest physiotherapy can help the bronchial drainage of mucus.
After the 3066 eruption of Mt. Rintalima, the healer, and mage Loomarelle Hantha, who worked for the Arcane Advisors at the Court Circle of Katrapetch, developed a method to support assisted breathing with a device she called the "aeolian bracket". This concentrates oxygen and purifies and filters air before presenting it to the lungs under moderate pressure. The illustration at the head of the article, shows a patient wearing an aeolian bracket.

Prognosis

About half of those who fall prey to the condition will eventually recover fully, although this can take anywhere from a month to a couple of years. Half of the remainder will suffer permanent long term damage to their respiratory system, leading to a reduced quality of life and a shortening of their lifespan to varying degrees. For some twenty five percent of sufferers, particularly the elderly, the condition will prove fatal and death can occur within a mere two weeks of the diagnosis.

Affected Groups

ROSS is a problem which only occurs in the regions around the Katra mountains of Punjuki and even there, only during times when the active volcanoes are polluting the atmosphere with dust. This is not common, since the Katra volcanoes are largely dead or dormant, but from time to time, there are still occasions when the air becomes thick with the deadly smoke and ash that gives rise to ROSS. The city of Katrapetch is by far the most populous area that falls under the cloud of the condition but even here, the knowledge of its history and the lore accumulated around its treatment are little known, except to some specialist medical experts, simply because many life-times can pass between one eruption and the next.
At its worst (such as the Mt. Gelzibom eruption of 211 APC), it is thought that ROSS eventually affected about twenty percent of the entire population, preferentially afflicting older people and those with pre-existing respiratory conditions but with potential to strike down even the most healthy citizen of any age.

History

The first cases of ROSS must have occurred prior to the Planar Conformation and geological analysis suggests that there should have been early outbreaks both in the 6th millenium BPC and again much later not long after the Old Pale Empire assumed control over Katrapetch, yet neither of these have left behind written evidence. We can perhaps allow that the elder is simply due to the great age of the eruptions believed to have happened then, with a smaller population, whilst the younger may have been masked by the political earthquakes which resulted from the Northern Punjuki Campaign and its aftermath.
It was only in 211 APC, following the eruption of Mt. Gelzibom, that scholars first began to document the effects of ROSS and much of this knowledge was lost before the eruption of Mt. Rintalima in 3065 APC which resulted in another outbreak of ROSS during the early years of the Time of Terrors.

The Mt. Rintalima eruption of 3065 seen from western Katrapetch by DMFW with Midjourney

The Mt. Rintalimia eruption would provoke the creation of the 'Sky Shield' Project, a plan described in the Diary of Clarise Vabatan. It would also lead to the most famous victim of the condition, the Raja, Bhupinder Rajput.

Type

Physiological

Origin

Natural

Cycle

Chronic, Acquired

Rarity

Uncommon

Loomarelle Hantha by DMFW with Midjourney