Dreamrot

Even as the flesh falls away and the sores burst open, the true horror of the dreamrot lies hidden. There is no sanctity in sleep, no repose in rest, for to face the darkness in one's own mind is too much to bear. All choose to suffer in the waking world, for none are brave enough to dream the rotten dreams.

— The Eclectic Panacea and Other Remedies

During the late Fifth Age, Lume was suddenly struck by a terrible disease. Appearing simultaneously in countless settlements across the world, it brought about the death of as many as 500 million people in but a few years. This disease was named "dreamrot," for it rotted away both the body and the mind.

Transmission & Vectors

When the wounds are open and the skin sloughs off, the sickness may spread by mouth or eye or cut.

— The Eclectic Panacea and Other Remedies

Dreamrot is primarily spread through sharing bodily fluids, usually blood or pus. The rotting flesh of the infected provides the perfect conditions for the disease to spread, making contact with the sick risky. Even after death the dreamrot remains, making corpses dangerous to handle.

The sickness can also be spread by scavengers, such as rats or carrion crows, who feed on the infected flesh and then taint waterways or food stores. One of the most dangerous carriers, however, is decidedly more monstrous. The Stirge is a bloodsucking creature that preys, among other things, on humans. It is naturally immune to the dreamrot, allowing it to drink infected blood without issue. These flying nocturnal predators can spread the dreamrot over long distances, infecting otherwise isolated communities.

A Stirge, carrier of dreamrot.

Causes

From where did the dreamrot come? Those inland point to the ports, those coastal point overseas, and those far-flung lands point back. In truth, none know its origin, for it befell all lands equally.

— The Eclectic Panacea and Other Remedies

The exact cause of dreamrot is unknown. The disease clearly has some origin in magic, as evidenced by the nightmares it causes, but the reason for its sudden global appearance is still a mystery. Some believe the dreamrot to be a divine punishment for an unknown slight, others blame the twisted experiments of Taruvata, First of the Undead. The mountain dwarves whisper of the ancient curse of Anduru, but ultimately the truth remains hidden.

The Cause

During the Second Age, the Grand God of the Void Maranam tasked one of his lesser gods with shepherding the souls of the dead – Odos, God of Souls. Odos was a devoted follower and took great pride in his work, but this pride slowly turned to obsession. Finally, there came a day where there were simply not enough souls to satisfy Odos' desires. In his madness, Odos descended upon Lume and began to slaughter all living things, so that he might once again have souls to shepherd.

What followed was a period of divine warfare as the other gods began to intervene but were unable to find unity between their pantheons. All the while, Odos' rampage continued. The five grand divine were loath to intervene, fearing the destruction their power might cause, but as the chaos grew Maranam decided to act. He descended from the Outer Planes and landed upon Lume, striking a single mighty blow to Odos, killing him instantly. The other warring gods were cowed, and the Second Age came to an end.

But one god was left unhappy – Ohenna, Goddess of Disease, wife of Odos. Though she professed loyalty to Maranam, she secretly began to plot her revenge. As fate would have it, she eventually met one whom Maranam had cast aside. Taruvata, First of the Undead, shared with her his secrets of necromancy, strong enough to revive a god. However, to do so would require the immense sacrifice of thousands of mortal souls. Ohenna knew such an act would not escape Maranam's notice, so she devised a plan to distract the grand god. She concocted a terrifying disease, one that would bring such pain and death that even Maranam would be overwhelmed, so that she might siphon souls unseen.

Symptoms

The sickness may begin without one knowing of it. First comes the nightmares, then comes the rot.

— The Eclectic Panacea and Other Remedies

Dreamrot progresses in three distinct stages. The first stage is marked only by developing nightmares and isn't always immediately noticed. The second stage is where physical symptoms appear and risk of infecting others begins. The third stage sees the namesake rot appear, and it is this stage that claims the most lives.

1st Stage (1 - 3 days)

Nightmares - These begin as mildly unsettling dreams, but quickly progress into more horrible and surreal nightmares. These nightmares have been known to include:

• Feelings of abject sorrow or misery
• Harm or death of loved ones
• Dismemberment
• A single recurring dream in which the infected is being stalked through a dark, featureless landscape but is unable to see their pursuer

2nd Stage (3 - 4 days)

Cysts - Painful lumps appear across the infected's body. These are filled with a cloudy white fluid, which can spread the dreamrot if burst.
Rash - The skin of the infected becomes blistered in places, prompting scratching. However, scratching only worsens this symptom, and can lead to bursting cysts.

3rd Stage (4 - 8 days)

Necrosis - The flesh of the infected begins to die before they do, turning black and tearing away. This dripping flesh poses an incredible risk to any caretaker, to say nothing of the damage to the victim.

Treatment

There is no cure. Only through inner strength can one survive, though few do. For those uninfected still, there is naught to do but run, run, run.

— The Eclectic Panacea and Other Remedies

There is no way to cure dreamrot. Magic may seal the wounds and reduce the symptoms, but the disease remains. Worse still, no magic can stop the nightmares. Traditional medicine is necessary to prevent death by rot or further infectious diseases.
The most difficult part of treating dreamrot is the lack of restful sleep its victims get. The nightmares make it nigh impossible to sleep soundly, and many infected choose to remain awake rather than face the horrors in their minds. A tincture of poppies has shown to provide some relief; a mixture of hemlock, bryony, and vinegar mixed with alcohol can induce unconsciousness. In severe cases, nightshade or hemlock can provide a calmer death.
Once the dreamrot has taken hold, survival depends on the infected's physical state. The young and frail are least likely to survive, while those who are physically strong can endure. Dreamrot also poses a significant mental strain, so those weak of mind are equally susceptible. Those few who do survive are blessed with immunity to future infection, though the ordeal always leaves its mark.

The Cure

In truth, dreamrot can be cured. However, this requires powerful healing magics that few are capable of, as well as expensive material components. The power needed to cast such spells means that a caster could only feasibly do it once or twice a day, and during that time hundreds more would be infected. The caster would likely find themselves infected as well, given their closeness to the sick, which would require them to spend their energy curing themselves. Ultimately, this cure was available to only the most wealthy and powerful who kept its existence a closely-guarded secret.

Strangely enough, even after curing dreamrot the nightmares remain, eventually fading after about a week.

Prevention

Burn the rags, burn the clothes, burn the bodies, burn the homes.

— The Eclectic Panacea and Other Remedies

The dreamrot does not die when its host does. Corpses can still infect new victims and so must be disposed of, usually by burning. Settlements thought to be free of the dreamrot have found themselves suddenly reinfected due to improper handling of bodies. Infected fluids on rags or clothes can also prove dangerous, though the disease will die off after a time away from a body.
When contact with the infected or corpses is necessary, proper covering can make the difference between life and death. Thick clothing and wraps around the nose and mouth are essential. Multiple layers are recommended, as are thick gloves. If available, a thin cloth draped over the face can provide minor protection against fluids splashed in the eyes, while still maintaining vision. Such coverings should not be reused, even if laundered. The smallest drop of blood can carry the potential to wipe out a city. When faced with such overwhelming devastation, there cannot be too much caution.

Symbol painted on the door of infected homes.

The Circle of Pestilence

The Circle of Pestilence was the primary sect of Ohenna, Goddess of Disease. Following the outbreak of the plague, Ohenna's followers were delivered a divine proclamation - to go forth and banish this unholy disease, whatever the cost. The Circle made great strides in the understanding of the dreamrot, but their greatest works were in doing what no one else would. They willingly aided the infected, risking their own lives when others would have left the ill to die. Many of them fell sick in the process, but those who survived would continue this thankless task, developing many of the preventative measures known today. Ultimately, the Circle of Pestilence was greatly diminished, but in the centuries following the plague many flocked to Ohenna's temples in thanks.

Sickly Mother, most beloved, with heavy heart I come to you. My mind was weak and sickness swiftly takes me. Have mercy on this unclean vessel and purge me of my illness and sin. Absolve me of this darkness that I may sing your praises anew.

— Prayer of the Circle of Pestilence, seeking cleansing

History

What fragmented histories remain tell of the widespread burning of bodies to fight the sickness...Though the need for such a practice has long since passed, the tradition lives on in the towns and villages dotted along the Cairn Road.

— Imperial historian Amrynn Leoris, on the Cairn Road

Though the dreamrot has long since faded from Lume, its effects still linger thousands of years later. Entire civilizations fell before it, giving new nations a chance to rise. Countries such as the Kingdom of Bresal, the Stawen Dynasty, and the Exalted Imperium of Oriand all were born of the defunct remains of the fallen.
The dreamrot also brought about major cultural and societal shifts. Prior to the plague, the mountain dwarf holds were regarded as unimportant isolationists. But it was this isolationism that allowed them to endure better than others, remaining intact and emerging as more prominent political powers. Likewise, on Sundercrag, the scattered Gnoll packs were able to grow into the vast tribelands of today. By preying on the remains of dead cities they became far more powerful than gnolls found on other continents.

Additional Reading

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Type

Magical

Origin

Divine

Cycle

Short-term

Rarity

Common