RMPIHEIAFA: Necromantic Fasciitis

Jan Brems

Welcome to the latest in a series I'm calling "Real Medical Problems I Have Encountered, Interpreted as Fantasy Ailments" or RMPIHEIAFA (rumpy-HAY-fah). Each entry will cover a real-life medical condition I have encountered in the American health system, adapted to suit the world of your fantasy RPG campaign.

Necromantic fasciitis is a thankfully rare but troublingly serious condition. Infection typically follows a botched resurrection, although the patient may not show immediate symptoms for several weeks.

In cases where a Raise Dead spell is performed by a cleric of insufficient experience, or the spell is interrupted at any point, the soul may not be fully reintegrated into the body. Any part not fully integrated is, for all intents and purposes, undead. In mild cases, this undeath may be confined to a small area, such as a finger, toe, or facial extremity. Affected areas do not give the appearance of dead flesh, so cases can go unnoticed for some period of time.

Symptoms of necromantic fasciitis begin with itching and muscle spasms of the affected area. Numbness is present in some cases, and wounds suffered in affected areas will neither bleed nor heal, either naturally or through magical means. Because the infection rests within the fascia, the thin sheath that connect and stabilize the muscles and organs, it will spread unchallenged throughout the body if not arrested quickly.

As the area of undeath expands, so too does the range of possible effects. Affected limbs may begin to take on a mind of their own. Hands will grasp and ungrasp at random, often dropping weapons and items intended for use. Legs may splay out in strange ways, ankles turn painfully, and joints swell. In the case of facial infection, grimacing, gurning, and twitching are most common.

What happens next should be familiar to anyone with sufficient experience in the necromantic arts. The undead have a natural hatred for the living that borders upon instinctual, and as more of the body is corrupted this hatred will manifest in every way it can find. Stories abound of veteran adventurers found dead in their tents, strangled by their own, still-flailing arm. Infected legs will throw their victim over cliffs or onto swords, infected tongues will sever and force their way down the victim's throat. At this stage, the victim is a tremendous danger both to themselves and those around them, and should be quarantined accordingly.

In death, the disease progresses unimpeded until the entire body is under its vicious control. Here is a true undead, under a new name: zombie. Now a full-blown carrier, the zombie is intensely contagious, and even so much as a scratch or bite is enough to spread necromantic fasciitis to a new host. The process begins again.

As mentioned before, treating necromantic fasciitis is difficult, as undead tissue naturally rejects any attempts at mundane or magical healing. The only known cure is amputation, liberally spaced from the area of infection and flawlessly executed. If there is even one square centimeter of corrupted tissue left upon the victim's personage, the risk of reinfection is high. Some success has been found with judicious use of anti-undead clerical magic, meant to stop, hold, or "turn" the hordes of the damned. However, evidence for this is scarce, and some suggest it may do more harm to future attempts to pacify the victim in the case that they build up a tolerance to the spell.

Real Medical Problems I Have Encountered, Interpreted as Fantasy Ailments: HPIT

Healing Potion-Induced Thrombocytopenia (HPIT)

Welcome to the first entry in a series I'm calling "Real Medical Problems I Have Encountered, Interpreted as Fantasy Ailments" or RMPIHEIAFA (rumpy-HAY-fah). Each entry will cover a real-life medical condition I have encountered in the American health system, adapted to suit the world of your fantasy RPG campaign.

In this episode, we'll be dealing with Healing Potion-Induced Thrombocytopenia, or HPIT.

Your standard Potion of Healing works by way of over-stimulating the body's natural ability to recover from minor wounds and illnesses. Tissue growth in particular improves exponentially: minor-to-moderate surface wounds are visibly observed to heal and close mere seconds after ingesting the elixir.

However, this overstimulation comes at a price. For all the popular talk of "natural magic," the forces of sorcery are still not widely understood, and their methods of interaction with living tissue are, at best, harmless only in small doses. With regards to HPIT, cases have shown that consuming multiple healing potions in a short period of time (most incidents seem to involve adventurers, whose natural rests are often interrupted by violent dungeon inhabitants) can cause the body to actively reject the curative as if it were a magic attack.

This rejection progresses through several stages. At first, the patient may feel uncharacteristically vigorous, as though the potion was working well beyond its intents. This is a deception of the foulest degree — investigation of the wounds will show they are, in fact, bleeding more profusely than before!

The second stage is more mercifully apparent. The patient will begin to feel lightheaded, and possibly nauseous. A fever may be present as the body attempts to fight off what it believes is an attempt at magical possession. The patients reflexes slow, halving their usual movement speed and imposing a +/-2 disadvantage on AC.

It has been recorded that particularly wizened patients — scholars, clerics, and the like — appear to be less susceptible to this stage of illness. The link is tenuous, however, as heavy potion use, and by extension HPIT, is most often found in individuals of lesser intelligence.

During this second phase, IT IS IMPERATIVE that the patient does not mistakenly consume another potion. Doing so will cause them to become violently ill, to the degree of 2d4+2 damage.

Barring further intervention, HPIT will usually resolve itself over the course of a long rest. If dizziness and bleeding persist, a chirurgeon or cleric may be consulted. If you feel that you or a loved one may be at risk for HPIT, send a scrying message to RMPIHEIAFA headquarters, Saviors Rest, Lithica. Our sages are standing by.