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Maddening

Chancellor Deepseer: "Tell me what you see."
Subject 14: "The stars! Everything! I see everything, and they're smiling at me!"
[Scribe's note: At this point the subject's eyes exploded. The subject did not appear to notice.]
Chancellor Deepseer: "Gods above!"
Subject 14: "It's so beautiful..."
[Scribe's note: At this point the subject experienced a seizure, which lasted approximately two minutes, then died. The subject smiled throughout.]
— Ikki Deepseer, 'Analysis of the Maddening'
 
The Maddening is the name given to an unnatural disease that originates within the Desolation. It subjects its victims to both physical and mental alterations, and usually ends up killing them or rendering them completely insane.

Origin & Transmission

The Maddening is endemic to the Desolation, and it seems possible to contract it from just about anything in that cursed wasteland. People have caught the disease by drinking the water, eating plants or animals from the region, or as a consequence of being injured by one of the horrors that roams the area. There have been claims that it can be caught from the air as well, as some people have become infected despite insisting they took every precaution to avoid contact with anything that might be infectious. It is also possible to catch the disease through skin contact with or fluids from another infected person. The disease is somewhat erratic in nature and not every contact with a source of infection will result in transmission, but any such contact could. No mortal species is known to be immune, or even resistant, to the disease, though some more exotic beings - such as Fey or Shardminds - have proven immune.
The Desolation
Worryingly, the Maddening appears able to bypass standard magical protections against disease. There are extensive documented reports of individuals being infected despite their active and consistent use of wards against disease. There have even been instances of individuals who should be immune to all diseases, such as paladins, being infected. The one saving grace is that the Maddening appears to require much greater exposure over a longer length of time to successfully penetrate such protections.
Surprisingly, and fortunately, the Maddening appears to be much less virulent outside the borders of the Desolation. While there have been many documented incidents of infected individuals or items spreading the disease beyond the wasteland, it does not happen with anywhere near the frequency that would be expected from such an ordinarily-virulent disease. Speculation is that the disease, which is clearly magical in nature, is in some way tied to the Desolation and loses much of its power outside the region.

Symptoms

The Maddening has two sets of symptoms with which it plagues its victims: physical and mental. The first to present are the physical changes. which are highly variable but typically involve significant modification to the victim's body, both internally and externally. Tumour-like growths are common on the skin, in more extreme cases bulging out several inches from the body. The body shape is frequently altered, with limb lengths and proportions as well as body shape and stature all changing seemingly at random. This alteration occurs rapidly over the space of a few days to two weeks, depending on the individual and the extent of the changes. The alterations are often painful or uncomfortable, but not to the extent that one would expect by looking at them.
More extreme physical changes include a change in skin colour, loss of hair, growth or loss of limbs, growth of tentacles, and growth of eyes in unusual places. On rare occasions the changes appear almost fungal in nature, rather than cancerous. These fungal presentations are almost always fatal.
A victim of the Maddening in the early stages of the disease
Nyarlathotep gnaiih nauh'e y-stell'bsna mnahn' ph'ee zhro ngilyaa, kn'aagl orr'e ehye hupadgh ep vulgtlagln nnnfm'latgh, gof'nn nog sll'ha'nl shuggor f'shugg li'hee. Y-y'hah ph'chtenff nanw mnahn' n'ghft athg nglui h'gof'nn geb ooboshu!
— Text painted on a wall by one of the infected in his own blood, shortly before his death.
The mental symptoms manifest a day or two after the first physical symptoms, and accelerate rapidly. The infected begin to act erratic, with wild mood swings. They then start hearing voices and seeing things that aren't there, and their grip on reality becomes tenuous at best. Many victims begin speaking or writing in tongues, all of them apparently using the same language which is not one that any scholar has been able to identify. Translation magic has been unsuccessful in deciphering the language, causing speculation that it is merely meaningless gibberish.

Treatment

Treating those infected by the Maddening has proven singularly difficult. No herbal remedy has been found that helps to any significant degree. More worryingly, normal curative magic has no or limited effect on the disease. Eradicating diseases and infections from an individual is ordinarily a fairly straightforward task for a moderately-skilled divine caster, but the Maddening is highly-resistant to such efforts.
Thanks to the research of Ikki Deepseer, specialised magical rituals have been devised which are effective at healing the infected. There are, unfortunately, limitations on the use of these rituals. Rare and expensive ingredients are required, and the complexity of the ritual requires multiple skilled casters to participate. Even then the rituals are only sometimes effective, and only ever in the earliest stages of the disease. If the ritual fails or is unavailable then all the healers can do is provide supportive care. They make the patient comfortable as best they can, and try to help the patient keep their strength up in the hope that they will throw off the disease on their own.
A more unusual presentation of the Maddening

Prognosis

There are four documented outcomes from the Maddening, and unfortunately most of them are unpleasant.

Dead - 60%

The majority of people who contract the Maddening die, either as a result of the physical changes proving too much for their body or their minds snapping completely and rendering them brain-dead. Providing supportive care to the patient to maintain their strength and keep them calm seems to improve survival rate marginally.

Maddened - 20%

A large number of those who survive the disease do not actually recover from it. Known as the Maddened they retain their physical mutations, and their minds are completely ruined. Utterly insane, these individuals are beyond saving or curing.Sometimes they are executed in what is described as a mercy-killing, while other times they are left in the Desolation to fend for themselves. This second option is not as cruel as it seems - the Maddened are highly infectious so cannot be allowed to mix with uninfected, but they seem quite at home in the Desolation. There have been multiple documented cases of a Maddened released outside the Desolation, only to immediately seek the wasteland out with unerring accuracy.
The Maddened are too far gone to maintain a proper society but there are reports of small, albeit temporary, groups of them cooperating deep within the Desolation. The Maddened are known to construct strange totems and things which appear to be ritual sites of some sort, though details are scarce (and the Maddened are far from consistent in their efforts). Although the Maddened seem to gain some sort of insight into the nature of the Desolation and its threats, they typically do not last long before succumbing to one danger or another - or simply forgetting to eat and drink.

A Relyth

An elf who survived the Maddening but was transformed into a Relyth

Cured - 15%

With luck, or help from specialised magical treatments, some infected survive the disease with their sanity mostly intact. In most of these cases their physical mutations fade, though they are usually left with at least some scarring, growths or disfigurements as a legacy of their ordeal. They usually experience some personality change, and their mental state typically remains shaky for the rest of their lives. These individuals do not carry the disease any longer, and are safe to re-enter society (after a lengthy quarantine to make certain the disease is gone). They do, however, experience significant social stigma, particularly in the lands surrounding the Desolation.

Transformed - 5%

Main article: Relyth
Rarely an infected individual undergoes a more ordered transformation. Their skin turns a shade of purple, their hair is replaced by tentacles, and their face flattens and becomes more alien in appearance. These individuals retain their sanity (or perhaps it would be more accurate to say they become productively insane), though their personality undergoes significant changes. These beings have chosen to call themselves Relyth. Although non-infectious they prefer to make their homes in the Desolation, where they establish small communities and worship nameless gods that are unknown to the rest of the world.

Cultural Impact

Although Calcerun is no stranger to diseases, the Maddening has proven particularly shocking due to its extreme effects and its resistance to magical cures. Stories of its potency and virulence have spread, and become exaggerated in the process. It is not an uncommon belief that merely being in the presence of something that has passed through the Desolation is enough to contract the disease. Authorities have attempted to play down these excessive beliefs to avoid panic, but are not helped by the fact that, just occasionally, the Maddening does appear to spread in a new and unexpected way.
This fear has led to some people being less interested in trade goods which pass through the Desolation on one of the Alliance-organised caravans, and has driven down prices as a result. Traders who previously relied on the land route between Esé-Nal and Yol have found their fortunes badly hurt. On the other hand, the port cities in the two nations have benefited from a large increase in demand for cargo ships.
The communities in the vicinity of the Desolation are particularly fearful of the Maddening. A common habit now is to cover one's mouth with a cloth when the wind is blowing from the wasteland, lest it bring the disease with it. National officials are quick to point out that there is no significant evidence that the Maddening can be transmitted by air, and in any case covering the mouth probably wouldn't do anything to help, but they are generally ignored. These communities have also become highly-sensitive to anyone with deformities or disfigurements of any kind, fearing that they may have contracted the disease. There have been some regrettable incidents of uninfected people being killed by a mob - usually by burning - for something as innocent as a large birthmark.

History

The Maddening first appeared in 1245 PC (220 AR) following the Night of Weeping Stars. As far as can be determined it became endemic to the entire Desolation more or less instantly. At first it was not recognised for the threat it was, but after the first group to become infected all died gruesome deaths the neighbouring nations took it more seriously. Chancellor Ikki Deepseer of the Autumnal Tower led a study to determine the scale of the threat and how the disease might be treated. It was this study that developed the specialised rituals which have had the most success in curing infected victims. On his recommendation the Alliance began its current strategy of containment and quarantine.
The Weeping falls on Ormithlor

The Maddening

Synonyms The Weeping Curse

A Maddening victim

A victim of the Maddening shortly before losing her sanity
Type Unnatural disease
Symptoms Cancerous growths, mutations, madness
Complications Malnourishment due to refusing to eat
Causes Contact with infected object or fluid, ingestion of infected material, speculated airborne component
Prevention Avoid any and all contact with infected or anything in the Desolation
Usual onset 1 day to 1 week post-exposure
Usual duration 1 to 4 weeks from first symptoms
Treatment Specialised magical rituals, supportive care
Prognosis 60% mortality, 20% Maddened, 5% Relyth

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Cover image: by Lane Brown and John Coulthart (see Author's Note)

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Author's Notes

Cover image credit: The work of two artists is represented in this page's cover image. The figure on the right is by Lane Brown (http://www.lanebrownart.com/), while the background is by John Coulthart (http://www.johncoulthart.com/).


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