Chronic Hemorrhagic Sicaremia Condition in Imperia Triplica | World Anvil

Chronic Hemorrhagic Sicaremia

That’s the thing about sicara poison:
no one realizes they’ve breathed their last breath
until they try to take the next one.
— Praetor Octavius Caelius Deceangius


If a person manages to miraculously survive Acute Hemorrhagic Sicaremia, they are almost guaranteed to experience its chronic form for the rest of their lives.

Transmission & Vectors

The initial poisoning with sicara poison must occur through mucosal contact, chiefly ingestion with food or drink, in order to cause Acute Hemorrhagic Sicaremia. Surviving this deadly condition almost never means a person makes a full recovery; rather, they are afflicted by a chronic form of the acute condition.


Caused by the sicara poison, the chemical of choice of the Sicarii assassins. Sicara poison acts on the clotting cascade, at first causing widespread and uncontrolled clotting, which uses up all clotting factor and leads to an inability to clot. The victim becomes hemorrhagic, bleeding out in a matter of hours if not given massive blood transfusions. Even in that case, recovery is not likely, with only 5% of people hospitalized with AHS making a recovery beyond 6 months from poisoning. Those who do recover develop CHS.


  • widespread clotting, followed by exhaustion of clotting cascade and inability to clot
  • purplish spotted rash on the skin
  • chronic renal failure
  • hepatic cirrhosis
  • increased chance of bleeding from the mucous membranes
  • bruising
  • mental fog
  • chronic fatigue


There is no cure or reversal agent. The only treatment is supportive care to alleviate the severity of symptoms and prevent CHS from exacerbating to a fatal degree.


Poor. The majority of people with AHS will succumb to their illness, and the same is true for CHS. CHS is a life-changing diagnosis that often means the person must alter their daily habits to avoid illness and injury, as any health complication could become fatal.


Chronic Hemorrhagic Sicaremia is the collection of sequelae that remains after someone has survived Acute Hemorrhagic Sicaremia.


There is no prophylactic care for sicara poison, nor is there any way to develop a tolerance for the poison. The Imperia spent years wiping out the plant the toxin is derived from, hemflos. However, as this flower is sacred on its native Deceangia and revered by the Cult of Saint Ulia, clandestine efforts to preserve the sacred flower were successful.

Chemical Compound
Chronic, Acquired


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