Thaldimine Poisoning

"What's wrong with you? Hey! Hey! Stop eating that! Titanium isn't good for you!"
"I! Have become a god! And I! Declare that you will become a chicken! Bawkbawk!"
"Still a dwarf."

— Conversation between two dwarves, one with thaldimine poisoning

A Dwarven Disease

Though thaldimine poisoning can affect anyone with prolonged exposure to thaldimine, it's most commonly found in dwarves who are the only ones able to mine and produce this precious metal. Due to this, it is often and erroneously believed that only dwarves can acquire it. Some nickel mines, particularly those in northern Kos produce thaldimine as a byproduct, and improper disposal of the slag can lead to an increase in thaldimine poisoning. Similarly, adventurers who wear thaldimine armor are at risk due to prolonged exposure.

Symptoms

Stage 1

The first symptoms of thaldimine poisoning are a cough and abdominal pain. This is caused by the internal organs starting to bronzify. They literally turn into bronze. Early treatment of thaldimine poisoning is imperative to mitigate the impact to quality of life. Depending on the amount of exposure, this stage may last from a few weeks to a few months while more of the internal organs begin to bronzify. There are no exterior signs of bronzification, and many patients report muscle cramps, stiffness, and fatigue as the organs are restricted.

Stage 2

The second stage of thaldimine poisoning is noted as being the most dramatic. It's marked by a sudden craving for metal along with psychotic delusions and premonitions which are often inaccurate. The craving for metal may be so intense that the patient begins consuming nails, metal tools, and metal decoration around the home. Autopsies on patients who died during this stage show the majority of the internal organs being partially turned into bronze. The external extremities also begin to bronzify which reduces mobility. Many patients die in the second stage due to premonitions about surviving dangerous stunts or rupture of the stomach from excessive metal consumption.

Stage 3

The final stage of thaldimine poisoning may occur between 1-3 years since the initial onset of symptoms. By this point, the patient loses the ability to move as the limbs lock in place. Speaking and breathing are difficult due to bronze restricting the lungs from expanding. The head is the final body part to bronzify, and by this point, even the skin is mostly bronze. Death occurs rapidly once the patient is no longer able to breathe, and clothes and worn items are also turned into bronze and cannot be recovered.

Treatment & Prognosis

To date, there is no known cure for Thaldimine Poisoning. Very early treatment can limit the extent of the symptoms, however there is no way to reverse bronzification. In the best case scenario, the patient is able to avoid thaldimine for the remainder of their life and only deal with shortness of breath, constipation, and moderate abdominal pain. By the time a patient reaches Stage 3 poisoning, only palliative care is available, and the patient will die within a year even if removed from all thaldimine and restrained to avoid metal consumption.

History

Accurate records of thaldimine poisoning are hard to obtain. However, it's likely that this condition has been around since the first thaldimine mines were established. It has gone through several names such as Miner's Psychosis, Dragon Sickness, Bronze Curse, and Acute Iron Binging Disorder (AIBD).
The most well known series of cases of thaldimine poisoning occurred at the Zynychy Mine five hundred years ago. Several miners fell ill within the span of a year of one another, and their condition worsened despite attempts at alleviating the symptoms. The mine healer took detailed notes, and after all of the affected miners died, there was a resounding call for an investigation into the source of the sickness. Other miners who were beginning to show symptoms were also examined, and for the first time, there was definitive proof that thaldimine was causing the illness. The mine was shut down, but demand for thaldimine remained high, and other mines remained active.
Since then, further study and research has been done. Recognition of the symptoms has allowed healers to seek treatment for thaldimine poisoning and keep patients alive to see the final stages of the illness. Precautions have been put in place at all thaldimine mines to mitigate prolonged exposure and remove ill miners so that they can continue to live out the rest of their natural lives.

— Andreivkr Stonefist Vyankin

Submission to Group 6 for Cato's Mixing Symptoms 2

Type

Magical

Origin

Magical

Cycle

Chronic, Acquired

Rarity

Rare

Affected Species

• Elf
• Dwarf
• Human

Prevention

The only known way to prevent thaldimine poisoning is not to become a thaldimine miner and to limit exposure to thaldimine. Thaldimine miners should be working on a rotation to ensure that less than half the year is spent in the mines. These guidelines are not always followed. Sale of thaldimine ore and armor should be properly labeled with warnings about thaldimine poisoning and early symptoms to be aware of. Adventurers should remove all thaldimine armor at night and spend at least two days every half cycle without wearing it to reduce the risk of poisoning.

Dragon Sickness

Thaldimine poisoning has long been misattributed to Dragon Sickness which presents with similar symptoms of craving and hoarding metal and mood swings with irritability and aggression. What makes thaldimine poisoning unique is that it causes bronzification. There is still a strong stigma around Dragon Sickness which causes many dwarves to delay pursuit of treatment and ignore the earliest symptoms of a cough and intenstinal cramping prior to craving metal. Unfortunately, the stigma means that many miners aren't removed from thaldimine exposure in time, and the only option left is palliative care.