[Sealed] Letter to the Legates

[NeedForGreed]

Legates,

This letter is primarily intended for Legate Komemnos as the newest Legate. I invite you both to meet with me in the coming days, to discuss how best to carry out my duty for the Pyramid. In my duty as Palatial Physician, I would like to bring you up to speed on matters of public health, particularly of the Blood Plague, and  health conditions in the refugee camps.

Health Survey of the Refugee Camps

Hide

I am currently conducting an extensive survey of the health of the refugees. This will take time, and in truth be a process that is always ongoing. The goal is to both capture the current state and needs of the refugees, and to monitor for outbreaks or growing problems. Additionally, to monitor for any successes!

Diseases associated with dehydration and malnutrition are the most common issues I observe. It remains to be seen what effect the "Haoma" will have on these issues. My primary concern is the lack of variety in diet. It is a known fact, and one we Modini are quite familiar with, that unvaried diets are almost as dangerous as starvation. I strongly urge the Legates to consider a subsidy of varied foods to supplement their diets, including fruit if at all possible. I will update the Pyramid on any changes I notice over time as a result of the Haoma.

Heatstroke is a common killer, as is violence between refugees.

At greatest risk are elderly and children. Nutrition and health are vital for children, as their bodies grow and may be permanently damaged from nutrition problems. Children sheltering from the sun and receiving poor nutrition are especially prone to rickets, which I have observed in some of the more sheltered and squalid areas of the camps. In my professional opinion, children should be the highest priority for the suggested food-variety subsidy, particularly:

Eggs
Livers
Fungi
Goat milks
Vegetables

The over-reliance on grains among the refugee population (it is not as if these poor souls have a choice) threatens to permanently damage their health and ability to care for themselves even if their housing situation improves. On a pragmatic level, surely the Legates can agree that weak, sickly refugees are unlikely to be able to take up jobs and contribute to our Well. Chronic malnutrition will permanently damage bodies and minds, and contribute to future disease spread.

I have hired a cook to provide nutrient-rich, fatty, real foods. These are being distributed to refugees and in particular the children to supplement their diets.

[close]

Blood Plague

Hide

I gathered this information and testimony from Sister Selsi (who was most helpful) and my interviews with witnesses of a recent infection. This report is a combination of interviews with her and with those witnesses.

What is the Blood Plague?

A highly infectious, mutagenic disease which has historically been devastating in its effections.The Priory has the ability to produce a Cure, some details of which have been shared with the Pyramid.

What does the Blood Plague do?

Causes fast-growing mutations of the flesh, including but not limited to: hemorrhaging, tissue death, accelerated production of blood and pus, weakness, organ eruption, and finally explosive death leading to spread of blood and pus which furthers the disease.

How does it spread?

Currently several methods are known. Exposure to the original meteor, exposure to blood and pus, potentially exposure to a 'green gas' observed by some witnesses, and potentially mere proximity to victims even through walls.

Ease of spread and progression of symptoms until explosion and death vary greatly between reports, and it appears that the amount of exposure to infected fluids is the greatest factor.

What are the risks?

Interviews have given mixed reports on how possible it is to prevent infection. According to Sister Selsi, it is impossible, and infection is inevitable with time and proximity. According to recent witnesses and the prior Palatial Physician, infection was preventable with precautions such as helmets, goggles, etc.

Interviews with multiple subjects have confirmed that the disease itself is highly mutable and unpredictable, with differences in symptoms and experience presented each time.

In the most recent case, witnesses encountered walking corpses infected with the disease who themselves spread it via contact during combat. This incident occurred at the Echoes, where miners had gone missing and become infected. The Green Gas was observed to follow in the wake of the "fleshy meat people".

There are always possibilities for "new strains", as the disease itself changes.

And, of course, there is the risk of the Blood Plague entering our walls. In the above incident, Ephia's Well narrowly escaped an outbreak. The infected individual was kept outside of the walls and far from the camp, with runners sent to seek help. Had those runners been infected themselves, or had the party decided to bring their infected into the Well: in the words of one of my interviewees, the result would have been "catastrophic".

The refugee camp, in particular, is a dangerous breeding ground for quick spread of the disease. According to multiple interviewees it has been so in the past. Squalor, poverty, and exposure could accelerate the spread.

What can we do?

Thankfully, a cure does already exist thanks to the work of the Priory. We can do more, however.

According to the Priory, the existing cure must be used immediately after synthesis and quickly degrades. Sister Selsi has provided helpful information on the specifics of the cure, but I believe that formally open-sourcing the information to the Pyramid will be valuable in the long term. For such a devastating disease, it is vital that the Pyramid itself have the knowledge to understand how to face the problem.

I request the Legates' support in requesting that the Priory allow observation of the synthesization of this cure, and a sample. Sister Selsi has explained to me that the Seers would need to give permission, and for this reason the Legates' support is vital. Especially if the Blood Plague changes or grows stronger, this transparency and trust between Pyramid and the Accord could save lives should the worst happen and the Blood Plague returns to our walls.

The best time to prepare is yesterday. The second best time is today. I ask us not to let ourselves be caught off-guard simply because it is not at our door already.

What is already being done?

Early discussions and planning between the healers of Ephia's Well. The priest Grenth Flamebringer has agreed to partner with me to prepare protocols and quarantine locations. None are ideal or complete solutions to the potential problem, but these will keep us more prepared should this or any other disease outbreak threaten the Well. We have prepared a potential quarantine room outside the walls, though it is not ideal.
Research into the Blood Plague. Doing so without direct observation of the Plague or field expeditions to known breeding grounds is less than ideal for research, but far safer. I have a strict "no risk tolerated" policy with this disease. The primary goal of this research is not to replace the existing Cure but to seek protective measures and monitor.
Stockpiling of medical supplies observed by the previous Physician as being necessary for healers interacting with Blood Plague victims. This cost has come out of my own pocket, and includes primarily plague masks (sealed, with goggles), gloves, medical supplies, etc.

I am hopeful that in the event of an outbreak of the Blood Plague or any other disease, the Pyramid and Fourth Legion will be open to cooperation and coordinated efforts.

[close]

Signed,

[caesaropapist]

MORE IMPORTANT RASH OF PRESSING CONDITIONS
NEED MEDICINE FOR "SCALD MADNESS" BEFORE IT INCAPACITATES ARMY
INQUIRE WITH COLMES

BRING WHAT YOU HAVE ON BLOOD PLAGUE

FRM
KMNOS

[NeedForGreed]

Legates,

I am happy to report that I am currently investigating this Scald Madness. I will meet with Colmes and compile a report of the information I have gathered so far.

Expect a report of current findings later today. In the meantime, I recommend careful monitoring of soldiers for the following symptoms:

- Itching "inside the head", or palms.
- Tingling sensations.
- Unusual dreams.
- Sensations of cold or difficulty breathing.

Signed,

[NeedForGreed]

As the other letters, this is sent to both Legates.

Honorable Legates,

A report, as promised:

Investigation into this matter began shortly after reports of the Scald Madness came out in the newspaper. Several helpful souls are helping me investigate, particularly good signore Grenth.

Initial investigations suggest this is not a disease or traditional malady, however, I seek the opportunity to perform medical examinations on the soldiers. I will be seeking this from Colmes, who has agreed to meet with me. He noted he is preparing his own report, and given his proximity to the War effort, no doubt it will include more information than I have already. I will update my own report and my own theories once we meet.

This appears to have begun soon after activity at a Monolith camp of the enemy. Recently, the War Council decided between the 'prison camp' and the Eye-Eater as missions. Attacking the Eye-Eater was chosen, and as a result some sort of ritual/excavation of a Monolith was completed at the prison camp. Got Valdhazr dwarves were some of those imprisoned at the camp.

Durgin of Duunthall reports having visited the camp to attempt to save the prisoners, but found the monolith excavated and all people in the camp completely vanished, by unnatural means. "Mid-step, mid-meal", etc. Symptoms were reported by he and his companions, which are similar to the symptoms reported in the War Camp. The rescuers then fell into a shared dream, which appeared based on a memory of Durgin's at Got Valdhazr. Within the dream, a familiar figure spoke mad words that made no sense to Durgin. They awoke far from the camp, together.

To me, this suggests that the root cause is likely to be the completed excavation of the Monolith rather than the later visit. It's possible that exposure has caused the effect of the Monolith to grow.

Symptoms related to the Monolith appeared to be localized to a proximity of 200 yards at the time. None of those near the Monolith experienced fits of madness or thoughts of suicide. It is my initial suspicion that the men at the War Camp are experiencing a shared dream of their own, but one born of far more minds, men who are traumatized by the War and the Scald. Add maddening words as Durgin reported, with uneasy feelings, and this would explain the suicides.

I must reiterate that this is only a theory, and that more investigation is needed. I've requested permission to examine victims directly, to visit the site, and to move Janissaries experiencing the worst of the symptoms to the hospital in Ephia's Well.

To summarize:

My initial interviews have suggested that the Monolith is inducing distressing, maddening dreams into the minds of the soldiers - most likely a shared dream which draws on existing memories and is upsettingly maddening. I have not been able to confirm yet whether the dream is in fact shared. These symptoms were observed by others in close proximity to said Monolith, but its effects appear to have spread broadly to the war camp and worsened dramatically. I have no information on whether the Monolith is still at the original camp where it was found.

In the meantime, an offer: please consider sending soldiers experiencing particularly dire symptoms, directly to the Hospital. Possibly with one or more guards. Those at highest risk of experiencing suicide may be preventable, if we get them away from the War Camp, into comfortable and peaceful settings, and keep them calm with mild sedatives (optional, if you prefer otherwise). My running theory is that the collective trauma of the war camp, combined with shared dreams infected with their own madness, are the direct cause of the suicides.

Next steps that I am looking into:
- Field expedition to the site.
- Sleep therapy and care of Fourth far from the site of the War Camp.
- Further investigation of victims and study of the dreams.

Examination of the site and of victims will be necessary to test potential therapies, while we wait for the root cause to be addressed.

An expert on the Monoliths would be ideal as part of the investigation, I am seeking if any are available among the Tower. Legate Moretti, I hope to speak with you soon on the matter, as you have more experience in the Scald and may be able to help with my efforts.

Signed,
Fiordelise Foscari
Palatial Physician