Disease in fantasy

When I was fourteen, I read a book called The Black Death, which is now out of print. It described how the titular plague might spread through the modern United States, and the descriptions of its effects – on the cellular level – were fascinating, like an arms race.

That began my love of microbiology, and ever since then I’ve liked learning about diseases. Not to mention writing about them, especially in the context of my other fascination, fantasy.

In pre-modern societies, people weren’t often aware of the exact means of transmission, so diseases could be passed more easily. Medieval cities also tended to have poor water treatment and sewer systems, both of which contributed to the spread of disease. Port towns were especially vulnerable because sailors and shipments could bring infections from afar; even something as simple as flushing ballast tanks could introduce foreign microbes into the water supply.

People still had ways to deal with disease. As far back as prehistorical times, it was known that certain plants and plant compounds could be used to treat illnesses – the athelas of The Lord of the Rings, for instance. People with diseases could also be isolated – for instance, sent to leper colonies or sanatoriums. That kind of stigmatization happens even in modern times – as experienced by the main character of Stephen Donaldson’s Lord Foul's Bane.

Diseases in fantasy can be very interesting to devise. My favorite part is naming them –wasteaway, the crawling stripes, coldfever, milkeye (myxomatosis, which in Watership Down is called the “white blindness”), stoneskin, fingerfall (leprosy), the red cough (tuberculosis).

Then there’s the method of transmission. Diseases in fantasy can be transmitted in bizarre ways – through flies or butterflies or even plant pollen. They can be spread by fomites (inanimate objects). And, of course, they’re transmitted by hosts or carriers – who may or may not be aware of the fact that they’re spreading a disease.

In a fantasy world, that might even result in the host being changed into a walking repository for the disease, able to do little else but eat, to keep the organisms alive, and travel, to spread them.

Or the disease could be something that everyone in a society is born with. Star Trek: Voyager did a pretty good job of that with an alien race called the Vidiians, which was completely ravaged by “the Phage”. As a result, their bodies are a patchwork of different types of grafts and organs, scavenged from other species.

The disease might be caused by a curse, or it could be something cyclical – people start to become sick at dawn, are in the throes of the illness at noon, which is when some die, and recover as dusk approaches. The night is usually filled with feverish (no pun intended) activity, to prepare for the inevitable sickness ahead.

Disease in fantasy, as in the real world, can be heartbreaking and horrific… and extremely interesting.