Five uses for disease in fantasy

This is inspired by a book I read recently – The Speckled Monster: a Historical Tale of Battling Smallpox. Smallpox was one of the most feared diseases in the world, and for good reason. If it didn’t kill its victims, it often left them horribly disfigured or even blind, when the pocks involved the eyes.

So, what uses can disease be in fantasy worlds?

1. Confers benefits

Half the fun of creating characters with abilities or powers normal humans don’t have is saddling the characters with disadvantages and flaws to make up for that. The flip side would be starting with the negative, giving the character a significant disease and showing how this gives him an equally significant advantage.

There’s precedence for this in real-life. People with the abnormal red blood cells produced by sickle-cell anemia have some protection from malaria. Maybe in a fantasy, people with terminal cancer become able to see glimpses of the future—including their own inevitable deaths. Or what if such superpowers were linked to genetic conditions like Down’s syndrome?

2. Adds physical flaws to a character

I once read a romance novel (Lorraine Heath’s Sweet Lullaby) where the hero had smallpox scars. They probably weren’t that disfiguring, but the very fact that he had an imperfection that wasn’t the usual thin, rakish duelling scar was something I remember years later.

Other diseases leave their own marks. Meningitis can lead to the amputation of limbs, and trachomatis to blindness. Be creative with fantasy diseases—perhaps being bitten by an infected mosquito leaves you with insectile features like compound eyes.

3. Biological warfare

This is my favorite, and yes, it can work in a medieval fantasy—though the flying corpses of Kaffa may not actually have spread the bubonic plague through a city in real life. Any communicable disease can work, as long as it acts quickly (AIDS is out) and can be spread with relative ease (AIDS is out, again). More effective killers would be transmitted through aerosols or droplets, by casual touch, by vectors like insects or by water.

It would also help if animals or humans used to spread the disease did not show any symptoms while they were infective (or even afterward—if they were the equivalent of Typhoid Mary). Rabies would be a great way to spread terror through a population if animals didn’t behave strangely or foam at the mouth.

4. Isolation tactic

This is a great way to provide some privacy in a medieval world. If a ship is coming into a foreign harbor with a cargo that might be better off not declared, have her docked at a distance while she’s inspected, on suspicion of plague. Of course there is none, but no one’s going to risk going aboard until that’s confirmed.

Plus, if a character makes her face up such that she resembles a leper, not many people will get close to her. Or know what she actually looks like, for that matter.

5. Natural population limiter

Humanoid populations probably don’t breed at such a rate that they would require this kind of check on their numbers, but it would work for any fecund species which might otherwise strain the environment’s carrying capacity. Think myxomatosis decimating rabbit populations in Australia.

This might, of course, be a problem if a humanoid population depended on this species for food. Or if the disease spread to the farmers and herders as well…

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