The Wasting Cough

Overview

The wasting cough takes years. A young woman in a damp room in town begins to cough one winter and is thinner the next, and her family watches her flush and fade for three or four years before she dies; by then her sister has the cough too. It is the most patient killer the peoples know, and the one they explain worst.

Cause

It is a sickness of the lungs that passes slowly on the breath. It takes hold in those who share close, damp air with the coughing sick through long months, and most of all in the underfed, the overworked, and those already weakened. Many who breathe it in carry it quietly for years and fall ill only when hunger, grief, or another sickness wears them down.

Who It Strikes

It strikes wherever many people share small, damp rooms and too little food: the poor quarters of towns, workshops, crowded winter houses, prisons, and barracks. Humans, Halflings, and Goblins of the town fringes take it most. Elves and Dwarves take it rarely. The Wrought do not breathe and never take it.

Signs and Course

It begins quietly: a cough that lingers past the winter, tiredness, a loss of appetite, and a little weight lost. Then come fever in the evenings, drenching sweats at night, and a bright flush on the cheeks that strangers mistake for health. The cough deepens and brings up thick phlegm, then streaks of blood.

The course runs over years, with good seasons and bad ones. Some patients mend in a good season and never fall ill again. In others the wasting goes on: the body thins to bone, the voice grows hoarse, the breath shortens, and at last the cough brings up blood in mouthfuls. Death usually comes from weakness or from a great bleed.

Contagion

It passes by breath, but slowly. A single meeting seldom gives it; months in the same room or bed do. Whole households fall to it one by one, which is why so many believe it runs in families.

Treatment and Its Limits

What helps is what the poor cannot get: rest, good food, a dry and warm room, and clean air, ideally away from the town. Herbs and honey ease the cough. A Vital healer can strengthen a wasted body for a season by giving it lifeforce, and a priest's Cure Affliction can drive the sickness back, but a deep-rooted case needs the work repeated with ordinary care beside it, and few families can pay for a healer's strength year after year.

Mortality

Most who reach the stage of coughing blood die of it within some years. A good part of those who take it mildly recover, and some live long with a scarred chest. It kills the young adults of poor households more than any other age.

Lore and Belief

Because it wastes and comes back to the same house, many believe the wasting is laid by something that feeds: a remnant of the dead, a curse, or one of the Ash-Wights, whose bereaved truly do waste among them, though from a different hunger. Families have dug up their own first dead to burn the heart. Others say it runs in the blood of a family. The bright cheeks are taken by some for a beauty the sickness gives, and it is sung about that way.

Grave-diggers who open a wasted family's graves to burn the hearts are hired by night and paid well, and some villages have driven a whole family out on the suspicion that it carried a feeding dead thing with it.

In the Medieval Era

The wasting cough is common in towns and in the winter quarters of crowded villages, and it is one of the great killers of young adults. Those who can afford it go to the country. The Gardens of Returning Breath, the quiet healing order of Vital Magic, keep rest-houses where the coughing are given air, food, rest, and slow transfers of vitality over long seasons. Most of the sick never see one and are nursed at home.

Where It Appears

This ailment grows out of:

• Ash-Wights (the wasting of the bereaved)
• Vital Magic (the Gardens of Returning Breath)