High Noon- OSR Gritty Western Game- APPENDIX M- Maladies and Diseases

I did some research on maladies and diseases that afflicted (and often killed) settlers and cowpolkes of the old west for my next project, High Noon.  I don’t plan to create mechanical rules for these, because I feel the players should die by more enjoyable means than cholera or small pox, I thought it would be a good way to insert these into towns and cities the group visits.  Having a cholera scare as the group is entering a town would be an interesting dilemma.

Don’t worry- I’m not going to put any pictures up- just because I was crazy enough to research this shit and look at horrible pictures doesn’t mean that is something EVERYONE wants to see.

APPENDIX M- Maladies and Diseases

Due to bacteria, a collection of pus that is impacted in tissues, organs or other spaces of the body (IE. abscess of the tooth).  Symptoms often include pain and inflammation.

A generic diagnosis given to any patient with a fever followed by symptoms of nausea and vomiting.  Maladies that the afflicted were actually experiencing were typhoid, malaria, or hepatitis.  This was a common diagnosis in the 18th and 19th century.

This infection starts with a very high fever, enlargement of the spleen (and sometimes enlargement of the liver).   The skin of the afflicted blackens, which gave the disease its name.  This disease weakens the immune system allowing other diseases and illnesses to take hold- especially in areas where sanitation and living standards are poor.  The victim would get small lesions on their face that would eventually spread throughout the whole body, resulting in possible blindness if they spread to the eyes.  Oftentimes the lesions would merge to form disfiguring swollen chancres.  This disease had an extremely high mortality rate.
An individual’s extremities have been exposed to extreme cold and then quickly warmed will swell, causing damage.  The skin will swell, become inflamed, itch, and sometimes blister.  This can be avoided (or reduced) by keeping feet and hands properly wrapped and protected in winter and avoid extreme temperatures.
Cholera causes the victim’s bowel movements to become large amounts of watery diarrhea.  The victim’s bowels may vacate so much and/or so often that they can become dehydrated within hours.  This dehydration leads to sunken in eyes, cold and clammy skin, fatigue, and wrinkled, less elastic skin.  Cholera also leads to vomiting and muscle cramps.


Two large cholera outbreaks erupted in America in the years 1832 (in Mississippi to New York) and again in 1849 (down to California along the Oregon Trail).  Over 150,000 people died during these outbreaks.

A person with diphtheria will usually have a high fever of 100°F or above.  The afflicted will also experience chills, fatigue, possible bluish skin discoloration, sore throat, cough, head ache, difficulty breaking, and a foul-smelling nasal discharge.  Diphtheria can also cause the lymph nodes in the neck to swell and bulge (AKA Bull Neck), causing a bark-like cough much like croup.


Severe symptoms of the disease include cardiac arrhythmia,  swelling and inflammation of the heart muscles, and spasms or paralysis of various muscles.


Malaria is a disease spread by mosquitoes.  Symptoms include a fever accompanied by feeling cold, chills, and shivers.  These symptoms appear every two to three days, giving malaria its nickname, Remitting Fever.  Other symptoms include headaches, back pain, enlarged spleen, fatigue, a raspy, dry cough, nausea and vomiting.


Contagious disease with fever and blisters
Small pox is a virulent disease that attacks the throat and mouth, lungs, and then migrates to the lymph nodes.  Initial symptoms include fever, fatigue, nausea and vomiting, and back aches.  After these symptoms have manifested for roughly 12 days, small reddish lesions appear on the afflicted person’s mouth and nasal cavity; these rapidly swell and burst.  48 hours after these lesions appear, the victim begins to manifest reddish legions on their forehead and face.  Within 36 hours these legions have spread through the victim’s body.  These legions quickly fill with fluid and become painful blisters.  These are also capable of transmitting the disease.  Small pox is highly contagious and has a mortality rate of 30%.  A highly malignant form of small pox exists and is almost always fatal.



A sexually transmitted disease that has four stages of development: primary, secondary, latent, and tertiary.  During the primary stage the afflicted will experience a single chancre at the point where contact (and transmission) was made.  During the secondary stage the afflicted will experience a rash, frequently also developing on the palms and soles of the feet.  Latent stage symptoms are minute or non-existent.  The final stage, tertiary, the afflicted will start developing guammas (non-chancre sores) all over their body, and will experience neurological (including blinding) or cardiac symptoms.  People will also experience swelling and disfiguration due to syphilis.  Tertiary syphilis is hard to diagnose because it often shares symptoms with several other diseases, putting it into the “great imitator” category of medicine.


A person afflicted with Typhoid Fever will experience the gradual onset of a high fever over several days as well as abdominal pain, constipation, and headaches.  Extreme cases, often associated with the high fever, will experience confusion and hysteria.  Some people will also develop a rash of rose-colored spots on their body.  In the 19th century these symptoms would last several weeks or months.


It is possible to carry the bacteria that causes Typhoid without being affected, making it possible to spread the disease to others (famous case: Typhoid Mary).


This highly infections fever is characterized by a high fever, headache, dizziness, a rash that starts on the trunk of the body and eventually spreads throughout to all extremities, and face.  Other symptoms include photophobia, delirium, paranoia, and coma.  If left untreated the mortality rate is high.
A disease spread by female mosquitoes.  Symptoms include fever and chills, headache, back pain, nausea and vomiting, dehydration, and fatigue; these symptoms usually last three to four days.  There is a slim chance that a second, more deadly onset will occur with a reoccurrence of a fever.  This second stage results in liver and kidney damage.  Bleeding from the mouth, eyes, and gastrointestinal tract will occur, as will black vomit (vomiting of blood).  These cases, if improperly cared for can result in death.


About wrathofzombie

I am a History major attending a community college until I can get more financial aid and attend a four year school. I am living in NJ with my girlfriend who is currently wrapping up on obtaining her PhD in Toxicology. I love Star Wars, Role-playing, video games, working out, reading, writing, and hanging with my girlfriend, dog (Perfect), and two kittens (Birch and Brambles). My main focus on this site will be my discussion of Role-playing games and ideas and hopefully contribute something worth a damn. View all posts by wrathofzombie

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