Disease and Fantasy
Illness and disease are rare in the realm of fantasy, the only real dangers coming from supernatural maladies such as mummy rot, lycanthropy, or some other exotic ailment. In the medieval era, disease was rampant. But most gamers seldom want to delve into the nitty gritty level of realism that indulges in infuenza and other infections. These can be used to enhance a game, provided they are used judiciously and with a proper mindset.

Infection and disease becomes a burden on a game when every injury runs the risk of becoming gangrenous, and any peasant sneezing might carry some hideous plague. Games are intended to be fun, and not germaphobia and dramatic heroes suffering through a second bout of Goblin Diarrhea. A disease should be used ideally as a plot device, can’t go that way, the village ahead has been afflicted with Dragonpox and been quarantined by the King, or we need a magical potion to cure the outbreak of Snotbone fever in the highlands.

I did mention a proper mindset. In our modern way of thinking, we know that diseases are caused by microscopic viruses and bacteria. We also have access to hand sanitizers, vaccines, and know that washing our hands and disposable tissues help prevent the spread of disease. As little as a century or two ago, Influenza killed millions of people. Now children are innoculated against this disease yearly, and in most industrialized nations it is just a crummy week you spend sick on the couch. In more primitive nations, it still kills by the thousands. In the proper fantasy mindset, there are no viruses, no germs, nothing invisible that can’t be revealed by a spell.

Possible Sources
As the scientificly proven method of disease transfer is not applicable in a fantasy setting, another sort of answer must be provided. Old cultures had differing opinions on what caused illness, and why it spread and methods of stopping it.

Demonic Forces - Illness is the taint of the infernal on the body, sinners suffer for their lack of purity, and the devout suffer to prove their faith. Demons spread the disease, and prayer and purification can cleanse the taint from the body.

Divine Forces - The God of Pestilence, or some other neutral type deity spreads disease to keep the population strong by weeding out the weak and infirm. Alternately, disease is a punishment from above, the wrath of an offended diety at impious humanity.

Magic - What can’t be easily explained is quite simply magic. An illness is caused by the sick person being hexed, jinxed, or cursed by a suitable practitioner of common magic.

30 Diseases

1. Ague
An archaic and vague term, Ague is a fever that is accompanied by chills and hot flashes. This fever is generally attributed to inhaling unhealthy air, such as that found in swamps, marshes, crypts, and other unclean places. Generally not life threatening.

2. Abortus or Amblosis
The archaic term for miscarriage. Only afflicting women, this is considered among the worst of afflictions as it is physically and emotionally debilitating. It is also the root of the modern term abortion.

3. Adynamia
This vague illness causes a depletion of strength and vigor. Recuperation time is long, but is generally not life threatening. In most civilized areas it is rare, but in more primitive and feudal areas, it is almost always considered to be laziness on the part of the infected.

4. Amass, or Alastrim
The archaic term for variola minor, a lesser strain of smallpox. Over two weeks, the infected develops pus filled boils, fever, scabs, rashes and other general nastiness. The disease is minorly fatal with proper attention.

5. Amentia
Mental retardation isn’t seen much in the fantastic setting, but there are plenty of folk who are rather slow of though, usually farmers, blacksmiths, or soldiers of large size and impressive armor. Could also be Ogre’s Disease.

6. Angina Maligna or Hogskin Angina
Best described as a malignant sore throat, this disease can spread to the lungs where it rapidly becomes pneumonia and leads to death by suffocation. In modern terms, this is Diphtheria. Angina refers to a feeling of constriction or suffocation.

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Lunacy was believed to be an affliction where the moon's face drove the weak-minded into fits of madness. Behavior associated with menstrual cycles also led to the idea of 'hysteria' or madness caused by internal organs. A village could be normal every time the adventurers pass through, but rumors might persist: a bare dozen travelers per year disappear on the road through this village.

Vibrio Vulnificus (and other Vibrio infections) are spread by the bites of reptiles such as alligators and would be attributed to poison or venom. The wound site turns black, green, or purple and swells. Skin near the wound develops pustules and boils, and the victim runs a high fever. Without treatment the limb might fall off -- but the time frame is long enough to spur a 'save the fighter's arm!' side quest. Kobolds, dragonkin, drakes, and other reptiles could spread disease instead of generic 'poison damage' if they live somewhere particularly septic like a swamp.