> Writing about Leprosy (For my Fellow Darkest Dungeon enjoyers)
Hello Baldwin enjoyers..... my promised revision of my previous leprosy post here, I haven't talked about leprosy and him in A While, so I thought I would reintroduce the core/basic understanding of leprosy in both modern and medieval times... just in case?
And to anyone who doesn't know me...... Hi..! I'm Boar, I work with mycobacteria (leprosy, tuberculosis and cia) and I'm a immunology and microbiology student, leprosy is the (academic,) Love of My Life and I love yapping about it!!!!!!
You can obviously write Baldwin the way you want! I'm not the authority of the DD fandom, this is merely me sharing my knowledge of leprosy as a researcher and enthusiast in hopes it could inspire and help someone🫡
Leprosy is unfortunately a very complicated and elusive disease, it's been more or so 100 years since we discovered the pathogen that causes it and we're still not even sure on how it passes to other people. This unfortunately leaves a lot of gap in our knowledge in what would be considered standard or basic understanding in other pathogens and also, consequently, makes understanding even the "basics" of leprosy extremely difficult. I will try my best to be through and use the simplest terms I can find and I'll be happy to elaborate on any topic mentioned. (In other words, if I look at every characteristic of leprosy we'll be here FOREVER so I'll be focusing on the important ones for 'writing'.)
Progression and transmission
What I see alot in most works within the fandom is the concern of transmission around Baldwin as well as his disease progressing. In reality, leprosy is a strictly genetic-based condition, you cannot catch leprosy if you do not have a specific genetic makeup. (We believe the % of people able to catch leprosy to be 0.1% at best and 1% at worst, globally... though some statistics state it can be high as 5-10%)
This comes of course from modern research, but already in medieval times there was at least some vague conceptions and mentions that, not everyone who was close to a leper contracted the disease, mostly stemming from leprosariums and other philantropic institutions that cared for lepers had staff that worked closely with the infected but did not catch the disease. (This, of course, worked to reinforce the idea that leprosy was not a diease but a divine punishment.)
The way leprosy progresses is also not "linear", it has spikes of remission and increase, someone may have leprosy for years before their health starts to tank, others can die within 3 years. I'll touch base on why this is a bit later.
Cultural impact
The thing that is least touched upon leprosy in DD universe is it's cultural impact, which is... fine. But considering the grimdark aspect, I always thought it was quite strange, because there's just so much potential! This is (what I imagine,) to be attributed to the fact he was based off a real figure, whom wasn't convicted to the latin/western ideas of leprosy at the time.
Indeed, the reason why the lack of sensation became the symbol of leprosy is because being a leper was pretty much a death sentence, legally speaking. Laws like the english common law (such as the de leproso amovendo), the lombard law and others stripped lepers of their titles, assets and property and at some places it was the only way to 'divorce' someone.
Leprosy was considered an extremely repulsive disease, closely tied to sexual deviancy, someone who was diagnosed with leprosy was marked with the title of a deviant or a rapist. The idea is that, since most sexual diseases had some sort of tie to skin symptoms, then leprosy must be the worst of all, and thus must be some sort of divine punishment leading to their isolation.
This idea is so persistent, that in some countries that have extremely strong traditional catholic influences (like mine, teheee), the word 'leper' is almost synonymous to rapist or monster. Personally, I was born at a time were we had laws that tried to reduce the stigma of leprosy by changing its name, I know leprosy by a different term, so darkest dungeon was actually the first time I saw the word leper, and it made me immediately assume that Baldwin was.. one of those two things.
For me, specifically, it would've been way more interesting if Baldwin was overthrown instead of abdicating, we have seem kings being overthrown for being diagnosed with leprosy in other places, and given the in-world vibe and theme, it would make way more sense. If his council wanted him out so bad, they could've just weaponized his leprosy against him, it would've been so easy, and it would've given a reason why he left his kingdom.
My Idea, is that everyone would have different perceptions of him depending on their cultural background, obviously not everyone is religious but religion often leaks into tradition and culture. It also gives him another layer on why he isolates so often.
Symptoms and all;
Leprosy is a spectrum, and a pretty large one at that. I cannot pinpoint exactly what type of leprosy Baldwin has, I also imagine RH didn't do their homework (which is like, fine, I don't think they should appease a freak on tumblr dot com) so some things are a bit all over the place.
Symptoms of leprosy tend to worse overtime as they progress to its final stage (lepromatous leprosy), but its natural that people may recover, or never progress to the final one.
The most common ones (and the ones I see most mentioned ofc) are obviously the lack of sensations and vision, here's some a curiosities on it;
Each nerve is assigned to transcribe a specific feeling or sensation. Leprosy tends to get rid of the ability to tell temperature first, then pain-pleasure then soft touches for last.
Leprosy follows a glove and stocking pattern (usually the limbs). Total loss of sensation is rare but it does happen! most people feel decreased sensation. These are a really good chart if you want a visual guide;
A key note, leprosy will often avoid the chest when it can as well as the genitals, here we see a total lost of sensation;
(I was actually, slightly appaled, I have never seem a fullbody loss before.)
You may have noticed that it avoids the genital areas, but also the armpits, and the elbow. The reason why is that leprosy does not like warmth, at all. It will avoid warm regions whenever possible, this means that during the summer, leprosy tends to become more bearable.
The eye symptoms, are also a bit more... distateful than just 'blindness', I will spare you the details- but many describe a feeling of "something stuck in your eyes". (For reference as well, leprosy vision is not symmetrical, one eye can work while the other doesn't. On average, 6ft seems the max distance people with leprosy can see without blurriness)
Regardless, I do think Baldwin has his leprosy "under control", he either manages it or hides his discomfort very well, however, its natural that he could worsen at any time (mostly during winter) or recover abruptly for no reason too, leprosy tends to be dynamic instead of a linear condition.
Since we glazed a little on leprosy's history and diagnosis, and that the lack of sensation became the face of the condition due to its legal ramifications. Other places at the time, who didn't have the same cultural views on leprosy, focused on different symptoms instead as its "main" thing, I can't obviously go over every single symptom since there are too many, but here's the ones I saw the most* (In medieval texts, not modern era.)
the steppage gait, you can see a good example here.
Trouble sleeping or very light sleep, this seems to be tied to how it can disable the ability of the eyes to roll to the back of the skull when entering deep sleep.
Trouble breathing, leprosy is related to tuberculosis, after all
Overprodution of mucus, I cannot stress enough how many times I've read this, apparently, what disgusted people the most about lepers is that they were always snotty. Which makes me envision Baldwin more like a miserable wet puppy
Trouble chewing, alot of their diet was just... Soup (but also snake meat, I'll get to it)
Raspy voice :)
In the modern era, a lot of the struggles revolving leprosy are its symptoms towards the final stage, namely amyloidosis, heart failure, kidney failure and the lepra reactions.
Lepra reactions are pretty much the only case where leprosy will directly kill you, its a phenomenon, where for some bizarre reason, the body will treat leprosy as an allergy instead of a disease and overreacts, alot
Up to 52% die during those episodes and it happens to 50-70% of all infected depending on type, they come abruptly and for no reason and can last for weeks to months, you get all the symptoms you usually have during allergies from joint pain, swelling, inflammation and terrible fever but also the skin starts to break and form several, small painful nodules... it can also give long-lasting side effects after recovery, like crooked fingers and scarring
So Personally, To Me. Baldwin never had this episode, yet, I'm not saying from a place of being able to recognize those scars, it's just my intuition that tells me. (I mean, his fingers are fine,) I really can't quite point out to all the symptoms or anything that sticks out to me in his condition because well... we don't get alot on it either (which is, weird, it's his entire thing) Is he just good at managing his condition? Lucky? Resillient? Probably all 3
The treatment itself
Leprosy is extremely hard to cure, even by today's standards, we're looking at 50mg of clofazimine daily and 300mg once a month, 600mg of rifampcin, 100mg of dapsone, prednisone, thalidomide (yes, that one), etc etc, usually for the course of 2 years. Because the bacteria is 1. has thick walls and 2. stays inside the cells it means that for the antibiotic to work, it has to penetretate some extra levels and still has to work, for this reason alone, most of them are pretty heavy hitters. Consistently, for years, the reason why leprosy remains an issue is because people tend to abandon their treatments due to the side effects, and, paradoxically, some of those antiobitics will also damage the same organs that leprosy is already damaging, meaning that you will also probably need to take MORE medication to undo it or change your lifestyle completely.
Now the world of medicine in DD is kind of a mess (curing rabies..?!), so if you assume they have something similar to modern treatment, this is it. But given that Baldwin mentions that there is no cure for his condition, I'm inclined to think he has an antibiotic resistant type of leprosy, which implies that he underwent treatment, and he (like many in real life) abandoned his treatment for whatever reason
For his case, there's nothing that can be done except remain taking second line antiobiotics (often worse than the first ones and with minimal results) alongside Direct Observation Therapy (DOT), which is when a medical worker stays with you when you take your meds to ensure you took all of them (given that people keep giving up on themselves)
The medieval treatment was not much different, I'm using a translated passage from Aretaios of Cappadocia in which he opens with; "In order to cure the sicknes, it is necessary that the cures be stronger than the diseases."
Bloodletting was common, because this is the dark ages and of course it was. The idea was that the blood nourished the disease, so in order to combat it, you must not nourish it. Bloodletting, laxatives, fasting, a diet of only watered down milk, forced vomiting, and so on and so forth. Other .. "medicines", include wine with honey, warm wine, ashes of grapes with animal fat, frequent baths, viper meat (it was believe they could absorb evil, I guess) seafood, salted meats, and some dull exercise.
With some modern knowledge, the amount of alcohol, seafood and salt in the.. "treatment" already raises some flags, leprosy already causes severe damage to the kidney, and the medieval treatment would likely worsen one's condition, no wonder those people died so early.
My little closing thoughts
Thank you for lettin me hold your hand through this *wink wink*, if I'm honest in the last part, I don't think Baldwin is letting himself get all that bloodletting, or the laxatives, or the milk thing. Sure he can have some wine with honey (as a treat), but he already accepted his demise and destiny, and it doesn't look like, to me, he's interessed in delaying the inevitable with any sort of treatment.
I hope this post was somewhat enlightening to you, I absolutely love talking about leprosy and studying it, I'm sorry I did not go indepth with the leprosy types just like last year, but the leprosy scale is usually meant for academia and remains largely unused in more informal discussions... Any other questions, feel free to let me know... I don't bite (hard)! I'm happy to go over any other details I missed, or if you wanna take a look at the translated texts I have saved
Reminder that the words bisexual, homosexual, and heterosexual were first created as clinical terms and applied to people by a binary obsessed medical community
The bisexual community has a long history of redefining a label that was initially forced onto us
For all of the northerners that stood up for Texas during our freeze and said, "Don't make fun of them, they've never dealt with this before. Their infrastructure isn't made for snow and freezing."
This one is for you.
Where I live 108°F with 80% humidity with no wind is normal.
Pacific North West is dealing historic best waves 35-40°C or 95-105°F.
First of all. Don't make fun of them for bitching about the heat. Just like Texas isn't built for a freeze and our pipes burst, Pacific North West isn't built for heat and a lot of their homes don't have AC.
If you live somewhere with a high humidity like 80+ HUMIDITY IS NOT YOUR FRIEND. The "humidity makes it feel cooler" is a lie once it gets beyond a point.
If you live somewhere with a lower humidity, misters are nice to cool off outside.
Once you get over 90°F (32°C) a fan will not help you. It's just pushing around hot air. (I mean if you can't afford a small AC unit because they're expensive as hell, by all means a fan is better than nothing).
Window AC units will let mosquitoes or other small bugs in. Sucks, but that's life.
Now is not the time to me modest. If you have to cover for religious reasons, by all means. If you don't, I've seen people wear short shorts and a swim top. It's not trashy if it keeps you from getting heat stroke.
If you do have to cover up for religious reasons, look for elephant pants or something similar. They're made with a breathable material.
Shade is better than no shade, but that shit it just diet sun after some point. Don't think shade will save you from heat stroke.
I know the "drink your water" is a fun meme now, but if you're sweating excessively you need electrolytes. Drink Gatorade, Powerade, or Pedialite PLEASE. I don't care if you're fucking sitting in one spot all day. That shit WILL save you from heat stroke.
Most importantly. RESEARCH THE DIFFERENCE BETWEEN HEAT STROKE AND HEAT EXHAUSTION PLEASE!
If you're diabetic and can't drink Gatorade, mix water, fruit juice, and either lite salt or pink salt
If you can afford it, cover windows with thick curtains to insulate the house
If you have tile floors, lay on them with skin to tile contact. If you don't, laying your head on cool counters works too.
If the temperature where you're at is hotter than your body temperature, don't wear heat wicking clothing. Moisture wicking is safe though.
Check your medication labels. Many make you more susceptible to sun and heat
-Room temperature water will get into your body faster. This is something I learned doing marching band in high summer in Georgia, and it saved all of our asses. Sip it, don't gulp it, especially if you're getting into the red; same goes for whatever fluid you're drinking. And just in general drink during the day.
-If you are moving from an air conditioned space to an un-air conditioned space, if at all possible try to make the shift gradual. When my dad and I were working outside and in un-ac houses a few years ago, he'd turn the air down to low in the truck about ten-fifteen minutes before we got where we were going. This way your body doesn't go from low low temps to high temps. S'bad for you.
-If you can, keep your lights off during the day. Light bulbs may not generate a lot of heat, but the difference is noticeable when it gets hot enough. I literally only turn my bedroom light on in the evening when it gets too dark.
Don't be afraid to just like... pour water on yourself if you need to. The evaporation will cool you off.
Put your hand to the cement for 15 seconds. If you can't handle the heat, it'll burn your dog's paws. Don't let them walk on it.
Dogs with flat faces are more prone to heat stroke. Don't leave them out unsupervised.
Frozen fruit is delicious in water.
Wet/Cold hat/handkerchief on your head/neck will help you stay cool.
Pickle juice is great for electrolytes! You can even make pickle juice Popsicles!
Heat exhaustion is more, "drink water and get you cooled off." Heat stroke is more "Oh my god call 911."
Image Description provided by @loveize
[Image description: an infographic showing the difference between heat exhaustion and heat stroke. The graphic is labeled "Heat Dangers: First Warning." Signs of heat exhaustion: faint or dizzy, excessive sweating, cool, pale, clammy skin, rapid, weak pulse, muscle cramps. If you think you or someone else may be experiencing heat exhaustion, get to a cool, air-conditioned place, drink water if conscious, and take a cool shower or use cold compress. Signs of heat stroke: throbbing headache, no sweating, red, hot, dry skin, rapid, strong pulse, may lose consciousness. If you think you or someone else may be experiencing heat stroke, call 911. End description]
Remember kids! NEVER save left-over antibiotics! You should never have leftover antibiotics, because you have to finish the whole course! Not doing so, or giving your antibiotics to someone else who hasn’t been prescribed them is how we got superbugs, that are resistant to antibiotics!
ALWAYS finish your antibiotics, even if you don’t think you’re sick anymore! NEVER give your antibiotics to other people, there is no guaruntee they will have any effect, or the same effect, and without a full course, will not help them even if it is the right medicine for the job.
BOTH cases result in resistant superbugs, which are dangerous to everyone, and hurt everyone. You might think you’re helping your poorer friends who cannot afford an antibiotic/to be seen by a doctor, but you’re not. You’re just hurting everyone.
Medicine that treats symptoms and painkillers are not antibiotics! Please stop bringing these up!
I am talking ONLY ABOUT ANTIBIOTICS ON THIS POST, please, please stop adding in about drugs that are not antibiotics on a post about specifically antibiotics! ONLY antibiotics cause super-bugs when taken incorrectly, medicine that alleviates symptoms, pain, or other things do not create super bugs, and I am not talking about them! Thanks!
and what are we going to do when the HP series comes out and we start seeing a resurgence of the fandom here including gifsets and fics. like are u guys gonna bring up your neurodivergence and cry "can we separate the art from the artist!!!!! you dont need to pay to watch it!!!!!its my comfort show and I'm DEPRESSED and AUTISTIC"
Reminder that "separating the art from the artist" is a sentiment that only works when the artist is dead and no longer profiting off the work in question.
JKR is still very much alive and very much openly devoted to spending as much of her money on efforts that increase transphobia. You cannot separate this artist from this art, because she is heartily using funds from that art to fund hate groups.
Do not watch it. Do not pirate it. Do not talk about it. Have nothing to do with it whatsoever.
See that picture above? That’s a close up of my great grandmother’s immigration papers when she first came to the US back in the early 20th century. But my great grandma’s information isn’t the important part here. The important part is that line in the middle there about how they arrived in the country.
And how ‘stowaway’ is a legitimate, valid option to select.
So yeah. They absolutely just showed up, and that part of immigration history needs to be talked about a lot more.
REMINDER THAT TRAVEL VISAS AS WE KNOW THEM TODAY WERE INVENTED IN THE 1930S TO KEEP JEWISH REFUGEES OUT OF COUNTRIES THAT DID NOT WANT AN ‘INFLUX’ OF THEM, THEREBY FACILITATING THEIR GENOCIDE :)))))
read What is A Refugee for more history. Educate yourselves.
We all know what erectile dysfunction is but literally no one is ever taught what vaginismus is and it can cause people to feel extremely lost, broken, and cause people to take their own lives.
Raise. Awareness.
For the uninformed, vaginismus is when the vagina painfully tightens and spasms when faced with pressure, usually from anything trying to insert into the vagina. It’s the reason I can’t wear tampons, and why many people can’t have vaginal sex without severe pain.
There’s not a lot of treatments, and there isn’t a single one that is for vaginismus exclusively - they’re all medications or treatments to treat symptoms, but not the causes. In fact, for a long time doctors waved off vaginismus as a purely psychological disorder in cis women.
Seriously, this is so unaddressed and uncared for in medical circles. Please spread awareness, even if all it’s for is to let those who have it but don’t have a name for it finally be able to understand what’s happening to their bodies.
Hi hello! This post is almost 10 years old and there ARE treatments for this. Vaginismus is otherwise known as pelvic hypertonia and it is a MUSCULAR condition that can be caused by many different factors including endometriosis, trauma, chronic UTIs, and connective tissue disorders.
It’s incredibly common! And it can be treated by physiotherapy.
I know this because I’m currently undergoing physio and although it can take months to recover, I’m already seeing improvement. A lot of the pelvic floor exercises are available online, but if you have these symptoms please TALK TO YOUR DOCTOR and see if you can get a physio referral (or investigation for underlying causes like endometriosis).
Also, my additions to posts never get reblogged so a note to my followers: this is SUPER IMPORTANT ISSUE that affects many people and is rarely talked about. Please reblog, and please share this info with as many people as possible.
Pelvic hypertonia/vaginismus is incredibly debilitating and psychologically damaging but it CAN BE TREATED. Spread the word, and you never know who you’ll be throwing a lifeline to.
My dad used to work for Vodafone and likes to tell a story about when he was working on a voicemail transcription service.
And there was a woman there who was some form of disability advocate (it was the 90s so her existence in the company was a minor miracle) and apparently she completely blew his mind on that project.
See, he'd imagined that this service was exclusively gonna be for deaf people. Obviously very useful for the very small number of people who couldn't hear their phone, but why would you even own a mobile phone if you couldn't hear?
But she described to him all the times he might want to read a message instead of listen to it. Maybe he was in a loud football crowd. Maybe there was important info that he needed to copy down that was spoken too fast. Maybe he was holding his sleeping newborn (me) and didn't want his phone to be loud and wake them up.
This doesn't feel as revolutionary as all that to those of us that have only ever known phones with the ability 'send text message', but given the timing and placement of this conversation I wonder if this woman and this project is *part of the reason text messaging exists*. The first text (SMS) message was sent by Vodafone UK in 1992 - where + when this conversation was happening - and then for a long time it was supported exclusively for 'messages from the carrier', and this project was an early potential extra use of the SMS protocol.
germansingergirl
gummygunk
andulkaphoto
kaledo-art
turnnoffyourmind
baratheonpilled
dailybridgerton
