Neutralize Pastry

Eric Lis

For roughly one percent of the population, the Detect Poison spell may point to nearby bakeries.

Celiac disease is one of a number of health problems related to the body experiencing a harmful reaction to gluten, a mixture of proteins found primarily in wheat, barley, rye, and other common grains. Celiac is an autoimmune disease, meaning that the symptoms are a result of the body’s own immune system attacking the body. The exact mechanism by which celiac causes damage to tissues is sufficiently complicated that I can’t be bothered to get into it, but the short, short, short version is that gluten gets broken down into absorbable molecules which, during the process of digestion in the gut, trigger the body’s immune cells to start attacking the walls of the digestive tract. This causes a host of symptoms, some of which have been convincingly demonstrated and some of which are only suspected or poorly understood, including pain (which can be severe), bloating, and diarrhea with failure to absorb important nutrients that can lead to deficiency in important vitamins and minerals. This mix of symptoms can lead to failure of growth in children, impairment of bone formation, fatigue, depression, and possibly even psychosis. Like all autoimmune disorders, having one also increases the odds of developing at least one other autoimmune disease during life. Other gluten-related diseases, such as non-celiac gluten sensitivity, tend to be less extreme but still very much not fun, and since they’re harder to diagnose they can actually cause a lot more suffering as people wander around for years without knowing exactly why they’re suffering.

Celiac disease and related problems almost certainly exist in a typical campaign setting. Celiac has probably been a problem for humans ever since the dawn of agriculture. Although the disorder has only been understood since the mid 20th century, and really entered the public consciousness (and “gluten intolerance” has become a fad) only in the last ten years or so, descriptions of Celiac go back to at least the second century. Recognition that certain foods were the cause dates back to the 1800’s, but the first several researchers who posited a curative diet tended to get it hilariously wrong. In real-world history, the discovery that wheat products were the cause was made in the context of famines which wiped out supplies of gluten-based products, leading to rapid improvements in sufferers; there’s every possibility that observant healers in a fantasy setting could have made a similar observation long before sophisticated medical technologies would be available.

Because celiac is an autoimmune disorder, storytellers might easily rule that it’s difficult to treat magically. Creatures with an inborn mutation have the disease programmed right into them from the moment of conception, so from a certain point of view, spells like remove disease might not do anything. Spells like restoration undoubtedly alleviate symptoms but likely won’t prevent a subsequent attack.

The really interesting question is whether a creature with gluten sensitivity can be protected with anti-poison spells. Consider: different substances are poisonous to different degrees in different species, just as chocolate is (basically) safe for humans but will kill dogs and cats. Logically, then, the detect poison spell presumably gives slightly different results if cast by a human or an elf or a dwarf or a catfolk, not merely detecting poisons but magically identifying any substance with the potential to poison the caster (and probably only the caster, which a clever storyteller could use to set up some hilarious misadventures). In contrast, delay poison and neutralize poison likely don’t need to have the same divinatory power, but somehow stop any substance in the body from causing harm. I’m actually unsure of how true that statement is, because in the d20 SRD there’s a part where the text for neutralize poison specifies that it works only on venoms, which would mean it has no benefit against the effects or arsenic or cyanide, but I suspect that was just bad writing as opposed to an intentional limit on the spell because many of the SRD’s specific poisons clearly aren’t venoms. In any event, it would seem very logical to me that a storyteller might rule that a creature who is protected by neutralize poison or delay poison before each meal is protected from being harmed by gluten; neutralize poison is obviously 100% protective for its duration and even delay poison, which remains active for hours, would stay effective for long enough that the dangerous gluten would be digested to non-harmful amino acids before the spell expires. Wealthy characters with celiac disease would almost certainly simply invest in a ring that protects them from all poisons – most merchants seem to buy these anyway to stave off assassination attempts – and never have to worry about what they eat again. Poor characters, who of course can’t afford sixty gold per day for anti-poison magic, let alone 27,000 gold for a protective magic item, are, as usual, out of luck. 

More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on February 14, 2016. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system