The Smell of Nomenclature In The Morning

Eric Lis

With all respect to Bill Shakespeare, if roses were called skunkbreath flowers or bileblossoms, they wouldn't be nearly as popular on Valentine's day.

It can be tricky to name a disease. Whether you're renaming an existing disease to keep your players from identifying it too quickly, or coming up with a name for a home-brew creation, a good name is important. In much the same way that the big bad final boss of your campaign isn't usually named Binky, a horrific, lethal plague rarely becomes known as "the sniffles." We all know how important a good name is; a name catches the audience's attention and changes the flavour of an object. The choice of a name allows a storyteller to make something seem far more dangerous, or much, much less, depending on the needs of the story. A name can point players in the direction of a story hook, like naming a plague after some prominent character or location, or can send the players off in the wrong direction entirely, as when a well-intentioned farmer tells the PCs that his rabies-infected son has lycanthropy. In real life, the name of a thing tends to give us a lot of information about it, and that can be endlessly useful to a storyteller, as a means of either informing or deliberately misinforming a group.

There are no shortage of approaches to naming a disease. The most important element is how well a name fits into an overall campaign setting. There are obvious concerns such as tone and theme -- darker games will have very different needs than sillier games -- but to me, the most important factor is the level of advancement in the society or societies in which the player characters move. Diseases can be expected to have very different names in a medieval campaign versus in a modern setting, for example. We have two broad ways of naming diseases, each of which may be more common to certain time periods and cultures. The most boring, but perhaps more easily converted to a fantasy setting, is the eponym, the naming of a disease after some person who was instrumental in its discovery. The eponym was popular in the early days of scientific discovery, but has since fallen out of favour; in addition to the fact that we finally caught on that we were immortalizing some very questionable people who might not deserve to be favourably remembered, these names don't effectively communicate. If someone told you that they suffered from Hirschsprung's disease, Addison's disease, or Klinefelter syndrome, the disease would be recognizable, but the name itself would tell you nothing about what the disease is if you didn't already know.

For most of history, healers have preferred the second way of naming diseases, which is to give them descriptive names, and if it turns into a catchy acronym, so much the better. Human Immunodeficiency Virus, Severe Acute Respiratory Syndrome, and Chronic Obstructive Pulmonary Disease are all disorders of relatively recent discovery and elucidation whose names describe precisely what they are, in fairly plain language. Not all descriptive names are in English, of course, and often those diseases which have been known for millennia are still known by their ancient names, most commonly names derived from Latin or Greek. Diabetes mellitus, hemophilia, and rabies are all examples of diseases whose names are actually wonderfully descriptive of some aspect of the disease, if only one speaks the relevant language.

There's more than one way of describing an illness, mind you, and this is where things can become fun for the storyteller. One of the most fun parts of writing Insults & Injuries was taking the time to research ancient names of many diseases and finding that many were wonderful and poetic, to say nothing of sometimes being terrifying. Illnesses like gout, which classically afflicted only the wealthy, were known for centuries by such evocative names as "rich man's disease" or "the pain of kings." Tuberculosis' old name, consumption, referred to the way that sufferers wasted away and were seemingly devoured from inside. A name in this style can add a curious touch of realness to a sickness which players might not get from a more abstract name. A properly poetic name can also instill fear much faster than any actual symptoms.

Another touch that storytellers can add is to make names more fantasy-appropriate. If the commoners in your campaign setting have typical fantasy names, which don't sound at all Western, then it might not make sense for them to come face to prion with, say, Creutzfeldt–Jakob disease. In settings where "modern" science is grounded in draconic or elven languages, it would make sense for many illnesses to have "official" names in those tongues, even though those names may be useless, impossible to remember, or even unpronounceable by players. Player characters may have a most dreadful time simply discovering what En'beyel'ayl's syndrome or Tiaachyoqqrahrd's fulminant malaise is, let alone how to treat it.

You can tell a lot about a culture by the diseases that it recognizes and how it approaches them. The way a society names its sicknesses is just one aspect of this, but it's an interesting one which is easily overlooked. As with everything else in gaming, it's the little details that help to bring a world to life and make it meaningful to the players. Getting a good handle on naming can add a lot of richness and depth for minimal effort. 

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 August 4, 2013. 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