I'd been putting off writing for some time, because I couldn't think of anything to say that hadn't been said better already. Having received an unpleasant but prolific gift for my 41st birthday, however, I can comment on something relevant to D&D.
A few weeks ago, a friend discovered a kitten under some industrial debris and texted me to ask if I wanted it. I didn't, particularly, but I promised to talk to my wife; when I did, she became giddy with excitement, and so the cat entered my house and I had to be nice to it. We did take it (or, I should say, her, the cat being female) to the animal hospital for a diagnostic, and she was pronounced free of parasites other than fleas, with which she was absolutely rife. The treatment for fleas was effective immediately; they dropped off overnight while she was confined to a cage. I had described the whole process in real time on a forum in which I sometimes participate, and one of the posters insisted, adamantly, that she be 'backlighted' (or 'blacklighted', I can't recall) for ringworm which, if present, would require a quarantine of two weeks. Although at this point I didn't quite know what ringworm was and put it in the same mental category as roundworm, tapeworm, and heart worm, I still put my trust in the veterinarian. I think I assumed, naively, that this was because the condition wasn't common in Japan; and for the past few weeks we have, stupidly, let her crawl all over us and sleep with us.
I noticed my first spot a week ago while being swarmed with mosquitoes during a neighborhood shrine-beautifying event. Although mosquito bites normally disappear from my skin within a few hours, one spot seemed particularly tenacious. I thought it was strange, but didn't pay much attention until it became larger, more pronounced, swollen, and perniciously itchy. By the end of the week it had expanded into a bright red, puffy ring in the middle of my wrist. Then while showering I noticed an identical ring on my knee. Then another on my forearm, and on the opposite one. With the new one that appeared on my back this morning, I now have five total.
Now, it is is my impression than in the West, skin conditions are generally perceived as ghastly. I've been careful to impress on the players in our campaign, for example, the extent of the terror fourteenth-century people feel toward leprosy, for example, quite often ostracising members of the community who might only have eczema, on the grounds that it just might be leprosy, which would mean the end of an individual's existence in society. Even now, at least among teenagers, there is a degree of ostracism associated with most skin conditions. In Japan, however, it's taken as quite normal; eczema and atopic dermatitis are omnipresent and death with by what amounts to a shrug of the shoulders.
The environment is humid, particularly in summer, and fungal infections thrive. It's simply that they're not accorded any particular gravity. This cultural difference from the West is one to which my eyes have only now been opened. The best comparison that comes to mind is with the flu, which is no big deal in the US. It's similar in symptoms to the common cold, except that it's accompanied by fever and joint pain, and the treatment is basically the same: Rest, Vitamin C, hot tea, stay home if you can but work if you have to. In Japan, however, the flu is always called by its full name, influenza, and always pronounced in ominous tones. People are expected to wear surgical masks when going outdoors and are almost shunned in horror. This, I'm told, is because somewhere, at some point in history, someone died from the flu. Odd, I think, because gastroenteritis, of which I myself nearly died in my early 30s, has a much higher mortality rate, and yet is included in same sociolinguistic category as the common cold: kaze, which normally describes light ailments that are not life-threatening.
I remember working on a translation of publicity materials for local hot springs with a Japanese translator; one bath was supposed to be good for what he directly rendered as 'skin diseases'. I pushed to have the phrase softened to 'skin conditions' on the grounds that Westerners wouldn't want to get into the water with people infected with contagious diseases.
Knowing what I know now, I'd have left it as diseases and left it to tourists' judgment whether they wanted to get into the hot spring.
In my aggressive search for information, I did see some sites that suggested ringworm can be spread in swimming pools and even house dust. I cannot vouch for the reputability of those sites, but I feel it is my moral duty to give as much information to the players in my campaign as possible, so that they can make informed decisions about whether or not they want to visit my house.
We took the cat to the veterinarian again yesterday, and he fearlessly touched her with his bare hands and let her rub all over him. It seems to be okay if you wash your hands afterwards. He even said it's fine to let her sleep with us. In the meantime, I'm rubbing anti fungal cream on my five spots three times a day after washing them thoroughly. There is a treatment for fabric that includes spraying it with two different chemicals and wiping it down with a third just to make sure, and this is what we're going to do with all the dining room chairs, for example. The cat was given both oral and topical treatments--we have to massage her with cream and make her swallow half a pill every morning--and she's expected to recover in a week. Diagnosis is similar for humans, although because we don't have fur our spots will still be visible for a month or so. I can't go to the beach party looking like a leper.
All this really impresses me with how inefficient are our standards of hygiene even in the 21st century. In the 14th century, living in close proximity to livestock and companion animals as so many people did, ringworm and other fungal infections, as well as myriad parasites, would have been ubiquitous. I live in a country and culture that prides itself on its cleanliness, and yet we succumb to infections like this, which make me afraid of my entire house and itch to an extent that my capacity to enjoy life is significantly reduced. Of course, the average medieval peasant would have been so covered with lice and fungus all the time that he wouldn't notice much difference.
Which brings us to the paladin.
The 2nd Edition Player's Handbook states that the paladin is 'immune to all forms of disease'. It says nothing about fungus, and as I've mentioned before, if she spends too much time in a wet saddle she'll end up with an itchy snatch. (This would amount to what, as children, used to call 'cooties'.) We'll also assume, for the sake of argument, that's she's usually got some lice. Perhaps not as much as the average Tom, Dick, and Beavis, but a few. Bear in mind that the medieval ritual of combing the hair was always done near a window, often with help so that the lice could be picked out one by one.
In other words, the average person on the muddy, feces-and-offal covered street would be used to a fair amount of itching on a daily basis. Therefore the symptoms of fungal infections or parasites would have to be pretty severe in order for penalties to THAC0 and AC to apply. Anal fistula would certainly do the trick, though athlete's foot and cooties probably wouldn't unless they reached a certain severity. This could give our campaigning party weeks to treat the problem, or at least air the skin out enough to keep it from getting too much worse too quickly.
These are all things the party should bear in mind, particularly now as the cold spell has ended and the humid summer will be soon upon them. A degree of circumspection should be applied when considering to walk about fully clothed in the rain, go for weeks without bathing, ride or wear armour for hours on end, and forego the price of a stay at an inn in favour of a straw bed where animals sleep, or an oily mattress in a roadside hospital.
In the real world, we have a session scheduled for the 18th of this month. This morning we gave the cat a double shampoo before rubbing her down with the cream as usual, and we've done our best to decontaminate the house, but as I said, you use your own judgment.