You don't need a weatherman to know which way the wind blows.
-Bob Dylan, "Subterranean Homesick Blues", 1967
US singer & songwriter (1941 - )

Warm in places, with scattered showers.
-John Kettley, Weatherman

Bowel Runs of the Stars

A common complaint heard by drunken critics when watching action movies and the like is this:

"If this is meant to be so realistic, why doesn't anyone ever go to the toilet?"

The same is true of roleplaying games. Aside from the token presence of a single latrine room in the corner of the dungeon, how often do you see man's lower functions accounted for in gaming?

Make no mistake - your bowels hold a veritable gold mine of story hooks to dig into. By the end of the next two articles I guarantee that you will be convinced that your bowel motions are interesting and exciting!

Probably.

Going Through the Motions

Broadly, normal human bowel habit is often defined as anything from once every three days to three times per day. Also, normal human bowel habit is, by its very nature, entirely irregular.

A paragon of perfect vegan health may have one motion every day at exactly eight in the morning, but most of us suffer considerable faecal variation as a reflection of the rigours of life.

The main determining factor to bowel habit is nutrition - what we eat and how we eat it effects what comes out the other end. However stress, dehydration, exercise, alcohol and the menstrual cycle can be reflected in our bowels, as can almost any environmental or biological influence.

In a roleplaying game the presence of alien or fantasy races can mix things up even more. If an average hobbit enjoys six meals a day, drinks copious ale and stands between two and four feet tall, then Bilbo had better provide adequate facilities at his birthday party! Likewise, who is to say what might be the laxative effects of quaffing eight Cure Light Wounds potions in a row?

An inventive GM can create scenarios where the natural waste output of a group of people becomes a serious issue. A medieval city under siege will start to poison itself in its own effluent. For a group of colonial marines trapped by Aliens in a small airlock for three days straight, the ammo cache is not the only dump that will weigh on their minds.

The dirt and grime of a character's defecations can also be used as window dressing to drastically change the mood of a scene. Imagine the archetypal princess being rescued from her tower cell, and then imagine overflowing slop buckets in the corner, the rank smell of old faeces and the buzzing flies. Romantic fantasy is transformed into WFRP in one scatalogical step!

When Bowels Go Bad

There is an entire speciality of medicine (gastroenterology) focused on bowels going bad, and many bowel dysfunctions can lend themselves to RPG stories.

As usual, there is a time and place for applying bowel-related stories. Nobody wants to hear that their Solar Exalted general has constipation from his week's forced march, unless of course they have recently spent XP on a Bowel-Cleansing Prana. On the other hand, application of bowel-related themes can introduce a certain level of realism and detail to grittier stories.

Diarrhoea

Diarrhoea is defined as the passage of more than 300g of stool in a day. Of course, unless your player characters are in the habit of weighing such things (maybe in D&D, where such differences in encumbrance could be critical) this isn't a very useful definition in-game.

Diarrhoea is normally associated with increased frequency of stool passage as well, and a softening of consitency. Sometimes there is faecal urgency (running to the toilet clutching your bottom) and sometimes leakage.

Most commonly diarrhoea is due to infection, though there are other causes. Laxative abuse, irritable bowel syndrome, inflammatory bowel diseases and cancer can all cause changes in bowel habit.

For those with a British sense of humour diarrhoea has great comedy value, but it should be remembered that it is potentially a killer. Worldwide, an estimated one thousand children die every day from diarrhoea.

Diarrhoea dehydrates, it stops nutrients being absorbed and it generally weakens the whole body. The very young and very old are most vulnerable, as they have less physiological reserve generally, but diarrhoea can kill anybody. For those of you aiming for a gritty medieval style (I'm looking at you WFRPers again) you could do a lot worse than considering cholera, campylobacter, shigella dysentry and e. coli.

Cholera, for example, is caused by the organism Vibrio cholerae. It's found in contaminated drinking water, particularly from shallow wells. Chlorination deals with it quite effectively, but in many rpg settings this level of sanitation simply does not exist. In a true medieval setting for D&D, a cleric's most useful spell is not Cure Light Wounds but Purify Water.

With Cholera it is not so much the bug itself which causes diarrhoea, but the endotoxin that the bug produces. Cholera toxin gets into the cells on the wall of the small intestine, and (via activation of adenyl cyclase) causes massive secretion of salt and potassium into the bowels. Water follows salt, and as a result the bowels are filled with a soup of nutrients that belong in the body but which end up in the motions.

Cholera is rapidly dehydrating and untreated is one of the most rapidly fatal infectious diseases known to man.

With adequate and rapid rehydration (normally oral, but sometimes intravenous) the death-rate can be knocked back to less than 1%, but the frail (again, young children and the elderly) can sometimes fail to survive the initial dehydration.

In game terms, a lot of drama can be found by inflicting a PC or DNPC with a cholera-like illness. The key issue to survival becomes getting copious amounts of fluid into the system (which is a good treatment for most diarrhoeas). Descriptions of passing "rice water stools" in great gushes should panic the most steadfast player, and as dehydration builds the individual will become increasingly unwell. Vomiting may occur as well, with a similarly soup-like consistency. Once this "evacuation phase" is over, the character will then enter the "collapse" phase as the sodium and water washout takes effect.

With moderate dehydration (5-10% of fluid total) the character will have sunken eyes, dry mucous membranes (eyelids, mouth, nose), dry skin, dark concentrated urine and a faster heartbeat. Though its obvious, don't forget to describe the sensation of thirst in detail to your players.

With severe dehydration (>10% of fluid total) blood pressure will start to drop, and urine output will fall to a minimum. With cholera in particular features of circulatory shock will come on quickly, with extremities turning blue.

In most cases of severe dehydration you also get the effects of increasing sodium concentration (because there's less water around to dissolve it in), most notably diminished conscious level, confusion and even hallucinations and coma. However because cholera flushes out sodium first and water second, you end up with the opposite effect of low sodium concentrations. These effects include headaches, irritability, personality change and severe muscle cramps. If sodium gets very low, then the symptoms can start to mimic those of pure water-only dehydration (confusion, coma, drowsiness and death.)

Finally, if given lots of water and sodium replacement, the character will gradually recover over a period of 1-3 days.

So how does this all come together into a story? How does knowing about cholera make for an interesting and engaging RP experience? Permit me, if you will, to give a little example...

It's been five days since we rescued milady from the tower, and four since we stopped at the shallow well so she could clean the dirt from her skin and drink a little to regain her strength. Now, I think she's dying. The depredations of the tower meant she was a shadow of her former beauty when we rescued her, but now... now she looks almost corpse-like.

The healer told us to give her plenty of clean water, with a spoonful of sea salt and cane sugar in each tankard. That makes little sense to me, as her body seems to be expelling the grey fluid as fast as we pour it into her.

She moans in pain occasionally, from the cramping of her muscles. When we move to comfort her she mutters half-formed obscenities and weakly pushes us away. Now the waterskins are empty again, and the nearest town is full of the duke's soldiers. Brengar, my mercenary companion, thinks that we should take a sword to her throat and tell her Lord that we failed to rescue her. He says it would be a saner route than trying to steal water from an area so heavily fortified.

I am tempted to agree.

See? Diarrhoea can make for moral conflict and engaging storytelling, and can be the gateway to bowel-themed adventure!

It needn't just be NPCs who are killed by diarrhoea either. If you put your players into the position of severe dehydration, they are forced to struggle for survival, and you can really stretch your storytelling muscles in describing the hallucinations and symptoms.

Next time we'll look at some more bowel-motion related problems that you can use in your games.

Till then, happy gaming, and don't forget to boil your water!