The workings of the heart are simple to understand: Etherus, lascivious, spontaneous, gives spark to the throbbing of the heart, and Jeyriall, life-embracing, health-nurturing, infuses life into the blood which flows through the veins. Failure of the heart is more difficult to fathom, however. Whether the divine sway loses its grip over the heart, or some external force puts the heart into a panic, heart failure can rapidly turn fatal if healing assistance is not close at hand. People who suffer a debilitation of the heart complain of pain and difficulty breathing.

. Pain in the chest is very common in heart failure, though not all chest pain comes from the heart. Difficulty breathing and a sensation of someone sitting on the individual's chest are also common complaints, though this is not exclusively seen with heart pain. Some people report a crushing pain in their belly, neck, or left shoulder. In some instances, fainting may be the first sign of heart failure. Other signs and symptoms to watch for are bluish hue in the lips and fingertips, weaking or fluttering of the heart throbs, nausea, and a sensation of impending doom.

Thorough examination is usually sufficient to diagnose heart failure, without need of further analyses. Feeling a heart flutter through the chest wall, diminished pulsations of the blood, and difficulty breathing are often enough to arrive at a conclusion.
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Effects. Left untreated, the blood loses its fluidity, becoming sluggish, even congealing in some places. Over weeks or months, heart flutter can lead to plugs of congealed blood congesting the veins, the heart, the brain, and other parts of the body. Heart failure congests the veins as well, but in this instance the sanguine turns cool, losing its vitality and spark, and the organs of the body similarly become sluggish and cold. Both sources of venous congestion can lead to death by depriving the vital organs of the life and spirit needed to sustain life.
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Cure/Prevention. Tonic of nightshade can correct heart flutter; one drop is sufficient. A plaster of nightshade, smeared over the victim's chest, can have a similar effect. Healer Hodgerick Glassblower has suggested two pastilles of willow tree extract to be ingested immediately at the first notice of chest pangs, to relieve pain. Herbalists prepare a concoction of false heart climber vine (bleeding or burning heart), used to heal heart problems; however, if the concoction is too strong, it can cause death. Leaves of the loriv berry plant may be dried and ground, then made into a tea. This tea helps with weak hearts, and gets the heart beating faster. Sap of the tareptail weed added to cha or another hot drink relieves one of unpleasant waters and may soothe the aching heart. Finally, chewing stalks of the waterstar flower similarly mobilizes the anima to help with heart problems, and may also alleviate swollen veins of old age or pregnancy.
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Vector/Cause. According to an informal survey of White Nehtorians, heart failure is believed to be the impedance of choler on the workings of the heart, felt to affect mostly men of advanced age. In particular, humans are at greater risk than males of the other intelligent races.

A gnome healer of much esteem, Hodgerick Glassblower, of the Daran gnome population of Cavthan, wrote in his 1652 a.S. letter to Ximaxian medical philosophers:

"I do not, as do many of my colleagues, accept without some misgivings the theory that heart failure is purely an ailment of the spirit. An informal survey of people I have attended for weak'ning of the heart demonstrates a role of lack of exercise and gorging on red meats in the development of heart problems. I have not, as yet, been able to formally establish the link connecting an unhealthy lifestyle with heart illness. Nonetheless, it is my practice to always prescribe regular exercise and adding salads to people's diets in an attempt to ward off further chest pangs."

Another prevalent view is that the Malefic Grip is a malign force, a magical invisible grip inside one's chest, perhaps an imp or evil spirit sitting on and crushing one's chest. This seems to fit better than the previous explanation as to the symptoms of sudden onset of shortness of breath, squeezing chest tightness, and sensation of impending doom. It is likely that the evil being feeds on the fear and anguish it creates when it 'sits on someone's chest'.

Just as likely is the explanation that the soul of a victim of the Malefic Grip is pulled down toward the Netherworlds by an evil possessing spirit, overcoming the soul's defences. This intuitively makes sense, since those of advanced age have more wrongdoings weighing down their souls, and the vices a person enjoys in life attract evil spirits to inhabit him and take away his soul. It has even been whispered by common folk that demons pulls victims to themselves in order to chew on the tender delicacies which are human souls throughout eternity. Ximaxian demon experts refute this folk tale as rubbish.

Some clerics assert that Jeyriall is dismayed with someone who develops the Malefic Grip. Although She isn't necessarily responsible for the blood pooling and turning torpid, She may have a hand in warning the person with symptoms such as a feeling of impending doom. It is likely that some evil force puts the Malefic Grip on a person, yet there remain some educated healers who maintain that people are responsible for the choler impeding the blood flow through neglect of their health.

Finally, though there be no solid evidence upon which to base this last claim, some scholars of ailments have tended to victims who were cursed by chisel witches. These scholars claim that chisel witches are capable of devising a wooden replica of a particular victim, an effigy of a sort. The witch may manipulate this effigy, moving it with her hands to make it run, do pushups, and all sorts of exercise. The victim will experience the exhaustion, the shortness of breath, even the heart throbs he or she would feel as if they had actually undertaken such exercise.
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History/Lore. The name of this disease stems from the frightful fire magic spell Grip of the Malefic, which causes the heart of the target to stop beating, as if the target's heart is being gripped by an invisible hand. This spell paralyzes the heart of the target, preventing the distribution and circulation of one of the most vital constituents of the body, the blood. As the flash of life in the sanguine is closely tied to the element of Fire, the ability to manipulate the Fire in the blood is at once fearsome and powerful.
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 Date of last edit 4th SleepingDreameress 1672 a.S.

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