12 Kythorn 1484
For your reference, I have compiled this list of the most common medical issues that may arise during ceremorphosis, as well as their symptoms and potential treatments. I would advise employees of this Unit not to give up on a host mid-transformation if they are suffering from a potentially treatable ailment. Remember; these are future members of our colony, and should be treated as such. If that fails to motivate you, it is also in our Unit's best interest to increase our success rates as much as possible in order to increase the allocation of resources to our Unit in the future, as well as raise our status and esteem within the Nourisher Creed.
Condition: Fever
Signs and Symptoms: Fever is an expected sign of ceremorphosis, but increased body temperature persisting beyond the second day of ceremorphosis is abnormal and may indicate a delay in the process or overactive immune response to the tadpole. If fever is abnormally high, it may also affect the health of the tadpole or severely damage the host's brain before the tadpole takes over vital functions. In case you cannot measure body temperature, other signs of an unusually high fever include: Convulsions, excessive sweating (or abnormally dry skin if the fever has caused dehydration), premature loss of consciousness, irregular heart rate, and rapid breathing.
Treatment: A properly maintained ceremorphosis pod should allow you to adjust the temperature to a lower setting. If the fever continues to be abnormally high or long-lasting, you may remove the host from the pod and partially immerse them in cool water. In extreme cases, ice may be used to rapidly decrease the host's body temperature.
Condition: Seizures
Signs and Symptoms: Unresponsiveness, muscle spasms or uncontrolled movements, intense brain activity without coherent surface thoughts, occasional foaming at the mouth
Treatment: Seizures are relatively common during the first few days of ceremorphosis as the tadpole consumes the host's brain tissue, but are usually brief and self-limiting. Ensure the insides of ceremorphosis pods are well-padded with moss to prevent injury. Track the length of a seizure whenever possible, and note whether it is an isolated incident or occurs multiple times in succession. Intervention is indicated if a seizure lasts more than five minutes, or if two seizures occur within a five minute period. It is often possible to stop a seizure with a well-placed mind blast, since the stunning effect of the psionic surge often serves to 'reset' brain activity. Remember: If it's not working right, turn it off and on again.
Condition: Dehydration
Signs and Symptoms: Cracked lips (if the host still has lips), sunken eyes, abnormally dry skin or mucous membranes
Treatment: Raise the humidity in the ceremorphosis pod to its maximum, and keep the glass cover closed when possible. Encourage the host to drink water as often as is tolerated in the early stages of ceremorphosis. If the host is unconscious or unwilling, you may need to take direct mental control to achieve this. It is difficult and frowned upon to mentally dominate a fellow illithid, but I believe there is nothing wrong with taking control of a partially transformed host or even a newborn illithid, as long as the end justifies the means.
Condition: Internal bleeding
Signs and Symptoms: Abnormally pale skin, weak and/or rapid pulse, shallow breathing, premature loss of consciousness, severe bleeding from the mouth, nose, eyes, or anus
Treatment: Apply pressure if there is a visible source of bleeding, though there often is not in such cases. Use a healing potion if available. If no alchemical potions are available, secondary remedies include horsetail extract or nettle juice. Try to prevent unnecessary movement, and encourage the host to drink water if conscious.
Condition: Retained vestigial appendages
Signs and Symptoms: Lack of detachment or reabsorption of vestigial appendages that are present in the original host species but not in a mature illithid. These include horns, tails, digits such as fingers and toes, nose, ears, and male genitalia. Cartilaginous tissues are normally reabsorbed. Other appendages such as fingers, tails, and external genitalia usually go through a process in which they lose circulation, become necrotic, and eventually detach on the fifth or sixth day of ceremorphosis. Sometimes, however, such appendages persist in a normal or partially necrotic state. This may be due to inherent flaws in the ceremorphosis process itself, or occasionally due to outside factors such as failure to remove tight or constrictive clothing from the host. In one particularly memorable example, a male host's penis failed to detach due to the presence of a male chastity device known as a "cock cage" that held it in an unnatural position. The origin of this device was unexplained, since the host was a former thrall of Oryndoll rather than a prisoner captured from the surface. In this case, it was necessary to surgically remove the device along with the appendage in question.
Treatment: Amputation of the vestigial limbs or structures if they persist into the seventh day of ceremorphosis. Use a sharp, sterilized blade to perform any amputations. If there is a clear line of demarcation between healthy and dead tissue, amputate along this line. Otherwise, use your best judgment or consult anatomical diagrams, and be ready to deal with any bleeding that may occur. It is also important to determine when to amputate. If the surgery is performed too early, it may cause severe bleeding if circulation is not fully lost, or preventable trauma since there is still a chance the unnecessary body parts in question can detach naturally later on. If done too late, the pain of the amputation may cause a threat response and lead the newborn illithid to awaken too early, before it is fully finished transforming. In the worst-case scenario, such a newborn may sustain physical injury or psychological damage leading it to see its fellow colony members as a threat.
Condition: Choking or airway obstruction
Signs and Symptoms: Airway obstruction may occur due to anatomical changes on the fifth and sixth days of ceremorphosis, after the host's nasal passages have closed but before tentacles have reached their full length. Changes to the structure of the jaw and mouth coupled with emerging tentacles may fully occlude the host's mouth, which is particularly dangerous after the host has lost consciousness but before the tadpole has fully taken control. Symptoms include wheezing or stridor (a distinctive high-pitched sound during inhalation), or in severe cases complete absence of breathing.
Treatment: If the issue is noticed early, treatment may be as simple as adjusting the angle of the ceremorphosis pod or moving aside the developing tentacles so they do not obstruct the mouth. Remember to secure the tentacles if they fall back into place, and check back often to ensure the issue does not re-occur. If breathing has already stopped entirely, clear the airway and wait several seconds to see if spontaneous respiratory effort resumes. Psionic stimulation of the medulla oblongata in the brain stem (which is preserved even if the tadpole has already consumed the remainder of the host's brain) may cause a resumption of breathing. If all else fails, a set of bellows (stocked in the supply room next door to the pods) may be used to provide artificial respiration. If the heart stops beating or spontaneous breathing does not resume within several minutes, the host body may be disposed of as a case of failed ceremorphosis.
Condition: Early failure to thrive
Symptoms: Ceremorphosis is a physically demanding process. Sometimes, it may deplete the host body's strength or nutritional reserves sufficiently to affect the resulting illithid, but without causing death or stalling the transformation entirely. In the past, it was thought that if an illithid survives ceremorphosis at all, that means it should be strong enough to hunt and fend for itself shortly after birth (Though obviously, education is necessary to mold a newborn into a productive member of a colony.) Any early weakness or illness was thought to indicate some intrinsic defect. However, I have found significant evidence that this is not the case, and that early weakness or failure to thrive can be a temporary and reversible condition. Symptoms include: Abnormal weakness, lethargy, or confusion in a newborn illithid; difficulty standing or walking, a complete inability to levitate, and absent or garbled telepathic communication. Sometimes, mild physical abnormalities may be present, such as a newborn appearing abnormally thin to the point of emaciation, or having unusually pale or semi-transparent skin.
Treatment: This condition is often correctable with early supportive care, which includes adequate rest and hydration as well as providing additional food in the early weeks of life. I have long supported waiving the requirement for early self–sufficiency in obtaining prey, since some newborn illithids are slow to develop their abilities. I have witnessed many newborns struggle to mentally dominate a thrall, and some even have difficulty with the physical effort required to restrain a prey item and break through its skull. In many cases, a period of rest after the grueling process of ceremorphosis and the provision of several pre-killed meals within the first few weeks of life is sufficient to allow a young illithid to successfully feed itself and develop more powerful psionics later on.