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  • Players who are at max disease will begin taking humour damage from symptoms.
  • Players who KO to a disease while it is max will Permanently die.
  • Using the wrong cure will reduce the chances of you getting cured from the correct cure.

Disease Image.png Diseases

There are four diseases you can catch in Salem either from a Rat, or from an infected dead or alive Pilgrim coughing nearby. These diseases are:

Disease Symptom Description Method of Cure
Big Pox An imbalance of the Yellow Bile Humor, it is characterized by excessive Coughing.
Character will flinch and make a distinct coughing sound when symptom strikes.
Cured by drinking Willowbark Tonic icon.png Willowbark Tonic.
Frontier Flux An imbalance of the Phlegm Humor, it is characterized by Vomiting.
Character will flinch and make a distinct puking sound when symptom strikes.
Cured by taking a dose of Columbine Paste icon.png Columbine Paste.
Land Legs An imbalance of the Black Bile Humor, it is characterized by extreme Dizziness.
Character will flinch without making a sound when symptom strikes.
Cured by sniffing Smelling Salts icon.png Smelling Salts.
Maroon Fever An imbalance of the Blood Humor, it is characterized by a splitting Headache.
Character will flinch and make a moaning sound when symptom strikes.
Cured by applying a Leech icon.png Leech to the shirt equipment slot, allowing it to drain some blood.

Disease can also be contracted from the Cozy Blanket icon.png Cozy Blanket, a 'gift' from the developers, one to each player. They are sometimes gifted to unsuspecting newbies.

NOTE: Players may not be allowed to enter the Providence Church if they have a disease.


[1] This video can help you identify your symptoms.

All four diseases will exhibit all four symptoms randomly, but one symptom will be more common than the others.

In the beginning, it is difficult to tell which disease has actually been contracted. As time passes, the disease will become more and more serious, the symptoms occurring more frequently. The worse the disease gets, though, the easier it is to figure out which symptom is the most common and therefore find the correct cure.

Be careful however as taking the wrong medicine will lower the chance of the right medicine curing the disease! Keep in mind though that it can take more than one dose to actually cure a disease even if no incorrect medicine have been taken beforehand. Once the disease bar is full, you will be dealt permanent humour damage and once a humour reaches 0, you permanently die.


It is possible to avoid infection in most cases and not have to worry about curing Disease. Rat bites can cause disease, but as rats only live in the Darkness and Twilight, they can be easily avoided by most players.

The Plague Doctor's Masque icon.png Plague Doctor's Masque and the Miasma Masque icon.png Miasma Masque can greatly reduce risk of infection from other Pilgrims. Only the Coughing symptom is contagious and the masks filter out the bad air.

Drinking Berry Juice will also provide immunity for a period of time.

Those who are infected can equip a Silk Hanky icon.png Silk Hanky in their hand to avoid infecting others.