I'm building a world which is broadly a standard fantasy setting - similar to 15th to 16th century Europe in technology, government, growing urbanization and trade, etc., but with some magic. Very basic magic is common, but powerful magic is very rare. Somewhere on that spectrum is the ability to cure disease, and I'm wondering where I should put it to avoid completely overturning the setting. If most village wise women and hedge mages can wipe away the Black Death with a few incantations, that would change everything. But what would be the impact if a select few had access to such magic?

For reference, roughly half of the kings and queens of England died of natural causes, as opposed to violence or happenstance. However, I doubt that all of them would have led long lives even with a court magician on hand to cure their ails:

  • The royal wizard may not be on hand; a monarch may travel or go hunting without his full court, or the wizard may be on vacation when plague hits. Some diseases can progress very quickly.
  • If only a few and powerful mages can cure disease, a monarch will have little leverage over them. The vizier or high priest may decide not to bother healing his or her liege, if said liege has not been a good ruler/sinned before the gods.
  • Assassinations are a little easier in this world, even with the presence of friendly defensive magic. Also, if there's little hope of one's enemies politely croaking off from syphilis, there's more reason to try to arrange for them to be overthrown or assassinated.
  • Old people are more accident-prone, so an elderly king or queen who's not succumbed to any bugs may still slip in the bathtub.

A few notes on how magic works in this setting:

  • There is normally no material cost in using magic; rare objects are useful in performing spells, but are not consumed. So the main limitation in getting a cure is having or finding an expert willing to devote some time, not cost per se.
  • Powerful magic eventually warps the user in a variety of ways. This effect is much more pronounced for the most advanced spells; simple spells are mostly harmless, but a single act of creating life or de-aging a person may have a serious consequence for the caster. So more powerful spells are not only less available, but the people who can do them have good reason not to (and they have less interest in petty things like money, too).
  • Relating to the warping effect, there's a cultural taboo against using magic on or for children, even to save a life. Even if curing magic is common, a prince or princess must survive childhood before he or she can benefit from it.
  • Spells can be stored in potions or enchanted items, but this is not very practical for curing disease, as each type of infection would need a separate device.
  • There are 13 schools of magic to be mastered separately. One includes infection diseases; basically, anything caused by microorganisms. Another covers non-infectious diseases and conditions like hereditary defects or cancer, as well as wounds and aging (a student of this school could help with those slippery bathtubs). So curing plague could be a relatively common spell, but curing heart disease could be rare, or vice versa.

To summarize, I'm asking "how would medieval-early Renaissance society be changed if the 1% were effectively immune to transmittable diseases?" The ultimate goal is to help decide how common to make cure disease-type magic.

Bonus points for answers which address the impact in a few different scenarios of rarity - e.g., only a few kings can afford it; most senior nobles can arrange for a cure; all non-impoverished nobles plus successful merchants have access to such magic.

  • $\begingroup$ Is your magic something a mage is innately born with, or does it improve with study? Perhaps making cure disease a "high level" spell that healers can only learn after years of training. There are people today who suffer from ailments because there are only a handful of surgeons in the world who are able to perform the needed operation. $\endgroup$
    – Kys
    Mar 29, 2016 at 21:02
  • $\begingroup$ Good question! Magic in this world is much like any other skill; some people have a degree of talent, but mostly it's study. Greater circles of power require more study, contributing to the rarity of such magic users. It is more difficult to get training than, as experts tend to go crazy and - for that reason - it's seen as a little crazy to want to study it. It's a little like nuclear energy - known to be powerful, but greatly feared, and not without reason. $\endgroup$
    – user243
    Mar 29, 2016 at 21:07
  • $\begingroup$ All that said, I'm not too worried about controlling the availability of this class of magic. There are several methods to available, starting with simply cranking up the spells' rank and therefore the skill required to cast them. Right now, I'm focused on what the impact would be if somewhere between 1 and 100 out of every 10,000 people had access to this type of magic. $\endgroup$
    – user243
    Mar 29, 2016 at 21:10
  • $\begingroup$ Does "cure disease" interfere with gaining natural immunity? This could be particularly interesting with plagues - with the Black Death, those who survived were naturally more resistant, preventing more waves. Without that natural selection, the Black Death could have come back again and again, like how the flu (which gets around natural immunity) does now. $\endgroup$
    – Rob Watts
    Mar 29, 2016 at 22:16
  • $\begingroup$ @RobWatts: I had not considered that. My working assumption is that magic simply kills all viruses or bacteria of the type targeted, so even if the victim has not been suffering for very long, the dead fragments would still be present to key the immune system. On the other hand, if nobles get a magical cure promptly every time they get a sniffle, their immune systems may atrophy. Certainly, evolutionary pressure for resistance to plague would disappear; a noble who could no longer afford magical medical care could be in big trouble. $\endgroup$
    – user243
    Mar 29, 2016 at 22:23

3 Answers 3


All the top of head no particular order

-) Being able to survive disease would be spun as more evidence of the nobility's superior nature and right to rule. This would delay or even block the evolution of democracy.

-) Nobles might use the offer of magical cures as a means of controlling the upper tier of the population. "Behave or when your kid gets sick, I won't help."

-) If the world has a universal religion like Buddhism, Christianity, etc., then the hogging of cures might causes serious moral revulsion among the majority of the population. "Death is the great leveler," and the idea that one's taxes went to pay for keeping the King's children alive but not your own might create political blowback.

-) A mere taboo will not stop people from trying to heal their children. I can infer from you adding this to the list that you don't have children. I personally would do horrible things to almost anyone in any numbers if doing so would save the lives of my descendants. I wouldn't give a bleep about custom, tradition law, fairness, or the consequences to myself. All parents feel this way when it comes down to life or death for their children.

Steven Spielberg said of the ending of Close Encounters of the Third Kind, where Richard Dreyfuss's character left his wife and children to fly off with aliens, that it seemed credible when he was single and childless but, after he had his own kids, the character's action seemed wholly implausible.

So, if you want to prevent children from being treated, then you'll have to create an actual magical barrier that no one can get around otherwise your readers with children will be yanked out of the story.

-) Greater political stability:

-) Assured succession: In the medieval world, kings functioned like the keystone in an arch, with the most powerful nobles being the stones pressing in from the side. The king had to be militarily powerful enough to bring the greatest nobles (e.g. dukes) to heel if they started private wars, refused to obey the law, or made foreign alliances. Moreover, kings were expected to be warriors who led from the front.

Basically, the medieval world was run like the mob and the king was the godfather or, more accurately, the mob is run like medieval kingdom. In either case, the guy at the top must have troops, military skill, and will to bust the heads of the most powerful when needed.

By the medieval age in Europe, the Germanic tradition of the legitimacy of a king being conferred by election had evolved to right by inheritance. If a king died before while his crown prince was still a child or, worse, died without heir, the kingdom lost its keystone and began to fall into internal war and disruption.

Improved medical care for royalty would provide greater stability by (1) increasing the lifespan of a monarch such that their heirs would be grown adults by the time the monarch died (this would also make policy more consistent and stable) and (2) would allow more heirs to survive, providing a greater talent pool from which to select an heir.

The best example of this phenomena would be the difference between Henry V and his son Henry VI. Henry V was the most effective political and military leader of his generation, accomplishing the feat of providing year-round logistics so his armies could campaign year round instead just through the summer months. It was that, more than his use of longbowmen, that allowed him to fight his way to the throne of France.

But he only reigned for the seven years 1415-1422, dying of dysentery while on campaign and leaving only his infant son as king. At first, the great magnates of the kingdom cooperated to keep things running smoothly and, for a decade, Henry V's brother was on hand over in France to slap nobles down when needed but, gradually, the English government became more dysfunctional.

Things got worse when Henry VI actually assumed the throne. Raised in a nightmare environment where he was constantly pulled this way and that by the most powerful men in the land, by his teens he was passive and likely to agree with the last person he talked to. He was a soft, unenergetic person with virtually no physical skills at all, much less a warrior. His inability to serve as as a keystone and contain the growing feud between the Duke of Somerset and the Duke of York triggered the War of the Roses.

Likewise, Edward IV managed to bring stability back to England but he died of natural causes, likely aggravated by his obesity and gluttonous living, leaving behind Edward V, a twelve-year-old. Edward V ended up murdered by Richard III by most accounts, triggering yet more instability which eventually led to Henry Tudor becoming Henry&bsp;VII.

If Henry V had been cured of his dysentery and survived another 20 or 30 years, his brilliance might have cemented an empire of England and France. Then either Henry VI would have assumed the thrown at middle-age, having had a less insane childhood or, if he still simply lacked the right temperament, could have become a monk (which he really wanted) and one of Henry V's other sons could have taken his place.

-) More first sons, raised to be kings would assume the thrown: In English history, there are two crown princes, both named Arthur, who died of disease thereby altering history.

The first was the son of Henry VII, who died shortly after marrying Catherine of Aragon, which triggered a whole avalanche of consequences when his younger brother, crowned Henry VIII, took the throne and Catherine as his wife.

The second Arthur was the first son of James II, the elder brother Charles II and his polar opposite in all regards. Charles was short, bowlegged from rickets, had a stutter, and had be raised in Scotland under the tutelage of radical Presbyterians whom he hated all his life. He was a Francophile with a Catholic wife who sought to become an absolute monarch. Arthur was raised largely in England, was an active Francophobe who probably would not have married a Catholic, and idolized the idea of a constitutional monarch. While Charles loathed such free-spirited men as Sir Francis Drake and other sea adventures, Arthur worshipped them. Had Arthur become king, it's unlikely the English Civil War would have occurred and that the transition of England to a stable constitutional monarchy might have occurred without violence.

Of course, then there would have never been the Dutch invasion under William III and, with it, the importation of Dutch innovations like insurance and banking, but it's likely enough that would have occurred by diffusion anyway.

-) More surviving children means more alliances through political marriages. In principle this would create more stability but, with more marriages and alliances, the value of each individual marriage alliance would decrease. You might see an effect common in medieval Islam in which a Sultan, Caliph, etc. had four wives, all owing to alliances. Each alliance was weaker than those formed in the monogamous culture in Christendom.

-) No mad kings: Henry V conquered France in large part because his opposite (IIRC, Charles II) had intermittent attacks of severe mental illness. A monarchial government can deal with a dead king, a child king, and an inept king to a degree, but one that goes utterly nuts is a nightmare as no legal means exist to remove him for incapacity. Henry VI lapsed into some sort of catatonia, a waking coma, for 18 months after learning of the fall of English France. England went to pieces during his incapacitation because nobody really had the authority to rule in his place.

The downsides:

-)Too many heirs not enough land: With larger royal families, that would mean finding titles and lands for more sons. It would also mean more opportunity for jealousies to lead to arm conflict. A disturbing number of medieval nobles got whacked by their own first- or second-order kin.

Even worse, as the generations progressed, more and more people would have royal blood and thus some claim on the throne. If the immediate heirs of crown did all get killed by a sudden combination of accident and warfare, then the resulting scramble for the throne would be a dogfight.

It might lead to more expansionism, more crusading/jihad, or more exploration.

-) Possibly more inbreeding: Historical European nobility are so inbred they make the proverbial (and largely fictional) inbred hillbillies look like paragons of genetic diversity. With larger royal families, all intermarrying, the possibility of marrying too closely over successive generations increases. (Again, this was and is a problem in high status Islam. The wealthy produce a large number of half-siblings, who marry into similar families, producing another batch of half-siblings, and, since marrying cousins is still legal, genetic consequences can be severe.)

On the other hand, if you can fix those problem with magic, then maybe not.

-) Mages who could heal would become viewed as assets to be captured and controlled. Given the intense need for lineage and dynasty at all levels of society, a king is not going to bargain excessively with a mage or take "no" for an answer. He's going to say, "Cure my child and I'll let you live in a fancy estate as your prison. Don't, I'll torture and kill your entire family, all your friends and your little dog too." And he'll keep doing that until someone capitulates. Once he has such a mage, he won't let him out of his control and will probably keep him nearby.

It's likely that an institution would develop in which the mages would be considered automatic retainers or even slaves of the monarch with the innate duty to see to the royal family's health for the good of the realm. Those that didn't would be seen as traitors threatening not only the lives of the royal family but the peace and prosperity of the entire kingdom.

  • $\begingroup$ Many excellent points, thanks! You are incorrect on one, though: I do have children, three of them. While there is perhaps nothing more painful than watching them suffer through illness, I think you underestimate the power of culture. There are people who would die rather than accept a blood transfusion, after all. There are others who would abort a daughter, or sell one to sex slaves, and places where that's quite normal. Keep in mind that the middle ages saw far more death than our sheltered first world today. Losing children was still a tragedy, but it was one that happened every day. $\endgroup$
    – user243
    Mar 31, 2016 at 12:45
  • $\begingroup$ @user243 It's not that you're wrong about other societies. It's that the blasé treatment of the truly poor or of societies accustomed to the majority of children dying in infancy are almost completely alien to 1st-world readers. It would absolutely pull them out of the story and cause shifting loyalty. "They won't cure the kids? F*** 'em. They deserve to be slaves until they learn their lesson and/or figure out how to make it work." $\endgroup$
    – lly
    Jul 9, 2018 at 4:18

Culturally, very little would change. It was already believed that the touch of a king could cure disease.

That this was actually true rather than a convenient myth might prolong the reign of kings in the more revolutionary countries as it would be considered evidence of the divine right of kings to rule.

You've already limited magic to not be used on children, and the oft quoted statistics about average age at death is primarily about surviving childhood, not the actual age at which people died.

  • $\begingroup$ That's interesting; I really wasn't expecting an answer of "not much," but your point about the perceived perfection of kings is solid. What if a larger number of wealthy or powerful people had access to this type of magic? Not just kings, but most landed nobles and successful merchant princes? $\endgroup$
    – user243
    Mar 30, 2016 at 15:40
  • 1
    $\begingroup$ @JonofAllTrades, you'd end up reinforcing the stratification of an already highly stratified society. The poor are already more likely to die of their diseases, you're simply reinforcing that. $\endgroup$
    – Separatrix
    Mar 30, 2016 at 15:51
  • $\begingroup$ @user16295 Nice point in your answer! Check out my answer on this page & feel free to upvote or help back it up with edits/sources, even if just in a comment replying to TechZen. I'm not sure my response is fully satisfactory there. $\endgroup$
    – Burned
    Mar 31, 2016 at 5:33

This is in some ways similar to the modern medical system in at least the United States, where the very rich can afford very advanced and expensive treatments of diseases that would otherwise eventually kill them or severely reduce quality of life.

This is an advantage given to those who are already quite advantaged, as a result of the fact that they are already quite advantaged. Magic or benefits like that serve to widen the gap between rich and poor (which, in the extreme, can be destabilizing to a society).

Reducing the leadership turnover rate could also reduce the rate of change and innovation, if the leaders are not open to new ideas.

The presence of this technology could reduce (but not eliminate) the incentive to develop biological warfare or infection-spreading weapons, like the smallpox-infected blankets that wiped out large numbers of American natives.

  • 1
    $\begingroup$ Excellent point regarding technology! You may want to mention that on the question regarding medieval stasis (worldbuilding.stackexchange.com/questions/3953/…), it doesn't seem to have been brought up. $\endgroup$
    – user243
    Mar 29, 2016 at 22:10
  • $\begingroup$ @JonofAllTrades Which paragraph of this answer are you referring to? $\endgroup$
    – Burned
    Mar 29, 2016 at 22:17
  • $\begingroup$ Sorry, I forgot you couldn't read my mind. If leaders live very long lives, perhaps with rejuvenation in addition to being disease-free, that could indeed slow technological progress considerably. That's not what I want for my project, but it would be a great contribution to that "medieval stasis" question. $\endgroup$
    – user243
    Mar 29, 2016 at 22:20
  • 1
    $\begingroup$ @Burned - You've been lied to as there is little is any difference in the quality of health care in the US by income. This is clearly showed by the overall outcomes in major diseases in the US, regardless of income as compared to say, Britain. I was shocked to see learn that while the five year survival for prostate cancer is 100% in the US, effectively cured, that the survival rate was only 84% in the UK. That translated to 5,400 people who would have lived if they'd been Americans. The same patterns occurs in all major diseases groups and for accidents the gap is enormous. Go check yourself. $\endgroup$
    – TechZen
    Mar 30, 2016 at 21:34
  • 2
    $\begingroup$ @TechZen The National Bureau of Economic Research opens a report with, "Richer, better-educated people live longer than poorer, less-educated people." Forbes writes in a headline that "Health Care Is Different If You're Poor." The US government's healthcare disparities report has some add'l. details; income-based disparities do exist. I'm not sure how any US/UK difference is relevant here. $\endgroup$
    – Burned
    Mar 31, 2016 at 1:03

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