TEXT: 1
  Tickets-of-Leave are small 
  self-contai ned addi ti ons 
  to the Convicts & Cthulhu 
  setti ng for Lovecraftian 
  roleplaying in the early 
  penal colonies of Australia. 
  Each includes a selection 
  of game elements which 
  c a n  e i t h e r  b e  u s e d 
  collecti vely as a thumbnail 
  sketch of a scenario, or 
  can be used in isolation 
  to  p rov i de p i e c es t ha t 
  enhance a scenario of your 
  own invention.
  CREDITS
  Ticket-of-Leave #11  is written by 
  Geoff Gillan & Dean Engelhardt; 
  original artwork by Reuben Dodd. 
  Copyright © 2018. Published by 
  Cthulhu Reborn Publishing .
  (w w w. c t h u l h u r e b o r n. c o m)
  The Convicts & Cthulhu setting 
  is published by Cthulhu Reborn 
  Publishing and is available via 
  RPGNow and DrivethruRPG as a 
  “Pay-What-You-Want” title.
  This PDF uses trademarks and/or copyrights 
  owned by Chaosium Inc/Moon Design 
  Publications LLC, which are used under 
  Chaosium Inc’s Fan Material Policy. We are 
  expressly prohibited from charging you to use 
  or access this content. This PDF is not published, 
  endorsed, or specifically approved by Chaosium 
  Inc. For more information about Chaosium Inc’s 
  products, please visit www.chaosium.com.
  11
  Introduction
  Investigators in Lovecraftian roleplaying games 
  cross paths with the medical profession with an 
  almost-alarming frequency. Whether it’s the need for 
  emergency treatment following a confrontation with 
  ne’er-do-wells, or unearthing the nefarious misdeeds 
  of would-be Herbert West types, investigators often 
  find themselves in the company of doctors. In the 
  penal colonies of early Australia, medical treatment 
  was frighteningly primitive even by the standards of 
  the day — and yet this is the only option available to 
  most characters in a Convicts & Cthulhu campaign.
  This Ticket of Leave provides an overview of medical 
  practice in the colony of New South Wales, describing 
  the dire state of medical supplies from England as well 
  as the historical Surgeons of the penal settlement. It 
  also provides a medical-themed tale of darkness and 
  horror, set in and around the hospital at Parramatta.
  While certain medical practitioners in the Colony 
  were coming to recognise the efficacy of traditional 
  Aboriginal medicine (“bush medicine”) and the 
  importance of knowledge of the medicinal and healing 
  properties of plants which were to hand in New South 
  Wales, most still relied on European methods. That 
  meant a reliance on concoctions made from European 
  ingredients, often prepared in England and shipped to 
  the colony to be administered in a European fashion. 
  Practitioners also relied heavily on European medical 
  books, which were rare items in the colonies.
  The Dispensatory Of 
  Doctor Macdead
  
  2
  To say that the colonies were poorly-supplied with 
  medicines and medical equipment would be a gross 
  understatement. Indeed, the colony's medical needs 
  were largely ignored altogether by the Colonial Office 
  in London. In February 1808, Colonial Surgeon 
  Thomas Jamieson wrote to the Colonial Office (with 
  the approval of Governor King) to request much-
  needed basic medicines and other medical supplies. 
  No such supplies materialised, meaning that three 
  years later he was forced to send the exact same 
  request (under the new Governor, Bligh) for the exact 
  same material. Clearly the medical care offered half a 
  world away to convicts and military gaolers was not 
  considered a high priority.
  The Colonial 
  Medical Service
  “a country and place so forbidding and so hateful as 
  only to merit excretion and curses...there was not a 
  single article in the whole country that in the nature of 
  things could prove of the smallest use” 
  — Principal Surgeon John White, quoted in  
  Cummins (see references)
  The doctors and surgeons of European Australia 
  are overseen by the Colonial Medical Service. The 
  medical service was original established by four of 
  the nine doctors sailing with the First Fleet — John 
  White, William Balmain, Thomas Arndell and Denis 
  Considen. Later, Thomas Jamison, then a surgeon's 
  mate, and John Irving, a convict who had shown 
  considerable medical talent on his voyage out, were 
  added to the initial roster of naval surgeons.
  The Colonial Surgeons provide medical treatment 
  to all residents of the colony including military, 
  civil, convicts, emancipists and even sailors from 
  ships who came into port. They sometimes treat 
  Aboriginal people, although these by-and-large 
  prefer their own healers.
  Additionally, Colonial Surgeons are expected to 
  supervise floggings and to attend executions. They 
  also act as part of medical boards convened for 
  specific occasions (see below). During most of the 
  Convicts & Cthulhu era, surgeons — as upstanding 
  members of the colony’s upper echelons — are 
  expected to also serve as magistrates when not 
  practicing their art.
  The standard arrangement during this period is 
  for the Colonial Medical Service to always supply 
  three serving medical officers for the colony at 
  all times, with a fourth being on leave. This small 
  group is expected to oversee the medical treatment 
  of thousands living in New South Wales.
  The surgeons initially worked only at the Sydney 
  Hospital (described in the core Convicts & Cthulhu 
  book), which was initially a makeshift affair of rough 
  buildings and tents with sometimes brutal convict 
  nurses. Governor King rationalises the service in 
  1806 and creates one Principal Surgeon and one 
  Assistant Surgeon in Sydney and one Assistant 
  Surgeon at Parramatta, Coal River and Norfolk 
  Island respectively.
  Questionable Practitioners
  The public has limited access to skilled medical 
  practitioners and there is not much oversight of 
  those wishing to set up private practice, meaning 
  patients often fall into the hands of charlatans, well-
  meaning or otherwise. No strong scrutiny exists 
  for medical practitioners coming from London: as 
  late as 1814, the Governor of the day (Macquarie) 
  proposes the need to establish tests of competence 
  to ensure doctors sent out by the Colonial Office 
  are properly skilled.
  It isn’t only dubious 'doctors' sent from England 
  that have caused the ranks of questionable medical 
  practitioners to swell. Some among the colony (free 
  settlers or convicts who had obtained a Ticket of 
  Leave or served out their sentence) see opportunity 
  in setting up shop to treat the ill and injured. 
  In New South Wales there is no real formality 
  around the medical trade until 1801 when a three-
  person board is convened to determine a person's 
  fitness for joining the Colonial Medical service. 
  These ad hoc boards are made up of respected 
  medical staff, such as Colonial Surgeons and their 
  assistants. In addition to deciding whether an 
  applicant is fit to serve as a doctor for the colonial 
  government, these boards are also convened to 
  investigate medical problems (or unusual medical-
  related events), or to deal with emergencies. These 
  medical boards do not regulate private practice: 
  anyone who wishes to start up on their own is 
  not impeded or investigated, unless some obvious 
  malfeasance is suspected.
  
  3
  Sample Colonial-Era Medicines and their Uses 
  (from the schedule of Medicines)
  The list nearby shows the range of medical supplies 
  requested for the colony in 1807. It includes many different 
  substances, but these fall into two main groups — the 
  “Simples” and items created by “Mechanical Operation”. 
  The former include herbs, roots, leaves and sprouts usually 
  of a European nature. The latter are medicines which have 
  been manufactured by work with combining or separating 
  substances, resulting in compounds or other substances 
  that are not occurring in nature.
  Many of the substances on the list were evidently 
  prepared in England and sent out as premade compounds. 
  The fact that the same list of items was still needed three 
  years later suggests that there was no significant chemical 
  knowledge in the colony to allow items to be synthesized.
  Some examples of how these substances were used:
  • 
  Acids — anything listed on the schedule with the 
  annotation “acidum”. These medicines are used 
  primarily as purgatives, but also used for other 
  forms of treatment. For example, the vapours of 
  Acidum Muratium are considered effective against 
  contagion (although must be used with care, since 
  they are also known to sometimes be lethal).
  • 
  Irons — anything listed on the schedule with the 
  annotation “ferrum”. These are medicines contain-
  ing high concentrations of iron, and are used to treat 
  haemorrhoids, diarrhoea, vomiting and fevers.  
  • 
  Salts — anything listed on the schedule with the an-
  notation “kali”. This group of medicines represent a 
  family of salts that can be used as a chalybeate (a kind 
  of mineral water which is believed to promote health).
  
  4
  An Unworthy Rabble
  All Governors and Surgeons throughout the 
  Convicts & Cthulhu era are frustrated by the 
  seeming indifference and consequent inaction of 
  the Colonial Office where it comes to the health 
  of the Colony. Governor William Bligh has an 
  especially combative relationship with the Medical 
  establishment during his tenure as Governor 
  (admittedly this is hardly surprising, given he 
  seems to manage a combative relationship with 
  around half the colony). Bligh believes there are 
  not enough doctors, and is frustrated that those 
  who are charged with looking after the health of 
  the colony appear to be more interested in trade 
  and profit than healing.
  The doctors themselves are also frustrated, 
  especially with the lack of supplies and other 
  support from the Governors and the Colonial Office 
  in London. This is compounded by the Colonial 
  Surgeons' obligation to attend to sick settlers and 
  others not victualed by the crown without being 
  paid a fee, a situation that will not be rectified until 
  well after the C&C era.
  The Colonial Surgeons
  Short NPC capsule summaries are provided below 
  for several of the major historical figures associated 
  with medical treatment in the early colony at 
  New South Wales. In addition to these, further 
  information about NSW Corps Surgeon Dr. John 
  Harris may be found in Ticket of Leave #10 (along 
  with an adventure featuring him and a fictitious 
  junior surgical assistant).
  John White 
  (NSW Colonial Surgeon: 1788—1794)
  White was born in 1757 and had been a surgeon's 
  mate in the Navy since 1778. He was made surgeon 
  in 1781 and was recommend for Botany Bay by 
  his Captain, Sir Andrew Snape Hammond, while 
  serving as Ship's Surgeon on the HMS Irresistible. 
  White came from a wealthy family and was notably 
  aloof. After assuming his role as NSW Colonial 
  Surgeon White fought Australia's first pistol duel 
  against his own subordinate, Dr William Balmain. 
  Both duellers were injured and the duel suspended, 
  although the antipathy between the men continued 
  for years afterwards.
  White was especially challenged by the starvation 
  conditions of the early colony and the rampant 
  sickness of the convicts of the Second Fleet. 
  However, by the time he resigned his post and 
  returned to England in 1794 he had lowered the 
  sickness rate in the colony considerably.
  White's 1790 book, Journal of a Voyage to New 
  South Wales, which included many illustrations 
  of native plants and animals, was a major success 
  in Great Britain. (The book is available free at 
  Australian 
  Gutenberg: 
  http://gutenberg.net.au/
  ebooks03/0301531h.html).
  After his time as Colonial Surgeon, White continued 
  to serve in the English Navy as surgeon on ships 
  and at Sheerness Naval Yard. He retired to Brighton 
  where he died aged 75 in 1832. He left behind his 
  wife and three children to her, as well as a fourth 
  child Andrew, born to convict Rachel Turner in 
  Sydney and who was brought up in England in 
  White's household. Andrew White later joined the 
  Royal Engineers, fought at the Battle of Waterloo, 
  and returned to NSW where he lived in Parramatta 
  with his mother from 1823 until his death in 1837.
  William Balmain
  (NSW Colonial Surgeon: 1795—1801)
  Balmain was born in 1762 in Scotland. He served in 
  the Navy as surgeon's mate before being chosen for 
  NSW. He was White's third assistant and his abilities 
  as an administrator were often eclipsed by his irascible 
  temper, his argumentativeness, his quickness to take 
  offence and his tendency to clash with his superiors 
  (see his duel with White, above, as an example).
  
  5
  After falling out with White, his superior, Governor 
  Phillip transferred Balmain to Norfolk Island to 
  ease tensions between the men. However, when 
  he returned to Sydney in 1795 having won the 
  trust and support of the new Governor (Hunter), 
  he continued to be ill-tempered. Indeed, on one 
  occasion the irascible Balmain accepted the 
  collective challenge to duel the entire NSW Corps 
  (one after the other!) — although this insane act of 
  bravado was later called off. Balmain argued with 
  John Macarthur over the treatment of a medical 
  orderly and nearly provoked a duel when he called 
  him to his face “a base rascal and an atrocious liar 
  and villain”. 
  Balmain 
  involved 
  himself 
  in 
  trade 
  and 
  agriculture, including the trade in rum. For all his 
  troublesomeness he worked tirelessly as surgeon 
  and magistrate and was one of the early advocates 
  for legal reform of the colony's systems.
  Eventually, he became disenchanted with Governor 
  King and returned to England in 1801 where he 
  died in 1803. He left his wealth to his three children 
  and to his de facto convict wife, Margaret Dawson 
  and their three children.
  Thomas Jamison
  (NSW Colonial Surgeon: 1802—1811)
  Born in Ireland in 1753, Jamison was Surgeon's 
  Mate on the First Fleet and acted as surgeon at 
  Norfolk Island until 1799. In 1801 he succeeded 
  William Balmain as Colonial Surgeon, but owing to 
  a delay in returning from leave in England he did 
  not take up the position until 1802.
  Jamison led the team which carried out the first 
  successful vaccination against smallpox in NSW. 
  Jamison was dissatisfied with the support he 
  received both from his assistants (he tried to 
  court martial two of them but failed) and from the 
  Colonial Office in terms of supplies and staff.
  Though he worked successfully under previous 
  Governors, he fell afoul of Bligh who considered him 
  too interested in trade at the expensive of medicine and 
  claimed he was “not an upright man”. Jamison allied 
  with Macarthur against Bligh in the Rum Rebellion 
  and served under the Rebel Administration.
  Jamison had many mercantile interests but was still 
  a notably competent official. He died in London 
  A Campaign Frame: 
  Investigators of the Colonial 
  Medical Service
  The upcoming release of the Convicts & Cthulhu 
  RPG will feature the notion of “campaign frames”, 
  frameworks for running sequences of scenarios linked 
  by a common theme. These offer quick and easy ways 
  for both Keepers and players to make use of different 
  aspects of the colonial prison setting to create games 
  with a particular flavour.
  The Colonial Medical Service offers a tempting ba-
  sis for a campaign frame, one in which players take on 
  the roles of investigators attached to either the Sydney 
  or Parramatta Hospital (or even one of their ad hoc 
  boards) and sent out to look into medical “anomalies” 
  that have been reported. 
  Investigators could be surgeons themselves, or 
  assistant surgeons working for the Colonial Medical 
  Service. Alternatively, they could be private medical 
  practitioners who have been asked to assist or consult. 
  Military doctors — such as those attached to the NSW 
  Corps or from naval vessels, stationed in the colony or 
  visiting — would make for another fine character option.
  Players who aren’t interested in playing medical 
  practitioners might take on the role of non-medical 
  members of one of the ad hoc boards. These groups also 
  include religious ministers, powerful merchants, and other 
  upstanding members of the community, any of which 
  would could be used as an investigator background. 
  While most doctors and board members are men, 
  this isn’t universal — players who wish to play female 
  investigators might play convict women serving as 
  nurses or influential women free settlers.
  Convict men are sometimes also involved in such 
  deliberations — perhaps because of their medical 
  knowledge (there are historical examples of this), 
  perhaps simply to act as strong backs and willing hands. 
  Aboriginal characters are also possible, representing 
  the ever-present need for diplomats or guides when 
  venturing out into the less-developed parts of the colony.
  The investigator party would most likely report to 
  the Colonial Surgeon but may also report directly to the 
  Chair of a Board. Their investigatory remit could be very 
  broad and encompass any mystery or strangeness with 
  a medical aspect including strange illness or reports of 
  contagion or disease. They could take investigators to 
  virtually anywhere in the Colony, including on board 
  visiting ships. See the introductory scenario in the core 
  Convicts & Cthulhu book (“Un-Fresh Off The Boat”) for 
  an example which touches on several of these themes. 
  
  6
  in 1811 leaving his widow Rebecca, their son and 
  two daughters, as well as five daughters to convict 
  Elizabeth Colley on Norfolk Island and another 
  son to convict Sarah Place.
  The Hospital at Parramatta 
  “I do not believe that there was ever such a place for 
  want, debaucheries and for every vice as the general 
  hospital at Parramatta” 
  — Reverend Samuel Marsden in a letter to the 
  Colonial Office, 1818.
  The scenario which forms the second half of this 
  Ticket of Leave revolves around the Parramatta 
  Hospital. In the Convicts & Cthulhu era this is 
  a relatively newly-constructed building, which 
  replaces a much more primitive facility.
  Parramatta's First Hospital was the 'tent hospital' 
  which operated between 1788 and 1792; this was 
  not actually a tent but two long thatched buildings 
  vaguely tent-shaped which accommodated 200 
  patients. With the population of Parramatta growing 
  larger than that of Sydney a more permanent 
  building, with improved conveniences, was desired.
  The C&C era hospital — a cluster of clay brick 
  buildings, plastered and whitewashed — was built 
  in 1791, and the patients removed to it in December 
  of that year. In all, the hospital includes two wards.
  Unfortunately, because of shortcomings in the 
  building materials — the bricks are lacking 
  limestone and are hence crumbly – the hospital 
  has already become quite dilapidated. It will 
  ultimately be demolished a decade or so after 
  the C&C era. Historical detail about this hospital 
  are sketchy, and largely come from work by 
  archaeologists who have only recently uncovered 
  the building’s foundation stones. A rough map of 
  the hospital (based on as much historical data as is 
  known) appears nearby.
  The Hospital Buildings
  All of the buildings are constructed from clay bricks, 
  with plaster and whitewash over them, but all are in 
  a state of disintegration owing to the lack of limestone 
  in the mix. The buildings have low ceilings and no 
  lights. There are no locks or bolts on any door, 
  meaning people can come and go as they please.
  Map of Parramatta Hospital
  The following buildings sit within the hospital 
  grounds (see the map for positions):
  • Two Ward Rooms (one Male and one 
  Female): In theory no fraternisation is 
  permitted between the sexes but in practice 
  this is difficult to police. The wards are badly 
  crowded and conditions are foul. The windows 
  are broken and the roof leaks whenever it 
  rains more than just a little. Stores are kept 
  at one end of the ward room but there is little 
  here except the very basic staples and often 
  not even these (rice and tea are especially 
  missed by patients). It is not uncommon for 
  dead patients to be left for a time in their beds, 
  since the hospital has no mortuary.
  • Two Guard Huts: these sit next to the ward 
  rooms. The guards are usually convict overseers 
  and on rare occasions NSW Corps soldiers.
  • Dispensary: Here drugs and medicine are 
  stored, but there is little enough of these, 
  with many empty shelves. Like the other 
  buildings this building cannot be locked, so 
  there are routine thefts.
  
  7
  • Two Convict Huts (one Male and one 
  Female): These are accommodation for the 
  convicts assigned to work in the hospital. The 
  buildings are as run-down as any of the others.
  • Two Surgeons’ Buildings: These are 
  accommodation for the Parramatta Surgeon 
  and his assistant. They comprise living 
  quarters for when the surgeon is attending, 
  as well as an office and a surgery. (It should 
  be noted most surgeons also maintain 
  private residences elsewhere, so these 
  accommodations are not always used.)
  The Hospital Staff
  The hospital has one surgeon and one assistant 
  surgeon. Its nurses, overseers, wardsmen and 
  gardeners are all assigned convicts. Often the 
  convict men are somewhat frail (being specimens 
  too old or decrepit to perform hard labour 
  elsewhere). Usually the women are assigned to 
  hospital duty as punishment for misconduct. Both 
  of these factors lead to the quality of care not being 
  very high. Indeed, settlers have reported that some 
  patients must be forced to attend the hospital 
  against their will.
  Scenario Seed: 
  The Dispensatory of 
  Doctor Macdead
  This scenario seed takes place mostly in and around 
  Parramatta, with a likely excursion to the secondary 
  penal settlement at Coal River. It concerns itself 
  with events surrounding an evil medical book 
  used by a dubious medical practitioner to perform 
  some terrifying and disgusting … alterations. The 
  scenario can be set any time after the building of 
  Parramatta Hospital in 1792, although if the Keeper 
  wishes to run it prior to 1801 (when Coal River was 
  established) he or she will need a substitute location 
  for the secondary place of punishment (e.g., the 
  Hawkesbury River).
  Parramatta and Coal River are described in the core 
  Convicts & Cthulhu book; Hawkesbury River will 
  receive a more detailed treatment in the upcoming 
  standalone Convicts & Cthulhu RPG.
  Keeper's Introduction
  Doctor James Macdead is a medical charlatan, 
  sentenced to transportation in London as punishment 
  for forging cheques from patients. Macdead had 
  accrued a little medical knowledge from helping a 
  ship's surgeon in his youth, and had enough knowledge 
  to perform minor medical treatment successfully and 
  pass off a lot of bafflegab as medical knowledge. While 
  his dubious treatments did no immediate harm to 
  patients, his conniving ways did have the unfortunate 
  side-effect of encouraging patients to leave their 
  ailments untreated by reputable doctors. In this way 
  he probably contributed to numerous deaths.
  Surgeons of Parramatta
  The Keeper’s choice regarding when he or she 
  wishes to set the scenario will dictate who is currently 
  serving as head surgeon at Parramatta. The historical 
  figures are described briefly below.
  1788—1792: Thomas Arndell. Navy surgeon 
  and assistant colonial surgeon. Was later made 
  apothecary at Parramatta (1798) and was a farmer 
  and grazier. Was a government loyalist and later fell 
  out with both military interregnums of Grose and 
  then the Rebel Administration.
  1792—1795: John Irving. A First Fleet convict 
  who was also considered the best surgeon in the 
  colony until his death in 1795.  
  1796—1802 (approx.): John Harris. Harris 
  was a surgeon and farmer as well as magistrate and 
  controller of the police in Sydney, all while attending 
  to his medical duties. He later became a bitter enemy 
  of Bligh. (See also his write ups in both the core C&C 
  book and Ticket of Leave #10).   
  1802 (approx.)—1808: D'Arcy Wentworth. 
  Wentworth was a colourful figure from an 
  impoverished aristocratic family who came to 
  the Colonies to avoid being arrested for highway 
  robbery. He later became NSW Colonial Surgeon 
  (under Governor Macquarie) and was known for 
  his tenderness to the ill, especially children. A tall 
  handsome Irishman, his friendship with Jane Austen 
  has led literary historians to speculate he may have 
  been the original of Mr Darcy in Pride and Prejudice.
  1809—1813: Edward Lutrell. Lutrell came to 
  the colony with his wife and 10 children but disliked 
  the medical profession and was considered an indif-
  ferent if not negligent surgeon.
  
  8
  Macdead is, however, quite a clever man 
  and managed to accrue some genuine skill in 
  pharmacology prior to his arrest and sentencing. 
  On his arrival in NSW he promptly began to treat 
  people and achieved some minor popularity as an 
  able convict medical assistant in a colony short on 
  medical knowledge.
  When eventually he attained his ticket of leave, 
  Macdead set up shop in Parramatta and began 
  to once again ply his somewhat dubious medical 
  trade. One of the first things that he did was to 
  send word back to family in England that he was in 
  need of the modest library of medical texts that he 
  had assembled (or perhaps stolen) over the years. 
  His London relatives were only too eager to satisfy 
  this request, boxing up the mouldy old tomes and 
  paying to have them shipped on the next vessel 
  bound for Botany Bay.
  Macdead’s collection reached him (eventually) 
  in Parramatta, along with a crate of old medical 
  apparatus. Both books and tools are a rarity in the 
  colony and go a long way towards lending the hoaxer 
  a (totally unwarranted) sense of trustworthiness.
  However, when Doctor Macdead received his 
  medical library he also received something else — 
  something unexpected and unearthly. In among the 
  box of tomes was a book titled 'The Dispensatory 
  of the Damned', a book which Macdead cannot 
  remember ever obtaining. Outwardly it resembles 
  a common pharmacopeia or dispensatory, but this 
  is just a disguise. In fact, the tome in question is 
  not a real book at all, but a malevolent alien horror 
  masquerading as a book.
  The Corruption of 
  Doctor Macdead
  Although mystified by the inclusion of the unexpected 
  dispensatory in the crate, Doctor Macdead was not 
  one to pass up an opportunity to profit from someone 
  else’s error (or alternatively as he rationalised it, the 
  munificent gift of some random stranger). Thus, James 
  Macdead studied the book, while simultaneously 
  growing his practice in Parramatta. The alien horror 
  inside the book slowly gained a hold on him, at first 
  dominating his dreams and then his waking thoughts. 
  Soon, Macdead was little more than a puppet to the 
  Thing in the Dispensatory.
  The book had its own sense of purpose, and soon 
  it compelled Macdead to obtain raw materials and 
  blend them using techniques written in its pages 
  to make dark and unnatural chemical compounds. 
  These he began to use in the treatment of patients, 
  with increasingly terrible results. People treated with 
  the medicines brewed using The Book’s dark arts 
  began to transform … growing strange appendages, 
  and in some cases warping their very form. These 
  changes are not mere random effects, but rather are 
  a part of a complex Mythos-related plot to open a 
  bridge to elsewhere, to ultimately allow a baleful 
  horror entry into our world.
  The Best-Laid Plans ...
  While James Macdead’s actions set in motion the series 
  of monstrous transformations, he has not been able to 
  personally see the fruits of his labours. Three weeks 
  ago, he was caught forging a promissory note. As a 
  Ticket of Leave convict, discovery of such a misdeed 
  has been punished by the Colonial government, swiftly 
  and harshly — Macdead was immediately sentenced 
  to a period of punishment at the (notoriously harsh) 
  convict mining camp at Coal River.
  Before departing for his punishment, Macdead 
  had enough presence of mind to entrust The Book 
  to someone reliable (or perhaps the book itself 
  compelled him to do so). He chose to leave it with 
  his convict mistress, a girl named Maggie Miles, 
  who works as a nurse at the Parramatta Hospital. 
  A sly young woman, Maggie has decided to hide 
  the medical tome in among the small collection of 
  medical texts already at the hospital in a storeroom.
  In the weeks since, Macdead has slowly gone 
  increasingly insane at Coal River. But he has not 
  been practicing his evil medicine in Parramatta, 
  which means that the horrible schemes of The Thing 
  in the Book have stalled, even as rumours of some 
  A Convict Named Macdead? 
  Although the surname “Macdead” sounds like a 
  pulpy made-up name, in fact James Macdead was the 
  actual name of a convict sent to Australia. Which only 
  goes to prove that real-life is always weirder than any 
  fiction we can dream up.
  The real Macdead wasn’t a medical man, and 
  didn’t arrive in the colonies until well after the Convicts 
  & Cthulhu era (he came in 1835, landing at Port Jackson 
  from Scotland on the convict ship Asia). However, such 
  a name is far too apt to pass up!
  
  9
  of the weirder transformations it has wrought have 
  come to the attention of colonial authorities.
  The Thing in the Book is, however, not content to 
  simply bide its time waiting for its disciple to return. 
  Wedged into a bookcase in a back room rarely 
  visited by anyone, the evil entity has been reaching 
  out mentally to whichever minds it can reach. Until 
  recently it had only been able to touch the mind of the 
  convict girl Maggie, who likes to visit the store room 
  whenever she can skive off from work for a short break 
  to smoke or indulge in other vices. While not an ideal 
  subject, The Book has been considering possessing the 
  girl … but in recent days she has begun bringing a man 
  back to the store room. Because, although serving as 
  Macdead’s mistress, Maggie has for some time also 
  been mistress to a conniving hospital wardsman 
  named John Wiley. The Book now has two options for 
  subjects to ensnare … and it is only a matter of time 
  before one (or both) of them succumbs to its influence, 
  reads the book, and becomes a new practitioner of 
  medical mayhem. Then the path towards its ultimate 
  goal will resume apace …
  Involving the Investigators
  The investigators’ involvement comes when colonial 
  authorities decide that someone should look into 
  the rash of weird medical-related stories that have 
  been circulating. While one or two outlandish stories 
  about strange mutations might be put down to lies, 
  heavy drinking, or over-active imagination, a series of 
  independent tales warrants investigation.
  The easiest way to get the investigators on the case 
  is for them to already be somehow connected to the 
  medical establishment of New South Wales. This can 
  be via tenuous connections such as being convicts 
  The Dispensatory
  The Book that is at the centre of all the strange 
  goings-on is a thick and worn-looking dispensatory 
  (a book of medicinal formulae — drugs and other 
  preparations — and methods of using them to 
  treat different conditions). Similar books are also 
  sometimes called pharmacopoeia.
  Keepers who want to inject some historical 
  realism into their game can readily find free online 
  scans of period dispensatories which have an 
  abundance of weird-sounding treatments. Macdead’s 
  “Dispensatory of the Damned” is particularly inspired 
  by The Edinburgh New Dispensatory, which collected 
  various Pharmacopoeias, including those from 
  Edinburgh, Dublin and London, into one massive 
  volume. That book served as a major text in the reform 
  of chemical pharmacy in the Age of Enlightenment. 
  The series was commenced by Doctor William Lewis in 
  1753. (A link to a full online version is below, uploaded 
  by the US National Library of Medicine). 
  The book is divided into three main sections:
  • 
  Section One deals with the chemicals and 
  elements as well as Pharmaceutical Operations, 
  the latter comprising weighing, measuring, 
  heating and combining with other chemicals.
  • 
  Section Two is the Materia Medica, which looks 
  at the materials including animal, vegetable and 
  mineral used in pharmacy and what general 
  ailments they are effective against.
  • 
  The 
  final 
  Section, 
  Preparations 
  and 
  Compositions, looks at how these materials 
  are combined into medicines and to what end.
  Illustrations from the real-world medical text may be 
  found scattered through this Ticket of Leave.
  
  10
  assigned to hospital duties, military or civil officers 
  assigned to work at the Hospitals, or even a private 
  medical official employed at the Governor's pleasure. 
  It would be helpful if the investigator group includes 
  at least one surgeon, even a ship's surgeon or surgeon's 
  mate or a military officer with some medical skill (e.g., 
  one attached to the Military Surgeon at the Parramatta 
  Barracks). If no players want to play the role of 
  surgeon, the Keeper might wish to add an NPC to 
  the assigned investigation team with those skills (e.g., 
  the fictional Assistant Surgeon Lt Jeremy Hale whose 
  game statistics appear on page 23).
  The scenario begins with the investigators being 
  summoned by the colony’s Principal Surgeon, Thomas 
  Jamison (unless the Keeper has chosen a setting before 
  1803, in which case see “The Colonial Surgeons” on 
  page 4). He meets them at Sydney Hospital — a 
  location described in the Sydney Gazetteer section 
  of the core Convicts & Cthulhu book. If the Keeper 
  is introducing an NPC surgeon such as Lt Hale, that 
  individual will be introduced to them at the hospital. 
  Jamison tells the assembled investigators that there 
  are persistent and wild stories circulating about some 
  alarming medical symptoms exhibited by certain 
  convicts and free settlers of the Parramatta region. 
  Scattershot accounts and rumours abound including 
  some horror stories that Jamison has no doubt have 
  been encouraged by drink. The Principal Surgeon has 
  asked for a list to be drawn up of all the Parramatta 
  residents whose curious afflictions have been reported, 
  though there may be other unreported cases as well. 
  Beyond this list of four names — which Jamison will 
  give to the most senior member of the investigator 
  team — there is no further information. The names 
  on the list are: Thomas Bradbury, Mary Hart, William 
  Green, and Ann Gabel.
  Jamison wants the investigators to look in to the matter, 
  determine if any outbreak has occurred and if not, what 
  other factors are leading to such bizarre reports. Once 
  they have ascertained the truth they are to report back. 
  If some action requires immediate medical treatment 
  they are to administer it, or consult the Head Surgeon 
  at Parramatta Hospital. Otherwise they must get 
  clearance from Jamison's office as to anything more far 
  reaching. The Principal Surgeon also gives the most 
  senior investigator a note authorising the team to draw 
  what medical supplies they need from Parramatta 
  Hospital, with the caution that supplies are always low 
  and should be used intelligently.
  Jamison concludes the short meeting by wishing 
  them luck and saying that he expects regular 
  reports if the investigation of this affair is to take 
  longer than three days.
  The True Nature         
  of the Threat
  The true nature and motivation of the horrors 
  behind the Parramatta mutations will depend on 
  which of the options the Keeper has chosen (see 
  Mythos Options on page 20).
  • Option A — Transpiercer From Yuggoth: 
  In this version, The Thing in the Book is an 
  ancient and very peculiar weapon left aeons 
  ago on Earth by the Mi-Go. Its purpose is 
  to open a gateway which permits a force 
  of Yuggothian warriors to emerge 'behind 
  enemy lines.' The process for opening this 
  gate involves the creation of nine mutated 
  specimens who will collectively carry out the 
  final ritual of opening.
  • Option B — The Beast of Nine Parts: In this 
  version, The Thing in the Book is a herald for 
  one of the gods of the Cthulhu Mythos, and 
  exists for the sole purpose of fashioning a 
  fleshy form into which the god can incarnate. 
  The creation of the god’s future form involves 
  mutating nine individuals then stitching 
  together a single enormous body from pieces 
  of their bloated and mutated corpses.
  • Option C — The Elevation of Doctor 
  Macdead: In this version, Doctor Macdead 
  is himself an unwitting pawn of a malevolent 
  Mythos cult who are well aware of the powers 
  lurking within The Book and their potential 
  to bring Mythos horrors into the world. This 
  group has silently groomed Macdead to be 
  their agent, knowing full well that the final 
  ritual that will breathe life into the nine 
  created horrors will also consume him.
  Getting Started: 
  Travelling to Parramatta
  The trip from Sydney to Parramatta should be unevent-
  ful. Transport is available by either boat or road (with 
  both described in the main Convicts & Cthulhu book). 
  
  11
  When the group arrives at Parramatta they may 
  be expecting that they will be able to obtain 
  accommodation at the Parramatta Hospital itself, 
  although those hopes will be quickly dashed. The 
  humble medical facility has no spare room for 
  them, forcing the group to seek out accommodation 
  at a local inn (unless one or more of the investigator 
  group is a Parramatta local or has friends or allies 
  in the vicinity). If the Keeper needs a representative 
  inn, the Freemason’s Arms described in the core 
  C&C book can be used for this purpose.
  Parramatta Investigations
  The investigators have a few different avenues of 
  investigation open to them in Parramatta. They may 
  choose to hunt down general rumours floating around 
  town — these tales are even being whispered amongst 
  staff and patients at the hospital. Alternatively, they 
  wish to try tracking down the four people whose 
  names appear on Jamison’s list.
  Investigating at the 
  Parramatta Hospital
  While the hospital forms a nexus for the activities 
  that are to unfold, at the outset there is very little 
  information that can be learned there. Asking about 
  strange medical symptoms or other weirdness will 
  elicit no specific details. Certainly, there have been 
  no unusual cases observed among the unfortunates 
  receiving treatment at the hospital, though most 
  have heard some of the gossip circulating around 
  town (see below).
  The main staff that the investigators will interact 
  with at the hospital will be the Parramatta head 
  surgeon (see the box “Surgeons of Parramatta” on 
  page 7 for a chronology of who filled this role 
  during the year in which the scenario is set), and a 
  few others as described below:
  • The Head Surgeon: this doctor works 
  directly under the Colonial Surgeon in 
  Sydney and will generally be willing to oblige 
  the investigators, at least so long as their 
  demands of his time and medical supplies 
  are not too onerous. He is dismissive of wild 
  tales of strange sickness and states outright 
  that he has seen no-one suffering anything 
  untoward presenting themselves at the 
  hospital. If asked whether he has looked into 
  the rumours circulating Parramatta he will 
  curtly reply that he is far too busy to check on 
  mad rumours!
  • The Assistant Surgeon: in addition to the 
  main surgeon there is a more junior doctor, 
  Barnabas Ritter, who is supposed to be 
  present at the hospital during daylight hours. 
  While the investigators may spot Ritter 
  occasionally, he seems to be missing for a lot 
  of the time. In reality, the young doctor has 
  a number of different vices (rum, women, 
  and tobacco being just the beginning of a 
  long list) that he likes to indulge in town 
  whenever “things seem to be under control” 
  at the hospital. This seems to be pretty much 
  any time he feels the need. The investigators’ 
  impression that the Assistant Surgeon is little 
  more than a nominal worker at the hospital 
  will be reinforced when they learn that 
  although Doctor Ritter has rooms allocated 
  for his accommodation at the hospital, he 
  never uses them. All of these details are well 
  known to most staff (and some patients) at 
  the hospital. The fact that Ritter’s surgical 
  room and its associated store room are 
  seldom used has provided Maggie Miles 
  with a convenient hiding place for The Book 
  (and later may provide a handy location for 
  carrying out additional surgical procedures ).
  • Convict Wardsman John Wiley: Wiley is 39 
  and hails from Birmingham. He works around 
  the hospital doing odd jobs, mostly cleaning 
  and carrying. The investigators will cross paths 
  with him frequently as they move around 
  the hospital. In addition to his work, Wiley 
  also runs a number of lucrative scams and is 
  an occasional paramour to nurse Miles (see 
  below). If asked, Wiley claims to have been a 
  medical orderly in the army but this is a lie, and 
  if pressed he struggles to summon any details of 
  his service except “fighting the French”. Wiley 
  is possessive of Maggie and likely to be violent 
  if roused. (See page 19, for more on Wiley’s 
  involvement later in the scenario).
  
  12
  • Convict Nurse Maggie Miles: Although 
  there are numerous nurses working at the 
  hospital, Maggie is the one who investigators 
  will run into most frequently at the hospital. 
  She is 27 years old and comes from London. 
  Maggie has a complex life. She is Wiley's 
  mistress and also an accomplice to several 
  of his illegal activities (happily sharing in 
  the profits of his perfidy). The relationship 
  between Maggie and Wiley is technically a 
  secret at the hospital, but many of the convict 
  staff have spotted the two wandering off 
  together for daytime liaisons, so most have 
  some suspicions about them. What nobody 
  at the hospital knows, however, is that for 
  some months Maggie Miles was also the 
  mistress and secret accomplice of Doctor 
  Macdead, assisting in his after-hours medical 
  preparations. She has a rudimentary medical 
  knowledge, ironically most of it learned from 
  her foul patron. (See page 19, for more on 
  Maggie's likely actions later in the scenario).
  During early visits to the hospital, investigators 
  probably have little reason to inquire about James 
  Macdead, but should they return later with 
  questions about the man, the following information 
  can be learned (with appropriate social skill checks):
  • Medical practitioners believe that the private 
  doctor is little more than a talentless charlatan, 
  probably not even trained in medicine. They 
  scoff at the notion that Macdead provided any 
  help to his private patients, asserting instead 
  that he probably did them immense harm. 
  Everyone seems glad to learn that Macdead 
  finally got his comeuppance and has been 
  exposed as the fraud he is.
  • Convict staff have no particular love for 
  Macdead either — he was an ill-tempered 
  and scruffy man who was an occasional 
  visitor to the hospital, though most think this 
  was only to pilfer supplies (this is partially 
  true, although he also visited Maggie). If 
  asked, several convicts recall him meeting 
  with Maggie at the hospital some weeks ago 
  but haven’t seen him since.
  While it is easy enough for investigators to snoop 
  around the Parramatta Hospital buildings, there is 
  not much that they are likely to discover. The Book is 
  currently buried in with a pile of other similar texts 
  in the storeroom adjacent to the Assistant Surgeon’s 
  medical room, though there is no particular reason 
  that investigators would spot it there.
  Gossip and Rumours around 
  Parramatta
  Passing through Parramatta and talking to people 
  at the hospital will uncover various rumours about 
  medical oddities and other curious goings-on. The 
  Keeper may call for social skill checks to convince 
  Parramatta residents to pass on what they know 
  (although most simply enjoy spreading gossip and 
  won’t need to be enticed too much to do so).
  • Many different accounts exist of a strange 
  and contagious illness doing the rounds of 
  Parramatta. This odd disease causes weird 
  pustules and lesions to grow on people’s 
  skin, especially around the chest and face.
  • Some versions of the tale also suggest that 
  victims of the “plague” have lost the ability 
  to speak and can only make a strange high-
  pitched whistle.
  • A few locals are saying that some illness 
  that makes people grow tentacles has been 
  contracted from the Parramatta River.
  • Some of the wilder stories abroad in the 
  taverns speak of sufferers' brains are 
  exploding out of their noses and ears.
  • Some say the symptoms are so hideous they 
  cannot be described, and that family members 
  have gone mad and locked the infected away. 
  While not all of these rumours are true, most of them 
  have some basis in what eyewitnesses have observed 
  of the transformations wrought by Doctor Macdead 
  (albeit exaggerated and distorted in the re-telling).
  Tracking Down Initial 
  Sufferers 
  Using the names on Jamison’s list it is easy to ask 
  locals for directions to the houses and farms where 
  each individual resides. All of the named people 
  live either in Parramatta township itself or on a 
  farmstead close to town. They are all victims of 
  Macdead’s experimental treatment, although some 
  are more advanced in their mutations than others: 
  each of these four people has at least passed 
  the first stage and entered full transformation, 
  
  13
  though some only recently. All four of them have 
  progressed to the point where own sanity has been 
  shredded by the changes, and most of them no 
  longer leave their houses for fear that someone will 
  notice the changes to their body. For individuals 
  who are especially advanced, it is likely that the 
  sufferer’s family has either gone mad also — or 
  has fled, leaving the growing horror to fend for 
  itself. Individuals who have so fled are likely to be 
  hiding, and in denial, and in no way interested in 
  contacting the authorities.
  The Keeper can use the details below to improvise 
  some suitably gruesome or pathetic scenes that 
  investigators encounter when they visit each of 
  the four victims’ homes. They will likely learn 
  very little from the patients themselves (since their 
  minds snapped long ago); most of the information 
  to be obtained will be gathered by talking to family 
  and friends. Investigators are welcome to attempt 
  a medical diagnosis of the victims they find (and 
  make rolls against relevant skills), however the 
  only thing that can really be learned is that none 
  of these strange mutations resembles any medical 
  condition reported in the normal literature. 
  Thomas Bradbury
  Bradbury is 53 years old and lives in a house in 
  Parramatta township. He is a convict worker 
  assigned to the farm of John Isley and family. A 
  month ago Bradbury had complained of a cough 
  and had consulted Doctor Macdead.
  When investigators visit the Bradbury house they 
  find that his wife answers the door and is reticent to 
  accept visitors. She seems distraught and the place 
  smells terrible. If they can convince her to allow 
  them entry they can see Bradbury, a husk of his 
  former self with a ropy green pseudopod protruding 
  from the back of his neck. His wife says he has a 
  second such tentacle beneath his clothing. The man 
  is non-responsive, staring off into the distance.
  Mary Hart
  Mary is a free settler, aged 29 years; wife to George 
  Hart. The two live on their farm in Toongabbie. 
  Mary had fallen six weeks ago and twisted her leg, 
  then come down with a fever. Doctor Macdead had 
  been summoned out to the farmstead to treat her.
  When investigators visit the farm, they will find it 
  silent with nobody answering their knocks at the 
  door. Mr Hart and the farm servants have all fled 
  in fear (and are in hiding on other nearby farms). 
  If investigators let themselves in, they can easily 
  find the unfortunate Mrs Hart — guided by the 
  terrible smell that pervades the entire house. In a 
  corner of the main bedroom, is a huge green-white 
  cocoon which looks like it has sat in place for some 
  days. The surface of the protective wrapping seems 
  to have been recently forced open — apparently 
  from within — and a half-human, half-insectoid 
  head sticks out of the hole. This is the victim, 
  recently having completed her first transformation 
  but left weak from malnourishment and unable to 
  pull herself clear of the cocoon. She is the most 
  advanced of the mutations.
  While there is nobody else in the house, investigators 
  can speak with neighbours at adjacent farms (and 
  may even discover the hiding husband) to learn the 
  history of Mrs Hart’s affliction and treatment.
  William Green
  Green is a nineteen-year-old convict boy who 
  works as a labourer for NSW Corpsman Sgt Joseph 
  Mitchell. He lives with Sgt Mitchell in his small 
  house in Parramatta township. Sgt Mitchell has not 
  been living in his house in recent weeks, having been 
  assigned duties elsewhere. However, his convict maid 
  Eleanor Childs has been present for the duration 
  
  14
  and has witnessed what has transpired with Green. 
  William’s original complaint was of headaches and 
  nausea, and he visited Doctor Macdead at his home 
  surgery on the road to Toongabbie. 
  When investigators visit the Mitchell house they will 
  find that the maid Eleanor is in a state of extreme 
  distress, and has been frantically asking at the 
  barracks of the NSW Corps for word to be sent to 
  Sgt Mitchell that he must return to see to a matter 
  “of some urgency.” Initially Eleanor will resist any 
  attempts to gain entry to the home, saying that she 
  is under instructions from the master of the house 
  to use force if needed to protect his chattels. If 
  investigators talk her around or force their way into 
  the house they can find William Green — insane and 
  with a grossly distorted skull, which has started to 
  separate under the pressure of something growing 
  within. Peering through the cracks, investigators can 
  see an oversized pulsing brain sits within his skull.
  Ann Gabel
  Ann is a 44-year-old convict woman who works 
  for farmer Jeremiah Pettitt and family and lives 
  on the family farmstead at Rose Hill. Ann initially 
  complained of headaches and fever and, after some 
  persuading the farmer convinced her to summon 
  Doctor Macdead.
  When investigators visit the Pettitt farm they will 
  find that only Mr Pettitt remains in the house. If 
  pressed he will say (untruthfully) that his servant 
  woman has gone to Sydney to visit her cousin. In 
  fact, Ann has been hidden by Jeremiah in the loft of 
  the farm’s larger barn, because he is too frightened 
  by what she is becoming. He sent away his wife and 
  the farm’s convict labourers for the same reason. 
  Investigators who wish to inspect Ann Gabel will 
  need to either break through the man’s wall of 
  deception or search thoroughly through the entire 
  cluster of farm buildings. If they find his wife (by 
  either means), Jeremiah Pettitt breaks down in 
  tears — saying over-and-over “I should never have 
  told her to summon the surgeon.” 
  In her hiding place in the barn, Ann is a drooling 
  parody of woman. Her torso has begun to warp and 
  harden, like the shell of some great insect. Massive 
  spines protrude from her back.
  Clues and Information
  Talking to family and friends of patients can reveal 
  several details. The Keeper should decide whether 
  some of these facts require skill checks to tease 
  from distraught relatives. Each interview should 
  reveal just a couple of these points, forcing the 
  investigators to piece together the whole picture 
  from numerous different accounts.
  • Each of the victims was a patient of the 
  private Parramatta doctor known as ‘Doctor’ 
  James Macdead;
  • Each of the households had bought goods 
  from the Riverman in the Red Boat in the last 
  four weeks;
  • Most family members are generally fearful 
  of the Parramatta Hospital and its resident 
  surgeons, saying that they wouldn’t go to them 
  unless they were at death’s door. (This fear is 
  borne from a general distrust of the authorities, 
  although investigators may incorrectly jump 
  to the conclusion that the hospital and its 
  surgeons are somehow involved);
  • The affected patients had been seeing Doctor 
  Macdead for some time, and each had 
  received treatment from him previously with 
  no ill effects;
  • At their last consultation with Doctor 
  Macdead, the patients were given a 
  concoction which the doctor told them would 
  ease their particular affliction. The patients 
  all took the medicines they were given;
  • To a couple of patients, the doctor mentioned 
  that the special treatment he has selected 
  was a “progressive and novel” one he had 
  discovered while consulting a new book — 
  and he believed that this new treatment would 
  yield marvellous effects;
  • Each patient has not returned to the doctor, or been 
  visited by him, since being given the medicine;
  • One of the relatives the investigators speak with 
  will happily admit that Macdead is “not really a 
  doctor” but despite that he has a rare talent for 
  helping out with all manner of minor problems; 
  all of his treatments have been efficient in the 
  past, and in fact far more reliable than going to 
  the hospital for treatment;
  
  15
  • If asked, the relatives of each victim can 
  confirm that none has had any contact with 
  any of the other afflicted members of the 
  list — at least not as far back as anyone can 
  recall. Similarly, no immediate member of 
  the victim’s family has been in contact with 
  any of the other victims either.
  Other Victims
  Although the investigators began with a list of four 
  reported victims of strange symptoms, those are in 
  fact not the only people who Doctor Macdead has 
  maligned with his evil treatment. If investigators 
  think to ask around the hospital, the local NSW 
  Corps barracks, or Parramatta’s pubs they may 
  hear mention of other strange medical afflictions. 
  As time goes on this becomes more and more likely 
  as these (newer) cases of Macdead’s treatments 
  begin to exhibit more severe transformations.
  If the investigators already suspect that Doctor 
  Macdead is the common connection between 
  the initial victims, they can also track down the 
  remaining victims by seeking information about 
  who else frequently consulted the not-so-good 
  doctor for medical treatment. 
  However they find them, the investigators should 
  eventually be able to track down three additional victims:
  • Richard Lift: A 23-year-old convict boatman 
  who lives on his boat in the Parramatta River 
  with his friend Isaac Jones (aged 29). Doctor 
  Macdead treated him for bouts of palsy. If 
  investigators inspect Lift’s body they will find 
  that there is a lump on his right leg that seems to 
  be developing into a pseudopod-like protrusion.
  • John Langley: A convict labourer, aged 30 
  years, who works on the public gang that 
  does government construction and demolition 
  around Parramatta. Langley original became 
  feverish and was attended by Macdead in a 
  worker's shack in Toongabbie. As far as the 
  man’s convict overseer is concerned, Langley is 
  still convalescing in that same shack … although 
  he hasn’t checked in on him for a week or more. 
  If investigators visit the shack they will find 
  Langley to be a raving mess, convinced that his 
  head is going to explode from within.
  • Amelia Lemon: A 27-year-old convict 
  maid assigned to Thomas Kelly, a farmer at 
  Toongabbie. Amelia first became sick with 
  “women’s problems” but after having been 
  treated by Doctor Macdead she wandered 
  in a daze out into the bushland at the edge 
  of the farmstead. Thomas Kelly has reported 
  the young woman to the Colonial authorities 
  as missing, but does not otherwise seem 
  concerned for her wellbeing. In fact, he says 
  she was “always next to useless anyway.” The 
  Keeper can decide on what has happened to 
  Amelia — conceivably she could have been 
  found and tended to by women from a local 
  Aboriginal community (see the Convicts & 
  The Man in the Red Boat
  A few of the stories the investigators are told 
  mention a “riverman in a red boat”. If the investigators 
  are interested in tracking down this reference they can 
  easily find the individual they pertain to. He is a convict 
  smuggler named George Ball. Ball is shifty about his 
  work and only plies his trade at night because he deals 
  largely in goods stolen from warehouses in Sydney, 
  stolen from ships in Sydney Harbour, or smuggled in 
  from boats on the Hawkesbury.
  The Man in the Red Boat has a birthmark on the 
  right side of his face and as afflicted with boils. He has 
  recently been getting stolen medicine from Sydney 
  hospital and bringing it upriver, which is how the local 
  patients of Doctor Macdead have come across him. 
  (John Wiley at Parramatta will happily put him out of 
  business if he finds this out, possibly by drowning him).
  The Man in the Red Boat is a red herring, 
  but adventurers can still provide a public good in 
  stopping him, and certainly earn the approval of the 
  Governor by doing so. Putting an end to his medicine-
  smuggling racket will also impress the Colonial 
  Medicine Service, especially if the investigators can 
  link him to a wider racket in selling stolen medicine 
  (investigating such activities may also bring some of 
  John Wiley’s extracurricular activities to light).
  If the Keeper wishes to expand upon this small 
  plot point, he or she could easily make George Ball a 
  part of a bigger gang of criminals. See Ticket of Leave 
  #3: Criminal Enterprise for a ready-made band of 
  hoodlums, the Jenks Gang, that could be employed 
  for exactly this purpose.
  
  16
  Cthulhu core book for details of the Aboriginal 
  peoples of the region). If investigators manage 
  to track her down and inspect her body, they 
  can find that Amelia’s body is just beginning 
  to sprout vestigial wings.
  Investigating these patients helps the adventurers 
  confirm the same information as the previous 
  sufferers, as well as providing extra information. 
  In the case of Lift, Isaac Jones knows that Maggie 
  Miles came to the boat and said she was following 
  up for Macdead, but would not be pressed on his 
  whereabouts, nor did she show much interest in 
  helping the patient.
  Investigating “Doctor 
  Macdead”
  It will quickly become obvious that all the sufferers 
  have in common some contact with 'Doctor' James 
  Macdead. This will naturally make him a suspect. 
  Finding him is, however, easier said than done. The 
  following notes provide the most likely avenues 
  of investigation in Parramatta and the general 
  information they might yield. Keepers should feel 
  free to require successful skill checks to uncover 
  some of the key details noted.
  • At 
  Macdead’s 
  house 
  and 
  surgery: 
  Investigators can readily find the house 
  occupied by James Macdead, which is between 
  Parramatta and Toongabbie. The place is, 
  however, completely empty and there is no 
  sign of anybody living there. If investigators 
  scour the place looking for unusual books, 
  they find nothing of the kind (since Macdead 
  gave The Book to Maggie before he was 
  sent to Coal River). If the Keeper is using 
  Mythos Option C (“The Elevation of Doctor 
  Macdead”) there is an additional clue in the 
  house — see the option description.
  If 
  investigators 
  speak 
  with 
  Macdead’s 
  neighbours they can learn that several recall 
  Maggie Miles as a regular guest and are happy 
  to repeat the salacious rumour that she is his 
  mistress, despite her relationship with John 
  Wiley at the hospital. They will also note 
  that in recent weeks Macdead became very 
  secretive and bad tempered towards “good 
  natured inquiring neighbours”. Perhaps, they 
  will opine, Maggie Miles is a bad influence — 
  since she is known as a “bad lot”.
  Halting the Transformations
  If the investigators have any compassion (or even simply 
  medical curiosity) then they will likely want to determine 
  whether there is some way to arrest or reverse the horrific 
  transformations that sufferers of Macdead’s treatments 
  are undergoing. The simple answer is that these mutations 
  are magickal rather than medical, and there is nothing in the 
  repertoires of 18th century surgeons that offers any insight into 
  treating such a case.
  However, that doesn’t mean that the afflicted are 
  absolutely doomed; clever investigators may derive 
  methods for derailing the horrible schemes of The Thing in 
  the Book. Here are a few ideas; consulting the background 
  for the specific Mythos Option the Keeper has selected 
  may offer some additional ideas.
  • 
  Death of the Patient — by themselves none of the 
  transformations will kill their victim. Indeed, it quite 
  important to the schemes of the Thing in the Book 
  that each of the victims remains alive until the final 
  ritual is performed. If investigators choose to “put 
  the victims out of their misery” they can certainly do 
  so. Curiously, victims who are killed before the final 
  ritual will slowly revert to human form in death.
  • 
  A Secret in The Book — the Keeper may wish to 
  allow diligent investigators who get their hands 
  on the Dispensatory of the Damned to find helpful 
  secrets within its pages. One such secret might be 
  a way of reversing the transformations induced by 
  Macdead. To understand such technical material, 
  investigators will need significant knowledge of the 
  Chemical sciences as well as a grasp of Medicine 
  that goes beyond mere first aid. Attempting such 
  a feat also opens the investigator up to potential 
  possession by the book. If successful, however, the 
  reversing process found in the Dispensatory will halt 
  the ongoing transformation immediately and take 
  1D3 days to reverse.
  • 
  Destruction of The Book — although it will likely 
  remain a mystery to the investigators, The Book is the 
  hub of the Mythos activity that is affecting Parramatta. 
  If investigators can somehow destroy the book, all of 
  the wicked deeds of Macdead (and any successors) 
  will be undone. All transformations will instantly end, 
  and over the course of days reverse. In both this and 
  the above case the patient will outwardly remember 
  nothing of their ordeal but their dreams are haunted 
  by strange callings and shamblings and they evidence 
  a deterioration in their nervous disposition. Note 
  that damaging The Book is not as easy as it sounds, 
  since not only does the thing have a hard carapace 
  armour (even in its book form), but when attacked is 
  almost certain to break its disguise and revert to its 
  monstrous form. See the statistics for The Thing 
  in the Book at the end of the scenario.
  
  17
  • At Parramatta Hospital — see “Investigating 
  at the Parramatta Hospital” on page 11.
  • Paperwork from the Colonial Medical 
  Service: Investigators might think to ask 
  the Colonial Medical Service whether they 
  have any information about Macdead. This 
  will probably require sending a letter back to 
  Sydney and waiting a day (or perhaps two) 
  for a reply letter. Ultimately investigators will 
  likely be disappointed to learn that the Medical 
  Service does not perform any vetting of private 
  doctors (or those who claim to be doctors), and 
  in fact keep no records about such individuals.
  • Convict Records: Investigators who write 
  to 
  Government 
  House 
  inquiring 
  about 
  Macdead’s convict records can learn the basics 
  of his crimes in London and the reason for 
  his sentence of transportation. The notes will 
  also include details of Macdead’s approval 
  for a Ticket of Leave. None of these details 
  is especially damning, painting Macdead as 
  nothing more sinister than a quack and a forger 
  who believes he is doing more good than harm. 
  A last-minute addendum to the records may be 
  of more interest since it records the (very recent) 
  finding that Macdead was guilty of reoffending 
  and has been sent to Coal River in an ‘agitated’ 
  state. This sentence was apparently carried out 
  only a week or two ago.
  • Asking Parramatta Locals: There are plenty 
  of people around Parramatta and Toongabbie 
  who know Macdead. Investigators may 
  be able to track down a boatman on the 
  Parramatta River who remembers the large 
  collection of crates that Macdead received a 
  couple of months back, allegedly possessions 
  from England. Similarly, speaking to a 
  Parramatta constable, night guard, or member 
  of the Volunteer Association might reveal that 
  Macdead has recently been found guilty of 
  forgery and as a reoffender has been sent for 
  punishment at Coal River. 
  • Pub Gossip: There are plenty of salty tales 
  told about James Macdead and the wantonly 
  nurse Maggie Miles. Most of them also caution 
  that John Wiley — Maggie’s ‘man’ — has a 
  violent temper and that woe betide Doctor 
  Macdead when that bruiser comes a-calling. 
  Notably, nobody around Parramatta has made 
  the connection between Macdead and the 
  curiously afflicted locals — although as soon as 
  the investigators begin asking questions which 
  imply such a link, rumours of such a connection 
  start to spread like wildfire as local gossip.
  At Coal River
  Investigators who are diligent in hunting down James 
  Macdead should ultimately come to learn that the man 
  has been recently sent to Coal River, as punishment 
  for some petty forgery. Coal River is a mining camp in 
  one of the most remote parts of the colony and is well 
  known for being a brutal hell-hole of forced labour. 
  Keepers can find more about the penal settlement at 
  Coal River in the Convicts & Cthulhu core book.
  If investigators wish to question Macdead in person 
  they will have no choice but to travel to Coal River — 
  this is no small undertaking, and probably involves 
  returning to Sydney township and taking a sailing 
  boat up the coast. In all, the trip will likely take two 
  or three days each way.
  When investigators arrive at Coal River they will find 
  that the prison authorities there are not well pleased 
  with Macdead, on account of the poor medical 
  treatment he has performed. The new arrival has 
  already been accused of botching a minor surgical 
  procedure to patch up the leg of an injured NSW 
  Corps soldier, Private Barnes. As a punishment 
  for his malpractice, Macdead has been placed into 
  solitary confinement.
  (In fact, the “botched” medical treatment of Barnes 
  was actually the result of Macdead’s continued 
  possession by The Book. Trying to replicate his dark 
  medical practices from Parramatta, the enthralled 
  doctor followed what steps he could remember. 
  Without the presence of The Book to consult, such 
  efforts were always doomed to failure.)
  E s c a p e !
  Macdead is supposed to be under guard but when 
  the investigators try to visit him they will find that 
  his guard has been drugged and Macdead is missing 
  from the hut in which he was kept confined. If the 
  investigators raise the alarm, they may be surprised 
  by the indifference of the local authorities — while 
  the investigators may wish the NSW Corps to 
  mount a search for the missing doctor, NSW Corps 
  officials are more likely to shrug their shoulders. In 
  
  18
  their opinion he will most likely die from exposure 
  in the bush. As such it’s not worth trying to track 
  him down. If the investigators somehow manage 
  to overcome this indifference they may be able get 
  the NSW Corps to pursue the mad doctor along the 
  coast or into a potentially hostile hinterland.
  In fact, Macdead has not attempted anything so 
  foolhardy as striking out into uncharted bushland. 
  Instead, he is hiding in an abandoned cutting on the 
  coast just south of Coal River. The smoke from his 
  cooking fire will give him away, if local Aboriginal 
  people cannot be convinced to track him first. If 
  investigators manage to find him, Macdead will be 
  a mess — ranting and raving like a lunatic. Amongst 
  all his nonsense, investigators should be able to piece 
  together the basics of Macdead’s story, as well as his 
  powerful belief that he is some kind of “Saviour” to 
  the colony. His rantings will describe how his life 
  was turned around by discovering a most remarkable 
  book — a tome which mysteriously appeared in the 
  boxes of possessions he had shipped from London. 
  By his account the book “spoke to him” when he 
  first read it, and even now he is performing a great 
  service by bringing forth The Book’s master, via his 
  medical “grand workings.”
  If the investigators quiz Macdead about where this 
  book might be found, he will readily admit that he 
  left it with Maggie and does not know for certain 
  where it is now kept. Regardless he is adamant that 
  he must return to continue his service to The Book. 
  To listen to his mad rantings is quite alarming (and 
  Keepers may call for a mild Sanity check).
  Investigators may decide to return Macdead to his 
  incarceration at Coal River — or they may decide that 
  it is safer to smuggle him back to Parramatta where 
  they can keep watch over him personally. If the Keeper 
  is using Option C (“The Elevation of James Macdead”) 
  there may be other shadowy forces that work behind 
  the scenes to set Macdead free from captivity, possibly 
  thwarting whatever plans the investigators have put in 
  place to keep him out of the action.
  The Lurking Threat: 
  Thralls of the Dispensatory
  The key to stopping the series of horrific mutations at 
  Parramatta will be understanding that the true source 
  of these evils is not Doctor Macdead but rather 'The 
  Dispensatory of the Damned'. Investigators might 
  make this realisation as a result of James Macdead’s 
  insane confession (above), or they may discover it as 
  a result of ongoing events at the Parramatta Hospital 
  which lead to brand new cases being reported there. 
  The investigation of these baffling new cases (which 
  Medical training suggests probably began well 
  after Macdead was sent to Coal River) may catch 
  one of The Book’s new disciples red-handed using 
  instructions from its foetid pages to prepare a horrible 
  new treatment for an unwilling hospital patient.
  For its own part, The Book is not content to simply sit 
  idle and wait for Doctor Macdead — its thrall — to 
  return to it. The creature that inhabits its pages has 
  no particular loyalty or regard for him, considering 
  him nothing more than a convenient and easy tool to 
  manipulate to achieve its goals. With him out of the 
  picture (at least temporarily), The Book has begun 
  to assess other options. Before his arrest, Macdead 
  successfully transformed seven people: to achieve 
  its goal The Book needs at least an additional two 
  mutated bodies (perhaps more if investigators have 
  decided some earlier patients should be “put out of 
  their misery”). To resume its activities, it will require 
  a new thrall, which in turn requires enticing someone 
  to spend considerable time in its proximity and to 
  read from its pages. Nurse Maggie Miles’ choice to 
  hide The Book in an out-of-the-way storeroom in the 
  rarely-used Assistant Surgeon’s building has severely 
  limited its options. While it could try possessing 
  Maggie — a frequent visitor to the storeroom – the 
  girl is only just literate enough to read its complex 
  passages. Another option is the wardsman John Wiley 
  who Maggie sometimes brings to the storeroom “for 
  a quick fling” when nobody is watching them. Wiley 
  can read quite well but is not very intelligent. Perhaps 
  the book will decide its best course of action is to 
  possess both of them and have them work as a team 
  to bring about the final mutations.
  The notes below provide details of the motivations of 
  the three main NPCs. Together with the overriding 
  goal of The Book (which will depend on which Mythos 
  Option the Keeper has chosen), these should provide 
  the Keeper enough information to sketch out the 
  behind-the-scenes action at Parramatta Hospital. As 
  investigators poke their noses into newer cases, they 
  are likely to cross paths with The Book’s new thralls, 
  perhaps interrupting one of their secret midnight 
  surgeries in the Assistant Surgeon’s building.
  
  19
  The Corrupt Nurse: 
  Maggie Miles
  Prior to the arrival of the investigators in Parramatta, 
  Maggie has not examined The Book herself, despite 
  having been a willing accomplice to Macdead’s earlier 
  mad schemes. She believes that the doctor is onto 
  something truly magnificent and his plans exercise 
  her own capacity for cruelty and her desire to be above 
  others. However, she is also smart enough to fear The 
  Book, and cunning enough to try and put others in 
  harm's way rather than handle the book directly.
  Once the investigators start snooping around the 
  hospital, Maggie will realise that it’s time to act. 
  She begins by trying to convince Wiley that there 
  is potential profit to be had by using the formulae 
  included in Macdead’s old book to make the 
  harmless rubbish that Macdead was peddling. Her 
  goal is to either coerce Wiley into taking a leading 
  interest in exploiting the ‘secret medical book’ or 
  alternatively engaging him as a ‘partner in crime’ 
  (depending on the Keeper’s preference).
  Maggie’s is not especially keen to be the primary 
  agent of The Book, and will instead try to engineer 
  situations where someone else take that role. If she 
  is unsuccessful in gaining Wiley’s interest, she may 
  latch on to a convict at the hospital who has some 
  medical knowledge and attempt to set them up as 
  The Book’s new thrall. Alternatively, she might 
  somehow arrange for The Book to end up on the 
  desk of Assistant Surgeon Barnabas Ritter on one of 
  the rare occasions he is in his office doing work. In 
  a push she may even arrange for a medically-skilled 
  investigator to stumble upon The Book in a lonely 
  place, assuming that the baleful thing’s mental can 
  quickly take hold of them and bend them to its will.
  The Malicious Wardsman: 
  John Wiley
  As described above, Wiley represents the most 
  logical person for Maggie to manipulate. If the 
  Keeper decides that he eventually succumbs to 
  greed, he will quickly become The Book’s new 
  thrall. This will bring about a visible change in his 
  behaviour. Prior to being possessed Wiley is his 
  normal cunning, bullying self. Afterwards he is more 
  withdrawn, and less mentally stable, occasionally 
  lashing out with incomprehensible violence. 
  Once possessed, Wiley will resume The Book’s 
  plan, aiming to bring the number of transformed 
  'Gate Openers' to at least nine (as required for the 
  final ritual). Unlike Macdead who was somewhat 
  careful to ensure his victims were spread across a 
  wide area, Wiley is not clever enough to employ 
  any subtlety. Instead he will simply select victims 
  at random from the current patients at Parramatta 
  Hospital. Once they have been treated he moves 
  his victims out of the main wards, purportedly to 
  isolate them and stop any risk of contagion. In fact, 
  he simply hides his victims away in the storeroom 
  in the Assistant Surgeon’s building, blocking the 
  doorway with a heavy bookcase outside. Because of 
  the general chaos that has enshrouded the hospital 
  (perhaps created by the investigators themselves), 
  it will be several days before anybody in authority 
  learns of these unauthorised treatments.
  The Mad Doctor: James 
  Macdead
  Macdead represents a wildcard that the Keeper can 
  use to season the ongoing crisis in a number of ways. 
  As described in the section on Coal River (see page 
  17), he will make efforts to escape his captivity 
  there. If the Keeper has chosen Mythos Option C 
  (“The Elevation of Doctor Macdead”) he may even 
  have considerable assistance in achieving that goal.
  If Macdead gains his freedom he will be drawn 
  inexorably back to The Book, an influence that stills 
  claws at his mind. While travelling overland from 
  Coal River to Parramatta would be a Herculean effort, 
  it is not impossible (historically a few convicts did 
  manage to make it from Coal River to the settlements 
  at Hawkesbury and eventually reach ‘civilisation’). Of 
  
  20
  course, if he has assistance from someone in a position 
  of power, this task will be much easier — perhaps 
  even leading to his return to Parramatta in mere days, 
  his forgery charge quashed and pardoned.
  If the Keeper decides to bring Macdead back into 
  the mix at Parramatta after another thrall has already 
  taken up The Book’s mission, there are questions to be 
  answered about Macdead’s reaction to having been 
  ‘forsaken and replaced’ by his master. Does the mad 
  doctor put this slight aside and join forces with the new 
  thrall? Or does he go violently insane and try to steal 
  The Book away from them? Conceivably this situation 
  could erupt into a strange kind of covert battle between 
  two different factions, each acting out of unwavering 
  loyalty to the Thing in the Book. In the worst case, both 
  factions might start destroying the mutations that the 
  other has wrought, leading to The Book’s whole scheme 
  unravelling — all thanks to petty human jealousy.
  The Book’s Last Stand: 
  Defeating the Horror
  There are two likely ways that the scenario will reach 
  its conclusion — either the investigators will catch 
  the thralls of The Book during one of their medical 
  ‘procedures’ and force a confrontation, or The Book’s 
  foul scheme will reach its climax at the final ritual.
  If the plans of The Book culminate in a final ritual 
  (after nine transformations have been completed), 
  the Keeper should consult the notes for the specific 
  selected Mythos Option for details about how the ritual 
  will play out. Also noted there are the consequences 
  should the horrible ritual be allowed to succeed.
  On the other hand, if the actions of the investigators 
  uncover the thrall of The Book in the middle of 
  a midnight surgery in the Assistant Surgeon’s 
  building, the Keeper can use this scene as a tense 
  final confrontation. Because of the constant looming 
  threat posed by the investigators, the final few 
  transformations are likely to be created using an 
  ‘accelerated’ procedure. This involves growing alien 
  body parts in a hidden tub stored in an outbuilding. 
  These parts are produced using strange elixirs 
  described in the book, mixed with fleshy samples 
  culled from rank human corpses piled around the 
  hospital. When they are fully-grown, The Book’s 
  thrall will steal the intended victim from the hospital 
  ward (at night, and likely against the patient’s will) 
  and drag them to the surgical room in the Assistant 
  Surgeon’s building. There, the tub-grown parts can 
  be surgically attached. As noted above, any victims 
  of successful attachment are locked away in the 
  storeroom adjacent to the surgery afterwards.
  These hideous surgical attachment procedures 
  are dramatic affairs — thanks to a lack of any 
  anaesthetic, the victim’s screams of terror and 
  pain are only muffled by the hands of the attending 
  doctor and any rags that are handy. Also, as the 
  alien parts are attached, The Book glows with an 
  eerie sepulchral light. Both the noise and the light 
  might attract the investigators’ attention, drawing 
  them to the horrifying surgical scene.
  The Keeper should consult the game stats for The 
  Thing in the Book, since any encounter that results 
  in physical violence — especially directed at The 
  Book — will cause the hideous thing to cast off its 
  disguise and attack investigators in its huge and 
  bloated insectoid true form.
  Mythos Options
  Three alternative Mythos-related mysteries are 
  offered. Keepers can decide which they will employ. 
  Each will have some effect on the clues to be found 
  during early parts of the adventure — as well as how 
  the grand finale will play out.
  Option A: Transpiercer 
  From Yuggoth
  If using this option, the Thing which inhabits Doctor 
  Macdead’s book is a strange kind of biological 
  weapon designed by the Mi-Go (Fungi From 
  Yuggoth). At some time in the Earth’s distant past, 
  at a period when the Mi-Go were fighting another 
  Mythos species for supremacy, they deployed the 
  Transpiercers. These were covert weapons designed 
  to serve as a kind of ‘Trojan Horse’ to allow a force of 
  Mi-Go to strike deep behind their enemy’s defences. 
  The Transpiercers were each linked to a dimensional 
  pocket outside space and time into which a group of 
  heavily-armed Mi-Go would be locked. The device 
  itself would be dropped somewhere the enemy 
  would discover it, and would disguise itself as some 
  form of written record (whatever the target species 
  routinely used, whether that be stone tablets, metal 
  
  21
  books, or carved hieroglyphs). The Transpiercers 
  were designed to, once deployed, wait for a suitable 
  target mind to come into their vicinity, overcome 
  their will, and compel them to carrying out the 
  lengthy ritual that would open a gateway between 
  the Transpiercer and the pocket dimension.
  Despite the fact that the war for which the Transpiercers 
  were deployed was fought many millions of years ago, 
  a handful of these dangerous weapons still exist. They 
  are quite dangerous still, because the force of Mi-Go 
  in the associated pocket dimension are outside time 
  altogether — hence not only are they still alive, but 
  they are still armed and ready for war.
  The existence of the Transpiercers From Yuggoth is 
  known to a few scholars of the Cthulhu Mythos (and 
  investigators who are especially knowledgeable 
  about such matters or who have extremely good 
  Occult knowledge may have heard of them). They 
  come to light only rarely these days — since most 
  have been activated or destroyed long ago. But 
  when they are discovered they are much-sought-
  after by certain secret societies, especially those 
  who wish to see the influence of the Fungi From 
  Yuggoth spread on Earth. It is a devotee of one such 
  cult who was responsible for slipping the infected 
  'Dispensatory of the Damned' into the crate bound 
  for Macdead in New South Wales.
  Dutifully, the doctor has carried out the first parts of 
  the multi-stage ritual, but more mutated specimens 
  must be created before the final ritual of opening 
  can be performed. When the requisite number has 
  been achieved, the Thing in the Book will direct its 
  thrall to take the assembled group of insane and 
  altered men and women out to a remote location 
  atop Prospect Hill, a few miles from Parramatta. 
  There they will join hands in a circle and, when Pluto 
  rises into the night sky, the enthralled individual 
  will intone the final incantation. An impossibly 
  bright light of shocking hue will descend from the 
  skies — visible from Parramatta township, where 
  most people will assume it to be some weird kind 
  of lightning. Carried on this ultraviolet glow will be 
  the shock troops of the Yuggoth battalion. 
  Additional Clue: 
  • If investigators ever inspect The Book in a 
  very quiet location, they may be able hear the 
  very faint sound of buzzing voices apparently 
  coming from its pages.
  Option B: The Beast of 
  Nine Parts
  If using this option, The Thing inside the Book is a 
  curious and obscure Cthulhu Mythos entity known 
  as The Herald of the Outer Dark. This creature’s 
  sole purpose is to bring about the creation of a 
  physical form for an extra-dimensional horror (or 
  perhaps a god) who cannot exist in our dimension 
  naturally. Exactly which Mythos god or species 
  has sent forth the Herald can be decided by the 
  Keeper, to best fit in with his or her campaign and 
  player group (however, logical candidates might be 
  Nyarlathotep, or Yog-Sothoth, or even Azathoth).
  The methods employed by the Herald to bring about 
  the creation of its master’s Earthly body are subtle. 
  As the creature cannot easily interact with the types 
  of matter found in our world, it needs to make use of 
  agents — individuals whose will it overcomes, and 
  whose hands it directs to build the warped fleshy 
  forms which most resemble the alien entity’s perfect 
  form. These it recruits by hiding inside repositories 
  of knowledge, in particular the types of written 
  records that students of the Black Arts (easy targets 
  for manipulation) are most likely to seek out.
  Doctor Macdead served as an ideal pawn, and 
  created the majority of the parts that will make 
  up the Earthly body (the hideously warped human 
  forms of Macdead’s patients). But his arrest has 
  halted the project with a couple of parts still to 
  be made. Once these have crafted from additional 
  human victims, the Herald will be ready to direct 
  the enthralled individual in the matter of stitching 
  the nine insane and mutated humans together, to 
  form a single gestalt form. 
  To this final end, once the nine 'Gate Opener' 
  transformations are complete, the Thing in the Book 
  will direct its thrall to bring them all to the Assistant 
  Surgeon’s surgery in the Parramatta Hospital. In a 
  complex and bloody ‘operation’ that will last for 
  five hours (and incorporate lengthy ritual chants 
  as well as disgusting abominations against human 
  flesh), the afflicted humans will all die. But their 
  conjoined body parts will all be stitched together 
  into a perfect shape – perfect at least to the alien 
  entity’s aesthetics. At this point, the final ritual will 
  be enacted and the extra-dimensional horror will 
  inhabit the horrid gestalt thing.
  
  22
  If this occurs, the terrible and disgusting patchwork 
  thing will slay all who behold it and stalk off into 
  the hinterland. There it crouches and sends psychic 
  messages to the gullible and evil, that the colony 
  may develop in even more cruel and depraved 
  ways. Kind Keepers might allow investigators to 
  follow its trail of destruction and mayhem and 
  challenge it in the hinterland, but most likely it will 
  vanish from all sight and its evil will simply seep 
  into the fabric of the emerging colony. From time 
  to time hideous mockeries will be born that will 
  resemble some aspect of the Gestalt Entity.
  Additional Clue: 
  • The families of some of Macdead’s part-
  transformed victims have heard them utter 
  occasional phrases in some kind of queer 
  foreign tongue. To someone knowledge-
  able in the Cthulhu Mythos, these nonsense 
  phrases suggest a relationship with a par-
  ticular Mythos god — whichever one the 
  Herald is working to build a new body.
  Option C: The Elevation 
  of Doctor Macdead
  If using this option, the charlatan Doctor Macdead 
  has been the victim of a Mythos cult from the very 
  beginning. Selecting him for occult purposes to 
  be their trailblazer in the new world, this group 
  manipulated events to ensure his capture in London 
  and sentence of transportation. Once installed in 
  the colony, and established as a dubious medical 
  man, the cult arranged for the 'Dispensatory of the 
  Damned' to be silently added to the contents of the 
  crate shipped from his relative in London. They 
  know full well the true horror that lurks in the pages 
  of the book, and the likely consequences of exposing 
  the weak-willed doctor to its influences. So far, their 
  scheme to use Macdead as an unwitting agent of 
  darkness has largely been going to plan … although 
  the sentencing of the pilfering doctor to Coal River 
  is certainly a setback.
  The dark society behind the plot is known as the Cult 
  of the Rancid Tome and is a shadowy group that sees in 
  the southern continent a place where their foul beliefs, 
  and the entities they serve, may thrive. It is highly 
  likely that this debased organisation already has some 
  members among the ranks of convict or free members 
  the colony — the Keeper can decide exactly who acts 
  in their interests. Such agents would likely be charged 
  with the mission of watching over Macdead, and killing 
  anyone who interferes with his progress. Indeed, 
  such agents will likely be working to either have his 
  incarceration at Coal River overturned, or perhaps 
  arrange to ‘break him out’ of the prison settlement to 
  allow him to return to his work at Parramatta.
  While the Rancid Tome worshippers are responsible 
  for setting events in motion, with Macdead currently 
  out of the picture and The Book starting to work its 
  dark influence on others, things are starting to take on 
  a momentum of their own. The cult is likely unaware 
  of this development, and would probably welcome 
  it as a positive development anyway: as long as 
  horrors are brought into the world, it doesn’t matter 
  to them who does it. The only reason they don’t use 
  the powers of The Book directly themselves is that 
  they know (from hard experience) that wielding its 
  power is a death sentence (see below). 
  If the schemes of The Book are allowed to reach 
  fruition, its current thrall will be compelled to gather 
  together the nine mutated humans and, under cover 
  of night, take them to the site where the Parramatta 
  Church is currently being constructed. Amid the 
  foundations of the holy building the thrall will be 
  forced to vivisect themself, carving off pieces of his 
  or her own body to feed to the transformed ‘Gate 
  Openers’. As each twisted human shape consumes 
  part of the thrall’s flesh, it undergoes a second 
  metamorphosis, turning into a Mythos servitor (the 
  Keeper can choose a race of human-sized creature, or 
  simply use the Fosterlings of the Old Ones described 
  on page 40—41 of the Malleus Monstrorum). At the 
  end of this bloody ritual, the thrall plunges a scalpel 
  into his or her own heart. The nine Mythos horrors 
  so-created are then loosed upon the streets of 
  Parramatta to kill and feed with wild abandon.
  Ironically, the incarceration of Doctor Macdead may 
  mean that this grand plan may come to fruition (by 
  someone else’s hand) before he is able to return to 
  Parramatta. If that is the case, after the dust has 
  settled the doctor will be venerated by the cult as 
  their “dark messiah” — and will likely become their 
  
  23
  leader. With help, he will slowly rise in the colony’s 
  pecking order and will use any new influence to 
  insinuate the cult’s influence into many Colonial 
  institutions, commencing with the Colonial Medical 
  Service. The Thing in the Book remains dormant until 
  it feels Macdead’s dark deeds are no longer extreme 
  enough to serve the needs its Mythos masters or until 
  Macdead is killed. If either of these things occur, the 
  cult will use The Book again to begin the cycle anew.
  Additional Clue: 
  • If the investigators perform a thorough search 
  of James Macdead’s home they may find 
  a partially-burned letter still sitting in his 
  fireplace. The part that remains legible reads 
  “should know that we can offer protection and 
  succour, having no small influence here in New 
  South Wales. In return we ask only that you 
  undertake your arts with diligence. Should you 
  reach your goal, we will know you as our sav…”
  Rewards and Penalties
  Destroying the book grants a reward of 1D6 Sanity. 
  Rescuing any victims of the book grants a bonus of 
  1 point each. Investigators who are successful and 
  keep the name of the Colonial Medical Service and 
  its Surgeons out of disrepute gain and additional 
  +5% on Credit Rating. If they are convicts they may 
  be considered for a less-strenuous assignment with 
  the CMS for their efforts.
  Statistics
  Game statistics for Call of Cthulhu 7th Edition are 
  shown below.
  Lt. William Ascott
  Naval Officer aNd SurgeON'S Mate, aged 24 
  (POSSible head Of iNveStigatOr Party if ONe 
  iS NOt drawN frOM their raNkS)
  STR 65 
   CON 60 SIZ 70 
  DEX 60  INT 70
  APP 65  POW 60  EDU 70 SAN 60 
  Hit Points: 13
  Damage Bonus:  +1D4 Build:1 Move: 7 
  Magic Points: 12
  Brawl 
   
  60% (30/12), damage 1D3 + Damage Bonus
  Flintlock Pistol(2) 60% (30/12), damage 1D6+1 [Range 10 yard;  
   
   
        1 shot per 4 rounds; Malfunction 95+]
  Sword 
   
  60% (30/12), damage 1D8 +  Damage Bonus
  Dodge  
   
  50% (25/10)
  Skills:  Credit Rating 60%, First Aid 60%, Insight 60%, 
  Language (Latin) 30%, Medicine 20%, Natural 
  World 65%, Pilot Boat 60%, Science (Biology) 50%, 
  Spot Hidden 60%.
  John Wiley
  cONvict wardSMaN aNd cONNiver, aged 39
  STR 90 
   CON 70 SIZ 90 DEX 60  INT 60 
  APP 55 
   POW 80  EDU 20 SAN 60 
  Hit Points: 16
  Damage Bonus:  +1D6 Build:2 Move: 8 Magic Points: 16
  Brawl 
   
  60% (30/12), damage 1D3 + Damage Bonus
  Axe 
   
  60% (30/12), damage 1D6+2 + Damage Bonus
  Dodge  
   
  50% (25/10)
  Skills: First Aid 30%, Insight 60%, Persuade 70%, Sleight 
  of Hand 60%, Spot Hidden 70%.
  Maggie Miles
  cONvict NurSe aNd accOMPlice tO terrOr, 
  aged 27
  STR 55 
   CON 70 SIZ 50 
  DEX 80  INT 80 
  APP 75 
   POW 50  EDU 40 SAN 10 
  Hit Points: 12
  Damage Bonus:  none Build:0 Move: 9 Magic Points: 10
  Brawl 
   
  50% (25/10), damage 1D3 + Damage Bonus
  Kitchen Knife 
  50% (25/10), damage 1D6+1 + Damage Bonus
  Dodge  
   
  50% (25/10)
  Skills: Credit Rating 10%, First Aid 30%, Insight 50%, 
  Persuade 80%, Spot Hidden 60%, Stealth 50%.
  James Macdead
  cONvict fOrger, quack dOctOr aNd thrall 
  tO darkNeSS, aged 45
  STR 45 
   CON 60 SIZ 50 
  DEX 90  INT 70 
  APP 45  POW 90  EDU 60 SAN 05 
  Hit Points: 11
  Damage Bonus:  none Build:0 Move: 7 
  Magic Points: 18
  Brawl 
   
  30% (25/10), damage 1D3 + Damage Bonus
  Dodge  
   
  50% (25/10)
  Skills: Credit Rating 20%, First Aid 70%, Insight 50%, 
  Medicine 
  20%, 
  Natural 
  World 
  45%, 
  Science 
  (Chemistry) 50%, Stealth 50%.
  
  24
  The Thing in the Dispensatory 
  of the Damned 
  The Dispensatory of Doctor Macdead is possessed 
  by this hideous creature, a foul monstrosity in 
  service to greater powers and wishing nothing 
  more than to bring its terrible masters to Earth that 
  they may cavort and feast. To this end it controls 
  readers of the book it inhabits and forces them to 
  create monstrosities whose physical and mental 
  characteristics are suited to being 'Gate Openers'.
  It has two physical forms. Most of the time it 
  resembles a suppurating malignant version of 
  the book it has chosen to inhabit. To outward 
  appearances the book appears normal, but a close 
  examination reveals it is anything but (see its 
  special powers below). If threatened, however, it 
  reverts to its true shape — a long-legged insectoid 
  thing with a massive pulsating brain from which 
  tentacles extrude. The Thing will normally only 
  change its shape when it is under physical attack 
  and its powers of mental possession have failed.
  In either form, The Thing can only communicate 
  via mental contact — aside from such telepathy all 
  it can manage is some disturbing gibbers and clicks.
  STR 0/150*   CON 100 SIZ 1/200 DEX 0/60  INT 80 
  POW 100  
  Hit Points: 10/30  
  Magic Points: 100
  Damage Bonus:  -2/+3D6 Build: -2/4      
  Move: 0/7 
  * The number before the slash is for the book form, the number 
  after the slash is for the thing's true insectoid form.
  ATTACKS
  Attacks per round: 1
  Fighting Attacks: The Thing can defend itself physically 
  if it is attacked but must assume its true form to do so. 
  Once it has assumed its true form the book it currently 
  inhabits is destroyed, and it must find another in 1D3 
  days or wither and die.
  Pincer 
   
  60% (30/12), damage 1D6 + Damage Bonus
  Tentacle Lash 
  40% (20/8), damage 1D8 + half Damage Bonus
  Dodge  
   
  60% (30/12)
  Armour: 6 points of carapace in either form.
  Sanity Loss: 1/1D4 to see its malignant book form. 1D4/1D10 
  to see the Thing's true form.
  SPECIAL POWERS
  Inhabit Book: The Thing can inhabit any book but prefers 
  Chemistry (or Alchemy) texts or Medical text books 
  since these better impart the dark knowledge it holds 
  regarding the recreation of life in a way best suited 
  to its Master's purpose. The Thing takes one hour to 
  fully absorb a book, and must be uninterrupted during 
  this time. Afterwards, it can make the host book seem 
  outwardly innocuous but this illusion can be defeated. 
  Anyone who succeeds in a POW check or who closely 
  examines the book for 1D3 minutes will see past the 
  illusion and perceive the book as a suppurating and 
  disgusting parody of the original book it has inhabited 
  (seeing this form requires a Sanity check, see below).
  Possess The Reader: The Thing in the Book's primary 
  function is to possess a reader of the text it inhabits. 
  This requires the reader closely reading the book for at 
  least 1D6 minutes. Following this the reader must make 
  an opposed POW vs POW roll against the Thing or 
  become its thrall. Those who become possessed begin 
  to use the secret magic of the book to create mutations 
  which can serve as Gate Openers. They are compelled 
  to do so, and to resist costs them 1D3 Hit Points per day 
  until they succumb or die.
  Transform Gate Opener: Once it has possessed a 
  reader, the book’s goal is to manipulate that person into 
  creating nine ‘Gate Openers’ for it to use in a final ritual. 
  To this end the possessed individual will be compelled 
  to find victims and use the book’s power to transform 
  them in disgusting and strange ways. This requires the 
  possessed reader to create an item or element using the 
  book's secret instructions which the would-be victim 
  must then wear or consume. After coming into contact 
  with the infectious item, the bodily transformation 
  takes 1D6 days to commence and a further 4D4 days to 
  complete. The transformation typically drives the victim 
  quite insane (although kindly Keepers might allow a 
  victim a Sanity check with a loss of 1D4/1D20). 
  
  25
  Those transformed by the evil arts of the book suffer 
  one of the following metamorphoses:
  Roll 1D8
  1 
  Grows An Alien Appendage — this is usually a tentacle 
  but can be any kind of pseudopod. The appendage 
  has 20 Hit Points and is autonomous of its host. It can 
  Strangle at 40% doing 1D4 damage plus suffocation. 
  The appendage can even strangle its host, detach and 
  find another. The new host must fail an Opposed roll 
  of its POW vs POW 50 for it to attach, otherwise it 
  withers and dies.
  2 
  Grows 2 Alien Appendages — as above
  3 
  Grows 3 Alien Appendages — as above
  4 
  Sprouts Alien Torso — victim’s body sprouts bat wings, 
  or its torso becomes a slathering maw always hungry 
  for flesh, or barbs appear down its spine that can be 
  detached or fired as weapons, or some similar mind-
  warping horror.
  5 
  Insectoid Skull — the head of the victim distorts and 
  resembles the cranium of a giant bug. Enough of the face 
  remains, gibbering in horror, to create a disturbing image.
  6 
  Pulsating Overgrown Brain — a great pulsating green 
  brain replaces the victim's own and bursts out of the 
  original skull. It hums and drools a fetid ichor. The victim 
  gains psychic powers at the Keeper’s discretion.
  7 
  Two Overgrown Brains — As above except the victim 
  can now only lie prone because of the brains' collective 
  weight. Touching the ichor from this double brain 
  causes visions of the otherworldly vistas — presumably 
  the bizarre dimension to which the Openers seek to 
  open a gateway. Sanity loss is 1/1D6 but may gain an 
  insight into the book and its purpose.
  8 
  Total Body Transformation — The victim’s body grows 
  a cocoon that it secretes from its pores in the usual 
  transformation time. The cocoon remains on the body 
  for a further 1D6 days after which the victim emerges a 
  tentacular thing with a giant brain and bat wings, which 
  flies off to join other transformed horrors.
  Open Gate: Once nine ‘Gate Openers’ have been created, 
  The Thing requires the possessed reader assemble them 
  in a place of psychic resonance where the final gateway 
  can be opened. Once this has been done, The Thing can 
  immediately open the extradimensional rift and open the 
  way for its terrible masters to travel to the Earth.
  Further Source Material
  There are several other places where the Keeper 
  can find information about medical practice in the 
  early Australian colonies. A couple of these are 
  freely obtainable online.
  Histories
  C. J. Cummins, A History of Medical Administration in 
  NSW 1788-1973 2nd Edition, NSW Department of 
  Health, 2003.  
  Denise Donlon, Mary Casey, Wolfgang Haak and Chris-
  tina Adler, Early colonial burial practices for perinates 
  at the Parramatta convict hospital, NSW, Australasian 
  Historical Archaeology. 2008, Vol. 26, p71–83. 
  Caey & Lowe: Archaeology & Heritage, Department 
  of Commerce, Excavation Permit Application: Par-
  ramatta Hospital Site, 2005. 
  Milton J. Lewis, Medicine in colonial Australia, 1788-
  1900, Medical Journal of Australia, 201, S5-S10. 2014. 
  Jennifer Hagger, Australian Colonial Medicine, Rigby, 1979. 
  Pearn J., Petrie A.F., Petrie G.M., An early colonial 
  pharmacopoeia: a drug list and its materia medica for 
  an Australian convict settlement, Medical Journal of 
  Australia, 1988 Dec 5-19;149 (11-12), pp 630–4.
  Online
  For a handy summary of Parramatta's General Hospital 
  and some excellent sources, see Michaela Ann Cameron, 
  Parramatta's General Hospital, 2015. https://dictionary-
  ofsydney.org/entry/parramattas_general_hospital
  The Medical Text
  William Lewis et al, The Edinburgh new dispensatory : con-
  taining, I. The elements of pharmaceutical chemistry : II. The 
  materia medica ... : III. The pharmaceutical preparations and 
  compositions : including complete and accurate translations 
  of the octavo edition of the London pharmacopoeia, published 
  in 1791 : Dublin pharmacopoeia, published in 1794 : and of 
  the new edition of the Edinburgh pharmacopoeia, published 
  in 1803 : illustrated and explained in the language and ac-
  cording to the principles of modern chemistry : with many new 
  and useful tables, and several copperplates, explaining the 
  new system of chemical characters, and representing the most 
  useful pharmaceutical apparatus. Published 1805. Online at 
  https://archive.org/details/2561027R.nlm.nih.gov
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SOURCE: textdata/thevault/Call of Cthulhu (CoC) (BRP) [multi]/7th edition/Convicts & Cthulhu/CoC 7e - Convicts & Cthulhu - Ticket of Leave #11 - The Dispensatory of Doctor Macdead.pdf