One of the most common mistakes in worldbuilding is treating culture like it’s arbitrary. Clothing styles, gender roles, and religion are decided as though they just popped out of the ether one day. In reality, few aspects of culture are arbitrary; most are the result of collective experiences. By asking how our cultures formed, we can create fictional societies that feel more real. To get started, let’s review the biggest influences on culture and think critically about the effect they might have in your world.
Hierarchy
Anyone with an oversized slice of power also has an oversized influence on culture. At the level of a society, those with power are generally the ones with:
- Military might: The generals, warlords, or commanders-in-chief of your society.
- Wealth: Anyone who gets the upper hand in the marketplace or inherits a fortune.
- Cultural legitimacy: Religious leaders, rightful heirs to a monarchy, or fairly elected officials.
When the leader of a nation doesn’t have the most might, wealth, or legitimacy, prolonged power struggles can result. For example, in thirteenth- and fourteenth-century Japan, the Shogun, who was in charge of the military, had a long power struggle with the Emperor, who had the greatest cultural legitimacy.
But power is about more than who rules a country. Whenever a line divides a group of people, one side of the line will usually become dominant. One ethnic group, one gender, and one age group will probably have more influence than others, though the level of imbalance will vary.
Regardless of which people or groups have power, they will inevitably use it to promote cultural narratives that glorify them and demonize those at the bottom of the ladder. Powerful people have many methods of cultural influence; they can be as aggressive as silencing dissenters or as subtle as commissioning favorable books and plays. That’s why many political leaders were also religious figures throughout history. If you have enough power, you can make everyone think you have the divine right to rule them.
Groups with more power are inevitably viewed as not only more virtuous but more attractive as well. In Western nations, pale skin is considered more attractive than dark skin because whites have been the dominant race for so long. This is also true in China but for a different reason. Traditionally, being pale meant being wealthy enough to stay inside instead of laboring outdoors.
Most people who aren’t involved in physical labor will choose clothing and jewelry designed to advertise wealth. In the US, glass and ceramics are the most common materials for dishware even though plastic is more cost effective and durable. That’s because plastic is considered “cheap.” Names associated with wealth are also considered more desirable. Data on names from California reveals that baby-name trends start with the wealthy and are then adopted by the lower classes.
Health and Population
Every society will have tragedies that rob them of members. Who dies and what everyone else does to adapt has a heavy influence on culture. Factors to consider include:
- Diseases: Common cases of malnutrition, plague, or genetic disorders could maim, kill, or hinder the population.
- Risk of injury: Historically, war has been a large killer of men and childbirth a large killer of women, but your space colony could lose members to hull breeches.
- Limited resources: Members of your society might suffer from starvation following droughts or from a lack of adequate shelter during harsh seasons.
Societies can become cruel in the face of tragedy. The vulnerable are often the target of culturally sanctioned killings, usually because resources are too scarce to support nonproductive members. Societies without birth control and pressured by possible starvation might resort to infanticide to keep their population down. Other cultures would leave the sick or elderly outside to die from exposure. More benignly, a culture with a high rate of infant death might not name a child for up to a year to lower emotional investment in case that child died. To cope with infant deaths, cultures might even believe that babies who die were really just demons sent to trick their parents.
Widespread diseases like malnutrition or plague also influence what traits are considered attractive. Take a look at the art on the Sistine Chapel, and you’ll see that, historically, Western culture considered plump women most attractive. But that was when starvation was a large threat to health. Now that many Western Countries struggle with obesity, thinness is considered beautiful. If your society has a widespread disease that leaves pock marks, you can bet that your culture will focus on smooth skin as essential to beauty.*
The proportions of people in different demographics will change the characteristics of a society. High numbers of disenfranchised young men strongly correlate with political instability and war.* Then, if all those men die off in a war, the balance of power may begin to tilt toward women simply because they are more numerous. On the other hand, the black plague in Europe is credited with creating the middle class of the Renaissance period, because workers were fewer and therefore more valued.
Cultures quickly respond to a scarcity or surplus of population. Inheritance rules that give everything to the oldest child are designed to prevent an estate from being split so thinly that none of the children can live off of it. Depending on how many unmarried women are available, marriage arrangements may include a payment to the husband’s family or the bride’s family. Some cultures practice polyandry to keep their population down when resources can’t provide for more children.
Economic Practicality
To a large extent, cultures eventually embrace the lifestyles that lead to the greatest economic prosperity. Consider your culture’s:
- Work roles: Different cultures have different ways of determining who does what. It could be based on a member’s place in the family or an individual’s value in the marketplace. Some castes may specialize in specific industries.
- Distribution of resources: Your culture might award the most resources to those who win competitions, those who are most productive, or those who have the greatest need.
- Primary goods and services: Your society might get most of their resources from growing and selling cotton, from independent farmsteads, or through financial investments.
A farming culture is very different from an industrial culture, which in turn is different from a post-scarcity culture. In most farming cultures, an extended family is the primary economic unit, whereas when wages are available, a single individual is the primary economic unit. That’s why industrial cultures offer more independence, which in turn leads to greater power for downtrodden individuals who previously depended on the people who controlled them. In many parts of Asia today, marriage is in steep decline among women. That’s because many of them are now economically independent, and marriage is a very traditional institution that hasn’t caught up to their modern lifestyles. An industrial culture gives them the power to turn it down. A post-scarcity culture is something we have yet to see, but I might guess it leads to even greater independence and a booming of leisure activities.
Members of a culture will restructure their lifestyle and beliefs around practical necessity. Laborers will almost always wear whatever clothes are affordable, safe, and comfortable for their work. Many societies restricted sex until marriage because they lacked birth control and because people became economically independent soon after sexual maturity. Delaying sex helped ensure that children were adequately supported by a strong economic unit – the family. But in many places, birth control is now available and educational requirements have delayed economic independence until long after sexual maturity. This makes restricting sex outside of marriage both unnecessary and impractical, and that’s why this restriction has been fading in the Western world.
Even elaborate rituals often hide a practical purpose. While many religions include a strict procedure for disposing of the diseased, a glance across cultures reveals that these stipulations usually reflect what is both affordable and sanitary for the society in question.
Connectivity
Cultures that are isolated can take a very different path from those that aren’t. Connections between societies can come in the form of:
- Communication: Even if one culture is on Earth and another on Pluto, if they frequently send transmissions back and forth, they will influence each other.
- Trade: Two cultures may rarely speak to each other but still have a great impact on the economy of each nation through trade.
- Transportation: If people can physically go back and forth between societies easily, it will both facilitate the exchange of ideas and create additional security concerns.
Cultures that are isolated are more likely to think of themselves as the center of existence. Because Earth is isolated by the vastness of space, humans spent thousands of years assuming the sun rotated around the Earth rather than vice versa. More connectivity brings better knowledge and awareness of the greater world.
Isolated cultures may also change much slower than their connected counterparts. Technological innovation and scientific knowledge don’t appear on their own; they require societal pressure to research and innovate. In addition, change requires the upending of existing power structures that thrive off the status quo.
As an example, let’s compare Europe and Japan. Europe has developed quickly because it’s made of a cluster of land-bordering nations that constantly competed with one another in both war and trade. In 1633, Galileo was convicted of heresy by the Catholic Church for teaching that the Earth rotates around the sun. But the church couldn’t achieve complete influence over all of Europe, and the competitive pressure to make discoveries remained. So Galileo’s theories slowly gained traction as more astronomers looked over the data.
On the other hand, Japan is a country that is surrounded by ocean and therefore easily isolated. In 1639, the Tokugawa shogunate severely restricted contact between Japan and the rest of the world. Foreign influence threatened the country’s stability, so the Tokugawa successfully kept outsiders away until 1853, when the United States forcefully ended their isolation. This policy helped keep Japan stable for 200 years, but it also made certain Japan’s science and technology didn’t advance at the same rate as that of Western nations.
While highly connected societies rapidly exchange ideas, they do not distribute culture evenly. The internet hasn’t unified culture so much as it has enabled people to form subcultures independent of distance. Minorities who find themselves outnumbered at home can form supportive communities online. Cultures will be more diverse within a given location in societies that are very connected.
Natural Cycles and Patterns
Society becomes obsessed with life or death events that are outside anyone’s control. These dramatic events usually come from:
- Weather: Our food and water supplies depend on yearly climate patterns, including flooding, storms, and dry spells.
- Orbital cycles: A space colony might find themselves bombarded by asteroids when the planets are in a specific position.
- Plate tectonics: Earthquakes and volcanoes have destroyed entire cities.
Every human civilization has identified and named star constellations. It’s not just that we have a natural inclination to find patterns in random occurrences; it’s also that we’ve used the stars as our calendars. Without a calendar, we couldn’t accurately anticipate seasonal changes. Strange celestial events like comets were widely considered bad omens, because people believed the stars determined destiny.
Important natural events inevitably appear in a culture’s belief systems. For instance, Ancient Egyptian civilization depended on the Nile. The river’s regular cycles of flooding and retreat became symbols of life and death. Many cultures have seasonal holidays and festivals that reflect how their lifestyles change throughout the year.
Any society with a history of disastrous events such as volcanoes eruptions or earthquakes will have coping mechanisms in place. In less advanced cultures, a religious figure or other guardian may be charged with watching the disaster area, appeasing it with rituals, or warning their people before a catastrophe. Sometimes these measures help protect people from disasters, sometimes they merely give the society a false sense of safety, even preventing them from evacuating when they need to.
History
While cultures change over time, that change can be slow and uneven. Any culture will have numerous remnants of their past. These remnants are especially likely to reflect:
- Dramatic events: Great tragedies and upheavals can impact the cultural mindset for hundreds of years.
- Old ways of life: Your culture may have a new lifestyle but look back on their old ones with wonder or nostalgia.
- Bitter feuds: Wounds inflicted on one group by another will be sore for a long time, sometimes leading to centuries of violence between groups.
The United States is an industrial democracy, but our imagination is captured by our less comfortable past. Kids are taught nostalgic songs like Old McDonald Had a Farm as though farming is still central to the average person’s life, when only about 2% of the population are engaged in farming or ranching. Our fantasy literature is filled with stories starring the rightful heir of a kingdom, even though we know that one person never has the right to control the lives of everyone else. Many of the symbols we consider mystical today – such as the hourglass – were once normal tools.
While the dominant group in a society might glorify the past, less dominant groups can rarely forget the atrocities that were inflicted on them. When a Native American watches a white person casually wear a feather headdress that’s sacred to their tribe, they do so with a strong cultural memory of being exploited by whites. The cultural interpretation of an event today is strongly influenced by its relationship to history. For instance, giving a homophobic speech at the Stonewall Inn – the first national monument dedicated to gay rights – would make people much angrier than if it were given elsewhere.
Dramatic events can determine how a society feels. Unfortunately, people are particularly motivated by fear. In the US, Pearl Harbor and 9/11 defined who was perceived as enemies for at least a generation. But tragic events can lead to positive outcomes as well. Britain achieved an unprecedented level of national unity in the face of Nazi bombing during WWII, leading to the establishment of vital social programs that lasted for many decades after the war ended.*
Thinking about how your fictional culture formed doesn’t just create a more realistic world; it’s also a lot of fun. Add an important event to your culture’s history, and watch its effects spill over into multiple aspects of the society. Pretty soon you’ll have a complex civilization that you understand completely.
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I have always suggested watching Dirty Jobs as part of the fantasy worldbuilding experience – I used to ask “what do they eat?” when presented with a new world but my newest question is “how do they poop?”
It’s a question that takes into account the sheer volume of waste a society produces. Humans produce about a pound to half a pound of bodily waste in a day, and that’s not taking into account the garbage a society produces (I’ve heard it said that Rome, in its day, had so much waste outside the walls that invaders could climb it like a normal hill into the city). How does this culture deal with people eating three pounds of foot and making one pound of shit a day? How do they replace hems on their clothing? What do they do with shells and bones of things they eat? Where does all the waste from crops go?
You can ask this of the Monster Manual in D&D or any game or movie, too. How does the monster a) eat, b) make little monsters, and c) deal with its waste materials. Even a monster that just lays its eggs in eyes and makes the babies explode out, fully adults, has a whole human body to deal with afterwards (I brought this up to a new gamer in our group and she nodded and said “Yeah now that I think about it, Pumpkinhead eats an awful lot of teenagers but I never see him take a crap, that’s so weird.”). How does it deal with that?
How do they poop?
“Regardless of which people or groups have power, they will inevitably use it to promote cultural narratives that glorify them and demonize those at the bottom of the ladder.”
I think that “demonize” is too harsh if you’re speaking in a general context. Even with a dominant group, there can always be neutral to positive depictions of those at the bottom – which is not “demonizing”.
I think that such narratives will in most cases give certain roles to certain groups, though.
“Groups with more power are inevitably viewed as not only more virtuous but more attractive as well. In Western nations, pale skin is considered more attractive than dark skin because whites have been the dominant race for so long. This is also true in China but for a different reason. Traditionally, being pale meant being wealthy enough to stay inside instead of laboring outdoors.”
I disagree on this point. The skin colour of the population in most European countries (which I think is what you include in “western nations”) does not vary as much as in the US. We do have a very small spectrum here, where it is not uncommon for someone from Central Europe to have a tan similar to a Southern European in summer. Therefore, the whole thing is – at least in Europe – not so much about white skin over black skin, but rather about “we only have ‘white’ skin”.
Also, I think that, for example, clear skin is more important than the actual skin-tone (as long as the skin-tone does not look as if you had some kind of illness).
What you wrote about China holds – as far as I know – for Turkey as well by the way.
“In the US, glass and ceramics are the most common materials for dishware even though plastic is more cost effective and durable. That’s because plastic is considered “cheap.””
In Europe glass and ceramics are the common materials for dishware too. But I don’t think, this is about plastic being “cheap” in the first place.
Hard plastic is commonly used for small children’s dishware, as it does not break if they throw it off the table. Yet, the plastic will get scratches, if you cut things on it. Small children don’t cut their own food, so it usually doesn’t matter, but adults do. Metal in contrast is durable and does not scratch, but it’s mainly used for camping and other outdoor activities, where you cannot afford to have your only bowl or plate break and neither want to carry more dishware than necessary. In a normal household you don’t want your dishware to break, either, but you can afford to. Which is why I’d say it’s not so much about the cheapness of the material, but rather about showing that you can afford to replace a broken piece. The whole thing is about showing wealth, nonetheless.
Actually, right into the 20th century and towards its end, pale skin was fashionable in Europe for pretty much the same reason as in China – those who were rich and influental didn’t need to go out and work in the sun. Especially women did a lot (including the digestion of several different poisons over time) to keep their skin pale. That’s where the parasol comes from – so the lady of fashion could go out during the day without risking her perfect porcelain skin in the sun.
It was only when travelling far came into fashion and the wealthy people were the first to fly to countries with hotter climates that tanned skin became fashionable – so fashionable that tanning beds became popular and people started to risk their skin just to look tanned even in the middle of winter.
Fact is, fashion is often connected to what the rich present. In societies with little food, being overweight is fashionable, because only the rich can afford it. In a society where only the rich can travel south, tanned is fashionable, because only the rich can do that easily. In a society where food is plentiful, so keeping slim can be a challenge, slim becomes fashionable, because the rich can afford to spend hours on their body and also can afford a personal trainer (or a liposuction). It’s always about what the rich do.
Thinking about how a culture in my story formed has always been something I do naturally. Whenever I start making up a culture, my first instinct is to figure out the culture’s long history, and then I build the culture from there.
Something I always think of is the temperature and humidity of a region; I think cultures develop differently in a rainy climate than they do in a place where there’s loads of sun. I also think people from islands have an instinctual distrust of people from continents (just look at Britain and Continental Europe).
Another thing is that cultures often develop certain traits out of reverence or hatred of a certain individual. People all over a country might adopt a hairstyle or dress a certain way in order to mimic a revered figure, and a hundred years later no one even remembers why they dress that way—they just do. On the other side of the coin, many cultures have changed greatly out of the desire to not be associated with Hitler; Adolf was a popular name when he was born, but since then almost no one has been so named, and the same can be said of his moustache.
I also think that certain facial features that people find attractive or unattractive are similarly influenced; a facial feature that reminds one of a mass-murderer who happened to have a similar look about them may cause people to react as they would to seeing the mass-murderer. Features may be considered attractive because of a resemblance to a revered person. Eventually, this just becomes a staple of a culture, and only historians know that it’s actually because of a specific person.
> Adolf was a popular name when he was born, but since then almost no one has been so named
That’s simply untrue.
It’s true that the usage of Adolf/Adolph declined as a given name in the US during and after WWII – but this was part of a general decline in German given names that started when immigration from Germany began to dry up a few decades earlier. German immigrants were more assimilated, and they gave their children more assimilated names, starting before Hitler’s rise to power.
It’s also true that the full name “Adolf Hitler” is banned in Germany – but I haven’t seen any evidence that the simple name “Adolf” is banned in Germany or Austria. Rather, names like that are considered old-fashioned – parents don’t give their children names like Adolf or Gretchen for the same reason you are unlikely to name your baby Beatrice or Floyd. Old-fashioned names can come back into fashion, with a sort of retro/classic shine, but it does seem that the current trend in Germany and Austria is for international-sounding names – their lists look a lot like the name lists you’ll see in any other Western nation.
You’re right – Adolf is not a forbidden name in Germany at least (that’s where I’m from). If you happen to have the last name Hitler (there are other people with that name, too, it wasn’t unique), it would probably be bad taste to name your child Adolf, but the real reason why it’s not common is simply that it’s not fashionable. That could change over time again. I actually had an uncle named ‘Adolf’ (he’s already dead).
The moustache as he wore it has been unfashionable, too, since then. Partially because he wore it, partially because things changed. It was pretty common before WWII – even before Hitler became a public person.
I used google to quickly check if the name “Adolf Hitler” specifically was banned in Germany, knowing that many places have stricter restrictions on what you can name a child than the US does. But I didn’t double check the google results!
That could change over time again.
It’s always hard to predict exactly which old fashioned names will become popular again and which will just sound increasingly silly, ugly, and old fashioned over time. You’re usually looking at three-ish generations from the last peak – nobody gives names from their own generation (boring) or their mother’s generation (dated) or even their grandma’s (old lady names) unless they are specifically honoring a beloved relative, but great-grandma has potential. But there’s weird confounding factors – popular culture, current events, the current fashion for what is considered “euphonious” or “ugly” in naming, which group has recently decided, as a group, to give more “assimilated” names or, alternatively, to go “back to their roots” and give more “ethnic” names (which, if the group is big enough or has a prominent enough member, can end up spilling out into the wide population).
I don’t see Adolf ever becoming popular again in Anglophone nations. The German immigration has ceased and is unlikely to start again, the descendants of German immigrants do not seem particularly interested in reviving heritage names for funzies, and Adolf in our context is just too tied in to Hitler by now – though, again, there was never a very steep drop in the US, it just tapered off with the rest of the German names.
But in Germany or Austria? I don’t know. First the trend has to come around to naming kids after that last generation where that name was really popular, and then… who can say which of those names will be resurrected and which will stay in the book?
The moustache as he wore it has been unfashionable, too, since then. Partially because he wore it, partially because things changed. It was pretty common before WWII – even before Hitler became a public person.
Forgot to say this – lots of fashions were common before WWII but aren’t now. You know that too, of course, unlike the person I first replied to. That’s another thing where the association is probably being overstated – did it fade because Hitler or because the trend in later decades was for men to be clean-shaven and that particular mustache just hasn’t come back in style yet?
I’ve got my suspicions. Hitler doesn’t help, but….
It might be useful for a character to have a motive regarding displays of wealth when it comes to dishes. However, I think your premise is flawed with regard to utility.
There are advantages for using ceramics and glass dishware instead of plastics and metals. They resist wear from utensils and are generally microwave and oven safe to ~350°, which is useful for some cooking/reheating techniques (melting/browning cheese in an oven or broiler, brûlée with a torch, flambée, etc. The thermal mass of ceramic and glass can keep hot foods hot if already hot, or they can absorb heat to bring the food down to an servable temperature. They are chemically inert and non-combustible. Breakability varies by chemistry and design, but some borosilicates and Corelle laminated glass dishware is fairly break-resistant. Ceramics can be made by artisans and small businesses as well as easily and cheaply mass produced and are a base-level technology suitable for most fictional cultures. Ceramics and glass can last for millennia, probably longer.
Plastic dishware vary by chemistry but most are not oven safe beyond low temps (~200° or less). Most are not microwave safe due to direct heating or melting from food heating. Additionally, plastics can leach dangerous chemicals (e.g. melamine or BPA) and are often combustible. They can be more easily scratched making sanitation more difficult. Many plastics are oleophilic, which makes degreasing harder. Many plastics are made via petroleum distillates and other chemicals that can be more harmful to manufacturers and the environment, necessitating a more advanced technological culture. Plastics tend to degrade, especially when exposed to UV light. As for cost, a look at Amazon shows Corelle is less than a comparable melamine dish set, but this will vary in fictional settings.
Metal dishes have problems with heat transfer and can be too hot to hold and can require insulating materials to place on a table. They don’t play well with microwave ovens, and it’s best to avoid. Metal dishes can also leach metals into foods. Different metal alloys in contact with acidic food can create an electrolytic battery, with the electric current exacerbating the leaching effect and causing discoloration, creating distasteful flavors and possibly rendering them dangerous to consume. Some metals dishware (iron, steel, copper, even silver) degrade over time and become unusable, but gold, aluminum and titanium may last a long time. Enamel-coated metal is an interesting hybrid to consider.
While it might be simpler to correlate an economic choice to envy, since it’s a base emotion, there’s a lot more to it. Cultural imperatives with tradition and/or subcultures can play a role. A more sophisticated culture, perhaps with competing cooking, hostessing and decorating authorities, might result in different products for different uses based on optimization, but that may take more verbiage to depict in literature. I like to subtly point out these small nuances in what I’m writing, but your mileage may vary.
This was a very insightful piece of work, I love the bullet points as they really helped frame and convey the ideas of the greater text efficiently.
This was a very interesting and thought provoking post (especially as I am in the phase of world-imagining for a future novel.) You gave me some new ideas to stimulate thought.
However, I think the value of “white-ness” in the modern world, or at least the U.S., is overstated, and its basis of comparison with darker races inaccurate.
In the middle ages and early industrial Europe, white-ness was valued, as in China, because it indicated the wealth and leisure that protected the paler-skinned wealthy from having to work outdoors.
Now, I would suggest, at least in the U.S., white-ness, at least in terms of actually being pale, is not valued. Because now, the wealthy and leisured have time and money to invest in tanning, either by using tanning facilities or travel to sunnier climates.
My adult daughter’s skin is practically as white as snow, and rather than just accepting it, she has over the years tried just about everything to get tan. Only recently has she made peace with her fair skin that only burns and will not tan.
There is, however, a distinct difference between being tanned (no matter how much) and having a darker skin by default (being ‘non-white’ in an ethnical way). Tanned skin indeed used to be a mark of having to work and white skin was reserved for the higher classes (especially the women from higher classes) who could avoid being out in the sun and the heat. Now things are indeed switched over, because the rich can afford either good tanning beds or simply long trips to warmer climates. The white in this article is not simple meant as the shade of the skin, it also refers to a specific ethnicity, namely being of European/Caucasian descent.
White in this context is the default for characters, authors almost always only mention skin colour when a character is not white (not as in pale, but as in being of European/Caucasian descent). Some non-white characters are even only defined by their skin colour and nothing else. That can be a real problem when you create your own culture and it can become a pitfall to avoid at all costs.
Seconding this. I grew up in a pretty racist small town/village. The bar for being considered “not white enough” in a race-sense was pretty low; like, there was a guy in my school who had naturally black hair, and he was teased for it because it looked “foreign” (even though he was white).
Still, everyone was obsessed with getting tanned, and I was ashamed of being so pale (later on, I moved to the big city and turned Goth; suddenly being as pale as an unwritten paper was all the rage in my circles… but that’s a different story :-) ).
“Many of the symbols we consider mystical today – such as the hourglass – were once normal tools”
made me think about how the symbol for saving files is a disquete, something little kids have to ask about because they never saw one in their lives
Or they wonder why we say ‘hang up’ when we end a phone call – since modern phones, even landline phones, usually only require pressing a button.
Yes, objects can become symbols while we forget what they were meant for in the beginning.
Didn’t read all comments so sorry if this was already mentioned. Under Health and Population for ‘Risk of Injury’ a place’s primary industry may be a large cause of injury/death—especially if said country has been imperialized or has a caste or slave system. Industries like mining, manufacturing, and hunting can dent a population if they’re dangerous enough and important enough.
This seems a bit human centric.
For cultures of fantastic species (at least in a sci-fi setting), I think evolutionary background would also play a big role.
In the final paragraph of the Economic Practicality section I can’t help but wonder whether it’s supposed to read deceased rather than diseased, since it’s not in the section on health (and since, while not unheard of, disposing of the dead is much more common than disposing of the sick).