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Coma

A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. The person may experience respiratory and circulatory problems due to the body's inability to maintain normal bodily functions. People in a coma often require extensive medical care to maintain their health and prevent complications such as pneumonia or blood clots. Coma patients exhibit a complete absence of wakefulness and are unable to consciously feel, speak or move. Comas can be derived by natural causes, or can be medically induced.

Clinically, a coma can be defined as the consistent inability to follow a one-step command. It can also be defined as a score of ≤ 8 on the Glasgow Coma Scale (GCS) lasting ≥ 6 hours. For a patient to maintain consciousness, the components of wakefulness and awareness must be maintained. Wakefulness describes the quantitative degree of consciousness, whereas awareness relates to the qualitative aspects of the functions mediated by the cortex, including cognitive abilities such as attention, sensory perception, explicit memory, language, the execution of tasks, temporal and spatial orientation and reality judgment. From a neurological perspective, consciousness is maintained by the activation of the cerebral cortex—the gray matter that forms the outer layer of the brain—and by the reticular activating system (RAS), a structure located within the brainstem.

Etymology
The term 'coma', from the Greek κῶμα koma, meaning deep sleep, had already been used in the Hippocratic corpus (Epidemica) and later by Galen (second century AD). Subsequently, it was hardly used in the known literature up to the middle of the 17th century. The term is found again in Thomas Willis' (1621–1675) influential De anima brutorum (1672), where lethargy (pathological sleep), 'coma' (heavy sleeping), carus (deprivation of the senses) and apoplexy (into which carus could turn and which he localized in the white matter) are mentioned. The term carus is also derived from Greek, where it can be found in the roots of several words meaning soporific or sleepy. It can still be found in the root of the term 'carotid'. Thomas Sydenham (1624–89) mentioned the term 'coma' in several cases of fever (Sydenham, 1685).

Signs and symptoms
General symptoms of a person in a comatose state are:
 * Inability to voluntarily open the eyes
 * A non-existent sleep-wake cycle
 * Lack of response to physical (painful) or verbal stimuli
 * Depressed brainstem reflexes, such as pupils not responding to light
 * Abnormal, difficulty, or irregular breathing or no breathing at all when coma was caused by cardiac arrest
 * Scores between 3 and 8 on the Glasgow Coma Scale

Causes
Many types of problems can cause a coma. Forty percent of comatose states result from drug poisoning. Certain drug use under certain conditions can damage or weaken the synaptic functioning in the ascending reticular activating system (ARAS) and keep the system from properly functioning to arouse the brain. Secondary effects of drugs, which include abnormal heart rate and blood pressure, as well as abnormal breathing and sweating, may also indirectly harm the functioning of the ARAS and lead to a coma. Given that drug poisoning is the cause for a large portion of patients in a coma, hospitals first test all comatose patients by observing pupil size and eye movement, through the vestibular-ocular reflex. (See Diagnosis below.)

The second most common cause of coma, which makes up about 25% of cases, is lack of oxygen, generally resulting from cardiac arrest. The Central Nervous System (CNS) requires a great deal of oxygen for its neurons. Oxygen deprivation in the brain, also known as hypoxia, causes sodium and calcium from outside of the neurons to decrease and intracellular calcium to increase, which harms neuron communication. Lack of oxygen in the brain also causes ATP exhaustion and cellular breakdown from cytoskeleton damage and nitric oxide production.

Twenty percent of comatose states result from an ischemic stroke, brain hemorrhage, or brain tumor. During a stroke, blood flow to part of the brain is restricted or blocked. An ischemic stroke, brain hemorrhage, or brain tumor may cause restriction of blood flow. Lack of blood to cells in the brain prevents oxygen from getting to the neurons, and consequently causes cells to become disrupted and die. As brain cells die, brain tissue continues to deteriorate, which may affect the functioning of the ARAS, causing unconsciousness and coma.

Comatose cases can also result from traumatic brain injury, excessive blood loss, malnutrition, hypothermia, hyperthermia, hyperammonemia, abnormal glucose levels, and many other biological disorders. Furthermore, studies show that 1 out of 8 patients with traumatic brain injury experience a comatose state.

Heart-related causes of coma include cardiac arrest, ventricular fibrillation, ventricular tachycardia, atrial fibrillation, myocardial infarction, heart failure, arrhythmia when severe, cardiogenic shock, myocarditis, and pericarditis. Respiratory arrest is the only lung condition to cause coma, but many different lung conditions can cause decreased level of consciousness, but do not reach coma.

Other causes of coma include severe or persistent seizures, kidney failure, liver failure, hyperglycemia, hypoglycemia, and infections involving the brain, like meningitis and encephalitis.

Pathophysiology
Injury to either or both of the cerebral cortex or the reticular activating system (RAS) is sufficient to cause a person to enter coma.

The cerebral cortex is the outer layer of neural tissue of the cerebrum of the brain. The cerebral cortex is composed of gray matter which consists of the nuclei of neurons, whereas the inner portion of the cerebrum is composed of white matter and is composed of the axons of neuron. White matter is responsible for perception, relay of the sensory input via the thalamic pathway, and many other neurological functions, including complex thinking.

The RAS, on the other hand, is a more primitive structure in the brainstem which includes the reticular formation (RF). The RAS has two tracts, the ascending and descending tract. The ascending tract, or ascending reticular activating system (ARAS), is made up of a system of acetylcholine-producing neurons, and works to arouse and wake up the brain. Arousal of the brain begins from the RF, through the thalamus, and then finally to the cerebral cortex. Any impairment in ARAS functioning, a neuronal dysfunction, along the arousal pathway stated directly above, prevents the body from being aware of its surroundings. Without the arousal and consciousness centers, the body cannot awaken, remaining in a comatose state.

The severity and mode of onset of coma depends on the underlying cause. There are two main subdivisions of a coma: structural and diffuse neuronal. A structural cause, for example, is brought upon by a mechanical force that brings about cellular damage, such as physical pressure or a blockage in neural transmission. While a diffuse cause is limited to aberrations of cellular function, that fall under a metabolic or toxic subgroup. Toxin-induced comas are caused by extrinsic substances, whereas metabolic-induced comas are caused by intrinsic processes, such as body thermoregulation or ionic imbalances (e.g. sodium). For instance, severe hypoglycemia (low blood sugar) or hypercapnia (increased carbon dioxide levels in the blood) are examples of a metabolic diffuse neuronal dysfunction. Hypoglycemia or hypercapnia initially cause mild agitation and confusion, but progress to obtundation, stupor, and finally, complete unconsciousness. In contrast, coma resulting from a severe traumatic brain injury or subarachnoid hemorrhage can be instantaneous. The mode of onset may therefore be indicative of the underlying cause.

Structural and diffuse causes of coma are not isolated from one another, as one can lead to the other in some situations. For instance, coma induced by a diffuse metabolic process, such as hypoglycemia, can result in a structural coma if it is not resolved. Another example is if cerebral edema, a diffuse dysfunction, leads to ischemia of the brainstem, a structural issue, due to the blockage of the circulation in the brain.

Diagnosis
Although diagnosis of coma is simple, investigating the underlying cause of onset can be rather challenging. As such, after gaining stabilization of the patient's airways, breathing and circulation (the basic ABCs) various diagnostic tests, such as physical examinations and imaging tools (CT scan, MRI, etc.) are employed to access the underlying cause of the coma.

When an unconscious person enters a hospital, the hospital utilizes a series of diagnostic steps to identify the cause of unconsciousness. According to Young, the following steps should be taken when dealing with a patient possibly in a coma:
 * 1) Perform a general examination and medical history check
 * 2) Make sure the patient is in an actual comatose state and is not in a locked-in state or experiencing psychogenic unresponsiveness. Patients with locked-in syndrome present with voluntary movement of their eyes, whereas patients with psychogenic comas demonstrate active resistance to passive opening of the eyelids, with the eyelids closing abruptly and completely when the lifted upper eyelid is released (rather than slowly, asymmetrically and incompletely as seen in comas due to organic causes).
 * 3) Find the site of the brain that may be causing coma (e.g., brainstem, back of brain...) and assess the severity of the coma with the Glasgow Coma Scale
 * 4) Take blood work to see if drugs were involved or if it was a result of hypoventilation/hyperventilation
 * 5) Check for levels of serum glucose, calcium, sodium, potassium, magnesium, phosphate, urea, and creatinine
 * 6) Perform brain scans to observe any abnormal brain functioning using either CT or MRI scans
 * 7) Continue to monitor brain waves and identify seizures of patient using EEGs

Initial evaluation
In the initial assessment of coma, it is common to gauge the level of consciousness on the AVPU (alert, vocal stimuli, painful stimuli, unresponsive) scale by spontaneously exhibiting actions and, assessing the patient's response to vocal and painful stimuli. More elaborate scales, such as the Glasgow Coma Scale, quantify an individual's reactions such as eye opening, movement and verbal response in order to indicate their extent of brain injury. The patient's score can vary from a score of 3 (indicating severe brain injury and death) to 15 (indicating mild or no brain injury).

In those with deep unconsciousness, there is a risk of asphyxiation as the control over the muscles in the face and throat is diminished. As a result, those presenting to a hospital with coma are typically assessed for this risk ("airway management"). If the risk of asphyxiation is deemed high, doctors may use various devices (such as an oropharyngeal airway, nasopharyngeal airway or endotracheal tube) to safeguard the airway.

Imaging and testing
Imaging basically encompasses computed tomography (CAT or CT) scan of the brain, or MRI for example, and is performed to identify specific causes of the coma, such as hemorrhage in the brain or herniation of the brain structures. Special tests such as an EEG can also show a lot about the activity level of the cortex such as semantic processing, presence of seizures, and are important available tools not only for the assessment of the cortical activity but also for predicting the likelihood of the patient's awakening. The autonomous responses such as the skin conductance response may also provide further insight on the patient's emotional processing.

In the treatment of traumatic brain injury (TBI), there are 4 examination methods that have proved useful: skull x-ray, angiography, computed tomography (CT), and magnetic resonance imaging (MRI). The skull x-ray can detect linear fractures, impression fractures (expression fractures) and burst fractures. Angiography is used on rare occasions for TBIs i.e. when there is suspicion of an aneurysm, carotid sinus fistula, traumatic vascular occlusion, and vascular dissection. A CT can detect changes in density between the brain tissue and hemorrhages like subdural and intracerebral hemorrhages. MRIs are not the first choice in emergencies because of the long scanning times and because fractures cannot be detected as well as CT. MRIs are used for the imaging of soft tissues and lesions in the posterior fossa which cannot be found with the use of CT.

Body movements
Assessment of the brainstem and cortical function through special reflex tests such as the oculocephalic reflex test (doll's eyes test), oculovestibular reflex test (cold caloric test), corneal reflex, and the gag reflex. Reflexes are a good indicator of what cranial nerves are still intact and functioning and is an important part of the physical exam. Due to the unconscious status of the patient, only a limited number of the nerves can be assessed. These include the cranial nerves number 2 (CN II), number 3 (CN III), number 5 (CN V), number 7 (CN VII), and cranial nerves 9 and 10 (CN IX, CN X).

Assessment of posture and physique is the next step. It involves general observation about the patient's positioning. There are often two stereotypical postures seen in comatose patients. Decorticate posturing is a stereotypical posturing in which the patient has arms flexed at the elbow, and arms adducted toward the body, with both legs extended. Decerebrate posturing is a stereotypical posturing in which the legs are similarly extended (stretched), but the arms are also stretched (extended at the elbow). The posturing is critical since it indicates where the damage is in the central nervous system. A decorticate posturing indicates a lesion (a point of damage) at or above the red nucleus, whereas a decerebrate posturing indicates a lesion at or below the red nucleus. In other words, a decorticate lesion is closer to the cortex, as opposed to a decerebrate posturing which indicates that the lesion is closer to the brainstem.

Pupil size
Pupil assessment is often a critical portion of a comatose examination, as it can give information as to the cause of the coma; the following table is a technical, medical guideline for common pupil findings and their possible interpretations:

Severity
A coma can be classified as (1) supratentorial (above Tentorium cerebelli), (2) infratentorial (below Tentorium cerebelli), (3) metabolic or (4) diffused. This classification is merely dependent on the position of the original damage that caused the coma, and does not correlate with severity or the prognosis. The severity of coma impairment however is categorized into several levels. Patients may or may not progress through these levels. In the first level, the brain responsiveness lessens, normal reflexes are lost, the patient no longer responds to pain and cannot hear.

The Rancho Los Amigos Scale is a complex scale that has eight separate levels, and is often used in the first few weeks or months of coma while the patient is under closer observation, and when shifts between levels are more frequent.

Treatment
Treatment for people in a coma will depend on the severity and cause of the comatose state. Upon admittance to an emergency department, coma patients will usually be placed in an Intensive Care Unit (ICU) immediately, where maintenance of the patient's respiration and circulation become a first priority. Stability of their respiration and circulation is sustained through the use of intubation, ventilation, administration of intravenous fluids or blood and other supportive care as needed.

Continued care
Once a patient is stable and no longer in immediate danger, there may be a shift of priority from stabilizing the patient to maintaining the state of their physical wellbeing. Moving patients every 2–3 hours by turning them side to side is crucial to avoiding bed sores as a result of being confined to a bed. Moving patients through the use of physical therapy also aids in preventing atelectasis, contractures or other orthopedic deformities which would interfere with a coma patient's recovery.

Pneumonia is also common in coma patients due to their inability to swallow which can then lead to aspiration. A coma patient's lack of a gag reflex and use of a feeding tube can result in food, drink or other solid organic matter being lodged within their lower respiratory tract (from the trachea to the lungs). This trapping of matter in their lower respiratory tract can ultimately lead to infection, resulting in aspiration pneumonia.

Coma patients may also deal with restlessness or seizures. As such, soft cloth restraints may be used to prevent them from pulling on tubes or dressings and side rails on the bed should be kept up to prevent patients from falling.

Caregivers
Coma has a wide variety of emotional reactions from the family members of the affected patients, as well as the primary care givers taking care of the patients. Research has shown that the severity of injury causing coma was found to have no significant impact compared to how much time has passed since the injury occurred. Common reactions, such as desperation, anger, frustration, and denial are possible. The focus of the patient care should be on creating an amicable relationship with the family members or dependents of a comatose patient as well as creating a rapport with the medical staff. Although there is heavy importance of a primary care taker, secondary care takers can play a supporting role to temporarily relieve the primary care taker's burden of tasks.

Prognosis
Comas can last from several days to, in particularly extreme cases, years. Some patients eventually gradually come out of the coma, some progress to a vegetative state or a minimally conscious state, and others die. Some patients who have entered a vegetative state go on to regain a degree of awareness; and in some cases may remain in vegetative state for years or even decades (the longest recorded period is 42 years, the Aruna Shanbaug case).

Predicted chances of recovery will differ depending on which techniques were used to measure the patient's severity of neurological damage. Predictions of recovery are based on statistical rates, expressed as the level of chance the person has of recovering. Time is the best general predictor of a chance of recovery. For example, after four months of coma caused by brain damage, the chance of partial recovery is less than 15%, and the chance of full recovery is very low.

The outcome for coma and vegetative state depends on the cause, location, severity and extent of neurological damage. A deeper coma alone does not necessarily mean a slimmer chance of recovery; similarly, a milder coma does not indicate a higher chance of recovery. The most common cause of death for a person in a vegetative state is secondary infection such as pneumonia, which can occur in patients who lie still for extended periods.

Recovery
People may emerge from a coma with a combination of physical, intellectual, and psychological difficulties that need special attention. It is common for coma patients to awaken in a profound state of confusion and experience dysarthria, the inability to articulate any speech. Recovery is usually gradual. In the first days, the patient may only awaken for a few minutes, with increased duration of wakefulness as their recovery progresses, and they may eventually recover full awareness. That said, some patients may never progress beyond very basic responses.

There are reports of people coming out of a coma after long periods of time. After 19 years in a minimally conscious state, Terry Wallis spontaneously began speaking and regained awareness of his surroundings.

A man with brain damage and trapped in a coma-like state for six years was brought back to consciousness in 2003 by doctors who planted electrodes deep inside his brain. The method, called deep brain stimulation (DBS), successfully roused communication, complex movement and eating ability in the man with a traumatic brain injury. His injuries left him in a minimally conscious state, a condition akin to a coma but characterized by occasional, but brief, evidence of environmental and self-awareness that coma patients lack.

Society and culture
Research by Eelco Wijdicks on the depiction of comas in movies was published in Neurology in May 2006. Wijdicks studied 30 films (made between 1970 and 2004) that portrayed actors in prolonged comas, and he concluded that only two films accurately depicted the state of a coma patient and the agony of waiting for a patient to awaken: Reversal of Fortune (1990) and The Dreamlife of Angels (1998). The remaining 28 were criticized for portraying miraculous awakenings with no lasting side effects, unrealistic depictions of treatments and equipment required, and comatose patients remaining muscular and tanned.

Bioethics
A person in a coma is said to be in an unconscious state. Perspectives on personhood, identity and consciousness come into play when discussing the metaphysical and bioethical views on comas.

It has been argued that unawareness should be just as ethically relevant and important as a state of awareness and that there should be metaphysical support of unawareness as a state.

In the ethical discussions about disorders of consciousness (DOCs), two abilities are usually considered as central: experiencing well-being and having interest. Well-being can broadly be understood as the positive effect related to what makes life good (according to specific standards) for the individual in question. The only condition for well-being broadly considered is the ability to experience its 'positiveness'. That said, because experiencing positiveness is a basic emotional process with phylogenetic roots, it is likely to occur at a completely unaware level and, therefore, introduces the idea of an unconscious well-being. As such, the ability of having interests is crucial for describing two abilities which those with comas are deficient in. Having an interest in a certain domain can be understood as having a stake in something that can affect what makes our life good in that domain. An interest is what directly and immediately improves life from a certain point of view or within a particular domain, or greatly increases the likelihood of life improvement enabling the subject to realize some good. That said, sensitivity to reward signals is a fundamental element in the learning process, both consciously and unconsciously. Moreover, the unconscious brain is able to interact with its surroundings in a meaningful way and to produce meaningful information processing of stimuli coming from the external environment, including other people.

According to Hawkins, "1. A life is good if the subject is able to value, or more basically if the subject is able to care. Importantly, Hawkins stresses that caring has no need for cognitive commitment, i.e. for high-level cognitive activities: it requires being able to distinguish something, track it for a while, recognize it over time, and have certain emotional dispositions vis-à-vis something. 2. A life is good if the subject has the capacity for relationship with others, i.e. for meaningfully interacting with other people." This suggests that unawareness may (at least partly) fulfill both conditions identified by Hawkins for life to be good for a subject, thus making the unconscious ethically relevant.

title: Coma


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Call of Cthulhu (role-playing game)

Call of Cthulhu is a horror fiction role-playing game based on H. P. Lovecraft's story of the same name and the associated Cthulhu Mythos. The game, often abbreviated as CoC, is published by Chaosium; it was first released in 1981 and is in its seventh edition, with licensed foreign language editions available as well. Its game system is based on Chaosium's Basic Role-Playing (BRP) with additions for the horror genre. These include special rules for sanity and luck.

Setting
Call of Cthulhu is set in a darker version of our world based on H. P. Lovecraft's observation (from his essay, "Supernatural Horror in Literature") that "The oldest and strongest emotion of mankind is fear, and the strongest kind of fear is fear of the unknown." The original edition, first published in 1981, uses Basic Role-Playing as its basis and is set in the 1920s, the setting of many of Lovecraft's stories. The Cthulhu by Gaslight supplement blends the occult and Holmesian mystery and is mostly set in England during the 1890s. Cthulhu Now and Delta Green are set in a modern/1980s era and deal with conspiracies. Recent settings include 1000 AD (Cthulhu: Dark Ages), the 23rd century (Cthulhu Rising) and Ancient Rome (Cthulhu Invictus). The protagonists may also travel to places that are not of this earth, such as the Dreamlands (which can be accessed through dreams as well as being physically connected to the earth), other planets, or the voids of space. In keeping with the Lovecraftian theme, the gamemaster is called the Keeper of Arcane Lore ("the keeper"), while player characters are called Investigators of the Unknown ("investigators").

While predominantly focused on Lovecraftian fiction and horror, playing in the Cthulhu Mythos is not required. The system also includes ideas for non-Lovecraft games, such as using folk horror or the settings of other authors and horror movies, or with entirely custom settings and creatures by the gamemaster and/or players.

Mechanics
CoC uses the Basic Role-Playing system first developed for RuneQuest and used in other Chaosium games. It is skill-based, with player characters getting better with their skills by succeeding at using them for as long as they stay functionally healthy and sane. They do not, however, gain hit points and do not become significantly harder to kill. The game does not use levels.

CoC uses percentile dice (with results ranging from 1 to 100) to determine success or failure. Every player statistic is intended to be compatible with the notion that there is a probability of success for a particular action given what the player is capable of doing. For example, an artist may have a 75% chance of being able to draw something (represented by having 75 in Art skill), and thus rolling a number under 75 would yield a success. Rolling or less of the skill level (1-15 in the example) would be a "special success" (or an "impale" for combat skills) and would yield some extra bonus to be determined by the keeper. For example, the artist character might draw especially well or especially fast, or catch some unapparent detail in the drawing.

The players take the roles of ordinary people drawn into the realm of the mysterious: detectives, criminals, scholars, artists, war veterans, etc. Often, happenings begin innocently enough, until more and more of the workings behind the scenes are revealed. As the characters learn more of the true horrors of the world and the irrelevance of humanity, their sanity (represented by "Sanity Points", abbreviated SAN) inevitably withers away. The game includes a mechanism for determining how damaged a character's sanity is at any given point; encountering the horrific beings usually triggers a loss of SAN points. To gain the tools they need to defeat the horrors – mystic knowledge and magic – the characters may end up losing some of their sanity, though other means such as pure firepower or simply outsmarting one's opponents also exist. CoC has a reputation as a game in which it is quite common for a player character to die in gruesome circumstances or end up in a mental institution. Eventual triumph of the players is not guaranteed.

History
The original conception of Call of Cthulhu was Dark Worlds, a game commissioned by the publisher Chaosium but never published. Sandy Petersen contacted them regarding writing a supplement for their popular fantasy game RuneQuest set in Lovecraft's Dreamlands. He took over the writing of Call of Cthulhu, and the game was released in 1981. Petersen oversaw the first four editions with only minor changes to the system. Once he left, development was continued by Lynn Willis, who was credited as co-author in the fifth and sixth editions. After the death of Willis, Mike Mason became Call of Cthulhu line editor in 2013, continuing its development with Paul Fricker. Together they made the most significant rules alterations than in any previous edition, culminating in the release of the 7th edition in 2014.

Early releases
For those grounded in the RPG tradition, the very first release of Call of Cthulhu created a brand new framework for table-top gaming. Rather than the traditional format established by Dungeons & Dragons, which often involved the characters wandering through caves or tunnels and fighting different types of monsters, Sandy Petersen introduced the concept of the Onion Skin: Interlocking layers of information and nested clues that lead the player characters from seemingly minor investigations into a missing person to discovering mind-numbingly awful, global conspiracies to destroy the world. Unlike its predecessor games, CoC assumed that most investigators would not survive, alive or sane, and that the only safe way to deal with the vast majority of nasty things described in the rule books was to run away. A well-run CoC campaign should engender a sense of foreboding and inevitable doom in its players. The style and setting of the game, in a relatively modern time period, created an emphasis on real-life settings, character research, and thinking one's way around trouble.

The first book of Call of Cthulhu adventures was Shadows of Yog-Sothoth. In this work, the characters come upon a secret society's foul plot to destroy mankind, and pursue it first near to home and then in a series of exotic locations. This template was to be followed in many subsequent campaigns, including Fungi from Yuggoth (later known as Curse of Cthulhu and Day of the Beast), Spawn of Azathoth, and possibly the most highly acclaimed, Masks of Nyarlathotep.

Shadows of Yog-Sothoth is important not only because it represents the first published addition to the boxed first edition of Call of Cthulhu, but because its format defined a new way of approaching a campaign of linked RPG scenarios involving actual clues for the would-be detectives amongst the players to follow and link in order to uncover the dastardly plots afoot. Its format has been used by every other campaign-length Call of Cthulhu publication. The standard of CoC scenarios was well received by independent reviewers. The Asylum and Other Tales, a series of stand alone articles released in 1983, rated an overall 9/10 in Issue 47 of White Dwarf magazine.

The standard of the included 'clue' material varies from scenario to scenario, but reached its zenith in the original boxed versions of the Masks of Nyarlathotep and Horror on the Orient Express campaigns. Inside these one could find matchbooks and business cards apparently defaced by non-player characters, newspaper cuttings and (in the case of Orient Express) period passports to which players could attach their photographs, increasing the sense of immersion. Indeed, during the period that these supplements were produced, third party campaign publishers strove to emulate the quality of the additional materials, often offering separately-priced 'deluxe' clue packages for their campaigns.

Additional milieux were provided by Chaosium with the release of Dreamlands, a boxed supplement containing additional rules needed for playing within the Lovecraft Dreamlands, a large map and a scenario booklet, and Cthulhu By Gaslight, another boxed set which moved the action from the 1920s to the 1890s.

Cthulhu Now
In 1987, Chaosium issued the supplement titled Cthulhu Now, a collection of rules, supplemental source materials and scenarios for playing Call of Cthulhu in the present day. This proved to be a very popular alternative milieu, so much so that much of the supplemental material is now included in the core rule book.

Lovecraft Country
Lovecraft Country was a line of supplements for Call of Cthulhu released in 1990. These supplements were overseen by Keith Herber and provided backgrounds and adventures set in Lovecraft's fictional towns of Arkham, Kingsport, Innsmouth, Dunwich, and their environs. The intent was to give investigators a common base, as well as to center the action on well-drawn characters with clear motivations.

Terror Australis
In 1987, Terror Australis: Call of Cthulhu in the Land Down Under was published. In 2018, a revised and updated version of the 1987 game was reissued, with about triple the content and two new games. It requires the Call of Cthulhu Keeper's Rulebook (7th Edition) and is usable with Pulp Cthulhu.

Recent history
In the years since the collapse of the Mythos collectible card game (production ceased in 1997), the release of CoC books has been very sporadic, with up to a year between releases. Chaosium struggled with near bankruptcy for many years before finally starting their upward climb again.

2005 was Chaosium's busiest year for many years, with 10 releases for the game. Chaosium took to marketing "monographs"—short books by individual writers with editing and layout provided out-of-house—directly to the consumer, allowing the company to gauge market response to possible new works. The range of times and places in which the horrors of the Mythos can be encountered was also expanded in late 2005 onward with the addition of Cthulhu Dark Ages by Stéphane Gesbert, which gives a framework for playing games set in 11th century Europe, Secrets of Japan by Michael Dziesinski for gaming in modern-day Japan, and Secrets of Kenya by David Conyers for gaming in interwar period Africa.

In July 2011, Chaosium announced it would re-release a 30th anniversary edition of the CoC 6th edition role-playing game. This 320-page book features thick (3 mm) leatherette hardcovers with the front cover and spine stamped with gold foil. The interior pages are printed in black ink, on 90 gsm matte art paper. The binding is thread sewn, square backed. Chaosium offered a one-time printing of this Collector's Edition.

On May 28, 2013, a crowdfunding campaign on Kickstarter for the 7th edition of Call of Cthulhu was launched with a goal of $40,000; it ended on June 29 of the same year having collected $561,836. It included many more major revisions than any previous edition, and also split the core rules into two books, a Player's Guide and Keeper's Guide. Problems and delays fulfilling the Kickstarters for the 7th edition of Call of Cthulhu led Greg Stafford and Sandy Petersen (who had both left in 1998) to return to an active role at Chaosium in June 2015. The print version of 7th edition became available in September 2016.

The available milieux were also expanded with the release of Cthulhu Through the Ages, a supplement containing additional rules needed for playing within the Roman Empire, Mythic Iceland, a futuristic micro-setting, and the End Times, where the monsters of the mythos attempt to subjugate or destroy the world.

Licenses
Chaosium has licensed other publishers to create supplements, video, card and board games using the setting and the Call of Cthulhu brand. Many, such as Delta Green by Pagan Publishing and Arkham Horror by Fantasy Flight, have moved away completely from Call of Cthulhu. Other licensees have included Infogrames, Miskatonic River Press, Theater of the Mind Enterprises, Triad Entertainment, Games Workshop, RAFM, Goodman Games, Grenadier Models Inc. and Yog-Sothoth.com. These supplements may be set in different time frames or even different game universes from the original game.

Trail of Cthulhu
In February 2008, Pelgrane Press published Trail of Cthulhu, a stand-alone game created by Kenneth Hite using the GUMSHOE System developed by Robin Laws. GUMSHOE is specifically designed to be used in investigative games.

Shadows of Cthulhu
In September 2008, Reality Deviant Publications published Shadows of Cthulhu, a supplement that brings Lovecraftian gaming to Green Ronin's True20 system.

Realms of Cthulhu
In October 2009, Reality Blurs published Realms of Cthulhu, a supplement for Pinnacle Entertainment's Savage Worlds system.

Delta Green
Pagan Publishing published Delta Green, a series of supplements originally set in the 1990s, although later supplements add support for playing closer to the present day. In these, player characters are agents of a secret agency known as Delta Green, which fights against creatures from the Mythos and conspiracies related to them. Arc Dream Publishing released a new version of Delta Green in 2016 as a standalone game, partially using the mechanics from Call of Cthulhu.

d20 Call of Cthulhu
In 2001, a stand-alone version of Call of Cthulhu was released by Wizards of the Coast, for the d20 system. Intended to preserve the feeling of the original game, the d20 conversion of the game rules were supposed to make the game more accessible to the large D&D player base. The d20 system also made it possible to use Dungeons & Dragons characters in Call of Cthulhu, as well as to introduce the Cthulhu Mythos into Dungeons & Dragons games. The d20 version of the game is no longer supported by Wizards as per their contract with Chaosium. Chaosium included d20 stats as an appendix in three releases (see Lovecraft Country), but have since dropped the "dual stat" idea.

Card games
Mythos was a collectible card game (CCG) based on the Cthulhu Mythos that Chaosium produced and marketed during the mid-1990s. While generally praised for its fast gameplay and unique mechanics, it ultimately failed to gain a very large market presence. It bears mention because its eventual failure brought the company to hard times that affected its ability to produce material for Call of Cthulhu. Call of Cthulhu: The Card Game is a second collectible card game, produced by Fantasy Flight Games.

Miniatures
The first licensed Call of Cthulhu 25 mm gaming miniatures were sculpted by Andrew Chernack and released by Grenadier Models in boxed sets and blister packs in 1983. The license was later transferred to RAFM. As of 2011, RAFM still produce licensed Call of Cthulhu models sculpted by Bob Murch. Both lines include investigator player character models and the iconic monsters of the Cthulhu mythos. As of July 2015, Reaper Miniatures started its third "Bones Kickstarter", a Kickstarter intended to help the company migrate some miniatures from metal to plastic, and introducing some new ones. Among the stretch goals was the second $50 expansion, devoted to the Mythos, with miniatures such as Cultists, Deep Ones, Mi'Go, and an extra $15 Shub-Niggurath "miniature" (it is, at least, 6x4 squares). It is expected for those miniatures to remain in the Reaper Miniatures catalogue after the Kickstarter project finishes. In 2020 Chaosium announced a license agreement with Ardacious for Call of Cthulhu virtual miniatures to be released on their augmented reality app Ardent Roleplay.

Shadow of the Comet
Shadow of the Comet (later repackaged as Call of Cthulhu: Shadow of the Comet) is an adventure game developed and released by Infogrames in 1993. The game is based on H. P. Lovecraft's Cthulhu Mythos and uses many elements from Lovecraft's The Dunwich Horror and The Shadow Over Innsmouth. A follow-up game, Prisoner of Ice, is not a direct sequel.

Prisoner of Ice
Prisoner of Ice (also Call of Cthulhu: Prisoner of Ice) is an adventure game developed and released by Infogrames for the PC and Macintosh computers in 1995 in America and Europe. It is based on H. P. Lovecraft's Cthulhu Mythos, particularly At the Mountains of Madness, and is a follow-up to Infogrames' earlier Shadow of the Comet. In 1997, the game was ported to the Sega Saturn and PlayStation exclusively in Japan.

Dark Corners of the Earth
A licensed first-person shooter adventure game by Headfirst Productions, based on Call of Cthulhu campaign Escape from Innsmouth and released by Bethesda Softworks in 2005/2006 for the PC and Xbox.

The Wasted Land
In April 2011, Chaosium and new developer Red Wasp Design announced a joint project to produce a mobile video game based on the Call of Cthulhu RPG, entitled Call of Cthulhu: The Wasted Land. The game was released on January 30, 2012.

Cthulhu Chronicles
In 2018, Metarcade produced Cthulhu Chronicles, a game for iOS with a campaign of nine mobile interactive fiction stories set in 1920s England based on Call of Cthulhu. The first five stories were released on July 10, 2018.

Call of Cthulhu
Call of Cthulhu is a survival horror role-playing video game developed by Cyanide and published by Focus Home Interactive for PlayStation 4, Xbox One and Windows. The game features a semi-open world environment and incorporates themes of Lovecraftian and psychological horror into a story which includes elements of investigation and stealth. It is inspired by H. P. Lovecraft's short story "The Call of Cthulhu".

Reception
Multiple reviews of various editions appeared in Space Gamer/Fantasy Gamer.
 * In the March 1982 edition (No. 49), William A. Barton noted that there were some shortcomings resulting from an assumption by the designers that players would have access to rules from RuneQuest that were not in Call of Cthulhu, but otherwise Barton called the game "an excellent piece of work.... The worlds of H. P. Lovecraft are truly open for the fantasy gamer."
 * In the October–November 1987 edition (No. 80), Lisa Cohen reviewed the 3rd edition, saying, ""This book can be for collectors of art, players, or anyone interested in knowledge about old time occult. It is the one reprint that is worth the money."

Multiple reviews of various editions appeared in White Dwarf.
 * In the August 1982 edition (Issue 32), Ian Bailey admired much about the first edition of the game; his only criticism was that the game was too "U.S. orientated and consequently any Keeper... who wants to set his game in the UK will have a lot of research to do." Bailey gave the game an above average rating of 9 out of 10, saying, "Call of Cthulhu is an excellent game and a welcome addition to the world of role-playing."
 * In the August 1986 edition (Issue 80), Ashley Shepherd thought the inclusion of much material in the 3rd edition that had been previously published as supplementary books "makes the game incredibly good value." He concluded, "This package is going to keep Call of Cthulhu at the front of the fantasy game genre."

Several reviews of various editions and supplements also appeared in Dragon.
 * In the May 1982 edition (Issue 61), David Cook thought the rules were too complex for new gamers, but said, "It is a good game for experienced role-playing gamers and ambitious judges, especially if they like Lovecraft’s type of story."
 * In the August 1987 edition (Issue 124), Ken Rolston reviewed the Terror Australis supplement for 3rd edition that introduced an Australian setting in the 1920s. Bambra thought that "Literate, macabre doom shambles from each page. Good reading, and a good campaign setting for COC adventures."
 * In the October 1988 edition (Issue 138), Ken Rolston gave an overview of the 3rd edition, and placed it ahead of its competitors due to superior campaign setting, tone and atmosphere, the player characters as investigators, and the use of realistic player handouts such as authentic-looking newspaper clippings. Rolston concluded, "CoC is one of role-playing’s acknowledged classics. Its various supplements over the years have maintained an exceptional level of quality; several, including Shadows of Yog-Sothoth and Masks of Nyarlathotep, deserve consideration among the greatest pinnacles of the fantasy role-playing game design."
 * In the June 1990 edition (Issue 158), Jim Bambra liked the updated setting of the 4th edition, placing the game firmly in Lovecraft's 1920s. He also liked the number of adventures included in the 192-page rulebook: "The fourth edition contains enough adventures to keep any group happily entertained and sanity blasted." However, while Cook questioned whether owners of the 2nd or 3rd edition would get good value for their money — "You lack only the car-chase rules and the improved layout of the three books in one. The rest of the material has received minor editing but no substantial changes" — Cook strongly recommended the new edition to newcomers, saying, "If you don’t already play CoC, all I can do is urge you to give it a try.... discover for yourself why it has made so many converts since its release."
 * In the October 1992 edition (Issue 186), Rick Swan admitted that he was skeptical that the 5th edition would offer anything new, but instead found that the new edition benefited from "fresh material, judicious editing, and thorough polishes." He concluded, "Few RPGs exceed the CoC game’s scope or match its skillful integration of background and game systems. And there’s no game more fun."

In his 1990 book The Complete Guide to Role-Playing Games, game critic Rick Swan gave the game a top rating of 4 out of 4, calling it "a masterpiece, easily the best horror RPG ever published and possibly the best RPG, period ... breathtaking in scope and as richly textured as a fine novel. All role-players owe it to themselves to experience this truly remarkable game."

In Issue 68 of Challenge, Craig Sheeley reviewed the fifth edition and liked the revisions. "The entire character generation process is highly streamlined and easily illustrated on a two-page flowchart." DeJong also liked the inclusion of material from all three of CoC's settings (1890s, 1920s, 1990s), calling it "One of the best features of this edition." And he was very impressed with the layout of the book, commenting, "The organization and format of this book deserve special mention. I hold that every game company should study this book to learn what to do right." DeJong concluded, "I am seriously impressed with this product. From cover to cover, it’s well done."

In a reader poll conducted by UK magazine Arcane in 1996 to determine the 50 most popular roleplaying games of all time, Call of Cthulhu was ranked 1st. Editor Paul Pettengale commented: "Call of Cthulhu is fully deserved of the title as the most popular roleplaying system ever - it's a game that doesn't age, is eminently playable, and which hangs together perfectly. The system, even though it's over ten years old, it still one of the very best you'll find in any roleplaying game. Also, there's not a referee in the land who could say they've read every Lovecraft inspired book or story going, so there's a pretty-well endless supply of scenario ideas. It's simply marvellous."

Scott Taylor for Black Gate in 2013 rated Call of Cthulhu as #4 in the top ten role-playing games of all time, saying "With various revisions, but never a full rewrite of its percentile-based system, Call of Cthulhu might be antiquated by today's standards, but remember it is supposed to be set in the 1920s, so to me that seems more than appropriate."

Call of Cthulhu has been reported to be the second-most popular game played on the virtual table top platform Roll20 in 2021 (the most popular being Dungeons & Dragons). It has also been reported to have found success especially in Korea and Japan, and to have overtaken D&D in Japan.

In his 2023 book Monsters, Aliens, and Holes in the Ground, RPG historian Stu Horvath noted up to this point in time, "roleplaying games are united in one way: In some fashion, they are all power fantasies. Characters go someplace, kill some things, find some loot, and maybe gain enough experience points to unlock their hidden personal potential in the form of new spells or a new power." Horvath then pointed out that this game, as the first horror RPG, had an essential difference: "Horror, as a genre, is generally concerned with powerlessness ... In a complete inversion of other RPGs, characters in Call of Cthulhu are doomed." About the game itself, Horvath commented, "I find Call of Cthulhu unabashedly fun, despite the scares and the despair ... The slumbering god is certainly one of the strangest of pop culture canonizations, but there seems to be an endless appetite — and deep wallets — for all things Cthulhu. So long as that remains true, the Great Old One will continue to loom large over RPGs."

Awards
The game has won multiple awards:

 * 1982, Origins Awards, Best Role Playing Game
 * 1981, Game Designer's Guild, Select Award
 * 1985, Games Day Award, Best Role Playing Game
 * 1986, Games Day Award, Best Contemporary Role Playing Game
 * 1987, Games Day Award, Best Other Role Playing Game
 * 1993, Leeds Wargame Club, Best Role Playing Game
 * 1994, Gamer's Choice Award, Hall of Fame
 * 1995, Origins Award, Hall of Fame
 * 2001, Origins Award, Best Graphic Presentation of a Book Product (for Call of Cthulhu 20th anniversary edition)
 * 2002 Gold Ennie Award for "Best Graphic Design and Layout".
 * 2003, GamingReport.com readers voted it as the number-one Gothic/Horror RPG
 * 2014, ENNIE Awards - Call of Cthulhu 7th Edition Quickstart - 'Best Free Product (Silver)'
 * 2016, UK Games Expo Awards - 'Best Roleplaying Game'
 * 2017, Beasts of War Awards - 'Best RPG'
 * 2017, Dragon Con Awards - 'Best Science Fiction or Fantasy Miniatures/Collectible Card/Role Playing Game' (for Pulp Cthulhu rules)
 * 2017, ENNIE Awards - 'Best Supplement (Gold)' (for Pulp Cthulhu rules)
 * 2017, ENNIE Awards - 'Best Cover Art (Gold)' (for Call of Cthulhu Investigator Handbook)
 * 2017, ENNIE Awards - 'Best Cartography (Gold)' (for Call of Cthulhu Keeper Screen Pack)
 * 2017, ENNIE Awards - 'Best Aid/Accessory (Gold)' (for Call of Cthulhu Keeper Screen Pack)
 * 2017, ENNIE Awards - 'Best Production Values (Gold)' (for Call of Cthulhu Slipcase Set)
 * 2018, Tabletop Gaming Magazine 'Top 150 Greatest Games of All Time' - Call of Cthulhu - Ranked #3 (Reader Poll)
 * 2019, ENNIE Awards - 'Best Rules (Gold)' (for Call of Cthulhu Starter Set)

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Call of Cthulhu (role-playing game)


text:
Constellations (journal)

Constellations: An International Journal of Critical and Democratic Theory is a quarterly peer-reviewed academic journal of critical post-Marxist and democratic theory and successor of Praxis International.

Constellations is committed to publishing the best of contemporary critical theory and democratic theory in philosophy, politics, social theory, and law. The journal aims to expanding the global possibilities for radical politics and social criticism.

Editorial team
Nadia Urbinati, Amy Allen, Jean L.Cohen, and Andreas Kalyvas are former co-editors. It is currently edited by Simone Chambers, Cristina Lafont, and Hubertus Buchstein. Ertug Tombus is the managing editor of the journal since 2009. Seyla Benhabib, Nancy Fraser and Andrew Arato are the co-founding former editors. With an international editorial contribution, it is based at the New School in New York.

title: Constellations (journal)


text:
Cape Breton Island

Cape Breton Island (île du Cap-Breton, formerly île Royale; Ceap Breatainn or Eilean Cheap Bhreatainn; ) is a rugged and irregularly shaped island on the Atlantic coast of North America and part of the province of Nova Scotia, Canada.

The 10311 km2 island accounts for 18.7% of Nova Scotia's total area. Although the island is physically separated from the Nova Scotia peninsula by the Strait of Canso, the 1385 m long Canso Causeway connects it to mainland Nova Scotia. The island is east-northeast of the mainland with its northern and western coasts fronting on the Gulf of Saint Lawrence with its western coast forming the eastern limits of the Northumberland Strait. The eastern and southern coasts front the Atlantic Ocean with its eastern coast also forming the western limits of the Cabot Strait. Its landmass slopes upward from south to north, culminating in the highlands of its northern cape. One of the world's larger saltwater lakes, Bras d'Or ("Golden Arm" in French), dominates the island's centre.

The total population at the 2016 census numbered 132,010 Cape Bretoners, which is approximately 15% of the provincial population. Cape Breton Island has experienced a decline in population of approximately 2.9% since the 2011 census. Approximately 75% of the island's population is in the Cape Breton Regional Municipality (CBRM), which includes all of Cape Breton County and is often referred to as Industrial Cape Breton.

Toponymy
Cape Breton Island takes its name from its easternmost point, Cape Breton. This may have been named after the Gascon fishing port of Capbreton, but more probably takes its name from the Bretons of northwestern France. A Portuguese mappa mundi of 1516–20 includes the label "terra q(ue) foy descuberta por Bertomes" in the vicinity of the Gulf of St Lawrence, which means "land discovered by Bretons". The name "Cape Breton" first appears on a map of 1516, as C(abo) dos Bretoes, and became the general name for both the island and the cape toward the end of the 16th century. The Breton origin of the name is not universally accepted, however: William Francis Ganong argued that the Portuguese term Bertomes referred to Englishmen or Britons, and that the name should be interpreted as "Cape of the English".

History
Cape Breton Island's first residents were likely archaic maritime natives, ancestors of the Mi'kmaq people. These peoples and their progeny inhabited the island (known as Unama'ki) for several thousand years and continue to live there to this day. Their traditional lifestyle centred around hunting and fishing because of the unfavourable agricultural conditions of their maritime home. This ocean-centric lifestyle did, however, make them among the first Indigenous peoples to discover European explorers and sailors fishing in the St Lawrence Estuary. Italian explorer (sailing for the British crown) John Cabot reportedly visited the island in 1497. However, European histories and maps of the period are of too poor quality to be sure whether Cabot first visited Newfoundland or Cape Breton Island. This discovery is commemorated by Cape Breton's Cabot Trail, and by the Cabot's Landing Historic Site & Provincial Park, near the village of Dingwall.

The local Mi'kmaq peoples began trading with European fishermen when the fishermen began landing in their territories as early as the 1520s. In about 1521–22, the Portuguese under João Álvares Fagundes established a fishing colony on the island. As many as two hundred settlers lived in a village, the name of which is not known, located according to some historians at what is now Ingonish on the island's northeastern peninsula. These fishermen traded with the local population but did not maintain a permanent settlement. This Portuguese colony's fate is unknown, but it is mentioned as late as 1570.

During the Anglo-French War of 1627 to 1629, under King Charles I, the Kirkes took Quebec City, James Stewart, 4th Lord Ochiltree, planted a colony on Unama'ki at Baleine, Nova Scotia, and Alexander's son, William Alexander, 1st Earl of Stirling, established the first incarnation of "New Scotland" at Port Royal (Annapolis Royal). These claims, and larger ideals of European colonization were the first time the island was incorporated as European territory, though it would be several decades later that treaties would actually be signed. However, no copies of these treaties exist.

These Scottish triumphs, which left Cape Sable as the only major French holding in North America, did not last. Charles I's haste to make peace with France on the terms most beneficial to him meant the new North American gains would be bargained away in the Treaty of Saint-Germain-en-Laye, which established which European power had laid claim over the territories.

The French quickly defeated the Scots at Baleine, and established the first European settlements on Île Royale, which is present-day Englishtown (1629) and St. Peter's (1630). These settlements lasted only one generation, until Nicolas Denys left in 1659. The island did not have any European settlers for another fifty years before those communities along with Louisbourg were re-established in 1713, after which point European settlement was permanently established on the island.

Île Royale

Known as Île Royale ("Royal Island") to the French, the island also saw active settlement by France. After the French ceded their claims to Newfoundland and the Acadian mainland to the British by the Treaty of Utrecht in 1713, the French relocated the population of Plaisance, Newfoundland, to Île Royale and the French garrison was established in the central eastern part at Sainte Anne. As the harbour at Sainte Anne experienced icing problems, it was decided to build a much larger fortification at Louisbourg to improve defences at the entrance to the Gulf of Saint Lawrence and to defend France's fishing fleet on the Grand Banks. The French also built the Louisbourg Lighthouse in 1734, the first lighthouse in Canada and one of the first in North America. In addition to Cape Breton Island, the French colony of Île Royale also included Île Saint-Jean, today called Prince Edward Island, and Les Îles-de-la-Madeleine.

Seven Years' War

Louisbourg itself was one of the most important commercial and military centres in New France. Louisbourg was captured by New Englanders with British naval assistance in the Siege of Louisbourg (1745) and by British forces in 1758. The French population of Île Royale was deported to France after each siege. While French settlers returned to their homes in Île Royale after the Treaty of Aix-la-Chapelle was signed in 1748, the fortress was demolished after the second siege in 1758. Île Royale remained formally part of New France until it was ceded to Great Britain by the Treaty of Paris in 1763. It was then merged with the adjacent British colony of Nova Scotia (present-day peninsular Nova Scotia and New Brunswick). Acadians who had been expelled from Nova Scotia and Île Royale were permitted to settle in Cape Breton beginning in 1764, and established communities in northwestern Cape Breton, near Chéticamp, and southern Cape Breton, on and near Isle Madame.

Some of the first British-sanctioned settlers on the island following the Seven Years' War were Irish, although upon settlement they merged with local French communities to form a culture rich in music and tradition. From 1763 to 1784, the island was administratively part of the colony of Nova Scotia and was governed from Halifax.

The first permanently settled Scottish community on Cape Breton Island was Judique, settled in 1775 by Michael Mor MacDonald. He spent his first winter using his upside-down boat for shelter, which is reflected in the architecture of the village's Community Centre. He composed a song about the area called "O 's àlainn an t-àite", or "O, Fair is the Place."

American Revolution

During the American Revolution, on 1 November 1776, John Paul Jones, the father of the American Navy, set sail in command of Alfred to free hundreds of American prisoners working in the area's coal mines. Although winter conditions prevented the freeing of the prisoners, the mission did result in the capture of Mellish, a vessel carrying a vital supply of winter clothing intended for John Burgoyne's troops in Canada.

Major Timothy Hierlihy and his regiment on board HMS Hope worked in and protected the coal mines at Sydney Cape Breton from privateer attacks. Sydney, Cape Breton provided a vital supply of coal for Halifax throughout the war. The British began developing the mining site at Sydney Mines in 1777. On 14 May 1778, Major Hierlihy arrived at Cape Breton. While there, Hierlihy reported that he "beat off many piratical attacks, killed some and took other prisoners."

A few years into the war, there was also a naval engagement between French ships and a British convoy off Sydney, Nova Scotia, near Spanish River (1781), Cape Breton. French ships, fighting with the Americans, were re-coaling and defeated a British convoy. Six French and 17 British sailors were killed, with many more wounded.

Colony of Cape Breton
In 1784, Britain split the colony of Nova Scotia into three separate colonies: New Brunswick, Cape Breton Island, and present-day peninsular Nova Scotia, in addition to the adjacent colonies of St. John's Island (renamed Prince Edward Island in 1798) and Newfoundland. The colony of Cape Breton Island had its capital at Sydney on its namesake harbour fronting on Spanish Bay and the Cabot Strait. Its first Lieutenant-Governor was Joseph Frederick Wallet DesBarres (1784–1787) and his successor was William Macarmick (1787).

A number of United Empire Loyalists emigrated to the Canadian colonies, including Cape Breton. David Mathews, the former Mayor of New York City during the American Revolution, emigrated with his family to Cape Breton in 1783. He succeeded Macarmick as head of the colony and served from 1795 to 1798.

From 1799 to 1807, the military commandant was John Despard, brother of Edward.

An order forbidding the granting of land in Cape Breton, issued in 1763, was removed in 1784. The mineral rights to the island were given over to the Duke of York by an order-in-council. The British government had intended that the Crown take over the operation of the mines when Cape Breton was made a colony, but this was never done, probably because of the rehabilitation cost of the mines. The mines were in a neglected state, caused by careless operations dating back at least to the time of the final fall of Louisbourg in 1758.

Large-scale shipbuilding began in the 1790s, beginning with schooners for local trade, moving in the 1820s to larger brigs and brigantines, mostly built for British ship owners. Shipbuilding peaked in the 1850s, marked in 1851 by the full-rigged ship Lord Clarendon, which was the largest wooden ship ever built in Cape Breton.

Merger with Nova Scotia
In 1820, the colony of Cape Breton Island was merged for the second time with Nova Scotia. This development is one of the factors which led to large-scale industrial development in the Sydney Coal Field of eastern Cape Breton County. By the late 19th century, as a result of the faster shipping, expanding fishery and industrialization of the island, exchanges of people between the island of Newfoundland and Cape Breton increased, beginning a cultural exchange that continues to this day.

The 1920s were some of the most violent times in Cape Breton. They were marked by several severe labour disputes. The famous murder of William Davis by strike breakers, and the seizing of the New Waterford power plant by striking miners led to a major union sentiment that persists to this day in some circles. William Davis Miners' Memorial Day continues to be celebrated in coal mining towns to commemorate the deaths of miners at the hands of the coal companies.

20th century
The turn of the 20th century saw Cape Breton Island at the forefront of scientific achievement with the now-famous activities launched by inventors Alexander Graham Bell and Guglielmo Marconi.

Following his successful invention of the telephone and being relatively wealthy, Bell acquired land near Baddeck in 1885. He chose the land, which he named Beinn Bhreagh, largely due to its resemblance to his early surroundings in Scotland. He established a summer estate complete with research laboratories, working with deaf people including Helen Keller, and continued to invent. Baddeck would be the site of his experiments with hydrofoil technologies as well as the Aerial Experiment Association, financed by his wife Mabel Gardiner Hubbard. These efforts resulted in the first powered flight in Canada when the AEA Silver Dart took off from the ice-covered waters of Bras d'Or Lake. Bell also built the forerunner to the iron lung and experimented with breeding sheep.

Marconi's contributions to Cape Breton Island were also quite significant, as he used the island's geography to his advantage in transmitting the first North American trans-Atlantic radio message from a station constructed at Table Head in Glace Bay to a receiving station at Poldhu in Cornwall, England. Marconi's pioneering work in Cape Breton marked the beginning of modern radio technology. Marconi's station at Marconi Towers, on the outskirts of Glace Bay, became the chief communication centre for the Royal Canadian Navy in World War I through to the early years of World War II.

Promotions for tourism beginning in the 1950s recognized the importance of the Scottish culture to the province, as the provincial government started encouraging the use of Gaelic once again. The establishment of funding for the Gaelic College of Celtic Arts and Crafts and formal Gaelic language courses in public schools are intended to address the near-loss of this culture to assimilation into Anglophone Canadian culture. In the 1960s, the Fortress of Louisbourg was partially reconstructed by Parks Canada, using the labour of unemployed coal miners. Since 2009, this National Historic Site of Canada has attracted an average of 90 000 visitors per year.

Geography
The irregularly-shaped rectangular island is about 100 km wide and 150 long, for a total of 10311 km2 in area.

It lies in the southeastern extremity of the Gulf of St. Lawrence. Cape Breton is separated from the Nova Scotia peninsula by the very deep Strait of Canso. The island is joined to the mainland by the Canso Causeway.

Cape Breton Island is composed of rocky shores, rolling farmland, glacial valleys, barren headlands, highlands, woods and plateaus.

Geology
The island is characterized by a number of elevations of ancient crystalline and metamorphic rock rising up from the south to the north, and contrasted with eroded lowlands. The bedrock of blocks that developed in different places around the globe, at different times, and then were fused together via tectonics.

Cape Breton is formed from three terranes. These are fragments of the Earth's crust formed on a tectonic plate and attached by accretion or suture to crust lying on another plate. Each of these has its own distinctive geologic history, which is different from that of the surrounding areas. The southern half of the island formed from the Avalon terrane, which was once a microcontinent in the Paleozoic era. It is made up of volcanic rock that formed near what is now called Africa. Most of the northern half of the island is on the Bras d'Or terrane (part of the Ganderia terrane). It contains volcanic and sedimentary rock formed off the coast of what is now South America. The third terrane is the relatively small Blair River inlier on the far northwestern tip. It contains the oldest rock in the Maritimes, formed up to 1.6 billion years ago. These rocks, which can be seen in the Polletts Cove - Aspy Fault Wilderness Area north of Pleasant Bay, are likely part of the Canadian Shield, a large area of Precambrian igneous and metamorphic rock that forms the core of the North American continent.

The Avalon and Bras d'Or terranes were pushed together about 500 million years ago when the supercontinent Gondwana was formed. The Blair River inlier was sandwiched in between the two when Laurussia was formed 450-360 million years ago, at which time the land was found in the tropics. This collision also formed the Appalachian Mountains. Associated rifting and faulting is now visible as the canyons of the Cape Breton Highlands. Then, during the Carboniferous period, the area was flooded, which created sedimentary rock layers such as sandstone, shale, gypsum, and conglomerate. Later, most of the island was tropical forest which later formed coal deposits.

Much later, the land was shaped by repeated ice ages which left striations, till, U-shaped valleys, and carved the Bras d'Or Lake from the bedrock. Examples of U-shaped valleys are those of the Chéticamp, Grande Anse, and Clyburn River valleys. Other valleys have been eroded by water, forming V-shaped valleys and canyons. Cape Breton has many fault lines but few earthquakes. Since the North American continent is moving westward, earthquakes tend to occur on the western edge of the continent.

Climate
The warm summer humid continental climate is moderated by the proximity of the cold, oftentimes polar Labrador Current and its warmer counterpart the Gulf Stream, both being dominant currents in the North Atlantic Ocean.

Lowlands
There are lowland areas in along the western shore, around Lake Ainslie, the Bras d'Or watershed, Boularderie Island, and the Sydney coalfield. They include salt marshes, coastal beaches, and freshwater wetlands.

Starting in the 1800s, many areas were cleared for farming or timber. Many farms were abandoned from the 1920s to the 1950s with fields being reclaimed by white spruce, red maple, white birch, and balsam fir. Higher slopes are dominated by yellow birch and sugar maple. In sheltered areas with sun and drainage, Acadian forest is found. Wetter areas have tamarack, and black spruce. The weather station at Ingonish records more rain than anywhere else in Nova Scotia.

Behind barrier beaches and dunes at Aspy Bay are salt marshes. The Aspy, Clyburn, and Ingonish rivers have all created floodplains which support populations of black ash, fiddle head fern, swamp loosestrife, swamp milkweed, southern twayblade, and bloodroot.

Red sandstone and white gypsum cliffs can be observed throughout this area. Bedrock is Carboniferous sedimentary with limestone, shale, and sandstone. Many fluvial remains from are glaciation found here. Mining has been ongoing for centuries, and more than 500 mine openings can be found, mainly in the east.

Karst topography is found in Dingwall, South Harbour, Plaster Provincial Park, along the Margaree and Middle Rivers, and along the north shore of Lake Ainslie. The presence of gypsum and limestone increases soil pH and produces some rich wetlands which support giant spear, tufted fen, and other mosses, as well as vascular plants like sedges.

Cape Breton Hills
This ecosystem is spread throughout Cape Breton and is defined as hills and slopes 150-300m above sea level, typically covered with Acadian forest.

It includes North Mountain, Kellys Mountain, and East Bay Hills.

Forests in this area were cleared for timber and agriculture and are now a mosaic of habitats depending on the local terrain, soils and microclimate. Typical species include ironwood, white ash, beech, sugar maple, red maple, and yellow birch. The understory can include striped maple, beaked hazelnut, fly honeysuckle, club mosses and ferns. Ephemerals are visible in the spring, such as Dutchman's breeches and spring beauty.

In ravines, shade tolerant trees like hemlock, white pine, red spruce are found. Less well-drained areas are forested with balsam fir and black spruce.

Highlands and the Northern Plateau
The Highlands comprise a tableland in the northern portions of Inverness and Victoria counties.

An extension of the Appalachian mountain chain, elevations average 350 metres at the edges of the plateau and rise to more than 500 metres at the centre. The area has broad, gently rolling hills bisected with deep valleys and steep-walled canyons. A majority of the land is a taiga of balsam fir, with some white birch, white spruce, mountain ash, and heart-leaf birch.

The northern and western edges of the plateau, particularly at high elevations, resemble arctic tundra. Trees 30–90 high, overgrown with reindeer lichens, can be 150 years old. At very high elevations some areas are exposed bedrock without any vegetation apart from Cladonia lichens. There are many barrens, or heaths, dominated by bushy species of the Ericaceae family.

Spruce, killed by spruce budworm in the late 1970s, has reestablished at lower elevations, but not at higher elevations due to moose browsing. Decomposition is slow, leaving thick layers of plant litter. Ground cover includes wood aster, twinflower, liverworts, wood sorrel, bluebead lily, goldthread, various ferns, and lily-of-the-valley, with bryophyte and large-leaved goldenrod at higher elevations. The understory can include striped maple, mountain ash, ferns, and mountain maple.

Near water, bog birch, alder, and mountain-ash are found. There are many open wetlands populated with stunted tamarack and black spruce. Poor drainage has led to the formation of peatlands which can support tufted clubrush, Bartram's serviceberry, coastal sedge, and bakeapple.

Cape Breton coastal
The eastern shore is unique in that while not at a high elevation, it has a cool climate with much rain and fog, strong winds, and low summer temperatures. It is dominated by a boreal forest of black spruce and balsam fir. Sheltered areas support tolerant hardwoods such as white birch and red maple. Many salt marshes, fens, and bogs are found there.

There are many beaches on the highly crenelated coastline. Unlike elsewhere on the island, these are rocky and support plants unlike those of sandy beaches. The coast provides habitat for common coast bird species like common eider, black legged kittiwake, black guillemot, whimbrel, and great cormorant.

Hydrology
Land is drained into the Gulf of Saint Lawrence via the rivers Aspy, Sydney, Mira, Framboise, Margaree, and Chéticamp. The largest freshwater lake is Lake Ainslie.

Government
Local government on the island is provided by the Cape Breton Regional Municipality, the Municipality of the County of Inverness, the Municipality of the County of Richmond, and the Municipality of the County of Victoria, along with the Town of Port Hawkesbury.

The island has five Miꞌkmaq Indian reserves: Eskasoni (the largest in population and land area), Membertou, Wagmatcook, Waycobah, and Potlotek.

Demographics

The island's residents can be grouped into five main cultures: Scottish, Mi'kmaq, Acadian, Irish, and English, with respective languages Scottish Gaelic, Mi'kmaq, French, and English alongside several sign languages including Maritime Sign Language. English is now the primary language, including a locally distinctive Cape Breton accent, while Mi'kmaq, Scottish Gaelic and Acadian French are still spoken in some communities. Amongst sign languages, it is unknown to what extent LSQ is spoken amongst Acadians, but American Sign Language is certainly predominant across the island, as it has gained significant numbers of signers, especially with the steep declines in Maritime Sign Language use.

Later migrations of Black Loyalists, Italians, and Eastern Europeans mostly settled in the island's eastern part around the industrial Cape Breton region. Cape Breton Island's population has been in decline two decades with an increasing exodus in recent years due to economic conditions.

Population trend

Religious groups
Statistics Canada in 2001 reported a "religion" total of 145,525 for Cape Breton, including 5,245 with "no religious affiliation." Major categories included:
 * Roman Catholic: 96,260 (includes Eastern Catholic, Polish National Catholic Church, Old Catholic)
 * Protestant: 42,390
 * Christian, not included elsewhere: 580
 * Orthodox: 395
 * Jewish: 250
 * Muslim: 145

Economy
Much of the recent economic history of Cape Breton Island can be tied to the coal industry.

The island has two major coal deposits:

 * the Sydney Coal Field in the southeastern part of the island along the Atlantic Ocean drove the Industrial Cape Breton economy throughout the 19th and 20th centuries—until after World War II, its industries were the largest private employers in Canada.
 * the Inverness Coal Field in the western part of the island along the Gulf of St. Lawrence is significantly smaller but hosted several mines.

Sydney has traditionally been the main port, with facilities in a large, sheltered, natural harbour. It is the island's largest commercial centre and home to the Cape Breton Post daily newspaper, as well as one television station, CJCB-TV (CTV), and several radio stations. The Marine Atlantic terminal at North Sydney is the terminal for large ferries traveling to Channel-Port aux Basques and seasonally to Argentia, both on the island of Newfoundland.

Point Edward on the west side of Sydney Harbour is the location of Sydport, a former navy base (HMCS Protector) now converted to commercial use. The Canadian Coast Guard College is nearby at Westmount. Petroleum, bulk coal, and cruise ship facilities are also in Sydney Harbour.

Glace Bay, the second largest urban community in population, was the island's main coal mining centre until its last mine closed in the 1980s. Glace Bay was the hub of the Sydney & Louisburg Railway and a major fishing port. At one time, Glace Bay was known as the largest town in Nova Scotia, based on population.

Port Hawkesbury has risen to prominence since the completion of the Canso Causeway and Canso Canal created an artificial deep-water port, allowing extensive petrochemical, pulp and paper, and gypsum handling facilities to be established. The Strait of Canso is completely navigable to Seawaymax vessels, and Port Hawkesbury is open to the deepest-draught vessels on the world's oceans. Large marine vessels may also enter Bras d'Or Lake through the Great Bras d'Or channel, and small craft can use the Little Bras d'Or channel or St. Peters Canal. While commercial shipping no longer uses the St. Peters Canal, it remains an important waterway for recreational vessels.

The industrial Cape Breton area faced several challenges with the closure of the Cape Breton Development Corporation's (DEVCO) coal mines and the Sydney Steel Corporation's (SYSCO) steel mill. In recent years, the Island's residents have tried to diversify the area economy by investing in tourism developments, call centres, and small businesses, as well as manufacturing ventures in fields such as auto parts, pharmaceuticals, and window glazings.

While the Cape Breton Regional Municipality is in transition from an industrial to a service-based economy, the rest of Cape Breton Island outside the industrial area surrounding Sydney-Glace Bay has been more stable, with a mixture of fishing, forestry, small-scale agriculture, and tourism.

Tourism in particular has grown throughout the post-Second World War era, especially the growth in vehicle-based touring, which was furthered by the creation of the Cabot Trail scenic drive. The scenery of the island is rivalled in northeastern North America by only Newfoundland; and Cape Breton Island tourism marketing places a heavy emphasis on its Scottish Gaelic heritage through events such as the Celtic Colours Festival, held each October, as well as promotions through the Gaelic College of Celtic Arts and Crafts.

Whale-watching is a popular attraction for tourists. Whale-watching cruises are operated by vendors from Baddeck to Chéticamp. The most popular species of whale found in Cape Breton's waters is the pilot whale.

The Cabot Trail is a scenic road circuit around and over the Cape Breton Highlands with spectacular coastal vistas; over 400,000 visitors drive the Cabot Trail each summer and fall. Coupled with the Fortress of Louisbourg, it has driven the growth of the tourism industry on the island in recent decades. The Condé Nast travel guide has rated Cape Breton Island as one of the world's best island destinations.

Transport
The island's primary east–west road is Highway 105, the Trans-Canada Highway, although Trunk 4 is also heavily used. Highway 125 is an important arterial route around Sydney Harbour in the Cape Breton Regional Municipality. The Cabot Trail, circling the Cape Breton Highlands, and Trunk 19, along the island's western coast, are important secondary roads. The Cape Breton and Central Nova Scotia Railway maintains railway connections between the port of Sydney to the Canadian National Railway in Truro.

Cape Breton Island is served by several airports, the largest, the JA Douglas McCurdy Sydney Airport, situated on Trunk 4 between the communities of Sydney and Glace Bay, as well as smaller airports at Port Hawksbury, Margaree, and Baddeck.

Language
Gaelic speakers in Cape Breton, as elsewhere in Nova Scotia, constituted a large proportion of the local population from the 18th century on. They brought with them a common culture of poetry, traditional songs and tales, music and dance, and used this to develop distinctive local traditions.

Most Gaelic settlement in Nova Scotia happened between 1770 and 1840, with probably over 50,000 Gaelic speakers emigrating from the Scottish Highlands and the Hebrides to Nova Scotia and Prince Edward Island. Such emigration was facilitated by changes in Gaelic society and the economy, with sharp increases in rents, confiscation of land and disruption of local customs and rights. In Nova Scotia, poetry and song in Gaelic flourished. George Emmerson argues that an "ancient and rich" tradition of storytelling, song, and Gaelic poetry emerged during the 18th century and was transplanted from the Highlands of Scotland to Nova Scotia, where the language similarly took root there. The majority of those settling in Nova Scotia from the end of the 18th century through to middle of the next were from the Scottish Highlands, rather than the Lowlands, making the Highland tradition's impact more profound on the region. Gaelic settlement in Cape Breton began in earnest in the early nineteenth century. The Gaelic language became dominant from Colchester County in the west of Nova Scotia into Cape Breton County in the east. It was reinforced in Cape Breton in the first half of the 19th century with an influx of Highland Scots numbering approximately 50,000 as a result of the Highland Clearances.

From 1892 to 1904, Jonathon MacKinnon published the Scottish Gaelic-language biweekly newspaper Mac-Talla (lit. 'The Echo') in Sydney, Nova Scotia. During the 1920s, several Scottish Gaelic-language newspapers were printed in Sydney for distribution primarily on Cape Breton, including the Teachdaire nan Gàidheal (lit. 'The Messenger of the Gaels'), which included Gaelic-language lessons; the United Church-affiliated An Solus Iùil (lit. 'The Guiding Light'); and MacKinnon's later endeavor, Fear na Cèilidh (lit. 'The Entertainer').

Gaelic speakers, however, tended to be poor; they were largely illiterate and had little access to education. This situation persisted into the early days of the twentieth century. In 1921 Gaelic was approved as an optional subject in the curriculum of Nova Scotia, but few teachers could be found and children were discouraged from using the language in schools. By 1931 the number of Gaelic speakers in Nova Scotia had fallen to approximately 25,000, mostly in discrete pockets. In Cape Breton it was still a majority language, but the proportion was falling. Children were no longer being raised with Gaelic.

From 1939 on, attempts were made to strengthen its position in the public school system in Nova Scotia, but funding, official commitment and the availability of teachers continued to be a problem. By the 1950s the number of speakers was less than 7,000. The advent of multiculturalism in Canada in the 1960s meant that new educational opportunities became available, with a gradual strengthening of the language at secondary and tertiary level. At present several schools in Cape Breton offer Gaelic Studies and Gaelic language programs, and the language is taught at Cape Breton University.

The 2016 Canadian Census shows that there are only 40 reported speakers of Gaelic as a mother tongue in Cape Breton. On the other hand, there are families and individuals who have recommenced intergenerational transmission. They include fluent speakers from Gaelic-speaking areas of Scotland and speakers who became fluent in Nova Scotia and who in some cases studied in Scotland. Other revitalization activities include adult education, community cultural events and publishing.

Traditional music
Cape Breton is well known for its traditional fiddle music, which was brought to North America by Scottish immigrants during the Highland Clearances. The traditional style has been well preserved in Cape Breton, and cèilidhs have become a popular attraction for tourists. Inverness County in particular has a heavy concentration of musical activity, with regular performances in communities such as Mabou and Judique. Judique is recognized as "Baile nam Fonn" (lit. 'Village of Tunes') or the 'Home of Celtic Music', featuring the Celtic Music Interpretive Centre. The traditional fiddle music of Cape Breton is studied by musicians around the world, where its global recognition continues to rise.

Local performers who have received significant recognition outside of Cape Breton include Angus Chisholm; Buddy MacMaster; Joseph Cormier, the first Cape Breton fiddler to record an album made available in Europe (1974); Lee Cremo; Bruce Guthro; Natalie MacMaster; Ashley MacIsaac; The Rankin Family; Aselin Debison; Gordie Sampson; John Allan Cameron; and the Barra MacNeils.

The Men of the Deeps are a male choral group of current and former miners from the industrial Cape Breton area.

"The Island" by Kenzie MacNeil, and "Rise Again", written by Leon Dubinsky and recorded by The Rankin Family, are each considered unofficial anthems of Cape Breton.

Film and television

 * My Bloody Valentine: 1981 slasher film shot on location in Sydney Mines.
 * The Bay Boy: 1984 semi-autobiographical drama film about growing up in Glace Bay.
 * Margaret's Museum: 1995 drama film which tells the story of a young girl living in a coal mining town where the death of men from accidents in "the pit" (the mines) has become almost routine.
 * Pit Pony: 1999–2000 TV series about small-town life in Glace Bay in 1904. The plot revolves around the lives of the families of the men and boys who work in the coal mines.
 * New Waterford Girl: 1999 comedy-drama film about two teenage girls in New Waterford, one an aspiring artist, the other a boxer.

title: Cape Breton Island


text:
Cthulhu Mythos

The Cthulhu Mythos is a mythopoeia and a shared fictional universe, originating in the works of Anglo-American horror writer H. P. Lovecraft. The term was coined by August Derleth, a contemporary correspondent and protégé of Lovecraft, to identify the settings, tropes, and lore that were employed by Lovecraft and his literary successors. The name "Cthulhu" derives from the central creature in Lovecraft's seminal short story "The Call of Cthulhu", first published in the pulp magazine Weird Tales in 1928.

Richard L. Tierney, a writer who also wrote Mythos tales, later applied the term "Derleth Mythos" to distinguish Lovecraft's works from Derleth's later stories, which modify key tenets of the Mythos. Authors of Lovecraftian horror in particular frequently use elements of the Cthulhu Mythos.

History
In his essay "H. P. Lovecraft and the Cthulhu Mythos", Robert M. Price described two stages in the development of the Cthulhu Mythos. Price called the first stage the "Cthulhu Mythos proper". This stage was formulated during Lovecraft's lifetime and was subject to his guidance. The second stage was guided by August Derleth who, in addition to publishing Lovecraft's stories after his death, attempted to categorize and expand the Mythos.

First stage
An ongoing theme in Lovecraft's work is the complete irrelevance of mankind in the face of the cosmic horrors that apparently exist in the universe. Lovecraft made frequent references to the "Great Old Ones", a loose pantheon of ancient, powerful deities from space who once ruled the Earth and have since fallen into a deathlike sleep. While these monstrous deities were present in almost all of Lovecraft's published work (his second short story "Dagon", published in 1919, is considered the start of the Mythos), the first story to really expand the pantheon of Great Old Ones and its themes is "The Call of Cthulhu", which was published in 1928.

Lovecraft broke with other pulp writers of the time by having his main characters' minds deteriorate when afforded a glimpse of what exists outside their perceived reality. He emphasized the point by stating in the opening sentence of the story that "The most merciful thing in the world, I think, is the inability of the human mind to correlate all its contents."

Writer Dirk W. Mosig noted that Lovecraft was a "mechanistic materialist" who embraced the philosophy of cosmic indifferentism and believed in a purposeless, mechanical, and uncaring universe. Human beings, with their limited faculties, can never fully understand this universe, and the cognitive dissonance caused by this revelation leads to insanity, in his view.

There have been attempts at categorizing this fictional group of beings. Phillip A. Schreffler argues that by carefully scrutinizing Lovecraft's writings, a workable framework emerges that outlines the entire "pantheon"—from the unreachable "Outer Ones" (e.g., Azathoth, who occupies the centre of the universe) and "Great Old Ones" (e.g., Cthulhu, imprisoned on Earth in the sunken city of R'lyeh) to the lesser castes (the lowly slave shoggoths and the Mi-Go).

David E. Schultz said Lovecraft never meant to create a canonical Mythos but rather intended his imaginary pantheon to serve merely as a background element. Lovecraft himself humorously referred to his Mythos as "Yog Sothothery" (Dirk W. Mosig coincidentally suggested the term Yog-Sothoth Cycle of Myth be substituted for Cthulhu Mythos). At times, Lovecraft even had to remind his readers that his Mythos creations were entirely fictional.

The view that there was no rigid structure is expounded upon by S. T. Joshi, who said

"Lovecraft's imaginary cosmogony was never a static system but rather a sort of aesthetic construct that remained ever adaptable to its creator's developing personality and altering interests…. There was never a rigid system that might be posthumously appropriated.…. The essence of the mythos lies not in a pantheon of imaginary deities nor in a cobwebby collection of forgotten tomes, but rather in a certain convincing cosmic attitude."

Price said Lovecraft's writings could at least be divided into categories and identified three distinct themes: the "Dunsanian" (written in a similar style as Lord Dunsany), "Arkham" (occurring in Lovecraft's fictionalized New England setting), and "Cthulhu" (the cosmic tales) cycles. Writer Will Murray noted that while Lovecraft often used his fictional pantheon in the stories he ghostwrote for other authors, he reserved Arkham and its environs exclusively for those tales he wrote under his own name.

Although the Mythos was not formalized or acknowledged between them, Lovecraft did correspond, meet in person, and share story elements with other contemporary writers including Clark Ashton Smith, Robert E. Howard, Robert Bloch, Frank Belknap Long, Henry Kuttner, Henry S. Whitehead, and Fritz Leiber—a group referred to as the "Lovecraft Circle".

For example, Robert E. Howard's character Friedrich Von Junzt reads Lovecraft's Necronomicon in the short story "The Children of the Night" (1931), and in turn Lovecraft mentions Howard's Unaussprechlichen Kulten in the stories "Out of the Aeons" (1935) and "The Shadow Out of Time" (1936). Many of Howard's original unedited Conan stories also involve parts of the Cthulhu Mythos.

Second stage
Price denotes the second stage's commencement with August Derleth, with the principal difference between Lovecraft and Derleth being Derleth's use of hope and development of the idea that the Cthulhu Mythos essentially represented a struggle between good and evil. Derleth is credited with creating the "Elder Gods". He stated:

Price said the basis for Derleth's system is found in Lovecraft: "Was Derleth's use of the rubric 'Elder Gods' so alien to Lovecraft's in At the Mountains of Madness? Perhaps not. In fact, this very story, along with some hints from "The Shadow over Innsmouth", provides the key to the origin of the 'Derleth Mythos'. For in At the Mountains of Madness is shown the history of a conflict between interstellar races, first among them the Elder Ones and the Cthulhu-spawn.

Derleth said Lovecraft wished for other authors to actively write about the Mythos as opposed to it being a discrete plot device within Lovecraft's own stories. Derleth expanded the boundaries of the Mythos by including any passing reference to another author's story elements by Lovecraft as part of the genre. Just as Lovecraft made passing reference to Clark Ashton Smith's Book of Eibon, Derleth in turn added Smith's Ubbo-Sathla to the Mythos.

Derleth also attempted to connect the deities of the Mythos to the four elements (air, earth, fire, and water), creating new beings representative of certain elements in order to legitimize his system of classification. He created "Cthugha" as a sort of fire elemental when a fan, Francis Towner Laney, complained that he had neglected to include the element in his schema. Laney, the editor of The Acolyte, had categorized the Mythos in an essay that first appeared in the Winter 1942 issue of the magazine.

Impressed by the glossary, Derleth asked Laney to rewrite it for publication in the Arkham House collection Beyond the Wall of Sleep (1943). Laney's essay ("The Cthulhu Mythos") was later republished in Crypt of Cthulhu #32 (1985). In applying the elemental theory to beings that function on a cosmic scale (e.g., Yog-Sothoth) some authors created a fifth element that they termed aethyr.

Fictional cults
A number of fictional cults dedicated to "malevolent supernatural entities" appear in the Cthulhu Mythos, the loosely connected series of horror stories written by Lovecraft and other writers inspired by his creations. These fictional cults have in some ways taken on a life of their own beyond the pages of Lovecraft's works. According to author John Engle, "The very real world of esoteric magical and occult practices has adopted Lovecraft and his works into its canon, which have informed the ritual practices, or even formed the bedrock, of certain cabals and magical circles".

Significance
The Cthulhu Mythos of H. P. Lovecraft is considered to have been highly influential for the speculative fiction genre. It has been called "the official fictional religion of fantasy, science fiction, and horror, a grab bag for writers in need of unthinkably vast, and unthinkably indifferent, eldritch entities".

Biology
Sollasina cthulhu, an extinct ophiocistioid echinoderm, is named after the Cthulhu Mythos.

title: Cthulhu Mythos