Did you know that some fictional works feature unique diseases created by authors that later become popular tropes in fandoms? If you are in a fandom, you might encounter works with a unique disease like ‘Hanahaki Disease’. This has become wildly known fiction trope in a lot of fandoms.

So, what exactly is Hanahaki Disease? It is a fictional condition where someone would cough up flowers that have developed in their body and lungs due to unrequited love (Uy and Iyer 2024, 1). The flowers would grow inside the sufferer’s lungs as the emotional pain intensifies, making it harder to breathe. If left untreated, it would be fatal as the sufferer would eventually choke on the flowers.  Hanahaki Disease serves as a great metaphor for the pain of unrequited love. 

The term “Hanahaki” comes from Japanese words, consisting of “Hana,” which means flower, and “hakimasu,” which means to vomit or cough up. This trope was popularized by Naoko Matsuda’s shōjo manga Hanahaki Otome (The Girl Who Spit Flowers), published in 2009. In this story, the main character suffers from a mysterious illness that begins with chest pain and eventually escalates to coughing up flower petals, ultimately leading to death. 

Hanahaki Otome by Naoko Matsuda

This fictional disease has become popular for its beautiful and tragic symbolism.  In most stories, the type and color of flowers often reflect the nature of the person’s feelings, adding even more symbolism. For example, white lilies might symbolize pure love, while sunflowers might represent warmth and affection. The more intense the unreciprocated feelings, the more intense the growth of the flower becomes. 

Hanahaki Disease symptoms start with a cough. As the unrequited love feeling intensifies, the symptoms worsen–eventually leading to vomiting a whole flower and experiencing severe pain. There are two options to cure this disease. The first one is by having the beloved to return the romantic feelings, or undergo surgery to remove the flowers. However, this surgery comes with a side effect where the memories of the beloved would be erased. If this disease is left untreated or remained unreciprocated, the sufferer might end up being suffocated by the flowers and die. These frequent sad endings emphasize more tragedy and beautiful symbolism of the invisible pain that a person experiences in an unrequited love. 

Hanahaki Disease is often used in fanfiction centered on angsty, pining romances. It often represents repressed or denied feelings, and the emotional burden can carry themes of guilt and longing. The person suffers not only physically but also emotionally from their inability to confess or resolve the feelings. 

However, not all Hanahaki Disease’ fanfictions are based on romantic feelings. It can also be portrayed through familial love. For instance, this trope is used in the fanfiction for Ragbros–the sibling duo Diluc Ragnvindr and Kaeva Alberich titled “no love lost, not for him” on Ao3. In this story, Kaeya felt unloved and was shattered by the fact that if he developed the disease he might be not loved even by his brother, Diluc Ragnvindr. The story develops as Diluc eventually finds out and tries to reassure his brother that Diluc still cares for him, despite their complex relationship. 

This shows how Hanahaki disease provides a creative way to explore the consequences of love. It has become one of the most popular tropes in fanfiction as a metaphor to dramatize the agony of love and loss. The disease not only serves as a plot device, but also as a lens for writers to explore the complexities of human emotion, self-sacrifice and the longing for connection.

Reference: 

Uy, Jamie, and Amrita S Iyer. “Hanahaki Disease.” Environmental Humanities 16, no. 3 (November 1, 2024): 692–96. https://doi.org/10.1215/22011919-11327388.