Examine the floor near the unlit fire pit on the right for the ruby. However, you can dependably pick one up from inside Shriekwind Bastion: Halfway through the dungeon, locate a blood-spattered room containing a single throne.
Flawless Ruby: This is probably the hardest of the items to obtain, as the standard way of doing so depends on randomly finding one while mining. Alternatively, you can put them in a nearby unused cooking pot and collect them after. Otherwise, the quest objective will not tell you to deliver the ingredients to him. Note that if you already have some or all of these items in your inventory, you will have to drop them after Kesh tells you to collect them, and then pick them back up. He will recommend shops for the dust, mines for the silver and ruby, and the frozen tundra for the flower, though he will warn you that obtaining vampire dust from Vampires can be very dangerous. Specifically, Kesh needs one of each of the following: Vampire Dust, a Silver Ingot, a Flawless Ruby, and a Deathbell flower. When you ask for an audience with Peryite, Kesh will advise you that, to gain one, some incense is needed and creating this incense involves mixing four items in the cauldron, each of which you will need to supply. When you approach Kesh, he will be quite surprised to see another person at the remote shrine. The only remaining worshipper of Peryite is a Khajiit named Kesh the Clean who wanders about the shrine. You will arrive at the shrine after being directed by the Afflicted Refugee, or simply find the way on your own after level 12, and you will notice that the shrine is relatively humble, containing little more than a table holding the Speech skill book The Buying Game, a cooking pot, an Alchemy Lab, and an odd-looking golden cauldron. The shrine is located in The Reach, far to the northeast of Markarth, a short walk northwest of Karthwasten, a little southwest of the Dragontooth Crater landmark. He will point you to Kesh at the Shrine to Peryite for more information before continuing on his way to High Rock, adding an objective to your journal. He will say, when asked about his unhealthy appearance, that he suffers from the plague and would have died years ago without Peryite's protection. You may encounter an Afflicted Refugee during your travels, once you have reached level 10, who asks you to stop "ogling the grotesque". Kill Orchendor in the Dwemer ruin Bthardamz.ĭetailed Walkthrough Escaped Afflicted. 
Inhale the incense fumes and speak to Peryite's apparition. Gather items needed by Kesh the Clean to make incense. (Optional) Meet with an Afflicted Refugee. The Shrine to Peryite in the mountains of The Reach
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