The Only Cure The Only Cure is a quest available in . Overview . It is obtained in a random encounter with one of the Afflicted or by approaching Kesh at the Shrine to Peryite . The Dragonborn must be level 10 or above to get the quest from the Afflicted , and level 12 to get the quest from Kesh . Kesh tells the Dragonborn that in order to speak to Peryite , they must : After doing so , Peryite will appear to the Dragonborn and entreat their aid in cleansing the Afflicted , who are being led by Peryite ' s current champion Orchendor . Orchendor has " strayed from the path , " displeasing Peryite , who will command the Dragonborn to : The quest can also be triggered by just collecting the items needed ( listed above ) and going to the cauldron and activating it . This will start the quest . Walkthrough . Initial items . Collecting the flawless ruby is by far the hardest part of the initial task . There are a few methods to be tried in order to get one for this quest : Deathbell can be found at the Alchemist ' s Shack , near Ivarstead , throughout the swamps of Hjaalmarch , and on the west coast of Solstheim . It can be found at Anise ' s Cabin , at the beginning of the game . It can also be bought at an alchemy store , which can be found in any city . Silver Ingots and Vampire Dust can be easily obtained during the Companions questline because members of the Silver Hand often carry these . If embarking upon an entire quest line to get these items is a problem , they can be purchased in shops throughout Skyrim , along with the Deathbell . There is also a silver ore vein on the western base of the shrine ' s mountain ( although a smelter will need to be found to convert the ore to an ingot ) . There are silver ore mines and a smelter in Karthwasten to the southeast of the shrine . Speaking to Peryite . Once all necessary ingredients have been gathered , they should be brought back to Kesh at the Shrine . Upon inhaling the fumes , Peryite will begin a conversation with the Dragonborn . He will give a task to kill his current overseer , Orchendor , who has forgotten his duty to Peryite . He will also state that the Dragonborn will replace Orchendor as his new champion . Kill Orchendor . Orchendor is a mage ( fire / ice ) who resides in the Dwemer underground fortress called Bthardamz . It will be quite a challenge to find him there because Bthardamz consists of several levels and areas filled with Afflicted ( minions of Peryite that Orchendor guides ) and Dwemer Automatons . The article on Bthardamz provides a good guide to navigating the dungeon . On the way to Orchendor , the Dragonborn may find the " Afflicted ' s Note " , saying that Orchendor has gone down to the ' Aerdrome . ' There is no place named Aerdrome in Bthardamz . Instead , what is meant is the Bthardamz Arcanex . At the Arcanex , Orchendor is guarded by numerous Dwemer Automatons , including a Dwarven Centurion . They can either be fought or sneaked past , depending upon the Dragonborn ' s abilities . Orchendor is in the large room past the centurion . He deals considerable Destruction damage and is completely immune to fire , frost , and shock spells , as well as absorption effects . He is capable of teleporting and will often do so up to the upper tiers of the room . Physical weapons are recommended to slay him , and archery is useful for being able to continue attacking him as he teleports . Alternatively , one with the Assassin ' s Blade perk , a decent dagger , an invisibility potion / spell and possibly the shrouded gloves should be able to kill him with a successful sneak attack . Once he is defeated , his valuables and loot should be taken , including the key to the Bthardamz Elevator . Exiting using the elevator will avoid retracing the long journey through Bthardamz . Upon return , Peryite will reward the Dragonborn with the Spellbreaker .