Damage and Disease

Injury and Death

Your hit points measure how hard you are to kill. No matter how many hit points you lose, your character isn’t hindered in any way until your hit points drop to 0 or lower.

Loss of Hit Points

The most common way that your character gets hurt is to take lethal damage and lose hit points

What Hit Points Represent: Hit points mean two things in the game world: the ability to take physical punishment and keep going, and capacity to turn a serious blow into a less serious one.

Effects of Hit Point Damage: Damage doesn’t slow you down until your current hit points reach 0 or lower. At 0 hit points, you’re disabled.

At from –1 to –9 hit points, you’re dying.

At –10 or lower, you’re dead.

Massive Damage (Cailore)

Characters who suffer more damage in a single attack than they have Constitution points are required to make a Fortitude saving throw (DC 15) to avoid being reduced to -1 hit point and gaining the ‘dying’ status. The character can still become stable or be helped by their friends, just like any other character reduced to -1 hp.

Disabled (0 Hit Points)

When your current hit points drop to exactly 0, you’re disabled.

You can only take a single move or standard action each turn (but not both, nor can you take full-round actions). You can take move actions without further injuring yourself, but if you perform any standard action (or any other strenuous action), you take 1 point of damage after the completing the act. Unless your activity increased your hit points, you are now at –1 hit points, and you’re dying.

Any healing that raises your hit points above 0 makes you fully functional again, just as if you’d never been reduced to 0 or fewer hit points. You can also become disabled when recovering from dying. In this case, it’s a step toward recovery, and you can have fewer than 0 hit points (see Stable Characters and Recovery, below).

Dying (–1 to –CON Hit Points)

When your character’s current hit points drop to between –1 and minus your character’s Constitution score inclusive, they are dying.

A dying character immediately falls unconscious and can take no actions.

A dying character loses 1 hit point every round. This continues until the character dies or becomes stable (see below).

Dead (–CON Hit Points or Lower)

When your character’s current hit points drop to a negative amount that is equal to their Constitution score or lower, or if they take massive damage (see above), they are dead. A character can also die from taking ability damage or suffering an ability drain that reduces his Constitution to 0.

Stable Characters and Recovery

On the next turn after a character is reduced to between –1 and –CON hit points and on all subsequent turns, roll d% to see whether the dying character becomes stable. They have a 10%+CON modifier chance of becoming stable. If they don’t, they lose 1 hit point. (A character who’s unconscious or dying can’t use any special action that changes the initiative count on which his action occurs.)

If the character’s hit points drop to –CON or lower, they are dead.

You can keep a dying character from losing any more hit points and make him stable with a DC 15 Heal check.

If any sort of healing cures the dying character of even 1 point of damage, they stop losing hit points and becomes stable.

Healing that raises the dying character’s hit points to 0 makes him conscious and disabled. Healing that raises his hit points to 1 or more makes him fully functional again, just as if they’d never been reduced to 0 or lower. A spellcaster retains the spellcasting capability they had before dropping below 0 hit points.

A stable character who has been tended by a healer or who has been magically healed eventually regains consciousness and recovers hit points naturally. If the character has no one to tend him, however, his life is still in danger, and they may yet slip away.

Recovering with Help: One hour after a tended, dying character becomes stable, roll d%. They have a 10% chance of becoming conscious, at which point they are disabled (as if they had 0 hit points). If they remain unconscious, they have the same chance to revive and become disabled every hour. Even if unconscious, they recover hit points naturally. They are back to normal when his hit points rise to 1 or higher.

Recovering without Help: A severely wounded character left alone usually dies. They have a small chance, however, of recovering on his own.

A character who becomes stable on his own (by making the 10%+CON modifier roll while dying) and who has no one to tend to him still loses hit points, just at a slower rate. They have a 10%+CON modifier chance each hour of becoming conscious. Each time they miss his hourly roll to become conscious, they lose 1 hit point. They also do not recover hit points through natural healing.

Even once they become conscious and is disabled, an unaided character still does not recover hit points naturally. Instead, each day they have a 10% chance to start recovering hit points naturally (starting with that day); otherwise, they lose 1 hit point.

Once an unaided character starts recovering hit points naturally, they are no longer in danger of naturally losing hit points (even if his current hit point total is negative).


After taking damage, you can recover hit points through natural healing or magical healing. In any case, you can’t regain hit points past your full normal hit point total.

Natural Healing: With a full night’s rest (8 hours of sleep or more), you recover 1 hit point per character level. Any significant interruption during your rest prevents you from healing that night.

If you undergo complete bed rest for an entire day and night, you recover twice your character level in hit points.

Magical Healing: Various abilities and spells can restore hit points.

Healing Limits: You can never recover more hit points than you lost. Magical healing won’t raise your current hit points higher than your full normal hit point total.

Healing Ability Damage: Ability damage is temporary, just as hit point damage is. Ability damage returns at the rate of 1 point per night of rest (8 hours) for each affected ability score. Complete bed rest restores 2 points per day (24 hours) for each affected ability score.

Temporary Hit Points

Certain effects give a character temporary hit points. When a character gains temporary hit points, note his current hit point total. When the temporary hit points go away the character’s hit points drop to his current hit point total. If the character’s hit points are below his current hit point total at that time, all the temporary hit points have already been lost and the character’s hit point total does not drop further. When temporary hit points are lost, they cannot be restored as real hit points can be, even by magic.

Increases in Constitution Score and Current Hit Points: An increase in a character’s Constitution score, even a temporary one, can give her more hit points (an effective hit point increase), but these are not temporary hit points. They can be restored, and they are not lost first as temporary hit points are.

Nonlethal Damage

Dealing Nonlethal Damage: Certain attacks deal nonlethal damage. Other effects, such as heat or being exhausted, also deal nonlethal damage. When you take nonlethal damage, keep a running total of how much you’ve accumulated. Do not deduct the nonlethal damage number from your current hit points. It is not “real” damage. Instead, when your nonlethal damage equals your current hit points, you’re staggered, and when it exceeds your current hit points, you fall unconscious. It doesn’t matter whether the nonlethal damage equals or exceeds your current hit points because the nonlethal damage has gone up or because your current hit points have gone down.

Nonlethal Damage with a Weapon that Deals Lethal Damage: You can use a melee weapon that deals lethal damage to deal nonlethal damage instead, but you take a –4 penalty on your attack roll.

Lethal Damage with a Weapon that Deals Nonlethal Damage: You can use a weapon that deals nonlethal damage, including an unarmed strike, to deal lethal damage instead, but you take a –4 penalty on your attack roll.

Staggered and Unconscious: When your nonlethal damage equals your current hit points, you’re staggered. You can only take a standard action or a move action in each round. You cease being staggered when your current hit points once again exceed your nonlethal damage.

When your nonlethal damage exceeds your current hit points, you fall unconscious. While unconscious, you are helpless.

Spellcasters who fall unconscious retain any spellcasting ability they had before going unconscious.

Healing Nonlethal Damage: You heal nonlethal damage at the rate of 1 hit point per hour per character level.

When a spell or magical power cures hit point damage, it also removes an equal amount of nonlethal damage.


When a character is injured by a contaminated attack touches an item smeared with diseased matter, or consumes disease-tainted food or drink, they must make an immediate Fortitude saving throw. If they succeed, the disease has no effect—his immune system fought off the infection. If they fail, they take damage after an incubation period. Once per day afterward, they must make a successful Fortitude saving throw to avoid repeated damage. Two successful saving throws in a row indicate that they have fought off the disease and recovers, taking no more damage.

These Fortitude saving throws can be rolled secretly so that the player doesn’t know whether the disease has taken hold.

Disease Descriptions

Diseases have various symptoms and are spread through some vectors. The characteristics of several typical diseases are summarized on Table: Diseases and defined below.

Disease: Diseases whose names are printed in italic in the table are supernatural in nature. The others are extraordinary.

Infection: The disease’s method of delivery—ingested, inhaled, via injury, or contact. Keep in mind that some injury diseases may be transmitted by as small an injury as a flea bite and that most inhaled diseases can also be ingested (and vice versa).

DC: The Difficulty Class for the Fortitude saving throws to prevent infection (if the character has been infected), to prevent each instance of repeated damage, and to recover from the disease.

Incubation Period: The time before damage begins.

Damage: The ability damage the character takes after incubation and each day afterward.

Types of Diseases: Typical diseases include the following:

Blinding Sickness: Spread in tainted water.

Cackle Fever: Symptoms include high fever, disorientation, and frequent bouts of hideous laughter. Also known as “the shrieks.”

Demon Fever: Night hags spread it. Can cause permanent ability drain.

Devil Chills: Barbazu and pit fiends spread it. It takes three, not two, successful saves in a row to recover from devil chills.

Filth Fever: Dire rats and other creatures that live on carrion or in sewage spread it. Those injured while in filthy surroundings might also catch it.

Mindfire: Feels like your brain is burning. Causes stupor.

Mummy Rot: Spread by mummies. Successful saving throws do not allow the character to recover (though they do prevent damage normally).

Red Ache: Skin turns red, bloated, and warm to the touch.

The Shakes: Causes involuntary twitches, tremors, and fits.

Slimy Doom: Victim turns into infectious goo from the inside out. Can cause permanent ability drain.

Table: Diseases
Disease Infection DC Incubation Damage
Blinding sickness Ingested 16 1d3 days 1d4 Str¹
Cackle fever Inhaled 16 1 day 1d6 WIS
Demon fever Injury 18 1 day 1d6 Con²
Devil chills3 Injury 14 1d4 days 1d4 STR
Filth fever Injury 12 1d3 days 1d3 DEX, 1d3 CON
Mindfire Inhaled 12 1 day 1d4 INT
Mummy rot4 Contact 20 1 day 1d6 CON
Red ache Injury 15 1d3 days 1d6 STR
Shakes Contact 13 1 day 1d8 DEX
Slimy doom Contact 14 1 day 1d4 Con²
¹Each time the victim takes 2 or more damage from the disease, they must make another Fortitude save or be permanently blinded.
²When damaged, a character must succeed on another saving throw or 1 point of damage is permanent drain instead.
³The victim must make three successful Fortitude saving throws in a row to recover from devil chills.
4Successful saves do not allow the character to recover. Only magical healing can save the character.

Healing a Disease

Use of the Heal skill can help a diseased character. Every time a diseased character makes a saving throw against disease effects, the healer makes a check. The diseased character can use the healer’s result in place of his saving throw if the Heal check result is higher. The diseased character must be in the healer’s care and must have spent the previous 8 hours resting.

Characters recover points lost to ability score damage at a rate of 1 per day per ability damaged, and this rule applies even while a disease is in progress. That means that a character with a minor disease might be able to withstand it without accumulating any damage.