Before the advent of sanitation and scientific medicine people suffered a broad range of afflictions that we don't ever have to think about. In order to present some medieval flavor to my games I've come up with a few unpleasant conditions for the players to suffer through and overcome.
Ranging form the merely pesky, like an infestation of fleas, to the deadly, such as The Black Death, these conditions can bring your players more fully into the setting you're trying to establish. Are they adventuring in the slums of this city? Better not drink that water unless you want Dysentery! Digging through the ogre's bed looking for lose gold? You're likely to take away some fleas with you along with that coin.
Many of these afflictions can be treated with simple care, bathing, proper diet or simple medicine - aka a Heal skill check. Others can be difficult to treat with the poor mundane techniques available to ancient physicians, wise women and barbers and may require a trip to the temple for the gods' intervention. Whichever disease you chose to afflict on your PCs, these diseases serve as a bit of detail to draw them into character, and perhaps relieve them of some of their coin, without becoming a game-stopper if you don't want it to be one.
These Diseases follow the standard rules for diseases (see DMG p.49). Characters who contract the disease begin at "Initial Effect" on the disease tract, and move towards Cured or Worsened and then Final Stage depending on the results of the Endurance or Heal check they make at the end of each extended rest.
DiseasesFleas - Level 1 Disease
Tiny bloodsucking insects that cause painful itching bites.Attack: +4 vs Fortitude upon touch exposure to a source of fleas.
Endurance: improve DC 16, maintain DC 11, worsen DC 10 or lower. Bathing and washing one's clothes gives a +4 on this check.
Cured: The target has freed itself from fleas, or is ignoring them completely.
Initial Effect: Painful itching from flea bites cause the target to lose one healing surge that they cannot regain.
Worsened: The infestation has grown, causing the loss of another healing surge that cannot be regained, and the fleas can attack to infest those in close proximity to the afflicted character (such as the other party members).
Final Stage: The target is constantly itching the fleas, taking a -1 penalty to skill checks in addition to the above effects. Also, the sores from itching may become subject to Infection (see below).
Food Poisoning - Level 3 Disease
Consumption of uncooked, spoiled or tainted foods can result in severe stomach and intestinal distress.Attack: +6 vs Fortitude upon consumption of tainted food or water.
Endurance: improve DC 18, maintain DC 13, worsen DC 12 or lower
Cured: The illness passes and the character recovers.
Initial Effect: Queasiness results in a -1 penalty to all attacks and skill checks, and the character loses one Healing Surge that cannot be recovered.
Worsened: Weakness and frequent vomiting and dihereah result in a -2 penalty to all attacks and skill checks, and the character loses two Healing Surges that cannot be recovered.
Worsened Further: As Worsened and the character is immobilized until they improve.
Final Stage: The character dies from dehydration.
Dysentery (aka the bloody flux) - Level 6 Disease
A disorder of the digestive system often caused by parasites that results in severe diarrhea containing mucus and blood in the feces. If left untreated, dysentery can and usually will be fatal.Attack: +9 vs Fortitude upon drinking tainted water.
Endurance: improve DC 21, maintain DC 16, worsen DC 15 or lower
Cured: The illness passes and the character recovers.
Initial Effect: Queasiness results in a -2 penalty to all attacks and skill checks, and the character loses two Healing Surges that cannot be recovered.
Worsened: Weakness and frequent vomiting and dihereah result in a -4 penalty to all attacks and skill checks, and the character loses four Healing Surges that cannot be recovered.
Worsened Further: As Worsened and the character is immobilized until they improve.
Final Stage: The character dies from dehydration.
Pox - Level 8 Disease
The pox begins with fever, aches and maliase. Then lesions form on the body and develop into inflamed ulcers that then cover over with thick black crusts. Attack: +11 vs Fortitude upon physical contact with an infected creature.
Endurance: improve DC 23, maintain DC 18, worsen DC 17 or lower
Cured: The pox clears, usually leaving extensive scars on the skin.
Initial Effect: About 12 days after exposure fevers set in and the target sufferes fatigue, headache and possible vomiting or dhiarreha. The character takes a -2 penalty to all attacks and skill checks and loses two healing surges that cannot be ragianed. In addition, the victim is contagious to others within 1 square for 5 rounds.
Worsened: The pox (red pimples) appears on the target, beginning in the mouth and spreading to the face, then chest, then the limbs. The character suffers the Initial Effect and is immobilized, but is no longer contagious.
Final Stage: Roll Percentile die: the character either dies (%1-75), is permanently blinded by pox on the eyes (%76-85) or suffers a permanent -1 to all attacks and skill checks (%86-100). If the character survives the disease has run its course and the character moves to Cured.
Infected Wounds - Level 9 Disease
Wounds that prevent sufficent bloodflow to the extremeties or that are not properly cleaned may become infected and begin to rot, turning black or green and exhuding a terrible stench.Attack: +12 vs. Fortitude if the character has open wounds that are not cleaned.
Endurance: improve DC 24, maintain DC 19, worsen DC 18 or lower
Cured: The infection clears up.
Initial Effect: The wound becomes red and inflamed, and pus or fluid drains from the wound. Lose one healing surge that cannot be regianed.
Worsened: Fever sets in. The tissue around the wound begins to turn an ugly dark color and smell like rotten meat. Red streaks may appear under the skin heading towards the character's heart. Lose two healing surges that cannot be regianed and take a -2 penalty to all attacks and skill checks.
Final Stage: The character dies from the infection.
Black Death - Level 12 Disease
Adieu, farewell earths blisse,
This world uncertaine is,
Fond are lifes lustful joyes,
Death proves them all but toyes,
None from his darts can flye;
I am sick, I must dye:
Lord, have mercy on us.
—"A Litany in Time of Plague"
by Thomas Nashe
Attack: +15 vs. Fortitude
Endurance: improve DC 27, maintain DC 22, worsen DC 21 or lower
Cured: The target recovers.
Initial Effect: The target experiences fever, headaches, painful aching joints, nausea and vomiting, and a general feeling of malaise. The target loses two healing surges that cannot be regained, is -2 to all attacks and skill checks, and cannot spend any action points.
Worsened: Painful buboes appear at the groin, armpits and neck and ooze pus and bleed, the target begins coughing up blood or purple skin patches appear on the target. The target is dazed in addition to the Initial Effect.
Final Stage: The target dies.
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