[d20 & D&D 3.5] Maiming, bleeding and botched healing

[Altair_the_Vexed]

D&D and other d20 systems apply no penalty to characters who are mortally wounded and then tended back to health. There are in fact no mechanics in the system for injuries that maim and hamper a person after they have otherwise healed.
Similarly, the D&D rules don't have any room for most characters to be laid low from wounds after the battle, perhaps as they crawl into a fort and collapse with a message clutched in their dying hand.
The following is an attempt to introduce rules that allow for more dramatic injuries, without upsetting the game balance too much.

Please let me know what you think of the rules in general, the DCs in particular and all that stuff.

Ta!

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MaimingWhenever you take direct damage that reduces your hit points from a positive amount to a negative amount, you run the risk of being maimed in some way by the injury. (Area effect damage does not maim.)

Roll a FORTITUDE save DC 15 + amount of -ve HP. Success means you are merely hurt and probably unconscious and dying. Failure indicates that you have been maimed.
Maiming never reduces HP, but usually incurs an ability penalty.

Roll 1d6 and consult the table below:
1: head: 1d4 INT damage
2: left arm: 1d4 STR damage, cannot use arm to wield weapons
3: torso: 1d4 CON damage
4: right arm: 1d4 STR damage, cannot use arm to wield weapons
5: left leg: 1d4 DEX damage, 1/2 movement rate
6: right leg: 1d4 DEX damage, 1/2 movement rate

Maimed characters can be restored to health by magically curing the ability damage incurred in the maiming, usually with Lesser Restoration or a similar spell, or with the Surgery application of the Treat Injury skill (DC20).
Natural rest and healing will not restore the maimed character to full health.


Imperfect healingWhen a character uses the Treat Injury or Heal skill (depending on game system) to stabilise a patient (or restore lost HP, in d20 modern), the GM rolls the check in secret.

Stabilising:
9 or below, the patient is not stabilised and you know you have failed.
On a 10 to 14, the patient is stabilised, but imperfectly. You can only see that you have stopped the bleeding. If he takes any strenuous action, such as running, fighting, climbing, lifting more than a heavy load, he loses 1 HP per minute until treated again. The patient and any other observers can attempt a Spot check (DC10) each time a HP is lost to detect her worsening condition.
On a 15 or higher, the stabilisation is fully successful. You can only see that you have stopped the bleeding.

Restoring HP:
9 or below, the patient is not healed and you know you have failed.
On a 10 to 14, the patient 1d4 gains temporary HP, but imperfectly. You can only see that you have stopped the bleeding. If she takes any strenuous action, such as running, fighting, climbing, lifting more than a heavy load, she loses the temporary HP at a rate of 1 per round. The patient and any other observers can attempt a Spot check (DC10) each time a HP is lost to detect her worsening condition. If the patient is allowed to rest, the temporary HP are lost at the same rate that the permanent HP are gained.
On a 15 or higher, the restoration of HP is fully successful. You can only see that you have stopped the bleeding.

Imperfect healing can be rectified with a second, more successful skill check.


Worsening woundsSome wounds can bleed long after they are inflicted, putting a character at risk if not treated.

If you take more damage than your CON ability score + character level in a single physical attack (that is, not energy damage), then you must make a FORTITUDE save DC 10 + number of dice used to inflict the damage (if the damage is a fixed amount, divide it by 4 to find the save DC modifier).
A successful save means you just take the damage. A failed save indicates that you have taken a worsening wound, and will bleed 1 HP per minute until healed. You (or any other observers) can attempt a Spot check (DC10) each time a HP is lost to detect your worsening condition.
Worsening wounds must be treated as if stabilising the patient.
Magical healing removes a worsening wound if the caster also succeeds in a Treat Injury of Heal check, DC15 - level of the healing spell.

[Innis Cabal]

Actually, they do in a way. The wounding property, and similar effects do this rather well. What your forgetting, is that magical healing exists in most D&D worlds. Unless its a suitably low magic world, these rules would rarely come into effect.

[Altair_the_Vexed]

...snip... What your forgetting, is that magical healing exists in most D&D worlds. Unless its a suitably low magic world, these rules would rarely come into effect.
These rules are also for use in d20 Modern.
Granted, once the PCs are above 5th or so, these rules won't be getting used nearly as often. For low level parties, though, these rules are likely to be used at least once per day, when the cleric has used up all the Cure Light Wounds and Cure Minor Wounds they have.
Also, magical healing costs more than peasant soldiers can easily afford. Yes, there will be a certain amount of magical healing available in wars, but it most likely to be used preferentially on the most "important" wounded people first.

[Innis Cabal]

See, thats a problem. Extra rules complicate things. Extra rules that just stop being useful even more so. Why bother commiting them to memory if by level 5 you'll really almost never need them again? Its a noble idea, but not well suited for 3.5

[Altair_the_Vexed]

Thanks - I'll bear that in mind, and look at simplifying the system later.

Different people play different games.
d20 Modern just plain doesn't have the level of magic that D&D has. Characters in D&D spend many game sessions at low levels. Some campaigns don't go beyond 5th level, because some players like it like that.

However, even in a relatively high magic game, these effects will eat into PC resources - maimed and bleeding characters need more spells to sort them out. This changes some of the dynamics of the game.
The worsening wounds are there to allow for PCs and NPCs to have a dramatic struggle while getting to help.

[Kaihaku]

I like that you're thinking about implementing a more realistic health system. I took a swing at it myself a couple of years ago now...

Injury Variant
>Injury: Each character maintains a list of injuries which adversely affect their health. Differing injuries have differing affect. Below is an example injury list. Generally, an injury is a condition which positive energy alone cannot wipe away. Some measure of further treatment, be it magical or mundane, is needed.

Example Injuries
Broken Arm: 50 IP / Resistance 20 / Heal DC 15
-6 STR/DEX on all activities involving the use of right arm and take 1d6 non-lethal damage when taking such actions.
Concussion: 150 IP/ Resistance 50 / Heal DC 30
-4 penalty on all saving throws, skill checks, and ability checks.
Broken Spine: 500 IP / Immune / Remove Paralysis, Heal DC 50, Restoration, Miracle
Permanent Paralysis. The spell Remove Paralysis allows the injury to be healed through positive energy as a DC 50 Heal check but does not negate the condition.

Each injury has a number of Injury Points (IP), when this number reaches zero the injury has been healed. Regaining hit points through rest or positive energy removes Injury Points however injuries generally have a resistance, think of it as damage reduction to healing effects, which can only be overcome by a successful heal check or specific level magic. Depending on the injury, the heal check may need to be for long term care as for a broken spine, once a day as for a Concussion, or once in general as for setting a broken arm.

This variant makes the Heal skill and the role of a Healer in the world much more vital and interesting than the standard. Traditional medicine, long rests to recover from injuries, grievous wounds, handicaps... All are no longer negated by Conjuration(healing) alone.
>Massive Damage: In this variant, the massive damage threshold becomes less of a brutal shock but continues to carry significant threat. Instead of saving versus death from massive damage, the character instead rolls to avoid serious injury. The greater their failure, the more serious injury they receive.
>Near Death: In this variant, a character no longer dies below -10 hitpoints, instead they continue to make fortitude saves as normal. Regardless of whether they stabilize or not, they gain an injury based on the extent of their wounds.

Wounds and Injury
-10 through -1/4 max hp : Moderate Injury
-1/4 max hp through -2/4 max hp : Serious Injury
-2/4 max hp through -3/4 max hp : Determined by DM
-3/4 through -max hp: Determined by DM
-max hp and above: Automatic Death

This variant makes falling unconscious and into negative hitpoints less desperate and final for a character, but still a situation of serious threat

[bosssmiley]

D&D and other d20 systems apply no penalty to characters who are mortally wounded and then tended back to health. There are in fact no mechanics in the system for injuries that maim and hamper a person after they have otherwise healed.

I draw your attention to the Disabled status effect. Simply apply this until a character is healed above whatever percentage of their normal full hp you deem fitting.

As for maiming from near-lethal wounds. You could just introduce a house rule that a maimed character suffers -2 to checks using a particular sense/limb. See if this is ok with your players first though - some deem permanent crippling injuries anti-heroic.


Similarly, the D&D rules don't have any room for most characters to be laid low from wounds after the battle, perhaps as they crawl into a fort and collapse with a message clutched in their dying hand.

Bleeding out at negative hp covers this.

Why reinvent the wheel?

[Clementx]

I incorporated maiming as an alternate function of Coup de Grace. Instead of forcing a save against instant death, you can try to inflict 1d6 points of ability drain, blind, deafen, sever a limb, or just keep them knocked out, raising their nonlethal damage to their max HP +10.

This gives sadistic enemies, torture, and hostage taking ("Move and I kill you" = Render yourself helpless and delay or else my readied attack goes off) a mechanical alternative.

[Altair_the_Vexed]

I draw your attention to the Disabled status effect. Simply apply this until a character is healed above whatever percentage of their normal full hp you deem fitting.
Yes, that is effectively what I've done with botched healing. With a failed-but-close check result, the character is effectively disabled. All the same conditions apply. I will update the OP with a clear citation of the disabled status.

As for maiming from near-lethal wounds. You could just introduce a house rule that a maimed character suffers -2 to checks using a particular sense/limb. See if this is ok with your players first though - some deem permanent crippling injuries anti-heroic.
A -2 penalty seems reasonable, and removes the randomness... It should still be removed by the Restoration spells - the SRD specifies that these spells heal crippled limbs.
I would still want to retain the loss of use of the limb - you can't wield a sword with a broken arm, nor can you run with a broken leg. Character can get over these issues with healing through skills and magic, so they're not permanent effects for PCs.

Bleeding out at negative hp covers this.

Bleeding while on negative HP is at 1 HP per round: way too fast. It represents a wound that is going to kill you in under one minute (unless you're rather lucky).
I want a system for more protracted bleeding / worsening of an injury. In my personal experience, effects injuries can be progressively disabling over a few hours without any sudden crisis (such as represented by losing 1 HP per round).

[Altair_the_Vexed]

After a playtest of the above system last night, I've revised Maiming to require a Fort save DC = your +ve HP before you were reduced to -ve HP.

The effect is that when you are on 1 HP and take 2 HP damage, that's only a very small amount of damage, so you only run a small risk of being maimed.