Tuberculosis as a 3.5 D&D Disease

[myancey]

Hey playgrounders,

I was wondering if you guys would help me design tuberculosis as an in-game, stated disease that can be usable on players and NPCs.

I was hoping for the disease to be able to be able to show different stages rather than being a set penalty till the disease is removed.

Players could then come across someone in an advanced stage of the illness, perhaps someone even dying from it.

Thanks.

[gkathellar]

This probably belongs in Homebrew.

I suspect TB would be a difficult disease to simulate by the present rules, because it's such a long-term illness. Running it by fiat might be more efficient. After all, you don't see rules for the common cold, because it's not a weird, super-potent magic disease.

[Yora]

Low Constitution damage with a high DC seems to be a good baseline. Since you heal 1 to 2 points of constitution every day, it will take quite some time to kill you, but with the save high enough, it's very unlikely that you get over it. Maybe make it even three consecutive successful saves to be cured.
Not entirely sure how it would affect Str and Dex.

[GoodbyeSoberDay]

Low Constitution damage with a high DC seems to be a good baseline. Since you heal 1 to 2 points of constitution every day, it will take quite some time to kill you, but with the save high enough, it's very unlikely that you get over it. Maybe make it even three consecutive successful saves to be cured.
Not entirely sure how it would affect Str and Dex.This is how I would model it. 1d4 Con damage a day is a little quick, but it'll do. Maybe throw in constant fatigue, and then at later stages constant exhaustion. Note that I'd make all the effects go away after one full day's bedrest if someone cast Remove Disease or the like on you.

[Psyren]

Low Constitution damage with a high DC seems to be a good baseline. Since you heal 1 to 2 points of constitution every day, it will take quite some time to kill you, but with the save high enough, it's very unlikely that you get over it. Maybe make it even three consecutive successful saves to be cured.
Not entirely sure how it would affect Str and Dex.

It wouldn't (http://snk.wikia.com/wiki/Ukyo_Tachibana)

[Yorae]

Please, oh, please tell me you are playing a Pathfinder Gunslinger.

Channel the awesome of Doc Holliday.

Edit: Relevant:

http://www.youtube.com/watch?v=qUPaigOxAi8
http://www.youtube.com/watch?v=_u5A0H6PkqE&feature=related

[Yora]

Or Captain Tuberculosis. I have to admit I completely forgot his actual name.

[Yorae]

Or Captain Tuberculosis. I have to admit I completely forgot his actual name.

Captain Jushiro Ukitake =D

Nearly forgot about him, he was totally awesome.

[Ravens_cry]

I would make it 1d3 Con damage. You will heal the damage most of the time, and a little lessor restoration will take care of the rest, but left untreated it will kill you.
Still, Real™ Tuberculosis is rather too chronic a condition to really fit in with D&D's disease mechanic.
It might make work better as a Flaw.
Maybe certain strenuous actions leave you fatigued and actions that leave you fatigued leave you exhausted.

[CTrees]

Real poisons and diseases are really not that similar to d&d. It's actually been a source of frustration to me a few times, but... oh well, I guess.

Some of these ideas here are decent for modeling tb, at least.

[Calanon]

While were at it lets just convert Leukemia to D&D :smallmad:

Tuberculosis would do no STR or DEX damage, the most it would do is 1d3 Con damage on a daily basis and the "victim" would be Fatigued at the end of every combat encounter or any strenuous activity, after which a Cleric with a caster level equal to the "victims" HD can perform a lesser restoration on you which will allow you to ignore the effects of the disease for the next 24 hours. This can only be performed after the first combat.

I did the 24 hours restoration thing since after we go to the doctors (My aunt) She oddly enough doesn't really look or act like she has Tuberculosis... :smallsmile:

[TurtleKing]

Thinking about it the medicine TB patients take would be similar to the effects of lesser Restoration in helping them to live longer. Otherwise slowly they waste away. While you may think the CON damage is how to represent it I think a very slow progression of CON DRAIN would fit better especially if untreated. With TB you are coughing up blood, and since you produce only so much blood at a time eventually you run too low. As such as they reach a certain amount of CON drain they then become fatigued all the time with the same happening again for exhaustion after so much. The rate of CON Drain would more likely be on a weekly basis with a save following the normal rules for diseases and saves. Since it is practically impossible to be cured of it would place the cured save DC really high.

Edit: If it matters any I used to be a Medical Lab Tech.

[deuxhero]

Please, oh, please tell me you are playing a Pathfinder Gunslinger.


Nah, he's doing a Summoner or Malconvoker (http://megamitensei.wikia.com/wiki/Geirin_Kuzunoha_the_XVII).

[myancey]

I would make it 1d3 Con damage. You will heal the damage most of the time, and a little lessor restoration will take care of the rest, but left untreated it will kill you.
Still, Real™ Tuberculosis is rather too chronic a condition to really fit in with D&D's disease mechanic.
It might make work better as a Flaw.
Maybe certain strenuous actions leave you fatigued and actions that leave you fatigued leave you exhausted.

I was thinking about making it a flaw, yeah. Too much activity forces some form of check to see if the character lands up coughing up blood on the floor, etc.

Probably some amount of con damage would be appropriate, as many have suggested. The 1d3 would be useful for the illness in its later stages, mostly since it would be a slippery slope for the character from there without any healing.

I had also though to make the disease resistant to remove disease, etc. Sometimes NPCs are meant to die...but at the risk of derailing my own thread, I'll stop there.

[Ravens_cry]

1d3 Con every day/week without treatment? I would still keep it a Flaw.
Flaws are not curable, diseases are. On the whole though, I would keep Realâ„¢ diseases out of D&D. One, it feels a little disrespectful when, by RAW, a mundane,however terrible it may be in the real world, disease can just be magiced away. Two, now you're opening a can of worms with "Well, does that mean viruses and germs exist in this world?" which leads to "Can I polymorph into one?" and other questions.

[gkathellar]

The thing is, though, TB is a weird disease. Sometimes it'll pop up in the wrong part of the body, and have different effects, or spread to a weird place and just devour that entirely*. Sometimes you'll have it and it won't do anything, because you're too generally healthy. And shaking it off seems to happen sometimes, and be completely impossible other times — and even with treatment, you need to follow the doctor's orders exactly or it'll just come back stronger.

All of this makes it hard to model with rules. I would really say it's just a descriptive, fiat thing — particularly because it usually progresses so slowly that you wouldn't need rules for it.

*In Mountains Beyond Mountains, Tracy Kidder talks about a woman whose spine was basically completely gone after decades of TB had run their course.

[TurtleKing]

gkathellar does have a point there. Some bacteria have different effects on the body depending on where the infection is or the age. Two notable ones are Staphoccocus Aureus and Streptococcus… memory a bit fuzzy… each have at least 10 diseases depending on where the body is infected. Mutations also increase this further such as Staph's now being mostly immune to Penicillin and derivative drugs. Example being Methicillin Resistant Staph Aureus

[Ravens_cry]

Even Chicken Pox can have weird effects if your body doesn't get rid of it completely and it travels to your nerves.

[gkathellar]

Even Chicken Pox can have weird effects if your body doesn't get rid of it completely and it travels to your nerves.

Yeah, I know a guy with shingles. Nice guy. Cornell physics professor.

My point is really that the D&D disease rules do a poor job of modelling real-world disease because real-world disease is weird. We want to say that "X disease saps your dexterity" for game purposes, but that could mean any one of a million things in the real world, things that could just as easily translate to different mechanics. And many RL diseases move slowly, or erratically, in ways that RPG diseases can't or don't need to simulate with rules.

Ghoul fever is one thing — it's weird and exotic and magical and comes from ghouls so it doesn't have to behave like a real disease. But try coming up with disease stats for influenza, or the common cold. TB is even more of an outlier case, because its progression is usually so slow. Even before there was effective treatment, people survived with it for years, even decades, and for all intents and purposes it was just their Incurable Cough of Death. And how do you translate diseases that lay someone out and then kill them? Because you can function fine at Con 1, but at Con 0 you drop.

RL diseases or diseases like them make for great Plot Stuff, as long as Cure Disease doesn't auto-eradicate them. But they don't translate well to game rules, on principle.

[Ravens_cry]

You don't exactly function fine at Con 1, you're significantly less resistant to many effects, like catching another disease, succumbing to a poison or certain magic, you're exhausted more easily (http://www.d20srd.org/srd/combat/actionsInCombat.htm#run) and you don't take a hit in combat as well, but it is still fairly an all or nothing thing, but to a lesser extant than, say, hit points.

[gkathellar]

You don't exactly function fine at Con 1, you're significantly less resistant to many effects, like catching another disease, succumbing to a poison or certain magic, you're exhausted more easily (http://www.d20srd.org/srd/combat/actionsInCombat.htm#run) and you don't take a hit in combat as well, but it is still fairly an all or nothing thing, but to a lesser extant than, say, hit points.

Right. As it is, D&D has no good way to model "on your deathbed, gasping for each breath" in the rules. That's because the rules are designed for adventurers who sometimes catch bizarre super-diseases, not the desperately ill. Why would you need to stat up a desperately ill character, anyway?

[Hunter Killer]

How about we help this guy out rather than say it won't work? :smallannoyed:

While I agree that it is impossible to model real life Tuberculosis in D&D without writing a complete sub-system of disease rules, I'm guessing that's not what the gentleman that started this thread is looking to do.

If I'd have to guess, this guy is looking to represent the wasting aspect and maybe the respiratory distress aspect of the disease (The two most well known effects). Furthermore, I'm betting that he'd be willing to abstract these to logical game approximations without super complex rules.

Let's start with what some of the other posters have suggested, because that's a good springboard. Light CON damage with an extremely high save. That makes it easy to catch, hard to resist damage, hard to recover from (Which are all things true of the real disease). I'd imagine something like this:

{table=head]Disease|Infection DC|Incubation|Damage

Tuberculosis|Contact 30|2d6 Weeks|1d3 Con[/table]

Let's attach additional rules to this:

Wasting and Strenuous Activity
We want the character to be tired, wasting away, and unable to perform at their best due to the disease. Furthermore, we want them to get worse based on strenuous activity.

There's precedent in 3.5 for diseases to do additional things based on the amount of damage they inflict (Blinding Disease). So let's say that if a character takes 2 or more damage from this disease, then they have to make an additional save or be Fatigued for 24 hours.

To represent the wasting further, and the exhaustive respiratory part of the disease, we could force an additional save if the character takes a physical Action (Move, Attack, Full-Attack, Run, etc...) in two or more consecutive rounds. Failure would set them to Exhausted until the end of the encounter. If the character was already Exhausted, then then a failed save instead means that they are effected as the spell Tasha's Hideous Laughter (Mundane and not subject to being Dispelled, of course).

Give It Teeth
The real problem with Tuberculosis in 3.5 is that it isn't really all that scary. In a world with Remove Disease and Fortitude Saves, it's really just not going to be the plague upon society that it was in the real world.

I propose two homebrew concepts to alleviate this problem. One or the other should do, based on how scary you want it to be. I'd use both, but I'm a sadist:

Magic Resistant Disease
Magic Resistance Diseases are not automatically removed by effects less than Wish or Miracle. Instead, the user of the Remove effect must make a check similar to a the targeted dispel check as noted in Dispel Magic. The DC for the check would be the disease's Infection DC + 11.

If we wanted to make this even more terrifying, we could say that the same check is required for effects that would remove ability damage cause by the disease (Restoration and the like). That makes the effects a lot more potent.

We could also add a third aspect to this... Upon a successful check, we could further say that there's a 50% chance that the disease is not removed but rather suppressed for the listed Incubation period.

Incurable Disease
This is a simple rule. Rather than the disease being cured after two consecutive successful saves, we'd just say that there's no possible way to recover from the disease regardless of the number of saves a character makes.

Magical healing would either function as normal, or have a 50% chance to suppress the disease for the Incubation period instead of removing outright.

[SowZ]

It wouldn't (http://snk.wikia.com/wiki/Ukyo_Tachibana)

Any chance that Li Xingke from Code Geass is based on this guy? They seem remarkably similar...

[Psyren]

I'm for making it a flaw rather than a true disease as well... although it's a bit farfetched to get a benefit from it.

A curse might better model its chronic nature and stubbornness. Or make it a hybrid disease-curse like Mummy Rot (only less fatal.)


Any chance that Li Xingke from Code Geass is based on this guy? They seem remarkably similar...

Many, many anime characters are based on Tachibana Ukyo (the historical figure, not the game character.) So it's possible, I guess.

[myancey]

How about we help this guy out rather than say it won't work? :smallannoyed:

True that, and thanks.

Also, I think that is a pretty well hashed out disease. I appreciate it--will probably use it.


1d3 Con every day/week without treatment? I would still keep it a Flaw.
Flaws are not curable, diseases are. On the whole though, I would keep Realâ„¢ diseases out of D&D.


It can still be a flaw but stated as a disease. As we're well in DM discretion territory, it wouldn't be much of a stretch to make a disease a flaw. Plus, as you said, it wouldn't be curable at that point.



One, it feels a little disrespectful when, by RAW, a mundane,however terrible it may be in the real world, disease can just be magiced away. Two, now you're opening a can of worms with "Well, does that mean viruses and germs exist in this world?" which leads to "Can I polymorph into one?" and other questions.

I'm not really following on the first point? I don't really see how trying to stat a disease is disrespectful... :smallconfused:

And on point two...just because there is a chance for opening up a can of worms doesn't mean it'll happen. DMs can put a stop to it at any point.


Why would you need to stat up a desperately ill character, anyway?

I might be DMing or playing in a campaign where the entirety of the campaign is over a small time period. The NPC or character in question is going to have a flaw or disease of some sort..and none of the Unearthed Arcana flaws really fit. I want something that will truly affect the character.

I can stat a pretty awesome character...but I enjoy characters more who present unique challenges when RPing.

I could just RP this disease...but I would rather try to turn it into his flaw and get a feat out of it.

[Hunter Killer]

True that, and thanks.

Also, I think that is a pretty well hashed out disease. I appreciate it--will probably use it.

I finished the writeup, if you're interested.

[myancey]

I finished the writeup, if you're interested.

Heck yeah, dude. That'd be great. I appreciate the help...my group has never delved deep into the disease territory so it's a new field for me.

[Hunter Killer]

Diseases are an interesting aspect of D&D, but the way they are presented in the books is very basic. Mostly, they are just another version of the same road bumps that follow similar rules (Curses, Poisons, etc...)

There's no real mechanisms in 3.5 D&D for long-lasting diseases, and since they affected by various Remove and Restoration effects, they aren't really that terrifying past a certain level.

I would suggest liberal amounts of houseruling and fiat if you really want to make them a big deal. Changing up the rules a little bit and throwing something at the characters like Magic Resistant and Incurable Diseases can be pretty fun.

[Ravens_cry]

I am willing to take complications for my character, but having something that says "Hey, you got this disease, now your character sucks and, no, there is Nothing You Can Do About It" doesn't sound like fun in most d20 campaigns. I can see some where it would work, but those are so close to free form one might as well just handwave the disease in instead of trying to model it.