How dangerous are diseases in a D&D world?

[Scalenex]

How willing would most churches be to dispense magical healing? Also assuming most of the churches were fully altruistic, how well could they keep diseases under control during "normal" times and how well could they keep diseases under control during times of plagues.

Then there are of course, magical plagues, but a magical plague is apt to be the center of a conflict or story with a grand quest involved whereas a normal plague (even a severe one) would be more background story than a full plot.

Finally under what conditions would evil clerics (or neutral, why not) decide that casting Contagion is a good idea given that in most worlds evil clerics are the minority and liberal use of Contagion could expose them to their enemies.

[Falkus]

Also assuming most of the churches were fully altruistic, how well could they keep diseases under control during "normal" times and how well could they keep diseases under control during times of plagues.

Not particularly well. Remove disease is a third level spell, so the number of clerics who can cast it is not overly high in most areas. And even then, a cleric could only cure a handful of people each day. They could keep the government and other important people safe, but any plague would still take its usual toll on the population, and would require regular methods to be controlled.

[That Lanky Bugger]

Diseases are probably not common. Most Clerics would be willing to use their ability to remove diseases freely, especially altruistic churches. Even non-altruistic churches would probably be pressed into service by the government in the case of a plague of some sort.

Likewise, Contagion is probably used, but not commonly. As a spell it has no application in combat, and even a relatively industrious evil priest could only infect something like a few dozen people a day.

[TheOOB]

Remember one key point, unlike modern medicine, while the Remove Disease spell may heal disease, it does nothing to prevent you from getting it again. In an epidemic situation a cure is worthless in comparison to a method of prevention, and in that respect disease is still deadly in the D&D world.

Sure your local church of Pelor may be able to cure 50 people of filth feaver a day, but when you have an ever growing colony of dire rats biting an ever growing number of people each day, the cure starts becoming irrelevent except for people in large, important positions.

In fact, the existance of a spell to cure diseases may acually make diseases worse because people rely on magic to help them. When you think magic can cure any ill you come up with, you don't put as much effort into developing vaccines and promoting clean, disease safe living conditions. The most dire threats are those not reconized as threats.

[Dhavaer]

Even a low level cleric could heal someone with the Heal skill. Given the low DCs for most diseases, with Skill Focus and a decent Wisdom any Cleric could be an effective doctor.

[oriong]

Even a low level cleric could heal someone with the Heal skill. Given the low DCs for most diseases, with Skill Focus and a decent Wisdom any Cleric could be an effective doctor.

This is actually a really good point. A Heal check is probably much more commonly used than a Cure Disease spell.

However, I'd say this still won't stop the spread of real disease in a major city area. First and foremost some will be unwilling or unable to seek treatment until it is too late, allowing the disease to spread further, and even given how little effort a Heal check takes there are only so many people who can reliably make it (if we assume a real 'plague' is something like Cackle Fever at DC 16) are those with a +6 bonus, your average first level, wisdom 10, cross-class healer will have only a +2 to +4 bonus, while a first level cleric could get a +8 to +10 easily enough even that will leave a large population of infected who can continue to spread the disease (since 1/4 checks will fail).

[TheOOB]

Besides, magical diseases that themselves cannot be healed by normal magic (wow not a dozen words into a post and allready an oxymoron). Several D&D adventures and models have used such as a disease as a major plot point (Neverwinter Nights comes to mind), and in a world of artifacts and dragons is not too unreasonable.

You build a better cure, we'll build a better disease.

[NullAshton]

Very dangerous. If the DM doesn't want a disease to be cured for a plot and the PC cleric is trying to go around healing everyone... all the DM has to do is slap the player and say it doesn't work.

[Dhavaer]

(since 1/4 checks will fail).

I can't access the SRD right now, but I'm fairly sure you can take 10 on a Heal check.

[Scalenex]

Remember one key point, unlike modern medicine, while the Remove Disease spell may heal disease, it does nothing to prevent you from getting it again. In an epidemic situation a cure is worthless in comparison to a method of prevention, and in that respect disease is still deadly in the D&D world.

Sure your local church of Pelor may be able to cure 50 people of filth feaver a day, but when you have an ever growing colony of dire rats biting an ever growing number of people each day, the cure starts becoming irrelevent except for people in large, important positions.

In fact, the existance of a spell to cure diseases may acually make diseases worse because people rely on magic to help them. When you think magic can cure any ill you come up with, you don't put as much effort into developing vaccines and promoting clean, disease safe living conditions. The most dire threats are those not reconized as threats.

Excellent point there, I didn't think about Remove Disease only being a temporary fix.

As for the second point, it took a long time for people in the real world to find a causal link between unsanitary conditions and disease. It may be even harder to find such a link in a D&D world because people could just assume it's vengeful gods or magic. Or the world could have different natural laws. Since you can have a D&D world that's flat instead of a globe I suppose you can have a world where diseases come from something other than bacteria, viruses, and other germs but then the line between magical and non-magical diseases becomes blurred.

[Dhavaer]

Since you can have a D&D world that's flat instead of a globe I suppose you can have a world where diseases come from something other than bacteria, viruses, and other germs but then the line between magical and non-magical diseases becomes blurred.

I generally assume that diseases are caused by an altered form of Negative energy.

[Tor the Fallen]

I'm playing in evil half-fiend in a campaign right now, and as characters go, he's not very optimized. Semi-impressive ability scores, but his LA puts him 3 under the party average, and getting to cast contagion 1/day and cause disease 2/week isn't doing much for me, in combat.

However, as the dominator type, the character's looking to conquer all in his path. How difficult do you think it would be to start an epidemic? My plan was to capture some poor bastard, hit him with a poison to drop his constitution, and wait to see if he dies from the con damage. If he doesn't die, I'd infect him with slimy doom.
He begins to turn into contagious slime, and dies.
I throw his contagious corpse down the town well.

[Collin152]

I would surmise that a cleric would attemptto treat people with Heal checks best they can, using remove disease to kept themselves healthy as well as anybody not reacting well to the treatment (ie, people that theu failed a lot of checks with). You should probably read Tamora Pierce's novels, particularly Briar's book, as that one in particular deals a lot with how they all strive to develpo a cure for a disease that turns out to have magical elements. Really quite... answering.

[Sardia]

Assuming they figure out where the diseases are coming from, a lot depends on preventing the diseases rather than curing them-- some notions:

Decanters of Endless Water instead of wells (which were generally putridly contaminated).
Repel Vermin to get rid of lice, ticks, fleas, etc.

Or Awaken a few rats, buff 'em up and send them to kill other rats.

[oriong]

Or Awaken a few rats, buff 'em up and send them to kill other rats.

Wow...this just inspired one of the weirdest ideas for an adventure ever. PC rats struggling to battle their own plague-tainted kind, epic battles against swarms of giant rats, the occasional dog, perhaps the deadly advanced house-cat.

[TheOOB]

Wow...this just inspired one of the weirdest ideas for an adventure ever. PC rats struggling to battle their own plague-tainted kind, epic battles against swarms of giant rats, the occasional dog, perhaps the deadly advanced house-cat.

That reminds me, I need to return redwall to the friend I borrowed it from...

In the long run however, disease is as dangerous as the DMs want it to be. The diseases in the core rulesbooks, barring the supernatural ones, are pretty weak and easy to deal with, but it would be easy to make a disease that is more dangerous. Increases the stat damage and DC and/or decreasing the incubation period can be quite potent, though I find the easiest way to make a dangerous disease to to give it a very long incubation period, and make it really really easy to transfer so by the time the pandemic is reconized it is far beyond even the most powerful clerics ability to control barring artifacts or divine intervention.

[Sardia]

Wow...this just inspired one of the weirdest ideas for an adventure ever. PC rats struggling to battle their own plague-tainted kind, epic battles against swarms of giant rats, the occasional dog, perhaps the deadly advanced house-cat.

To a point. If you put the advanced rats in tiny suits of armor of invulnerability, that damage reduction will make them immune to whatever gnaws on them at that size. Slaughter ensues.

[Olethros]

As for the second point, it took a long time for people in the real world to find a causal link between unsanitary conditions and disease.

Actually, this is a common historical misconception. Modern western medicin took a staggering backslide in the middle ages after the fall of Rome, but the concept of a connection between cleanliness and health existed within the earliest known civilizations. The City States of mesopotamia had laws regulating the disposal of wastes, pacement of wells and handling off foodstuffs (not exactly handwwashing or anything) all related to public health. Even earlier, many of the traditions and taboos of tribal society are best explained by a basic understanding of the need for rudamentary sanitation.

I have always thought of the D&D church as loath to perform its magics on the populace at large, even those spells that have no "cost" associated with them. If they were willing to constantly heal, anyone who stepped through the doors of the temple, you would have whole villages that, barring sudden lethal accident, would all live to there maximum age. The cost of which in terms of food, space, and other resources could be staggering.

[oriong]

Ah, but then they have to face Kaggoth! The Half-Dragon rat! The son of the red dragon with the oddest fetish ever!

[Rabiesbunny]

Considering that leprosy exists in the D&D world, on top of a staggering amount of other, nasty diseases...

...well, they can be devastating. I'm waiting 'til my character hits high levels. She'll be able to walk into town, sneeze on someone, waltz out, and a week later the town will have horribly imploded. The amount of clerics to commoners in any given D&D setting is so small...

[Thomas]

It may be even harder to find such a link in a D&D world because people could just assume it's vengeful gods or magic.

What are you talking it about? It is vengeful gods or magic, half the time...

Anyway, diseases are obviously less dangerous in most D&D worlds than in the real world. How much less so depends on the world, the area, and the amount of clerics available.


I actually like the way diseases work in Glorantha, though applying it to a D&D world would be tricky indeed.

Diseases are caused by spirits sent by Mallia, the goddess of disease; each disease spirit carries a different sort of disease, and when it enters a victim, it infects them. So long as the spirit remains in the victim, the disease cannot be overcome or cured - the spirit has to be exorcised (which usually requires a shaman, since priests don't know how to deal with spirits; shamans are very rare outside of primitive hunter-gatherer and nomad societies). A single disease spirit could easily infect an entire village in a week (especially as the disease begins to spread normally from the infected victims) - but the disease spirits are rarely found alone!

Mallia's worshippers also spread disease "manually" - brewing foul potions and using them to poison wells or food.

The most common cure for disease is to sacrifice to a healing deity, which may or may not help. Another "cure" is to propitiate Mallia so that she'll not send her spirits, or withdraw them (which may work temporarily, but always makes the disease goddess stronger).

I like the model, because it allows for deadly epidemics in a magical world where an individual adventurer can easily be healed of disease by magic. Replicating it in D&D would be difficult indeed, though. I suppose using some sort of disease-spreading ghosts (or other incorporeal, even ethereal creatures) might do the trick...

[Shhalahr Windrider]

Not particularly well. Remove disease is a third level spell, so the number of clerics who can cast it is not overly high in most areas. And even then, a cleric could only cure a handful of people each day. They could keep the government and other important people safe, but any plague would still take its usual toll on the population, and would require regular methods to be controlled.

Of course, in a particularly wealthy and forward-thinking kingdom, you might have programs set up to stockpile wands and potions of remove disease. An especially wealthy and forward-thinking kingdom might even manage to get some of that stockpile spread out amongst the little hamlets and thorps along the fronteir. These stockpiles would help reduce the reliance on a limited number of spells per day from a limited number of clerics capable of casting 3rd-level spells.

But that's a pretty idealized situation, I think.

[hewhosaysfish]

Of course, in a particularly wealthy and forward-thinking kingdom, you might have programs set up to stockpile wands and potions of remove disease. An especially wealthy and forward-thinking kingdom might even manage to get some of that stockpile spread out amongst the little hamlets and thorps along the fronteir. These stockpiles would help reduce the reliance on a limited number of spells per day from a limited number of clerics capable of casting 3rd-level spells.

But that's a pretty idealized situation, I think.

But it does over the possibility that the evil servants of the evil plague god(dess) might steal/destroy your stockpiles (or swap them with wands of contagion, bwahahaha!) forcing you to hire a band of travelling adventurers to return/replace you healing supplies... and catch the evil cultist/spy/traitor responsible.
It doesn't matter how wealthy and forward-thinking your kingdom is, something will always go to smash just to generate plot hook. Hm... a really clever kingdom might ban adventures entirely, just so that all the campaigns take place on the other side of the campaign setting.

[MrNexx]

Of course, I wouldn't be surprised if there were other spells, not detailed, that specifically add to the disease save of large numbers of people.

[PMDM]

This is a setting question. Do you think t should be big deal??

[Shhalahr Windrider]

It doesn't matter how wealthy and forward-thinking your kingdom is, something will always go to smash just to generate plot hook. Hm... a really clever kingdom might ban adventures entirely, just so that all the campaigns take place on the other side of the campaign setting.

Ah, indeed. That would probably be the most effective public health program one could come up with.

[Collin152]

But if there are no adventures, they will cease to exist! Rule number 1 about being in a campain setting: YOu exist to suit the needs of the plot. If the plot does not involve you, you do not exist.

[rob]

I had a big problem with this personally, in trying to GM a DnD setting in darklands (old early 90s video game)-style medieval europe; though mine was set on the Cote d' Azure in between Marseilles and Rome. Trying to come up with a sufficient scenario in which the black plague would be a major threat.

First, I had to make sure that the vast majority of religious were adepts or non-magical religious. Clerics were mostly a staple of the orders military of the church (the crusaders, templars, hospitallers), at least in the context of christians.

Second, I added a bit of 'terror' by linking it, as a plot point, with the appearance of Haley's comet in the 14th century as a harbinger of the end times, and the sudden appearance of abberations across europe. This explained the general impotence of the religious community to do much about it.

(Also made a great Shadow Over Innsmouth / Horror at Red Hook (both HP Lovecraft short stories) segue adventure, where the party got trounced by an Aboleth and its oppressed worshippers...)

[Beleriphon]

Keep in mind that the DMG only explains the fictional diseases that exist for D&D. Nothing is preventing you from coming up with your own version of the black plague. Something of that nature is deadly to a highly populated, dense, urban environment. Of course the thing could have been avoid with soap, but that just reinforces the point.

If you take a look at the major settings for D&D most wouldn't have a terribly hard time dealing with a disease. Forgotten Realms has enough high level casters of all sorts that it shouldn't be a problem, add to that most cities having real, functional sewers, and you remove a fairly significant problem of waste disposal. I don't see Waterdeep having London's problem with plagues.

In Eberron the society is advanced enough to understand plagues, and with House Jorasco providing expert healing services a plague is unlikely to take hold except in situations where it spreads faster than the treatment, usually slums.

Planescape is interesting in that plagues could both exist in a terrible way, and not in another. Most of the creatures of the planes are immune to disease, or can cleanse themselves. I can see a plague breaking out in Sigil, in certain parts of the city at any rate, but I don't see it being a massive problem overall.

With Greyhawk I see the most likely setting to end up with some kind of plague. Not for lack of magical abilities, but rather for lack of people to actually make use of the magic. That and of all of the D&D settings its the one that is most similar to medival Europe.

It doesn't matter how wealthy and forward-thinking your kingdom is, something will always go to smash just to generate plot hook. Hm... a really clever kingdom might ban adventures entirely, just so that all the campaigns take place on the other side of the campaign setting.

That sounds like a Discworld response. Everything was terrific in the kingdom until some adventurer showed up and things promptly went to pot. A plague started, the king is assassinated, demons invaded and a dragon kidnaped the princess.

[Thomas]

I had a big problem with this personally, in trying to GM a DnD setting in darklands (old early 90s video game)-style medieval europe; though mine was set on the Cote d' Azure in between Marseilles and Rome. Trying to come up with a sufficient scenario in which the black plague would be a major threat.

Darklands! Total classic. I've got it on my computer at this very moment.