Damage and healing

Some of this is the normal rules, some I have modified slightly. Also check out the wounds rules, as the Wound Damage heals like normal hit point damage. You can also read the Hitpoint article for my view on DnD hit points.

Hitpoints

Hit points are generally a compromise between fast and easy gameplay and realism. A problem is naturally that real battle never work like hit points, so I'm taking a pragmatic view on the topic.

What Hit Points Are

Hit points are a combination of minor injuries, exhaustion, emotional shock and simple "battle luck" in a combat. Losing 90% of your hit points is not the same as having a sword stabbed through your lung, it's simply a game mechanic to show your luck is about to run out, and you know it. Whatever the case, at -10 hit points, you ARE dead.

This also explains how hit points can regenerate so quickly; the loss of hit points only marginally represent actual injuries. In most cases they represent bruises and weariness rather than injuries.

Wounds

Wounds are not used in all campaigns!

In an attempt to bring some realism and keeping as much as possible of the relatively quick gameplay of DnD, I added Wounds. These are actual injuries on a player and these takes a lot longer time to heal than "just a loss of hit points", while at the same time mostly have a pretty small impact on gameplay. In worst case scenarios, however, they DO affect gameplay, and to keep having to fight day after day will bring a character to a point where they will be easily defeated or even die.

This mechanic adds the requirement of the players to find a way to heal up before the next encounter, be that through expensive magical services or through spending days or weeks in bed taking it slow.

Because most wounds simply accumulate, and are "manageable", a character can have several at once without a massive issue. However, if she is unlucky and receives another wound which gives penalties, it will take a very long time for the body to heal that wound, since it's also healing all the other wounds at the same time.

Wounds then don't become a massive nerf or killability of characters, but a somewhat realistic system to make them slow down their pace, or at least be very careful, if they have a couple of wounds.

Lethal Damage Conversion

• Receive as normal, but note Damage Conversion (non-magic AC converts its bonus to non-lethal).
• Heals at slower rate if unattended.

Death

Death itself can be through shock, cardiac arrest, massive organ failure, asphyxiation or simply bleeding to death. The dying status represents one or all of these effects, while the shock status added by me specifically deals with shock only.

In this particular campaign setting, resurrection is very uncommon, so as to alleviate this, I've added a new spell, Resuscitation, which will work in very limited circumstances, more similar to a skilled paramedic of today than an actual Raise Dead spell.

Rules

I'm using Pathfinder's rules for dying in both Pathfinder and any 3.5 campaigns I run:

A dying creature is unconscious and near death. Creatures that have negative hit points and have not stabilized are dying. A dying creature can take no actions. On the character's next turn, after being reduced to negative hit points (but not dead), and on all subsequent turns, the character must make a DC 10 Constitution check to become stable. The character takes a penalty on this roll equal to his negative hit point total. A character that is stable does not need to make this check. A natural 20 on this check is an automatic success. If the character fails this check, he loses 1 hit point. If a dying creature has an amount of negative hit points equal to its Constitution score, it dies.

Also: Heal check (DC15) stabilises the character.

• Shock
  • A ruleset belonging to Wounds. Ignore if your campaign isn't using wounds.
  • Shock is almost the same as dying, with the main difference being that you retain your hit points. Though, by definition, you are dying.
  • While in shock, the target lose one hit point per round at the end of her turn.
  • As when dying, there is a chance to become stable, with a difference: The first turn there is a 10% chance of spontaneously become stable, the second, it's 9%, the third it's 8% etc until the victim is either stable or fail the last (1% chance) attempt and dies.
  • If the victim is dealt further damage, each point of damage lowers the chance to stabilize by 1%. If the damage makes this chance lower than 1%, the victim dies.
  • A first aid Heal check (DC20) or at least one Hit Point of magical healing will stabilize a person in shock.
  • If the victim becomes stable, she is unconscious until she has healed (natural or magic) at least as many points of damage as she lost during shock, plus one.
  • Thereafter the victim can act normally, but she's likely to have had a near-death experience.

Death

• After the body dies, it takes 2+D2 minutes before the brain is irreparably dead also (even with decapitation). At that point, the soul leaves the body.
• It's possible to cast spells on a dead body to heal wounds or to remove diseases or toxins.
• Potions work on dead bodies because they are activated by the act of being put in a person's mouth rather than swallowing.
• The spell Resuscitation can be cast on a body which has not suffered complete brain death.

Natural Healing

Because of the damage conversion (and if the wounds are used), I have modified the healing rules as well.

Nonlethal Damage

• 1 per hours as normal.
• Magic healing heals one nonlethal damage per regular hit point healed.
• If the character only has nonlethal damage, magic heals 2 points per point of healing.

Healing from Resting

• Healing effects stack, unless otherwise noted. Numbers are rounded up to nearest whole number.
• Sleeping/resting for 8 hours per day recuperates lost hit points.
• DM can decide to give bonus HP for low lvl characters using good services.
• DM can decide if partial rest (like 4 hours) still count for anything.
• Whole day spent in bed (24 hours) recuperates +1 point per level*.
• Carer: If another character cares (DC15 Heal) for the injured during the rest, the recuperation is increased by +1 point per level*.
• Other recuperation modifiers:
  • 0.25 per lvl per "uncomfortable" rest (outside on an uncomfortable bed or in bad weather or sleeping in armour without the Endurance feat).
  • 0.50 per lvl per "low quality" rest (decent conditions outside or in indoors on low quality bed).
  • 0.75 per lvl per "average" rest (indoors on an average quality bed or outdoors in excellent camping conditions/bedding).
  • 1.00 per lvl per "good" rest (indoors with access to servants, bath, clean cloths etc or a staffed field hospital, receiving plenty of attention).
  • 1.25 per lvl per "excellent" rest (indoors in an extravagant setting or general treatment at a hospital - staff understands your needs but you are not specifically cared for).
  • 2.50 per lvl per "hospitalised" rest (in a specialised hospital where you are especially cared for). Does not stack with a carer.
  • Spending the time with a courtesan (if you are so capable) improves the recuperation by +0.5 per level*.
• Ability Damage
  • The same numbers as above, but not "per lvl".

Carer - A person who competently aids the injured person. Includes change of bandages and/or soothing herbs etc. The carer will obviously not be able to sleep for the duration.

(*) - Applied after other modifiers.

Wound Healing

Wound damage is essentially the same as normal hit point loss, but hit point lost from wounds heal 'after any normal hit point losses are recuperated.