22  Healing and Injuries

Healing and Rest

Characters recover 1 hit point of damage every day, provided that normal sleep is possible. Characters who choose full bedrest regain an additional hit point each evening.

Normal characters require 6 hours sleep out of every 24. Subtract from this number of hours the character’s Constitution bonus; so a character with 18 Constitution needs only 3 hours sleep per night (and a character with 3 Constitution needs 9 hours). Note that these figures are minimums; given a choice, most characters would prefer to sleep two or more hours longer.

Characters who get less than the required amount of sleep suffer a -1 penalty on all attack rolls and saving throws (as well as not receiving any hit points of healing). For each additional night where sufficient sleep is not received, the penalty becomes one point worse. Regardless of how long the character has gone without adequate sleep, the normal amount of sleep will remove these penalties.

Conditional States

If more than one condition affects a character, apply them all. If certain effects can’t combine, apply the most severe effect.

Ability Damaged and Constitution Point Losses

When a creature suffers ability damage, it temporarily loses 1 or more points from one or more ability scores. Lost points return at a rate of 1 per day unless otherwise noted by the condition causing the damage.

  • A creature with Strength 0 falls to the ground and is helpless.
  • A creature with Dexterity 0 is paralyzed.
  • A creature with Constitution 0 is dead.
  • A creature with Intelligence, Wisdom, or Charisma 0 is unconscious.

Ability damage differs from penalties to ability scores, which disappear once the conditions causing them go away.

Constitution Point Losses

When a character temporarily loses Constitution points (such as due to a disease), they may regain them with normal rest. The recovery rate is one point per day, awarded each morning after a normal night’s sleep. If more than one Constitution point was lost, the character must make a save vs. Death Ray (without adjustments) to regain the final point; failure results in the permanent loss of that point.

If a temporary Constitution loss results in a lower bonus or penalty, the character’s maximum hit points must be adjusted accordingly. For example, if a character’s Constitution drops from 16 to 15, their bonus decreases from +2 to +1, resulting in a loss of one hit point per die rolled. If this adjustment reduces the maximum hit points to less than the current hit points, the current hit points are immediately reduced to the new maximum.

When regaining Constitution, any increase that raises the character’s Constitution bonus restores the lost hit points to the maximum hit point figure only. Current hit points must be regained through normal healing methods.

Blindness

A blinded creature suffers the following effects:

  • A -4 penalty to attack rolls.
  • A -4 penalty to Armor Class.
  • A -2 penalty to Initiative rolls.
  • Movement is at half speed.
  • The creature is surprised on a DC 6 check.

These effects may be modified for creatures with unusual sensory abilities. For example, bats may be affected by deafness as if blinded instead. These penalties apply primarily to characters or creatures recently handicapped. Those who are normally blind may have reduced penalties at the DM’s discretion.

Blown Away

Depending on its size, a creature can be blown away by winds of high velocity.

  • A creature on the ground that is blown away is knocked down and rolls 1d4 × 10 feet, taking 1d4 points of nonlethal damage per 10 feet.

  • A flying creature that is blown away is pushed back 2d6 × 10 feet and takes 2d6 points of nonlethal damage due to battering and buffeting.

Checked

Prevented from achieving forward motion by an applied force, such as wind. Checked creatures on the ground merely stop. Checked flying creatures move back a distance specified in the description of the effect.

Confused

A confused creature’s actions are determined by rolling a d20 at the beginning of its turn:

  • 1-3: Attack caster with melee or ranged weapons (or close with caster if attacking is not possible).
  • 4-8: Act normally.
  • 9-13: Do nothing but babble incoherently.
  • 14-17: Flee away from caster at top possible speed.
  • 18-20: Attack nearest creature (for this purpose, a familiar counts as part of the subject’s self).

A confused creature that can’t carry out the indicated action does nothing but babble incoherently. Attackers are not at any special advantage when attacking a confused character. Any confused character that is attacked automatically attacks its attackers on its next turn if it is still confused.

A confused creature does not make attacks of opportunity against any creature that it is not already devoted to attacking (either because of its most recent action or because it has just been attacked).

Cowering

The creature is frozen in fear and can take no actions. A cowering creature takes a -2 penalty to Armor Class and loses its Dexterity bonus.

Dazed

The creature is unable to act normally. A dazed creature can take no actions but has no penalty to AC. A dazed condition typically lasts 1 round.

Dazzled

The creature is unable to see well because of overstimulation of the eyes. A dazzled creature takes a -1 penalty on attack rolls, Search checks, and Spot checks.

Dead

The creature’s hit points are reduced to -10, its Constitution drops to 0, or it is killed outright by a spell or effect. The character’s soul leaves its body. Dead creatures cannot benefit from normal or magical healing, but they can be restored to life via magic.

A dead body decays normally unless magically preserved, but magic that restores a dead character to life also restores the body either to full health or to its condition at the time of death (depending on the spell or device). Either way, resurrected characters need not worry about rigor mortis, decomposition, and other conditions that affect dead bodies.

Deafness

Deafened creatures cannot hear and can react only to what it can see or feel, is surprised on a DC 10, and suffers a -1 penalty to its Initiative rolls.

They automatically fail Listen checks and have a 20% chance of spell failure when casting spells with verbal components.

A creature who remains deafened for a long time grows accustomed to these drawbacks and can overcome some of them.

Diseased

Disease sets in after 1d4 hours. A diseased target suffers a -2 penalty on initiative, to hit, and on saves. Cure disease will end the effect.

Drowning

Characters can hold their breath for a number of rounds equal to 1d4 plus their Constitution bonus before they start drowning.

Dying

A dying creature is unconscious and near death. At the end of each round (starting with the round in which the character dropped below 0 hit points), the character loses 1 hit point. If a dying character reaches -10 hit points, the character is dead. A dying creature can be stabilized with aid from another character (such as a Heal check or magical healing).

Energy Drain

Characters may sometimes be exposed to energy drain from undead or evil magic, resulting in “negative levels.”

Effects:

  • Negative Levels: The creature gains one or more negative levels, which might permanently drain the character’s levels. If the subject has as many negative levels as Hit Dice, they die.

  • Penalties: Each negative level gives a creature the following penalties:

    • A -1 penalty on attack rolls, saving throws, skill checks, and ability checks.
    • Loss 1d[Class Hit Dice] of hit points. e.g. 1d4 for a Magic-user
    • A -1 to effective level (for determining the power, duration, DC, and other details of spells or special abilities).

  • Spellcasting: A spellcaster loses access to one of their highest-level spell slots.

  • Saving Throw: Whether a saving throw is allowed to resist the effect depends on the specific monster type.

  • Immediate Death: If a character’s hit points are reduced to zero or less by energy drain, the victim is immediately slain. If an undead monster causes the energy drain, the victim is usually transformed into that sort of undead, with exact details varying by type.

Recovery:

Negative levels can be removed by magic, such as the restoration spell. To determine how many hit points are restored when a negative level is removed, divide the total number of hit points lost by the number of negative levels, rounding normally.

For example, if a character suffers three negative levels of energy drain with hit point losses of 6, 5, and 2 (totaling 13 points lost), the first negative level removed restores 13 / 3 = 4.33 hit points (rounded to 4). Now the character has two negative levels and 9 hit points lost. The next negative level removed restores 9 / 2 = 4.5 hit points (rounded to 5). The final negative level removal restores the remaining 4 points.

Those who have suffered energy drain typically appear gaunt and haggard, a noticeable change to observant characters.

Entangled

  • The creature is ensnared and can’t move or perform any other physical action. Speech remains possible, however.

Exhausted

  • An exhausted creature moves at half speed and takes a -3 penalty to Strength and Dexterity. After 3 turns of complete rest, an exhausted character becomes fatigued. A fatigued character becomes exhausted by doing something else that would normally cause fatigue.

Fascinated

  • A fascinated creature is entranced by a supernatural or spell effect. The creature stands or sits quietly, taking no actions other than to pay attention to the fascinating effect, for as long as the effect lasts. It takes a -4 penalty on skill checks made as reactions, such as Listen and Spot checks.
  • Any potential threat, such as a hostile creature approaching, allows the fascinated creature a new saving throw against the fascinating effect. Any obvious threat, such as someone drawing a weapon or casting a spell, automatically breaks the effect.

Fatigued

  • A fatigued creature can neither run nor charge and takes a -1 penalty to Strength and Dexterity. Doing anything that would normally cause fatigue causes the fatigued creature to become exhausted. After 3 turns of complete rest, fatigued creatures are no longer fatigued.

Frightened

  • A frightened creature flees from the source of its fear as best it can. If unable to flee, it may fight. A frightened creature takes a -2 penalty on all attack rolls, saving throws, skill checks, and ability checks. A frightened creature can use special abilities, including spells, to flee; indeed, the creature must use such means if they are the only way to escape.

Grappled

  • Engaged in wrestling or some other form of hand-to-hand struggle with one or more attackers. A grappling character can undertake only a limited number of actions. They do not threaten any squares and lose Dexterity bonus to AC (if any) against opponents they aren’t grappling.
  • An opponent is pinned if the attacker wins three consecutive Grapple Checks. A pinned opponent is held immobile.

Helpless

  • A helpless creature is paralyzed, held, bound, sleeping, unconscious, or otherwise completely at an opponent’s mercy. A helpless target is treated as having a Dexterity of 0 (-5 modifier). Melee attacks against a helpless target get a +4 bonus (equivalent to attacking a prone target). Ranged attacks get no special bonus against helpless targets. Rogues can sneak attack helpless targets.
  • As a full-round action, an enemy can use a melee weapon to deliver a coup de grace to a helpless foe. An enemy can also use a bow or crossbow, provided they are adjacent to the target. The attacker automatically hits and scores a critical hit. If the defender survives, they must make a DC check (DC 10 + damage dealt – Con) or die.

Incorporeal

  • Having no physical body. Incorporeal creatures are immune to all nonmagical attack forms. Only other incorporeal creatures, +1 or better magic weapons, spells, spell-like effects, or supernatural effects can harm an incorporeal creature.

Insane

  • A creature suffering from insanity loses the ability to think rationally or understand what is happening around them. They may experience hallucinations, delusions, and extreme paranoia. An insane creature is incapable of performing any deliberate actions and cannot distinguish friend from foe. They may exhibit unpredictable behavior, including attacking allies or fleeing from nonexistent threats. Insanity typically imposes a severe penalty on all skill checks, attack rolls, and saving throws, usually around -6 or more, reflecting the complete disarray of the creature’s mental state. The exact nature of an insane creature’s behavior can vary, but it is always detrimental and chaotic. This condition can only be cured by powerful magic, such as a Heal spell or similar effects.

Invisible

  • An invisible creature is visually undetectable. An invisible creature gains a +2 bonus on attack rolls against sighted opponents and ignores its opponents’ Dexterity bonuses to AC (if any). (See Invisibility, under Special Abilities.)

Nauseated

  • Experiencing stomach distress. Nauseated creatures are unable to attack, cast spells, concentrate on spells, or do anything else requiring attention. The only action such a character can take is a single move action per turn.

Panicked

  • A panicked creature must drop anything it holds and flee at top speed from the source of its fear, as well as any other dangers it encounters, along a random path. It can’t take any other actions. In addition, the creature takes a -2 penalty on all saving throws, skill checks, and ability checks. If cornered, a panicked creature cowers. A panicked creature can use special abilities, including spells, to flee; indeed, the creature must use such means if they are the only way to escape. Panicked is a more extreme state of fear than shaken or frightened.

Paralyzed

  • A paralyzed creature is frozen in place and unable to move or act. A paralyzed character has effective Dexterity and Strength scores of 0 and is helpless but can take purely mental actions. A winged creature flying in the air at the time that it becomes paralyzed cannot flap its wings and falls.
  • A paralyzed swimmer can’t swim and may drown. A creature can move through a space occupied by a paralyzed creature—ally or not. Each square occupied by a paralyzed creature, however, counts as 2 squares.

Petrified

  • A petrified creature has been turned to stone and is considered unconscious. If a petrified creature cracks or breaks, but the broken pieces are joined with the body as they return to flesh, they are unharmed. If the creature’s petrified body is incomplete when it returns to flesh, the body is likewise incomplete and there is some amount of permanent hit point loss and/or debilitation.

Pinned

  • A pinned opponent is held immobile.

Poisoned

  • A poisoned target suffers a -2 penalty on initiative, to hit and on saving throws. While poisoned in this way, the target can’t regain hit points.

Prone

  • The creature is on the ground. An attacker who is prone has a -4 penalty on melee attack rolls and cannot use a ranged weapon (except for a crossbow). A defender who is prone gains a +4 bonus to Armor Class against ranged attacks but takes a -4 penalty to AC against melee attacks. Standing up is a move-equivalent action that provokes an attack of opportunity.

Shaken

  • A shaken creature takes a -2 penalty on attack rolls, saving throws, skill checks, and ability checks. Shaken is a less severe state of fear than frightened or panicked.

Sickened

  • The creature takes a -2 penalty on all attack rolls, weapon damage rolls, saving throws, skill checks, and ability checks.

Stable

  • A creature that was dying but has stopped losing hit points and still has negative hit points is stable. A stable creature is no longer dying but is still unconscious. If the creature is stable because of aid from another character (such as a Heal check or magical healing), then the character no longer loses hit points. There is a slim chance (DC 20 + Constitution) that a character can become stable without aid.

Staggered

  • A creature whose nonlethal damage exactly equals their current hit points is staggered. A staggered creature may take a single move action or standard action each round (but not both, nor can the character take full-round actions). A creature whose current hit points exceed their nonlethal damage is no longer staggered; a character whose nonlethal damage exceeds their hit points becomes unconscious.

Stunned

  • A stunned creature drops everything that they are holding, can’t take actions, takes a -2 penalty to AC, and loses their Dexterity bonus to AC.

Turned

  • Undead that are affected by a turn undead attempt must flee for 10 rounds (1 minute) by the best and fastest means available to them. If they cannot flee, they cower.

Unconscious

  • An unconscious creature is knocked out and helpless. Unconsciousness can result from having current hit points drop to 0 or below, or from nonlethal damage more than current hit points.