I'm a DM who likes a more gritty (maybe bloody and realistic) approach to wounds and healing. So I basically deny people of HD for healing unless they can sleep, stitch up and have proper care. I also like to bring up things like infection, disease, bleeding and amputation every now and then.
Do you guys have any good homebrew rule set for healing and wounds?
Devious serpent folk devoid of compassion, yuan-ti manipulate other creatures by arousing their doubts, evoking their fears, and elevating and crushing their hopes. From remote temples in jungles, swamps, and deserts, the yuan-ti plot to supplant and dominate all other races and to make themselves gods.
well, typically in my games I generally depending on the nature of the injury tend to make the person roll an approximate length of time (in weeks) in which the subject player must roll based on the severity of the injury. for medical reference human tissue grows back at a rate of millimeter per day so a knife wound can take several weeks to fully heal. things to note about injuries also, each person heals differently so in that sense there is no cookie cutter rule per say to healing. for example Jorris received a 6 cm knife slash from a would be thief and escaped, he received nine stitches to close the wound, the time it would take for that wound to heal being that it was a mild gash would be rolled on the d6 in weeks.
a deeper or wider wound might require a person to spend up to twelve weeks healing depending again on the severity of the wound. a major wound could take up to half a year to a full year(example deep internal injuries sustained during a fall from a cliff, or a severed limb and or deep surgical wound) in which a player may end up "laid up" for that amount of time under the care of a nurse.
now dealing with infections, for each day a person has an exposed injury that person if not being treated properly the risk of infection increases. something to also note that from a medical stand point an infection can spread through sixty four layers of gauze packing and that all wounds must be kept sterile constantly. how infections spread are through, person to person contact, old and soiled bandages, improper self care (example: a person forgets to wash his hands after using his bedpan and touches his wound regularly) and any contact with contamination from others who may be sick and or have not practiced proper hygiene) in which case an exposed wound depending on the severity may be at risk for infection based on a saving throw once per week with mild wounds, and once per day with serious wounds. (generally id recommend rolling a percentile for a player's risk of infection in a sterile environment, and outside of a sterile environment id give them five chances to roll a 20 on the d20 sided dice per day until healed.
what determines an infection? if a wound appears to be bright red or salmon in color, if the wound exhibits an odor such as rotting onion, and or rotting almond (this is an indication of staph infection which is fatal if untreated in a timely manor) and or the presence of necrotic tissues (blackened dead tissue) and or necrotic blood, scabs, and the presence of burning, itch and or corroding skin. infections are often preceded by an itch, fever, and or mild odor. in which case generally back in the medieval days the limb was either amputated or the dead flesh was cut away carefully then the wound treated with a strong alcohol. minor infections were often treated with salt brine or urea (pee) the other method of treating infection was cauterization if it was determined that the infection had not spread in the case of wounds.
sleep in the cases of injury is not always the solution to wound recovery. however treated wounds require 12 hours of sleep or more to receive the benefits of healing. inversely a lack of sleep has the reverse effect where a person's condition may worsen.
for things like frostbite, a good swift saving throw is in order. if a person fails their saving throw then their toe is amputated and put in a sour toe cocktail (whiskey with a toe in it... its a popular tradition in the Yukon territories.)
(bear in mind if you decide to go this route your players may never forgive you)
something to note.. post injury tissues heal in four stages, there is the inflamitory stage , stage 2 Fibroblastic proliferation (typically white slimy fibrous surface development) , stage 3 granular tissue remodeling and stage 4 epithelial remodeling stage (surface tissue repairs it's self) this is if you want to go for hard realism (base these healing phases on length of recovery time)
con modifiers help in speeding up healing. big thing is HP recovery under a realistic rule set is based on healing time, you aren't fully recovered hp wise till that injury is fully healed. (if you fully heal that is)
P.S. Are you a doctor, nurse or something like that?
Me or junoberries?
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Devious serpent folk devoid of compassion, yuan-ti manipulate other creatures by arousing their doubts, evoking their fears, and elevating and crushing their hopes. From remote temples in jungles, swamps, and deserts, the yuan-ti plot to supplant and dominate all other races and to make themselves gods.
been under the knife a few times for major things, a lot of time was spent practicing wound care, I own a massive stack of medical manuals... I'm an afficianada (or female admirer of in this case... medical books). I say little else aside from being happy to be alive and gaming :) and really happy to share insight.
Btw, if you decide you want a bit more abstraction for the sake of easier gameplay, the DMG also offers a "realistic gritty" healing option where a short rest becomes a night's rest, and a long rest becomes a week long "holiday", i.e. spending a week resting.
It's not nearly as in depth as Junoberries' detailed description of wound healing, but depending on how much you and your players want to track, it could help make the game feel grittier than the regular system, without having to track the exact severity and treatment of each wound your player characters take.
well for the sake of time saving the best thing i do to alleviate some of the problems with time and healing is that i fast forward through non critical stages of a character's healing span and transition to recovery. this way the only thing that gets used up is in game time not playing time.
I have always seen Hitpoints as being a bit more of an abstract than a literal. So while an orc attacking me may do 6 damage, I don't necessarily think the orc cut me with his axe. I like the idea of Crits being special in this way, an actual cut, or being knocked to 0 being a serious head wound, shock due to loss of blood, etc.
The question is: if you implemented this rule would you run it the same way? Or would you scale the severity of the wound received based on the damage taken? And how does this system play within the context of the other rules, such as spell recharge times? I am supposed to be able to use my Hit Dice, and my spell slots all in a given day with them recharging over night. So if healing doesn't happen overnight any longer but instead takes weeks, does that also carry over for spell slots?
I have always seen Hitpoints as being a bit more of an abstract than a literal. So while an orc attacking me may do 6 damage, I don't necessarily think the orc cut me with his axe. I like the idea of Crits being special in this way, an actual cut, or being knocked to 0 being a serious head wound, shock due to loss of blood, etc.
RAW, HP is an abstraction. PHB, combat section:
Hit points represent a combination of physical and mental durability, the will to live, and luck.
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"Any society that would give up a little liberty to gain a little security will deserve neither and lose both" -- allegedly Benjamin Franklin
in many of the games I've played in hit points have been determined rather literally and with a good measure of brutality to them. its really just dependent on play style. not disagreeing honestly. if you are going for a literal style to determine hp then one would think that using low magic rules as a wise choice is best. though lets say for example (in a high fantasy setting with these rules) if someone were to cast a spell like fireball or chromatic orb if you are depicting damage from a realism aspect, the target player who is getting hit with said spell would experience second/3rd degree burns or shrapnel injuries which would take time to heal. the thing to point out is this is a house rule not a universal law for all dungeon masters to follow. honestly though for myself and my own game, the notion presented is what is asked of me for the sake of a great story with a lot of hardship and decisive strategy. to more directly answer your question, using spells (in my world under this rule set) requires first off difficult time consuming preparation and material components (example a necromancy spell requiring a fresh body, or a conjuration spell needing the right location and offerings). if you are injured it certainly would make it harder to conduct preparations. secondly spells would not have the destructive and devastating level of damage one most commonly finds. or the effects in the case of some spells might not have a known effect until it's discovered that the person who you have cast said spell on happened to end up with severe effects some time later. really it puts the campaign's magic system more leaning towards wild magic. in that sense magic from my standpoint is treated sometimes as being much slower and more vindictive. as for recharging spells, it would be really more of a case of reproducing the conditions that allowed for the spell to work in the first place. sure it's more complicated but that's the beauty of style differences in storyarcs and in writing. for fodder sake, comparing one to the next it's like putting Conan the barbarian next to harry potter to cast insight on what the result of a change in the style of which the rules flow under.
its not for the sake of running a dungeon diver type campaign, but rather offers an alternative for the die hard survivalist Madclergy. at the end of the day some people like a rich vibrant game full of magic, spells, scores of monsters and tropes. while a few small groups want the feel of fighting against nature, the elements, fear, disease, war and famine.
neither person is wrong. but every Dm you will come across is unique and treats the rules with their own personal perspective. the point of having a hardcore rule set like this is more so to make the players think about their choices carefully before they proceed, act more tactfully when dealing with diplomacy or hand to hand combat. and it conveys a clear message that some actions have dire consequence. what i suggest here is a guide based on what i found works best for my particular group and game flavor, not in any means an absolute. none the less it's at the extreme end of a low fantasy play style as opposed to say forgotten realms, or even further in the way of high fantasy D&D online as the polar extreme on the opposite end.
I find the rules for healing in the PHB (everyone is magically restored after a long rest) to be too unrealistic and video-gamey. The alternate rules in the DMG take things a little too far the other way, and I wanted to come up with something in between.
I've written my house rules, so that characters may spend only 1HD after a short rest. Constitution modifiers apply as do the modifiers of anyone proficient in Field Medicine who tends to them (which is part of my skill proficiency homebrew rules). After a long rest, characters automatically gain back a number of hit points equal to their level or number of Hit Die, i.e. a 4th level character would get back 4hp after a long rest. Again, Constitution modifiers apply (along with modifiers of those proficient in Healing & Herbalism who tend to them). Also after a long rest, characters may also opt to spend as many Hit Die as they have available to gain back hit points. Hit Die are only replenished 1/day after a long rest, however.
I was trying to come up with a system for injuries: you sustain an injury if you suffer a damage from a certain amount of massive damage. You suffer Disadvantage on relevant checks and your hit point maximum is reduced by 25% until the injury is healed, either magically or in 2d4 weeks. I'd come up with a table similar to the one in the DMs guide, but would have it use percentile dice to lessen the chances of terrible permanent outcomes, and where the most likely outcome is a broken bone or internal injury that will heal over time. The second most likely outcome would include permanent scarring, or minor loss of mobility (limp). The chances of major permanent injury (i.e loss of limb, eyesight) would be very unlikely, but still possible.
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Hello there,
I'm a DM who likes a more gritty (maybe bloody and realistic) approach to wounds and healing.
So I basically deny people of HD for healing unless they can sleep, stitch up and have proper care. I also like to bring up things like infection, disease, bleeding and amputation every now and then.
Do you guys have any good homebrew rule set for healing and wounds?
The Dungeon Masters Guide has a table showing the detriments of missing body parts if that's helpful.
Devious serpent folk devoid of compassion, yuan-ti manipulate other creatures by arousing their doubts, evoking their fears, and elevating and crushing their hopes. From remote temples in jungles, swamps, and deserts, the yuan-ti plot to supplant and dominate all other races and to make themselves gods.
well, typically in my games I generally depending on the nature of the injury tend to make the person roll an approximate length of time (in weeks) in which the subject player must roll based on the severity of the injury. for medical reference human tissue grows back at a rate of millimeter per day so a knife wound can take several weeks to fully heal.
things to note about injuries also, each person heals differently so in that sense there is no cookie cutter rule per say to healing. for example Jorris received a 6 cm knife slash from a would be thief and escaped, he received nine stitches to close the wound, the time it would take for that wound to heal being that it was a mild gash would be rolled on the d6 in weeks.
a deeper or wider wound might require a person to spend up to twelve weeks healing depending again on the severity of the wound. a major wound could take up to half a year to a full year(example deep internal injuries sustained during a fall from a cliff, or a severed limb and or deep surgical wound) in which a player may end up "laid up" for that amount of time under the care of a nurse.
now dealing with infections, for each day a person has an exposed injury that person if not being treated properly the risk of infection increases. something to also note that from a medical stand point an infection can spread through sixty four layers of gauze packing and that all wounds must be kept sterile constantly. how infections spread are through, person to person contact, old and soiled bandages, improper self care (example: a person forgets to wash his hands after using his bedpan and touches his wound regularly) and any contact with contamination from others who may be sick and or have not practiced proper hygiene) in which case an exposed wound depending on the severity may be at risk for infection based on a saving throw once per week with mild wounds, and once per day with serious wounds. (generally id recommend rolling a percentile for a player's risk of infection in a sterile environment, and outside of a sterile environment id give them five chances to roll a 20 on the d20 sided dice per day until healed.
what determines an infection? if a wound appears to be bright red or salmon in color, if the wound exhibits an odor such as rotting onion, and or rotting almond (this is an indication of staph infection which is fatal if untreated in a timely manor) and or the presence of necrotic tissues (blackened dead tissue) and or necrotic blood, scabs, and the presence of burning, itch and or corroding skin. infections are often preceded by an itch, fever, and or mild odor. in which case generally back in the medieval days the limb was either amputated or the dead flesh was cut away carefully then the wound treated with a strong alcohol. minor infections were often treated with salt brine or urea (pee) the other method of treating infection was cauterization if it was determined that the infection had not spread in the case of wounds.
sleep in the cases of injury is not always the solution to wound recovery. however treated wounds require 12 hours of sleep or more to receive the benefits of healing. inversely a lack of sleep has the reverse effect where a person's condition may worsen.
for things like frostbite, a good swift saving throw is in order. if a person fails their saving throw then their toe is amputated and put in a sour toe cocktail (whiskey with a toe in it... its a popular tradition in the Yukon territories.)
(bear in mind if you decide to go this route your players may never forgive you)
something to note.. post injury tissues heal in four stages, there is the inflamitory stage , stage 2 Fibroblastic proliferation (typically white slimy fibrous surface development) , stage 3 granular tissue remodeling and stage 4 epithelial remodeling stage (surface tissue repairs it's self) this is if you want to go for hard realism (base these healing phases on length of recovery time)
con modifiers help in speeding up healing. big thing is HP recovery under a realistic rule set is based on healing time, you aren't fully recovered hp wise till that injury is fully healed. (if you fully heal that is)
This is perfect! I will develop the whole wound system from this base you gave me. Thanks a lot.
P.S. Are you a doctor, nurse or something like that?
Devious serpent folk devoid of compassion, yuan-ti manipulate other creatures by arousing their doubts, evoking their fears, and elevating and crushing their hopes. From remote temples in jungles, swamps, and deserts, the yuan-ti plot to supplant and dominate all other races and to make themselves gods.
Hi DungeonLord, it was meant to ask juno, as he/she gave a lot of details about healing and infection.
Also interested in the realistic approach to wounds and HP?
been under the knife a few times for major things, a lot of time was spent practicing wound care, I own a massive stack of medical manuals... I'm an afficianada (or female admirer of in this case... medical books). I say little else aside from being happy to be alive and gaming :) and really happy to share insight.
Btw, if you decide you want a bit more abstraction for the sake of easier gameplay, the DMG also offers a "realistic gritty" healing option where a short rest becomes a night's rest, and a long rest becomes a week long "holiday", i.e. spending a week resting.
It's not nearly as in depth as Junoberries' detailed description of wound healing, but depending on how much you and your players want to track, it could help make the game feel grittier than the regular system, without having to track the exact severity and treatment of each wound your player characters take.
well for the sake of time saving the best thing i do to alleviate some of the problems with time and healing is that i fast forward through non critical stages of a character's healing span and transition to recovery. this way the only thing that gets used up is in game time not playing time.
I have always seen Hitpoints as being a bit more of an abstract than a literal. So while an orc attacking me may do 6 damage, I don't necessarily think the orc cut me with his axe. I like the idea of Crits being special in this way, an actual cut, or being knocked to 0 being a serious head wound, shock due to loss of blood, etc.
The question is: if you implemented this rule would you run it the same way? Or would you scale the severity of the wound received based on the damage taken? And how does this system play within the context of the other rules, such as spell recharge times? I am supposed to be able to use my Hit Dice, and my spell slots all in a given day with them recharging over night. So if healing doesn't happen overnight any longer but instead takes weeks, does that also carry over for spell slots?
Thanks :D
RAW, HP is an abstraction. PHB, combat section:
"Any society that would give up a little liberty to gain a little security will deserve neither and lose both" -- allegedly Benjamin Franklin
Tooltips (Help/aid)
in many of the games I've played in hit points have been determined rather literally and with a good measure of brutality to them. its really just dependent on play style. not disagreeing honestly. if you are going for a literal style to determine hp then one would think that using low magic rules as a wise choice is best. though lets say for example (in a high fantasy setting with these rules) if someone were to cast a spell like fireball or chromatic orb if you are depicting damage from a realism aspect, the target player who is getting hit with said spell would experience second/3rd degree burns or shrapnel injuries which would take time to heal. the thing to point out is this is a house rule not a universal law for all dungeon masters to follow. honestly though for myself and my own game, the notion presented is what is asked of me for the sake of a great story with a lot of hardship and decisive strategy. to more directly answer your question, using spells (in my world under this rule set) requires first off difficult time consuming preparation and material components (example a necromancy spell requiring a fresh body, or a conjuration spell needing the right location and offerings). if you are injured it certainly would make it harder to conduct preparations. secondly spells would not have the destructive and devastating level of damage one most commonly finds. or the effects in the case of some spells might not have a known effect until it's discovered that the person who you have cast said spell on happened to end up with severe effects some time later. really it puts the campaign's magic system more leaning towards wild magic. in that sense magic from my standpoint is treated sometimes as being much slower and more vindictive. as for recharging spells, it would be really more of a case of reproducing the conditions that allowed for the spell to work in the first place. sure it's more complicated but that's the beauty of style differences in storyarcs and in writing. for fodder sake, comparing one to the next it's like putting Conan the barbarian next to harry potter to cast insight on what the result of a change in the style of which the rules flow under.
its not for the sake of running a dungeon diver type campaign, but rather offers an alternative for the die hard survivalist Madclergy. at the end of the day some people like a rich vibrant game full of magic, spells, scores of monsters and tropes. while a few small groups want the feel of fighting against nature, the elements, fear, disease, war and famine.
neither person is wrong. but every Dm you will come across is unique and treats the rules with their own personal perspective. the point of having a hardcore rule set like this is more so to make the players think about their choices carefully before they proceed, act more tactfully when dealing with diplomacy or hand to hand combat. and it conveys a clear message that some actions have dire consequence. what i suggest here is a guide based on what i found works best for my particular group and game flavor, not in any means an absolute. none the less it's at the extreme end of a low fantasy play style as opposed to say forgotten realms, or even further in the way of high fantasy D&D online as the polar extreme on the opposite end.
I find the rules for healing in the PHB (everyone is magically restored after a long rest) to be too unrealistic and video-gamey. The alternate rules in the DMG take things a little too far the other way, and I wanted to come up with something in between.
I've written my house rules, so that characters may spend only 1HD after a short rest. Constitution modifiers apply as do the modifiers of anyone proficient in Field Medicine who tends to them (which is part of my skill proficiency homebrew rules). After a long rest, characters automatically gain back a number of hit points equal to their level or number of Hit Die, i.e. a 4th level character would get back 4hp after a long rest. Again, Constitution modifiers apply (along with modifiers of those proficient in Healing & Herbalism who tend to them). Also after a long rest, characters may also opt to spend as many Hit Die as they have available to gain back hit points. Hit Die are only replenished 1/day after a long rest, however.
I was trying to come up with a system for injuries: you sustain an injury if you suffer a damage from a certain amount of massive damage. You suffer Disadvantage on relevant checks and your hit point maximum is reduced by 25% until the injury is healed, either magically or in 2d4 weeks. I'd come up with a table similar to the one in the DMs guide, but would have it use percentile dice to lessen the chances of terrible permanent outcomes, and where the most likely outcome is a broken bone or internal injury that will heal over time. The second most likely outcome would include permanent scarring, or minor loss of mobility (limp). The chances of major permanent injury (i.e loss of limb, eyesight) would be very unlikely, but still possible.