So I was listening to a podcast the other day (Dungeoncast I think) and the hosts had a very brief discussion on diseases and poisoning in which they essentially felt that both are poorly done in DnD mechanics wise. Their gripe was essentially that if a character is effected by poison, he/she will typically get over it fairly easily (2nd level Cleric spell, a potion of lesser restoration, or in many instances waiting a duration of 1 minute for the condition to wear off). Where is the lasting effects? Disease is practically in the same realm yet from what I can tell disease is addressed even less in the rules. At least there is a poisoned condition that you get disadvantage on attack and ability rolls.
My question to you is this, do you have to come up with your own disease rules if you wish to incorporate them into the game? If so have you created one in your campaign? Was it overpowered or did the characters sluff it off just as easily as the rules seem to indicate?
usually a monster that causes a disease will lay out what that disease does (for instance the rot grub), as far as I know there isn't just a generic "disease" so if you wanted to have a plague or something you would need to engineer your own rules for it.
And have had 2 campaigns with diseases, one the disease was magical and couldn't be simply cured by lesser restoration or lay on hands so the cause had to be found quickly. Another it could be cured but it got progressively more violent as it came back each time.
Basic floating around diseases I don't think are to much of an issue in a world with godly powers at peoples finger tips, the only people that would really struggle would be common folk on the fringes or those that can't afford a clerics healing (hey not every church is just gonna heal everybody) that's why we always have the forces of evil readily available to come up with heinous and incurable ones if it needs to be a focal point
3.5E had plenty of disease rules you could modify and bring over if you wanted to make the Medicine skill do something useful for a change. The biggest issue you'd have is that they dealt stat damage, which broadly isn't a thing in 5E. Shadows deal stat damage, though, so it's still around, and you could make.it worse.
Here's 3.5E Blinding Sickness, which is in the 3.5 SRD so it's kosher to present, ported directly to 5E - you can modify it if you like.
Blinding Sickness is spread by tainted water. If a creature drinks water carrying the contagion, they must roll a DC 16 Constitution save. If they fail, the DM rolls 1d3 and notes this down. That many days later, they begin exhibiting symptoms.
Symptoms: Every 24 hours, make a DC 16 Con save or Strength score is reduced by 1d4. Strength reductions are cumulative and persist until the creature is cured and finishes a short or long rest. If the creature is reduced to Strength 0, they die. If the 1d4 result is 2 or more, the creature must roll a second DC 16 Con save. On a failure, they go permanently blind. Succeeding on the initial save two days in a row cures the disease.
Medicine rules: if the creature spends 8 hours under the care of a medic, during which the creature must short or long rest, on the creature's next Con save, the medic makes a Medicine check. Use the higher of the save and the check to try to beat the DC.
I think it's best to homebrew whenever possible, so the players who have read all the books can still be surprised every now and then. Most diseases (imho) should only be used to soften up the characters rather than to kill them. Sure, diseases can be deadly, but bards don't sing songs about the brave paladin who contracted dysentery and pooped himself to death. But if a few characters are feeling under the weather, and their capabilities are lessened, then the CR of everything they face will seem heightened. So let's think of a few off the top of our heads, shall we?
Shade Warts - large dark gray blisters you contract by contact with dead creatures or the undead. Make a Con save DC 15. If you fail you get a dozen or so blisters that gradually darken, and you take 1 hp of necrotic damage per hour until you are healed. Also, if a blister pops it'll smell like rotting flesh in a 5 foot radius. (Sure, 1 hp seems like nothing, but this could kill an average person fairly quickly!)
The Nether Flux - you might get this by drinking water in the Shadowfell. Con save DC 15 or suffer horrible diarrhea, dizziness and vertigo until the end of your next long rest. Disadvantage on Dex and Con skill checks and saving throws, and every five minutes you have to roll a d6. If you roll a 1 you have to stop what you're doing and go poop. (You will have one minute, or else it'll just happen! And remember, it takes five minutes to get out of heavy armor!)
Phantom Chills - you may catch this in an old tomb or mausoleum, or in the lair of a cold-based monster like a white dragon. Con save DC 12. On a fail you feel extremely cold, your movement speed is halved, and you take 1 hp of cold damage every ten minutes until healed. Also, you radiate cold in a 10 foot radius. Anyone who enters this radius or ends their turn there must make the Con save or catch the Chills from you.
Totem Pox - you may catch this by walking barefoot through infected water or mud. The infection rises up the legs causing painful blisters that are vaguely shaped like scary faces. Con save DC 11. On a fail you gain one level of exhaustion. Re-roll the save every hour. On a fail you gain another level of exhaustion. On a success the progression stops but the existing levels of exhaustion remain until healed normally.
Dr. Wickett's Viscous Sickness - this disease is caused by an attack from an ooze, or a gelatinous cube, or maybe a hag, or an oblex. Make a Con save DC 15. On a fail your skin becomes gross and rubbery and is covered in a slimy goop. You must re-roll the save every hour until cured. On your second fail, you suffer disadvantage on all Cha and Wis checks and saves. On your third fail, you suffer disadvantage on all Dex checks and saves BUT you gain advantage on avoiding or breaking a grapple. On your fourth fail, your body has become so oozy that you can no longer hold a weapon or other object, and your clothing and armor just slide right off you, BUT you gain the ability to move through spaces as narrow as 1 foot wide without squeezing. On your fifth fail your body collapses into a medium-sized puddle of gross oozy goo.
Sure, these diseases, like most, can be cured by lesser restoration. The DM could also rule that a player with the Healer Feat could use one or two uses of their healer's kit to cure a basic disease. I don't think diseases should be used to kill characters. Rather, they should be used to remind players that losing hit points is not the only way their characters can take damage, and that they need to think three dimensionally in their preparations. They should be used to weaken the party enough so that everything else they face becomes a little harder and a little deadlier. Just adding one more thing to worry about will cause enough stress in the player's minds that maybe they'll start second guessing themselves. It's fun to make them squirm sometimes.
As you say lesser restoration at level 2 can cure disease and clerics, paladins, rangers, bards and druids all get it. So high level characters could cure a dozen or more people per rest cycle. With all of that it is hard to imagine common diseases causing much concern.
As you say lesser restoration at level 2 can cure disease and clerics, paladins, rangers, bards and druids all get it. So high level characters could cure a dozen or more people per rest cycle. With all of that it is hard to imagine common diseases causing much concern.
This is 5E. The world *isn't* full of people built like the PCs. You can't assume anything about anyone's capabilities. For example, Rime of the Frostmaiden has "druids" that fundamentally don't wild shape using the wild shape rules, they have their own custom mechanic with almost no relation to it. It's plausible lesser restoration is *around*, but you can't assume it's around in high numbers.
Exactly. The power level difference between Tier 1 characters and NPCs is about the same as the difference between Tier 3 and Tier 1. So the characters may be able to brush off any disease in their party very easily, but....
Let's say the disease doesn't hit the party (at least not right away). Let's say there's a town where the party calls home. Let's say they have friends and family members in that town. Now the party is off adventuring... meanwhile... a disease sweeps through that town. Even if they rush home to help - sure, the characters can cast Lesser Restoration a dozen times per day, but there's 300 people in town and they're dying at the rate of 3 or 4 per day and it's getting worse. So now the party is in a race against time to find the source of the disease and stop it - and hopefully to find a cure as well.
As you say lesser restoration at level 2 can cure disease and clerics, paladins, rangers, bards and druids all get it. So high level characters could cure a dozen or more people per rest cycle. With all of that it is hard to imagine common diseases causing much concern.
This is 5E. The world *isn't* full of people built like the PCs. You can't assume anything about anyone's capabilities. For example, Rime of the Frostmaiden has "druids" that fundamentally don't wild shape using the wild shape rules, they have their own custom mechanic with almost no relation to it. It's plausible lesser restoration is *around*, but you can't assume it's around in high numbers.
The world doesn't have to be full of people similar to the PCs, it just needs low level magic to be common, and that certainly seems to be the case in most fantasy settings. I mean the PCs aren't unique in their abilities. Imagine your average city with a dozen temples, numerous adventurer guilds, the local Bard College, and just how many people would be capable of a basic level 2 spell. Hell, if you have someone able to cast mass heal then 700 people could be cured per casting. That's a level 9 spell, so perhaps only a handful of people in the city could cast it, the high priests or some such but you wouldn't need many.
Once you get away from the population centres then it would get harder. Your average farming village might have one or two clerics at the most, and it would be easy for a disease to outstrip their limited abilities. Story wise it's perfectly fine to say its so infectious that it spreads faster than can be cured and unlike natural recovery where you gain antibodies, a magical curing might leave you open for reinfection.
Disease is handled very poorly in D&D. A few monthe back I wrote a book that contained diseases and parasites based on real world ones that impacted PC's like the actual disease.
Some require you to make con saves every few hours and leave you under the effects of the confusion spell when awake.
Others are three to seven days of making connsaves against low DC's (like 2 or 5), and with 3 collective fails you die.
Consumptiob drops your strength score slightly and each day you roll 1d20. On a 1, you have a bad week.
Each of these diseases call out that they can only be cured by a special remedy, or Greater Restoration, or Wish.
Heck, there's a common parasite that eats your feet. You get it by walking through poop barefoot (or swamps. All I'm saying is that the monk should wear shoes).
As someone else said, diseases should force players to make harder choices, not actually kill them outright... unless that's the DM's goal.
I don't have any real solutions for you other than to agree that both poison and disease are utterly terrible in 5e. You used to have to save vs. poison or die. Now you save vs. poison or get a little nauseated for a few hours. Disease is effectively the same way. The only way to make a poison actually scary is to say that if you fail you take XD6 of damage on top of the poisoned condition. So essentially you have to homebrew something by adding damage to it (and lots of damage if the PCs are above 3rd or 4th level) to make it even slightly scary. Disease is similarly underwhelming. As people have said, once the PCs have access to Lesser Resto, these normally very dangerous features of a typical fantasy world become utterly toothless.
As I say, I dislike this but I have not come up with any solutions. I mean, one could theoretically nerf Lesser Resto, but that would unbalance hundreds of monsters in the CR 5-10 range who have the ability to poison/disease and a certain DC on the built-in assumption by the designers that Lesser Resto is available to the PCs at that level.
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Disease is handled very poorly in D&D. A few monthe back I wrote a book that contained diseases and parasites based on real world ones that impacted PC's like the actual disease.
Some require you to make con saves every few hours and leave you under the effects of the confusion spell when awake.
Others are three to seven days of making connsaves against low DC's (like 2 or 5), and with 3 collective fails you die.
Consumptiob drops your strength score slightly and each day you roll 1d20. On a 1, you have a bad week.
Each of these diseases call out that they can only be cured by a special remedy, or Greater Restoration, or Wish.
Heck, there's a common parasite that eats your feet. You get it by walking through poop barefoot (or swamps. All I'm saying is that the monk should wear shoes).
As someone else said, diseases should force players to make harder choices, not actually kill them outright... unless that's the DM's goal.
On the upside I've heard of some people using hookworms (you can get them from walking barefoot in human feces) will cure some seasonal allergies. I suppose a DM could work that into a story. A dwarf who can't stand pollen has to seek out a hookworms regularly b/c his immunity to poisons keeps killing them off yet wont do a thing for his hay fever.
I don't have any real solutions for you other than to agree that both poison and disease are utterly terrible in 5e. You used to have to save vs. poison or die. Now you save vs. poison or get a little nauseated for a few hours. Disease is effectively the same way. The only way to make a poison actually scary is to say that if you fail you take XD6 of damage on top of the poisoned condition. So essentially you have to homebrew something by adding damage to it (and lots of damage if the PCs are above 3rd or 4th level) to make it even slightly scary. Disease is similarly underwhelming. As people have said, once the PCs have access to Lesser Resto, these normally very dangerous features of a typical fantasy world become utterly toothless.
As I say, I dislike this but I have not come up with any solutions. I mean, one could theoretically nerf Lesser Resto, but that would unbalance hundreds of monsters in the CR 5-10 range who have the ability to poison/disease and a certain DC on the built-in assumption by the designers that Lesser Resto is available to the PCs at that level.
Although it may not make a lot of sense, perhaps a disease or poison that would scale would work (i.e. take half the player's hit points immediately or scale upward based on player constitution). Its just irritating when I try something like poison the characters and they immediately turn to the cleric and it just goes away and/or the dwarf simply says 'is it poison cause I'm practically immune?' Really WotC you couldn't nerf the poison resistance a little given they typically have high constitutions already?
I think it boils down to the fact that save-or-die/long-term debilitating effects aren't really that fun; it just feels like punishment. No player wants to be the one lying on their deathbed while the rest of the party seeks a cure.
If you want disease drama, have a whole town affected, forcing the party to find/obtain an alternate way to cure 200 people within 5 days or whatever.
As you say lesser restoration at level 2 can cure disease and clerics, paladins, rangers, bards and druids all get it. So high level characters could cure a dozen or more people per rest cycle. With all of that it is hard to imagine common diseases causing much concern.
This is 5E. The world *isn't* full of people built like the PCs. You can't assume anything about anyone's capabilities. For example, Rime of the Frostmaiden has "druids" that fundamentally don't wild shape using the wild shape rules, they have their own custom mechanic with almost no relation to it. It's plausible lesser restoration is *around*, but you can't assume it's around in high numbers.
The world doesn't have to be full of people similar to the PCs, it just needs low level magic to be common, and that certainly seems to be the case in most fantasy settings. I mean the PCs aren't unique in their abilities. Imagine your average city with a dozen temples, numerous adventurer guilds, the local Bard College, and just how many people would be capable of a basic level 2 spell. Hell, if you have someone able to cast mass heal then 700 people could be cured per casting. That's a level 9 spell, so perhaps only a handful of people in the city could cast it, the high priests or some such but you wouldn't need many.
Once you get away from the population centres then it would get harder. Your average farming village might have one or two clerics at the most, and it would be easy for a disease to outstrip their limited abilities. Story wise it's perfectly fine to say its so infectious that it spreads faster than can be cured and unlike natural recovery where you gain antibodies, a magical curing might leave you open for reinfection.
Your actually describing a very high level of magic.. there is not a D&D setting I can think of where the "average" city has a number of 17th level or higher characters in it let alone even having one person that powerful.. typically the capitals might have someone that high, the high priestess of the main church of whatever god for instance MIGHT be lvl 17. Even the epic npcs in the stories usually cap out around 10-14. So no level 9 spells wouldn't really be that widely available in any D&D setting.
magical (or even mental) effects are easier to say lesser resto does not work on.One example is a diesese i made called macle(it used to be called gastar after someone in the discord server campaign i used it on).It was a mental effect that spread slowly through direct interaction and quickly through psychic effects it cause very slow mental degradtion (slowly reduced mental effects and giving occasional insanity).It being mental not psychical could be cured through lesser restoration (greater restoration worked to give advantage on saves).It was very effective especially due to one player being baddly hit (they failed every save thanks to already having negative wis) and become a mind controlled vector for the effect.
The world doesn't have to be full of people similar to the PCs, it just needs low level magic to be common, and that certainly seems to be the case in most fantasy settings. I mean the PCs aren't unique in their abilities. Imagine your average city with a dozen temples, numerous adventurer guilds, the local Bard College, and just how many people would be capable of a basic level 2 spell. Hell, if you have someone able to cast mass heal then 700 people could be cured per casting. That's a level 9 spell, so perhaps only a handful of people in the city could cast it, the high priests or some such but you wouldn't need many. Once you get away from the population centres then it would get harder. Your average farming village might have one or two clerics at the most, and it would be easy for a disease to outstrip their limited abilities. Story wise it's perfectly fine to say its so infectious that it spreads faster than can be cured and unlike natural recovery where you gain antibodies, a magical curing might leave you open for reinfection.
Reinfection would be an even bigger problem for a highly populated area. Plus, there's the question of who pays for the spells? Not all of the gods are particularly altruistic and back in the Renaissance, people with enough money just LEFT during a plague. I also think you're underestimating the rate of infection compared to the availability of spell slots. I mean, the Black Death lasted four years and wiped out a third of the population of Europe. By the time you know there's a problem and assemble your 700 candidates, there are 7000 infected. The next day you cure another 700, but you're up to 8000 infected.
I want to be careful about what I say next here, because people like to get offended, but it's hard to believe anyone could look at the last year and a half and NOT imagine a complete collapse of an explicitly faith-based public health system in the face of a plague. It's impossible to get even highly educated people to agree even to quarantine or engage in prophylactic behavior, let alone submit to an overt religious ceremony. People who could get a free shot, won't. They are discouraged from doing so by people they choose to believe. Whatever they or I think of their reasons, I can't believe they'd be willing to kiss the bronze butt of a statue of Bhaal, instead. So on they go, reinfecting all their neighbors who just got magically cured, while the ones who didn't get magically cured just get worse and worse.
In my opinion, what an outbreak of disease would look like is rich people paying to a church to cure their household members and servants regularly and everyone else getting thrown overboard. Just based on recent personal experience, that seems more plausible than getting a coalition of a dozen temples (to different deities), numerous rival adventurer guilds, a bardic college AND an entire kingdom to cooperate long enough to stop a widespread disease.
The world doesn't have to be full of people similar to the PCs, it just needs low level magic to be common, and that certainly seems to be the case in most fantasy settings. I mean the PCs aren't unique in their abilities. Imagine your average city with a dozen temples, numerous adventurer guilds, the local Bard College, and just how many people would be capable of a basic level 2 spell. Hell, if you have someone able to cast mass heal then 700 people could be cured per casting. That's a level 9 spell, so perhaps only a handful of people in the city could cast it, the high priests or some such but you wouldn't need many. Once you get away from the population centres then it would get harder. Your average farming village might have one or two clerics at the most, and it would be easy for a disease to outstrip their limited abilities. Story wise it's perfectly fine to say its so infectious that it spreads faster than can be cured and unlike natural recovery where you gain antibodies, a magical curing might leave you open for reinfection.
Reinfection would be an even bigger problem for a highly populated area. Plus, there's the question of who pays for the spells? Not all of the gods are particularly altruistic and back in the Renaissance, people with enough money just LEFT during a plague. I also think you're underestimating the rate of infection compared to the availability of spell slots. I mean, the Black Death lasted four years and wiped out a third of the population of Europe. By the time you know there's a problem and assemble your 700 candidates, there are 7000 infected. The next day you cure another 700, but you're up to 8000 infected.
I want to be careful about what I say next here, because people like to get offended, but it's hard to believe anyone could look at the last year and a half and NOT imagine a complete collapse of an explicitly faith-based public health system in the face of a plague. It's impossible to get even highly educated people to agree even to quarantine or engage in prophylactic behavior, let alone submit to an overt religious ceremony. People who could get a free shot, won't. They are discouraged from doing so by people they choose to believe. Whatever they or I think of their reasons, I can't believe they'd be willing to kiss the bronze butt of a statue of Bhaal, instead. So on they go, reinfecting all their neighbors who just got magically cured, while the ones who didn't get magically cured just get worse and worse.
In my opinion, what an outbreak of disease would look like is rich people paying to a church to cure their household members and servants regularly and everyone else getting thrown overboard. Just based on recent personal experience, that seems more plausible than getting a coalition of a dozen temples (to different deities), numerous rival adventurer guilds, a bardic college AND an entire kingdom to cooperate long enough to stop a widespread disease.
You seem to be jumping to the conclusion that the disease in question will be as deadly as the plague. Seems there's a whole spectrum of diseases from the sniffles through to some kind of airborne ebola. Sure the hypothetical disease could be highly infectious but equally it might not be. It would seem that low to medium infectious diseases could be readily dealt with and the risk is ones where the rate of infection outstrips the divine magic available.
The PHB says "Hiring someone to cast a relatively common spell of 1st or 2nd level, such as cure wounds or identify, is easy enough in a city or town, and might cost 10 to 50 gold pieces". With that in mind healing would be commonly available to middle to upper class, but the lower classes would struggle with those costs.
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So I was listening to a podcast the other day (Dungeoncast I think) and the hosts had a very brief discussion on diseases and poisoning in which they essentially felt that both are poorly done in DnD mechanics wise. Their gripe was essentially that if a character is effected by poison, he/she will typically get over it fairly easily (2nd level Cleric spell, a potion of lesser restoration, or in many instances waiting a duration of 1 minute for the condition to wear off). Where is the lasting effects? Disease is practically in the same realm yet from what I can tell disease is addressed even less in the rules. At least there is a poisoned condition that you get disadvantage on attack and ability rolls.
My question to you is this, do you have to come up with your own disease rules if you wish to incorporate them into the game? If so have you created one in your campaign? Was it overpowered or did the characters sluff it off just as easily as the rules seem to indicate?
usually a monster that causes a disease will lay out what that disease does (for instance the rot grub), as far as I know there isn't just a generic "disease" so if you wanted to have a plague or something you would need to engineer your own rules for it.
And have had 2 campaigns with diseases, one the disease was magical and couldn't be simply cured by lesser restoration or lay on hands so the cause had to be found quickly. Another it could be cured but it got progressively more violent as it came back each time.
Basic floating around diseases I don't think are to much of an issue in a world with godly powers at peoples finger tips, the only people that would really struggle would be common folk on the fringes or those that can't afford a clerics healing (hey not every church is just gonna heal everybody) that's why we always have the forces of evil readily available to come up with heinous and incurable ones if it needs to be a focal point
3.5E had plenty of disease rules you could modify and bring over if you wanted to make the Medicine skill do something useful for a change. The biggest issue you'd have is that they dealt stat damage, which broadly isn't a thing in 5E. Shadows deal stat damage, though, so it's still around, and you could make.it worse.
Here's 3.5E Blinding Sickness, which is in the 3.5 SRD so it's kosher to present, ported directly to 5E - you can modify it if you like.
Blinding Sickness is spread by tainted water. If a creature drinks water carrying the contagion, they must roll a DC 16 Constitution save. If they fail, the DM rolls 1d3 and notes this down. That many days later, they begin exhibiting symptoms.
Symptoms: Every 24 hours, make a DC 16 Con save or Strength score is reduced by 1d4. Strength reductions are cumulative and persist until the creature is cured and finishes a short or long rest. If the creature is reduced to Strength 0, they die. If the 1d4 result is 2 or more, the creature must roll a second DC 16 Con save. On a failure, they go permanently blind. Succeeding on the initial save two days in a row cures the disease.
Medicine rules: if the creature spends 8 hours under the care of a medic, during which the creature must short or long rest, on the creature's next Con save, the medic makes a Medicine check. Use the higher of the save and the check to try to beat the DC.
I think it's best to homebrew whenever possible, so the players who have read all the books can still be surprised every now and then. Most diseases (imho) should only be used to soften up the characters rather than to kill them. Sure, diseases can be deadly, but bards don't sing songs about the brave paladin who contracted dysentery and pooped himself to death. But if a few characters are feeling under the weather, and their capabilities are lessened, then the CR of everything they face will seem heightened. So let's think of a few off the top of our heads, shall we?
Shade Warts - large dark gray blisters you contract by contact with dead creatures or the undead. Make a Con save DC 15. If you fail you get a dozen or so blisters that gradually darken, and you take 1 hp of necrotic damage per hour until you are healed. Also, if a blister pops it'll smell like rotting flesh in a 5 foot radius. (Sure, 1 hp seems like nothing, but this could kill an average person fairly quickly!)
The Nether Flux - you might get this by drinking water in the Shadowfell. Con save DC 15 or suffer horrible diarrhea, dizziness and vertigo until the end of your next long rest. Disadvantage on Dex and Con skill checks and saving throws, and every five minutes you have to roll a d6. If you roll a 1 you have to stop what you're doing and go poop. (You will have one minute, or else it'll just happen! And remember, it takes five minutes to get out of heavy armor!)
Phantom Chills - you may catch this in an old tomb or mausoleum, or in the lair of a cold-based monster like a white dragon. Con save DC 12. On a fail you feel extremely cold, your movement speed is halved, and you take 1 hp of cold damage every ten minutes until healed. Also, you radiate cold in a 10 foot radius. Anyone who enters this radius or ends their turn there must make the Con save or catch the Chills from you.
Totem Pox - you may catch this by walking barefoot through infected water or mud. The infection rises up the legs causing painful blisters that are vaguely shaped like scary faces. Con save DC 11. On a fail you gain one level of exhaustion. Re-roll the save every hour. On a fail you gain another level of exhaustion. On a success the progression stops but the existing levels of exhaustion remain until healed normally.
Dr. Wickett's Viscous Sickness - this disease is caused by an attack from an ooze, or a gelatinous cube, or maybe a hag, or an oblex. Make a Con save DC 15. On a fail your skin becomes gross and rubbery and is covered in a slimy goop. You must re-roll the save every hour until cured. On your second fail, you suffer disadvantage on all Cha and Wis checks and saves. On your third fail, you suffer disadvantage on all Dex checks and saves BUT you gain advantage on avoiding or breaking a grapple. On your fourth fail, your body has become so oozy that you can no longer hold a weapon or other object, and your clothing and armor just slide right off you, BUT you gain the ability to move through spaces as narrow as 1 foot wide without squeezing. On your fifth fail your body collapses into a medium-sized puddle of gross oozy goo.
Sure, these diseases, like most, can be cured by lesser restoration. The DM could also rule that a player with the Healer Feat could use one or two uses of their healer's kit to cure a basic disease. I don't think diseases should be used to kill characters. Rather, they should be used to remind players that losing hit points is not the only way their characters can take damage, and that they need to think three dimensionally in their preparations. They should be used to weaken the party enough so that everything else they face becomes a little harder and a little deadlier. Just adding one more thing to worry about will cause enough stress in the player's minds that maybe they'll start second guessing themselves. It's fun to make them squirm sometimes.
Have fun!
Anzio Faro. Protector Aasimar light cleric. Lvl 18.
Viktor Gavriil. White dragonborn grave cleric. Lvl 20.
Ikram Sahir ibn-Malik al-Sayyid Ra'ad. Brass dragonborn draconic sorcerer Lvl 9. Fire elemental devil.
Wrangler of cats.
As you say lesser restoration at level 2 can cure disease and clerics, paladins, rangers, bards and druids all get it. So high level characters could cure a dozen or more people per rest cycle. With all of that it is hard to imagine common diseases causing much concern.
This is 5E. The world *isn't* full of people built like the PCs. You can't assume anything about anyone's capabilities. For example, Rime of the Frostmaiden has "druids" that fundamentally don't wild shape using the wild shape rules, they have their own custom mechanic with almost no relation to it. It's plausible lesser restoration is *around*, but you can't assume it's around in high numbers.
Exactly. The power level difference between Tier 1 characters and NPCs is about the same as the difference between Tier 3 and Tier 1. So the characters may be able to brush off any disease in their party very easily, but....
Let's say the disease doesn't hit the party (at least not right away). Let's say there's a town where the party calls home. Let's say they have friends and family members in that town. Now the party is off adventuring... meanwhile... a disease sweeps through that town. Even if they rush home to help - sure, the characters can cast Lesser Restoration a dozen times per day, but there's 300 people in town and they're dying at the rate of 3 or 4 per day and it's getting worse. So now the party is in a race against time to find the source of the disease and stop it - and hopefully to find a cure as well.
Use what they love against them.
Anzio Faro. Protector Aasimar light cleric. Lvl 18.
Viktor Gavriil. White dragonborn grave cleric. Lvl 20.
Ikram Sahir ibn-Malik al-Sayyid Ra'ad. Brass dragonborn draconic sorcerer Lvl 9. Fire elemental devil.
Wrangler of cats.
The world doesn't have to be full of people similar to the PCs, it just needs low level magic to be common, and that certainly seems to be the case in most fantasy settings. I mean the PCs aren't unique in their abilities. Imagine your average city with a dozen temples, numerous adventurer guilds, the local Bard College, and just how many people would be capable of a basic level 2 spell. Hell, if you have someone able to cast mass heal then 700 people could be cured per casting. That's a level 9 spell, so perhaps only a handful of people in the city could cast it, the high priests or some such but you wouldn't need many.
Once you get away from the population centres then it would get harder. Your average farming village might have one or two clerics at the most, and it would be easy for a disease to outstrip their limited abilities. Story wise it's perfectly fine to say its so infectious that it spreads faster than can be cured and unlike natural recovery where you gain antibodies, a magical curing might leave you open for reinfection.
Disease is handled very poorly in D&D. A few monthe back I wrote a book that contained diseases and parasites based on real world ones that impacted PC's like the actual disease.
Some require you to make con saves every few hours and leave you under the effects of the confusion spell when awake.
Others are three to seven days of making connsaves against low DC's (like 2 or 5), and with 3 collective fails you die.
Consumptiob drops your strength score slightly and each day you roll 1d20. On a 1, you have a bad week.
Each of these diseases call out that they can only be cured by a special remedy, or Greater Restoration, or Wish.
Heck, there's a common parasite that eats your feet. You get it by walking through poop barefoot (or swamps. All I'm saying is that the monk should wear shoes).
As someone else said, diseases should force players to make harder choices, not actually kill them outright... unless that's the DM's goal.
I don't have any real solutions for you other than to agree that both poison and disease are utterly terrible in 5e. You used to have to save vs. poison or die. Now you save vs. poison or get a little nauseated for a few hours. Disease is effectively the same way. The only way to make a poison actually scary is to say that if you fail you take XD6 of damage on top of the poisoned condition. So essentially you have to homebrew something by adding damage to it (and lots of damage if the PCs are above 3rd or 4th level) to make it even slightly scary. Disease is similarly underwhelming. As people have said, once the PCs have access to Lesser Resto, these normally very dangerous features of a typical fantasy world become utterly toothless.
As I say, I dislike this but I have not come up with any solutions. I mean, one could theoretically nerf Lesser Resto, but that would unbalance hundreds of monsters in the CR 5-10 range who have the ability to poison/disease and a certain DC on the built-in assumption by the designers that Lesser Resto is available to the PCs at that level.
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On the upside I've heard of some people using hookworms (you can get them from walking barefoot in human feces) will cure some seasonal allergies. I suppose a DM could work that into a story. A dwarf who can't stand pollen has to seek out a hookworms regularly b/c his immunity to poisons keeps killing them off yet wont do a thing for his hay fever.
Thanks for the post.
Although it may not make a lot of sense, perhaps a disease or poison that would scale would work (i.e. take half the player's hit points immediately or scale upward based on player constitution). Its just irritating when I try something like poison the characters and they immediately turn to the cleric and it just goes away and/or the dwarf simply says 'is it poison cause I'm practically immune?' Really WotC you couldn't nerf the poison resistance a little given they typically have high constitutions already?
Thanks for posting.
Check out the Malady Codex series over on DM's Guild. Lots of interesting ideas in there. :)
I think it boils down to the fact that save-or-die/long-term debilitating effects aren't really that fun; it just feels like punishment. No player wants to be the one lying on their deathbed while the rest of the party seeks a cure.
If you want disease drama, have a whole town affected, forcing the party to find/obtain an alternate way to cure 200 people within 5 days or whatever.
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(Artificer) Swordmage | Glasswright | (Barbarian) Path of the Savage Embrace
(Bard) College of Dance | (Fighter) Warlord | Cannoneer
(Monk) Way of the Elements | (Ranger) Blade Dancer
(Rogue) DaggerMaster | Inquisitor | (Sorcerer) Riftwalker | Spellfist
(Warlock) The Swarm
Your actually describing a very high level of magic.. there is not a D&D setting I can think of where the "average" city has a number of 17th level or higher characters in it let alone even having one person that powerful.. typically the capitals might have someone that high, the high priestess of the main church of whatever god for instance MIGHT be lvl 17. Even the epic npcs in the stories usually cap out around 10-14. So no level 9 spells wouldn't really be that widely available in any D&D setting.
magical (or even mental) effects are easier to say lesser resto does not work on.One example is a diesese i made called macle(it used to be called gastar after someone in the discord server campaign i used it on).It was a mental effect that spread slowly through direct interaction and quickly through psychic effects it cause very slow mental degradtion (slowly reduced mental effects and giving occasional insanity).It being mental not psychical could be cured through lesser restoration (greater restoration worked to give advantage on saves).It was very effective especially due to one player being baddly hit (they failed every save thanks to already having negative wis) and become a mind controlled vector for the effect.
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Reinfection would be an even bigger problem for a highly populated area. Plus, there's the question of who pays for the spells? Not all of the gods are particularly altruistic and back in the Renaissance, people with enough money just LEFT during a plague. I also think you're underestimating the rate of infection compared to the availability of spell slots. I mean, the Black Death lasted four years and wiped out a third of the population of Europe. By the time you know there's a problem and assemble your 700 candidates, there are 7000 infected. The next day you cure another 700, but you're up to 8000 infected.
I want to be careful about what I say next here, because people like to get offended, but it's hard to believe anyone could look at the last year and a half and NOT imagine a complete collapse of an explicitly faith-based public health system in the face of a plague. It's impossible to get even highly educated people to agree even to quarantine or engage in prophylactic behavior, let alone submit to an overt religious ceremony. People who could get a free shot, won't. They are discouraged from doing so by people they choose to believe. Whatever they or I think of their reasons, I can't believe they'd be willing to kiss the bronze butt of a statue of Bhaal, instead. So on they go, reinfecting all their neighbors who just got magically cured, while the ones who didn't get magically cured just get worse and worse.
In my opinion, what an outbreak of disease would look like is rich people paying to a church to cure their household members and servants regularly and everyone else getting thrown overboard. Just based on recent personal experience, that seems more plausible than getting a coalition of a dozen temples (to different deities), numerous rival adventurer guilds, a bardic college AND an entire kingdom to cooperate long enough to stop a widespread disease.
You seem to be jumping to the conclusion that the disease in question will be as deadly as the plague. Seems there's a whole spectrum of diseases from the sniffles through to some kind of airborne ebola. Sure the hypothetical disease could be highly infectious but equally it might not be. It would seem that low to medium infectious diseases could be readily dealt with and the risk is ones where the rate of infection outstrips the divine magic available.
The PHB says "Hiring someone to cast a relatively common spell of 1st or 2nd level, such as cure wounds or identify, is easy enough in a city or town, and might cost 10 to 50 gold pieces". With that in mind healing would be commonly available to middle to upper class, but the lower classes would struggle with those costs.