This concoction has an almost sickly sweet smell, which masks the tangy scent of spilled blood beneath its profile to all but the most perceptive. Effects such as the Identify or Detect Magic spells reveal that this potion is suffused with transmutation magic, but reveal little else.

If you drink the scarlet sacrament, you are afflicted by a curse known as the scarlet sickness. The true nature of this potion is revealed only by abilities that can detect undeath, such as the spell Detect Good and Evil or a paladin’s Divine Sense.

The Scarlet Sickness

When afflicted by the scarlet sickness, you initially appear hale and energetic. As the curse progresses your appearance becomes more withered and sickly, until it’s final stages when your visage is nearly corpselike. At the end of each long rest you must make a DC 15 Constitution saving throw. On a failure, the scarlet sickness progresses to the next stage.

Whenever you succeed on a saving throw against the Scarlet Sickness or one of its effects, the save DC for that effect increases by 1 until you fail it, at which point it resets to DC 15.

Stage 1: You have advantage on all melee attack rolls, and you deal 1d4 additional damage with each attack. Additionally, your sense of smell heightens, granting you advantage on tracking creatures that are wounded, and you can only receive sustenance from blood.

Stage 2: You begin to feel a constant, insatiable hunger, and when a creature whose blood you can see or smell is critically hit or reduced to half its hit points, you must make a DC 15 Wisdom saving throw. On a failure, you must move up to your speed to it and make one melee attack against it. Additionally, you are no longer able to sleep when taking a long rest, and you regain only half your hit dice and hit points when finishing a long rest.

Stage 3: When you are in direct sunlight, you have disadvantage on all attack rolls, ability checks, and saving throw, and attack rolls against you are made with advantage. Additionally, every 4 hours you must succeed on a DC 15 Wisdom saving throw or be overcome by an intense craving for blood, causing you to seek out and attack the nearest creature until you have dealt damage to it equal to five times your level in hit points.

Stage 4: You can hear the heartbeat of any creature within 50 feet of you, and you register as undead to spells and other effects that detect the presence of the undead creature type. Additionally, you are no longer able to receive healing from spells or potions.

Stage 5: For 24 hours you lose all sense of control and undergo a violent metamorphosis, at the end of which you become a vampire spawn. You continue to crave the scarlet sacrament, and regard any creature that provides it to you as your master. Additionally, the only areas you can use as a resting place are those under the effect of the hallow spell that does not ward against the undead.

The scarlet sickness can be treated in only one of two ways: either by imbibing the scarlet sacrament, which causes you to revert to stage 1 of the scarlet sickness so long as you have not reached stage 5 of the curse, or by performing a special ritual by trapping the afflicted target in a magic circle warding against undead for the circle’s duration, at the end of which you cast remove curse using a 6th level spell slot using a vial of holy water as a material component which is then consumed, thereby ending the scarlet sickness on the target.

Notes: Consumable, Cursed