A blood red ray of necrotic energy shoots from your outstretched hand towards a target you see in range. The target's eyes begin to water and tear uncontrollably. Their nose begins to run as mucus drains from their nose. Their mouth begins to water as if severely irritated. They must make a Constitution save or lose 1d4+2 hit points are are blinded until the beginning of your next turn. This spell has no effect on undead or constructs.
At Spell Level 4, the target will bleed (blood or other vital fluids) from the ears and have very loud ringing. Their eyes will also water from the pain. They are deafened until the start of your next turn. At Spell Level 6, the target will violently erupt blood or other vital body fluids from all of their orifices. Their hit points will be reduced to half of their current total and they are poisoned until the start of your next turn. Casting at a spell slot higher than 6th level will also add two levels of exhaustion and knock the target prone.