Eldritch Scalpel

Making a series of seemingly nonsensical gestures that get steadily more painful to look at for non-aberration creatures you touch a dead or willing living creature suffusing them with your eldritch energy. While concentrating on this spell you can while within 5 feet of the target, use the energy in the targets body to manipulate their physical form and assist in invasive surgery, making incisions with a thought, peeling skin from muscle and muscle and tendon from bones, along with other bodily manipulations this can also be used to make inscriptions in flesh and bone through scarification and chiseling.

If used on a willing living creature the creature takes 1 force damage every  minute increasing by 1dpm every 5 minutes ignoring resistance. While the spell is active regardless of if the spells effects are being actively used, this damage cannot be reduced or redirected in any way.

The damage dealt cannot reduce a creature to 0 hit points and the creature cannot lose consciousness while it's active. 

The effects of this spell on the living are excruciatingly painful and all but the toughest can bear it without issue. Every 5 minutes under this spell drives the creature closer to madness and it must make a Constitution saving throw (DC starting at 10 and increasing by 5 every subsequent saving throw). Upon failing it must make a roll on the temporary madness table. This failure can be negated if the creature immediately upon failure attempts to leave the effective range of the spell thus becoming unwilling and breaking the connection. Creatures at 1 HP automatically fail the save.

If a creature fails the save and continues under the effect of the spell while the DC is 20 or above roll on the permanent madness table instead.

While concentrating on this spell, the damage that it has been done to can be healed to a degree. You can choose to heal up to half of the damage dealt (rounded down) as you magically suture and put the creature back together. This immediately ends the spell.

At the end of the spell make a Nature check, with advantage if it is a species you have dissected before, DC at the discretion of the DM to see how well the creature was put back together and what kind of scars are left.

Delicate control is needed to sustain this spell, concentration is lost if the caster takes damage, rolls initiative or moves greater than 20 feet from the target.