DISEASES
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not necessarily due to any immediate external injury.
Anthrax
Type infection; Save Fortitude DC 22 (Inhalation)
Onset 1–3 days; Frequency 1/day
Effect Nauseated or ability damage (1d6 Con), possible
unconsciousness or death (2 weeks); Cure 2 consecutive saves
This is the pneumatic version of anthrax, not the
subcutaneous. Anthrax has been around for many years, and was known as
Woolpicker's disease or Ragpicker's disease due to the prevalence of the
illness coming from sheep's wool. Anthrax causes flu-like symptoms, then sudden
respiratory collapse; it can also cause stomach ache and vomiting of blood, and
bloody diarrhea. If the PC fails the check by more than 5 points, s/he suffers
the ability damage mentioned (1d6 Con) and falls unconscious. If the PC fails
the check by more than 10 points, s/he dies.
Anthrax is especially feared in port cities, textile
warehouses, and caravan routes where untreated wool and hides are handled in
bulk. The disease spreads quietly at first, moving from laborer to laborer
before anyone realizes something is wrong, and by then it is often too late to
contain. Entire shipments are sometimes burned as a precaution, and districts
quarantined with brutal efficiency.
Those who survive rarely recover fully. Their lungs remain scarred, their breathing shallow, and physical exertion becomes a lasting struggle. In more superstitious regions, anthrax is blamed not on bacteria, but on cursed animals or “bad wind,” leading to rituals, burnings, and the destruction of entire herds to prevent its return.
Bog Rot
Type disease, contact; Save Fortitude DC 16
Onset 1 day; Frequency 1/day
Effect 1d6 Str, Dex, Con, or Cha (determine randomly using 1d4)
damage; Cure —
Creatures afflicted with bog rot do not heal naturally and
gain only one-half benefit from magical healing until the disease is cured. Unlike
normal diseases, bog rot continues until the victim reaches Constitution 0 (and
dies) or receives a remove disease spell or similar magic. The save DC is
Charisma-based. A character with bog rot will develop 3d6 green pustules all
over that last for the length of the infection, and there is a 10% chance per
day that one of these pustules will naturally rupture (they can be
intentionally ruptured with a pinprick). Anyone coming in contact with the puss
after a rupture risks infection.
Bog rot festers in stagnant marshes, drowned forests, and
places where decay has settled deep into the land. The pustules that form are
slick, green, and faintly warm, often pulsing as though something beneath the
skin is alive. In darkness, they may emit a dim, corpse-like glow, marking the
afflicted as something halfway claimed by the swamp.
Among certain swamp cultures, bog rot is not seen as a disease at all, but as a form of communion with the land. Shamans may interpret its progression as a message, while less reverent groups harvest the infectious fluid as a weapon. To outsiders, however, it remains a slow, inevitable, and deeply unsettling death.
Brainworms
Type disease (parasite), contact or injury; Save Fortitude
DC 14
Onset 1 day; Frequency 1/day
Effect 1d3
Individually, these tiny parasites are almost invisible to
the naked eye, yet en masse they’re capable of taking down even the strongest
animals. Entering the body through contact with an infected host or corpse (especially
through open wounds), these thin worms quickly migrate to the brain and begin
reproducing. The infestation is typically evidenced by a dulling of the senses
and intellect and by erratic bouts of irrational rage toward other creatures
during which the worms attempt to spread to other hosts through combat and
injury. Examining the brain of a late-stage victim reveals a living carpet of
thousands of tiny parasites.
Early symptoms are subtle - misplaced thoughts, slow
reactions, and strange lapses in judgment. As the infestation progresses, these
give way to violent mood swings and sudden aggression, often without warning. Victims
may experience fleeting clarity, becoming aware of their condition only long
enough to fear what they are becoming.
In rare and disturbing cases, individuals have willingly exposed themselves to brainworms, believing the parasites grant insight or shared consciousness. These infected groups are far more dangerous, retaining enough coordination and awareness to act as a unified threat rather than mindless hosts.
Bubonic Plague
Type disease, injury or inhaled; Save Fortitude DC 17
Onset 1 day; Frequency 1/day
Effect 1d4 Con damage and 1 Cha damage and target is
fatigued; Cure 2 consecutive saves
Infected vermin and parasites spread this disease, also
known as Daemon’s Touch or the Black Death, through their bites. Once
contracted, the disease spreads quickly, polluting the victim’s body with
toxins. As the disease reaches the lymph nodes, the victim suffers extreme
inflammation of glands, and his skin might take on a black pallor. Symptoms
include fever, headaches, nausea, fatigue, and swelling of the lymph nodes (called
buboes) on the neck, underarms, and inner thigh areas, and eventually bleeding
beneath the skin. A victim who takes any Constitution damage from the disease
must immediately make a successful Fortitude save or become fatigued until all
his Constitution damage is healed. Each time a victim takes 2 points of
Constitution damage from Black Death, he also takes 1 point of Charisma damage.
The plague does not simply kill - it dismantles societies. Streets
empty, trade halts, and the living avoid one another as much as the dead. Entire
districts may be sealed off, with guards ordered to prevent escape at any cost,
turning containment into quiet execution.
Its horrific symptoms make it unmistakable, and victims are often abandoned long before death. In some regions, the disease is seen as divine punishment, while in others it is believed to be carried by unseen spirits or demons, spreading fear as effectively as infection.
Cholera
Type disease (injury); Save Fortitude DC 13
Onset 1d3 days; Frequency 1/day
Effect 1d2 Con damage; as long as a character suffers Con
damage from Cholera, he is fatigued; Cure 2 consecutive saves
This is an infectious and often fatal bacterial disease of
the small intestine, typically contracted from infected water supplies and
causing severe vomiting and diarrhea.
Cholera spreads fastest where desperation already exists - refugee
camps, war zones, and cities with poor sanitation. Victims can lose dangerous
amounts of fluid within hours, leaving them weak, disoriented, and unable to
stand without assistance.
Survivors often develop a lasting distrust of water sources, refusing to drink without purification. In some regions, elaborate rituals or blessings are performed over wells and rivers, blending practical caution with superstition.
Dysentery
Type disease (parasite), contact or injury; Save Fortitude
DC 16
Onset 1d3 days; Frequency 1/day
Effect 1d6 nonlethal damage and target is fatigued and
staggered; Cure 2 consecutive saves
A broad family of intestinal afflictions caused by
everything from bacteria to viruses to parasitic worms, dysentery is
characterized by explosive and sometimes bloody diarrhea, leading to
dehydration and occasionally death.
Among soldiers and travelers, dysentery is often more feared
than combat itself. It weakens quietly but completely, draining strength,
morale, and dignity in equal measure. Entire expeditions have failed not due to
enemies, but to this slow internal collapse.
Its danger lies not only in its severity, but in its timing. It strikes when rest is scarce and movement is required, turning even simple travel into a deadly gamble.
Grave Rot
Type disease (necromantic), contact or injury; Save
Fortitude DC 19
Onset 1 day; Frequency 1/day
Effect 1d4 Con damage and 1d4 Dex damage; target is
fatigued; Cure 2 consecutive saves
A creature that dies while afflicted by Grave Rot rises as a
skeleton (as the standard monster description) within 1 hour. Upon death, the
flesh rapidly blackens, liquefies, and sloughs from the bones, leaving behind a
clean, animated skeleton. This transformation cannot be prevented except by
remove disease, remove curse, or similar magic cast before death.
Even before death, Grave Rot carries an unmistakable
presence. The afflicted feel unnaturally cold, their skin tightening and
darkening as though already preparing for decay. A faint dry smell, like old
crypts and dust, follows them wherever they go.
Necromancers value this disease as a weapon and tool alike, allowing the dead to rise without further effort. Entire battlefields have turned against the living when fallen soldiers stand again within the hour, stripped of flesh and mercy alike.
Lantern Fever
Type disease (supernatural), inhaled; Save Fortitude DC 17
Onset 1d3 days; Frequency 1/day
Effect 1d3
Afflicted creatures become unnaturally drawn to sources of
light. Whenever a visible light source is within 60 feet, the target must
succeed on a Will save (DC 15) or move toward it by the safest available route,
treating it as a fascination effect. At 0 Wisdom, the creature becomes
completely obedient to the nearest light source, ignoring all other stimuli.
Lantern Fever often begins with harmless curiosity - a
flicker in the distance, a glow just beyond the treeline, something that seems
worth investigating. Victims may initially dismiss it as imagination, but over
time the lights become more persistent, more vivid, and impossible to ignore.
Entire groups have vanished after a single afflicted individual wandered off, drawn toward unseen lights into swamps, cliffs, or deep water. Many believe the disease is tied to will-o’-wisps or malicious spirits, using infected victims as lures to draw others to their doom.
Leprosy
Type disease, contact, inhaled, or injury; Save Fortitude DC 12 (initial), Fortitude DC 20 (secondary)
Onset 2d4 weeks; Frequency 1/week
Effect 1d4 Cha damage, 1d2 Con damage; Cure 3 consecutive saves
Leprosy is spread by victims of the disease through direct,
even casual, contact. Leprosy results in skin lesions, extreme nasal
congestion, and wounds that do not heal. A highly visible malady, leprosy can
permanently disfigure those who don’t receive magical aid. If left untreated,
the victim develops sores and becomes easily fatigued. While leprosy can prove
difficult to contract, few overcome the disease once infected. When exposed to
leprosy, a character must make a DC 12 Fortitude save to resist the disease. If
he fails, once the affliction’s incubation time passes and symptoms begin
showing, the save to recover from the malady increases to DC 20. Suffering from
a slow deterioration, particularly hardy lepers can remain quite active for
years after first exhibiting signs of the disease.
The physical symptoms of leprosy are only part of its burden.
Victims are often shunned or cast out long before the disease becomes
debilitating, forced into isolated communities or left to wander alone. The
fear of contagion spreads faster than the disease itself.
Despite its severity, leprosy progresses slowly, and some individuals manage to live long, functional lives while afflicted. This has led to conflicting beliefs - some view it as a curse, others as a test of endurance or even a strange form of transformation.
Malaria
Type disease, injury; Save Fortitude DC 18
Onset 1d3 days; Frequency 1/day
Effect 1d3 Str damage and 1d3 Con damage and target is
fatigued; Cure 2 consecutive saves
A classic traveler’s nightmare, malaria is transmitted by
the bites of mosquitoes and leads to fever, vomiting, shivering, and
convulsions, and sometimes even severe brain damage, particularly in children.
Malaria is infamous for its cycles - periods of relative
calm followed by sudden, overwhelming waves of fever and weakness. Victims may
believe they are recovering, only to be struck down again hours later, their
strength drained anew.
Swamps, jungles, and still waters are its favored breeding grounds, and seasoned travelers learn quickly to fear the hum of insects in the night. Entire expeditions have been lost not to monsters, but to the relentless attrition of this disease.
Mononucleosis
Type disease, infection; Save Fortitude DC 20
Onset 3–6 weeks; Frequency 1/day
Effect Sore Throat, fatigue, headache, insomnia (see text);
Cure 2 consecutive saves
This disease is spread from anyone who has the disease, and
it is spread through the mildest contact, including handshakes. Anyone who
contracts this disease feels the symptoms 3–6 weeks later, and the symptoms
last for 1–3 weeks. Anyone who contracts this disease is contagious, and can
therefore spread it to their party, so often they are left behind for the
duration (though they are not contagious until the symptoms appear). Those who
contract this disease feel the following symptoms:
Fatigue: A fatigued character can neither run nor charge and
takes a –2 penalty to Strength and Dexterity. Doing anything that would
normally cause fatigue causes the fatigued character to become exhausted.
Headache: A character with a headache cannot concentrate as
well as normal. This causes a –6 penalty to Concentration checks.
Insomnia: A character with insomnia cannot sleep very well. Any
time the character attempts to fall asleep, and every hour that they remain
sleeping, they must succeed a fortitude save (DC 15) or wake up, not being able
to fall asleep again for 6d4 minutes. If a character of a race that does not
sleep (such as elves) has insomnia, treat his form of sleep (such as meditation)
as sleep for the purposes of this symptom.
Sore Throat: Any time the character attempts to speak, he
must succeed a fortitude save (DC 15) or take 1 Voice damage. This damage is
permanent, unless treated specifically with a healing spell (the voice has its
own HP, so a healing spell must target the voice specifically, rather than the
body). If the character's voice HP is reduced to 0, the damage cannot be healed.
Voice Damage: All characters have 10 Voice HP. Whenever a
character attempts to speak, he must roll a d10. If the result of the d10 is
greater than the character's current voice HP, he fails to say what he was
attempting to, and cannot speak for one full round. If a character's Voice
Damage isn't healed within 2 weeks of its initial occurrence, the damage is
completely permanent.
Mononucleosis is deceptively mild in appearance, often
dismissed as simple exhaustion or a lingering cold. By the time its true nature
is understood, it has usually already spread to others, quietly undermining
entire groups.
Though rarely fatal, its lingering effects can cripple an adventuring party’s effectiveness. Fatigue, poor sleep, and reduced focus make even simple tasks difficult, turning routine travel into a frustrating and dangerous ordeal.
Pneumonia
Type disease, infection; Save Fortitude DC 24 (after long
illness only, see description)
Onset 1–4 weeks; Frequency 1/day
Effect Sick or nauseated, exhausted or fatigued, possibly
confused or prone, possibly staggered or unconscious; Cure 2 consecutive saves
Pneumonia is no laughing matter. It is most definitely fatal
in long-term illnesses. Pneumonia is generally a complication of other diseases
(though it can be caught by it's lonesome) and causes coughing (with or without
blood), chest pain, fever, shaking, chills, headaches, sweaty skin, fatigue,
blueish skin, nausea, joint pains and muscle aches.
If the PC fails their check by more than 5 points, s/he
becomes nauseated instead of sick, and fatigued instead of exhausted. If the PC
fails by more than 10 points, s/he becomes confused and staggered in addition
to nauseated and fatigued. If the PC rolls a natural 1 or fails by more than 15
points, s/he becomes prone and unconscious (effectively helpless) until some
Good Samaritan drags him or her off to be healed.
Pneumonia often appears when a body is already weakened,
turning a survivable illness into a fatal spiral. The steady decline in
breathing capacity creates a sense of slow suffocation that is as terrifying as
it is deadly.
Healers often treat pneumonia as the final threshold - the point where intervention must be immediate and decisive, or not at all. Without aid, even the strong can fade quickly.
Rabies
Type disease, injury; Save Fortitude DC 14
Onset 2d6 weeks; Frequency 1/day
Effect 1 Con damage plus 1d3
Rabies is a viral disease that causes inflammation of the
brain in humans and other mammals. Early symptoms can include fever and
tingling at the site of exposure. These symptoms are followed by one or more of
the following symptoms: nausea, vomiting, violent movements, uncontrolled
excitement, fear of water, an inability to move parts of the body, confusion,
and loss of consciousness. Once symptoms appear, the result is virtually always
death.
Rabies carries a particular terror because of how it changes
behavior. Victims may lash out at allies, animals, or even themselves, driven
by confusion and instinct rather than reason.
The infamous fear of water is often misunderstood, but deeply unsettling to witness. Once symptoms manifest, even powerful magic may struggle to save the afflicted, making early intervention critical.
Red Harvest
Type disease (magical), injury; Save Fortitude DC 18
Onset 1 day; Frequency 1/day
Effect 1d4 Con damage and 1d4 Str damage; target takes 1
point of bleed damage; Cure 3 consecutive saves
Whenever a creature afflicted with Red Harvest takes
slashing or piercing damage, they take an additional 1d4 bleed damage. This
bleed stacks with itself and persists until magically healed or the disease is
cured.
Red Harvest gives the unsettling impression that the body
has forgotten how to hold itself together. Small cuts reopen, bruises seep, and
even pressure alone can cause the skin to split. Blood flows too easily, too
freely, and refuses to clot.
The disease is often associated with cursed weapons or battlefields soaked in excessive bloodshed. Some believe it marks those who have taken too many lives, while others deliberately inflict it as a slow and inescapable death sentence.
Smallpox
Type disease, contact, inhalation; Save Fortitude DC 18
Onset 1–4 days; Frequency 1/day
Effect Nauseated or exhausted, possible ability damage; Cure
3 consecutive saves
Smallpox may have been eradicated in our world, but during
the Middle Ages it was an unrepentant killer. Known as alastrim, cotton pox,
white pox, and milk pox, it was common throughout the history of the world. It
causes fever, muscle pain, headache, nausea, and vomiting; within 12–15 days
small white lesions appear in and around the mouth, these will grow and rupture.
The white lesions may spread across the body and then stop. If the PC fails the
check by more than 5 points, s/he becomes exhausted instead of fatigued. If the
PC fails the check by more than 10 points, s/he suffers 1d6 Con damage.
The disease leaves its mark long after survival. Scarring is
common and often severe, permanently altering the appearance of those who live
through it. In some cultures, these scars are seen as marks of endurance, while
in others they are a sign of contamination.
Outbreaks of smallpox have reshaped entire populations, leaving lasting effects not just on individuals, but on societies and histories.
Tetanus
Type disease, injury; Save Fortitude DC 14
Onset 1d6 days; Frequency 1/day
Effect 1d4 Dex damage and 50% chance stiffened jaw muscles
prevent speech for the next 24 hours; Cure 2 consecutive saves
Tetanus is an infection caused by bacteria called
Clostridium Tetani. When the bacteria invade the body, they produce a poison (toxin)
that causes painful muscle contractions. Another name for tetanus is “lockjaw”.
It often causes a person's neck and jaw muscles to lock, making it hard to open
the mouth or swallow.
The disease often begins subtly, with stiffness or
discomfort that gradually worsens into full muscle rigidity. As it progresses,
even simple movements become painful, and the inability to speak or swallow
creates a deeply unsettling sense of helplessness.
Adventurers are particularly vulnerable, as even minor wounds can lead to infection if left untreated. Many seasoned warriors develop strict habits around cleaning and tending injuries, knowing how quickly tetanus can take hold.
Tuberculosis
Type disease, inhaled; Save Fortitude DC 18
Onset 1d4 days; Frequency 1/day
Effect 1d4 Str damage and 1d4 Con Damage; Cure 3 consecutive
saves
This disease flourishes in unsanitary conditions, places of
stale air, and many humanoid cities. Symptoms include chest pain and a
productive, prolonged, bloody cough. If left untreated, the disease quickly
progresses, leading to high fever, chills, night sweats, appetite loss, pallor,
fatigue and eventually death.
Tuberculosis is slow and relentless, wearing down its
victims over time rather than striking quickly. The persistent cough becomes a
grim constant, often worsening until blood is present.
Because of its gradual progression, it is sometimes ignored until it becomes severe. In crowded cities, it spreads easily, making it one of the most common and quietly deadly diseases among the poor.
Typhoid Fever
Type disease, injury; Save Fortitude DC 15
Onset 5d6 days; Frequency 1/day
Effect 1d6 Str damage and 50% chance of 1 Con Damage; Cure 2
consecutive saves
Typhoid fever, also known as typhoid, is a disease caused by
salmonella serotype typhi bacteria. Symptoms may vary from mild to severe, and
usually begin six to 30 days after exposure. Often there is a gradual onset of
a high fever over several days. This is commonly accompanied by weakness,
abdominal pain, constipation, headaches, and mild vomiting. Some people develop
a skin rash with rose colored spots. In severe cases, people may experience
confusion. Without treatment, symptoms may last weeks or months. Diarrhea is
uncommon. Other people may carry the bacterium without being affected, but they
are still able to spread the disease to others. The risk of death may be as
high as 20% without treatment.
Typhoid is particularly dangerous because it can spread
silently. Carriers who show no symptoms may unknowingly infect entire
communities, making containment extremely difficult.
Its long duration and gradual worsening make it especially draining, turning even strong individuals into weakened shadows of themselves over time.
