Note From the Author

This class is a WORK IN PROGRESS and does not represent a refined product.

If you have any feedback for me, please contact me on reddit under /u/lukemortora01

Playtest at your own risk.

V4.4 - 03/03/2020

Plague Doctor

He coughs into his beaked mask, the various aromatic herbs and flowers inside doing little against the putrid air. The stench of death was everywhere, but the woman before him was not yet meant for death. Her wounds begin close as he draws on divine power to stablise her critical condition.

He takes her in his arms, the poisonous cloud he had summoned to dispatch her ailants making way for the procession to this woman's salvation.

He was the one who would stand between aliment and rot, between life and death, and between this woman and a gruesome end. In his wake, he left the corpses of the weak.

Plague doctors are a symbol of fear amongst many, their presence often denoting the coming of disease and grim duties. They commit themselves to complete the work too grisly for even the strongest of stomachs.

They are masters of improvised medicines and, through divine intervention, controlling miasmas of plague.

Ordained Healers

Plague doctors were the norm in areas where the power of prayer had yet to reach the settlements there, and even in places where a cleric's power was limited.

Their medical instruments were crude, but the power to control and cure disease was often mistaken for a miracle. In actual fact, these dark drudges were acting as the instruments of the deities who needed a conduit to save the people of the material plane from their mortal ravages.

In the modern day, the methods that plague doctors employ is an out-moded form of healing, but there are some who believe that some day, the gods may stop answering their prayers, and there will only be those who have learned these medical practices to keep mortal men from perishing.

Plague doctors accept that their otherworldly power comes from a divine source, but are fully prepared to continue their deity's work should their absence ever come to pass.

Grim Laborers

The life of a plague doctor is generally unpleasant. They are witness to a great many unsightly illnesses and grisly scenes which carry the stench of death. The practice of being a plague doctor is usually born of neccessity, but sometimes passed down within a family bloodline to ensure the skills and knowledge aren't lost.

In some places, plague doctors are not recognised as holy vessels, and Clergy often dismiss their tools and methods as unnecessarily inhumane. Plague doctors whole-heartedly believe in their tried-and-true practices, and often use the fear and stigma they incite with their presence as leverage in difficult situations.

Although they're given a wide berth by most, they endeavour to live by their hippocratic oaths, lending their assistance to the innocent in suffering.

Some plague doctors swear their oath to their deity, where as some simply swear it to their people. In either case, they understand that their job might be an undesirable one, but they fulfil their duties with somber dignity.

PART 1 | CLASSES

The Plague Doctor
Level Proficiency Bonus Features Cantrips Known 1st 2nd 3rd 4th 5th 6th 7th 8th 9th Techniques Known
1st +2 Medical Techniques 3 2 2
2nd +2 Restorative Regimen 3 3 2
3rd +2 School of Medicine 3 4 2 2
4th +2 Ability Score Improvement 4 4 3 2
5th +3 4 4 3 2 3
6th +3 Grim Harvest 4 4 3 3 3
7th +3 School of Medicine Feature 4 4 3 3 1 3
8th +3 Ability Score Improvement 4 4 3 3 2 3
9th +4 4 4 3 3 3 1 4
10th +4 School of Medicine Feature 5 4 3 3 3 2 4
11th +4 Adaptive Procedures 5 4 3 3 3 2 1 4
12th +4 Ability Score Improvement 5 4 3 3 3 2 1 4
13th +5 5 4 3 3 3 2 1 1 5
14th +5 School of Medicine Feature 5 4 3 3 3 2 1 1 5
15th +5 Waste Not, Want Not 5 4 3 3 3 2 1 1 1 5
16th +5 Ability Score Improvement 5 4 3 3 3 2 1 1 1 5
17th +6 5 4 3 3 3 2 1 1 1 1 6
18th +6 School of Medicine Feature 5 4 3 3 3 3 1 1 1 1 6
19th +6 Ability Score Improvement 5 4 3 3 3 3 2 1 1 1 6
20th +6 WIP 5 4 3 3 3 3 2 2 1 1 6

Creating a Plague Doctor

While you are creating your plague doctor, consider where you acquired your skills and power. Is the profession a family tradition? Or were you taught by someone else? How did you get your practitioner's manual and tools?

The other question should consider is whether you worship a deity or not. You may choose to serve a deity if you choose, but even if you don't, you are still the instrument of some deific intervention. Not all plague doctors need to worship a deity, and some are entirely unaware that their power comes from a divine source - your DM may even decide to use this as a plot hook.

Quick Build

You can make a plague doctor quickly by following these suggestions. First, make Wisdom your highest ability score, followed by Constitution. Second, choose the acolyte background.


Class Features

As a Plague Doctor, you have the following class features.

Hit Points


  • Hit Dice: 1d8 per plague doctor level
  • Hit Points at 1st Level: 8 + your Constitution modifier
  • Hit Points at Higher Levels: 1d8 (or 5) + your Constitution modifier per plague doctor level after 1st

Proficiencies


  • Armor: Light armor.
  • Weapons: Simple Weapons, hand crossbows.
  • Tools: Herbalism Kit, Practitioner's Kit.

  • Saving Throws: Constitution, Intelligence
  • Skills: Choose three from History, Insight, Investigation, Medicine, Nature, Religion and Survival.

Equipment

You start with the following equipment, in addition to the equipment granted by your background:

  • A Simple weapon, leather armor and a practitioner's kit
  • (a) A hand crossbow with 20 bolts or (b) a dagger
  • (a) A priest's pack or (b) a scholar's pack
  • (a) A holy symbol or (b) a component pouch

PART 1 | CLASSES

Practitioner's Kit

A practitioner's kit contains bandages, salves, and splints as with the healer's kit, but also contains syringes, a bone saw, an artificial leech, suture wire, needles, and medicines for common ailments. Most importantly, it contains a practitioner's manual which you use to prepare your spells, and your plague doctor mask.

In addition, it contains the same things a herbalism kit does. The kit weighs 8lbs in total and costs 20GP to replace if lost.

The kit has ten uses. As an action, you can expend one use of the kit to stabilize a creature that has 0 hit points, without needing to make a Wisdom (Medicine) check, or remove the infected condition from one creature. You can replenish these uses by buying the supplies required for 5GP.


Spellcasting

As a conduit for divine power, you can cast plague doctor spells. See chapter 10 of the Players Handbook for the general rules of spellcasting. The plague doctor spell list is detailed at the end of the plague doctor class section.

Cantrips

At 1st level, you know three cantrips of your choice from the plague doctor spell list. You learn additional plague doctor cantrips of your choice at higher levels, as shown in the Cantrips Known column of the plague doctor table.

Preparing and Casting Spells

The Plague Doctor table shows how many spell slots you have to cast your spells of 1st level and higher. To cast one of these spells, you must expend a slot of the spell's level or higher. You regain all expended spell slots when you finish a long rest.

You prepare the list of plague doctor spells that are available for you to cast, choosing from the plague doctor spell list. When you do so, choose a number of plague doctor spells equal to your Wisdom modifier + your plague doctor level rounded down (minimum of one spell). The spells must be of a level for which you have spell slots.

You can change your list of prepared spells when you finish a long rest. Preparing a new list of plague doctor spells requires time spent in study of your practitioner's manual: at least 1 minute per spell level for each spell on your list.


Plague Doctor Unique Spells

As a Plague Doctor, you learn spells unique to your class at the following prerequisite levels. These spells do not count towards the number of spells you can prepare. In addition, you know the poison spray cantrip, which does not count against your cantrips known.

Plague Doctor Level     Bonus Spell
1st   Miasma
3rd   Expunge
5th   Vermintide
7th   Wall of Corpses
9th   Deadly Pathogen
11th   Maddening Haze
13th   Nebulous Form
15th   Namtar's Revulsion
17th   Pandemic

New Condition: Infected

While a creature is infected, it suffers minor adverse effects such as a cough or fatigue, and is unable to gain advantage by any means. Many of your plague doctor unique spells and class features interact with the infected condition. This infection is unique to you, therefore you should track infections from other sources separately. The infected condition can be removed with lesser restoration or similar healing magic.

Plague Doctor's Mask

While you are wearing your plague doctor mask, you gain immunity to the effects of the spells cast by you listed under the plague doctor unique spells feature, but you have disadvantage on Wisdom (Perception) checks.

Spellcasting Ability

Wisdom is your spellcasting ability for your Plague Doctor spells. The power of your spells comes from your devotion to your deity. You use your Wisdom whenever a Plague Doctor spell refers to your spellcasting ability. In addition, you use you Wisdom modifier when setting the saving throw DC for a Plague Doctor spell you cast, and when making an attack roll with one.


Spell save DC = 8 + your proficiency bonus +

your Wisdom modifier

Spell attack modififer = your proficiency bonus +

your Wisdom modifier

Ritual Casting

You can cast a plague doctor spell as a ritual if that spell has the ritual tag and you have the spell prepared.

Spellcasting Focus

You can use a holy symbol or a component pouch (found in chapter 5 of the Player's Handbook) as a spellcasting focus for your Plague Doctor spells.

Medical Techniques

Through your learned craft of medical procedure and study of your practitioner's manual, you are privvy to techniques which enhance your abilities.

Starting at 1st level, you learn two medical techniques of your choice. Your technique options are detailed at the end of the class description. When you gain certain plague doctor levels, you gain additional techniques of your choice, as shown in the Techniques Known column of the Plague Doctor table.

Additionally, when you gain a level in this class, you can spend an hour in study of your practitioner's manual and choose one of the techniques you know and replace it with another technique that you could learn at that level.

Restorative Regimen

Starting at 2nd level, you can use a single charge of a healer's kit or a practitioner's kit to provide treatment to a number of willing creatures equal to your Wisdom modifier at the end of a long rest.

As long as each creature has had an adequate amount of food and drink, this treatment grants the same effect as the lesser restoration spell.

School of Medicine

At 3rd level, you commit to a School of Medicine, all detailed at the end of the class description. The school you choose grants you features at 3rd level and again at 7th, 10th, 14th, and 18th level.

Ability Score Improvement

When you reach 4th level, and again at, 8th, 12th, 16th, and 19th level, you can increase one ability score of your choice by 2, or you can increase two ability scores of your choice by 1. As normal, you can't increase an ability score above 20 using this feature

Grim Harvest

Starting at 6th level you are able to tap into the life-energy of creatures that die around you. Whenever a hostile creature within 60ft of you is reduced to 0 hit points, you can store a small amount of their life energy within your spellcasting focus for 1 minute.

When you cast a spell of 1st level or higher that deals damage or restores hit points, you can choose to expend this life energy to deal additional necrotic damage or increase the healing by an amount equal to your Wisdom modifier.

This feature is effective on spells that affect multiple creatures, but only necrotic damage or additional healing can be chosen, not both.

Adaptive Procedures

Starting at 11th level, you can spend a hour in study of your practitioner's manual to exchange one of your prepared spells for another spell on the plague doctor spell list.

Once you have used this feature, you must complete a long rest before you can use it again.


Waste Not, Want Not

Starting at 15th level, if you have spell slots left over at the end of a long rest, you can choose one of these spell slots to store a spell of 5th-level or lower from the Unique Plague Doctor Spells list. You can cast the stored spell once without expending a spell slot. You cast this spell at the level at which it was stored.

This effect lasts until the end of your next long rest.

Affliction

When you reach 20th level, you can unleash a disease of your own invention. As an action, you can become a conduit to this plague for 1 minute, touching any number of creature for the duration to attempt to inflict them with this disease. Any creature you touch must succeed on a Constitution saving throw or become afflicted with your disease. A creature that succeeds or fails this saving throw is not aware of this at the time you attempt to inflict it.

Once you use this feature, you must complete a long rest before you can use it again.

Each time you use this feature, you decide upon the disease anatomy as per the below appendix.

Any creature attempting to diagnose or treat against your affliction uses your spell save DC for any checks. You automatically succeed on any check made to diagnose or treat your own affliction, but this may not guarentee recovery of the creature depending on the nature and intention of the disease.

Disease Anatomy

You use the below to decide upon the details of the disease:

Incubation Period. This represents the time it takes for a disease's symptoms to appear. The minimum incubation period is 1 hour, and the maximum is 96 hours.

Symptoms. Symptoms of a disease can include painful rashes, coughing, nausea etc. Your disease must have at least 1 symptom which an afflicted creature will notice once the incubation period expires.

Contagiousness. You can decide whether the disease you inflict is contagious or not. It can be any combination of contact, airborne and waterborne. It is also capable of passing between different specific creature types of your choosing. (A highly contagious disease can have disasterous consequences.)

Duration. This represents how long the symptoms of a disease last. The minimum is 2 days and the maximum is 2 weeks.

Severity. This represents whether a disease is intended to be fatal or not. If you choose for a disease to be fatal, at the end of the duration, the creature must succeed on three Constitution saving throws. A creature that has recieved any form of appropriate treatment makes these saves with advantage. Once the creature reaches 3 failures, it is reduced to 0 hit points and dies. A creature that succeeds on these saving throws recovers instead, but has its maximum hit point total halved for one week.


DM Notes on Affliction

When a player uses affliction, you should consider how it might affect the creature they have targeted.

If the disease was contagious and applied to a travelling trader, would they reach their destination before they died? How likely is it that the infection would spread? Does their destination have adequate medical help to prevent an outbreak?

If the disease was applied to a creature, what kind of effect would it have on the wildlife or nearby settlement?

A settlement currently in danger of an outbreak might put out an urgent request for help and inadvertantly spread the disease. It is your discretion how the disease spreads and how the players learn of the consequences of this action.


Schools of Medicine

Infectious Diseases

You have specialised in the field of infectious diseases which has given you the ability to better control the miasmas of plague you spread. Not only that, but you are also able to increase the potency of your diseases, afflicting those who would not normally be susceptable to its ravages.

Controlled Contaminant

Your understanding of how your plague spreads allows you to manipulate which creatures it affects to varying degrees of success. Starting at 3rd level, creatures you designate gain advantage to saving throws against your spell effects which cause poison damage or the infected condition.

Potent Mutagen

Defying all expected outcomes, your diseases are able to affect creatures in unique ways. Starting at 7th level, your spells ignore resistances to poison damage and the poisoned condition. Creatures that are immune to poison take half damage from your spells that deal poison damage.

This sometimes manifests itself in visible ways, such as patches of rust on an iron golem, or rigor mortis upon the undead.

Virus Mastery

You have mastered the ability to control the effects of your diseases. Starting at 10th level, whnever you cast a plague doctor spell, creatures you designate gain immunity to your spell effects which cause poison damage or the infected condition.

Symbiotic Bond

Starting at 14th level, once per turn when you cast a spell that targets a single creature, you can target an additional creature within 15 feet of it as long as the secondary target is suffering from the infected condition.


Enigmatic Element

The potency of your diseases has increased to violently unstable levels. Starting at 18th level, creatures have disadvantage on saving throws that would result in poison damage or the infected condition.

Sawbones Medic

Apothecary

Starting at 3rd level, You can use your practitioner's kit to make makeshift tinctures and ointments to cure minor ailments like headaches and rashes. You can also choose to spend an hour creating a medical prescription which will suppress the effects of a disease. Whilst under this effect, a creature can ignore the most severe effect of a disease it is currently afflicted by, unless that effect causes the creature to die or fall unconscious. This effect lasts for 24 hours.

Additionally, you gain proficiency in the medicine skill. If you are already proficient, double your proficiency if you have not already done so.

Renewal

Starting at 7th level, you are able increase the potency of your healing spells. When casting any healing spell of 2nd level or higher, you can also end one condition afflicting each target. The condition can be blinded, deafened, paralysed or poisoned.

Curative Methodology

You have learnt how to deal with high-pressure situations where lives are on the line. Starting at 10th level, as long as you have a practitioner's kit, you have advantage when performing any wisdom (medicine) check.

In addition, you can use your practitioner's kit to aid in the recovery of your allies. Whenever a creature spends a hit die during a short rest, they recover additional hit points equal to your Wisdom modifier for each hit die they roll.

Envoy of Plague

Starting at 14th level, at the end of the long rest, you can give a treatment to one willing creature using your practitioner's kit. This creature becomes immune to any adverse effects of any infected condition you inflict. Additionally, whenever the treated creature would take poison damage from spell effect you cast, the treated creature automatically passes the saving throw, ignores any damage, and instead regains hit points equal to twice the spell's level. (for multiple instances of damage such as expunge, this effect is additive)

This effect only ends at the end of a long rest.

Surgeon General

Starting at 18th level, You have mastered your craft to the point of perfection. You have a near-encyclopaedic knowledge of ailments and diseases, as well as their treatments.

When making a Wisdom (Medicine) check to determine the details on a disease, treatment, wound, cause of death, or similar knowledge, treat any roll of 9 or lower as a 10.

In addition, your presence on the battlefield instills courage in your allies. You can take the Help action as a bonus action on each of your turns. That ally also gains 10 temporary hit points which last until the start of your next turn.

Medical Techniques

Black-feather Malady

Prerequisite: Infectious Diseases school

Whenever you cast poison spray on a target and it fails its saving throw, that target is also infected for 1 hour.

In addition, you can add your wisdom modifier to the damage you deal with this cantrip.

Corvidae Corvus

You can cast find familiar once per day without using material components or a spell slot. You can only choose a Raven as its form (PHB 309).

Your familiar uses your spell attack bonus for its attacks, and its maximum hit points are increased by twice your plague doctor level.

When your raven hits with a melee attack, you can force the target creature to make a constitution saving throw using your spell save DC. On a failed save, the creature is infected for 1 hour.

In addition, you are able to speak with Ravens and similar avian creatures as if you had cast speak with animals.

Dark Laborer's Armor

Instead of relying on your own ability to avoid attacks, you instead rely on the guidance of a power greater than yourself.

When calculating your armor class, you can use your wisdom modifier in place of your dexterity modifier.

Doctorate

You gain proficiency in a skill of your choice. If you are already proficient, double your proficiency for that skill if the skill is on the plague doctor skill list. You can take this technique more than once, but only once per skill.

Divine Esteem

Prerequisite: 5th level, Sawbones Medic school Choose three spells from the cleric spell list. These become plague doctor spells for you, and you can choose these when preparing your spells.

Whenever you gain a level in the plague doctor class, you can change these three spells for another three.

Expanded Medical Plan

Prerequisite: 15th level, Sawbones Medic school

The number of creatures you can treat with your Envoy of Plague feature increases to 2. At 18th level, the number of creatures increases to 3.

Experimental Booster Shot

Prerequisite: 3rd level, Sawbones Medic School

As an action, once per day, you can administer an experimental concoction to a willing creature using your practitioner's kit. This concoction has all of the effects of the enhance ability spell, and lasts for 1 hour.


Healing Hands

Prerequisite: 13th level, Sawbones Medic school

When casting any healing spell of 2nd level or higher, you can also end an additional condition afflicting each target. The condition can be paralysed, petrified, stunned or a condition listed under the renewal feature.

Infectious Impingement

Prerequisite: 7th level

When a creature hits you with a melee attack, you can use your reaction to force them to make a constitution saving throw. On a failed save, the creature takes poison damage equal to your plague doctor level and is infected for 1 hour.

Miasmatic Affinity

Prerequisite: 5th level, Infectious Diseases school

The damage caused by your miasma spell increases by 1d4 at 5th, 11th and 17th level.

Neurological Assault

Prerequisite: 15th level, Infectious Diseases school

Your diseases have devastating effects on a creature's synaptic processes.

Whenever you inflict the infected condition on a creature, you can also choose to cause the creature to fall prone and become stunned until the start of its next turn.

Once you have used this technique, you cannot use it again until you complete a short or long rest.

Physiological Analysis

Prerequisite: 11th level

You can use an action to perform a Wisdom (Medicine) check on a creature to determine its physical weak points. The DC equals 8 + the CR rating of the creature. On a success, you determine a weak point for your allies to strike. Any subsequent attack roll that hits the creature deals additional damage equal to your wisdom modifier. This effect lasts for 1 minute.

This check automatically fails if performed on a creature with no physical form.

If you fail this check, you cannot make it again on the same creature until 24 hours have passed.

Plaguebringer

Prerequisite: 17th level, Infectious Diseases school

Casting Miasma at any level becomes a cantrip for you.

Makeshift Potions

Prerequisite: Sawbones Medic school

Using your practitioners kit and questionable ingredients you find in your vicinity, you can create makeshift healing potions. These potions only last 24 hours before they spoil; a spoiled potion becomes mundane and has no effect when drunk.

At the end of a long rest, you can create a potion which heals a creature for Xd4 plus your plague doctor level, where X is your wisdom modifier.








Symptom: Lethargy

Prerequisite: 13th level, Infectious Diseases school

When you inflict the infected condition on a creature, its walking and climbing speed is also halved for the duration of the condition.

Trauma Kit

Prerequisite: 7th level, Sawbones Medic School

You can use a charge of your practitioner's kit to cast Gentle Repose on a creature without material components or expending a spell slot.

In addition, You can use two charges of your practitioner's kit to cast Revivify on a creature without material components. You must have the spell prepared, and you must also expend a spell slot of 3rd level or higher to cast it.


Transformative Technique

Prerequisite: 17th level Sawbones Medic school

Creatures treated by your Envoy of Plague feature can use a bonus action to gain resistance to bludgeoning, piercing and slashing damage from non-magical weapons for 1 minute.

If a creature under this effect drops to 0 hit points, they can make a DC10 constitution saving throw to instead stay on 1 hit point. A creature can only make this save once per treatment.

Violent Expulsion

Prerequisite: 7th level, Infectious Diseases school

The area of effect of your expunge spell increases by an additional 5ft.

Virulent Strain

Prerequisite: 3rd level, Infectious Diseases school

Whenever you inflict the infected condition, you can designate a creature within 10ft of the infected creature to make a Constitution saving throw if they have not make a saving throw to resist this condition already this turn. On a failed save, that creature is infected for 1 hour.

Plague Doctor Spells

Cantrips (0 Level)
  • Acid Splash
  • Chill Touch
  • Guidance
  • Infestation XG
  • Light
  • Mending
  • Poison Spray
  • Resistance
  • Spare the Dying
  • Toll the Dead XG
1st Level
  • Cause Fear XG
  • Create or Destroy Water
  • Cure Wounds
  • Detect Poison and Disease
  • Expeditious Retreat
  • False Life
  • Fog Cloud
  • Healing Word
  • Inflict Wounds
  • Miasma*
  • Purify Food and Drink
  • Ray of Sickness
  • Sleep
  • Unseen Servant


2nd Level
  • Aid
  • Blindness/Deafness
  • Calm Emotions
  • Crown of Madness
  • Enhance Ability
  • Expunge*
  • Gentle Repose
  • Hold Person
  • Lesser Restoration
  • Melf's Acid Arrow
  • Prayer of Healing
  • Protection from Poison
  • Ray of Enfeeblement
3rd Level
  • Animate Dead
  • Bestow Curse
  • Create Food and Water
  • Dispel Magic
  • Fear
  • Feign Death
  • Gaseous Form
  • Hypnotic Pattern
  • Magic Circle
  • Mass Healing Word
  • Remove Curse
  • Revivify
  • Speak with Dead
  • Stinking Cloud
  • Vermintide*

4th Level
  • Aura of Life
  • Aura of Purity
  • Death Ward
  • Evard's Black Tentacles
  • Freedom of Movement
  • Hallucinatory Terrain
  • Vitriolic Sphere XG
  • Wall of Corpses*
5th Level
  • Cloudkill
  • Contagion
  • Deadly Pathogen*
  • Enervation XG
  • Greater Restoration
  • Insect Plague
  • Mass Cure Wounds
  • Raise Dead
  • Synaptic Static XG
6th Level
  • Bones of the Earth XG
  • Circle of Death
  • Create Undead
  • Disintegrate
  • Harm
  • Heal
  • Maddening Haze*


7th Level
  • Finger of Death
  • Forcecage
  • Nebulous Form*
  • Regenerate
  • Ressurection
  • Symbol
8th Level
  • A-D's Horrid Wilting XG
  • Antipathy/Sympathy
  • Dominate Monster
  • Feeblemind
  • Namtar's Revulsion*
  • Power Word Stun
9th Level
  • Mass Heal
  • Pandemic*
  • Power Word Heal
  • Power Word Kill
  • True Ressurection






Miasma

1st level conjuration


  • Casting Time: 1 action
  • Range: 60 feet
  • Components: V, S, M (a piece of blue toadshade mushroom)
  • Duration: Concentration, up to 1 minute

You make a swirling motion with your hands and conjure a barely visible pale green cloud, riddled with all manner of toxic substances.

You create a 5ft radius cloud of poisonous gas centred on a point within range which lasts for the duration. The cloud spreads around corners. When a creature enters the spell's area for the first time on a turn or starts its turn there, that creature must make a Constitution saving throw or take 2d4 poison damage and become infected for 1 hour.

Whilst concentrating on the spell, you can use your bonus action to move the area up to 20 feet to a point within range you can see.

At Higher Levels. When you cast this spell using a spell slot of 2nd level or higher, you can increase the radius that miasma covers increases by an additional 5 feet per spell level beyond the 1st, up to a maximum of 10 additional feet.

Expunge

2nd-level evocation


  • Casting Time: 1 action
  • Range: 120 feet
  • Components: V, M (a dried leech)
  • Duration: Instant

A sickly wave of energy erupts from your hand, accelerating the effects of nearby infections and causing them to burst violently from their hosts.

You target any number of creatures within range that are currently infected by you. The target creatures and any creature within 5ft of each target must make a constitution saving throw or take 1d6 poison damage. If a creature would be subjected to multiple instances of this effect, they make this saving throw only once, and all sources of damage apply. Creatures that pass the saving throw take half damage. Targets of the spell are no longer infected.

At Higher Levels. When you cast this spell using a spell slot of 3rd level or higher, the damage of expunge increases by 1d6 for each slot level above 2nd up to a maximum of 3d6 additional damage.

Vermintide

3rd-level conjuration


  • Casting Time: 1 action
  • Range: 120 feet
  • Components: V, S, M (a small rodent's skull)
  • Duration: Instant

You target a creature within range that is currently infected by you and conjure a swathe of rats and vermin which overwhelm it. The creature must make a dexterity saving throw or become incapacitated and take 4d4 piercing damage at the start of each of it's turns.

A creature incapacitated this way can make a dexterity saving throw at the end of each of its turns to end this effect.

If it succeeds on this saving throw it instead takes half damage and is only incapacitated until the end of it's next turn.

A creature that is incapacitated by this spell by any means has its speed reduced to 0.

Once the effect ends the rats disperse and vanish.

Wall of Corpses

4th-level necromancy


  • Casting Time: 1 action
  • Range: 60 feet
  • Components: V, S, M (a scrap of disease-ridden flesh)
  • Duration: Concentration, up to 10 minutes

You touch the ground and it erupts before you in a mound of bones and flesh.

You create wall of corpses on a solid horizontal surface within range. You can make the wall up to 30 feet long, 10 feet high and 5ft thick. The wall can be any shape you choose, and lasts for the duration.

Any creature that attempts to climb the wall must succeed on a athletics check to climb it, The DC equals your spell save DC. Anyone who touches the wall must also make a constitution saving throw or become infected for 1 hour. The surface on top of the wall is difficult terrain.

Each 5ft section of the wall has an AC of 10, 70 hit points, is resistant to bludgeoning, piercing and slashing damage and immune to poison damage.

Deadly Pathogen

5th-level evocation


  • Casting Time: 1 action
  • Range: 120 feet
  • Components: V, S
  • Duration: Instant

You point at a creature and a streak of pale green energy shoots from your hand and strikes it.

A target within range must make a constitution saving throw. If it is infected by you, it makes this saving throw with disadvantage. On a failed save, the creature takes 4d10 + 20 poison damage and becomes poisoned for 1 minute.

A creature poisoned this way takes 2d10 + 10 poison damage at the start of each of its turns.

On a successful save, the creature takes half damage and is not poisoned.

At Higher Levels. When you cast this spell using a spell slot of 6th level or higher, the damage of all effects caused by this spell increases by 1d10 for each slot level above 5th.

Maddening Haze

6th-level enchantment


  • Casting Time: 1 action
  • Range: 300 feet
  • Components: V, M (a drop of mercury)
  • Duration: Instant

You must be concentrating on a miasma spell in order to cast this spell, otherwise the spell fails.

Your miasma turns a shade of purple as you magically infuse it with hallucinogenic toxins.

All creatures within the area of effect of your miasma must succeed on a Wisdom saving throw or take 6d8 psychic damage and use its reaction to immediately move up to its speed and make a melee attack with advantage against a random creature also within the miasma. On a successful save, a creature takes half damage and does not use its reaction.

Nebulous Form

7th-level transmutation


  • Casting Time: 1 action
  • Range: Touch
  • Components: V, S, M (A small vial of poisonous gas)
  • Duration: Concentration, up to 1 hour.

You transform a willing creature you touch, along with everything it's wearing and carrying, into a gaseous plague cloud for the duration. The spell ends if the creature drops to 0 hit points. An incorporeal creature isn't affected. While in this form, the target's only method is a flying speed of 50ft. The target has resistance to nonmagical damage, and has advantage on Strength, Dexterity and Constitution saving throws.

The target can pass through small holes, narrow openings, and even mere cracks, though it treats liquids as though they were solid surfaces. The target can't fall and remains hovering in the air even when stunned or otherwise incapacitated.

While in the form of a gaseous plague cloud, the target can't talk or manipulate objects, and any objects it was carrying or holding can't be dropped, used, or otherwise interacted with. The target can't attack or cast spells.

The target can enter and occupy the space of another creature - if it chooses to do so at any point, that creature must make a consitution saving throw or take 8d8 poison damage and become infected for 1 hour. On a successful save, the creature takes half damage and is not infected.


Namtar's Revulsion

8th-level illusion


  • Casting Time: 1 action
  • Range: 120ft
  • Components: S, M ()
  • Duration: Instant

You conjure up vile false images and smells which attempt to overwhelm a creature's senses.

Choose any number of creatures within range that are currently infected by you. These creatures must succeed on a wisdom saving throw or take 8d6 psychic damage. On a successful save, a creature takes half damage. On a failed save, the creature falls prone and is incapacitated as it begins vomiting profusely if it is able to vomit.

At the start of each of its turns it succeed on a constitution saving throw or take 4d6 psychic damage, and be incapacitated and fall prone as it continues to vomit.

A creature incapacitated by this spell has its speed halved.

Pandemic

9th-level enchantment


  • Casting Time: 1 action
  • Range: 120ft
  • Components: V, S, M (A plague doctor's mask, which you are wearing.)
  • Duration: Instant

You speak a small prayer into your mask which resigns the irredeemably sick to death, intended to open the gates to the afterlife.

You target any number creatures within range that are currently infected by you. If the target has 50 hit points or fewer, it dies. If the target has more than 50 hit points, it must succeed on a constitution saving throw or take half of its current hit points in poison damage. Any creature that dies expels noxius fumes within 10ft of it. All creatures within this area must suceed on a consitution saving throw or become infected by you for 1 hour.

Changelog

v4.4
  • Renamed Schools of "Medicine" to Schools of Medicine.
  • Reworked Restorative Regimen
  • Buffed Grim Harvest to be more in line with extra attack and similar features
  • Stipulated a duration of "Waste not, Want not". RAW is was possible to infinitely store a spell each day which was not the intention.
  • Affliction buffed slightly and moved to 20th level capstone feature.
  • Enigmatic element moved to 18th level because perma-disadvantage is VERY strong
  • Symbiotic Bond added as 14th level feature
  • Reworked Divine Esteem as it was granting access to the entire cleric spell list which is unfair. Unsure if this should be limited to 5th level or lower spells.