```metadata
title: Commander Fayne's Lasting Injuries
description: >-
This is the old injury system, preserved for posterity. The new system is
included in Revise Combat Rules.
tags: []
systems:
- 5e
renderer: legacy
theme: 5ePHB
```
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# Lasting Injuries
___
While hit points can be seen as an abstract measurement of flesh wounds or bruises that can be ignored with enough grit or resolve, Lasting Injuries represent debilitating wounds which punish heroes for taking massive damage. Furthermore, falling to 0 hit points becomes the direct result of receiving a mortal blow that puts someone out of a fight, instead of being simply knocked unconscious and waiting for +1 hit point from some source. If revived and brought back to consciousness, the player now needs to fight through the pain or crippling nature of a serious injury and will be severely handicapped until it is healed. This creates a critical role of a party healer that does more than store spell slots for Healing Word, and gives importance to the Medicine skill and healer's kits to treat these wounds during an encounter much like a combat medic.
Players will need to consider their playstyle and present danger before taking risks. Falling to 0 hit points or absorbing an extremely damaging attack has the potential to take them out of the fight until they can be treated by a skilled medic.
#### The Trappings of Adventure
When a character receives an injury, describe the wound and penalties to your player, but don't tell them the name of the injury or how it can be cured; that information should be saved for anyone who successfully diagnoses the Injury with a DC10 Medicine check. A failure of this check means the player gets partial information; you can choose which information they get from the diagnosis. Even if an injury might be obvious, such as a broken bone or open wound, the Medicine check represents how best to administer treatment, not only exactly what the Injury is.
#### Healing an Injury with Magic
There are three ways to heal an injury; magic, healer's kits, and time. Any spell or magical effect which gives hit points, such as *Cure Wounds,* *Lay on Hands,* the **Second Wind** ability, or even a character with the **Healer** feat using a Healer's Kit is able to heal an injury which can be cured by Magical Healing.
When one of these spells or effects is used, the player using the ability or spell decides if they wish to forgo the hit points gained, and instead attempt to cure the injury. This promps a Wisdom (Medicine) check vs the DC listed in the injury's description. If the Medicine check is successful, the injury is healed and resolved as described in its description. If failed, the injury is not healed but can be attempted to be healed again with more magical healing.
If an Injury requires a different spell, such as *Lesser Restoration* or *Heal* in order to cure it, this means the Injury cannot be healed with magical healing and instead requires that specific spell.
If a character is able to cast a spell at a higher level than is normal for the spell, the first level of the spell can be used to treat the injury, rolling a medicine check as usual, and the higher levels can be used to restore lost Hit Points. For example, if a character has a punctured lung, which requires magical healing, a Cleric can cast *Cure Wounds* using a 2nd level spell slot. In this case, the first slot is used to cure the injury, while the second slot is used to give the player character d8 hit points. This is especially useful for when a player is unconcious with 0 hit points and also has an injury.
Finally, any item which gives magical healing, such as a Healing Potion, can make a medicine check when used as well. A common item rolls a d20+1, Uncommon a d20+3, Rare 20+6, Very Rare d20+9, and Legendary d20+12.
#### Healing an Injury with Medicine
Some Injuries prompt a Medicine Check to heal them naturally, either in absence of magical healing such as stitching a wound closed or to prepare them for magical healing such as setting a broken bone. If the check is failed for the following cases, something different happens.
- For Broken Bones, when the medicine check fails, the character suffers a setback listed in its description. Consult the setback table for the amount of damage the character will receive as the wound is damaged by the broken bone lacerating surrounding tissue.
- In the case of relieving symptoms of an injury, such as the pain from scars, limps, or crippling wounds, a failed check means the Check can be attempted again after 10 minutes.
- When promoting natural healing of an injury, such as a Damaged Eye or Open Wound, the failed attempt only costs a use of the Healer's Kit, and can be attempted again immediately.
\page
## Injury Table
#### Injury chance
If one of the following happens to a creature, roll a d100 and consult the injuries table.
- Drop to 0 hit points
- Receive a Critical Hit, then fail a Constitution Saving Throw against a DC of half the total damage received
- Receive damage equal to more than half its hit point maximum from a single attack or effect in one turn. (Only implement this rule when your party is level 3 or higher)
##### Lasting Injuries Table
| Roll | Wound |Cured with Spell|
|:--|:--|:--
|1-10 |Destroyed Item |Mending|
|11-20|Shock |Lesser Restoration|
|21-29|Internal Bleeding |Magical Healing|
|30-38|Limp |Magical Healing|
|39-46|Open Wound |Magical Healing|
|47-54|Punctured Lung|Magical Healing|
|55-59|Broken Arm|Magical Healing|
|60-64|Broken Leg|Magical Healing|
|65-69|Broken Jaw|Magical Healing|
|70-74|Damaged Eye|Lesser Restoration|
|75-79|Fouled Wound|Lesser Restoration|
|80-84|Concussion|Lesser Restoration|
|85-89|Disorientation|Lesser Restoration|
|90-93|Crippling Injury|Greater Restoration|
|94-95|Minor Scar|Heal|
|96-97|Major Scar|Heal|
|98-99|Permanent Pain|Heal|
|100|Severed Body Part|Regeneration|
#### Suffering a setback
Some injuries further damage the character as they suffer. When a character suffers a setback, consult the table below for the amount of damage they receive.
| Character Level | Minor Setback | Major Setback
|:---:|:--|:--
| 1-4 |1d10| 2d10 |
| 5-10 |2d10| 4d10|
| 11-16|4d10| 10d10|
| 17-20 |10d10| 18d10 |
#### Injury Choice over Chance
Injuries may not necessarily be related to the source that caused them. If an Ogre crushes your hero with a tree trunk, but you roll a missing eye, the result may be one of the tree branches tore her eye out as she was crushed beneath it. You may also choose an injury to fit the source. For example, if a character takes a psyblast from a mind flayer, you may choose Concussion or Disorientation instead of possibly rolling a Broken Arm, which would be hard to explain.
```
```
\page
### Injuries List
##### Broken Arm
*Magical Medicine: DC10*
Your off-hand arm is broken, and you cannot equip a shield, two-handed weapon, off hand weapon, or use a versatile weapon with two hands. You immediately drop items held in that hand only on the ground. If you suffer this injury again before this one is healed, you cannot equip any weapon, shield, or item in your hands.
To set the bone, you or another creature must use an action and a use of a Healer's Kit to roll a DC 10 Medicine check. On a failure, the bone scrapes the inside of your muscles and you suffer a **Minor Setback.** On a success, you suffer no further damage and the bone is set properly.
When you receive any magical healing, if the source of your healing succeeds on the magical medicine check and your bone is set properly, your Broken Arm is cured. However, if it is not set properly, your bone mends at an angle and you suffer **Permanent Pain**. This injury persists until you rebreak the arm and set it properly. When you rebreak your arm, you suffer a **Major Setback**.
##### Broken Jaw
*Magical Medicine: DC10*
You are unable to speak or eat food, as your jaw is either dislocated or broken entirely. You cannot cast spells that require verbal components and you can only shout or groan, unable to speak any language out loud properly. You suffer disadvantage any attack roll or ability check.
To repair your broken jaw, you or another creature must use an action and a use of a Healer's Kit to roll a DC 10 Medicine check. On a failure, your jaw injures you, causing a **Minor Setback**. On a success, you suffer no further damage and the jaw is set properly.
When you receive any magical healing, if the source of your healing succeeds on the magical medicine check and your jaw is set properly, your Broken Jaw is cured. However, if it is not set properly, your bone mends at an angle and you suffer **Permanent Pain**. This injury persists until you rebreak your jaw and set it properly. When you rebreak your jaw, you suffer a **Major Setback**.
```
```
##### Broken Leg
*Magical Medicine: DC10*
One of your legs is broken, and your walking speed is halved and you must use an aid to move while standing or you will fall prone. If you suffer this injury again before this one is healed, your speed becomes 0.
You have disadvantage on checks which use full body Strength or Dexterity, such as pushing a boulder or balancing on a moving cart.
To set the bone, you or another creature must use an action and a use of a Healer's Kit to roll a DC 12 Medicine check. On a failure, the bone scrapes the inside of your muscles and you suffer a **Minor Setback.** On a success, you suffer no further damage and the bone is set properly.
When you receive any magical healing, if the source of your healing succeeds on the magical medicine check and your bone is set properly, your Broken Leg is cured. However, if it is not set properly, your bone mends at an angle and you suffer **Limp**. This injury persists until you rebreak the leg and set it properly. When you rebreak your leg, you suffer a **Major Setback**.
##### Concussion
*Magical Medicine: DC15*
The DC for Constitution saving throws related to this injury is 10 + 2 for each concussion your character has suffered over their entire life.
Upon receiving a concussion, you must immediately succeed a Constitution saving throw or fall unconscious. As an Action, a creature can expend a use of a Healer's Kit to awaken you with smelling salts.
While you have a concussion you end Concentration and are unable to cast any spell with Concentration. At the start of your turn, you must succeed a Constitution saving throw or suffer the Incapacitated condition until the beginning of your next turn.
After 1 minute, you no longer suffer the incapacitated condition of this injury. When you complete a long rest, your concussion is healed naturally.
##### Crippling Injury
*Magical Medicine: DC15*
This serious, debilitating wound is related to the source which caused it, such as acidic burns, radiant boils, or necrotic wasting. You gain 3 levels of Exhaustion. As an action, you or a creature can expend a use of a Healer's Kit to roll a DC 10 Medicine check to relieve 2 levels of exhaustion for 1 hour, after which they will return. The spell *Lesser Restoration* can remove one point of exhaustion, which can be repeated, while the spell *Greater Restoration* can remove all points of exhaustion. Completing a long rest will remove one point of exhaustion, until all points are removed.
##### Damaged Eye
*Magical Medicine: Requires Lesser Restoration*
The eye has been scratched or the surrounding tissue is so swollen you cannot see out of it. You suffer disadvantage on Perception Checks and ranged attack rolls which rely on sight. Using a healer's kit as an action, a successful DC10 Medicine Check can restore your sight 1 hour after the success. Completing a long rest will cure a damaged eye.
\page
##### Destroyed Item
*Magical Medicine: Requires Mending*
Some piece of equipment takes the blow and is destroyed, or if it is magical, forced to roll a damage check. A potion or scroll is immediately destroyed unless it is in a scroll or potion case.
|d10|Result|
|:--|:--|
|1-2|Held object in the primary hand
|3-4|Held object in the off hand. If none, this defaults to the primary hand
|5-7|Armor; the AC of which is lowered by 2. If using RAE item damage, the armor is lowered by two tiers.
|8-9|A random worn piece of equipment, such as an amulet, ring, or cloak.
|10| A random item elsewhere on the character, such as items in the backpack or stowed on the belt
Depending on the nature of the destruction, the *Mending* cantrip may be used to repair the break. Remember a destroyed magical item loses its magical properties, even if it is later repaired.
##### Disorientation
*Magical Medicine: Requires Lesser Restoration*
You hear ringing, suffer sensitivity to light, and are off balance. You suffer a point of exhaustion, attacks against you gain advantage, and any spell you are concentrating on immediately fails. To cast any spell, you must succeed at a Concentration check DC equal to 10 + the spell's level. Using a healer's kit as an action, a successful DC 15 Medicine check clears the ringing immediately, allowing you to concentrate on spells once again, but you still suffer the other effects of this wound. Completing a short rest will relieve disorientation.
##### Fouled Wound
*Magical Medicine: Requires Lesser Restoration*
This wound has a foreign body such as a broken arrowhead, sliver of claw, or is otherwise fouled by filth and dirt in the wound itself. You recieve only half of a healing total whenever you would recover hit points from any source. Using a healer's kit as an action, a successful DC10 Medicine Check can remove the foreign body or cleanse the wound, curing the injury. If this check is failed, you may try again using another use of a healer's kit.
##### Internal Bleeding
*Magical Medicine: DC15*
You are suffering severe bleeding or heavy bruising to your internal organs which is extremely painful. You have disadvantage on attack rolls and ability checks, and automatically fail Strength saving throws. Using a healer's kit as an action, a successful DC 10 Medicine Check can stop the bleeding.
```
```
##### Limp
*Magical Medicine: DC15*
Your leg or foot is damaged so severely that you cannot properly walk. Your walking speed is reduced by 10. Any time you move your full speed in one turn, you must succeed on a DC 10 Acrobatics Check. If you fail, you fall prone at the end of your movement. If you have a walking aid, your speed is not reduced. Using a healer's kit as an action, a successful DC 10 Medicine Check can prevent making Acrobatics Checks to stay upright for 1 hour. When you complete a long rest, you must succeed on a DC10 Constitution saving throw or continue to suffer this injury.
##### Major Scar
*Magical Medicine: Requires Heal*
This scar is visible and the effects are immediate. You choose what your scar looks like, but it must be a visible, disfiguring scar, such as a severed ear, torn lip, misshapen hand, etc.
When you receive this wound you must roll a single hit die and subtract your constitution modifier. This hit die is expended, and the total is subtracted from your hit point maximum. When you finish a long rest, your hit point maximum resets to full, and you repeat this process.
Additionally, you gain advantage on intimidation checks.
##### Minor Scar
*Magical Medicine: Requires Heal*
This could be a jagged line down your face from a claw, or splotchy skin from an acid burn, or it may simply be a missing tooth. This scar may or may not be visible, and you choose where it is and what it looks like, but if it is visible, you have advantage on intimidation checks.
Any time you receive cold or necrotic damage, you also receive a level of exhaustion as your scar aches painfully in response. As an action, a DC10 medicine check using a healer's kit can alleviate this pain.
\page
##### Open Wound
*Magical Medicine: DC10*
Whether a ragged wound or disembowelment, or even just impaled through by a javelin, an open wound is serious enough that bleeding out is a real possibility. While you have an open wound, at the start of your turn you suffer a **Minor Setback.** This continues until you or another creature uses a Healer's Kit as an action to stabilize you.
While you are stable, every hour you suffer a **Minor Setback** to your maximum hit point value. If you are incapacitated while you have an Open Wound, you have disadvantage on Death Saving Throws. Using a healer's kit over the course of 10 minutes, successful DC10 Medicine Check can sew the wound closed, removing this wound entirely. If, at the end of this 10 minutes the check is failed, you suffer another **Minor Setback** but the stitching can be immediately attempted again.
##### Permanent Pain
*Magical Medicine: Requires Heal*
You suffer constant, chronic pain that never truly heals. You suffer disadvantage on initiative, wisdom saving throws, and intelligence checks. Additionally, when you are concentrating on a spell, you must pass a DC10 concentration check each round or your concentration fails.
Whenever your altitude or the weather dramatically changes, or you recieve cold or necrotic damage greater than your constitution modifier, you gain a level of exhaustion. Using a healer's kit as an action, a successful DC15 Medicine Check can alleviate this exhaustion. If you fail this check, you can try again in 10 minutes when you realize the medicine isn't working.
```
```
##### Punctured Lung
*Magical Medicine: DC10*
One of your lungs is punctured, making it nearly impossible to breathe or talk without excruciating pain. During combat, you may take an action or move, but not both, and you are unable to take bonus actions or reactions. You cannot cast any spell with a verbal component.
While you have a punctured lung, you cannot hold your breath. Puncturing both of your lungs will cause you to begin immediately suffocating until at least one of your lungs is healed. Using a healer's kit as an action, a successful DC10 Medicine Check plugs the hole and allows you to cast spells with a successful DC10 concentration check, but you still cannot take reactions or hold your breath until it is healed completely.
##### Shock
*Magical Medicine: Requires Lesser Restoration*
Your body goes into shock; shallow breathing, quickened pulse, tunnel vision, and general weakness. You suffer disadvantage on all attack rolls and ability checks, but you gain advantage on Dexterity and Strength saving throws. Additionally, you must succeed on a DC10 Concentration Check in order to complete the casting of any spell. This injury will fade after 10 minutes.
##### Severed Body Part
*Magical Medicine: Requires Regeneration*
A part of your body is severed or torn off. You treat the stump as **Major Scar** but this scar can be hidden by a prosthetic. Roll a d4, consulting the table below. Flip a coin to determine which of the left or right side of the body is severed.
|||
|:--|:--|
|1|Eye|You suffer Disadvantage on Perception checks which rely on sight. You have disadvantage on Charisma Checks while your missing eye is uncovered.
|2|Arm|You can no longer hold or do anything which requires both hands, such as using a bow, reloading a crossbow, or wielding a greatsword.
|3|Hand|You can no longer hold anything in that hand but may do something with two hands as long as you have basic a prosthetic, such as a hook.
|4|Leg| You must have a crutch or prosthetic to stand or walk. Without it you will fall prone. If you obtain a crutch or prosthetic, you will still suffer the Limp injury.
>#### Magical Prosthetics
For an ordinary person, missing an arm or leg would be the end of their adventuring career. However, it may be possible for your character to seek out a clockwork or magical prosthetic, created by a skilled artificer.
>
>If fitted with one of these prosthetics, your character no longer suffers the effects of the missing limb, but still has the Major Scar.
\page
### Rest Modification
The rests of 5e are very forgiving. If you wish, it may be more interesting to modify the rest system to more accurately represent natural recovery outside of combat.
Instead of a long rest recovering all lost hit points, you could play that the only way to naturally recover hit points is by expending hit dice, either during a short or long rest. At the end of a long rest, players gain half their level in hit dice, representing the body's decreased reserves as they recover, but are well enough to travel or fight again if needed. However, one can see that continuing this pattern of fighting, getting hurt and sleeping it off, each day the players would have only half their level in hit dice to spend on natural recovery, representing the continued decline in health from constantly recovering from injuries.
As an additional way to differentiate short and long rests, consider another rule; during a short rest, to use any hit dice, you must expend a use of a healer's kit, one use for any number of hit dice the player wishes. A long rest does not require a healer's kit, but still allows the use of hit dice to recover.
This modification makes natural healing a bit more time consuming, and also gives your players a chance to roleplay healing, as well as giving more weight to the value of Healer's Kits and those proficient enough to use them. This also makes sure Healer's Kits remain relevant if your party has a magic healer as well.
- ##### [Return to Top](#p2)
```
```
### Practical and Arcane Medicine
A Healer's Kit contains pain relieving extracts or salves, bandages, curved needle and thread, stiff clear alcohol, and often various non-magical potions which may settle the stomach, promote clotting, or even encourage blood production. Any Medicine Check made with a Healer's Kit, or any use of the Healer's kit to treat a Lasting Injury expends a use of that Healer's Kit, regardless of success or failure.
While magical healing is always better than practical medicine, in this system, magical healing is treated as simply speeding up the body's own natural healing processes. If a wound is infected, simply speeding up the healing process won't remove the infection. Further, if the body won't heal naturally from a wound, for example, severe concussions, missing limbs, widespread burns, etc, then magical healing won't heal it either. These injuries are represented as needing different spells or treatments other than recovering hit points from magic or bedrest.
>#### Injuring the Enemy
It may be fun to use this table against enemy combatants if they can be injured in the ways the table describes, but be careful not to use this table on creatures much too large or too alien for these wounds. It can be hard to explain how a gelatinous cube breaks a bone, or how an Ancient Vampire goes into shock!
