The Hirudo

The Leechfolk, commonly known as Leechmen, Sanguinites and River-Feeds, these sentient Leeches resemble Mer-Folk, leading some planeswalkers to suspect a common ancestor or effect from the Elemental Plane Of Water.

"I NEVER BELIEVED SUCH GRACE COULD BE SEEN IN A MAN-LEECH" the Undine softly said, the hunt had been long, weeks spent tracking blood trails and divining had given them barely enough at each turn. the Pod had been split between them as the Lecches spared them from their Sanguinus fluids in minutes, the undines began their journey home, prey in hand and leech in mind
-Zubin Dantas, Planeswalker, Pathfinder Chronicler and Proud Gnassi.

The Hirudo, or Leechfolk to most commoners, are a typically jovial and empathetic race who are becoming well-known as healers of great skill. Dwelling in swamps, along waterways, the coasts, and anywhere sufficiently wet they are still a relatively rare sight away from their villages and cities but more and more are hearing the call to adventure. Their unique skill-sets make them valued members of their groups, ranging from natural healers, skilled alchemists, and deceptively capable combatants. (both D&D 5E and Pathfinder stats included!)

Large, Vibrant and wet

Fully grown they can reach sizes from 6-10ft but their bodies, lacking bones and hard structures, are very flexible with the ability to stretch or compress themselves depending on their mood or current area. Hirudo have a wide range of coloration, varying from shades of brown and tan to vibrant blues, oranges and greens with markings such as stripes, speckles, or dots that is unique to each Hirudo. Their main mode of transportation is slithering, able to swim at great speed, and “standing” upright on their tails that end in a powerful suction cup, allowing them to remain in place in their watery homes or to even climb slowly up near vertical surfaces.

Ringing their mouths are clusters of muscular “feelers” that are packed full of chemical, taste, and olfactory receptors that allowed their primitive ancestors to hunt easily in the muddy swamps they rose from. Typically two to four of these feelers are larger and stronger than the others, allowing them to manipulate tools and their environment. While not particularly strong by themselves, these limbs are highly elastic allowing for wide swings of weapons that rely on momentum, their traditional javelins relying on this elasticity to propel them at high speeds over long distances.

These feelers also give the Hirudo one of their most valued skills. The complex array of chemical receptors allow the Hirudo to “taste” traces of disease and sickness within even a small sample of blood. From infections to cancers to viruses the Hirudo are capable of accurately pinpointing and diagnosing a wide variety ailments. Originally this was used in their ancestors to avoid sickly prey, toxic waters, and hunting in the murky waters of their swampy origins.

Hirudo posses powerful chambered lungs, allowing them to hold their breath for incredible lengths of time underwater. These powerful lungs also provide the Hirudo strong voices and in turn singing, their unique warbling singing carrying out over the landscape around their isolated homes. Hirudo martial artists have also devised a technique that allows one to expel a shockwave of compressed air from their mouths, strong enough to knock back most attackers.

Most if not all Hirudo live in areas with high moisture and access to bodies of water. Swamps, rivers, lakes, and rain forests are all ideal locations for the Hirudo who must keep their skin moist to remain healthy. While the majority of Hirudo prefer to dwell in fresh-water sources, there are coastal and island dwelling Hirudo who are quite hardy and adapted to sea salt.

Profitable Ventures and in need of dentures

Unlike their mundane cousins Hirudo mouths are large and flexible, liked with rows of sharp teeth. Their saliva is a potent anti-coagulant that can leave a wound bleeding for hours. This saliva is so potent that Hirudo warriors will often coat the tips of their weapons such as blowdarts, javelins, and arrows. Often assassins will barter with a Hirudo for this saliva for their weapons, or to foolishly attempt to take it for themselves by force.

Requiring a diet of liquid blood they can gorge themselves on a meal that can last them weeks at a time or focus on smaller portions spaced out every few days or so. Many civilized Hirudo populations will have herds of domesticated animals that they may feed from occasionally while ensuring the lasting health of the animal. The freshness of the blood does not matter to them nutritiously but some Hirudo consider fresh blood to be much healthier than any that has been previously extracted and preserved.

They can also feed on various fruits that, while offering little in nutritional value compared to blood, are enjoyed for their flavor and sugars, sucking the juices from them much like the blood from their animal meals.

Patient and Honorable

Most Hirudo are slow and methodical in their decision making, preferring to think out their plans before acting. When they are hungry their attitudes can become more aggressive and short-tempered, many civilized Hirudo feeling somewhat embarrassed about their attitudes once they have sated their hunger.

Far from defenseless, their history of persecution at the hands of other races meaning they have developed their own forms of warfare adapted to their typically swampy homes. Relying on hit-and-run attacks with weapons coated in their anticoagulant saliva before retreating into the waters so their foes must tend to their vicious wounds. Many tribes are adept at trap-making the areas around their homes off the roads and paths likely to have snares and alarms to deter and warn against interlopers.


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PART 1 | Culture and Background

Most Hirudo are Lawful aligned along with Neutral and Good. There are of course the Chaotic and Evil members of their race who do feed upon the sentient populations or raid their homes for supplies, slaves, and livestock, often all three obtained with a single captive.

Cautious Vampiriphobes

The Hirudo worship a deity they call Sanguisuga, the myths stating they were a common Hirudo who fed upon the blood of a dying god in an effort to learn how heal them. By doing so they became a minor God of Medicine and Medical Professionals whose worship has even spread beyond the Hirudo to the healers and doctors of other races, their holy symbol of a flask or vial of blood wrapped in a bow of bandages becoming a common sign marking hospitals across the land.

Hirudo culture has a long history of isolation and persecution from other races, forcing many Hirudo civilizations to develop far from the other races. Their alien forms, natural isolationist behaviors, and sanguivorous diets made them easy targets for fearful populaces that often would drive them out of their homes and villages. There is still a common superstition that Hirudo are all vampires or the final stage of the vampiric infection, a superstition that most would Hirudo find amusing if not for all the times mobs have descended upon peaceful members of their kind.

In fact, Hirudo have a long cultural history of fighting against vampiric infestations, their god Sanguisuga traditionally opposed by a minor vampiric god Coagula who was believed to be their sibling in life. Coagula was believed to be Sanguisuga’s sibling who also fed upon the dying god. Rather than moderate their intake like their kind sibling, Coagula gave into their hunger and drained the remaining life from the god, slaying them to become a minor God of Vampirism and Gluttonous Consumption.

Despite the superstitions of the other races they are a deeply empathetic people, offering aid to those that would accept it or come to them seeking it. Hirudo are natural healers, the trained masters of their healing orders using their ability to “taste” disease from a sample of blood allowing them to devise treatments tailored to the individual. Payment for such treatment is usually a donation of blood upon their recovery or monetary support for their hospitals.

Their greatest healers are the clerics of Sanguisuga who have taken to creating neutral zones were members of all races and factions may come in peace to have their injuries and sickness treated in the comfort of the Sanguisugan hospitals. These healing locations have made great strides in breaking the prejudice that many Hirudo suffer from. Many of those who have been saved and health returned by the Hirudo have pledged to defend them, more than one angry mob stopped by the army of a grateful lord whose wasting sickness was cured by the Hirudo.

There are some isolated Hirudo tribes or solitary members who relish in the consumption of blood, believing that the blood of sentient lifeforms held a power that feral creatures could not provide. These Hirudo are called Wasters by their more civilized cousins and worship Sanguisuga’s twisted sibling Coagula. Many of its worshipers are granted vampirism as a reward for loyal service and to better spread the vampiric infection. To counteract them, some Hirudo worshipers of Sanguisuga become paladins to better hunt down their evil, and often undead, cousins in an effort to ensure their infection and evil can no longer taint the land

Linguistics Without Lips

Song is very important to the Hirudo, much of their history shared through song. Their powerful lungs mean they can hold notes for a long time, their songs nearly impossible for most other races to sing in full. Instruments such as flutes, pipes, and wooden drums are common to the Hirudo with a growing appreciation for dwarvish and halfling bagpipes beginning to spread to the tribes from visitors and Hirudo returning from abroad.

Hirudo speak their own language that sounds like a series of gurgling and clicking or rasping their teeth together with a heavy emphasis on body language, in particular involving their feelers. They are capable of speaking other languages, albeit with practice and a heavy accent since their auditory capabilities are very different than most sentient races.

Hirudo healers, traders, and adventurers who interact with the other races often speak at least one additional language to their own, usually Common or whatever language the majority of their customers/patients may speak such as Halfling or Dwarf. Sylvan is a common secondary language for Hirudo tribes who use it to communicate with the dryads and Fey creatures that often live in close proximity to their homes.

The Leechfolk Apurandi

In most tribes Hirudo split the responsibilities according to the individuals desires with apprenticeships being common. Commonly tribes are lead by the clerics of Sanguisuga but for large decisions that will affect the whole tribe they will call for votes.

Most tribe members become caretakers to their herds of domesticated beasts, ranging from giant frogs and other amphibians and manatees in the swamps to oversized crustaceans and pinnipeds along the coasts where they harvest excess blood and ensure their comfort.

Hirudo are often hunters, the game caught during their hunts providing resources for crafting and trade with other races. These hunters are also the the defenders of their tribe, warriors capable of turning the very landscape against their enemies.

Some solitary Hirudo feel the call of Nature, becoming druids who protect the fierce wilderness. These druids range in alignment, some of the good worshiping and serving nature spirits and gods while the evil align themselves with Hag covens or worship Coagula in attempts to root out pockets of civilization.

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PART 1 | Culture and Background


There is a long tradition of martial artists among the Hirudo with several monasteries hidden in isolated locales where would-be trainees must seek them out. Practicing a form a martial arts unique to their elastic and near serpentine bodies few outsiders have encountered these monasteries. However, there have been individuals such as Good or Neutral aligned Yuan-Ti and members of other serpentine races to train and learn from the Hirudo monks to utilize the energetic and unpredictable fighting forms.

The Hirudo’s natural ability for “tasting”, as they put it, makes them natural healers and alchemists. Often these professions are intertwined, the same Hirudos creating medicine and potent alchemical concoctions. In the Hirudo’s native language Doctor and Alchemist are interchangeable. Their medicines, potions, and tonics are one of the Hirudo’s main exports, the creators often being the ones to travel to make their sales and trades. Often these interactions with the outside world are what inspire the younger Hirudo doctor-alchemists to set forth and explore the world of adventure.

Adventurers: Their natural pragmatism means that few Hirudo feel the call of adventure that many of the other races do but there are those among them that do heed its call and journey forth into the wider world.

Often these Hirudo become traveling healers, offering their services to whatever village or city they pass if they are welcomed rather than turned away. Sometimes Hirudo will join adventuring parties or mercenary groups, their medical skills a great boon to their forces. Some Hirudo find they have a skill for combat, either through their traditional ranged and saw-toothed weaponry or adapting a unique fighting style utilizing their muscular forms for grappling.

Hirudo adventurers are commonly Fighters, Druids, Monks, Rogues, Paladins, Sorcerers, or Clerics of Sanguisuga

Helpful but Gross

Although they can be Repulsive to humanoid races, the Hirudo are generally gracious and helpful to most they come across, still, if they don't see good in somone immediately they'll cirtainly try.

Dwarves. "Dwarves are mistrusting little forge-men, full of strength and possesing the highest honor and valor that only enhances their already massively impressive forgework."

Humans. "Interesting little creatures, they adapt fast and bond faster, at the very least they can pay for their medical expences, with that said they are the most reckless species on a whole, and the phrase 'Why Not' is one to be treated with caution."

Halflings. "These small people (even by humanoid standards) are to be trated with caution, a great number use recreational drugs that can throw off your diagnosis, they may also be attempting to steal medical supplies, when treating make sure to keep an eye on your equipment and check for foreign agents."

Elves. "some of the tallest humanoids, when in a pinch, they are stalwart allies, however egotistical and fast to call 'Abomination' if they are unaware of your sentience."

Hirudo Names

Hirudo have no strict naming structure and a lot of the language is based from their teeth clicks, gurgles and body language, as such names consist of these sounds and precise movements without good translation, when dealing with the outside world they tend to chose names that are easier to pronounce to the other races rather than their unique Hirudo names.

Hirudo Traits (D&D 5e)

Your Hirudo character has a variety of natural abilities, the result of nature's art of selection.

Ability Score Increase. Your Constitution score increases by 1 and your Dexterity score increases by 2.

Age. Hirudo Mature at arround 5 years of age but live to around 135 years.

Alignment. The Vast Majority of Hirudo are Lawful, the majority being Lawful Good and Lawful Neutral, Lawful evil is less comon but still seen. there are also rare cases of Chaotic Evil Hirudo that raid and slave humanoid camps.

Size. Hirudo range from 6-10ft and average 150 pounds, your size is Medium.

Tool Proficiency. Hirudo are trained in self defense due to their stereotype as untrustworthy by humanoids, you are always proficient in Light Armors and Simple Weapons.

Speed. Hirudo slither on land, giving themselves a respectable 25ft movement speed, however, in water they are truely at home with a swim speed of 40ft.

Hirudo Resistance. Hirudo have a natural resistance to both magical and mundane poisons, you have poison resistance.

Observant physicians. Most Hirudo are trained in Medical observation from a young age, you are proficient at Mediscine, Survival and Perception Checks.

Languages. Hirudo Adventurers typically speak Hirudan, Common, and one other language (typically, Dwarvish, Halfing, Sylvan)

Hirudo Traits (Pathfinder)


+2 Dexterity, +2 Constitution, -2 Charisma: Hirudo are Deceptively nimble and hardy but their alien appearence unnerves most people.

Monstrous Humanoid: Hirudo are Humanoids with the Monstrous Subtype

Normal Speed: Hirudo have a base movement speed of 30 feet.

Exeptional Swimmer: Hirudo have a base swim speed of 40 feet.

Darkvision: Hirudo have Darvision up to 60 feet.

Poison resistance: +2 on fortitude saves vs Poison.

Learned physician: Heal is always a class skill for you, even if not in your base skill list.

Languages: Hirudo begin play speaking Common and Hirudo. Hirudo with high Intelligence scores can choose any extra language (except secret languages such as druidic).

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PART 2 | Statistics and Gameplay

Pathfinder: Racial Options.

Alternate Racial Traits


Defender: Some Hirudo, instead of training in medical, decide to defend their community. You gain proficiency with Simple Weapons and Poisons. This replaces Learned Physician.

Exposed: Some Hirudo willingly expose themselves to diseases to improve their resistances to disease, however, this mass of diseases can perminantly scar and damage the Hirudo. You gain a +2 Fortitude bonus vs Poison. This replaces Darkvision.

Anylitical: Many hirudo chose to studdy the sciences to aid their medical profession at the cost of refining their natural abilities. You gain Craft(Alchemy) and Profession(Alchemist) as class skills. This decreases swim speed by 10 feet.

Improved Suction: Due to circumstances of birth your suction is stronger than most. You add a +2 racial bonus to Climb and Rde checks. This reduces Swim speed by 10 feet.

Fearsome: you can use your disconcerting nature to your advantage. You gain a +4 Circumstance bonus on intimadate checks. This replaces Learned Physician

Bloodsense: you can sense when somebody is afflicted with vampirism, is close to the stages of Vampirism or has Vampiric ancestry trough their blood's scent, unfortunately, this scene interfears with your poison resistances. You gain a +4 Circumstance bonus onchecks to discurn Vampirism. This replaces Poison Resistance.

Favored Class Options


Alchemist: The alchemist gains +1/6 of a new discovery.

Cleric: Cleric: Add a +1/2 bonus on Knowledge (planes) checks relating to the Paraelemental Plane of Ooze and the Beastlands

Druid: Add +1/2 to the druid’s wild empathy bonus.

Fighter: Add +1 to the fighter’s CMD when resisting a grapple or trip attempt.

Inquisitor: Add a +1 bonus on concentration checks made to cast inquisitor spells.

Oracle: Add +1/4 to the armor or natural armor bonus granted by oracle spells she casts on herself.

Monk: Add a +1/4 bonus on combat maneuver checks made to grapple or trip.

Racial Archetypes

(these can both be found in paizo Products)

Dirty Fighter (Fighter)

The dirty fighter laughs at concepts like honor and fair play. He cares only for victory, no matter how he achieves it, and spends as much time mastering sneaky combat maneuvers as he does drilling with weapons or learning how to wear armor, this may have come about by necessity or choice. A dirty fighter has the following class features.

Sidestep (Ex): At 2nd level, a dirty fighter learns how to evade his enemies when they react to his combat maneuvers. He gains a +1 dodge bonus to his AC against attacks of opportunity provoked by him while attempting a combat maneuver. This bonus increases by +1 for every four levels beyond 2nd level. This ability replaces bravery.

Maneuver Training (Ex): At 5th level, a dirty fighter becomes a master of dirty tricks. He gains a +2 bonus on dirty trick combat maneuver checks (Advanced Player’s Guide 320) and +2 to his CMD when he is the target of a dirty trick combat maneuver. This ability replaces weapon training 1. Speedy Tricks (Ex): At 9th level, a dirty fighter has perfected how to quickly perform dirty tricks. He can make a dirty trick combat maneuver as an attack instead of a standard action. This ability replaces weapon training 2.

Double Tricks (Ex): At 13th level, when a dirty fighter performs a combat maneuver, he may apply two different conditions to his target instead of one. Each penalty condition requires a separate action to remove. At 17th level, he may apply three different conditions. This ability replaces weapon training 3 and 4.

Sacrimental Alchemist

Sacrament alchemists serve in a great variety of priestly roles for their deities. A sacrament alchemist is often invaluable even to like-minded allies who are not adherents of the alchemist’s religion but who nonetheless rely on his divine abilities.

Faithful: Like a cleric, a sacrament alchemist must worship a deity, and must be within one step of his deity’s alignment.

Sacramental Cognatogen (Su): A sacrament alchemist can anoint himself as his deity’s servant using his own special version of a mutagen called a sacramental cognatogen. This is brewed, imbibed, maintained, and can nauseate non-alchemists in the same way as a mutagen. While a sacramental cognatogen is in effect, the sacrament alchemist takes a –2 penalty to Dexterity.

Instead of providing physical benefits, the sacramental cognatogen grants the sacrament alchemist access to the domain powers of one domain or subdomain belonging to his deity as if he were a cleric of his alchemist level. The sacrament alchemist must choose the domain or subdomain when he brews the sacramental cognatogen. A sacrament alchemist can select an alignment domain only if his alignment matches that domain. He treats his alchemist level as his cleric level for purposes of using these domain powers, and treats his Intelligence modifier as his Wisdom modifier for purposes of variable effects. The effects of the sacramental cognatogen last for 10 minutes per alchemist level.

A sacrament alchemist doesn’t gain the bonus spells listed for each domain, nor does he gain any bonus spell slots. Levels of classes that normally provide access to domains stack with the sacrament alchemist’s alchemist level for purposes of determining domain powers and abilities, but not for purposes of determining bonus spells. Discoveries, feats, and effects that interact with the mutagen class feature do not affect sacramental cognatogen. A sacrament alchemist cannot take the cognatogen or mutagen discoveries.

This ability replaces Mutagen.

Divinely Inspired Alchemy (Su): At 3rd level, a sacrament alchemist’s faith inspires him with ideas for novel alchemical achievements, although the mental strain means that he can’t reliably repeat them. Once per day while preparing extracts, for a period of 24 hours, a sacrament alchemist can gain an alchemist discovery for which he qualifies. He treats his alchemist level as 2 lower for the purpose of this discovery.

This ability replaces swift alchemy.

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PART 2 | Pathfinder: Racial Options


Discoveries: The following discoveries complement the sacrament alchemist archetype: combine extracts, dilution, infusion, and ranged baptism.

Hirudo feats


Resistant Blood

Your blood is infused with holy power.


  • Prerequisite: Hirudo, Con 13

Benefit: You gain a +2 bonus on saving throws against effects with the evil descriptor and on Constitution checks to stabilize when you are reduced to negative hit points (but not dead). Furthermore, each time you take bleed or blood drain damage, each undead creature or creature with the evil subtype that is currently adjacent to you also takes 1 point of damage

Rough Skin

Your skin glistenes with natural oils


  • Prerequisites: Resistant Blood, Hirudo.

Benefit: You take a –2 penalty on Disguise and Stealth checks but gain one of the following benefits, depending on the Consistancy of your Natural Oils (choose one). Moistening: You gain fire resistance 5 and a +2 bonus on saves against fire effects.

Matte: You gain a +2 bonus on saves against blindness, dazzling, patterns, and effects with the light descriptor. When you cast spells or use spell-like abilities that are from the illusion (pattern) subschool or have the light descriptor, you do so at +1 caster level.

Hardening: You gain a +1 natural armor bonus to AC, and your unarmed strikes or natural weapons count as cold iron for the purpose of overcoming damage reduction.

Blackened Skin

Bad luck befalls those who dare to cross you.


  • Prerequisite: Hirudo

Benefit: Once per day as an immediate action, when you are hit by a melee attack, you can force the opponent who made the attack to reroll it with a –4 penalty. The opponent must take the result of the second attack roll. This is a supernatural ability.

Special: If you take this feat and don’t already have all black skin/matt mucus, your skin turns completely black when you take this feat

Racial Items

Cost Item effect
100gp Medical Leech apply to subject for 1d6 hp on short rest
50gp Slimey Ointment -2 on grapple checks both on target and from target.
400gp Hirudo saliva a Poison that does 1d8 damage on a failed fortitude save and half damage on a sucess, only works when contact is made with skin.

Credit: Anonymous

Special thanks to:

Justin Wiysel and /tg/ for the concept, 5E stats and majority of the lore.
Yackronin(Myself) for making the pathfinder stats.
Homebrewery, for the system i've used to make this doc
And finally, Paizo and WotC who own Pathfinder and D&D respectively.

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PART 2 | Pathfinder: Racial Options