1
Credits
Content, Design, and Editing: Thomas Pfeifer
Art Direction and Consultation: Lakeysha
Best Boy: Terry
Special Thanks to:
The Knights of Bohnenburg and Castle Ramrod: Lakeysha,
Julie, Rachel, Mark, Adam, Rion, Erin, Hanna, and Jen - for
being the eternal best.
David, Michael, Stephan, and Heidi - for being awesome in
general and letting Maxwell do what Maxwell does.
And, of course, to my mom, dad, brother, and sister.
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Disclaimer: Maxwell's Manual of Malicious Maladies (and
Miraculous Medicine) is unofficial Fan Content permitted
under the Fan Content Policy. Not approved/endorsed by
Wizards. Portions of the materials used are property of
Wizards of the Coast. ©Wizards of the Coast LLC.
This work contains material that is copyright Wizards of the
Coast and/or other authors. All other original material in this
work is copyright 2021 by Thomas Pfeifer.
Maxwell's Manual of Malicious Maladies contains
descriptions of injuries and violence potentially resulting in
permanent disability.This work makes use of humor and
hyperbole in reference to this content. The designer of this
work understands that it describes aspects of physical and
mental disability and has made every effort to avoid language
and ideas that are ableist. At core is intended to be
empowering and promote empathy and understanding for
people with physical and mental disabilities.
2
Contents
Introduction
4
How to Use This Book
Part 1: Lingering Injuries .................................................... 4
Part 2: Surgical Treatment .................................................. 5
Part 3: Items, Magical and Mundane ................................ 5
Magical Healing
The Regenerate Spell ........................................................... 5
Interaction with Injuries ...................................................... 5
Part 1: Lingering Injuries
6
How to Use This Section
When Do Characters Roll on the Lingering injury
Tables? ................................................................................. 6
Step By Step .......................................................................... 6
Damage Explanations .......................................................... 7
Lingering Injury Tables
Acid Damage ......................................................................... 9
Bludgeoning Damage .......................................................... 10
Cold Damage ......................................................................... 11
Fire Damage .......................................................................... 12
Force Damage ....................................................................... 13
Lightning Damage ............................................................... 14
Necrotic Damage ................................................................. 15
Piercing Damage ................................................................. 16
Poison Damage .................................................................... 17
Psychic Damage ................................................................... 18
Radiant Damage ................................................................... 19
Slashing Damage ................................................................. 20
Thunder Damage ................................................................. 21
Anatomy Tables
Scar Chart ............................................................................. 23
Large Limb Table ................................................................. 24
Small Appendage Table ...................................................... 24
Nonfunctional and Missing
The Nonfunctional and Missing Conditions .................. 26
Part 2: Surgery
28
Surgery Rules
Prepping the Patient ........................................................... 28
Initiating Surgery ................................................................ 28
Assisting with Surgery ...................................................... 28
Recovery ................................................................................ 28
Finding a Surgeon ............................................................... 28
List of Common Surgeries
General Surgery ................................................................... 29
Save Sense Surgery ............................................................ 29
Save Limb Surgery .............................................................. 29
Amputation ............................................................................ 29
Example Surgery
Part 3: Items and Accessibility
31
Item Lists
Mundane Items ..................................................................... 31
Magical Items ........................................................................ 32
Maxwell's Farewell
34
3
Introduction
W
elcome, prospective student, to Maxwell's
Manual of Malicious Maladies (and
Miraculous Medicine). I am the distinguished
surgeon, Maxwell Gonzolaz, though you may
have heard of me by my popular moniker:
Maxwell Hacks-Well.
In this comprehensive (and dare I say,
preeminent) guide you will find descriptions of all manner of
injury: physical, mental, spiritual, and arcane. I will take you
on a sanguinary journey through a universe of traumatic
possibility and illustrate how you (an industrious and clever
budding surgeon) can wrest your companions from the foulsmelling maw of death and dismemberment.
You will also find within a variety of cutting-edge surgeries
(pun intended) which are guaranteed* to get your compatriots
back on their feet, especially if their feet were missing to
begin with.
But wait, my friend, there's more! When the worst happens
(and you aren't around to prevent it, of course), maiming and
dismemberment are no longer the end. Thanks to modern
medical -- and magical -- technology there are a variety of
options described within to get your kickers back kicking and
your snatchers back snatching. Brilliant!
So, my young pupil, oil up your bone saw, sharpen your
scalpel, and get those bandages boiling, it's time to save some
lives!
4
How to Use This Book
This book is organized into three parts. The first part is a
series of tables describing Lingering Injuries based on the 13
different damage types (acid, bludgeoning, cold, fire, force,
lightning, necrotic, piercing, poison, psychic, radiant,
slashing, and thunder). Each table has a variety of injuries,
conditions, and effects that increase the risk of combat and
provide interesting and dire narrative opportunities. The
second part is a system for characters to perform surgery.
Surgery is a new and unique skill challenge that has the
potential -- with a bit of talent and luck -- to treat some of the
injuries described in the first section. The final section is a
collection of mundane and magical items focussed on
accessibility and allowing options for adventurers with
physical disabilities.
Part 1: Lingering Injuries
Adventuring is a dangerous business, and combat a more
dangerous business still. Your players are consistently
encountering monsters, traps, hazards, and all manner of
opportunities for injury and death. The Lingering Injury
tables in this book provide an interesting way to give your
campaign's conflict a risk of more permanent consequences.
Why play with Lingering Injuries though?
Overcome Your Limitations. Dungeons and Dragons is a
game about narrative, creative problem solving, and
overcoming obstacles. Whether it be an alchemist who paid
an arm and a leg for his powers, a blind geomancer who
"sees" through vibrations in the earth, a psionic professor
confined to his wheelchair, or a blind attorney with his own
version of justice, there are plenty of examples of characters
in the media who never let their physical limitations stand in
the way of their goals. Injuries are an opportunity for your
characters to experience unique challenges and triumph over
them. There is no injury so great that your character cannot
be a hero.
Risk and Reward. When characters can seemingly heal
from even the more grievous injuries with a full night's rest,
sometimes it's difficult to maintain immersion. Lingering
injuries provide a ever-present risk that any combat
encounter will have a serious consequence. Even so, the
Lingering Injury tables were designed so that the probability
the most serious injuries (such as losing an arm, leg, vision,
or hearing) are relatively small compared to that chance your
characters will end up with a purely cosmetic scar.
Scars are Fun. These charts give your players the
opportunity to pick up purely cosmetic reminders of struggles
past (some of which even have some unique properties!). Give
your players the opportunity to show off their battle scars in
the local tavern. Let your players laugh at the hideous scar
one took when they were fighting rats at Level 1 now that
they are fighting dragons at Level 12. Let your Barbarian
(who seems to take 90% of the party's damage) turn into a
physical roadmap of your adventure history. Scars are
interesting way to evolve your characters' appearance and
bookmark the memories of their past struggles.
Part 2: Surgical Treatment
There are some injuries that potions, salves, and bandages
just aren't enough for. Part 2 of this book describes Surgery, a
new skill challenge that allows your characters the chance to
mitigate the effects of injuries they've taken. With some skill
and luck, your characters will be able to reattach an arm
severed by a mighty attack, remove an arrowhead left behind
in the chest of their comrade, neutralize acid threatening to
permanently damage the vision of the sharp-eyed rogue, and
more. Surgery is not without its risks, however, and no
surgery is guaranteed to be successful.
Ultimately, Surgery offers a second chance for your
characters to avoid the permanent effects of some of the
more dire lingering injuries.
Part 3: Items, Magical and Mundane
Despite your characters' best effort to prevent them,
permanent injuries are going to occur. The final part of this
book contains a variety of options -- both magical and
mundane -- focussed on accessibility, so that no physical
limitation will stand in their way.
Magical Healing
Maxwell Says: "Magical healing is a fickle thing, my friend.
I've travelled far and wide, studied with clerics and scholars,
and let me tell you, it's a rare spell that can do what I can
with a scalpel and some catgut.
"Your humble teacher Maxwell has been in one or two
scraps himself, and seen a thing or three. Magical healing is
great for getting you back on your toes in a pinch, but it
sometimes it responds.... oddly. Most often it seals up your
wounds lickity-split without so much as a weal or welt left
behind. Other times, you're left with a wicked looking cicatrix
that looks like it's been with you for since that time you
played with daddy's sheep shears as a child, even though he
told you not to.
"Now, -- and mind you, this is still just a theoretical
postulation -- I believe that magical healing (to its capacity)
acts on the reflected image of oneself that lies deep within
our inner soul. When a particularly grievous wound is taken it
damages not only our physical body, but our spiritual sense of
self. It traumatically changes our inner perception, and when
we receive magical healing, that perception is outwardly
reflected on the body.
"Simply put: 'See stars? Get scars.' "
Regenerate
7th-level transmutation
Casting Time: 1 minute
Range: tough
Components: V, S, M (a prayer wheel, holy water, and healing
potions worth at least 400 gold, which the spell consumes)
Duration: 1 hour
You touch a creature and stimulate its natural healing
ability. The target regains 4d8 + 15 hit points. For the
duration of the spell, the target regains 1 hit point at the start
of each of its turns (10 hit points each minute).
The target’s severed body members (fingers, legs, tails, and
so on), if any, are restored after 2 minutes. If you have the
severed part and hold it to the stump, the spell
instantaneously causes the limb to knit to the stump. This
spell does not heal any injury or scar that is older than one
week.
This optional change gives Regenerate a new material
component which may or may not be available to the
characters, and lets them make the choice between
attempting surgery or consuming potentially precious healing
resources. It also does not instantly remove the scars and
other marks your players may have collected during their
adventures, so long as they are older than one week.
Interaction with Injuries
Though the DM always has the final ruling, magical healing
is intended to be ineffective at treating lingering injuries
unless the treatment section of the lingering injury chart
specifies otherwise. Narratively, the magic is considered
ineffective at treating the source of the injury or effect. For
example, magical healing fixes up the damage from a
standard long sword wound without any trouble, but can't
knit together a broken bone.
The Regenerate Spell
Regenerate is a 7th level spell available to the Bard, Cleric,
and Druid that threatens to make the entire lingering injury
system obsolete. Where is the threat when a 13th level
character can cure even the direst of injuries with the only
cost being a night's rest? While most campaigns are played
between 1st and 12th level, if you enjoy this system and want
to DM for a higher-level campaign, you may want to alter the
Regenerate spell as follows:
5
Part 1: Lingering Injuries
M
axwell Says: "From acid to thunder,
you'll find all manner of injury, insult,
infection, and affliction listed below. It
is my humble hope that you witness
only enough of them to keep you
comfortably in business."
How to Use This Section
Below you will find three different sections. The first section
is the Lingering Injury tables themselves. Your characters
will roll on these tables to determine what manner of injury
or affliction they've received. Second are the Anatomy Tables.
You may need to use these tables to determine location of a
scar or injury. The third section contains the mechanical
effects for two new conditions, nonfunctional and missing.
Some lingering injuries may apply one of these effects to a
limb or other body part.
When Do Characters Roll on the
Lingering injury Tables?
There are two different circumstances that will cause
characters to roll on the Linger Injury tables:
Critical Hits. Any time one of your characters receives a
critical hit from any source (combat, traps, spell attacks, etc.)
they roll 3d6 on the table that matches that damage type. If
the critical hit deals more than one type of damage, they roll
on the on the table for the type that dealt the majority.
Critically Failed Saving Throws. Any time one of your
characters critically fails a saving throw that would cause
them to take damage (including spells, traps, environmental
effects, etc.) they roll 3d6 on the table that matches that
damage type. If the failed saving throw would cause them to
take more than one type of damage, they roll on the table for
the type that dealt the majority.
6
Step By Step
1.Roll on the Lingering Injury Tables
The character receives a critical hit or critically fails a saving
throw. Allow them to roll 3d6 to determine the injury or
affliction they'll receive.
2. Roll on the Anatomy Tables, if needed
Some options may have you roll on an Anatomy Table to
determine the location of the injury or scar. The DM may
always directly choose the location instead of rolling if it
better fits the situation's narrative. If, by chance, you roll a
situation that is physically impossible or simply doesn't make
sense given the established narrative (one of your characters
takes shrapnel to their left leg when it is already missing, for
example), then there is no effect, and the character (luckily)
escapes the situation without an injury.
3. Narrate the Injury and its Effects
The DM narrates the result of the injury and describes any of
its mechanical effects to the player. You may need to consult
information in the section that describes the nonfunctional
and missing conditions.
4. Treatment
Some (though not all) injuries are treatable. Treatment allows
characters to reduce the duration of injuries, or even
potentially cure them altogether. Unless otherwise stated, any
treatment that requires a Wisdom (Medicine) check takes
one action. In general, it is assumed that each character will
have one opportunity to attempt this Wisdom (Medicine)
check. The DM may allow repeated attempts at a failed
treatment check at their discretion, but after a success
further treatment attempts are not allowed (to further
decrease the injury’s duration).
Assume that all characters are aware of the information in
the treatment section of the lingering injury charts and
understand how to tend to these injuries. As long as a
character has a Healer's Kit it is assumed they will have any
equipment needed for a treatment that requires a Wisdom
(Medicine) check.
Some more serious injuries will require surgery to treat.
Surgery is a skill challenge described in Part 2 of this book.
Even if an injury has no treatment listed, the DM is
welcome to work with the character to find a cure that works
well within the campaign's narrative.
Damage Explanations
Lightning
Maxwell Says: "As you may have heard, knowing is half the
battle (the other half generally being gratuitous violence). The
better you understand the capabilities of these different styles
of damage, the better you will be able to respond to them.
Sharpen your quill, and take note..."
They say lightning never strikes the same place twice, but ask
any poor soul who's gone up against a Wizard with the
Lightning Bolt spell...that's just a flagrant lie. Lightning
damage can seize muscles, damage the heart, and even alter
the brain. When treating lightning damage, always remember
to look for the electricity's entry and exit point...after you are
completely certain the patient is grounded, of course.
Acid
Necrotic
A damage so nice, it burns you twice. Acid damage hurts you,
but it also eats through your equipment if you're not careful.
Any adventurer who has had the misfortune to come face-toface with a Black Ooze can tell you that. Magical equipment
can generally recover from this damage...but dammit Jim, I'm
a plague doctor, not a blacksmith. I stitch flesh, not clothing.
You will have look to other expertise if you want your
belongings repaired.
Bludgeoning
Ah, is there any sound more dissonant than the crunch of a
broken bone? Few types of damage are more efficient at
taking your limbs out of commission than bludgeoning. Do
not forget to assess your patient's noggin, though. An errant
club swing can result in a nasty concussion or a ruptured
eardrum. Most often, though, bludgeoning leaves you with the
colorful parting gift of a black eye or a broken nose. Not the
prettiest accessories for polite company.
Cold
Simply put, the cold makes you slow and stupid. Expect your
patients to be numb, clumsy, and frostbitten. Fortunately,
there is an easy solution to almost every wintery woe: warm
them back up. You will need a crackling fire, thick blankets,
or at the very least, the body heat of a willing volunteer. Do
not rewarm them too fast, mind you. Slow and gentle, like
thawing meat from the icebox.
Fire
Fire burns. What more need you know? Fire damage
presents a singular challenge for the industrious surgeon; it
is rather difficult to reattach a limb turned to ash. You may
also find your patients dangerously fatigued with heat
exhaustion or heat stroke. It need not be said that if you
happen to come across a patient who is still actively on
fire...put them out!
Force
Strange things can happen when you use the raw force of
magic. Most of the time it behaves and does the thing you
want it to do, but every so often a small string will come
loose. How is interacts with you or the environment around
you is anyone's guess. As a small point of trivia, did you know
that Druids were originally inspired to create the Reincarnate
spell by studying the En Vivo Reincarnem effect and learning
to reproduce it? It's not a bug, it's a feature!
If you want to see the most harmful effects of necrotic
damage, look inward, not outward. Necrotic damage erodes
the soul. Necrotic damage is misery, and misery loves
company. Treat what you can, but be aware your patient may
need a Cleric more than they need a surgeon.
Piercing
Daggers and arrows and teeth, oh my! Treat piercing wounds
gingerly, as they are likely to be painful and make movement
and action more difficult in general. And always be wary of
wounds to the abdomen. A perforated bowel left untreated is
a death sentence. As a side note, I find that advising my
patients never to run with scissors reduces the rate of
piercing related complaints by a surprising amount.
Poison
Poison is difficult to physically treat, and I would advise you
to make antitoxins a permanent part of your repertoire. There
are many different types, some with the potential to harm the
sensitive structures in your ears, liver, or even your blood
itself. Remember not to induce vomiting unless you are
certain the poison is not also corrosive.
Psychic
It is best not to even bother attempting to treat psychic
injuries yourself. I had a stint practicing trepanning once,
would not recommend. A surgeon is simply unqualified to
treat afflictions of the brain. I refer all my patients with
psychic related damage to a respectable psychological
authority, such as your local phrenologist.
Radiant
I am still in the process of studying the enigma of radiant
damage. The blindness I can treat. The mild burns I can
treat. What I do not yet understand why some patients come
to me with a soft, unearthly glow, or hair loss. Fear not,
though! In time I shall find a merry cure to these as well.
Slashing
Here is a tip for you to scrawl, please underline it twice: the
blood belongs inside the body. When you find a bleed, it is
your responsibility to stop it as quickly as possible. Do not
rely on magical healing to fix the issue, use pressure and
tight bandages. Use of leeches not recommended; you want
more blood inside the body, not less.
Thunder
The damage type you're most likely to experience after a poor
performance by your resident Bard. Ha! I jest (mostly). Be
wary of your eardrums and watch out for shrapnel. If you
want to reattach a concussively amputated limb, you'd best
keep a close eye on where it lands!
7
Lingering Injury Tables
May you roll on them infrequently
8
Acid Damage
3d6
Injury
Description
3
Ocular Acid has splashed over both of your eyes. You are blinded and both your eyes are nonfunctional. If you do
Corrosion not receive treatment within 30 minutes your vision will be permanently missing.
Treatment - A DC 20 Save Sense Surgery.
4
Dissolved Roll on the Large Limb Table. Acid coats your limb, and you hear the sizzle as it starts to dissolve. This limb
Limb is nonfunctional. If you do not receive treatment within 30 minutes, the limb dissolves away and is missing.
Treatment - A DC 20 Save Limb Surgery. You get 1 check for this surgery; if you do not meet the DC on the
first check, the limb is lost.
5
Dissolved Roll on the Small Appendage Table. Acid splashes over your appendage and sizzles as it begins to dissolve.
Appendage This appendage is nonfunctional. If you do not receive treatment within 30 minutes, the appendage
dissolves away and is missing.
Treatment - A DC 20 Save Limb Surgery. You get 1 check for this surgery; if you do not meet the DC on the
first check, the appendage is lost.
6
Corroded Your weapon has been coated in corrosive acid and is getting duller by the second. Each round your weapon
Weapon takes a cumulative -1 to Damage Rolls. When a mundane weapon reaches a -5 penalty it is destroyed. When
a magic weapon reaches a -5 penalty all magical effects are suppressed for 1d4 days (after which the
penalty disappears and the weapon functions normally).
7
Caustic Any friendly character you touch or otherwise interact with physically takes acid damage equal to your level.
Coating Creatures you grapple take this damage at the beginning of their turn. This effect lasts 1 minute.
Treatment - A DC 15 Wisdom (Medicine) check ends this effect. You may reattempt this check.
8
Caustic The acid has left you with a superficial, but painful burn. You take 1 point of acid damage per 5 feet of
Burn
movement while on initiative.
Treatment - A DC 13 Wisdom (Medicine) check ends this effect.
9
Dissolved Your arcane focus or spell component pouch is dissolved and destroyed. If your arcane focus is magical, it
Arcane instead has its magical effects supressed for 1d4 days and is unusable during that time.
Medium
10 Dissolved Your shield is dissolved and destroyed. If your shield is magical, it instead has its magical effects supressed
Shield for 1d4 days and is unusable during that time.
11
Dappled Roll on the Scar Chart. You have a silvery white speckled scar as a result of acid splashing on that area of
Scar
your body.
12 Corroded Your clothes have been corroded to the point of uselessness. If they are magic, they instead have any
Clothes magical effects supressed for 1d4 days. You are luckily unharmed, apart from a potentially awkward
situation with your party members.
13
14
Toxic You've inhaled the acid's toxic fumes causing you to cough and hack violently. You are incapacitated until
Inhalation the end of your next turn.
Caustic You've deeply inhaled the acid's toxic fumes causing you to go into a coughing fit. You are incapacitated for
Lung 1d4 rounds.
15 Scaly Scar Roll on the Scar Chart. The acid injury has resulted in a scar that is gnarled and scaly with a light sheen the
same color as the acid that damaged you. You gain +2 Natural Armor from it, or +1 if you already have a
Natural Armor bonus.
16 Corroded The acid has covered your armor, slowly eating away at it. Each turn your armor takes a cumulative -1
Armor penalty to AC. When the armor's AC reaches 10, it is destroyed. If the armor is magical, its magical effects
are instead suppressed for 1d6 days and it is unusable during this time (after which the penalty disappears
and the armor functions normally).
17 Dissolved Acid has eaten into the essence of one of your magic items, expelling its arcane energy and rendering it
Magic mundane. Choose a magic item on your person at random. That item loses all magical effects permanently.
If the item's rarity is Legendary or Artifact, its magical effects are instead supressed for 3d6 days (and return
to normal after this period).
18 Vocal Cord The acid's caustic fumes have wreaked havoc on your vocal cords. Your voice is nonfunctional and you are
Damage mute. If you do not receive treatment within 30 minutes it will be permanently missing.
Treatment - A DC 19 Save Sense Surgery.
9
Bludgeoning Damage
3d6
Injury
Description
3
Ruptured A violent impact to the side of your head has caused your right eardrum to rupture. Your right ear is
Right nonfunctional. If it is not treated within 24 hours, your hearing in this ear is permanently missing.
Eardrum Treatment - A DC20 Save Sense Surgery.
4
Limb Torn Roll on the Large Limb Table. The enormous impact of the blow has caused your limb to be torn from its
Asunder socket. The limb is missing and thrown 15 feet in a random direction.
Treatment - A DC 22 Save Limb Surgery.
5 Lost Tooth A blow to your face has knocked one of your teeth clean out of your mouth.
Treatment - A DC 15 Wisdom (Perception) check will allow you to recover the tooth. A DC 19 General
Surgery within 1 day of the injury occurring allows you to reinsert the tooth.
6 Concussion A mighty strike to your head has left you with dizziness, nausea, and a lingering headache. Any time you
make an Intelligence, Wisdom, or Charisma saving throw you are also stunned until the end of your next
turn. This condition lasts 1d12 days.
Treatment - A DC 15 Wisdom (Medicine) check reduces the duration of this injury by 1d8 days.
7
Wind You gasp for breath as the blow knocks you flat onto your back. You are prone and you lose concentration.
Knocked
out of You
8 Numb Left The force of the impact jars your nerves and sends a spreading numbness through your left arm. You drop
Arm
anything you are holding with that arm and it is nonfunctional for 1d4 turns.
Treatment - Any amount of magical healing will end this effect.
9
Broken You feel a sharp pain as the blow lands directly on one of your extremities. Roll on the Small Appendage
Appendage Table. That appendage is broken and nonfunctional for 1d12 days.
Treatment - A DC 12 Wisdom (Medicine) check reduces the duration of this injury by 1d10 days.
10 Dislocated Roll to randomly determine the left or right arm. The intensity of the blow has forced your shoulder joint
Shoulder from its socket. This arm is nonfunctional.
Treatment - While on initiative, make a DC 18 Constitution check as a bonus action to force the joint into
place and end this injury. Off initiative, a DC 18 Wisdom (Medicine) check will end this injury.
11 Black Eye You've got yourself a good ol' fashioned shiner. It will resolve on its own in 1d6 days, but you may look out
of place in polite company until then.
12
Broken
Nose
A sharp impact to your face has left you with a painfully broken nose.
Treatment - A DC 8 Wisdom (Medicine) check will set your nose properly, otherwise it has a 50% chance
of healing slightly crooked in 1d6 days. The DC of this check increases by 2 each time your nose is broken.
13
Numb The force of the impact jars your nerves and sends a spreading numbness through your right arm. You drop
Right Arm anything you are holding with that arm and it is nonfunctional for 1d4 turns.
Treatment - Any amount of magical healing will end this effect.
14
Bruised Your entire body aches and you are left with some extensive ugly bruises. Any time you make a Strength
Black and (Athletics) or Dexterity (Acrobatics) check you take bludgeoning damage scaled to the damage that caused
Blue
the lingering injury: 1-10 damage (1d4), 11-20 damage (1d6), 21-30 damage (1d8), 31-40 damage
(1d10), >40 damage (1d12). This injury resolves on its own in 1d4 days.
15
Aching
Bones
Roll on the Scar Chart. The ache of your injury never completely leaves you and even years later you
sometimes feel a twinge of pain. The bones in/around the area rolled ache 6 hours before (roll 1d6): 1)
Rain, 2) Bright Sunshine, 3) Snow, 4) Fog, 5) Storms, 6) Calamities and Natural Disasters
16
Broken
Limb
Roll on the Large Limb Table. This limb is broken and nonfunctional for 1d12 days.
Treatment - A DC 15 Wisdom (Medicine) check reduces the duration of this injury by 1d8 days.
17
Crushed Roll on the Large Limb Table. Your limb is crushed to the point of uselessness and permanently
Limb
nonfunctional. If it isn't reconstructed, the limb will not regain functionality.
Treatment A DC 23 Save Limb Surgery.
18 Ruptured A violent impact to the side of your head has caused your left eardrum to rupture. Your left ear is
Left
nonfunctional. If it is not treated within 24 hours, your hearing in this ear is permanently missing.
Eardrum Treatment - A DC20 Save Sense Surgery.
10
Cold Damage
3d6
3
4
5
6
7
Injury
Description
Chilblains You've been frigid one too many times and your skin easily develops a rash and blisters in cold. You have
disadvantage to Constitution checks and saving throws made to resist the environmental effects of cold.
Frozen
Cornea
Roll to randomly determine the right or left eye. The frigid air has frozen over the surface layer of your eye.
The eye is nonfunctional. If not treated within 12 hours, your vision will be permanently missing.
Treatment - A DC 20 Save Sense Surgery. If the player spends a short rest rewarming the area within 15
minutes of the injury occurring, this DC is decreased to 10.
Extensive Roll twice on the Small Appendage Table. These appendages are firm, frigid, pale, and nonfunctional. If not
Frostbite treated within 15 minutes they will necrotize and fall off in 1d4 days (after which they are missing).
Treatment - A short rest slowly rewarming the appendages.
Severe
Your core body temperature has plummeted dangerously low. While on initiative you function as if
Hypothermia affected by both the Slow and Confusion spells. If untreated for one hour, you fall unconscious.
Treatment - A short rest slowly rewarming yourself ends this effect.
The Shivers You are so cold your hands are shaking uncontrollably and your voice quavers as you speak. The next three
spells you cast have a 50% chance to fail. This effect ends after three spells are attempted.
8 Frost Nipped Your hands are so cold you barely have any feeling in them. Your next three attacks have disadvantage.
Fingers
9
Frozen in You attempt to move your feet but find the intensity of the cold has frozen you directly to the ground.
Place
You are restrained. If you are flying or otherwise not contacting a surface, there is no effect.
Treatment - A Strength check (DC equals half the damage that caused the lingering injury or 10,
whichever number is higher) as an action allows you to break free.
10 Hypothermia The extreme cold has leeched away a large amount of your body heat. While on initiative you function as if
affected by the Slow spell. If untreated for two hours, the condition advances to Severe Hypothermia. .
Treatment - A short rest slowly rewarming yourself ends this effect.
11
Pale Blue
Dot
Roll on the Scar Chart. This body area is left with a pale, blue-tinged scar.
12 Cold Brand Roll on the Scar Chart. This area of your body has been cryo-branded, and will result in a defined, pale scar.
Any hair on the affected area will grow back white.
13 Frost Nipped You cannot take the dash action. This effect lasts 1d6 rounds.
Toes
14 The Umbles You are cold. So cold. You stumble. You fumble. You tumble. You mumble and grumble. You cannot take
the disengage action for 1d6 turns.
15 Heart of Ice Roll on the Scar Chart. In a freak instance of chance, the cold has interacted with a thread of natural magic
within you. This area of your body is permanently frigid (though to you it feels pleasantly cool) and it
radiates a faint aura of Transmutation. You have advantage on Constitution checks and saves made to
resist the environmental effects of cold. You may supress this effect by maintaining concentration.
16 Frost Bitten Roll on the Small Appendage Table. This appendage is firm, frigid, pale, and nonfunctional. If not treated
Appendage within 15 minutes it will necrotize and fall off in 1d4 days (after which it is missing).
Treatment - A short rest slowly rewarming the appendage.
17 Frost Bitten Roll on the Large Limb Table. Your limb is frozen, rigid, numb, and nonfunctional. If not treated within 15
Limb
minutes the limb will necrotize and fall off in 1d4 days (after which it is missing).
Treatment - A short rest slowly rewarming the limb.
18
Slowed
Reflexes
The cold has permanently damaged your nerves and your reflexes have become dull and sluggish. You
have disadvantage on initiative checks.
11
Fire Damage
3d6
Injury
Description
3
Heat
You just can't take the heat. Any exposure causes you to sweat, turn beet red, and become quickly
Intolerance fatigued. You have disadvantage on Constitution checks and saving throws made to resist the
environmental effects of heat.
4
Immolated Roll on the Large Limb Table. The limb is charred black, completely covered in extensive burns, and
Limb
nonfunctional. If untreated within 24 hours the limb will necrotize and fall off in 1d4 days (after which it
is missing).
Treatment - A DC 21 Save Limb Surgery. You get 1 check for this surgery; if you do not meet the DC on
the first check, the limb is lost.
5
Immolated Roll on the Small Appendage Table. The appendage is charred black, completely covered in extensive
Appendage burns, and nonfunctional. If untreated within 24 hours the appendage will necrotize and fall off in 1d4
days (after which it is missing).
Treatment - A DC 21 Save Limb Surgery. You get 1 check for this surgery; if you do not meet the DC on
the first check, the appendage is lost.
6 Third Degree You have a deep burn penetrating through your skin, resulting in a cracked, red wound. While on
Burn
initiative you take 1 fire damage for every 5 feet of movement. In addition, you take 1d4 fire damage
every time you take an action or bonus action. This injury lasts 1d8 days.
Treatment - A DC 16 Wisdom (Medicine) check reduces the duration of this injury by 1d8 days.
7
Heat
Sweat breaks out on your brow, your pulse is thready, and your muscles feel weak. You take 1 level of
Exhaustion exhaustion.
Treatment - A long rest or the Greater Restoration spell removes this exhaustion as usual.
8
First Degree An angry red burn flashes over your skin. It's tender and painful to move. While on initiative you take 1
Burn
fire damage per 10 feet of movement. This injury heals in 1d6 days.
Treatment - A DC 10 Wisdom (Medicine) check reduces the duration of this injury by 1d6 days.
9
Heat Stroke It's so hot you feel faint. Your muscles are cramping. It feels as if your blood is about to boil in your body.
You take 2 levels of exhaustion.
Treatment - A long rest or the Greater Restoration spell removes this exhaustion as usual.
10
Second Your skin bubbles and blisters as the burning flashes over it. While on initiative you take 1 fire damage
Degree Burn per 5 feet of movement. This injury heals in 1d8 days.
Treatment - A DC 12 Wisdom (Medicine) check reduces the duration of this injury by 1d8 days.
11
Burn Scar
Roll on the Scar Chart. This area of your body is left with a creased and wrinkled burn scar.
12
Branded
Roll on the Scar Chart. This area of your body is left with a defined, slightly depressed branding scar.
13
Ignited
You. Are. On. Fire. Dancing flames lick around your body. At the beginning of your turn, you take fire
damage scaled to the damage that caused the lingering injury: 1-10 damage (1d2), 11-20 damage (1d4),
21-30 damage (1d6), 31-40 damage (1d8), >40 damage (1d10).
Treatment - You may use an action to extinguish the flames.
14
15
Searing The temperature around you skyrockets, flash-heating everything nearby. Any flammable objects being
Temperatures worn or wielded are ignited. You drop anything metal you are carrying in sudden shock.
Treatment - You may extinguish any worn or wielded items that were ignited with a bonus action. If you
attempt to pick up any dropped items, make a Constitution saving throw (DC equals half the damage that
caused the lingering injury or 10, whichever number is higher) to brave the heat and retrieve them.
Inner Fire
Roll on the Scar Chart. In a freak instance of chance, the heat has interacted with a thread of natural
magic within you. This area of your body is permanently hot (though to you it feels pleasantly warm) and
radiates a faint aura of Transmutation. You have advantage on Constitution checks and saving throws
made to resist the environmental effects of heat. You may supress this effect by maintaining
concentration.
16
Incinerated Roll on the Small Appendage Table. The blazing fires have scoured through until nothing but ash remains.
Appendage The appendage is missing and the resulting wound is cauterized.
17
Incinerated Roll on the Large Limb Table. The voracious fire has devoured your limb, leaving nothing but smoking
Limb
cinders in its wake. The limb is missing, and the resulting wound is cauterized.
18 Airway Burn You inhale the scorching air around you and it burns a path straight down to your lungs. Your sense of
taste and smell are nonfunctional If not treated within 24 hours they will be permanently missing.
Treatment - A DC20 Save Sense Surgery.
12
Force Damage
3d6
Injury
Description
3
Third Eye Something vital, yet intangible within you falls deathly silent. You feel...disconnected. You lose the ability to
Blinded communicate telepathically. All magical communication that specifically targets you fails (such as the
Message, Sending, and Telepathic Bond spells). Your mind cannot be read or detected.
4
Pertinax Your spells struggle to take and always seem like they need a little something extra. Any spell with a
Machina material component cost requires double that cost to cast. If the spell consumes the components, double
the cost in components are consumed.
5 Null Arcana As the arcane energy strikes you, you feel something within you sputter and fizzle. You lose the ability to
cast spells through any means (including class features, racial traits, or magical items) for 1d4 days.
6 Ligo Secare You feel the abrupt and disconcerting recoil of a severed connection. You lose attunement to anything you
are currently attuned to. You may not attune to anything for 1d4 days.
7 Wild Magic An errant thread of magic comes loose, slipping away from you and causing havoc. The creature or source
Feedback of the damage rolls on the Wild Magic Surge Table (PHB pg.104).
8 Wild Magic An errant thread of magic comes loose, slipping towards you and causing chaos. Roll on the Wild Magic
Surge Surge Table (PHB pg.104).
9
Null Scola You can feel the magic pulse and resonate with the arcane residue that clings to you from the last spell you
cast. There's a searing feeling deep in your mind. You lose the ability to cast spells from the same school of
magic as the most recent spell you've cast for 1d4 days.
10
Mana You feel an almost anticlimactic pop and then, nothing. All your spell slots are harmlessly expended. You
Discharge may reprepare spells as usual after a long rest or as your class dictates.
11
Lingering Roll on the Scar Chart. Sometimes there are strange side effects when you deal with raw magical energy.
Aura
This body part emits faint, misty whisps of arcane energy with the following color and faint magical aura
(roll 1d4): 1) Orange, Conjuration, 2) Red, Evocation, 3) Blue, Abjuration, 4) Green, Transmutation.
12
Lingering Roll on the Scar Chart. Sometimes there are strange side effects when you deal with raw magical energy.
Aura
This body part emits faint, misty whisps of arcane energy with the following color and faint magical aura
(roll 1d4): 1) Black, Necromancy, 2) White, Enchantment, 3) Yellow, Illusion, 4) Violet, Divination.
13 Mana Burn You feel the energy tug violently at your arcane essence until a portion of it tears loose. One of the highest
level spell slots you have available to cast is harmless expended. You may reprepare this spell slot as usual
after a long rest or as your class dictates.
14
Mana
Syphon
You feel the energy suck away your arcane essence and are left with a lingering feeling of emptiness. Two of
the highest level spell slots you have available to cast are harmless expended. You may reprepare these
spell slots as usual after a long rest or as your class dictates.
15
Imbuant Roll on the Large Limb Table. When the arcane energy has been expelled and the pain recedes, you flex
Artus your limb and find some of that energy has decided to stick with you. Unarmed strikes and weapons
wielded by this limb count as magical for the purpose of overcoming resistance and immunity to nonmagical attacks and damage.
16 Dessico Vis Your magical equipment fizzles and starts to emit a high-pitch whine. You're pretty sure it's not supposed
to do that... Choose one of your magical items that has charges at random and roll 1d4. That many charges
are immediately expended (targets chosen at random, if necessary) and the item's maximum charges are
permanently reduced by that amount (to a minimum of 1).
17 Anathema You shake your head from the force of the arcane blow and, it's gone. The knowledge, that is, not your
Magicka head. You lose the ability to cast your most recently cast spell permanently. You can never cast this spell
again by any means (including class features, racial traits, or magical items). If your class allows you to
replace spells on your spell list when leveling up, you may replace this spell normally.
18
En Vivo You experience the feeling of something unlocking, something leaving, something returning, and then
Reincarnem grinding bones, stretching muscles, and sliding viscera. When it's all over you're left gasping for breath, and
you're different. You change race as if the Reincarnate spell had been cast on you.
13
Lightning Damage
3d6
3
Injury
Description
Arrhythmia Electricity surges into the core of your being, causing your heart to stutter. It is far more difficult for you
to handle physical activity without becoming greatly fatigued. Any time you would take levels of
exhaustion you take one additional level.
Treatment - A DC25 General Surgery.
4
Cardiac
Arrest
As the electricity leaves your heart, it beats one last time before silence. You are unconscious and dying,
your hit points drop to 0.
Treatment - If you are stabilized your heart gallops back to life, you are no longer unconscious, and your hit
points return to the total they were at before they dropped to 0.
5
Muscle
Avulsion
Roll on the Large Limb Table. Your muscle has contracted so strongly that its been torn free of the bone.
Your limb is nonfunctional and will not properly heal without surgery.
Treatment - A DC 20 Save Limb Surgery.
6
7
Personality Your brain has been damaged by the electrical surge and you're not acting like yourself. You take a flaw
Change chosen randomly or by the DM.
Treatment - After each long rest roll a d20. On a 19 or 20, the flaw disappears.
Muscle
Spasms
Your muscles twitch in repetitive patterns and you have difficulty coordinating your movement. You have
disadvantage on all Dexterity based attacks, checks, and saves for 1d4 turns.
8 Electrocution Your muscles seize, your eyes roll back, and you cannot seem to force your body to function. You are
paralyzed until the end of your next turn. Critical hits as the result of your paralysis do not cause you to roll
another lingering injury.
Treatment - The Lesser Restoration spell removes this paralysis as usual.
9
10
True
Your body convulses and seizes, you can hardly even think, much less move it. You are paralyzed for 1d2
Electrocution rounds. Critical hits as the result of your paralysis do not cause you to roll another lingering injury.
Treatment - The Lesser Restoration spell removes this paralysis as usual.
Numbed
Nerves
Your nerves are shot, you feel numb, and you're having trouble making your body respond with the speed
you need it to. You cannot take reactions for 1d4 days.
Treatment - A DC 14 Wisdom (Medicine) check reduces the duration of this injury by 1d4 days.
11
Grounding Roll twice on the Scar Chart. Each area of your body is left with a round scar, one where the electricity
Scar
entered, and one where the electricity left.
12
Lictenburg Roll on the Scar Chart. This area of your body is left with a Lictenburg Figure, a scar resembling lightning
Figure
that runs along the path the current took through your body.
13
Arc Flash
The electricity's current has ignited you aflame. At the beginning of your turn, you take fire damage scaled
to the damage that caused the lingering injury: 1-10 damage (1d2), 11-20 damage (1d4), 21-30 damage
(1d6), 31-40 damage (1d8), >40 damage (1d10).
Treatment - You may use an action to extinguish the flames.
14
Lightning The electricity crackles around your body for a second, looking for the closest thing to discharge to. The
Rod
electricity then arcs from you to the nearest creature carrying metal weapons or wearing metal armor. This
creature takes lightning damage equal to half the damage that caused the lingering injury.
15
Static Arc Roll on the Scar Chart. In a freak instance of chance, the electricity has interacted with a thread of natural
magic within you. This body part emits a small electrical arc of energy every few minutes. If you use an
action to touch this body part to a character with 0 hit points they become stable in the same manner as
the Spare the Dying cantrip. You may suppress the arcing effect by maintaining concentration. The limb
emits a faint aura of Evocation.
16 Destructive Roll on the Small Appendage Table. The electricity has violently exited your body at this point, charring it
Grounding to the point of being nonfunctional. If not treated with 24 hours, the appendage will necrotize and fall off
in 1d4 days (after which it is missing).
Treatment - A DC 21 Save Limb Surgery.
17
Heart
Shocked through the heart, and you're to blame. Any time you are charmed or frightened you take 1 level
Palpitations of exhaustion.
Treatment - A DC25 General Surgery.
18 Brain Injury The electricity lances across the wiring of your brain, short circuiting your neurons and changing you
permanently. Your alignment shifts one step towards neutral on the law/chaos axis. If it is already neutral,
treat this roll as a 15.
14
Necrotic Damage
3d6
Injury
Description
3
Corrupted
Soul
You've bore witness to a deep darkness and even now you can feel its touch lingering on your soul. Your
alignment shifts one step towards evil. If you are already evil, treat this roll as a 15.
4
Tenuous Grip You feel like you've seen the face of death and can recall its grim visage with ease. You require one less
on Life
failed death saving throw before you die.
5
Necrotic
Wound
Your wound festers with a dark energy. It resists both magical and natural healing. Your maximum hit
points are reduced by the amount of damage that caused the lingering injury.
Treatment - A DC 18 General Surgery check or the Greater Restoration spell.
6
Withered
Away
You feel frail, drained, as if your life's very essence has been stolen away from you. You have
disadvantage on Strength (Athletics) checks and both Strength and Constitution saving throws for 1d4
days.
7
Malicious
Outburst
You are filled with a blind rage and an overwhelming violent compulsion. You immediately use your
reaction to make a melee attack against the nearest creature (at random). You spend the next 1d4 turns
pursuing and attacking whatever creature is closest to you, regardless of if they are friendly or not.
Treatment - Any spell or effect that would end a Barbarian's rage also ends this effect.
8
Sorrow
All positive emotion within you shatters like a mirror are you are left only with painful, distracting shards.
If you have Inspiration, you lose it. You lose any nonmagical effect granting you a temporary bonus or
advantage (such as Bardic Inspiration, Barbarian Rage, the Dodge action, or the Help action).
9 The Stench of Your are plagued by the lingering stench of rotting flesh. It clings to you and is perceivable by anyone
Decay
within 5 feet of you. For 1d6 days you have disadvantage on all Charisma based checks.
Treatment - Scouring clean in a long, hot bath will reduce the duration of this effect by 1d6 days.
10
Cursed
You feel the negative energy latching on to you, actively working against you. You are afflicted as if by
the Bestow Curse spell, with the specific curse chosen at random, or by the DM. For the purpose of
identifying targets, the source of the damage is assumed to be the caster of the curse. The curse lasts
until the next sunrise.
Treatment - A Remove Curse spell will end this effect, as usual.
11 Shadow Scar Roll on the Scar Chart. You are left with a curious scar that appears to be a shadow over the wounded
area. No amount of light seems to be able to eliminate this shadow.
12 Dark Vessels Roll on the Scar Chart. You are left with a lingering blackness along the veins in this area of your body.
13
Mitotic
Rejection
You cannot be magically healed for 1d6 turns. This includes spells which restore hit points, cure
conditions, and raise the dead.
14 Path to Your You are struck by a short, traumatic vision of your own demise, and your heart is filled with dread at this
Grave
portent. You have vulnerability to the next source of damage that harms you, after which this effect ends.
Treatment - The Remove Curse spell ends this effect.
15 Phantom Limb Roll on the Large Limb Table. This limb is pale, bloodless, and dead. Yet somehow...you can still move it
normally. The limb emits a faint aura of Necromancy. You can supress this effect with an effort of
concentration. This renders your physical limb inanimate and a ghostly, phantom limb appears from
within it, staying attached to you. This incorporeal limb can pass through creatures and objects and
interact with both the Material Plane and the Border Ethereal Plane. If the Phantom Limb ever spends
more than 6 seconds inside an object, it flickers from existence and you take 1d6 force damage.
Treatment - Any spell that returns the dead to life will return your limb to normal, provided you follow
the spell's normal requirements.
16
Insidious Slowly, you feel the building urge to destroy something beautiful. You have 1d6 days to commit an act
Compulsion of senseless destruction or violence (outside of what would be normal behavior for your character). If
you do not do this within the time limit, the compulsion builds to distracting levels, and you have
disadvantage to all attack rolls, ability checks, and saving throws until you do.
17 Chronoscarred Every cell in your body protests as the they are assaulted by the flow of time itself. Your body ages 1d10
years. Your mind is unaffected.
18 Felt the Dark A small mote of corrupt power has taken residence within you and you feel a tiny part of your soul
become unhinged. You take a flaw that would be considered malevolent, violent, cruel, or volatile.
15
Piercing Damage
3d6
Injury
Description
3
Gouged You've taken grievous damage directly to your right eye. Your eye is nonfunctional. If untreated within 8
Right Eye hours, your vision will be beyond saving (and be considered missing).
Treatment - A DC20 Save Sense Surgery.
4
Severed Roll on the Large Limb Table. Through precision or just sheer luck, the blow has severed a nerve in one of
Nerve your major limbs. This limb is nonfunctional and will not heal properly without surgery.
Treatment - A DC 22 Save Limb Surgery.
5
Severed Roll on the Small Appendage Table. You feel a stabbing pain in your appendage, and then an instant
Small numbness. The appendage is nonfunctional and will not heal properly without surgery.
Nerve Treatment - A DC20 Save Sense Surgery.
6
Deep The superficial wound closes easily, but the attack has left an insidious contamination deep inside. At the
Infection end of every long rest, roll your class's hit die and reduce your max hit points by this amount. If this effect
reduces your hit points to 0, you fall unconscious and will die in 1d6 days.
Treatment - Once per day you may attempt a DC 22 Constitution saving throw or a DC 17 Wisdom
(Medicine) check. A success on either cures the infection. The Greater Restoration spell restores the max
hit point damage as usual, but does not cure the infection.
7
Deep You bite back a snarl as the attack penetrates just a little bit deeper. You take one extra damage die of
Perforation whatever type the damage was dealt with.
8 Punctured The attack sinks into the meat of your arm. It's probably not serious, but the pain makes you treat your arm
Arm
gingerly. You no longer get one free object interaction per turn. This effect lasts 1d8 turns.
Treatment - Any amount of magical healing will end this effect.
9 Punctured You cough up blood. The wound has made it past your ribs and into your lung. You make Strength
Lung (Athletics) and Dexterity (Acrobatics) checks at disadvantage for 1d6 days.
Treatment - A DC 15 Wisdom (Medicine) check reduces the duration of this injury by 1d4 days.
10
Ran
The attack went in one end and out the other. Luckily, it's missed anything vital, but you can still feel the
Through agony of it in every motion you make. Bonus actions require a full action instead. This effect lasts for 1d4
days.
Treatment - A DC 15 Wisdom (Medicine) check reduces the duration of this injury by 1d2 days.
11
Gnarled Roll on the Scar Chart. You are left with a raised, gnarled scar on this area of your body.
Scar
12 Depressed Roll on the Scar Chart. You are left with an indented, depressed scar on this area of your body.
Scar
13 Punctured The attack sinks into the meat of your leg. It's probably not serious, but the pain of it makes you treat your
Leg
leg gingerly. Your speed is reduced by 10 feet for 1d8 rounds.
Treatment - Any amount of magical healing will end this effect.
14
Visceral What did that attack even hit? Your liver? Your spleen? Whatever it was, who knew it could hurt so much?
Pain
You let out an ear-splitting cry of pain. If they enemy wasn't aware of you, they sure are now. Every creature
within 60 feet of you knows your exact location, and you are no longer hidden.
15
Roguish Roll on the Scar Chart. You are left with a scar that somehow gives you a distinct roguish charm. When this
Scar
scar is visible you have a +1 bonus to Charisma (Deception) checks. If you collect multiple Roguish Scars,
this bonus does not stack.
16
Foreign The attack is over, but it's left something left behind. An arrowhead, a chip from the creature's tooth, or the
Body broken point of a sword, perhaps. Whatever it is, you can still feel it cutting within you. Any time you use an
action, bonus action, and movement on the same turn you are incapacitated until the end of your next turn.
Treatment - A DC 19 General Surgery removes the foreign body and ends this effect.
17 Perforated You look down at your stomach and a wave of cold fear washes over you. You've taken a gut wound, and it's
Gut
only a matter of time until it turns septic. You are poisoned. Every 24 hours you gain 1 level of exhaustion.
This level of exhaustion may not be removed by nonmagical means.
Treatment - A DC 21 General Surgery. Any effect that cures disease will remove 1 level of exhaustion. A
Lesser Restoration spell temporarily removes the poisoned condition for 24 hours. A Greater Restoration
spell removes exhaustion levels as usual, but does not stop the infection.
18
16
Gouged You've taken grievous damage directly to your left eye. Your eye is nonfunctional. If untreated within 8 hours,
Left Eye your vision will be beyond saving (and be considered missing).
Treatment - A DC20 Save Sense Surgery.
Poison Damage
3d6
3
Injury
Description
Ototoxicity Roll to randomly determine your left or right ear. The poison has spread to the delicate structures in your
inner ear. This ear is nonfunctional, and if not treated within 12 hours, your hearing will be damaged
beyond repair (and be considered missing).
Treatment - A DC20 Save Sense Surgery.
4
Vertigo
You feel dizzy, the world seems to be shifting under your feet. The problem only gets worse when you're
near a great height. You have disadvantage on Dexterity (Acrobatics) checks. You have disadvantage on all
attacks and ability checks when you are within 5 feet of a height 15 feet or greater.
5
Anemic
When the poison has run its course you are left with a permanent weakness. Your carrying capacity is
reduced by half.
6
Lingering
Poison
7
Splitting You can feel your head pounding as the poison pumps through your veins. You gain no advantage from
Headache short rests until you take a long rest.
The poison is particularly strong and you can't seem to shake free of it. You are poisoned for 1d6 days.
Treatment - After each long rest you may make a Constitution saving throw (DC equals half the damage
that caused the lingering injury or 10, whichever number is higher). On a success, you are no longer
poisoned. Any effect that cures poison (such as the Lesser Restoration spell) instead temporarily
suppresses the poison for one hour.
8
Virulent
Poison
You can physically feel the poison eating away at you from the inside, and the adrenaline pumping
through you is only helping to force it throughout your body. At the beginning of your turn you take
poison damage scaled to the damage that caused the lingering injury: 1-10 damage (1d2), 11-20 damage
(1d4), 21-30 damage (1d6), 31-40 damage (1d8), >40 damage (1d10). This effect continues until you
are off initiative.
Treatment - Any spell or effect that cures the poisoned condition will end this effect.
9
Cyanotic
Your lips turn blue, you're out of breath and you feel like you can't suck in enough air no matter how hard
you try. You suffer three levels of exhaustion.
Treatment - You may remove these levels of exhaustion with either a long or a short rest. Any spell or
effect that removes one level of exhaustion instead removes all three.
10
Blurred
Vision
Your eyes cloud over, your vision blurs, and distinct shapes become amorphous blobs. You have
disadvantage on Wisdom (Perception) checks relying on vision and all ranged attacks for 1d4 days. If you
have darkvision, you lose it for this duration.
Treatment - A DC 15 Wisdom (Medicine) check reduces the duration of this injury by 1d2 days.
11
Residual Roll on the Scar Chart. The poison has had the interesting effect of dying your skin. This area of your body
Pigmentation has taken on a light shade the same colour as the poison, or roll to determine the color randomly (1d4):
1) Green 2) Purple 3) Orange 4) Blue.
12
Scarred
Veins
Roll on the Scar Chart. Your veins have been scarred in this area, leaving them slightly raised and
pigmented the same color as the poison, or roll to determine the color randomly (1d4): 1) Green 2) Grey
3) Red 4) Brown.
13
Nausea
You feel a sick, oily feeling deep in your stomach and bile roiling up your throat. You have disadvantage on
all ability checks for 1d6 rounds.
14
Vomiting
You feel sick, and without warning, the last meal you ate is purged from your stomach. You are
incapacitated until the end of your next turn, and you have disadvantage on all ability checks for 1d2
rounds.
15 Unexpected Roll on the Scar Chart. The poison has interacted with your body in a thoroughly unexpected way, causing
Mutagen a strange alteration in appearance. This area of your body takes on a physical attribute somehow related to
the source of the poison (such as green scales from the poison breath of a dragon). At the DM's
discretion, this new attribute may give you a +1 bonus to an ability check.
16
Inefficient You feel hungry all the time, and it's very difficult for you to gain weight. You require double the normal
Metabolism amount of food and water per day.
17
Slowed You hardly ever feel hungry, and it's very easy for you to gain weight. You require half the normal amount
Metabolism of food and water per day. Potions you use require one full minute to take effect instead of taking effect
immediately.
18
Liver
Cirrhosis
The poison has left your liver scarred and damaged. There's never been a better time to give up drinking.
Any amount of alcohol you consume gives you the poisoned condition. Alcohol or other drugs affect you
for double their normal duration. You have disadvantage on any Constitution checks or saving throws
made to resist poison.
17
Psychic Damage
3d6
Injury
3
Apathy
Description
You mind has been indelibly altered, and you just find it more difficult to care. Your alignment shifts one
step towards neutral on the good/evil axis. If it is already neutral, treat this roll as a 15.
4
Crippling Unconsciously, you brain has made a connection between something random and the pain it felt, now you
Phobia can't help but associate the two. The DM chooses something unique about the source of the damage or
the current setting. Any time you move within 15 feet of this thing you are frightened until you move at
least 50 feet away from it.
5
Insomnia Your brain feels wired, and you cannot force it to rest no matter how hard you try. You cannot benefit from
short or long rests for 1d4 days (You do not regain HD, cannot regain spell slots or prepare spells, and do
not heal). During this time you are immune to magical sleep.
6
A Taste of You feel something within your mind come a touch unhinged. Roll on the Long Term Madness Table (DMG
Madness pg.260). This effect lasts 1d10 x 10 hours.
7
Terrified You feel a bubbling terror rising into your throat, and suddenly all you can think of is getting away. You are
terrified of the source of the damage as if affected by the Fear spell (saving throw DC equals half the
damage that caused the lingering injury or 10, whichever number is higher).
8
Frightened A sudden jolt of intense fear lances through you from your scalp to your toes. You are terrified of the
source of the damage as if affected by the Fear spell until the end of your next turn.
9 A Touch of You feel your mind stretch as if to the point of breaking, and then all of the sudden things become clear
Madness again. Roll on the Short Term Madness Table (DMG pg.259). This effect lasts for 1d10 minutes.
10 Persistent Your head throbs, the light aggravates you, and all you want is for the pounding to stop. You cannot benefit
Migraine from a short rest for 1d4 days.
11
Tic
The psychic assault has left you with a small vocal or motor tic; a brief compulsive behavior you find
difficult or impossible to suppress. The DM may choose a specific tic or roll to determine the tic randomly
(1d6): 1) Eye twitching, 2) Finger clicking, 3) Touching other people or things, 4) Grunting, 5) Repeating a
sound or phrase, 6) Grimacing.
12 Nosebleeds You now tend to experience nosebleeds when you exert a great force of mental effort. The nosebleeds
occur when (roll 1d6): 1) You are frightened, 2) You are charmed, 3) You make an Intelligence saving throw,
4) You make a Wisdom saving throw, 5) You make a Charisma saving throw, 6) You take psychic damage.
13
Charmed Against all logic, you feel yourself becoming warm and endeared. You are charmed by the source of the
damage as if under the effects of the Charm Person spell. This effect lasts until the end of your next turn.
Treatment - Taking any amount of damage from the source of the charm ends this effect.
14 Enamoured A bit confused, you feel a wave of unexpected affection wash over you. You are charmed by the source of
the damage as if under the effects of the Charm Person spell. This effect lasts 1d4 rounds.
Treatment - Taking any amount of damage from the source of the charm ends this effect.
15
Illusory
Limb
Roll on the Scar Chart. In a freak instance of chance, the physic assault has interacted with a thread of
natural magic within you. The appearance of this body part keeps subtly shifting, though it feels exactly the
same as before. This area of your body is permanently under the effect of a Minor Illusion spell and emits a
faint aura of Illusion. You can suppress or control this effect with an effort of concentration, otherwise the
body part slowly shifts through minor changes in colour, size, shape, and appearance seemingly in relation
to your general mood. The spell save DC for this illusion is 10 + your current level.
16 Temporary Your attempts to be understood are met with nothing but narrowed eyes and confused looks. You lose
Aphasia proficiency with all languages except common, which you can understand, but not speak. You cannot read
or write. Any attempt to speak a language results in a garbled string of seemingly random words. This effect
lasts 1d4 days.
Treatment - Any spell that allows the caster to comprehend the literal or implied meaning of
communication will function as normal.
18
17
Night
Terrors
You tend to wake up in the middle of the night in a cold sweat, the horrors you've seen replaying in your
mind. You regain only 1/4 of your HD on a long reast, instead of half (rounded down).
18
Paranoia You find it difficult to stop being distracted by the feeling that there is someone or something out to get
you. Whenever you must maintain concentration, roll 1d4. This is the maximum amount of rounds you may
maintain concentration for that spell or effect.
Radiant Damage
3d6 Injury
Description
3
Purged The purging light has scoured clean the filth in your soul. Your alignment shifts one step towards good. If your
Soul alignment is already good, treat this roll as a 15.
4
Blinded Roll randomly for the right or left eye. Even through closed lids all you can see is an empty whiteness. Your
eye is nonfunctional, and if not treated within 24 hours your vision will be permanently missing.
Treatment - A DC 20 Save Sense Surgery.
5 Irradiated The energy that washed over you has left you with a lingering feeling of sickness and nausea. You are poisoned
for 1d4 days. During this time, you slowly lose all the hair on your body. After 1d12 days, it begins to regrow
at the normal rate.
6
Flash
Burn
You were unprepared for the overwhelming torrent of brilliance and stared right into it. You are blinded for
1d6 days.
Treatment - A DC 15 Wisdom (Medicine) check reduces this injury's duration by 1d4 days.
7
Razzle You blink the spots from your eyes, but your vision is taking a while to return. You are blinded for 1d4 turns.
Dazzled Treatment - A Lesser Restoration spell will cure this condition as usual.
8
Dazzled Lights dance in your vision and you shake your head in an attempt to clear it. You are blinded until the end of
your next turn.
Treatment - A Lesser Restoration spell will cure this condition as usual.
9 Unearthly Oddly, after the radiance of the attack fades you are left with a dull, green glow. This affects you in the same
Glow manner as the Faerie Fire spell, though the effect itself is non-magical. It last 1d20 hours.
10 Penitent You seem to have lost your stomach for killing. The thought of taking a life fills you with abject disgust. You
Mercy may not willingly take a life. Any damage dealt by you that reduces a creature’s hit points to 0 automatically
knocks them out instead of killing them. This effect lasts 1d4 days.
11 Prismatic Roll on the Scar Chart. You are left with smooth scar on this part of your body that seems to shimmer through
Scar the prismatic colors when the light catches it.
12 Bleached Roll on the Scar Chart. This area of your body is left bleached a bone white, and hair no longer grows on it.
13 Sunburn The light sears a painful red burn into your skin. You take 1 radiant damage per 10 feet of movement while on
initiative. This injury lasts 1d4 days.
Treatment - A DC 12 Wisdom (Medicine) check reduces this injury's duration by 1d4 days.
14
15
16
A Brief You've received a brief glimpse of something greater and you can't help but pause for a moment of distracted
Stillness contemplation. You cannot take reactions for 1d4 turns.
of the
Soul
Halo
Roll on the Scar Chart. This area of your body flares with a sudden radiance, which then dies down to a soft,
dull glow. It emits bright light in a 5 foot radius, dim light in an additional 5 foot radius, and has a faint aura of
Evocation. An effort of concentration can either suppress this effect or flare the light to the brightness of a
torch.
Forced As the energy of the attack passes, you have a revelation clawing at the edge of your brain, you're sure of it.
Epiphany You have 1d6 days to withdraw from activity and spend 24 hours alone in silent, individual contemplation
about your god, belief set, or yourself. After this, you come to an enlightening realization. If you do not do this
within the time limit, the nagging urge builds to distracting levels and you have disadvantage to all attack
rolls, ability checks, and saving throws until you do.
17 Fountain As the divine energy fades you feel as if some of the great burden of time has left with it. Your body is 1d10
of Youth years younger. Your mind is unaffected.
18 Seen the You feel as if you've seen a glimpse of something greater than yourself, and a tiny mote of that light has come
Light to rest on your soul. You take a flaw that would be considered benevolent, self-sacrificing, unyielding, or
militant.
19
Slashing Damage
3d6
Injury
3
Sliced Eye
Description
Roll to randomly determine your left or right eye. You've taken a grievous wound across this eye. It is
nonfunctional, and if not treated within 12 hours, your vision will be permanently missing.
Treatment - A DC20 Save Sense Surgery.
4
Severed Limb Roll on the Large Limb Table. The intensity of the blow has sliced your limb clean off. It lands severed at
your feet and is considered missing.
Treatment - A DC 22 Save Limb Surgery.
5
Severed
Roll on the Small Appendage Table. The savagery of the blow has severed one of your small appendages.
Appendage It lands at your feet and is considered missing.
Treatment - A DC 22 Save Limb Surgery.
6 Exsanguinating The attack has hit one of your vital points and opened a large artery. You are bleeding out. At the end of
each turn, take one level of exhaustion.
Treatment - A DC 16 Wisdom (Medicine) check staunches bleeding. On a failed save you do not take a
level of exhaustion at the end of your next turn. You may reattempt this check.
7 Hemorrhaging You see blood pour from your wound and you feel a bit light headed. At the end of each turn you take
damage to your maximum hit points scaled to the damage that caused the lingering injury: 1-10 damage
(1d4), 11-20 damage (1d6), 21-30 damage (1d8), 31-40 damage (1d10), >40 damage (1d12).
Treatment - A DC 11 Wisdom (Medicine) check staunches the bleeding. You may reattempt this check.
8
Bleeding
You see blood trickling from your wound. It's not a lot, but it adds up. At the end of each turn you take
damage to your maximum hit points scaled to the damage that caused the lingering injury: 1-10 damage
(1d2), 11-20 damage (1d4), 21-30 damage (1d6), 31-40 damage (1d8), >40 damage (1d10).
Treatment - A DC 10 Wisdom (Medicine) check staunches the bleeding. You may reattempt this check.
9
Festering
Wound
Your wound looks angry near its edges and stubbornly refuses to heal. You cannot heal hit points
through nonmagical means (such as short or long rests).
Treatment - Once per long rest you may make a DC 18 Wisdom (Medicine) check to heal this injury.
10 Leg Laceration You've taken a long, painful slash to one of your legs. Your speed is reduced by 10 feet. This injury lasts
1d8 days.
Treatment - A DC 15 Wisdom (Medicine) check reduces the duration of this injury by 1d6 days.
11 Sinuous Scar Roll on the Scar Chart. You are left with a thin, sinuous scar on this area of your body.
12 Hypertrophic Roll on the Scar Chart. You are left with a thick, raised scar on this area of your body.
Scar
13
14
Stubborn
Bleeding
You see blood trickling from your wound. It must be a nicked vein because it's difficult to staunch. At
the end of each turn you take damage to your maximum hit points scaled to the damage that caused the
lingering injury: 1-10 damage (1d2), 11-20 damage (1d4), 21-30 damage (1d6), 31-40 damage (1d8),
>40 damage (1d10).
Treatment - A DC 14 Wisdom (Medicine) check staunches the bleeding. You may reattempt this check.
Stubborn With every beat of your heart you can feel your lifeblood spilling out. At the end of each turn you take
Hemorrhaging damage to your maximum hit points scaled to the damage that caused the lingering injury: 1-10 damage
(1d4), 11-20 damage (1d6), 21-30 damage (1d8), 31-40 damage (1d10), >40 damage (1d12).
Treatment - A DC 15 Wisdom (Medicine) check staunches the bleeding. You may reattempt this check.
15 Aesthetic Scar Roll on the Scar Chart. You are left with a scar that look particularly well placed on you. When this scar is
visible you have a +1 bonus to Charisma (Persuasion) checks. If you collect multiple Aesthetic Scars, this
bonus does not stack.
16
Traumatic Roll on the Small Appendage Table. The savage slash has cloven your appendage from you, flinging it
Amputation into the distance. It lands 15 feet away in a random direction and is considered missing.
Treatment - A DC 22 Save Limb Surgery.
17
Hamstrung You feel the cut rake across the back of your leg, and you stumble, crying out in pain. Your speed is
reduced by 10 feet.
Treatment - A DC20 Save Limb Surgery.
18
Sliced Ear
Roll to randomly determine your left or right ear. You've taken a grievous wound across this ear. It is
nonfunctional, and if not treated within 12 hours, your hearing will be permanently missing.
Treatment - A DC20 Save Sense Surgery.
Note: Damage to maximum hit points caused by loss of blood heals at a rate of the character's HD + their Constitution modifier
per long rest (the same rate as recovering from surgery). This damage is cured by the Greater Restoration spell as usual.
20
Thunder Damage
3d6
Injury
3
Ruptured
Eardrums
Description
The sonic assault has blown out your eardrums. You are deafened and your ears are nonfunctional. If not
treated within 24 hours, your hearing will be permanently missing.
Treatment - A DC20 Save Sense Surgery.
4
Concussive Roll on the Large Limb Table. The concussive blast has torn your limb clean off and sent it sailing through
Amputation the air. It lands 30 feet from you, pushed away from the direction of the attack and is considered missing.
Treatment - A DC 22 Save Limb Surgery.
5
Small
Roll on the Small Appendage Table. The concussive blast has torn your appendage free and sent it flying.
Concussive It lands 30 feet away from you, pushed away from the direction of the attack, and is considered missing.
Amputation Treatment - A DC 22 Save Limb Surgery.
6
Leg Shrapnel The attack has turned small fragments of debris in the surrounding area into deadly ballistic projectiles,
many of which have found their way deep into your leg muscles. Your speed is reduced by 10 feet.
Treatment - A DC 22 General Surgery.
7 Disorientation The force of the blast has left you reeling. You are stunned until the end of your next turn.
8
Percussive As the attack's thunderous echo fades, you find that your hands are empty. Anything you were holding is
Disarming wrenched free of your grip and lands 50 feet from you, pushed away from the direction of the attack.
9
Tinnitus
You are left with an annoying ringing in your ears. You have disadvantage on perception checks related to
sound for 1d6 days.
Treatment - A DC 12 Wisdom (Medicine) check reduces the duration of this injury by 1d4 days.
10
Deaf and
Dazed
You are bowled over by the percussive assault and the only thing you hear is an atonal ringing. You are
knocked prone and deafened for 1d6 hours.
11
Extensive
Bruising
Roll on the Scar Chart. You have some massive, ugly bruising in this area, but it looks worse than it feels.
The bruising will fade after 1d8 days.
12 Speckled Scar Roll on the Scar Chart. The ballistic debris has left you with a speckled scar in this area.
13
Knocked
Around
The force of the blast has knocked you backwards. You are pushed away from the source of the damage
an amount of feet scaled to the damage from the lingering injury: 1-10 damage (5 ft.), 11-20 damage
(10 ft.), 21-30 damage (15 ft.), 31-40 damage (20 ft.), >40 damage (25 ft.).
14 Blown Away The concussive wave sends you flying back. You are blown away from the source of the damage an
amount of feet scaled to the damage from the lingering injury: 1-10 damage (10 ft.), 11-20 damage (20
ft.), 21-30 damage (30 ft.), 31-40 damage (40 ft.), >40 damage (50 ft.).
15
Acoustic Roll on the Scar Chart. In a freak instance of chance, the sonic assault has interacted with a thread of
Dead Zone natural magic within you. Everything around this part of your body seems strangely...silent. All noise
within a half foot radius of this area of your body is inaudible as if under the effect of a Silence spell, and
the area emits a faint aura of Illusion. An effort of concentration will supress this effect.
16 Arm Shrapnel Roll to randomly determine the left or right arm. The attack has turned small fragments of debris in the
surrounding area into deadly ballistic projectiles, many of which have found their way deep into your arm
muscles. Attacks made by this arm have disadvantage. Shields used by this arm provide 1 AC instead of 2
AC.
Treatment - A DC 21 General Surgery.
17
18
Barotrauma The concussive force reverberates through the gas inside your lungs, doing major damage to them. You
can only hold your breath for half the normal duration. In addition, the blood vessels in your eyes have
ruptured, turning the whites of your eyes the color of your blood for 1d6 days.
Unlucky
Shrapnel
Roll to randomly determine your left or right eye. An unlucky piece of shrapnel has ricocheted straight
into your eye. This eye is nonfunctional. If not treated within 4 hours, your vision permanently missing.
Treatment - A DC20 Save Sense Surgery.
21
Anatomy Tables
May Your Scars Bring you Glory
22
d100 Body Area
Scar Chart
d100 Body Area
d100 Body Area
51 Left Hip
76 Back of Right Hand
52 Left Arm
77 Right Thumb
d100 Body Area
53 Left Arm
78 Right Index Finger
1
Head
26 Left Chest
54 Left Arm
79 Right Middle Finger
2
Head
27 Left Chest
55 Left Arm to Elbow
80 Right Ring Finger
3
Face
28 Left Chest
56 Left Arm to Elbow
81 Right Pinky Finger
4
Face
29 Right Chest
57 Left Arm to Elbow
82 Left Leg
5
Forehead
30 Right Chest
58 Left Hand
83 Left Leg
6
Left Cheek
31 Right Chest
59 Left Hand
84 Left Leg
7
Right Cheek
32 Upper Back
60 Left Palm
85 Left Leg to Knee
8
Chin
33 Upper Back
61 Back of Left Hand
86 Left Leg to Knee
9
Hair/Horns/Scalp
34 Upper Back
62 Left Thumb
87 Left Leg to Knee
10 Nose
35 Left Upper Back
63 Left Index Finger
88 Left Foot
11 Tongue
36 Left Upper Back
64 Left Middle Finger
89 Left Foot
12 Lips/Mouth
37 Left Upper Back
65 Left Ring Finger
90 Toes on Left Foot
13 Eyes/Over Eyes
38 Right Upper Back
66 Left Pinky Finger
91 Right Leg
14 Left Eye/Over Eye
39 Right Upper Back
67 Right Arm
92 Right Leg
15 Right Eye/Over Eye
40 Right Upper Back
68 Right Arm
93 Right Leg
16 Ears
41 Along Spine
69 Right Arm
94 Right Leg to Knee
17 Left Ear
42 Lower Back
70 Right Arm to Elbow
95 Right Leg to Knee
18 Right Ear
43 Lower Back
71 Right Arm to Elbow
96 Right Leg to Knee
19 Neck
44 Lower Back
72 Right Arm to Elbow
97 Right Foot
20 Neck
45 Stomach
73 Right Hand
98 Right Foot
21 Back of Neck
46 Stomach
74 Right Hand
99 Toes of Right Foot
22 Throat
47 Stomach
75 Right Palm
100 Player's Choice
23 Chest
47 Left Hip
24 Chest
49 Left Hip
25 Chest
50 Right Hip
23
Further Anatomy Tables
Large Limb Table
1d20
24
Limb
Small Appendage Table
1d20
Appendage
1
Entire Left Arm
1
Left Index Finger
2
Left Arm Above Elbow
2
Left Middle Finger
3
Left Arm Below Elbow
3
Left Ring Finger
4
Left Hand
4
Left Pinky Finger
5
Left Hand
5
Right Index Finger
6
Entire Right Arm
6
Right Middle Finger
7
Right Arm Above Elbow
7
Right Ring Finger
8
Right Arm Below Elbow
8
Right Pinky Finger
9
Right Hand
9
Left Big Toe
10
Right Hand
10
Left 2nd Toe
11
Entire Left Leg
11
Left Middle Toe
12
Left Leg Above Knee
12
Left 4th Toe
13
Left Leg Below Knee
13
Left Pinky Toe
14
Left Foot
14
Right Big Toe
15
Left Foot
15
Right 2nd Toe
16
Entire Right Leg
16
Right Middle Toe
17
Right leg Above Knee
17
Right 4th Toe
18
Right Leg Below Knee
18
Right Pinky Toe
19
Right Foot
19
Two Random Fingers
20
Right Foot
20
Two Random Toes
Nonfunctional and Missing
May Your Injuries Never Be Greater than the Strength of your Will
25
The Nonfunctional and
Missing Conditions
Maxwell's Manual introduces two new conditions,
nonfunctional and missing. These two conditions are the
same in terms of how they affect characters mechanically.
They may differ, however, in how the injury is treated
surgically, or what types of items are available to characters
to assist with their injury. If the distinction is important, it will
be listed in the surgery or item's description.
Nonfunctional describes a limb or sense that has been
damaged to the point where it ceases to function. A leg
broken by a greatclub, ears temporarily deafened by a violent
percussive attack, or fingers in the early stages of frostbite
are considered to have the nonfunctional condition.
Missing describes a limb or sense that is permanently
gone, destroyed, or otherwise unattached from the body. An
arm severed by the mighty swing of a greatsword, a leg
incinerated by the flame of a dragon, or an untreated spray of
acid into a character's eyes are all considered to have the
missing condition.
The following tables describe the mechanical effect that
nonfunctional or missing body parts have on players:
Note: Some of these effects are the same as the Lingering
Injury Table found on page 272 of the DMG, while others are
expanded on or completely new. If playing with Maxwell's
Manual, it is recommended you only use the effects listed
here.
The Remarkable Adaptability of the
Human (and elf, dwarf, etc.) Body
The human body is an incredible thing, and the
human will even more so. The longer a person lives
with an injury or disability, the more they are able
to adapt to it. Many of the penalties listed here may
be able to be overcome with practice, training, and
resilience.
Maxwell Says: "I once, in the folly of youth, made
the lamentable error of challenging a man missing
an arm to an arm wrestling competition. Little did I
consider his normal day involved doing the same
work with one arm that I did with two.
"Long story short, I ended up setting my first
broken bone."
26
Vision
# Effect
One You have disadvantage on Wisdom (Perception)
Eye checks that rely on sight and on ranged attack rolls.
Both You are blinded.
Eyes
Hearing
#
Effect
One You have disadvantage on Wisdom (Perception)
Ear checks that rely on hearing.
Both You are deafened.
Ears
Sense of Smell and Taste
Effect
Smell You cannot smell. You automatically fail any ability
check that requires smell.
Taste You cannot taste. You automatically fail any ability
check that requires taste.
Speaking
Effect
Voice You cannot speak. You automatically fail any ability
check that requires the use of your voice. You
cannot use your voice to provide the verbal
component of spells. You have disadvantage on
Charisma ability checks unless you are proficient in
gestural language or are communicating
telepathically.
Upper Body
#
Effect
1 Arm You can no longer hold anything with two hands,
or and you can only hold a single object at a time. You
Hand have disadvantage on Strength and Dexterity based
ability checks that would normally require the use
of both arms (such as a Strength [Athletics] ability
check made to climb, or a Dexterity ability check
made to use thieves' tools). At the DM's discretion,
a character may be able to eliminate these
penalties over time through practice and training.
Both You can no longer hold anything. You automatically
Arms fail any ability check that normally requires the use
or of both arms. At the DM's discretion you may
Hands attempt ability checks requiring the use of one
arm, as long as you have a reasonable way to do so
(such as particularly dexterous feet, or a prehensile
tail).
Phalanges
#
Fingers
1 The loss of one finger provides no significant
Finger penalty to your character, though depending on
which it was your character may lose the ability to
express rude gestures.
2 Melee weapons wielded by this hand have
Fingers disadvantage on attacks unless they have the light
or finesse property. You may wield two-handed
weapons as normal.
3 All weapons wielded by this hand have
Fingers disadvantage on attacks unless they have the light
or finesse property, except crossbows. You have
disadvantage on Dexterity (Slight of Hand) checks
using this hand, and any ability check to use tools
that require delicate precision (such as thieves'
tools or surgeons' tools). At the DM's discretion, a
character may be able to eliminate these penalties
over time through practice and training.
4 You take the same penalties as if you had lost one
Fingers hand. You can no longer wield weapons or shields
with this hand unless you have a way to strap
them to your arm.
Lower Body
# Effect
1 You require the use of assistive equipment to walk,
Leg such as a cane, crutches, or a prosthesis. Without
or this equipment your speed is halved and you fall
Foot prone after using the dash action. You have
disadvantage on dexterity checks made to balance.
Both You require the use of assistive equipment to move,
Legs such as a wheelchair. Without this equipment, your
or speed is 10 feet, and you are unable to stand from
Feet prone.
Phalanges
# Toes (total)
4 or The loss of up to four toes provides no significant
Less penalty to your character, apart from losing the
ability to properly recite "This Little Piggy Went to
Market".
5 - 8 When using the dash action, your speed is reduced
Toes by 10 feet.
9 - When using the dash action, your speed is reduced
10 by 10 feet. You have disadvantage on Dexterity
checks made to balance.
27
Part 2: Surgery
M
axwell Says: "Ah, surgery. Nothing
makes you feel quite so alive as being
elbow deep in blood and humors.
Surgery, as you will find out my friend,
is more of an art than a science.
Something out of place? Excise it.
Something need to be in place? Stitch
it. Once you know the basics, my apt pupil, it's off on your
own like a baby bird falling from the nest.
Prepping the Patient
Surgery pits the skill of the surgeon against the life force of
the patient. Surgeries are meant to be difficult, and many of
them may require multiple consecutive attempts before the
surgery is successful. Be careful, however, as the longer the
surgery takes, the more unstable your patient may become...
Attempting surgery requires three things:
A Set of Surgeons' Tools. From catgut to clamps, from
bandages to bone saws, surgeon's tools contain all the
necessary equipment to attempt any surgery.
A Character Proficient with Surgeons' Tools. Surgery is
a specialized skill and impossible to attempt by anyone
untrained.
A Controlled Environment. This means a stable setting
free of threats and distractions for the duration of the surgery.
Ideally a dedicated room. At the least, a stable encampment.
Concentration. Surgery requires concentration, so the
surgeon may not also concentrate on a spell at the same time
as performing surgery.
Initiating Surgery
Once the three requirements above are met, a character may
initiate the skill challenge. Each round of the skill challenge
takes place as follows:
Surgeons' Tools Check. The character attempting the
surgery makes an surgeons' tools ability check (generally
using either Dexterity or Intelligence) opposed by the DC of
the surgery. Each attempt takes 30 minutes. If the character
meets or exceeds the DC, the surgery is a success. If they fail
to meet the DC, they have not yet succeeded and may be able
to reattempt.
Max Hit Point Damage. The character undergoing
surgery takes damage to their maximum hit points equal to
their class's hit die (for example, a Barbarian takes 1d12 of
damage to their maximum hit points). If the DC is failed by 10
or more, the character undergoing surgery takes two hit dice
worth of damage to their max hit points instead. This damage
represents trauma to the body through surgery and loss of
blood. It occurs whether or not the surgery was a success.
Decision to Continue. If the DC was not met, it increases
(cumulatively) by 1. The surgeon may choose to either
proceed with surgery and make another surgeons' tools
ability check or abandon the surgery.
Dying Patients. If the character's maximum hit points are
ever reduced to 0, they are dying. If the surgeon immediately
abandons the surgery at this point they are stabilized and
regain 1 to their max hit points. If the surgeon proceeds with
the surgery, the character dies.
28
Assisting with Surgery
Maxwell Says: "I always strive to have the maximum
available amount of hands possible, both in my help and on
my patients."
Second Surgeon. A character may use the help action to
assist with surgery only if they are also proficient in surgeons'
tools. In this case, the surgeon rolls their surgeons' tools
check with advantage.
Assessing the Patient A character proficient in Wisdom
(Medicine) may assist the surgeon by assessing the patient's
condition. After max hit point damage is done, they may roll a
Wisdom (Medicine) ability check:
Wisdom
(Medicine)
DC
Information Known
8
You know if the patient has 0 HP and is
dying.
10
You know if the patient has 15 or less HP.
15
You know if the patient is above or below
half their original maximum health
20
You know the patient's exact HP
If the surgeon chooses to assess the patient, they make
their next surgeons' tools ability check with disadvantage.
Splitting their attention between the patient's vital signs and
the surgery itself is distracting and they need their whole
focus to do their best surgical work.
Other Ways to Help. Any spell, ability, or mechanic that
gives advantage or a bonus to ability checks functions as
normal, but only pertains to a single surgeons' tools check
unless its duration extends beyond 30 minutes. These
include bonuses gained from effects such as (but not limited
to) Inspiration, Bardic Inspiration, Guidance, Enhance
Ability, and the Lucky feat.
Recovery
Damage to maximum hit points inflicted by surgery recovers
at a rate of 1 class HD + the character's Constitution modifier
per long rest. For example, a Barbarian with a Constitution
score of 18 would recover 1d12 + 4 to their maximum hit
points after a long rest. The Greater Restoration spell cures
this damage to maximum hit points as usual.
Finding a Surgeon
The adventuring party should be able to find surgeons in any
major city with little trouble, though they may not be cheap.
The average surgeon charges 500 gold for a surgery, and the
most skilled surgeons charge up to double that (though for a
higher success rate, it may be worth the money).
Finding a surgeon in a mid-sized town or smaller village is
more difficult. There is a 50% chance an NPC proficient with
surgeons' tools resides in any given mid-sized town, and only
a 10% chance in a smaller village. Even if the party manages
to find someone who knows their way around a scalpel, often
these people are more used to treating injured farm animals
than they are people.
List of Common Surgeries
Below is a collection of standard surgeries that you are able
to perform with a set of surgeons' tools. The specific surgery
required for each different injury is listed in the treatment
area of the Lingering Injuries Tables.
General Surgery
General surgery is the most standard surgery and can be
used for a wide variety of applications. Removing the broken
tip of a weapon from inside someone, stitching back together
a perforated bowel, or removing necrotic tissue so a wound
can properly heal would all be considered General Surgery.
General surgery has no additional rules or requirements
unless they are listed in the treatment section of the injury.
Save Sense Surgery
A Save Sense Surgery attempts to save one of the character's
senses, such as vision or hearing. Reconstructing a slashed
ear or neutralizing acid splashed into an eye are examples of
injuries requiring a Save Sense Surgery.
Sensory structures are generally delicate and small, and as
a result, all one is often able to do is repair the surrounding
area, apply salves and bandages, and hope for the best. As a
result, you may only ever make one surgeon's tool's ability
check for a Save Sense Surgery. If it is not successful on the
very first try, then the surgery was a failure.
After a Save Sense Surgery, characters must wait 1d4 days
before they remove the bandages and dressings to see if the
surgery was successful.
Save Limb Surgery
A Save Limb Surgery is attempted when you want to reverse
damage done to a limb or small appendage. Reattaching a
severed limb, treating an immolated arm, or reconstructing a
crushed leg are all examples of injuries requiring a Save
Limb Surgery.
When a limb is missing, the surgeon is racing against the
clock. Each hour that the limb is considered missing before
the surgery begins increases the DC of the surgery by 1. A
Gentle Repose or Feign Death spell cast on the limb
eliminates this DC increase for their duration.
A limb recovering from this type of surgery is weaker than
normal and takes a penalty similar to if the Resurrection spell
had been cast on it: The limb takes a −4 penalty to all attack
rolls, saving throws, and ability checks requiring its use.
Every time the character finishes a long rest, the penalty is
reduced by 1 until it disappears.
Amputation
Sometimes a body part is beyond saving. Sometimes a
character is bitten in the arm by a werewolf and wants to
prevent lycanthropy by any means necessary. For those
occasions, there is Amputation.
Amputation grants the missing condition to a body part.
Amputation's DC is always 10.
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Example Surgery
Maxwell Says: Now, let me regale you with a story of one of
my first surgeries, the account of how I, the great Maxwell,
saved the arm of one of my good friends, Ferrin the
Barbarian.
Ferrin: Ferrin walks into Maxwell's shop, carrying his
severed arm by the wrist. There's tacky, drying blood coating
the right side of his body. He says, "Maxwell...I got hurt a bit."
Maxwell: "Certainly, certainly!" Maxwell says, clapping his
hands together, "Now, what seems to be the problem?"
Ferrin: Ferrin holds his arm out to Maxwell and attempts
to shrug.
Maxwell: "Ah, of course! That little thing. A paltry issue for
one such as myself. Please, lay yourself down on the table,
make yourself comfortable, and I'll have it fixed up in no time
at all."
Ferrin: Ferrin wastes no time in laying himself down on
the operating table, and sets his severed arm across his
chest.
DM Ferrin came to you as soon as he could, but it took him
an hour to reach you, so that's going to increase the DC of the
Save Limb Surgery from 22 to 23.
Maxwell: "Nothing I can't handle." Maxwell spreads his set
of surgeons' tools out on the tray beside the operating table
and applies an anesthetic to knock out Ferrin for the surgery.
DM: Okay, you're all set to begin. Make a surgeons’ tools
check using Intelligence.
Maxwell: Maxwell rolls an 11 and adds 7 to his roll for a
total of 18.
DM: Not quite good enough to complete the surgery. You've
began to reattach blood vessels, but the surgery is proving to
be trickier than you expected.
(In secret, the DM rolls the Barbarian's HD, 1d12, and gets
a 9. This is subtracted from Ferrin's maximum hit point total
of 40 to get 31.)
Do you want to continue the surgery? The DC has now
increased to 24.
Maxwell: Of course I'll continue!
Maxwell wipes the sweat from his brow and steadies his
scalpel.
He again rolls a surgeons' tools check using Intelligence.
He rolls a 5 and adds 7 for a total of 12.
DM: Uh-oh. Maxwell's nicked an artery and Ferrin is
bleeding profusely. Maxwell spends the majority of that check
attempting to control the bleeding.
(Since Maxwell missed the surgery's DC by more than 10,
Ferrin takes two Barbarian HD, 2d12, of damage to his
maximum hit points. The DM rolls a 3 and a 7, decreasing
Ferrin's maximum hit point total to 21.)
Do you want to keep trying? The DC is now 25.
Maxwell: Maxwell feels a bit concerned about the amount
of blood Ferrin has lost and would like to assess the patient
before he continues.
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DM: Okay, roll a Wisdom (Medicine) check to assess Ferrin.
Maxwell: Maxwell rolls a 16 and adds 4 to his roll, for a
total of 20.
DM: Ferrin is looking a bit pale from blood loss, but he's
still breathing regularly and appears stable.
With that Wisdom (Medicine) check, you know that Ferrin
has 21 hit points left.
Maxwell: "Ha! Still plenty of life left in you yet." Maxwell
continues the surgery.
DM: Okay, since you've split your attention while keeping an
eye on Ferrin's vital signs, you'll make your next surgeons'
tools check with disadvantage.
Maxwell: Maxwell rolls another surgeons’ tools check
using Intelligence. He rolls a 20 and a 16, so with
disadvantage and the 7 he adds, his total comes to 23.
DM: So close! Maxwell continues to stitch the arm back
into place, but his work isn't quite done. The surgery has
been going on for a while at this point though, and Maxwell is
beginning to get a bit fatigued.
(In secret, the DM rolls the Barbarian's HD, 1d12, and gets
a 12. This brings Ferrin's maximum hit point total down to
only 9.)
Do you want to continue the surgery? The DC is at 26 now,
it's getting pretty high.
Maxwell: Maxwell never gives up, he can feel he's getting
close!
Maxwell again rolls a surgeons' tools check using
Intelligence. He rolls a 19 and adds 7 for a total of 26.
DM: Even though Maxwell's fingers are aching and
cramped at this point, he finishes suturing the arm into place.
(In secret, the DM rolls the Barbarian's HD, 1d12, and gets
a 6. This brings Ferrin's maximum hit point total down to just
3.)
As you finish the last stitch you see the sutures shimmer
briefly red as the healing potion imbued in them begins to
dissolve, giving Ferrin's tissue a head start in knitting back
together. The surgery is successful.
Maxwell: Maxwell wipes the blood from his hands and
bends his cramped fingers into a thumbs-up, "Easy as pie."
Maxwell then brings a vial of smelling salts underneath
Ferrin's nose, rousing him back to consciousness.
Ferrin: "Urg...I feel...faint... Maxwell, how much blood did I
just lose?"
DM: Maxwell, you look down and see that you are
practically wading in red. A large pool has spread out from
the operating table.
Ferrin, your maximum hit points are down to 3.
Maxwell: Maxwell gives a nervous chuckle, "A bit, friend,
just a bit. You were never in any real danger."
Ferrin: Ferrin weakly flexes the fingers of his newly
reattached arm, "Well, I guess I can't argue with the results.
I'd give you a high five, but I don't know if I can lift it yet."
Maxwell: "No need, the sentiment is enough. Another
successful surgery for Maxwell Gonzolaz!"
Part 3: Items and Accessibility
M
axwell Says: "Well, my studious
apprentice, you have made it this far,
and so you are deserving of the
explanation for the asterisk on the very
first page of this manual. The bitter
truth is, try and we might, we cannot
save them all. We cannot fix every
injury, every illness, every ill. I lied, and I hope you will forgive
me. Nothing is guaranteed.
"Sometimes a surgery is unsuccessful despite your best
efforts, and you need to resort to other options. There are all
manner of equipments out there that can help get your
patient back on their feet, swinging dragons, slaying swords,
and whatnot. No pupil of mine is going get a complete
education without knowing about all of them."
A Note on Prosthetics
It can be challenging to get used to wearing a
prosthetic limb after a new injury. Some
prosthetics take weeks of practice before they
begin to feel natural. As a DM, you may decide to
not to give your players some of the mechanical
benefits of wearing a prosthetic right away to
reflect this.
Mundane Items
Cane. From a simple stick to an ornate staff, a cane helps
you move about. Canes require one arm to use and allow you
to ignore up to 10 feet of movement penalty caused by a
lingering injury to one leg.
Captains' Hook. This wickedly curved hook has a
reputation for being associated with dastardly pirates. You
may attach this hook in place of a missing hand. While
attached, the hook is a weapon that deals 1d4 piercing
damage and has the light and finesse properties.
Crutches. Crutches are a mobility aid that allows you to
move with the help of their upper body when your lower body
is injured. Crutches require two arms to use and allow you to
ignore any movement penalty caused by a lingering injury.
Ear Trumpet. This item resembles a curled horn. When
you hold the narrow end your ear canal you may ignore any
disadvantage to Wisdom (Perception) checks made to hear
that were caused by a lingering injury.
Ironsights. This delicate crosshair attachment can be
fitted to any crossbow with a DC 15 Tinker's Tools check.
While fitted, you may ignore the penalty to ranged attacks
when one of your eyes is nonfunctional or missing.
Modular Prosthetic. This is a prosthetic attachment with
an empty port at its end that may be attached in place of a
missing arm or hand. The prosthetic's port can be adjusted to
accept any set of tools, from a piton hammer in Climber's Kit
to a bow of a violin. Wearing this prosthetic allows you to use
any set of tools or instrument normally, provided you are
proficient with them.
Shield Strap. This set of leather straps can be affixed to
any shield with a DC 15 Tinker's Tools check. They allow the
shield to be attached to an arm missing a hand or with a
below-the-elbow amputation. A shield with this modification
requires an action to don or doff. While the shield is strapped
to your arm, you have advantage to any checks made to
disarm it.
Simple Arm Prosthetic. This is a prosthetic attachment
with a hook or simple grasping mechanism that may be
attached in place of a missing arm or hand. Wearing this
prosthetic allows you to ignore the penalty to ability checks
normally requiring the use of both arms. This prosthetic may
not be used to make attacks.
Simple Leg Prosthetic. This is a prosthetic attachment
with a simple peg or bent band of metal that may be attached
in place of a missing leg or foot. Wearing this prosthetic
allows you to ignore the movement and Dexterity check
penalties associated with your injury.
Springheel. This gadget of Gnomish make appears to be a
clockwork foot featuring a heavy spring coiled within its heel.
It may be attached to a missing leg or foot where it acts as a
Simple Leg Prosthetic. As an action you may compress the
spring and lock it in place. The next time you make a
Strength (Athletics) ability check to jump, the mechanism
fires, releasing the spring and giving you advantage on this
check.
Strap-In Saddle. This saddle is specifically constructed
for people who have lost the use of their legs and includes
leather straps that secure the rider in place. Mounting and
dismounting this saddle requires an action instead of half of
your movement. You have advantage on Dexterity saving
throws made to prevent being thrown from your mount while
using this saddle.
Surgeons' Tools. This black leather bag contains
everything you'd need to perform surgery, including
anesthetics, scalpels, clamps, bandages, salves, and catgut
sutures imbued with healing potion residue to help speed
healing and prevent infection. Proficiency with these tools
allows you to add your proficiency bonus to any ability check
you make to perform surgery. Proficiency with surgeons' tool
is required to attempt surgery.
Sword Cane This seemingly simple cane houses a thin,
wickedly sharp blade. Normally, this object functions as a
cane. A character may use an object interaction to draw or
sheathe the blade inside. While drawn, it functions as a
rapier (dealing 1d8 piercing damage with the finesse
property). While the blade is drawn, the character does not
get the movement penalty reduction the cane offers.
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Wheelchair. A wheelchair facilitates movement for a
character without the use of one or both legs. Using a
wheelchair allows you to move at your normal speed. While
on initiative, any amount of movement with the wheelchair
requires an object interaction (one object interaction allows
both movement and the dash action). On difficult terrain, your
speed is 10 feet.
White Cane. A white cane is a several foot long cane used
by people who are blind to get a sense of their surroundings.
If a blinded character trains with a white cane for two
months (or a shorter duration at the DM's discretion) they
may use it to gain blindsight out to their reach.
Working Animal. Any animal with an Intelligence of 3 or
greater is capable of being a working animal. These
rigorously trained animals are taught from birth to be highly
attentive to their master and their surroundings. Whenever
you would make a Wisdom (Perception) check you may have
your working animal make the Wisdom (Perception) check
instead. Your working animal can use body language to
communicate non-specific information based on the result of
the check, such as "everything is fine", "be cautious", or
"danger ahead".
New Language: Gestural
Gestural is a silent language conveyed with hand gestures,
body language, and facial expressions. It is used as a form of
communication for creatures of all races who are deaf, mute,
or simply find it easier to communicate without the use of
sound. While different races may have different dialects, as
long as both characters are proficient in Gestural they are able
to understand and converse with each other.
Magical Items
Amulet of the Chimera
Wondrous item, very rare (requires attunement)
This small amulet features a polished green stone that seems
to emit a sickly light. While attuned to this amulet you may
have a character perform a DC 22 Save Limb Surgery to
graft a body part onto you from any creature that shares your
size category. To attempt this surgery, your equivalent body
part must be considered missing.
After one year the new limb becomes permanent. If you
remove the amulet or otherwise unattune from it before that
time, the limb begins to reject and will necrotize and fall off
within 1d6 days.
While you are attuned to this amulet you have disadvantage
on Constitution saving throws made to resist disease.
The amulet emits an Abjuration aura.
Artificer's Prosthesis
Wondrous item, uncommon (requires attunement)
This clockwork limb appears to have additional slots, latches,
and switches along its body. The Artificer's Prosthesis
functions identically to a Prosthetic Limb (TCE pg.134), but
with the following additions:
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Any Artificer may spend a short rest tinkering with this
prosthesis and incorporating up to three light weapons or
small wondrous items into its make. While wearing this
prosthesis you may access these items with a free action and
activate them using a gesture from the prosthesis (using the
weapon or item’s normal action cost).
A non-Artificer incorporating items into this prosthesis
may attempt a DC 20 Tinker's Tools check over a short rest.
On a success, they may incorporate one item.
Corpsmen's Spectacles
Wondrous item, uncommon (requires attunement)
These simple wire spectacles require an object interaction to
take on and off. While worn, the skin of all creatures within
10 feet of you appears invisible, resulting in a clear view of
their muscle and sinew. While this grim view may not be
appropriate for daily wear, it is singularly useful when
treating injuries. While you are wearing these spectacles, you
have advantage on any Wisdom (Medicine) check made to
treat a lingering injury.
Ersatz Ear
Wondrous item, common
This artificial ear replaces one that is missing. The item itself
resembles a small nautilus shell and adheres to your head
when placed just behind the ear. While the ersatz ear is
adhered, it can’t be removed by anyone other than you, and
you can see hear through it as if it were your normal ear.
Ethereal Eye
Wondrous item, very rare (requires attunement)
This small sphere of glass appears to have a ghostly grey fog
undulating within it. If you are missing an eye and imbed it in
that eye socket, the Ethereal Eye allows you to see into the
Ethereal Plane. This sight stops when you close that eye.
Attempting to look into both the Ethereal Plane and the
Material Plane at the same time results in a barrage of
sensory information. Looking into these planes
simultaneously results in you taking 1 psychic damage per
round.
The eye has an aura of divination.
Cloak of Arcane Authority
Wondrous item, rare (requires attunement)
This ostentatiously embroidered cloak was originally used as
an at-a-glance way to display your association with the
arcane. While wearing this cloak you may speak a command
word to hover a few inches above the ground and move at
half your speed. You maintain this speed regardless of any
difficult terrain or movement penalties granted from injuries.
You cannot be knocked prone. This effect continues until you
speak the command word, even if you are unconscious or
incapacitated.
This cloak has an aura of Transmutation.
Fable Fish
Wondrous item, rare (requires attunement)
Oddly, this earring does not resemble a fish at all, but rather
an elongated, yellow teardrop. When you wear it, you
understand any audible speech within 30 feet of you as if
under the effects of a Comprehend Language spell. You
perceive this translated language telepathically.
The Fable Fish has an aura of Divination.
Fire Finger
Wondrous item, common-uncommon (requires attunement)
Fire fingers are the pet project of a (rather eccentric) wizard
who had more than one of her fingers bitten off in an illconceived attempt to breed swamp dragons. These magical
prosthetics attach to your hand in place of a missing finger.
They function identically to the finger while in place,
removing any penalty associated with the missing finger.
Fire fingers may contain the same spells as any wand of
common or uncommon rarity. Casting from the fire finger
merely requires pointing the finger and may be done even
while wielding an item in the same hand.
You can detach or reattach a fire finger as an action, and it
can't be removed against your will. It detaches if you die.
Gift of the Faerie Queen
Wondrous item, very rare (requires attunement)
This item, unnervingly, resembles an eyeball with a dark
purple iris down to the smallest detail (including a slightly
moist feeling). It functions identically to an Ersatz Eye (XGE
pg.137), but with the following additions:
While removed, you may use concentration to see through
the eye. If at any time you are on a different plane as the
eyeball, this effect continues to function for 1d6 days before
you are unattuned.
Gift of the Merfolk King
Wondrous item, very rare (requires attunement)
This item resembles a simple, innocuous looking seashell. It
functions identically to an Ersatz Ear, but with the following
additions:
While removed, you may use concentration to hear through
the seashell. If at any time you are on a different plane as the
seashell, this effect continues to function for 1d6 days before
you are unattuned.
Gloves of Signing
Wondrous item, common
These thin leather gloves have red stitching that appears to
shimmer softly as the fingers of the glove move. If you are
proficient in Gestural and sign using these gloves, the gloves
translate the gestures into Common. This 'speech' retains the
intended emphasis, volume, and tone of your signing.
You may use this 'speech' as the verbal component for your
spellcasting.
These gloves emit a faint aura of Illusion.
The Legerde-Main
Wondrous item, uncommon
The Legerde-Main resembles a half foot diameter bowl
engraved with arcane runes and sigils. If you hold the bowl to
an end of a missing arm or hand, it adheres and shrinks to
cup the area. A spectral hand then appears, similar to the
Mage Hand cantrip.
This hand hovers in place of where your hand would be,
and you may move it within your arm's reach at will. It can
only attack with light weapons, cannot activate magic items,
and can only carry up to 20 pounds. An unarmed attack with
this hand deals Force damage instead of Bludgeoning
damage.
You can detach or reattach it as an action, and it can't be
removed against your will. It detaches if you die.
Periapt of the Third Eye
Wondrous item, common (requires attunement)
This pink pearl on a thin silver chain is designed to sit in the
middle of your forehead. You may attune to it by painting a
small dot the same colour as your eyes onto the pearl. While
wearing the periapt you may open a telepathic link with one
creature at a time, allowing you to send and receive thoughts
in any language you understand. This telepathic link
functions out to a range of 30 feet.
Seeds of the Serene Druid
Wondrous item, rare (requires attunement)
These small seeds always occur in pairs within an iridescent
purple shell. The seeds are attuned to when one is placed in
each of your ears. Over a 24 hour period, small vines sprout
from these seeds, wrapping around your ears and sprouting
delicate, green leaves. While you are attuned to the seeds,
your hearing is considered nonfunctional and you are
deafened.
Through the vines in your left ear, you may understand
animals as if permanently under the effects of a Speak with
Animals spell. Through the vines in your right ear, you may
understand plants as if permanently under the effects of a
Speak with Plants spell. You may communicate freely with
both plants and animals as described in the respective spells.
You may unattune from the seeds by pulling the vines from
your ears. Your normal hearing is restored, but the plants die
within seconds if one or both are removed.
The Tremblestick
Wondrous item, rare (requires attunement)
This thin, three-foot-long rod appears to be made of a smooth
black metal and resonates with a subtle vibration when
touched to the ground. If you are blinded and hold the
Tremblestick to the ground, you gain blindsight in a 30 foot
radius. In addition, the rod vibrates rhythmically in response
to impending attacks, warning you and giving a +2 bonus to
your AC.
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Maxwell's Farewell
W
ell, my pupil, you've been burning the midnight
oil at both ends, and ol' Hacks-Well is proud of
you. Open the back packet of this manual to
find enclosed your honorary graduation
scalpel. It is my sincere hope that while using
it you are fondly reminded of our time
together.
If I leave you with one thing, I want it to be a deep instilled
feeling that it is worth it to help others. Both crutches and
kind words can help people get back on their feet. Giving a
person their hearing back means nothing if you're not willing
to listen to them. And finally, if I ever find out you've turned
down a child because they can't pay for treatment, I will
personally hunt you down and beat you with my Surgical
Stick (patent pending).
Good wishes, good tidings, and may your injuries never be
greater than the strength of your will.
Related Items and Media:
Ersatz Eye - a magical prosthetic eye (XGE pg. 137)
Prosthetic Limb - a magical prosthetic limb (TCE pg. 134)
Combat Wheelchair - an all-in-one wheelchair for
adventuring and combat Click here
Archmage Hegis' Arcane Prosthesis - an accessibility
related module Click here
Disabilities, Prosthetics, and Guide Animals - an
accessibility related module Click here
Inclusive Game Spaces - a module related to inclusivity
(including disability) in gaming spaces Click here
A Note from the Author
I hope you enjoyed Maxwell's Manual of Malicious
Maladies, it has been a project of mine for quite a
while and nothing would be more rewarding to me
than to know people are using it and enjoying it.
If you have any particularly notable stories, I would
love to hear them. Email me at
maxwellsmanual@gmail.com with stories,
thoughts, comments, or just a kind word.
Happy adventuring!
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