House Rules - Wounds

Adventuring is dangerous business. Okay, sure, they're trained for it. They might even be heroes - but it doesn't change the fact that getting swung at with swords and axes, shot at with arrows and bolts, blasted with fire and ice, or just plain devoured by enormous beasts is not at all good for life expectancy. While many attacks will just graze the heroes, drawing beads of blood or leaving stinging welts, sometimes more permanent damage is inflicted.

The wound system detailed here is an addendum to the 4E D&D hit point system. Where hit points model a sort of vitality, "fighting trim" of the characters, and healing surges represent their day-long staying power, neither does a particularly good job of modeling true harm. For some games, that's a sort of over-the-top heroism - characters back on their feet from vicious brawls in minutes, and hours at the most. For other games, time spent recovering from rough fights, and sometimes pushing on despite bruises, breaks, and pains, is more appropriate to the feel that's trying to be established.

To be clear, this wound system does not mean that hit point damage never represents any injury. What it means is that hit point damage represents minor, generally insignificant injuries. Cuts, scrapes, bruises, singed skin, and the like, but nothing that a determined adventurer can't ignore with a few minutes of effort. This is important to note, especially in the case of effects such as poison that obviously require a character to be injured for the effect to enter the bloodstream - that still happens. If the character only suffers hit point damage, and no wound, then it was just a shallow cut that let the effect in, and so forth.

Wound Overview

The wound system works much like the disease system from the core rules. Over time, characters may make an endurance check in order to heal the injury. Each wound has two DCs listed - one to improve the condition, and one to maintain. If the character fails to meet either DC, the wound worsens, moving him down the wound track. Endurance checks are usually made once per wound during an extended rest, but some wounds may specify a longer (or shorter) period between checks.

Another character may chose to aid an injured individual, making a Heal check that replaces the Endurance check. It is important to note, however, that the Heal check replaces the Endurance check even if the Endurance check would be greater - an incompetent healer sometimes makes things worse, after all! On the other hand, if the character also makes a successful Endurance check to at least maintain the wound, it provides a +2 bonus to the Heal check - a strong-willed patient often recovers quicker.

In addition to replacing the Endurance check, using the Heal skill sometimes has other benefits - it can mitigate the effects of supremely dangerous wounds if used quickly, and trained medics may be able to hasten the recovery period for a wound. Any time you receive first-aid immediately following a combat, a successful Heal check against the maintain DC provides a +2 bonus to your first recovery check. Increase this bonus to +4 if the Heal check hits the improve DC.

Ways to Incur Wounds

The primary method of incurring a wound is Heroic Effort. Putting the ball in the player's court, a character can choose to gain a wound at any time, as long as he or she is currently bloodied. This is more of a meta-situation - the character isn't chosing to become wounded, the player is. In this case, the character immediately suffers a wound of the DM's choice, with its severity based on the character's current hit points. If the character is bloodied, the wound is moderate - if the character has fallen unconscious, it is a significant wound, and if the character would otherwise die (negative their bloodied value), then the wound is severe. When a character takes a wound, they may immediately spend a healing surge as a free action to regain hit points, even if they have no healing surges remaining.

Extraordinary Circumstances: This is, frankly, a nicer way to say "DM fiat". Situations where the PCs are working outside the rules may involve wounds being assigned when there's otherwise no hit point damage. A captive PC may have his arm broken, for instance, or one who falls 80 feet may break several ribs and shatter a leg. These situations should be few and far between, but they can happen.

Dangerous Monsters: Most attacks don't cause permanent injuries to the heroes. They're heroes, after all. That said, there are opponents out there of similar skill and drive as the heroes, and those enemies are sometimes capable of causing significant damage. Whenever a monster spends an action point, if the action granted by that action point knocks a character into the bloodied condition, he may be wounded. Roll an immediate saving throw with a +8 bonus - if the save fails, the character must take a wound. If the action granted by the action point knocks a character unconscious, make the save with only a +4 bonus.

Living with Wounds

Once a character has incurred a wound, dealing with it is something that will be an issue for some time. Immediate medical care is always helpful, but usually takes at least 10 minutes to perform. If a Heal check at the listed Improve DC for a wound is made immediately following an encounter in which a wound is taken, the wound immediately moves up one step on the condition track. Endurance cannot be used to improve a wound in this fashion.

Many wounds list an aggravation trigger - some action that requires an immediate Endurance check at the listed DC. On a failed check, the wound immediately moves down one stage on the condition track. Aggravation checks happen immediately upon triggered, do not use an action, and cannot be aided.

Finally, there are several rituals, including Mend Flesh and Mend Injury, that can be used to magically provided accelerated treatment.