Injury and Dismemberment

Disclaimer: all homebrew is subject to alteration at my discretion. By all means come to me with suggestions and criticism if you have them.

Disclaimer 2: out of all the homebrew systems, this one is almost entirely my own, so the above disclaimer applies doubly.

I used to be an adventurer like you…

I want to emphasise that the adventuring life takes its toll on people. As a result, this injury system adds extra penalties for you when you come close to death. Most of these injuries can only be healed during downtime. I’m also considering a mental trauma system a la Darkest Dungeon, but we’ve got enough to be getting on with for now.

So, without further ado:

Injury and Dismemberment

Whenever you fall unconscious, roll a d20, and record the results. Alternatively, you can present an item you are holding, such as a shield or weapon, to take the blow instead. That item is immediately damaged (see below), and you do not take an injury from that attack, though you still take the damage.

Unless otherwise specified, you can heal injuries with powerful magic such as greater restoration or regeneration, or you can recuperate in town. Alternatively, if you reach full health during a short or long rest and have used at least one hit dice, you or an ally can roll a Wisdom (Medicine), or Wisdom or Intelligence (Herbalism Kit) check. The DC for the check is 10 + 5 for every death save you failed before stabilising/reviving.

Injury table.

1-2 – Mutilation - A limb is badly damaged, possibly beyond conventional healing. Record the damage of the injuring blow, and roll a d6:

1-2 – Eye – you are at disadvantage on Wisdom (Perception) checks that rely on sight. In addition, all weapon ranged attacks are at disadvantage for the first range increment, and you cannot target a creature within the second range increment. Ranged spell attacks are at disadvantage,and all spells and have their effective range halved. If this happens twice you are blinded.

3-4 – hand/arm – you cannot use that hand (which one is your choice), you are at disadvantage on checks that require two hands to carry out, and you can only hold one object at a time.

5-6 – foot/leg – your speed on foot is halved, or reduced by 1/3rd if you have a crutch, cane or some other prosthesis. You fall prone after using the dash action. You have disadvantage on rolls made to dodge and balance.

Over the course of a short rest, you or an ally can examine the injury to determine if it is permanent or healable. Roll a Wisdom (Medicine), or Wisdom or Intelligence (Herbalism Kit) check with a DC equal to 5 + half the damage of the injuring blow, or 10, whichever’s higher. On a success, the injury can be treated like any other. On a failure, the injury is permanent and can only be healed by powerful magic such as the regenerate spell. You cannot heal this injury until its permanency has been established.

3-5 – Internal Injuryonly a creeping black bruise belies the seriousness of this wound. You have heavy internal bleeding, or damaged internal organs. Until this injury is cured, you are at disadvantage on all death saving throws and saving throws to resist exhaustion.

6 – Critical injurySevere blunt trauma, flash-freezing, full thickness burns, severed ligaments, gut wound – You lose a d6 from your lowest ability score.

7-8 – Acute injury  - sloughing acidic burns, patches of necrosis, significant bone fractures, nerve damage – You lose a d4 from your lowest ability score.

9 – Serious injuryresidual poison, fractured ribs, embedded arrowheads, teeth or weapon shards, frostbite; You lose a d6 from your highest ability score.

10-11 – Major Injury significant bleeding, concussion, bruised bones – You lose a d4 from your highest ability score.

12-14 – Windedthe blow isn’t fatal, but it leaves you shaken and keenly aware of your own mortality. You gain a point of exhaustion. This can be cured in the normal manner.

15-16 – Broken itemyour equipment took the brunt of the blow, but was it worth the cost? The item you most recently used, or an item you are wearing, is broken (see below for repair rules). Record the damage of the damaging attack.

17-20 – Minor injury‘tis but a scratch! – no additional effect.


Note: ability score loss.

Loss affects your score, not your modifier, and has a knock-on effect on your dependent abilities. Reduction to 0 renders you unconscious, and you cannot become conscious again until that score is raised above 0.

Note: Magic item durability.

Magic items are resistant to harm, but they are not unbreakable. If a magic item is targeted by this rule, then mark that it’s damaged. Magic items can be damaged a certain number of times before they’re broken, dependent on their rarity:

Common/uncommon/rare – once

Very rare- twice

Legendary – three times

Note: repairing items

Over the course of a short rest, you can make an Intelligence, Wisdom or Dexterity check with the relevant toolset to attempt to repair a broken item. The DC is equivalent to 5 + half the damage of the damaging blow, or 10, whichever’s higher. If the check fails, then the item is permanently broken. Alternatively, you can give the damaged equipment to someone in town who can repair it for a fee.

Magic items require proficiency in both Arcana and the relevant toolset. Getting someone else to repair them will probably be the source of an adventure in itself. NB: This is a placeholder.


Appendix: Design notes

These injuries are meant to be debilitating but manageable, 'cos this system is swingy and I want the players to be hurt by bad decisions while insulating them from consistent bad dice rolls. I want the point of urgency for decision-making to be "I'm getting low" not "I'm unconscious". I want this to happen at most twice a session, and for it to be conceivable to go a whole session without injury occurring.

Out of the injury results, 20% are a Hail Mary reprieve,  35% require/encourage resting, which the players are more likely to want to do immediately, while the other 45% encourage retreat, which I hope is more likely to be viewed as a last resort. This will be put into tension by the wandering monster and exploration mechanics (COMING SOON!).

Ability score reduction doesn't appear that much in 5e, and it's something I'm interested in seeing in operation. Hopefully it won't slow down play too much while the damaged player re-calculates their dependent stats.

In addition, hopefully the item damage mechanic is significant without being too punishing – I'm assuming that the most likely candidates for destruction are weapons and armour – the design conceit here is that injury damages the character, not necessarily the person.

Injury and Dismemberment

Interregnum bewilderbeast