Wounds & Damage Types

 Today I'm thinking about damage types and Wounds and Exhaustion and Stress.

Exhaustion and Stress we'll leave for another time.

Diegetically Derived Debuffs

So I'm kicking around the old thought-ball. Brain's on what happens when a character hits 0 HP. People complain about yoyoing dying characters back from the brink, Healing Word and all that, so... What if it really sucked to hit zero?

Other fixes I've seen impose Exhaustion, but as I said, we're leaving Exhaustion for a different day, except to say this:

5e has this nice little Exhaustion mechanic that kind of sucks to use. Like everything else about that system, it's expected to be a catch-all. An uncomplicated, barebones way to give player characters a debuff for exerting themselves or fighting the elements. It factors into the "exploration pillar" and doesn't really show up otherwise. But it does have a neat effect:

If you get 6 levels of Exhaustion, you die.

I like that.

So instead of Exhaustion, we'll take that rule and apply it to Wounds. Wounds are what happen when you hit 0 HP. You fall unconscious, you begin dying, and you roll a Wound. Get six: die.

Or, you would roll a Wound, if I weren't obsessed with making the fiction match the mechanics. Instead, I thought today I'd come up with narratively appropriate Wounds for each damage type. That way when your character hits zero from burning hands, it hits different than when you eat a glaive to the face. 

Treating Wounds is the concern of those proficient in Medicine. Herbalists and alchemists can make potions and supplies which aid in the care of the wounded, but patching someone up takes skill.

(I'm sick of the Medicine skill being a wasted investment in 5e.)

Once a Wound is treated, it remains on your character until healed but doesn't impose its debuff unless the Wound reopens, which can happen when you take a critical hit. Healing a Wound happens when you finish a long rest, but you can heal more than one if you receive medical care during that long rest.

Disclaimer: These aren't meant to be perfect representations of real life medical conditions. They're here to make almost dying suck and be meaningful.

Physical Damage

Bludgeoning

• Broken ribs. Your maximum Bulk is halved and you have disadvantage on attack rolls.
• Internal bleeding. If you move and use your Action in the same turn, you take 1d4 damage.
• Concussion. Any time you make an attack or are hit by an attack, there is a 1-in-10 chance that you fall unconscious for 1 minute or until roused.

Slashing

• Lame arm. One of your arms is nonfunctional and cannot be used to wield or manipulate anything.
• Hamstrung. Your movement speed is halved.
• Wicked gash. Any time you make an attack or are hit by an attack, there is a 1-in-6 chance that you begin to Bleed, as the condition.

Piercing

• Rattling Breath. You cannot Dash or use your Bonus Action.
• Bleeder. Every hour, save vs. DC 12 Constitution or take 1d4 damage.
• Septic. You have a fever and suffer 1d4 levels of Exhaustion which cannot be removed until your Wound is treated.

This is pretty good start. These suck! I wouldn't want to suffer any of them and I know my players wouldn't either. 

I wouldn't say I want risk averse player characters, but I do want cautious ones. These Wounds help reinforce that level of caution.