320 Healing

That’s awesome, and very much like the leveling mechanic in The Black Hack. You have to carouse and share one or more stories about your PC’s past to hit that new level.

This topic was a weird one for me, because it seems pretty dialed in on just the D&D experience. I like all sorts of damage / healing systems, depending on what game I’m playing and what fiction or genre I’m trying to emulate. (Magic healing is frankly one of the things that drove me away from D&D, decades ago. I’m a low fantasy grunt at heart.)

Anyway, some of my favorites:

Barbarians of Lemuria has an excellent, fairly gritty system that models the hit points abstraction that D&D goes for in a more sensible way, IMHO:

  • Characters have a Lifeblood score of 10 + Str (0-3)
  • Weapons deal, on average, 1d6 damage. Armor reduces damage.
  • After a combat, participants can take a knee and recover up to half of the Lifeblood that they lost.
  • Each night of good rest, get back 1 Lifeblood
  • Death is at -5 Lifeblood, and if you’re below 0, you’re losing 1 per round. You’re dying, and this can only be prevented by your friends helping, the Gods intervening, or spending a Hero Point.

Into the Odd and it’s offspring (Electric Bastionland, Mausritter, etc.) have very cool mechanics where characters have relatively few HP… and where the “HP” actually means “Hit Protection” in the latest incarnations of those games. Once those are gone, damage goes straight to your STR attribute and you have to make a save to avoid a critical injury every time you take a hit. HPs return right after the battle, but it takes a long time to heal attribute damage. (A week, if memory serves.) So you have a buffer, then is gets serious, fast.

In general, I don’t think any system can touch Fate for realism, since ‘Consequences’ can model any kind of injury – mental, physical, social or spiritual, and it can take a long time to recover from these, depending of if they are Mild, Moderate, or Severe. Mild clears after one scene, Moderate after one session, Severe only after a milestone, which might mean “the whole adventure.” I also highly recommend the optional Extreme Consequences, which forever change the character (and one of their aspects). Basically, “you live, but…”

If you limit the conversation to D&D-styled play, I agree with Warden and a few others upthread – ask how do you want the game to feel? Dangerous but heoric fantasy vs. gritty OSR play vs. epic heroes bristling with healing magic who never need to worry about injuries. Very different styles, even within the same overall game.


I really like the mechanics that you describe in Into the Odd. Those are smart. Does AC factor into that system, too? Armor class + hit protection?

It surely does not, @Gabe !

Into the Odd and its more refined successor Electric Bastionland lean hard into speeding play, into allowing the PCs to do things without a roll if they are playing smartly, and in marking the rolls that do happen really matter.

There are really just two types of rolls – Saves, which are based off one of three stats and are intended to prevent something bad happening to you, and attacks… which are straight-up damage rolls based on the weapon you’re using. It’s usually a d6, a d8 or the like, but if you’re impaired for some reason, you have a d4. If your attack should be particularly effective, you roll a d12. The effectiveness of your attack is wholly determined in one go with your damage roll.

It takes some wrapping your head around, but it means combats are fast and dangerous. In play (I’ve played EB exactly once), I really liked it.

The other neat element that factors into the equation in EB is that the only way to increase your hit protection is to be reduced to exactly 0 HP. That gives your a ‘scar’ and you consult a table to find out what form it takes. Some of those entries actually add to your total HP… so you get tougher by surviving your wounds. Love it.


How do we sign up for the Eberron give away?

@sean and he’ll tell you!

That’s a game that is on my list to check out - might have to snag a PDF of it. I keep hearing interesting things whenever it comes up

It’s a goodie. If you dig swords and sorcery, definitely check it out. The Lemuria bit is optional – it’s very adaptable and does any type of S&S very well. You could easily connect it to Hyborian Age stuff pretty easily. There are fan hacks and such out there, including a very cool end-of-Norse-days campaign called Fjarrstrand. Page is here, PDF that uses BoL rules here.

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Sweet - thank you!

Here you go @GrinReaper


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Thank you sir.

Thanks to @sean and @Fafhrd for reading this one on the latest episode. I didn’t realize how good this is when I originally read it in the thread. I kept rewinding 10 sec. to capture all the details. This is brilliant! I started a file for all the Homebrew ideas I get from this forum and this idea is going right up there with no uncommon races! :+1:

I think that healing is a really personal thing that is dictated by past experience.

For me, I can’t stand how a character can potentially just spend an hour and regain all his HPs in 5E. I have a high tolerance for pain and a stab wound in the shoulder takes at least three days before you can do anything of value with that arm! And that’s with proper medical treatment!

(I wasn’t stabbed BTW. :smile: I have a heart birth defect so I have a pacemaker that needs to be changed every 7-12 years. I’m on my third. The operation is basically a 2 inch incision in the shoulder which is as close to a stab wound as you can get.)

Of course, I’m not looking for exact representation. But if I’m going to play a real human (or humanoid) just give me Indiana Jones / Aragorn toughness. Not Spider-Man super healing.

Also, I’d love to try a system where your fighting abilities diminish with the accumulation of wounds/exhaustion. This would create a real effect of suspense where a fight would become more and more difficult towards the end. (I know it exists, I just can’ remember where I’ve seen it)

On the other hand, it would drag fights out. Plus, if it was going to be fair, the monsters/NPCs would also have to be affected by this mechanic. And that’s most likely additional work for the DM who is already busy enough, IMO.


To clarify, RAW state that one hour of rest is a short rest, and the PC can only regain full HP with an 8 hr (long) rest.

While I’m sometimes not hip on that, I can see 1 hr of rest per HD they want to spend…

Thanks, @Judge_Mathieu! I can’t claim credit for this house rule (it’s from Into the Unknown), but I agree that it feels like a good way to add more gritty healing rules.

With regards to consequences: A couple of folks on the chat mentioned the idea of adding 1 level of exhaustion when a character drops to 0 HP. Possibly give them a chance to do a CON save first. That would add some tangible consequences, so may be worth experimenting with. I believe @huscarl may also be experimenting with some variation on this.

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We all know there are many, but two that come immediately to mind are Rolemaster, which probably provides the genesis of the now common term “death spiral,” and what I’ve been playing the most recently, Conan 2d20. In this latter, each Wound causes the Difficulty of physical tests to go up by one each (there is something commensurate for mental Trauma).

As far as it dragging out fights… I know we’ve hashed this to death, but an actual option for a PC is to try to run away or sue for peace. I recognize that this PC Action is less common in D&D, again because this approach is a form of “failure.”

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Hey @digitalhobbit,

Yes I have a “HOOS rule” below. I may amend it with your CON save suggestion. Since I implemented the rule only 6 hours of games time has elapsed, so I don’t have any feedback yet. I think that it adds a level of grit to 5e. The remaining HP thresholds are a little arbitrary and may be confusing, but I used the language that 5e uses to discuss going to ZERO HPs. I contemplated doing a percentage of Max HPs below ZERO, but some people have problems with math…

My HOOS Rule
Recovery and Healing & Dropping to 0 Hit Points
Level 1-4: no special rules
Level 5+: If a PC is rendered unconscious they will immediately suffer levels of exhaustion based on remaining hit points after being reduced to zero. See tables below.
Remaining Hit Points Effects 5th - 12th Levels
• 1-4 2 levels of exhaustion
• 5-9 3 levels of exhaustion
• 10+ 4 levels of exhaustion
Remaining Hit Points Effects 13th - 20th Levels
• 1-3 2 levels of exhaustion
• 4-6 3 levels of exhaustion
• 7-11 4 levels of exhaustion
• 12+ 5 levels of exhaustion

To recover levels of exhaustion you must complete a long rest to remove 1 level. To remove 2 levels takes 2 long rests, no more than 1 long rest can be done in a single 24 hour period.


What does this phrase mean? If your HP are at 0, you have no remaining hit points, right?

Do you mean “negative hp value?” What about hits after being dropped to 0? Does the negative HP max still apply, is it cumulative? Savings throws remain the same?

As I read this, going to -1 HP means taking 2 levels of exhaustion. Pretty brutal - has anyone in your game over 5th level had to deal with these effects yet?

BTW, you could state it in negative HD size increments instead of percentage.

Forbidden Lands does this in spades, FYI for all those who just picked it up…

I introduced some altered rules around hitpoints, damage and healing to add a little more tension to combat and address some of the things raised on the podcast. As said on the pod, players approached fights with a certain amount of recklessness knowing they had a big cushion of HP, and also took for granted violence was always the answer. It felt like a video game. So I added a little spice to the normal 5e rules.

Health points.

While hit points are an abstraction of fatigue, morale, getting battered, endurance etc, Health points are physical health. Characters only get 10+CON, and it never changes. When you run our of Hit Points, it piles onto to Health points. Also, critical hits do not to double damage or anything, it simply gets applied directly to Health points. That means combat can go south at any time with a good hit, which really added tension to combat.


Healing spells work as normal on hitpoints, but only heal the spell level in damage to Wound points during combat - so they are far less effective. Outside of combat, healing spells do normal healing to Wound points, but it takes as long as a ritual.

Since these changes rely on the existing 5e rules it was easy for everyone to adapt, and it really added tension! The players approached fights with a bit more thought knowing that their huge numbers of HP wouldn’t matter against a skilled (ie. lucky) opponent.

However - it only lasted two sessions. The players decided they actually liked the recklessness and video game feel that comes with 5e, and preferred it to the more tense approach!



Alot of this is fun for me to read and warp, as I have to think about house rules moving to other systems. I don’t run 5e, but many of the concepts can rhyme

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Sorry for the delay in responding. I was attempting to write up the rule using the language of 5e. I realize that this language is clunky, but 5e does not talk about negative HPs. That line would be clearer if it reads, “remaining damage after being reduced to zero.”

Yes, 2 levels of exhaustion. My thinking is that if you are rendered unconscious from a beating it will take at least 2 days (2 long rests) to recuperate.

We have 2 party members who have dealt with this. One had 2 levels of exhaustion and he recovered over 2 longs rests. The other had 4 after falling 60 feet and surviving. He is currently at 2 levels after doing 1 long rest and the life cleric using his channel divinity and prayer to remove a level.

My goal in this is to make combat have consequences if characters go down and remove some magic from healing. One thing about 5e that I find too fantastical is the base assumption that you long rest and you are full health.

I am not sure I grok the HD size increments. Can you elaborate?

Semper Fidelis & Good Gaming

I also really like the @digitalhobbit’s idea of Death Saves not going away easily as mentioned in the episode on Codified Rules in RPG’s. I may add that to my house rules. My initial thoughts are long rest can clear an exhaustion level or a death save, but not both.