Keh'mania

"You've got a keh'mania in you!"
~Common Maecodian parental expression of frustration with a child.
Bile dolls are created and distributed by Night Hags. The Hags will become invisible and ethereal, and creep into the bedchamber of a newly pregnant woman or the location of a freshly laid egg. There, they will implant the doll into the new life, as a seed of evil, the source of violent madness later in life, and the stain on a fresh soul. Souls so tainted are, interestingly enough, supposedly gifted with intelligence and cunning as well as a connection to magic, though this last may be propaganda by the College of Questions and similar, older organizations.
Why they do this and what they get out of it are a mystery.
If a Night Hag is slain (a difficult and rare occurrence) and a bile doll is found on them, it has a number of uses. It can be used as a powerful arcane focus, it can be consumed by the brave or depraved in order to gain intelligence or magic ability, and it can be used in the crafting of mighty (evil) magical items.

Manufacturing process

Wretched souls are boiled in the cauldron by a coven of Night Hags. These souls take days to melt in the brackish water, and they experience every moment of it. The torment is part of the process, and Hags will throw in acid or bile occasionally if they feel the souls aren't suffering enough. The souls in the cauldron melt together, losing their senses of identity, until they cannot even distinguish themselves from the screaming soul-flesh broth around them.
They are then ladled into iron molds of roughly humanoid shape into keh'mania (sometimes colloquially known as Bile Dolls). When the flesh solidifies in the mold, they are peeled out and placed in the Night Hags' sacks for distribution.

Significance

Night Hags smelt wretched souls into keh'mania before depositing them into freshly conceived children as a seed of darkness or insanity.

Item type

Magical

Rarity

To find a physical keh'mania generally means one has slain a Night Hag; no easy feat. They are Very Rare.

Weight

.5 lbs

Raw materials & Components

Wretched souls, the putrid and stagnant water of the Shadowfell, and ill intentions.

Tools

A Night Hag's cauldron

Bile Doll

Wondrous Item

Very Rare Necromancy

Also called a Keh'mania, this doll is no child's toy. It is made of an ashen gray clay, and while completely hairless it still bears the all too realistic face of someone who has died. This face strains silently against the cinnabar wire sewing its mouth shut, and it slowly writhes and wriggles in constant agony. Most recognizable are the eyes - the same it had in life, which roll in horror at its surroundings.

This item contains the wretched soul of a dead, sentient evil being usually made by Night Hags in the Shadowfell. Night Hags place them into unborn children as a seed of evil, where they bond into the child's soul. The child becomes more powerful, possibly inheriting a connection to magic or greater physical prowess, but will always feel their vices stronger.

In the hands of mortals, and presumably in the hands of hags, these dolls have other uses as well; they can be consumed to power a spell, 'traded' for a life (mimicking the Revivify spell, with the doll taking the place of the material cost), creating a small area of Taint, consumed, used to make the most powerful health potions, used to create a Slithering Tracker, as a shortcut to costs and time in enchanting, and traded to Night Hags as a commodity. While other uses perhaps exist, they are less known even among the sages that would know of this spell in the first place. Each use takes one full action, and the doll is consumed in the process.

Component

If consumed in the course of casting a spell, the spell has the following riders: The casting time becomes at least 1 full round if it was less before. All damage done by the spell now does half its damage (rounded down) as necrotic damage. If the spell required concentration, it can now persist 1d4 rounds after concentration is broken. Both the target of the spell and the caster of the spell must roll a Charisma save against the caster's DC or acquire Taint. 

Additionally, there is a 5% chance that the spell will become a Living Spell and attack the target until they or it are destroyed, and then become free willed and hostile entity. If the spell had no specific target, then it immediately becomes free willed and hostile to all life.

Revive

By entreating death to take the trapped soul instead of a freshly dead creature, the user of the Bile Doll can mimic the Revivify spell with the following changes: The doll replaces the material components, the revived creature comes back with a random short term madness, and the revived creature is immediately familiar to any Night Hag that they come across in the future.

Consume

By physically eating the bile doll, the soul inside can be consumed. The consumer must make a Constitution save DC 17. If they fail, they become horribly nauseous, unable to hold down food of any kind for 2d12 hours, after which they may roll again to end the effect. It is possible to starve to death in this fashion. 

If the consumer makes the first save, they successfully devour the soul. This confers the following temporary benefits: They can recall vague memories once possessed by the soul for ten minutes before their personality is completely subsumed. They can use the soul they have consumed to regain a spell slot (if they cast spells) or 2d12 temporary hit points.

Consuming also confers one of the following permanent benefits (consumer's choice): One point in any Ability Score (maximum 20), proficiency in a skill possessed by the soul, or Darkvision.

Finally, consuming the doll also confers the following permanent penalties: The consumer gains Taint, they gain an indefinite madness, and their skin becomes sallow and ashen. 

Potionmaking

With a recipe and an alchemy kit, the bile doll can be used to make the strongest health potions (Superior and Supreme) at half the normal cost. Potions made with bile dolls can go terribly wrong; at the end of the process, the alchemist must roll a DC 16 Intelligence check with the Alchemist Supplies.

If they succeed, they make the potion with the following rider: The consumer of this potion gains Taint. 

If they fail, not only does consuming the potion gain Taint but the potion also does necrotic damage in the amount that it should heal. 

These two results are indistinguishable from each other, though a process that costs 100 GP in alchemist's supplies can identify which result was achieved.

Slithering Tracker

Implanting the bile doll into a dead body and whispering the name of a target over and over again causes the confused and traumatized soul in the doll to become a Slithering Tracker, pulling itself out of the corpse and seeking out the target. The ritualist who initiates this metamorphosis has no further control of the Slithering Tracker, it becomes free willed after its mission has been accomplished.

Enchanting

By working a bile doll into an object while it is being created, its connection to magic is immediately increased and a skilled craftsman can use that to work magic into the very materials. Doing so halves the cost in time and materials of enchanting. The item now gives off an aura of necromancy, and the item has an Ego of 2d6, and wishes to blindly do harm.

Trade

While black market fences can sometimes move bile dolls if they're so inclined, the only reliable recipient of bile dolls are Night Hags. Just expressing a desire to trade within earshot of the doll will get the nearest Night Hag's attention, and they will likely appear to make a trade. They cannot take the doll by force, but they are also not obligated to make the trade if they find the holders of the doll to be unreasonable.

Additionally, each month the doll is possessed has a 5% chance of attracting the attention of a Night Hag on its own.

Cost: Priceless (Illegal)
Weight: .5 lbs