DISEASE RULESET

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Disease Ruleset

How Diseases Are Contracted

Diseases may be contracted when characters are exposed to dangerous conditions such as:

Bites & Scratches: From infected beasts, vermin, undead, or fiends.

Contaminated Food or Water: Drinking tainted water, spoiled food, or blood.

Environmental Exposure: Wading through swamps, sewage, plague pits, or cursed ruins.

Contact with the Dead: Handling corpses, rotting matter, or blood-soaked remains.

Magical Contamination: Ley-tainted areas, eldritch growths, or cursed relics.

Whenever a player is exposed, the DM may call for a Disease Roll.

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Disease Roll

Roll a d20.

On a 1–5 → Disease check triggers.

On a 6–20 → No disease (unless DM overrides for high-risk situations).

If a disease check triggers:

DM chooses a fitting disease, or

Rolls on the appropriate table (Lesser, Moderate, Major, Deadly, Lifelong).

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Disease Levels

Each level represents severity, duration, and difficulty to treat.
When rolling, match the situation’s danger to the disease level:

Lesser – Minor illnesses, easy recovery.

Moderate – Serious sickness, requires treatment.

Major – Disabling, long-lasting, can kill if untreated.

Deadly – High fatality, magical or virulent.

Lifelong – Permanent afflictions, curses, or degenerative plagues.

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Disease Tables

Curing Diseases

Lesser: Natural rest, herbs, clean food/water (1d4 days).

Moderate: Requires medicine or healing magic.

Major: Demands powerful cleric aid, rare herbs, or ritual cleansing.

Deadly: Requires rare relics, holy sites, or ley-aligned cures.

Lifelong: Cannot be cured; may only be managed or slowed.

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Lesser Diseases

Roll	Name	Effect	Duration	Contagion	Cure
1	Mild Fever	Disadvantage on CON checks	1d4 days	Close contact	Rest, water, herbs
2	Skin Rash	-1 AC	1d6 days	Contact with infected	Herbal wash
3	Food Poisoning	-1 STR, -1 DEX	1d4 days	Tainted food/water	Charcoal, medicine
4	Coughing Illness	-2 Stealth checks	1d6 days	Airborne	Rest, warmth
5	Ear Infection	Disadvantage on Perception (hearing)	1d6 days	Water, hygiene	Poultice
6	Eye Irritation	Disadvantage on ranged attacks	1d4 days	Swamp water	Clean rinse
7	Head Cold	-1 to all rolls	1d4 days	Airborne	Rest
8	Minor Worms	-1 CON	1d6 days	Raw meat	Bitter root
9	Heat Rash	Disadvantage on STR checks	1d4 days	Heat exposure	Cooling rest
10	Minor Nausea	Disadvantage on DEX saves	1d4 days	Tainted food	Fluids
11	Athlete’s Itch	-2 movement	1d6 days	Moisture	Ointment
12	Indigestion	-1 WIS	1d4 days	Bad food	Light food
13	Sun Blisters	-2 CHA checks	1d4 days	Sun exposure	Balm
14	Cold Sores	Disadvantage on Persuasion checks	1d6 days	Contact	Salve
15	Sleep Ailment	Disadvantage on Initiative	1d6 nights	Bad environment	Herbal tea
16	Stomachache	-1 STR, -1 CON	1d4 days	Poor food	Rest
17	Sore Throat	Disadvantage on verbal casting	1d6 days	Airborne	Honey
18	Chills	-1 DEX, -1 WIS	1d6 days	Cold exposure	Warmth
19	Fatigue Sickness	-2 movement, exhaustion risk	1d6 days	Overwork	Food, sleep
20	Bug Rash	-2 CHA with NPCs	1d4 days	Biting insects	Poultice

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Moderate Diseases

Roll	Name	Effect	Duration	Contagion	Cure
1	Swamp Rot	-2 STR, -2 CON	Until cured	Swamp water	Cleric blessing
2	Blood Fever	Lose 1 HP per day	1d6+3 days	Blood contact	Medicine, healing
3	Gut Parasite	-3 STR, -3 DEX	2d6 days	Bad meat	Purge potion
4	Lung Rot	Disadvantage on CON saves	2d6 weeks	Airborne	Strong medicine
5	Festering Wound	Heals half as fast, risk of Major disease	Until cured	Dirty wounds	Cleaning
6	Contagious Flu	-2 to all stats	1d6+3 days	Airborne	Quarantine
7	Marsh Fever	-3 CON, high exhaustion risk	2d6 days	Swamps	Herbal cure
8	Spider Fever	-2 DEX, paralysis risk (1/6 chance)	1d6 days	Spider bite	Antidote
9	Boil Disease	Painful boils, -2 CHA, -1 CON	1d6 days	Contact	Poultice
10	Miner’s Cough	-2 CON, -1 STR	2d6 days	Dust/mines	Clean air
11	Bloody Flux	Lose 1d2 HP daily, dehydration risk	1d6 days	Tainted water	Strong herbs
12	Rat Fever	-2 DEX, -2 WIS	2d6 days	Rats, bites	Priest cure
13	Mold Fever	Disadvantage on all rolls indoors	1d6 days	Moldy areas	Herbs
14	Bitter Cough	Disadvantage on CHA & STR	1d6+3 days	Airborne	Tonics
15	Cold Rot	-2 DEX, -2 CON	2d6 days	Frostbite wounds	Warmth, medicine
16	Tremor Sickness	Hands shake, -2 to attack rolls	1d6 days	Magical residue	Cleric aid
17	Irritable Gut	-2 STR, -2 CON, exhaustion risk	1d6 days	Poor food	Rest, herbs
18	Green Pox	Green welts, -2 CHA, spreads easily	1d6 days	Contact	Poultice, priest
19	Night Fever	Disadvantage on saves at night	1d6+2 days	Airborne	Tonics
20	Shaking Ague	-3 STR, -3 DEX, exhaustion	1d6+3 days	Swamp insects	Priest blessing

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Major Diseases

Roll	Name	Effect	Duration	Contagion	Cure
1	Brain Fever	Disadvantage on INT/WIS rolls, hallucinate	1d6 weeks	Insects, cursed zones	Ritual
2	Black Cough	Lose 1d4 HP daily, spreads fast	2d6 weeks	Airborne	Strong cleric aid
3	Swamp Fever	-4 STR, -4 CON	Until cured	Swamp mists	Rare flower
4	Necrotic Plague	Wounds won’t heal, 1 HP lost per combat	Until cured	Corpse contact	Holy rite
5	Ley Sickness	-2 saves vs spells, mutations possible	Until cured	Ley exposure	Mage + cleric
6	Blood Rot	No magical healing works	Until cured	Blood relics	Holy water
7	Crimson Ague	Lose 1 CON per 3 days	Until cured	Rats, fleas	Ritual
8	Crystal Cough	-3 CON, coughing shards (damages throat)	1d6 weeks	Magical dust	Mage ritual
9	Pus Fever	-3 STR, -2 CON	Until cured	Contact	Priest aid
10	Ash Plague	Lose 1d6 HP/day, skin greys	Until cured	Cursed air	Holy relic
11	Wasting Pox	-2 all stats per week	Until cured	Contact	Sacred pyre
12	Red Mist Fever	Rage bouts, disadvantage WIS/INT	1d6 weeks	Magical fog	Rare herbs
13	Blind Pox	Gradual blindness	Until cured	Close contact	Holy aid
14	Yellow Cough	Cough blood, lose 1d2 HP/day	1d6 weeks	Airborne	Cleric
15	Spore Fever	-3 CON, lose 1 HP/hr in spore-filled areas	Until cured	Fungus	Rare herb
16	Serpent Fever	Disadvantage DEX, hallucinations	2d6 days	Venomous bites	Antidote
17	Vein Rot	Dark veins, -2 STR, -2 CON	Until cured	Blood contact	Ritual cleansing
18	Hollow Cough	Disadvantage CHA/CON, echoing cough	1d6 weeks	Mines, caves	Herbs
19	Plague Blisters	Painful sores, -2 DEX, -2 CHA	Until cured	Contact	Priest
20	Withering Fever	-1 STR/DEX per day	Until cured	Magical exposure	Divine healing

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Deadly Diseases

Roll	Name	Effect	Duration	Contagion	Cure
1	Bone Rot	Lose 1 CON/day until cured or dead	Until cured	Corpse contact	Relic
2	Plague Fever	50% fatal untreated	2d10 days	Rats, towns	Quarantine
3	Pox of the Ley	-4 to all rolls	Until cured	Ley exposure	Archmage
4	Consumption	Permanent -2 STR/CON	Lifelong	Airborne	Long rest
5	Bleeding Fever	Lose 1d6 HP/hour, contagious	1d6 days	Blood	Rare extract
6	Death Rot	Die in 1d10 days, rise undead	1d10 days	Undead, corpses	Sacred pyre
7	Crimson Rot	-5 CON, lose 1 HP/minute untreated	2d6 days	Blood	Relic
8	Black Vein Fever	Veins burst, lose 1d4 STR/day	Until cured	Blood	Ritual
9	Spine Rot	Paralysis after 1 week	Until cured	Contact	Relic
10	Mage’s Plague	-2 INT, -2 WIS, lose spells	Until cured	Ley zones	Archmage
11	White Plague	Pale skin, lose 1d6 HP/day	2d6 days	Airborne	Holy relic
12	Bloody Cough	Lose 1d4 HP/day, spreads in towns	1d6+3 days	Airborne	Quarantine
13	Frost Plague	Freeze to death in 1d10 days	1d10 days	Cold contact	Warmth, relic
14	Necro Fever	Turn undead after death	Permanent	Necrotic aura	Priest
15	Vile Flux	-4 STR, -4 CON, vomit blood	2d6 days	Food/water	Priest
16	Carrion Rot	Flesh rots alive, lose 1d6 HP/day	Until cured	Carrion contact	Relic
17	Cursed Plague	Disadvantage all rolls, spreads magically	Until cured	Curse zones	High priest
18	Ash Rot	Cough ashes, -2 CON/day	1d6 days	Airborne, cursed	Holy pyre
19	Blistering Death	Skin peels, -5 CHA, -3 CON	2d6 days	Contact	Relic aid
20	The Red Death	Die in 1d4 days unless cured	1d4 days	Blood, cursed relics	Only divine

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Lifelong Afflictions

Roll	Name	Effect	Duration	Contagion	Cure
1	Cursed Bloodline	Descendants inherit weakness	Permanent	Relics, rituals	None
2	Eldritch Parasite	Mutations worsen over years	Permanent	Ley zones	Slowed only
3	Blindness Plague	Gradual, permanent blindness	Permanent	Mist, cursed air	Irreversible
4	Bone Decay	-1 STR per month until crippled	Permanent	Bloodline curse	None
5	Mindrot	Memory and willpower loss	Permanent	Cursed knowledge	None
6	Hollow Heart	Cannot feel joy, CHA -4 permanently	Permanent	Necrotic curse	None
7	The Withering	-1 CON per week	Permanent	Curse, relics	None
8	Iron Rot	Metal corrodes on touch	Permanent	Cursed blood	None
9	Stone Lung	Suffers petrification over years	Permanent	Dust, curse	Slowed
10	Leech Veins	Blood sapped slowly, -1 HP/day forever	Permanent	Eldritch parasite	None
11	Ash Skin	Skin greys, -2 CHA permanent	Permanent	Ash exposure	None
12	Soul Hunger	Must consume rare herbs monthly	Permanent	Curse	Only managed
13	Hollow Mind	-1 INT each year	Permanent	Cursed relics	None
14	Black Veins	Veins blacken, weakness grows	Permanent	Cursed blood	None
15	Wasting Bones	Body shrinks, lose 1 STR/CON yearly	Permanent	Curse	None
16	Eldritch Tumors	Mutations, growths	Permanent	Ley energy	None
17	Burning Lungs	Breath shortens, -2 CON permanent	Permanent	Curse air	None
18	Dead Sight	Sees spirits, -2 WIS permanent	Permanent	Necrotic curse	None
19	Blood Oath Pox	Linked to cursed pact, CHA/INT -2 forever	Permanent	Ritual, pact	None
20	Hollow Womb	Cannot produce heirs	Permanent	Cursed exposure	None

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