When a character suffers large amounts of damage at once, he may have taken a grievous wound. Grievous wounds are traumas such as deep slashes, broken ribs, punctured organs, extensive third degree burns and the like. They are a stage beyond the cuts, scratches and bruises represented by ordinary wounds.
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A proud warrior displays his scars
Any wound that exceeds the character’s Grievous Wound Threshold counts as grievous. Your Grievous Wound Threshold is the average of your Strength and Constitution ability scores, rounded down. For example, if you had a Strength ability score of 11 and a Constitution ability score of 10, then your Grievous Wound Threshold would be 10 and a 12-point wound would be a grievous wound for you. If you receive a grievous wound, tick the ‘Grievously Wounded’ box on the character sheet. The Heal skill cannot help with grievous wounds, as they are too severe; Heal only covers the application of what we would call ‘first aid’ in the modern era. You can use the Heal skill to reduce a grievous wound by a point, but it is still considered grievous. Only the Medicine skill can assist with grievous wounds.
Note that your base Constitution and Strength ability scores are used to determine your Grievous Wound Threshold, not your current Constitution and Strength ability scores. For example, even if you have taken sufficient damage to lower your Constitution, a wound must still exceed your Grievous Wound Threshold to be considered grievous.
Effects Of Grievous Wounds: The moment a grievous wound
is received from a bludgeoning source, the character who has suffered it must make a Fortitude saving throw against a DC of 10 or be knocked unconscious. (See ‘unconsciousness’ in the section below for how you recover from unconsciousness.) Grievous wounds from slashing or piercing sources do not have this effect.
Grievous wounds weaken
characters physically. Every grievous wound a character sustains inflicts a point of temporary Strength damage that cannot be
recovered by resting until the wound is no longer grievous. If a grievous wound is twice as
large as your Grievous Wound Threshold when inflicted or deteriorates so that it reaches that size, you suffer an additional point of Strength damage; a wound three times as large inflicts a further point and so on.
Recovering From Grievous Wounds: When a character is
grievously wounded, the wound does not heal over time like ordinary wounds. Instead, the character’s condition is liable to worsen. Wounds severe enough to be counted as grievous
begin to fester, widen and mortify if they are not properly treated. Characters are exposed to infection and other secondary damage. In the ancient world, you can die from your wounds days after you actually receive them. This is one reason why journeying far from civilisation is so dangerous. At dawn every day, a grievously wounded character must make a Fortitude saving throw against a DC equal to the grievous wound’s size. This must be done once for each grievous wound, if he has more than one. Success means that the character’s condition gets no worse, but he does not improve either. If the saving throw fails, the wound increases by one point, causing the character’s hit points to be reduced by the same amount. If the saving throw fails by more than 10 points, the wound worsens by 1d4 points instead of only one. Grievous wounds never heal without medical attention except in the case of a miraculous recovery, for which see below. As ever, if the character’s hit points are reduced below zero, he begins to lose points of Constitution every time he loses hit points; if he reaches zero
Constitution, he dies.
If the character rolls a natural 20 when making his Fortitude saving throw to avoid his wounds worsening, he may have made a miraculous recovery. He must immediately make a Constitution ability score check with a DC equal to the size of the grievous wound. If the check is successful, the wound is no longer considered grievous. You cannot spend Divine Points to turn the Fortitude saving throw into a natural 20, as it must be an unmodified score of 20, though you may spend Divine Points to increase your Constitution ability score check. A character that receives medical attention from a barber-surgeon or similar expert has a chance to recover from grievous wounds. A Medicine check can turn a grievous wound into a normal one. The DC of this check is the size of the wound. If the Medicine check fails by more than 10 points, the wound increases in size by one point. For a Medicine check to be attempted, the patient must have remained in bed for a whole day and engaged in no stressful activity. A character may attempt a Medicine check more than once on the same wound, but no single wound may receive more than one treatment attempt in any one day.
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Scars
Grievous wounds that have healed often leave scars behind. When a grievous wound that was received from any damage source other than bludgeoning is turned into a normal wound by the use of the Medicine skill or by a miraculous recovery, roll 1d6. On a roll of 1 to 3, the wound has left a scar. (Exception: grievous wounds caused by fire always leave a scar.) It is up to the player to record where on his body the scar is; refer back to the circumstances in which the wound was received. For example, an arrow wound might leave a round scar on the character’s shoulder, while a wound received from a labrys could leave a scar shaped like a broad streak across an arm or leg.
Scars in the ancient world have two roles. Each scar has a story attached to it, which can give you credibility when dealing with warriors and similar fighting men. For every scar that you can show, you receive a +1 circumstance bonus to any Charisma-based skill check when interacting with people whose main concern is with fighting, to a maximum bonus of +5. Scars prove that you have been in fierce battles and come away alive and that gains you respect, whether the people you are talking to like you personally or not.
The other role of a scar is as a means of identification. If a select few people know that you have a scar in the shape of a lightning stroke down the back of your left calf, then it prevents anyone from being able to impersonate you to these people. Creating a real scar for disguise purposes is possible, but painful!
Cautery
The treatment of grievous wounds with fire is common practice in the ancient world; we retain the medical term ‘cauterise’ from the old term ‘cautery’, the art of healing by fire.
Cautery is a swift, drastic, risky method of turning a grievous wound into a normal one. It can only be applied to wounds that were received with slashing or piercing damage. Hot metal is applied to the wound in order to seal it. This is agonising for the recipient but may mean the difference between life and death. As a substitute for hot metal, molten pitch is sometimes used. If there is no fire source to hand, then cautery cannot be applied. A flaming torch or burning oil is not sufficient, as intense heat must be applied to a specific area to achieve cautery.
Cautery has to be applied within an hour of the grievous wound occurring. A successful Heal or Medicine check is needed against a DC of 20, irrespective of the size of the wound; the recipient of the cautery must make a Will saving throw against a DC of 15 or fall unconscious because of the pain, if he was not already unconscious. Administering cautery is a full-round action that requires concentration.
When a grievous wound is cauterised, it is worsened by 1d6 points of damage but if the Heal or Medicine check is successful, the wound is no longer grievous. If the check fails, the wound is both worsened and remains grievous. In either case, the additional damage dealt is removed from the patient’s hit points (or Constitution, if he is already below zero hit points), which may kill him even if the check was successful. If the check fails by more than 10 points, the temporary Strength damage caused by the grievous wound becomes permanent, the wound remains grievous and the fire damage is still suffered. Such a serious failure is a disaster for any character, as a large grievous wound can make multiple points of temporary Strength damage permanent. Additional points of temporary Strength damage resulting from the wound’s worsening do not automatically become permanent, even if they were caused by the cautery itself.
For example, the hero Temocles has been gored badly by a wild bull, suffering a 14-point wound from the bull’s horns, which do piercing damage. This is higher than Temocles’ Grievous Wound Threshold of 12, so the wound is grievous. The artificer Xemothrax, who is working in his forge, offers to use a hot poker to seal the wounds and prevent Temocles from dying an unpleasant, lingering death. Xemothrax has no ranks in either Heal or Medicine, but Heal can be used untrained, so he has a chance of success. The hot poker is applied to the wound and Xemothrax rolls for additional damage; five points are applied to the wound, turning it into a 19 point wound. He then makes his untrained Heal check against a DC of 20 and to his great relief, he succeeds. The point of temporary Strength damage will be restored as soon as Temocles has had a chance to rest and he will now recover at the usual rate of one hit point removed from his wound per day.
Cautery can be attempted more than once on the same wound, inflicting fresh damage with each attempt. However, each repeated attempt is made against a DC of +2, as it becomes steadily more difficult to do any good. Botched cautery can turn a grievous wound into a horrible mess that it is next to impossible to treat. A wound that has been unsuccessfully
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treated with cautery can still be treated with the Medicine skill.
The great advantage of cautery as a method of dealing with grievous wounds is that it is quick. Medicine checks to treat grievous wounds take a whole day and do not allow the character to do anything other than rest. Cautery requires only a swift application of hot iron. For this reason, it is used on battlefields.