Wounds and Vitality

Wounds and Vitality

Just as armor class is an abstraction, so are vitality points —after all, just because a dagger does 1d4 points of damage doesn’t mean a high-level fighter is somehow immune to having his throat slit. This alternate system attempts to better represent the differences between injuries and impeded performance, and represents the fatigue that a character gathers over the course of a battle

When a fighter gains a level, his body does not suddenly become more resistant to damage. A sword’s strike does not suddenly do proportionately less damage. Rather, vitality points suggest that the fighter has undergone more training, and while he may have improved his ability to deal with wounds to a small degree, the vitality points gained at higher levels reflect less his capacity for physical punishment and more his skill at avoiding hits, his ability to dodge and twist and turn. Each loss of vitality points, in this case, suggests that he is becoming progressively less nimble over the course of combat—in other words, that the decreasing vitality points are a marker for his overall endurance and condition. It’s not quite as satisfying, however, to roll a critical hit and then tell a player that his opponent ducked out of the way, but that the sword’s slash made the enemy a little less lucky. This variant system for tracking wounds and vitality should help to remedy that.


Determining Wound Points and Vitality Points

Instead of vitality points, creatures using this system have a number of wound points and vitality points. These two replacement scores are kept track of separately, and represent different ways a character handles the damage inflicted on him. The following are descriptions of these scores and how they work within the variant system of damage tracking. You also gain a certain amount of additional vitality points from your race each level. The general rule of thumb is that races with a -4 racial con penalty get +2 vitality, races with a -2 racial con penalty get +3 vitality, races without a racial con modifier get +4 vitality, races with a +2 racial con bonus get +5 vitality, and races with a +4 racial con bonus get +6 vitality. For creatures who do not have class levels, and instead have racial hit dice, add an additional 50% of the racial hit die to the creature’s vitality gained per racial hit die. For creatures who are not PC races, but still have class levels, add ? their racial hit die to the vitality they gain each level. 


Wound Points 

Typically a creature has a number of wound points equal to twice its Constitution score. It also has a wound threshold equal to its Constitution score. Wound points represent the amount of physical punishment a creature can take before it dies. When a creature’s wound points drop to or below its wound threshold, that creature becomes wounded. When a creature is wounded, it gains the staggered condition until it is no longer wounded. Furthermore, when a creature is wounded, if that creature takes any standard or move action on its turn, its remaining wound points are reduced by 1 and it must make a DC 10 Constitution check (+1 to this DC for every wound point the creature is below their threshold). If the creature fails that check, it falls unconscious. When a creature reaches 0 or fewer wound points, it is dead.


Wound Points and Constitution Damage, Drain, and Penalties

A creature’s wound points and Constitution score are intrinsically linked. For each point of Constitution damage a creature takes, it loses 1 wound point, but this damage does not affect the creature’s wound threshold. When a creature takes a penalty to its Constitution score or its Constitution is drained, it loses 1 wound point per point of drain or per penalty for the duration of the penalty or drain. A penalty to Constitution or Constitution drain has no effect on the creature’s wound threshold.

Creatures without constitution scores (such as undead or constructs) do not have wound points. Undead add their Charisma bonus times their hit dice to their vitality points as they would with hit points, and constructs still gain bonus vitality points based off size equal to the number of bonus HP they would gain normally. When reduced to zero vitality points, these creatures are destroyed. They may not benefit from the Toughness feat. If a creature has the Toughness feat and becomes undead, that creature may replace the Toughness feat with any feat that it currently meets. 


Vitality Points

Vitality represents a creature’s ability to avoid the majority of actual physical damage it might take from an attack. When a creature takes damage, the damage typically reduces its vitality points first. Some special attacks either deal wound point damage directly or deal both vitality and wound point damage (see Critical Hits).

Creatures with one or more full Hit Dice or levels gain vitality points. With each level gained or each Hit Die a creature has, it gains a number of vitality points equal to the max of its Hit Die type. Use the creature’s Hit Dice to generate its vitality points, just like you would vitality points, but without adding the creature’s Constitution modifier. A creature with less than one Hit Die has no vitality points; it only has wound points. Young creatures only have a number of wound points equal to their Constitution score.

When a creature no longer has any vitality points, any additional damage it takes reduces its wound point total.


Healing Spells and Effects

When casting healing spells or using an ability with a healing effect (such as channeling holy energy on living creatures or the paladin’s lay on hands ability), the creature casting the spell or using the effect must choose whether it wants to heal wound points or vitality points. The creature decides this before casting the spell or using the ability. When that creature decides to heal vitality points, the healing spell or effect acts normally, replenishing a number of vitality points equal to the number of vitality points the spell or effect would normally heal. If the creature decides to heal wound points, it heals a number of wound points equal to the number of dice it would normally roll for the healing spell or effect. In the case of effects like the heal spell, where a spell or effect heals 10 vitality points per caster level, the creature heals its caster level in wound points. For instance, if a 12th-level cleric uses her channel positive energy power to replenish wound points to living creatures, she would typically heal 6 wound points for all living creatures with her channel energy burst. If she casts the heal spell, she would restore 12 wound points to the creature touched.



When a creature has a full night’s rest (8 hours of sleep or more), that creature regains all its vitality points and 1 wound point. If there is a significant interruption during a rest, the creature regains neither wound points nor vitality points. If a creature undergoes complete bed rest for an entire day, it regains half its level in wound points and all its vitality points.


Restoration and Similar Effects

When a creature regains Constitution points by way of the restoration spell or a similar effect, that creature regains 2 wound points for every Constitution point regained. Relieving a Constitution penalty or Constitution drain regains any wound points that were lost from that penalty or drain.


Critical Hits

When a creature is subject to a critical hit, the critical hit deals the damage normally, reducing vitality points first, and then reducing wound points when vitality points are gone. Critical hits do not multiply the weapon’s base damage. However, a critical hit also deals an amount of wound point damage equal to its critical multiplier (for example, 3 wound points for a weapon with a ×3 modifier), on top of any wound point damage the creature might take from the critical hit. Creatures without wound points do not take extra damage from critical hits (however, all other precision damage, such as Sneak Attacks, still affect them unless otherwise specified). Critical hits still trigger on crit effects, like Flaming Burst weapons.


Fast Healing and Regeneration

Creatures with the fast healing ability may only recover vitality points through their fast healing. Creatures with the regeneration ability heal their vitality points first, and after that they begin healing wound points. Once their wound points are fully healed, they begin regenerating any body parts they may have lost.


Negative Energy Damage

When a creature deals negative energy damage to a creature with a spell or effect, it can choose to deal wound point or vitality point damage (but not both) with the spell or effect. If that creature chooses to deal vitality point damage, the spell or effect deals negative energy damage normally, and that damage reduces vitality points only, even if it deals more damage than the target has vitality points. If the spell or effect deals negative energy damage to wound points directly, it deals an amount of wound point damage equal to the number of dice the creature would roll for that effect; if the effect deals a number of points per caster level (such as the harm spell), it deals a number of wound points equal to the caster level of the spell.


Temporary Hit Points

When a creature would normally gain temporary hit points, it gains temporary vitality points instead. When that creature takes damage, it loses these temporary vitality points first. If an attack deals damage to wound points only, these temporary vitality points are not lost.


Nonlethal Damage

When a creature takes nonlethal damage, it takes that damage in vitality points only, even if the attack deals more damage than the creature has vitality points. If the creature has no vitality points (and no temporary vitality points), each time that creature takes damage from an attack that deals nonlethal damage, it takes either 1 wound point of damage, or a number of wound points in damage equal to the attack’s critical hit modifier if the attack is a critical hit. If the attack crits and is dealing vitality point damage, the creature takes no wound point damage from the critical hit, although on-crit effects (such as Flaming Burst) are still triggered.


Spells or Effects with Hit Point Triggers

When using this system, if a spell or an ability has an effect that occurs when you reduce a creature to 0 or fewer vitality points (such as the disintegrate spell), that effect is instead triggered when a creature is wounded. In the case of the harm spell or a similar effect where a creature cannot be reduced below 1 vitality point by the spell or effect, a creature’s wound points cannot be reduced to or below that creature’s wound threshold.

Wound Levels

In a standard Pathfinder game, when a dragon with 800 vitality points has taken 798 points of damage, it's still fighting at full capacity, but as soon as it has taken 801 points of damage, it's knocked completely unconscious. Though this ensures that injured characters remain useful and effective, it can feel unrealistic, and it devalues any healing that doesn't strictly prevent a knockout. Consider using the following variant to add tension and increase the strategic value of healing, but be aware that it can lead to situations that punish the side that's already behind, and that the pace of fights could drag in the late stages as two injured parties slug it out. Wound Levels also make it especially dangerous for a party to take on higher-CR opponents.


In the wound levels variant, a character divides her vitality point total into four quarters, and takes penalties whenever she's not in her top quarter. A character at 3/4 of her maximum vitality points is less effective than one at full vitality points, one at 1/2 is less effective than one at 3/4, and so on.

To prevent the need to divide on the fly, start out by calculating 3/4, 1/2, and 1/4 of your total vitality points and add them to your character sheet as "Grazed (–1)," "Wounded (–2)," and "Critical (–3)." If you have a Constitution bonus of +1 or higher, also write down the negative of your Constitution bonus next to the word "Disabled." These terms indicate the conditions a character gains as her vitality points drop. For example, a 7th-level sorcerer with a maximum of 71 vitality points would become grazed at 53 vitality points, wounded at 35 vitality points, and critical at 17 vitality points. If she had a Constitution score of 12, she would be disabled if she had 0 or –1 vitality points, and would start dying at –2 vitality points. As usual, she would die when her vitality points drop to –12 or lower.

Levels and Conditions

This rules variant uses three special conditions that apply automatically when a character reaches the corresponding wound levels: grazed, wounded, and critical. These conditions are not cumulative—only the most severe one applies at a given time. The disabled and staggered conditions have the same effects as in the core rules, but apply to a wider range of vitality point totals, as described below. Unlike grazed, wounded, and critical, the disabled and staggered conditions stack, so a character who is disabled or staggered is still critical as well.


A character above her grazed level (3/4 of her maximum vitality points) is healthy, applying no special modifiers. The character doesn't gain a condition in this state.


A character above her wounded level (1/2 of her maximum vitality points) but at or below 3/4 of her maximum vitality points is grazed. She takes a –1 penalty on all attack rolls, saving throws, skill checks, and ability checks, as well as to AC and caster level.


A character above her critical level (1/4 of her maximum vitality points) but at or below 1/2 of her maximum vitality points is wounded. She takes a –2 penalty on all attack rolls, saving throws, skill checks, and ability checks, as well as to AC and caster level.


A character at or below 1/4 of her maximum vitality points is in critical condition. She takes a –3 penalty on all attack rolls, saving throws, skill checks, and ability checks, as well as to AC and caster level.


Instead of being staggered only when their amount of nonlethal damage equals their remaining vitality points, characters using this system are staggered when they are at or below their wound threshold. Such character’s penalties from wound levels are doubled.

Caster Level Penalties

The penalty to caster level from the grazed, wounded, or critical condition can make it so an injured spellcaster is unable to cast the highest levels of spells she would normally be able to. However, it doesn't cause her to lose any prepared spells or spell slots. The penalty to caster level also reduces her bonus on concentration checks and lowers the range, duration, and effectiveness of her spells. The penalty can't make her effective caster level lower than 1.

Wound Threshold Feats

The following feats are either new feats or Core Rulebook feats adapted to work with the wound threshold system. Though the system doesn't require their use, they're a great way to expand the role of wound thresholds in your game.

Critical Cure

Your healing is more effective if your patient is badly injured.

Prerequisite(s): Able to cast at least one conjuration (healing) spell

Benefit: When you cast a conjuration (healing) spell, it cures 1 additional vitality point if the recipient of the healing is grazed, wounded, or critical. The additional healing increases by an additional 1 point at caster level 6th, and every 6 caster levels thereafter.


Harsh conditions or long exertions do not easily tire you.

Benefit: You reduce the penalty from being grazed, wounded, or critical by 1 (to –0, –1, and –2, respectively).

In addition, you gain a +4 bonus on the following checks and saves: Swim checks to resist nonlethal damage from exhaustion, Constitution checks to continue running, Constitution checks to avoid nonlethal damage from a forced march, Constitution checks to hold your breath, Constitution checks to avoid nonlethal damage from starvation or thirst, Fortitude saves to avoid nonlethal damage from hot or cold environments, and Fortitude saves to resist damage from suffocation.

You can sleep in light or medium armor without becoming fatigued.

Normal: A character without this feat who sleeps in medium or heavier armor is fatigued the next day.

Twist the Knife (Combat)

You're especially dangerous against enemies who are suffering from injuries.

Benefit: You gain a +1 bonus on attack and damage rolls against grazed, wounded, or critical enemies.

Deathless Initiate (Combat)

For you, impending death is a call to wrath.

Prerequisites: Str 13, Con 13, Diehard, Endurance, base attack bonus +6.

Benefit: You are not staggered when your wound points reach your wound threshold, but you lose 1 wound point if you take any action during your turn. You only take 1 wound point each round when you take actions. Furthermore, you gain a +2 bonus on melee attacks and damage rolls when your wound points are at or below your wound threshold.

Deathless Master (Combat)

Even if you suffer a grievous wound, you can shrug off the damage and continue your relentless assault.

Prerequisites: Str 13, Con 15, Deathless Initiate (above), Diehard, Endurance, Ironhide, base attack bonus +9.

Benefit: When your wound points reach your wound threshold, you do not take 1 wound point when you take an action.

Special: Creatures with Orc Ferocity may select this feat with the following prerequisites: Str 13, Con 13, Diehard, Endurance, base attack bonus +6.


You keep on going, even when your wound points are lower than your wound threshold.

Benefit: When your current wound point total is below your wound threshold, you do not need to succeed at the DC 10 Constitution check to stay conscious.


You have enhanced physical stamina.

Benefit: You gain 1 wound point for every level or Hit Die your character has.

Orc + Half-Orc Changes

Creatures with the Orc Ferocity racial feature gain Deathless Initiative as a bonus feat at level 1. Creatures with the Ferocity racial feature gain Deathless Initiative and Deathless Master as bonus feats at level 1. This may seem like a lot, but tbh I’m overhauling the races, too, so it’ll be balanced, I pinky promise.

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