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GM Core / Chapter 2: Building Games

Afflictions

Source GM Core pg. 86 2.0
Wherever there is life, there are insidious perils that threaten the health and well-being of living creatures. Some of these afflictions, including many diseases, are inherent to the natural world. Others—curses being the most notorious—exist solely to cause harm to others.

Afflictions strike creatures with potent and often escalating results. This section presents a variety of curses, and diseases for use in your game. A broad sampling of poisons can be found beginning on page 248, and the rules for afflictions start on page 430 in Player Core.

Depending on the tone of the campaign, the GM might want to roll secret saving throws for PCs affected by an affliction. This is particularly effective when the affliction is an element within a survival or horror game, or when it's part of a mystery.

Curses

Source GM Core pg. 86 2.0
A curse is a manifestation of potent ill will. Curses typically have a single effect that takes place upon a failed saving throw and lasts a specified amount of time, or can be removed only by certain actions a character must perform or conditions they must meet. Rarely, curses will have stages; these follow the rules for afflictions.

Curses may come from a malicious action, such as a lich's Paralyzing Touch or a spell from an evil spellcaster. Guardians of a tomb or treasure might ward their charge with a curse as protection against thieves. Gods may inflict curses on servants who have raised their ire. In some rare cases, a curse might manifest as a response to a terrible act, such as a massacre. When using a curse in your game, assign the curse to an item, location, situation, or similar element. Then, decide on a trigger for the curse—such as a creature attempting to steal a warded book, destroy a work of art, or slay a specific creature. A curse can even be tied to a specific location, in which case it functions as a simple hazard. Once that trigger occurs, the curse affects the triggering creature or creatures. Each affected creature must attempt a saving throw against the curse; if they fail, they are subject to the effects specified in the curse's Effect entry.

Diseases

Source GM Core pg. 88 2.0
Exposure to disease can be a hazard, such as when PCs come into contact with a plague-ridden corpse; such hazards grant XP as a simple hazard of the disease’s level. When a disease gives a sickened condition that can’t be reduced until it runs its course, that typically means the disease has symptoms such as a difficulty swallowing, loss of appetite, or nausea that make eating and drinking difficult but not impossible. Despite the condition’s prohibition on eating or drinking, a creature can slowly and carefully eat and drink as long as they aren’t in an encounter.