Wednesday, April 25, 2012

Memorable Mechanics Part 2: Disease

So, my series on using unusual mechanics in 4e games continues today with the subject of disease. On paper, I kind of like the look of how 4e handles disease. Gone are the absurd "realistic" diseases of the 1e days (Kidney infection? Fun!). Still, the 4e system has the disease affect the PC in stages. This is where the problems come in. I have yet to see a PC hit the late stages of a disease. Between saving throw bonuses and wonky Endurance DCs, it is rare that a PC contract a disease at all. This defeats the purpose. Furthermore, keeping track of stages is kind of annoying to begin with. So, here are my ideas on how to include diseases in your 4e game.

You get no save. You have the disease, period.
Pretty simple, the diseased bat bites you, you have the disease. Might sound harsh but, hey, thats disease.

The disease has no 'stages'. It is what it is.
It is my advice to go ahead and get straight to the juicy stuff. Ravage the PCs body with disease while you have the chance. Severe is good. Severe is memorable. Nobody remembers the time they got stage one of some wussy disease that gave them a -1 Fort for 6 hours. They DO remember that time their body parts started falling off and they had to carry them in their backpack. For published diseases, go straight to the final stage.

After an extended rest, make a hard Endurance check.
If the PC passes the check, they are cured. If they fail, they aren't. You can have the PC die after failing an Endurance check if you like, or it can just be chronic until they beat the DC. Nice and simple. No stages to track. Allies can treat a disease as normal.

That's pretty much it. I promise you you will see more ritual use in your games after a disease or two like this! Making diseases memorable starts with simply making diseases a threat, and the way the rules currently play, disease is no threat at all to a group of PCs. Let's change that.

Do you have any memorable disease stories? Please leave a post!


  1. Well this is timely. The game I ran last saturday prominently featured a disease (the whole party started the adventure infected with it). I'm currently writting up a synopsis of the session to post over at Crypt Thing.

    I agree that 4e diseases are way too wimpy. Although I included stages, I custom built mine to have some more gravity to it.

  2. thanks for the comment! i look forward to reading your post

  3. Very cool, man. I'm currently doing an adaptation of an OD&D mini megadungeon and it utilizes diseases often. I've been trying to do a pretty faithful conversion but it just astounds me how weak the diseases really are.

    I like your input though, I might tweak my adaptation a little based on this!

  4. Wow rat swarms suddenly become a threat again. I may actually try this out in one of my games.

  5. haha yes! let me know if you do!

    if any readers find this a little too extreme, you could maybe just have 2 really severe stages, or just no save vs contracting the disease. there is some middle ground to work with. i say go for it though, make it brutal