Afflictions in D&D 5E


In a D&D Facebook group, some people argued whether being a Vampire should be a class or a race. I consider both takes on that to be erroneous, so I sat down and jotted down these optional house rules. To be able to properly resolve the problem, I introduced the concept of Afflictions.

Afflictions are a mechanic that describes an evolutionary progress of complex diseases and other long-term effects to a character. In a sense, Afflictions are mini games within the game. You have a progress not unlike leveling your class, with two important differences:

  1. Instead of advancing using XP, each affliction has individual prerequisites for evolving. The prerequisites can be different for each stage of the affliction.
  2. The evolvement of an affliction can be reversed, using a similar mechanism of prerequisites as evolving.

So, without further ado, here are the rules.

Rules

An Affliction is a type of prolonged effect. Examples of Afflictions includes diseases, lycanthropy, etc.

An Affliction can have one or more Stages. Each Stage represents a new phase of the Affliction. Afflictions can have a Stage 0. In this case, the Affliction is dormant. There are no signs that the person is afflicted, although a thorough examination – magical or non-magical – will reveal the Affliction, if successful.

Each Stage have the following optional components:

  • A General Description of the Stage of the Affliction.
  • Benefits are effects that generally are positive to the afflicted person.
  • Drawbacks are effects that are generally negative to the afflicted person.
  • Progress Prerequisites and challenges for advancing the Affliction to a more serious Stage of the Affliction. These describes how to escalate to a new Stage of the Affliction. If there’s no higher Stage of the Affliction, this is empty.
  • Egress Prerequisites and challenges that needs to be fulfilled in order to de-escalate the affliction to a more benign stage. If no egress is mentioned, you cannot be cured from this stage.

Unless if specifically mentioned, you keep the benefits and drawbacks of previous stages of an affliction. If two benefits or drawbacks conflict, the one from the higher stage overrides the lower one.

Afflictions

This section lists a couple of afflictions and defines them, mostly to serve as an example on how to craft afflictions.

Vampirism

Stage 0Description You have been bitten by a vampire and failed your saving throw. You feel nauseous for a while, but it soon passes, and you feel well. However, the vampire is in your blood, and it is only a matter of time before your true nature will reveal itself. A medical exam or the spell Detect Poison and Disease (PHB231) will reveal your true nature.
Benefits None.
Drawbacks None.
Progress Each time you are exposed to blood, you roll a CON Saving Throw. A failure will progress you to Vampirism/1.
Egress A Wish spell will remove the affliction. Also, if the character is killed and then brought back to life, the affliction will be removed. (PHB295)
Stage 1Description
Benefits
Drawbacks
Progress
Egress
Stage 2Description
Benefits
Drawbacks
Progress
Egress
Stage 3Description
Benefits
Drawbacks
Progress
Egress
Stage 4Description
Benefits
Drawbacks
Progress
Egress

Lycanthropy

Stage 0Description
Benefits None.
Drawbacks None.
Progress At the first full moon, make a CON Save. If you fail, you will progress to Lycanthropy/1.
Egress A Remove Curse or a Greater Restoration will remove the affliction.
Stage 1Description
Benefits
Drawbacks
Progress
Egress
Stage 2Description
Benefits
Drawbacks
Progress
Egress
Stage 3Description
Benefits
Drawbacks
Progress
Egress
Stage 4Description Your soul has been expelled from your animal manifestation. Instead, you are cursed to travel in ethereal form alongside the beast. You can no longer control the actions but are cursed to watch in horror as it ravages the world around you.
Benefits None.
Drawbacks You are stuck in an animal state you cannot control.
Egress To reverse this stage to stage 3, someone need to capture the beast, induce a sleepy, trancelike state to it and resurrect you, for your soul to be able to repossess the body. Although your soul is willing to return, the animal will make a saving throw. If it is sleeping, the save is at a disadvantage.