Maladies of the Fens: D&D Diseases and Cures
“Okay, so you jump into the foetid pond - could you just give me a Constitution save. 8? Okay…”
Suspicious silence intensifies while the GM makes a quick note.
“Moving on…”
Wellcome Collection (CC BY 4.0)
Is there anything more worrying than rolling a distinctly worse-than-average saving throw, only for seemingly nothing to happen? Well… yes - and one of them is waking up with an interesting new disease.
Diseases can be interesting for both role-play and game-play, adding mechanical challenges, character quirks, and player motivations in trying to find a cure.
For our D&D5E adventure Elvers and Betters, I wanted to create a visceral sense of damp and decay. Miasmas, bacterial infections and parasites seemed like a logical next step.
You’re welcome to make use of this content in your own games so long as you’re not making money out of it.
Diseases of the Fens
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Fenrot is caused by prolonged contact with foetid water. Open wounds are particularly susceptible to infection.
If left untreated for several days, the disease can cause significant damage. Affected limbs may require amputation. Severe cases can result in death.
Characters entering bogs and fens must succeed on a DC11 Constitution saving throw or become infected. Roll with disadvantage if the character is currently wounded.
Eight hours after infection, thesufferer develops painful ulcers on their feet, reducing their movement by half.
After each Long Rest, an infected character must succeed on a DC11 Constitution saving throw to recover from the infection.
If they fail. they suffer damage equal to a quarter of their maximum hit points (rounding down). If this reduces them to less than one quarter of their maximum hit points then an affected foot must be amputated before they can be cured.
Fenrot can be cured by spells such as Lesser Restoration and Heal. Leeches applied for the duration of each Long Rest will prevent damage occuring as a result of a failed saving throw, but will not cure the disease.
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Swamp Ague is a blood-borne infection. Leeches are a common vector.
A character bitten by a Leech must succeed on a DC15 Constitution saving throw or become infected.
Once infected, a character gains two levels of Exhaustion after each Long Rest until cured or killed.
Swamp Ague can be cured by spells such as Lesser Restoration and Heal. Infusions of Bladderwort may ease symptoms.
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It burns! It burns!
Remedies and Quackery
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Bladderwort is abundant in the fens, preferring deeper water. Leaves can be brewed into a bitter tea.
Once per day, when consumed, Bladderwort tea reduces Exhaustion by one level.
A character who consumes Bladderwort tea is afflicted by Pisswrack for 24 hours.
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Medical-grade leeches for use in curing and alleviating symptoms of disease.
Side-effects may include Swamp Ague.
Sick of D&D?
If you like a random disease table, we’ve been enjoying Swyvers. It offers not only d12 maladies, but an additional d6 STDs, from the do-you-even-want-to-know Frog’s Pocket, to the feels-like-a-personal-attack Tom’s Face.
Have TTRPGs made you ill? Share your horror stories below…
