Wound Thresholds
New Rules
 
Wound Thresholds were proposed in Pathfinder Unchained page 136. I would like to experiment with them. Basically the rule states that for conditions of grazed ¾ hit points, wounded or bloodied ½ hit points, critical ¼ hit points and disabled the creature gains conditions that worsen its combat. Conditions are not cumulative. This adds a new condition where the character is at negative hit points up to his full Con multiplier and is still able to function. Creatures with a 12 Con would be able to function between 0 and negative 1 hit point, creatures with 11 Con or less would be able to function at 0 hit points. For example creatures with a Con score of 18 would have a Con modifier of +4 and so be able to function between 0 and negative 4 hit points. They would still die if they fall below -18 hit points (-36 if the character becomes mythic and gains Hard to Kill) and would start bleeding if they fall below -4 hit points or take an action at -1 hit points or less. In addition they would be staggered; able to only perform a single action (either a move or a standard action) on their turn.
 
Hit Point Level Condition Modifier
Full Maximum None
¾ or less Grazed -1 attack/save/skill and ability checks, -1 AC and caster level
½ or less Bloodied -2 attack/save/skill and ability checks, -2 AC and caster leve
¾ or less Critical -3 attack/save/skill and ability checks, -3 AC and caster level
0 to -Con Modifider Disabled -3 attack/save/skill and ability checks, -3 AC and caster level
    and only able to take a single move or standard action; taking such an action causes the creature to start bleeding 1 hp/rnd bleeding that can be stopped with any medical treatment, magical healing or a successful stabilize check.
 
The caster level can't be reduced to less than level 1 and a creatures attack/save/skill and ability checks cannot be reduced to less than 1 nor can its AC be reduced to less than 1.

What's good for the goose is good for the gander and this rule would apply to monsters as well. In massive combats the DM would only track those creatures who are bloodied and they would suffer the -2 modifier. Important NPCs and boss monsters or monsters in small scale battles would have their individual wound levels tracked.

The biggest complaint I see to this is that spell casters would lose access to their most powerful spells. This loss of access would be temporary and not mean an actual reduction in the number of spells memorized. Since casters try to not be hit at all in combat I don't see this as a major deal. It does make an area effect spell like fireball more deadly since it would not only affect more creatures it would be likely reducing a spell caster's effective caster level. With the decrease in level comes a decrease in range of the caster's spells, a decrease in damage die of most spells and a decrease in other effects like duration. This makes initiative more important for spellcasters since they are likely to try and get their high level spells off early.

If a creature is healed to over a wound threshold then they would regain access to their spells and suffer the negative modifiers of the lower wound level. This would result in some extra tracking, but it should not be out of line. Simply record your wound thresholds for your hit point total and your Con modifier and track your current negatives depending on your current health.

The rule also proposes new feats: Critical Cure, Twist the Knife and a new effect to add to Endurance. Basically; Critical Cure adds 1 hit point of healing per heal spell cast which increases by 1 at 6th level, 12th level and 18th level. Endurance would have its normal effects and would reduce the effects of wound levels by one level. So a creature with Endurance would suffer a -1 at ½ of their hit points, a -2 at ¾ of their hit points and would be Disabled at 0 to negative her Con modifier. Twist the Knife would allow the creature to gain +1 bonus on attack and damage rolls against grazed, bloodied or critical enemies.

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