Diseases

Update: A PDF of these diseases and poisons – expanded and revised – is available exclusively on the DMs Guild site, here.

Black Vomit

Spread through biting insects, this disease can infect most humanoid creatures and some livestock. This disease is most common in regions bordering swamps and other wetlands.

After 12-hours spent in an area with insects carrying the disease, a humanoid creature must succeed on a DC 12 Constitution saving throw or become infected. Spells and other effects that ward against insects can either grant advantage on the saving throw or outright immunity depending on the nature and potency of the effect.

The incubation period is 1d4 days, after which time symptoms appear, including fever, chills, nausea, and pains throughout the back and head. Infected creatures find it difficult to keep their food down and their vomit is black. The infected creature must succeed on a DC 10 Constitution saving throw to drink water or other fluids, and a DC 15 Constitution saving throw to eat food without vomiting.

At the end of each long rest, the affected creature must make a DC 15 Constitution saving throw. On a successful save, the DC for this saving throw is reduced by 1d4. When the DC of the saving throw drops to 0 the creature has recovered from the disease. If a creature naturally recovers from black vomit they are immune to this disease and cannot be infected again.

Bloody Flux

This stomach ailment is contracted by consuming contaminated water or food, or contact with unsanitary conditions. If often affects travellers in distant lands, who are unaccustomed to local foods.

When a creature comes in contact with the disease, the creature must make a DC 12 Constitution saving throw or become infected. If the creature has consumed infected food or drink they have disadvantage on this saving throw.

Symptoms of the disease begin after 1d3 days. Infected creatures develop a mild fever, stomach pain, and have a frequent need to defecate. Their stool is liquidy and black or bloody. An infected creature suffers 1 level of exhaustion. While the creature has 1 level of exhaustion they must consume twice the normal amount of water each day.

After each long rest the infected creature must make a DC 12 Constitution saving throw. If they did not drink enough water the previous day, the creature has disadvantage on this saving throw. On a failure they gain 1 level of exhaustion. On a success the creature’s level of exhaustion is reduced by 1 level. When a successful saving throw reduces the creature’s level of exhaustion below 1 the creature has recovered from the disease.

Delver’s Malady

This disease is common among adventurers, sailors, and soldiers that spend lengthy periods of time surviving on preserved rations or magically created food. Races accustomed to living underground are often naturally immune to this disease; this includes dwarves, gnomes, and half-orcs.

After a month without fresh food, especially fruits and vegetables, a humanoid creature must make a DC 12 Constitution saving throw. On a failed save, the creature begins to show symptoms. On a success, the creature has avoided the disease but must repeat the saving throw in a month unless they consume fresh food.

Infected creatures become lethargic, with a spongy tongue and gums, and slight bleeding from the nose and ears. The infected creature suffers 1 level of exhaustion. While the creature has 1 level of exhaustion the number of Hit Dice they regain after a long rest is halved.

Until fresh food is consumed the disease cannot be cured. A remove disease spell will only remove the symptoms. After each long rest the creature must make a DC 10 Constitution saving throw. On a failure they gain 1 level of exhaustion. If the creature has eaten fresh food in the past day, a successful saving throw reduces the creature’s level of exhaustion by 1 level. When a successful saving throw reduces the creature’s level of exhaustion below 1 they are cured.

Great Pox

Also known as “reveler’s bane”, this disease is common among prostitutes and amorous adventures. Despite rumours to the contrary, elves are not immune to this disease, but they display no symptoms and suffer no negative effects. Elves can spread the disease to other races.

When a creature has sexual contacted with an infected creature they must make a DC 14 Constitution saving throw or become infected. If the infected creature is symptomatic all saving throws to avoid infection have disadvantage. There are many proposed methods of preventing infection, none of these have any actual effect.

The disease lies dormant for a variable length of time, and creatures can be asymptomatic for many weeks. Symptoms of the disease do not appear for 1d10 weeks but the infected creature is contagious after 1d10 days. Symptoms include a rash across the hands and groin that spreads and becomes painless ulcers.

After each long rest the infected creature takes 7 (2d6) poison damage and must make a DC 13 Constitution saving throw. On a failure they the poison damage increases by 3 (1d6). On a successful saving throw the damage decreases by 3 (1d6). When a successful saving throw reduces the damage below 1 the creature symptoms go away, but the creature remain infected and must continue to make saving throws. After three consecutive failures, symptoms return, and after three consecutive successes the creature is cured.

Jungle Fly Fever

Transmitted by insects bites, this disease only infects humanoid creatures. It is typically limited to tropical areas, but there are occasional outbreaks in temperate areas during warm seasons.

After 12-hours spent in an area with insects carrying the disease, a humanoid creature must succeed on a DC 14 Constitution saving throw or become infected. Spells and other effects that ward against insects can either grant advantage on the saving throw or outright immunity depending on the nature and potency of the effect.

Symptoms of the disease appear after 2d10 days. Symptoms include headaches, fever, and nausea; symptoms of the disease are cyclic, alternating between severe and mild. The infected creature gains 1 level of exhaustion.

At the end of each long rest, the affected creature must make a DC 10 Constitution saving throw. On a failure they gain 1d3 levels of exhaustion. On a success the creature’s level of exhaustion is reduced by 1d3 levels. When a successful saving throw reduces the creature’s level of exhaustion below 1 the disease goes into remission, but the creature remain infected and continues to make saving throws. After two consecutive failures symptoms return, and after four consecutive successes the creature is cured.

Scarlet Blight

An infectious disease that spreads through proximity with infected creatures or their bodily fluids. Virulent and dangerous, the disease would be more rampant if not for the visible signs of illness.

The infection moves slowly, and symptoms do not manifests for 3d6 days. During this period of incubation, the infected creature is not contagious. Symptoms include fluid filled blisters, fever, and a red rash. A creatures that starts its turn within 5 feet of a symptomatic creature, touches the bodily fluids of an injected creature, or holds an item used by an infected creature risk infection. When a humanoid creature comes in contact with the disease, they must succeed on a DC 15 Constitution saving throw or become infected.

After each long rest the infected creature has their hit point maximum reduced by 7 (2d6) and must make a DC 15 Constitution saving throw. On a successful save, the DC for this saving throw is reduced by 1d6. A creature that fails three of these saving throws becomes blinded until its vision is restored by spells such as lesser restoration or heal. When the DC of the saving throw drops to 0 the creature has recovered from the disease, and their hit point maximum increases by 1d6+1 after each long rest until it returns to normal. If a creature naturally recovers from scarlet blight they are immune to the disease and cannot be infected again.

Twisting Rot

This disease hideously scars its victims with deformities resembling rough scales. Because of the appearance of its victims this disease is often known as “scaley blight” and is often blamed on association with reptilian humanoids such as kobolds or dragonborn.

Prolonged contact with the victims of this disease can result in infection. For each day spent in contact with an infected creature a humanoid creature must make a DC 10 Constitution saving throw or catch the disease. If the creature succeeds on four consecutive saving throws they are immune to twisting rot.

The disease lays dormant for some time before the infected creature begins to show signs of illness. Symptoms do not begin for 3d6 months. The disease causes sore skin as patches of pale scaly bumps appear across the body. If the disease is not cured these lumps eventually cover the entire body. The disease slowly causes numbness in the extremities, making delicate manipulation tricky and leading to repeated injuries that often become infected. The infected creature has disadvantage on Constitution saving throws related to disease and checks that require finesse, such as Dexterity (Sleight of Hand) or treating injuries with Wisdom (Medicine). In areas where the disease is prevalent, infected creatures can be shunned, and also have disadvantage on Charisma (Persuasion) checks.

Creatures stricken with twisting rot remain infected until they die or the disease is cured with magic. There are a number of herbs and tonics that are said to cure the disease, but none have any lasting effect.

Poisons

Item Type Price per Dose
Cyanide Ingested/Inhaled  300 gp
Deadly Nightshade Ingested 200 gp
Distillation of Time Ingested 350 gp
Dreamweed Inhaled 150 gp
Healer’s Bane Injury 500 gp
Hemlock Ingested 500 gp
Magebane Ingested 400 gp
Strychnine Ingested 400 gp
Touch of Servility Ingested 200 gp

 

Cyanide (Inhaled or ingested). This deadly toxin can be brewed as both a liquid or a vapour. A creature subjected to this poison must succeed on a DC 15 Constitution saving throw or become poisoned for 8 hours. The poisoned creature cannot eat or drink anything and gains 1 level of exhaustion. If the saving throw fails by 5 or more, while poisoned the creature damage rolls from Strength-based weapons are halved.

Deadly Nightshade (Ingested).  A creature subjected to this poison must succeed on a DC 13 Constitution saving throw or become poisoned for 8 hours. The poisoned creature gains 1 level of exhaustion. If the saving throw fails by 5 or more, the creature is also paralyzed while poisoned. Also known as belladonna, this poison is often used as a foundation for brewing a potion of flying.

Distillation of Time (Ingested). A creature that ingests this poison must succeed on a DC 15 Constitution saving throw or become poisoned for 48 hours. The poisoned creature ages rapidly, rapidly becoming frail and wizened. Every 4 hours the poisoned creature must make a DC 12 Constitution saving throw, gaining 1 level of exhaustion on a failure.

Dreamweed (Inhaled). A creature subjected to this poison must succeed on a DC 13 Constitution saving throw or become poisoned for 8 hours. This poison is known for causing pleasing hallucinations and vivid dreams, and while poisoned the creature has disadvantage on Wisdom (Perception) checks and saving throws to avoid falling asleep. Repeated use has been known to cause madness.

Healer’s Bane (Injury). A creature subjected to this poison must succeed on a DC 16 Constitution saving throw or become poisoned for 48 hours. The poisoned creature cannot recover hit points from resting or expending hit dice. If the creature receives magical healing they must make a DC 14 Constitution saving throw. On a failure, the hit points gained are temporary hit points that last 1 hour. On a successful saving throw the creature recovers half the normal amount of hit points.

Hemlock (Ingested). A creature subjected to this poison must succeed on a DC 17 Constitution saving throw or become poisoned for 12 hours. The poisoned creature has their speed halved. If the saving throw fails by 5 or more, the creature is paralyzed. The creature can repeat the saving throw at the end of each of its turns, ending the paralysis on a success.

Magebane (Ingested). A creature subjected to this poison must succeed on a DC 12 Constitution saving throw or become poisoned for 4 hours. While poisoned the creature cannot maintain concentration on a spell. If the saving throw fails by 5 or more, the creature cannot cast spells of 1st level or higher while poisoned.

Strychnine (Ingested). A creature subjected to this poison must succeed on a DC 14 Constitution saving throw. On a failed save, the creature takes 14 (4d6) poison damage and become poisoned for 8 hours. The poison causes convulsions when a poisonous creature is exposed to loud noises or pain. After taking damage, the creature must make a DC 17 Constitution saving throw or become incapacitated for 1 minute. If the creature takes thunder damage they have disadvantage on this saving throw. The creature can repeat the saving throw at the end of each of its turns, ending the effect on a success.

Touch of Servility (Ingested). A creature subjected to this poison must succeed on a DC 13 Constitution saving throw or become poisoned for 24 hours. The poisoned creature loses much of its free will and is highly suggestible. The creature has disadvantage on Wisdom saving throws, and is considered charmed by all creatures.

 

Back to the 5e Content