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18 Diseases and Ailments for your enjoyment
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Authors: Scott Stokes
Scott Stokes
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Table of Contents
Bone Rot Disease 3 Muck-Blood 13
Dung Beetle Virus 4 Philanderer’s Punishment 14
Dragon’s Feet 5 Psychic Malaise 15
Ethereal Fever 6 Snake Blood Sickness 15
Fairy’s Angst 8 Stone Golem Syndrome 17
Fiery Ant Fever 9 Topaz Pneumonia 17
Hell Gout 10 Warrior’s Wrack 18
Lilith’s Lament 11 Winter Seed Ague 19
Mind Spikes 12 Zombie Plague 20
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Bone Rot Disease
This disease is also called Brittle Bone disease. It causes your bones to rot from the
marrow out, literally destroying you from within. As the interior of the bone rots away
they are still hard on the outer layers but have none of the Strength of a solid bone and
therefore tend to break easily.

Bone Rot was accidentally created by the cleric Sestrin while mixing some natural
healing herbs in conjunction with a raise dead spell. The spell fumbled with the herbs
being affected. The resulting mixture formed something completely new and terrible with
Sestrin never realizing what had happened until it was too late. The disease struck the
small village where he resided. It was only after a three week period and the deaths of 15
people that a paladin was able to heal the last of the diseased persons. The disease still
appears on occasion. Although no one has found the source, it is believed that either
someone who was infected left the town before the disease was realized or that perhaps
an animal became infected and serves only as a carrier. It is believed that creatures who
do not possess a skeletal structure may also serve as carriers.

Since the carrier source is unknown, no one is certain. However, the paladin involved in
curing the first outbreak in Sestrin’s village did note that all of the infected people had
some form of physical contact with another at some point before coming down with the
disease. It seems that to contract this disease one needs only to touch the infected person.

Upon making physical contact with a carrier, the individual must make a Fortitude save
(DC 19) to avoid being infected. If the save is successful, a new save does not need to be
made from contact by the carrier for 24 hours. However, if touched by a different carrier,
a new save must be made.
If the saving throw is failed, the infected person begins to feel tired after about 2 hours
and suffers 1d6 temporary Con damage. At this point, she becomes completely exhausted
and must rest. She must then make a second Fortitude save (DC 19) with failure resulting
in the infected person remaining in an exhausted condition. After 1d4 days the person’s
suffers 2d6 temporary points of Strength damage reducing her strength (minimum score
of 3). Combined with her already exhausted state, the weakness makes it impossible for
her bones to continue to support her body’s mass and weight. For every three hours that
the infected individual does not remain in a fully resting position, there is a 25%
cumulative probability of a bone breaking. Any bone that does break will inflict 1d6
points of piercing damage to the victim plus 1d4 points of nonlethal damage from the
pain of the bone breakage.
Any attempts to move the patient must be done with great care. A successful Heal
check (DC 25) will allow the caregiver to reduce the probability of additional bone
breakage to 15%. The probability does remain cumulative, however. If fashioning a litter

from tree limbs or such, then 5 or more ranks in Knowledge (nature) or Survival will
grant a +2 synergy bonus to a Heal check in this circumstance.
Unless treated by heal or remove disease (cast at 10th level), the infected individual
does not regain lost Constitution and Strength points as normal. After 1d4 additional
days, the marrow inside the patient’s bones has effectively rotted away and the bones
grow very brittle. Movement is restricted to only the smallest of motions and performing
those requires a Fortitude save (DC 15) to withstand the pain or fall unconscious. The
probability of bone breakage rises to 50% with each action the patient attempts. Due to
the level of pain and brittleness of the bones and teeth, eating becomes virtually
impossible. At this stage of the disease’s progression, the patient will die from starvation
unless a wish, miracle or similar powerful effect is cast that will restore the bones to their
former state.

Once infected, a Heal check (DC 30) or a remove disease spell within the first two
hours of contraction will cure the affliction. In the next 22 hours a remove disease (cast at
10th level) or heal spell is needed. After that, only a wish or miracle or similar power will
bring back the afflicted to his former form. Magic theoretically may be used to sustain a
person until help could be found. Form-altering spells or special abilities such as
polymorph, wild shape or lycanthropy will change the physical form but the affected
condition still remains and affects the bones of the new form as well. A victim can not
survive this disease with out care.

Dung Beetle Virus

Said to be a condition of the poor by the wealthy, this disease causes the individual to
have chills, turn pale in color, and become nauseated. Airborne, its ability to rapidly
spread among the traditionally poor, densely populated city districts where sanitation
barely exists lends to its name.

The Dung Beetle Virus’ origins are a mystery but the first recorded outbreak dates back
to 100 years ago in kobold lore. The lore suggests the birth of the virus within the realms
of the deep earth. Kobold belief is that the Dung Beetle Virus serves as a divine
punishment for kobolds associating with surface dwellers. Though, the truth is unknown
about its original source the real source is likely more terrestrial in nature.
This is an airborne virus that spreads quickly. The onset time is 1d4 days after
exposure. Individuals coming into close proximity (less than 5 foot) to someone that has
been infected must make a Fortitude save (DC 12) or become infected. If an infected
person’s blood should come into contact with an open wound or be consumed, the
Fortitude save is increased to a (DC 15). Those who fail the save suffer 1d3 points of
temporary Constitution damage and become nauseated.

The victim becomes nauseated and takes on a very pale complexion after the onset
time. They take 1d6 temporary constitution damage. 1d4 days later, the character suffers
an additional 1d6 loss of temporary Strength damage due to high fever and chills. After
this time the disease ends. Additionally the victim acts as a carrier of the virus for the
duration of the infection.

Remove disease cures the victim completely but does not restore ability damage. This
must be recovered through rest or divine magic. Also the victim of the Dung Beetle Virus
gains a +4 bonus to his Fortitude save if he encounters the virus again within the next 6
months. Treat Disease is allowable to help with the saves but not generally needed.

Dragon's Feet
Generally easy to spot,
Dragon's Feet is a blood
condition that develops from
contact with juvenile draconic
blood or a creature that serves as
a carrier. It causes the skin on
hands, feet and other extremities
to harden and crack in scale-like
patterns until it flakes off in
small sections revealing oozing
and infected tissue underneath.
The blood vessels of those who
contract the disease become
inflamed and swollen which
causes the skin to crack.

The primary outbreak of this infection can be traced back to a conflict between an
adventuring party and a young green dragon. The adventurers contracted the disease as a
result of having wounds that came into contact with the dragon’s blood and the
adventurers soon fell ill. As symptoms emerged and oozing sores formed on their skin,
the disease quickly passed from caregivers to the general community as a mild plague.
Travelers then carried it to the far shores with great speed. Eventually the spread of the
disease was halted through a concerted effort by priests of many faiths. In some regions,
it eventually found its way into the annals of history as a mere footnote of bad spell
results. Still, rumors from the shorelines held that the disease itself survived the purge in
the shallow bays and reefs of the shoreline waters as a fish-borne plague of lethal nature,
after the locals dumped the remains of several old people that died from Dragon's Feet.

The most common form of contracting this condition is the consumption of food
containing the parasite itself. So far, only fish and certain types of birds have been
demonstrated to carry the parasite. It is also naturally occurring in the blood of juvenile
dragons much like the common parasites that exist in newborn puppies. Sages who study
such matters have yet to determine why the parasites only exist in juvenile dragons but
suspect it may be tied to their innate magical abilities.
Contact with an infected area on a diseased creature or person will cause infection.
Coming into contact with blood, puss, sores or flaked skin of an infected individual will
facilitate the need for a Fortitude save (DC 14). If an open wound comes into direct
contact with the diseased area or infected blood, the Fortitude save is (DC 18). Failure of
a saving throw sends the disease into its incubation period of 2d6 days before symptoms

After 1 hour, those individuals who contract Dragon’s Feet suffer a -2 circumstance
penalty to all Dexterity based skills and a -1 circumstance penalty to Reflex saving
throws due to the pain of the wounds as they erupt on the extremities. Additionally, they
suffer a -1 reaction penalty to Charisma due to the visible presence of the infection and
seeping wounds. Until cured, all physical signs and symptoms of the disease remain.

Casting remove disease will cure the victim of the parasites. The visible sores disappear
1d4 days after the spell is cast, negating the penalties imposed by the disease. Treat
Disease has no affect on this disease.
Ethereal Fever

This is not a fever in the
typical sense. The first
sign of the disease is a
feeling of begin light-
headed and of euphoria.
The victim’s temperature
is elevated at this time but
the euphoria gives the
victim such a good feeling
that they don’t usually
notice the fever until it is
too late. The next stage;
the victim experiences a
lightness in her step as if a
load has been lifted from
them physically. Finally
the victim becomes

This fever is brought on by exposure to Ghost Weed. Ghost weed is a rare plant found
growing near the grave site of a person who has become a ghost. The plant actually
simultaneously exists on the prime and ethereal planes. However, this fact is not readily
apparent unless a person has the capability to see into the ethereal plane. The plant is a
gray/green color and has a thin white film of fibrous fuzz on the leaves. The plant grows
slowly and lives as any normal plant does.

An individual only has to breathe in the fuzz to contract the disease. Thankfully, the
fuzz is not as easy to blow as dandelion fuzz. Individuals that work around graveyards
can come into contract with the fuzz from digging and maintaining the graveyard.
Anyone inhaling the fuzz must make a Fortitude save (DC 17) or become infected.

Once infected it is very hard to cure naturally. The first effects appear after 48 hours.
The victim begins to feel light headed and euphoric. Nothing to worry about yet! The
individual’s movement becomes easier after another day and any limitations due to
equipment and carried weight are gone, as well as any physical impediment such as a
lame leg. The victim will realize the weight and impediment are still there but their
effects are gone. The full effect will finally come to being on the next new moon. The
individual wakes from a frightful sleep, cold and clammy and very pale, his body is
slipping into the ethereal plane and a Will save (DC 22) will allow the victim to keep
himself partially on the plane of origin. A failed save and the victim slips into the ethereal
plane completely. The Will save must be made every hour during the night of the new
moon. The victim keeps his native plane status and alignment. A victim who makes his
save can see into the prime but can only touch items with a hardness of 5 or better. The
victim passes through everything else as an ethereal creature would. The victim can affect
things on the ethereal plane as an ethereal creature could and they can of course interact
with him. This dual status only exists during the night of a new moon. When the new
moon has passed the person becomes corporeal again.
Those who see the victim at night, while the victim is in their dual status, see her with a
gossamer glow surrounding them. The victim seems to glide more then walk, although
they are walking. This of course only lasts while the person can hold themselves on the
prime. Obviously anyone witnessing this will be naturally fearful. A victim if killed in
this dual status will become a ghost unless some intervention is done.

Remove disease from a paladin or cleric of 15th-level or higher will cure the disease.
Treat Disease is allowable to help with the saves, this consists of 30 consecutive days of
bed rest and on each day a Fortitude save (DC 25) must be made. If the creature goes
ethereal during that time all long term healing effects are lost and you will need to start

Fairy’s Angst
This magical disease resembles the special power of some faerie creatures to confound
their enemies. Spell casters (Divine and Arcane) are the only individuals that can be
affected by this disease.

A malicious wizard in an attempt to block magical travel into his mountain top
stronghold, created this enchanted bacteria. Soon after its creation the bacterium quickly
replicated and the wizard lost control of it. The wizard’s stronghold is now abandoned
and the bacterium has spread to the Astral, Ethereal, and Shadow planes. Spell casters
using magic to travel to these areas can become infected.

Each time an individual uses magic to travel (i.e. dimension door, teleport, plane shift,
etc.), there is a 2% chance they attract the magical bacteria that causes this disease. If the
traveling spell caster rolls a 1 or 2 on percentile dice he must then make a Fortitude save
(DC 14) or suffer the effects. SR is applicable; the Bacterium is treated as a 10th level

There are no initial ill affects from contracting this disease. This makes the disease very
hard to detect.
Any time an infected spell caster attempts to cast a spell she must make a Will save
against his own spell DC to cast the spell. If this save is failed, roll on the following chart
to determine what effect actually happens instead of the desired spell. Effects are on a
random creature (possibly even the caster). If the Spellcraft roll is successful then the
spell goes off normally.

d8 Effect
1 Confusion
2 Invisibility
3 Detect thoughts
4 Dispel magic
5 Sleep
6 Irresistible dance
7 Memory loss
8 Roll for two effects

Confusion: As lesser confusion spell cast by a 1st level bard.

Invisibility: As the spell cast by a 3rd-level sorcerer.
Detect thoughts: As the spell cast by a 3rd-level sorcerer.
Dispel magic: This is a targeted dispel as cast by a 5th-level sorcerer.
Sleep: As the spell as cast by a 1st-level sorcerer, with a random creature as the center of
the 10 ft. burst.

Irresistible dance: As the spell cast by a 12th-level Bard.
Memory loss: Victim must succeed a Will save DC 15 or lose all memory. The subject
retains skills, languages, and class abilities but forgets people, places and things until he
or she receives a heal spell or memory restoration with limited wish, wish, or miracle.
Once the specific effect is determined, randomly determine one creature within the
effect’s area to receive the disease’s effect.

Remove disease and a Spellcraft check (DC 18) will remove the disease. Until the
victim has the diseased removed, she will suffer the effects of this spell. This disease
cannot be cured by Treat Disease.

Fiery Ant Fever

An individual infected by the fever is affected immediately by physical weakness and
chills that lasts for 72 hours. Your skin may also display bright red patches, this happens
about 80% of the time.

This Fever was born during a small civil war in an eastern forest region, long ago. The
fever was first noticed when urban clerics attempted to cure advanced poisons used
against their people in the war. The fever spread from the war camps to the cities and
quickly ended the war as both sides watched their armies falter under its effects.
Modern cases of Fiery Ant Fever have been reported by adventuring groups opening
old tombs or disturbing long forgotten battlefields. The Fever spreads quickly but modern
clerics are aware of its signs and can stop the fever before it turns into an epidemic.

Fire Ant Fever spreads through simple skin-to-skin contact. If a Detect magic is cast on
the victim while you are infected the taint of this foul magic glows with an un-healthy
green glow. When anyone comes into contact with an infected person, they must
immediately make a Fortitude save (DC 18) or they become infected with the fever. It
can not be spread through ranged touch attacks. Onset time is immediate with sudden
feelings of weakness.

Anyone that contracts this disease suffers 4 points of Strength and Constitution damage.
This lasts for the next 72 hours. These affects stack with other losses.

This disease confounds lesser magic and can only be cured by a heal spell or other
more powerful magic. The disease ends by itself, though at the end of the 72 hours.
Victims that suffer through this illness are immune to its effects after it passes. Generally,
people will survive this illness even without care. Treat Disease has not affect on this

Hell Gout
When an individual first contracts Hell Gout is a foot condition. It begins with extreme
itching, and then you develop red burning blisters. Left untreated these blisters fester and
the victim’s feet develop bleeding wounds. These wounds will bleed and puss up until
cured. Long term care is required to control the bleeding and thus stop you form dieing
from the blood loss.

Hell Gout permeates the 9 layers of hell. It is in the dirt and water of every layer. It
leaves a residue on anything it touches. Holy water is the only thing known to be able to
remove the residue. The residue mixes with your sweat and gets into your skin. Natives
of hell seemed to be immune.

An individual only needs to use any of the natural elements to clean your armor,
weapons, or them selves to contract Hell Gout. As an individual sweats and the residue
mixes with that sweat they must succeed a Fortitude save (DC 17) or the individual will
contracted the disease. As an individual goes deeper into the layers of hell the DC
increases by 1 per layer.

The first day after contracting Hell Gout, your feet begin to blister. The pain is bad
enough that the victim is no longer able to run. The second day the victim’s normal
movement is halved. By the third day the victim’s feet and ankles are causing so much
pain that the victim can only hobble along at ¼ their normal land based movement and all
terrain is considered rough terrain. A Heal check (DC 17) is needed daily to stop the
bleeding. On any day the bleeding is not stopped the victim will take one point of
Constitution damage. The losses are cumulative. When the individuals Constitution
reaches 0 the victim dies.

Thankfully, curing this horrible gout is fairly simple. To stop the disease from
spreading, cleaning the infected areas of the infected person with holy water will stop the
progress of the disease. A remove disease will then cure victim of the infection. Any
items not properly cleaned can still re-infect a person, but if they are washed with holy
water thoroughly they can be worn again. To properly clean such items a wisdom check
(DC 15) might be in order.

Lilith’s Lament
Lilith’s Lament is a disease that only affects a few creature types. Those being: Giants,
Trolls and Goblinoids. This disease goes unaddressed by the good peoples of the realms,
and encouraged by others. This disease initially causes a sort of docile effect, this lasts
about 48 hours. This 1st stage is quiet and non-threatening. The 2nd stage lasts 3 days and
is quite the opposite of the 1st stage. The victim becomes violent, and enraged. The
creature will attack anyone near him and do so in a most violent way. They will flee if

The virus is naturally occurring virus, much like the flu.

An individual contracts Lilith’s Lament by eating any contaminated food or water. It is
also able to be contracted by blood to blood contact, but contraction in this manner occurs
less often.

Once an individual has eaten any contaminated food or water a Fortitude save (DC 18)
must be made. The individual if they succeed the save is immune for 24 hours no matter
how much of the foul food or water they consume.
Eight hours after the victim has contracted the disease she will have an extremely
submissive and & indulgent attitude toward everything, this lasts 48 hours. They are calm
and refuse to engage in combat, as they don’t really care, and they run if threatened.
The next 72 hours is very violent. The victim looses all control, they are not be effected
by morale effects and can not be reasoned with. Their Strength, Dexterity, and
Constitution each receive a +2 circumstance bonus, and their Intelligence, Wisdom and
Charisma are all 10, all of this lasts for the entire 3 days. The victim will not eat or sleep
during the 3 days. They receive a +4 circumstance bonus vs. all charm, compulsions
spells and even if they are affected by the spell the duration of such spells is halved or 1
round per level which ever is less. The victim at the end of the 3 days collapses into a
coma-like state. They victim is exhausted and her Strength & Constitution score are 3.
The disease has now passed and normal healing and curing can be used to help the victim
to recover.
The deadly part of this contagion is surviving those around the victim during the 2nd
stage. They are not going to let a raving lunatic run around killing everyone.

A remove disease will work if caught before the violent stage sets in. Once the violent
stage sets in, a heal, limited wish, miracle or wish is needed. The only option using Long-
term care would be to restrain the victim and let the disease run its course.

Mind Spikes
Normal people suffer with headaches every day. Some suffer with severe headaches
such as migraines. A victim who suffers the debilitating affect of a mind spike would
gladly trade with either of them. Most victims describe this affliction as having an
invisible dagger thrust into their eye, or into the back of the head.

The disease is a mystery to everyone. Some have postulated that the victim has
wandered into some kind of magical turbulence. Others believe it is elemental in nature,
spawning from rifts in the barriers between the various planes. Still others believe it is
somewhat geological in nature, and point to the few instances where crystalline growths
were found in the brains of those who died while suffering the affects of the disease.

Again, the experts disagree. Some believe it has to do with areas of ‘dead’ or ‘wild’
magic, and that by simply passing through such an area can cause the affliction to strike.
Others believe that the use of various means of magical transportation, especially if they
involve inter-planar travel, can cause the occurrence. Still others believe that it is a
product of the environment, that it is somehow contained in the soil, or the air, and that
the simple act of breathing, eating, or drinking is all it takes. Despite the common miss-
conception that this disease only strikes spell casters, it is found equally among all
professions and adventuring classes. Every character has a 1% chance per adventuring
level of contracting it after being exposed. The check is made at the time a new character
level is gained. Additional checks are made any time a character utilizes any sort of
planar travel to one of the elemental planes.

There is a base 5% chance to suffer an attack each day. Anytime a victim engages in
difficult activities it increases the chance and the initiates a need to make an immediate
save. The activities usually involve one of three things: Making a concentration check,
using a skill with a negative circumstance modifier or using a feat in a difficult
circumstance such as combat. These affects stack with each other.
When the disease strikes, the victim must make a Concentration check (DC 25). If they
fail they are stunned for the round, otherwise they are just dazed. Each subsequent round,
the DC for the Concentration check is reduced by 5, until the attack is over, 5 rounds
later. Failing the check during the first round of the attack results in the character being
stunned, otherwise he is dazed. If they make the save by more then 5 then they are only
sickened. This new calculated percentage of an attack lasts until all the affects of all
failed concentration checks are gone.

There malady has no known cure. In reality, the disease is really a psychic disorder
that has caused a physical weakness in the victim’s brain. There are treatments that can
mitigate the frequency of the attacks, but they are costly. Some of the treatments that
seem to work the best are listed below. We suggest that a cure become available or
perhaps be the subject of a quest.

Under the effect of a Bless spell Chance of Attack Decreases by 2%

Subject of any Cure spell Chance of Attack Resets to 5%
Subject of a Heal spell Chance of Attack drops to and
remains 2 for 1 month.
Subject of a Wish or Miracle spell Will Remove the condition
Psychic Chirurgery Chance of Attack drops to and
remains 1%.
Effects of treatments are not cumulative; only the best one remains in effect.

This disease lasts for 3 weeks. It causes a victim's blood to thicken, causing blood clots
that often kill them.

Muck-Blood is a naturally occurring virus that attacks the red blood cells. It causes the
blood cells to reproduce in massive quantities, thereby thickening the victim’s blood.

The virus that causes Muck-Blood is a naturally occurring waterborne virus found only
in tropical swamps, but thankfully it is extremely rare even in these environments. A
person in most cases must be exposed to the virus for more than 24 hours before
contracting the disease. Muck-blood is non-communicable, and cannot be transmitted
from one host to another by touching, kissing of any other similar activities. But, the
disease lives in the waste of a victim for 4 hours. Any contact by someone with that waste
would be subject to the disease and need to make a save. In either case a Fortitude save
(DC 21) will resist this exposure to the disease.

The victim’s first symptoms begin 2 days after contraction. They symptoms are a
reddish complexion, a burning sensation, numbness, and/or tingling in the arms, legs,
toes, or fingers causing a penalty of -2 to Dexterity. As the disease progresses the victim
begins to experience a rapid weight loss, -2% total body weight loss each day. This lasts
till their body reaches ½ his weight at the time of contraction. During this time the victim
is weak and dizzy causing -2 penalty to Constitution and an additionally -2 to Dexterity.
When the victim’s weight has reached the ½ way point there is a 50% chance the victim
will have a stroke. This increases each day by 5%. Each stroke causes the victim to make

a Fortitude save (DC 28). A failed save results to a -1 to a random ability score. If the
save is failed by more then 5 the loss is doubled. If the save is failed by more then 10 the
loss is tripled. A successful save means there is no stroke that day. Treat disease can be
used to aid the victim with the fortitude saves.

A remove disease spell kills the virus, ending any further effects. Alternatively, a
separate and successful Heal check (DC 28) will effectively halve the effects of the
disease, including reducing the chance for a stroke to 25% and reducing the save to a (DC
14). Treat Disease is able to help a victim with his fortitude saves.

Philanderer’s Punishment
This disease causes you to suffer an embarrassing and painful, but otherwise harmless,
skin condition.

The original source for this virus is unknown. As far as anyone knows, it has always
been around, much like the common cold. Most cases, however, are reported by
prostitutes (or their clients—hence the name).

Philanderer’s Punishment can only be contracted through fluid exchange with an
infected person.

The virus attacks the inside of the victims thighs after a 1 week incubation period,
causing them to become red, scaly, and itchy causing a -4 penalty to Dexterity and -6
circumstance penalty to Concentration checks). This condition persists for 3 weeks
adjusted by your Con modifier, with a minimum of 1 week. At the end of that time, the
virus goes into remission for 1d3 weeks. Once the remission is over, the victim must
make a Fortitude save (DC 25) or suffer another flare up. After 3 flare ups whether the
saves were made or not there are no more saves allowed to stop a flare up. The virus has
built up so much inside your body that no Fortitude save will stop the flare up.

The penalties bestowed during a flare up can be halved by a successful Heal check (DC
18). The virus can be force into remission by a successful Heal check (DC 24). The only
way to be rid of the virus completely is to receive a remove disease, heal, miracle, limited
wish, or wish spell.

Psychic Malaise
Psychic Malaise is a disease that seems to only affect Psychic and Psionic creatures.
The disease is manifest not in the infected Psi user, but in those around her. Any time a
Psi user manifests a power (spends Power Points) a person or creatures nearby is struck
by a severe headache. The pain is excruciating and quite debilitating. The Psi users mind
is so disciplined that it won’t let the infection hurt his own mind so the Id actually sends
the pain away from the Psi user to protect itself. The effected individual is random.

Some believe this is a curse against Psi users. This is of course absurd. The root cause
is generally organic. Any contact with a hallucinogenic substance has a chance of
infecting a Psi users mind.

Obviously only Psi users and potential Psi users can contract Psychic Malaise. It is
contracted through the consumption of certain hallucinogens. The Psi user must make a
Fortitude save (DC 15) to avoid the contraction each time he inhales or otherwise
partakes of a hallucinogenic. The DC increases to 18 or even higher by particularly
strong hallucinogens.

Any use of a victim’s psi power will cause this effect to manifest itself. The effect of
Psychic Malaise is a sudden pain in the brain of a random creature within 50’ of the
infected Psi user. The effect is a severe head ache that the person it affects is dazzled for
2 rounds. Any spellcaster that gets affected by the headache must make Concentration
check to cast or maintain any spell. The concentration DC is 10+ the power points used to
manifest the Psi power that caused the head ache. If they fail this check the spell is lost.

An infected Psi user is cured by a Remove disease from a cleric or paladin of 12t-level
or higher. A heal spell will work also. Treat Disease has no affect. The only way to
naturally overcome Psychic Malaise is to stop using Psi abilities for 2 weeks. If the
infected Psi user also casts spells they must refrain from casting for those 2 weeks as
well. Any use even to defend your self will negate any time you have devoted into resting
your mind. The victim will have to start over at the beginning and rest their mind for an
entire 2 weeks again.

Snake Blood Sickness

The Snake Blood Sickness is something that came about when the Snake People started
taking on the mortal races as slaves. It is a sickness that only manifests itself in cold
weather and then it causes your metabolism to slow down. This is very debilitating and

will kill an individual if left untreated. The only visible sign is a lethargic and drowsy
feeling when the victim should otherwise be awake and alert.

This sickness was first noted after the rescue of slaves held by the Snake People. The
carriers are never affected, but those exposed to the blood, or other bodily fluids of a
former slave (Carrier) can become infected and they are now carriers as well. This
sickness was a purposeful creation on the part of the Snake People’s Imperial Alchemists
to insure that no slave that escaped would do so without a cost. Normally after a rescue
people go home and thereby infecting the ones they loved.

Contraction is through any type of bodily fluid contact. All four Snake People breeds
are immune to this. If you ingest a tainted liquid you must make a Fortitude save (DC 21)
any other contraction type requires a fortitude save (DC 15).

Early on the victim will become very lethargic any time the temperature drops below
75°. See the table below.
75° - 70° the victim becomes tired and unable to react quickly. This results in a -4 to
spot and listen skills, and a -1 to Reflex saves.
69° - 65° you become very tired you have a hard time staying awake and in addition to
the above effects your movement is ½ and you Dexterity and Strength are at a -4 penalty.
64° - 60° the victim becomes is basically in out of a light sleep. You can be awoken for
short times and even move with help. But that is all. You can’t cast spells or do combat.
The only skills you can use are those that take little time, concentration and effort to
59° and below the victim becomes comatose and begins to die as their metabolism is
moving so slow that it can’t move the nutrients and oxygen throughout the body
effectively. After 3 days in this state the toes and fingers die and begin to rot away, after
1 week hands and feet and after 2 weeks legs and arms and at the end of the 3rd week the
victim dies a horrible and agonizing death.
If the victim is warmed back up the effects don’t progress and recovery is normal until
the weather turns cold again, at which time the effects will begin again, stacking with any
previously unhealed effects suffered.

After contraction, Treat Disease is affectively keeping your patient warm. The best
way to keep things from getting worse is to keep the victim warm. To cure the victim she
must have a remove poison and remove disease cast on her within 1 minute of each other.
If just one is cast the victim will stabilize for the next 24 hours no matter what the
temperature but then after that any cold condition will trigger the effects again.

Stone Golem Syndrome
This affliction causes a victims skin to take on a grayish color, thicken, and harden.
While it makes you resistant to damage, it also slows you down.

A sorceress, while creating stone golems for use to guard her tower, inadvertently
created one that carried a strange disease. Not long afterwards, The Sorceress’ skin
began to get thicker, making it harder for her to cast spells. The sorceress spent many
long hours of study, experimentation, and numerous used many remove disease potions
(due to re-infection). She finally realized that it was her stone golem that kept giving her
this sickness. Rather than lament at her mistake in creating this mutated guardian, she
capitalized on it, creating several more just like it.

Any stone golem has a 5% chance of carrying this disease. Any person that comes with
in 10’ of infected stone golem must make a Fortitude save (DC 18) each hour you remain
within range. The disease will begin to manifest itself immediately, with a thickening and
graying of your skin. The disease completely takes hold after 24 hours.

The victim’s skin grays and hardens. Then after 24 hours after infection the victim
suffers all of the effects. This disease grants the victim a +2 natural armor bonus. The
victim also has their movement reduced by one-half and receives a -4 to their dexterity
(minimum of 3) and a -2 to their Charisma (minimum of 3). Additionally a spell caster
will suffer a 10% spell failure while under the affect of Stone Golem Syndrome; this
penalty stacks with any normal armor worn.

Strange as it may sound, the main cure for this syndrome is a tea made from the ground
up remains of an actual stone golem, infected or not. However, a Heal check (DC 14) or
another Profession (herbalist) skill check DC 16 is required to properly brew the tea.
Alternatively, a remove disease spell will also do the trick.

Topaz Pneumonia
Topaz Pneumonia is a respiratory ailment. It first manifests itself as a cough that
worsens over a 24 hour period. After the first 24 hours you start to show jagged yellow
stripes on your chest and neck. The second 24 hours the cough tapers off a bit but
breathing becomes painful and strained, any physical activity is very difficult. After
another day the victim’s pupils turn yellow and the victim’s life begins to ebb away over
the next two days.

This disease comes from certain types of lichen in underground caverns. Usually it is
ingested but, if someone is working in areas where this lichen is living it can become
airborne and infection can be contracted through breathing in the spores.

Anyone eating this tasty topaz color lichen needs to succeed a Fortitude save (DC 19)
or become infected. If an individual makes either save they are immune for the next 72
hours. If they breathe in the spores they must succeed a Fortitude save (DC 21). If they
make their save they are immune to this disease.

The victim begins to show the first signs after one hour with a mild cough and the
cough progressively gets worse for the next 24 hours tiring the victim, they are fatigued.
On the third day the victim begins to show yellow stripping on his chest and neck. The
victim becomes incapacitated at -1 Hit Point by the end of the 3rd day. Now the victim
will begin to loose 1 hit point per day until dead.

The victim can be kept alive and cured with treat disease. To keep the disease from
getting worse the Heal DC is (DC 19) and the victim will not loose the 1 hit point. If this
heal check succeeds 3 days in a row, the victim is cured and will regain lost hit points
normally. Alternatively a remove disease by a 10th-level cleric or Paladin will cure the

Warrior’s Wrack

This strange disease was actually manufactured. There is no known cure to it, yet, but
clerics are hopeful. This disease causes the victim to have a violent reaction to any
ferrous metal left against her skin for more then 10 minutes. Your skin seems to leach the
ferrous elements out of the metal and leave the metal brittle and worthless. The ferrous
elements being introduced into the blood stream cause sever mental distress, resulting in
a loss of the victims will.

The actual source of this disease was a witch from long ago. The witch’s greatest secret
was let out by one of her their own. The witches have a weakness when ferrous metals
are placed around them, such as a ring, armor or even an arm band. The witch devised a
curse of sorts that infected ferrous metal ores. The infection spread into some of the veins
in the earth. Anyone coming in contact with this metal is subject to the awful effects.

Anyone wearing, holding or touching the effected metal for more then 10 minutes will
activate the malicious affliction. The actual break down begins to take place if contact is
maintained for more then 10 minutes. The amount of metal does not matter only the
contact time with the metal affects the course of this disease.

There are no noticeable effects during the first 10 minutes, but after that any skin in
contact with the metal becomes noticeably cooler. After 1 hour the ferrous element has
leached out of the metal completely, its hardness is reduced to 1, with 1 hit point. The
coolness will subside as well. The victim will need to make a Will save (DC 14) or loose
one wisdom point. This repeats each hour until the victim’s wisdom is reduced to 3.
Owl’s wisdom only has half the effect on a person infected with this disease. After the
Wisdom reaches 3 the disease has run its course and the infected person can be healed
normally. They still have the disease though. So if they wear or contact any ferrous metal
again the process starts over again.

A remove disease will cause the disease to go dormant for 24 hours. A remove disease
by a paladin or cleric of 18th level or greater can eradicate the disease. Treat disease has
no effect on the course of the disease, but can aid in the Will save as normal.

DM ONLY: A mundane cure, while unknown, is to grind up a 1-pound magnet and

consume it slowly over a 24 hour period. This will remove the disease.

Winter Seed Ague

This disease in the first 24 hours appears like any common flu and the victim’s skin is
very cold to the touch as the disease progresses. After the first 24 hours the victim begins
having spasms from being extremely cold. It becomes very difficult to undertake any
activity involving fine motor skills. This continues for until the victim is warmed up or

The source of this ailment is the seed of a popular cold climate fruit, the Winter Flame.
This decorative flowering plant has large, spectacular scarlet flowers that bloom in mid-
winter, and is used to brighten up many homes during the winter months. Its seeds are
produced as spring approaches (indeed, the plant seeding is a harbinger of the end of
winter). The fruit produces a single crunchy seed.

An individual contracts winter seed ague by ingesting the seed. The seed’s affects are
known by the communities where the fruit is plentiful. The disease usually gets started
when a strangers to the area eats the fruit & Seed and occasionally by small children who

don’t know better. The fruit is apple size and has a sweet honeydew type taste. Assassins
have used the seed (ground up) and places in sweet foods.

During the 1st 24 hours the victim is considered nauseated. After the initial 24 hours the
victim is so cold that they receive -4 to their Dexterity and a -2 to Intelligence. This
disease seems to cloud the mind of its victims for some reason that is yet unexplained.
The victim also suffers an additional -2 modifier to any cold-based hazards from weather,
spells, and magical effects.

Eating the peel of the fruit is an effective cure. Of course, as the winter flame only
grows in cold climates and only seeds but once a year, this can prove quite an
eventful search. A Fortitude save (DC 20) for 5 consecutive days will cause the disease to
go into remission. Treat disease must include keeping the victim warm (above 70
degrees) during this time as they have no body heat to do this. If the victim is exposed to
cold weather below freezing there after, there is a chance of a relapse. They must succeed
a Fortitude DC (20) or the process begins again. A Cure Disease will also cure the

Zombie Plague
Zombie’s being what they are; it is no surprise that a plague would be named after
them. The first hour after contraction itchy sores appear around the victims eyes. Rubbing
her eyes spreads the infection onto the victim’s hands and from there even a hand shake
will spread the plague. After about 12 hours the victim gets head aches, fever, and her
right arm and leg go numb. This causes the victim to walk with a limp favoring left side.
Your right arm hangs limp at your side.

This plague is an insidious disease and is spread to the living from the festering corpse
of a zombie. As if the smell was not bad enough! It seems to be in the creation of the
zombie that they become carriers. About 25% of zombies carry this plague. Alchemists
have not been able to tell what exactly causes certain zombies to carry this plague, but
just about any contact from a plague carrying zombie can infect someone. The disease is
easy to fight off in its initial stages. If left untreated though, it can kill.

A victim contracts this plague by coming in contact with any excretion from an infected
zombie (or any carrier of the disease). There are many entry points; being wounded by
the zombie’s bite, rubbing your eyes, mouth, nose, coughing/sneezing on someone or on
their food, or if the zombie gets some of its puss on a wound of an individual, that is all it
takes. All of these instances allow a reflex save DC 10 + the HD of the zombie to avoid
contracting the disease. Knowledge of the potential infection is not necessary.

The first effects, itchy sores around the eyes, appear after 1 hour. Then there is redness
to the eyes themselves and a swelling. The entry point, no matter where it is, becomes
irritated also and will begin to fester.
Treat Disease will save most people at this point. After about 12 hours the victim
becomes fatigued, and starts to have head aches, fever, and their right arm and leg go
numb. This causes you to move slower by 25% and you can not run. You walk with a
limp favoring your left side. Your right arm hangs limp at your side. The disease will last
for 2 days. The person either will live or die depending on other factors. The infected
creature remains contagious the whole time. Simple sanitary precautions are enough to
stop the spread of the disease. It is not an airborne contagion.

This disease can be cured with a remove disease, or Treat Disease. Treat Disease
requires complete bed rest for the victim. The fortitude save is (DC 19) and must be
successful for 2 consecutive days. The victim awakes after that 2nd check fatigued and is
no longer contagious. Any failed save results in the constitution of the victim dropping by
3 points. This will continue until the victim recovers or dies.

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System Reference Document Copyright 2000-2003, Wizards of the Coast, Inc.; Authors Jonathan Tweet, Monte Cook,
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18 Diseases and Ailments for your enjoyment Copyright 2007, d20 Magazine Rack.; Authors
Scott Stokes, Craig Tidwell, Joseph Blosch, Megan C Robertson, and Patrick & Marie Ciriello

Cover Artist: Craig Tidwell

Interior Artwork: Megan Stewart.