When are wound infections appropriate?

[Mastikator]

In a high fantasy D&D game a PC being worried about their wounds being infected from their last battle seems out of the question, but in a zombie horror survival game it seems almost a given that a zombie bite is a potential death sentence even if you get safely away.

On a sliding scale of grittyness (between those two extremes), at what level is having to deal with wound infections appropriate?

[Braininthejar2]

Somewhere around The Witcher I guess. Definitely in stuff like Game of Thrones

[Cazero]

Check whether your ruleset have rules for it. If it does, it's probably supposed to be handled ingame (I have no doubt zombie games do it). If it doesn't, regular damage are probably handwaved to cover it (as D&D might be doing, who knows).

[Jay R]

It's not about grittiness. If it's only a tool for removing hit points for awhile, it's just annoying. If it has a clear purpose - making them turn aside to find the apothecary who also has the Potion of Dragon Control they need, or making one kind of monster more threatening by giving it consequences that last beyond the CLW spell, then go ahead and use it.

[Melzentir]

Appropriate? It all depends on whether or not the DM thinks it would contribute to the players' experience in an entertaining way. Note that I use the word entertaining, not fun. Stories that make us cry are not fun but often still held in high regard and given much praise. Hence the popularity of Dwarf Fortress.

[Samuel Sturm]

I'm imagining a dungeon crawl where they're having to deal with the results of SCIENCE! Also a good chance to inflict them with the mutations table, Far Realms feats, and refluffed Totemists.

[LibraryOgre]

In a high fantasy D&D game a PC being worried about their wounds being infected from their last battle seems out of the question, but in a zombie horror survival game it seems almost a given that a zombie bite is a potential death sentence even if you get safely away.

On a sliding scale of grittyness (between those two extremes), at what level is having to deal with wound infections appropriate?

On a 1-7, with 1 being "dung and dirt" and 7 being "light and polish", I'd put it at a 3... the kind of thing that encourages you to think about the consequences of fighting beyond simple wounds, but not necessarily all the way down in the dumps (though it's going to show up there, as well).

Personally, I've always liked the 1e DMG take on it.

[Fire Lord Pi]

I would put dealing with wounds at around a 5 on the scale of 1-7 (7 is the grittiest grit). Infection is truly horrible if you have a nack for flavour. And without a Cure Disease and only pre-modern medicine, watching a friend waste away is scary, very much producing urgency if you are on a quest for a cure/doctor.

My belief is that realism is of the utmost importance, so I use disease liberally.

[VoxRationis]

Despite my tendency towards realism in my games, I use disease sparingly—mostly when the threat of infection is especially bad (when fighting enemies with poor hygiene, for instance, or when fighting in disease-bearing environments).

[Vitruviansquid]

It's not about the grittiness of the game.

It's about whether you want a player to be hamstrung in your next fight or big event, or totally excluded from it. I'd usually be hesitant to use or implement wound infection mechanics because it's inherently anti-fun to be sick and unable to participate in the game for awhile, but sometimes it's a sacrifice you'd want to make for a stronger atmosphere (like if you're running a survival based game), or for some resource management mechanics (your group has a limited amount of medicine, and negating wound infections costs medicine), or some other mechanic you care about.

[Honest Tiefling]

I think it has more to do with the idea of how common combat is, and the approach the setting has to it. If enemies and important characters, even the big bads, can be taken out by unlucky strikes, infections, or other mishaps, then yes. Combat is cruel, uncaring and can lay low even the greatest of people, and you must exercise caution before going into it because anyone can die.

If it is more heroic fantasy, then it seems out of place, hampering melee characters who then must track down cures all of the dang time. I could easily see curing this become oddly mundane and boring unless handled well. Only time I'd throw it in here is if there are some minions, an army or a fort the characters can utilize and a lot of characters invested into healing.

[Slipperychicken]

I think this depends greatly on a game's pacing. It would be perfectly reasonable in a game like Pendragon, where fights are generally months or years apart, between which all kinds of misfortunes can potentially kill or cripple the PCs, moving the game to the PCs' progeny.

Similarly, it depends on whether the game rules already account for normal diseases. It's unfair to saddle some characters with wound-borne illnesses, but not include other maladies.

It also depends on how brutal the rules are for infections. If they can be avoided by just quickly treating the wounds, or if you can just sleep off an infection with proper medical care, it's not such a big deal. Similarly, if infections don't usually impact performance or result in fatality, it doesn't seem like a huge handicap in the first place.

It's also not a big deal if the game setting has magic to deal with it. Like if your standard cure-wounds spell also took care of infections.

[Erik Vale]

In a high magic world where presdigitation and magical healing abounds [if you're rich/adventurers], it rates a not-relevent except when the game rules say so or I think it would make for good plot. Of course, this is also the sort of setting where people fight to the death a lot.

For the rest of the time, well... Now you know why the greatest killer in battle is disease... And no, it's not just because they keep running away.

[Gnome Alone]

Personally, I've always liked the 1e DMG take on it.

Does that involve, like, rolling percentage dice on a random table to determine whether you have magic sentient gangrene or if there are interdinensional portals growing in your stumps and so forth?

[Mr Beer]

It's something I would consider Harsh Realism in a game with frequent combat, so I do consider this a matter of 'grittiness'.

[PersonMan]

Also important is the type of game - are the players going to be up against a group of enemies who keep coming back? Or are wound infection mechanics only usable for the enemy because by the time it would matter for the enemy, they're dead anyways?

[LibraryOgre]

Does that involve, like, rolling percentage dice on a random table to determine whether you have magic sentient gangrene or if there are interdinensional portals growing in your stumps and so forth?

Rolling percentages? Yes. However, it's based on things like health, cleanliness, diet, etc., and gives you a chance to develop a variety of generalized diseases (i.e. you might get acute respiratory or chronic gastrointestinal diseases, rather than tuberculosis or tapeworms).

[TheCountAlucard]

Exalted's got rules for wound infections. The Exalted themselves are heavily resistant to these sorts of things, but mortals in the setting are as susceptible to it as anyone; the presence of cholera and infected wounds cut a stark contrast to the wire-fighting demigods.

[Alejandro]

Just remember, the bigger a part of the game you make something, the more your players will either want to use it, or defend against it. So, I would expect to deal with players trying to use, essentially, biological warfare on their enemies. Kill just a few goblins, fling their corpses into the goblin fort, hope to start spreading an epidemic? Do I get XP if I kill half the thieves' guild with smallpox?

[Slipperychicken]

Just remember, the bigger a part of the game you make something, the more your players will either want to use it, or defend against it. So, I would expect to deal with players trying to use, essentially, biological warfare on their enemies. Kill just a few goblins, fling their corpses into the goblin fort, hope to start spreading an epidemic? Do I get XP if I kill half the thieves' guild with smallpox?

It actually was a historical strategy to smear dirt or feces on arrowheads to increase the risk of infecting the enemies' wounds. British bowmen, for example, would sometimes stick their arrows in dirt for that exact purpose, and the Viet Cong would often smear feces or other toxic substances on their spiked-pit traps to infect enemy soldiers' wounds.

[WarKitty]

Probably also depends on the setting. So this could be really interesting in, say, a WoD game. In a first world country infections are most likely not going to be the long sentence that they would be otherwise. But it does make for quite an interesting hospital trip.

[Tengu_temp]

Warhammer Fantasy Roleplay has rules for wound infections. Therefore, I'd say it's the level of grittiness when they should be considered. Higher than it, they mostly serve as a plot thing.

Do note that WFRP is not as gritty as the grimdarkness of WH40K. And Warhammer Fantasy Battle is even less gritty than WFRP, being only somewhat darker than your average epic heroic fantasy.

[Gnome Alone]

Rolling percentages? Yes. However, it's based on things like health, cleanliness, diet, etc., and gives you a chance to develop a variety of generalized diseases (i.e. you might get acute respiratory or chronic gastrointestinal diseases, rather than tuberculosis or tapeworms).

That sounds cool. I figured it was either super granular like that, or out of nowhere like the things I thought of; such is my conception of 1e D&D.

[KillianHawkeye]

In a high fantasy D&D game a PC being worried about their wounds being infected from their last battle seems out of the question, but in a zombie horror survival game it seems almost a given that a zombie bite is a potential death sentence even if you get safely away.

I would say this depends heavily on the circumstances.

Zombism isn't normally transmitted as a disease via cuts or bites in D&D, but that's a really popular "pop culture" version in movies and things so it's not too far out of left field if you want to add that. If so, then come up with the rules for it (i.e., Fortitude saves to contract the illness when bit by a zombie or whatever).

For more pedestrian infections, if you want to be really gritty you can have a rule that any injury that isn't treated with first aid or healing magic has a chance to become infected. The chance would be pretty low in a relatively clean environment, but if you're sleeping in caves, trapped in a dungeon, or slogging through sewers then chances are any open wounds you have will get an infection. This should probably be something relatively mild, like Filth Fever, but you can make it something worse that (if left untreated for too long) can require amputation if the disease is not magically cured.

Again, this really depends on the environment. If the characters are somewhere filthy or rampant with disease, open wounds will probably become diseased as well.

[Nagash]

I use infected wounds as a possibility in pathfinder games. I like the PF desease rules quite a bit and its a good reason for players to actually take the heal skill and buy medicine or have skills to let the characters make medicine rather then relying on CLW wands.

Also I think theres a sort of ingame logic for it. The cure disease spell exists, and it is significantly higher level then CLW. Which to me implies you cant just swap out CLW for infections, diseases and such. It doesnt come up everytime but I will point out that characters need to use the heal skill to make sure things are clean and the wound is recovering okay periodically.

[Cazero]

Also I think theres a sort of ingame logic for it. The cure disease spell exists, and it is significantly higher level then CLW. Which to me implies you cant just swap out CLW for infections, diseases and such. It doesnt come up everytime but I will point out that characters need to use the heal skill to make sure things are clean and the wound is recovering okay periodically.

While it is true that the cure disease spell is of a much higher level, it is also mostly intended to cure potent disease, more often than not transmitted supernaturally (like the mummy rot), not common wounds infections. In that sense, I would rule that the cure wounds spells are more than enough to prevent common wounds from infecting.

[zilvar]

Wound infections are appropriate if it advances the story narrative in some fashion. Or you're in a highly simulationist game (which is technically the same thing, since that part of the simulation advances that narrative).

[Firest Kathon]

Check whether your ruleset have rules for it. If it does, it's probably supposed to be handled ingame (I have no doubt zombie games do it). If it doesn't, regular damage are probably handwaved to cover it (as D&D might be doing, who knows).

Zombism isn't normally transmitted as a disease via cuts or bites in D&D, but that's a really popular "pop culture" version in movies and things so it's not too far out of left field if you want to add that. If so, then come up with the rules for it (i.e., Fortitude saves to contract the illness when bit by a zombie or whatever).

In D&D3.X/Pathfinder, wounds usually do not get infected. If they can, it is a disease special ability on the attack (see e.g. the Apocalypse Zombie) and usually a magical disease.

[Mastikator]

Wound infections are appropriate if it advances the story narrative in some fashion. Or you're in a highly simulationist game (which is technically the same thing, since that part of the simulation advances that narrative).

But isn't simulationism a part of creating immersion?

[Jay R]

But isn't simulationism a part of creating immersion?

Not automatically. If we had to simulate every flower in the forest, the effort would distract from the immersion, overwhelming it.