So, this idea is not at all original. It came from Keith Baker. I just wrote it up in a slightly more "formal" way, and included the idea of players accepting wounds voluntarily (which I also stole, from the upcoming A Song of Ice and Fire RPG). Please let me know if these seem balanced, usable, etc.
-- 77IM
Wounds
Some stories are more interesting if the protagonists suffer grievous wounds in the course of their quest, and must cope with broken arms, internal bleeding, and dizzying blows to the head. Because of the fast-paced action-oriented nature of D&D, these rules assume that wounds are a somewhat rare occurrence. A player facing a difficult encounter can choose to become crippled rather than face defeat, and it's possible to deliberately wound someone, rather than slay them. Both options are meant to use wounds as interesting plot elements, not simulate tissue trauma in general (the hit point system already does a sufficient job of that).
Characters who are severely damaged can elect to take a wound instead of hit point damage. Wounds cause long-lasting penalties and may hamper the character's performance over the course of many adventures. Wounds are similar to diseases in many ways, including the use of a "wound track," but they are not diseases -- immunity to disease does not protect against a wound, and the Cure Disease ritual does not affect wounds.
SUFFER WOUND: Free Action
INFLICT WOUND: Part of an attack
Wound Effects
Any sort of wound hampers your mobility a bit, imposing a -2 penalty on all Acrobatics, Athletics and Stealth checks. Each wound has additional penalties, based on the part of the body it affects.
Curing Wounds
Wounds use a wound track, similar to the disease track. Unlike a disease, the penalties from the wound don't get any better or worse at each stage in the track. You suffer the full penalties from the wound until you are cured.
Cured <- Initial <-> Worsening -> Permanent
After each extended rest, make an Endurance check.
Stable DC = 10 + 1/2 the wound's level
Improve DC = 20 + 1/2 the wound's level
If you beat the wound's improve DC, your wound moves one step up the track. If you beat the wound's stable DC, nothing happens. If you fail to hit the wound's stable DC, you move one step down the track. Your wound starts in the initial state. When it moves into the cured state, you no longer suffer any effects from the wound. If it reaches the permanent state, you no longer make Endurance checks after extended rests.
Another character can use the Heal skill to treat a wound. This works exactly like using the Heal skill to treat disease.
There is also a ritual available, Cure Wound. This ritual is identical to Cure Disease in every way, except that it cures wounds instead of diseases. It is a separate ritual from Cure Disease (knowing one ritual does not mean you know the other -- you must learn them both separately).
-- 77IM
Wounds
Some stories are more interesting if the protagonists suffer grievous wounds in the course of their quest, and must cope with broken arms, internal bleeding, and dizzying blows to the head. Because of the fast-paced action-oriented nature of D&D, these rules assume that wounds are a somewhat rare occurrence. A player facing a difficult encounter can choose to become crippled rather than face defeat, and it's possible to deliberately wound someone, rather than slay them. Both options are meant to use wounds as interesting plot elements, not simulate tissue trauma in general (the hit point system already does a sufficient job of that).
Characters who are severely damaged can elect to take a wound instead of hit point damage. Wounds cause long-lasting penalties and may hamper the character's performance over the course of many adventures. Wounds are similar to diseases in many ways, including the use of a "wound track," but they are not diseases -- immunity to disease does not protect against a wound, and the Cure Disease ritual does not affect wounds.
SUFFER WOUND: Free Action
- Negate Damage: Use this action when you take damage. You negate damage from a single source, up to your healing surge value. For example, if your healing surge value is 14, and you fall off a cliff for 19 damage, you would only suffer 5 damage for the fall.
- Stabilize When Dying: You can also use this action when you are dying. You heal an amount equal to your healing surge value (as though you had rolled a 20 on your dying save). You must use this action before you are actually dead (you can't fail your final death save and then decide to suffer a wound).
- Costs a Healing Surge: Suffering a wound uses up a healing surge, but you don't get the normal benefits of using a healing surge. You must have at least one healing surge available to suffer a wound.
- Gain a Wound of the DM's Choice: You immediately gain a wound. The DM selects the type of wound based on manner in which you took damage. The level of the wound is equal to the level of the creature, trap, or hazard that inflicted the damage, or equal to the level of the encounter if it wasn't inflicted by a creature, trap, or hazard. If you suffer a wound outside of an encounter, the DM selects the level of the wound.
INFLICT WOUND: Part of an attack
- Declare Before you Attack: You must declare your attempt to wound an opponent before making your attack roll. You must also specify what type of wound your attack will cause.
- Damage Penalty: Your attack takes a damage penalty equal to the victim's healing surge value. Unlike most damage penalties, this can reduce the damage from your attack to 0 (but not below 0).
- Damage Causes the Wound: If your attack deals at least 1 point of damage (after applying the penalty), your victim suffers the wound you specified, in addition to the damage. If the damage was reduced to 0, the victim doesn't suffer the wound -- they are too tough, or they were able to evade your fancy maneuver.
- Wound Level: The wound's level is equal to your level.
Wound Effects
Any sort of wound hampers your mobility a bit, imposing a -2 penalty on all Acrobatics, Athletics and Stealth checks. Each wound has additional penalties, based on the part of the body it affects.
- Head Wound: You suffer a -2 penalty on Perception and Insight checks, and on all attack rolls based upon Intelligence, Wisdom, and Charisma. You can only suffer one head wound at a time.
- Arm Wound: You can no longer hold a shield in that arm, and take a -2 penalty on all attack rolls using a weapon held in that arm, and a -2 penalty on Thievery checks using that arm. You can have one arm wound per arm.
- Leg Wound: Your speed is decreased by 2. You can have one leg wound per leg.
- Vitals Wound: You take a -2 penalty to your Fortitude, Reflex, and Will defenses. There is no limit to the number of vitals wounds you can suffer.
Curing Wounds
Wounds use a wound track, similar to the disease track. Unlike a disease, the penalties from the wound don't get any better or worse at each stage in the track. You suffer the full penalties from the wound until you are cured.
Cured <- Initial <-> Worsening -> Permanent
After each extended rest, make an Endurance check.
Stable DC = 10 + 1/2 the wound's level
Improve DC = 20 + 1/2 the wound's level
If you beat the wound's improve DC, your wound moves one step up the track. If you beat the wound's stable DC, nothing happens. If you fail to hit the wound's stable DC, you move one step down the track. Your wound starts in the initial state. When it moves into the cured state, you no longer suffer any effects from the wound. If it reaches the permanent state, you no longer make Endurance checks after extended rests.
Another character can use the Heal skill to treat a wound. This works exactly like using the Heal skill to treat disease.
There is also a ritual available, Cure Wound. This ritual is identical to Cure Disease in every way, except that it cures wounds instead of diseases. It is a separate ritual from Cure Disease (knowing one ritual does not mean you know the other -- you must learn them both separately).