Bill Zebub
“It’s probably Matt Mercer’s fault.”
I don't think they represent injury, and I'm not being disingenuous.
Generally I think the loss of hit points consists in being set back in the current fight, but what that being set back looks like I think is very contextual. Some instances of hit point loss correspond to the suffering of an injury. Some don't.
Suppose a PC starts the day with 20 hp, and then in a fight with Orcs is hit 4 times, taking average damage from their swords, and thus loses 18 hp. The PC now has 2 hp left, and is likely to be felled by any Orc blow that they cannot dodge or parry. The player knows this. I don't see how the PC knows it - especially if the combat in which they lost 18 hp is over, and they've caught their breath and bandaged any nicks and scratches. They might know that they're not at their peak; but I don't think they can know that the next Orc blow will probably be fatal (or near-fatal, depending on edition).
In support of that viewpoint: I was just reading the quickstart for Nimble, which is 5e derived/adjacent, and in their model once you reach zero HP you start taking wounds. At six wounds you are dead. HP can be healed quickly, but wounds can take much longer.
In that model it seems that HP represent some kind of luck or skill or hero points or whatever, and you don't actually take physical damage until they are exhausted.






