D&D (2024) 5.5/6e - Is it time for Wounds/Vitality?

I think this "death spiral" malarky is just a screen to say "I don't want things to change" or "I like the system the way it is" or "Wounds are fine and 5e is the best thing since sliced bread."

The only way you end up in a death spiral is if you continue to press on when you get injured, or your ability to do what you do. And you know what you do then, you flee. You leave the fight. Not every fight needs to be to the death. You take a week to recover. Gee, I'm at 2 Exhaustion, let's keep going deeper into the dungeon! Let's go fight the BBG. No, how about you wait and recover first. And if its impossible to flee or have the time to rest (due to the way ticking clocks and "adventure paths" work now), that's a table issue, not a game issue. We play older school rules with much lower hit points, non-balanced encounters, etc. and both monsters and characters flee fights they can't win. If I'm poisoned, I'm not going anywhere. If I'm non combat capable in a fight, we're withdrawing, and the game/table accommodates that.

I like @Steampunkette's suggestion about a critical doing 1 vitality. 5e is simple at its core, it needs more dials to turn, especially around healing. Their gritty healing seems half baked.
The rules are simply not set up well to allow fleeing. You start engaged, eat an attack of opportunity, then end up engaged after they catch up. Any slower companions (small or heavy armor wearers) are left behind to die. The chase rules are also awful. 5E (and D&D in general) is simply not set up mechanically well to allow for players to escape without magic or the DM just letting you get away.

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I doubt we'll ever see it in the base rules. Too complicated and they've never been part of it. HP serve the needs of most well enough, so "if it ain't broke, don't fix it."

IMO to do a wound system properly, the number needs to be based on creature size/race, which doesn't change over time. They're the character's Meat Points, and unless they somehow get bigger, that's all they'll ever have. Probably gain a wound the first time you reach half HP after a long rest, when you take a critical hit, when you drop to 0 HP, and when you fail a death save. HP may come back overnight, but wounds take longer.


You'd need a better system than the star wars d20 W/V system. The main issue with that, from memory, was that a critical hit bypassed vitality and went straight to wounds. Since wounds were generally just your Constitution Score it often didn't matter how powerful you were or if you were at max vitality, a lucky hit could straight up kill you.

Star Wars SE used hit points and a condition track, I don't think they had wounds/vitality and I can't recall how you moved down the condition track, though I assume that critical hits were one of the things that pushed you down it. Things like that always seemed cool, but I'm with others in that I prefer my games without death spirals as they take away from our fun when playing dnd.

If I were to do it...

Adds a tiny layer of complexity to health, but small compared to some options. And it doesn't wind up massively inflating your hit point totals. It also makes crits more deadly without making them implausibly monstrous.

I think instead of having Wound Points as a separate pool (and having to figure out how many WP monsters of different sizes should have, and having the GM need to track two pools per foe), the easiest way to have a 'modular wound system' would be to make wounds conditions that critical hits can cause instead of extra damage.

One benefit is that if you had a player who wanted to opt out of suffering wounds for safety tool reasons, you could just let them use the normal 'crits do double damage dice' system the core rules have, while everyone else uses 'crits cause wounds but no extra damage.'

There are 5 locations that can be wounded, and 4 degrees of severity.

When an attack rolls a natural 20, it causes a wound to a random location. To determine randomly, you roll 1d6:

1 - mobility
2 - primary attack
3 - secondary attack
4 - stamina
5 - sensory
6 - attacker chooses

Mobility wounds affect legs, wings, or whatever worms and stuff use to move. It knocks the creature prone, and for the duration of the wound they're slowed.

Primary attack affects whatever the most threatening attack mode of a creature is (typically the primary hand for a humanoid). The creature drops whatever its holding in that limb, and for the duration of the wound that attack does half damage (or has disadvantage if it doesn't deal damage [or the save to resist has advantage if it both deals no damage and has no attack roll]).

Secondary attacks are any other attack, or just a spare limb (typically the off hand for a humanoid).

Stamina is meant to represent bleeding or some sort of reeling blow. Note the damage dice the attack deals. At the start of the attacker's next turn, roll those dice and the wounded creature takes that damage. This just happens one time. Then, for the duration of the wound, the creature has its maximum hit points reduced by the amount of the wound.

Sensory wounds affect eyes (or other primary sensing organs) and make you count as blind for one round. For the duration of the wound, the creature treats everyone as having concealment.

There are four levels of severity. If the creature struck is at 1 HP or above after the attack deals damage, the default severity is moderate. If they are at 0 HP, the default severity is serious. The creature struck can make a Constitution saving throw (DC 10 + attacker's proficiency mod) to reduce the severity by one level.

Light Wounds last until the end of the encounter or receive 1 die of magical healing. Mostly they just spice things up a bit during a combat.

Moderate Wounds last until you take a short rest or receive 2 dice of magical healing at once.

Serious Wounds last until you take a long rest or receive 3 dice of magical healing at once.

Critical Wounds last forever but can be healed with the (now 4th level spell) regenerate. These attacks don't happen randomly, only with special effects like vorpal swords or high-level spells.

Special Notes
If a creature is already at 0 HP, you can use an attack to intentionally inflict a wound.

Certain creatures might be immune to wounds (like ghosts). Others might require wounds to defeat - like perhaps zombies only go down when you inflict a stamina crit. Heck, maybe zombies suffer a crit with any attack that deals more than 10 damage. You could have fun with it.

There could be a Rip and Tear sub-variant where the default severity of wounds goes up one step if the attacker's proficiency bonus is higher than the defender's, and goes down in reverse. This lets groups that want really over the top delimbing to do it without the PCs themselves falling apart to hordes of weak minions.


And that's all you need. It fits into a page, and allows for the narrative effect of long-term wounds without really having a death spiral, and without requiring tracking a second pool of numbers.
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Victoria Rules
I think instead of having Wound Points as a separate pool (and having to figure out how many WP monsters of different sizes should have, and having the GM need to track two pools per foe),
In any system where you don't get into WP/BP until you're out of VP/FP, why would you ever need to track two pools?

WP + VP = HP. Just track HP as normal, other than rare corner cases e.g. slitting the throat of a defenseless foe.

The biggest complication (and it's really not that bad) is around curing and resting, as WP/BP come back at a different (slower) rate than do VP/FP regardless of the method used.


@vincegetorix @DND_Reborn The current house rules I'm using for my Theros campaign changes up both the Rests system and the Dying system and what happens when you hit 0 HP (which includes the Exhaustion chart). For those that care, here are the rules which I'm currently using. The new Resting rules split up the regaining of long rest class features from full overnight healing (slightly making full healing more difficult). It also allows PCs to remain conscious and moving while at 0 HP in order to retreat, and removes the conscious to unconscious to conscious ping-ponging of healing at 0 HP by not removing the Dying condition even when given healing. (Note that these aren't extremely detailed for every little questionable bit because unless stated otherwise anything else is run with the standard death and dying rules. If there's a question about anything in particular I'd be happy to explain it.)

  • A Short Rest is 10 minutes, during which you may spend hit dice to regain hit points and regain features that refresh on a Short Rest.
  • A Long Rest is 8 hours of light activity or sleep, after which you regain all of your spent hit dice, regain all features that refresh on a Long Rest, and you lose your level of exhaustion if currently at Level 1 (creatures at any higher exhaustion levels do not lose any.) You do not automatically regain all hit points following a Long Rest. However, the effects of a Short Rest are included at both the beginning and end of a Long Rest. (I.E. you may spend any remaining hit dice you have at the beginning of the Long Rest to regain hit points, and then may spend any new hit dice you just regained following the Long Rest to regain more hit points.)
  • An Extended Rest is 24 hours of uninterrupted bed rest in a safe location and counts as a Short and Long Rest. You regain all hit points, all hit dice, all class features, and may possibly reduce levels of Exhaustion you currently have. At the end of the Extended Rest another character may attempt a WIS (Medicine) check. If the check reaches DC 10 it reduces your Exhaustion level by 1, if it hits DC 20 it reduces it by 2 levels, and at DC 30 by 3 levels. This WIS (Medicine) check to remove Exhaustion levels may be tried after every Extended Rest the character takes.

Dying and Exhaustion

  • When a creature reaches 0 hit points, they are Dying. They remain Dying until they are Stabilized.
  • A Dying creature has the Incapacitated condition (instead of Unconscious) and at the start of each of their turns make Death saving throws with a DC 10 to succeed. (An Incapacitated creature cannot take actions or reactions but may still move.)
  • Every level of Exhaustion a creature has raises the DC by 1.
  • Each failed Death saving throw causes one level of Exhaustion.
  • Death occurs at Exhaustion Level 6 as per the Exhaustion chart (and not 3 failed Death saving throws as normal.)
  • A creature may regain hit points while Dying (via abilities, spells and items as normal), but that does not remove the Incapacitated condition, does not stop the rolling of Death saving throws, and does not adjust or affect their Exhaustion level. They are still considered Dying even though they are no longer at 0 HP.
  • To no longer be considered Dying (and thus remove the Incapacitated condition and stop the rolling of Death saving throws) requires the target to be Stabilized.

Stabilizing a Dying Creature

  • A Dying creature that makes three successful Death saving throws or rolls a Natural 20 on a Death saving throw automatically Stabilizes.
  • Another character adjacent to an Incapacitated character can attempt to Stabilize them by using an Action to make a WIS (Medicine) check with a DC equal to the target’s current Death save DC.
  • Stabilizing a creature does not remove any levels of Exhaustion or gives them additional hit points.
  • A Stabilized creature has however many hit points they have received (if any) while Dying. A Stabilized creature who was not healed while Dying is still at 0 HP but can act normally.

Combat While Dying or Stabilized

  • Any successful attack made on a Dying creature immediately results in one automatic failed Death saving throw.
  • Any attack on a Dying creature that has hit points does not cause hit point damage but rather still causes an immediate automatic failed Death saving throw.
  • An attack on a Stabilized creature causes hit point damage. If the creature is at 0 HP or the attack drops them back to 0 HP, it immediately ends the Stabilization and they are considered Dying again.
  • A creature that begins Dying again has their successful Death saving throws reset to 0. Their Exhaustion level is at wherever it was previously.

Exhaustion Chart

  • Level 1: Speed halved.
  • Level 2: Max HP halved.
  • Level 3: Disadvantage on attack rolls and saving throws.
  • Level 4: Disadvantage on ability checks.
  • Level 5: Unconscious.
  • Level 6: Death.

Simplicity is key.
I currently use the exhaustion track as a wound metric but ideally you'd like to separate the two.

If you were to separate you'd have to determine
(1) What earns one a wound (it is a crit, is it a failed death save on a critical, falling below 0hp, a failed death save while unconscious, half your hit points in damage, something else)
(2) If a wound "climbs" the wound track or can one have multiple wound levels (i.e. one can have two level 1 wounds) and the effects of having multiple wound levels has.
(3) The mundane recovery process depending on the level of wound (1 day, 1 week, 1 month, 1 year..etc).
(4) The recovery process via magic depending on the level of the wound/s.
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For my sins, I ran a long d20 Star wars campaign using VP/WP.

It was a train wreck of a system, frankly. Among the problems (SWd20 had a LOT of problems and I still personally resent whoever it was at WotC who wrote, tested, and okayed that disastrous system to be sold to the unsuspecting public, but I'll try to stick to VP/WP issues here) were:
  • players optimising their characters to fish for crits to hit the wounds of an enemy rather than bothering to chew through the VP.
  • pretty much no thought given to how things like area effect weapons or persistent effects like being on fire interacted with the new system
  • as damage inflated at higher level, it made crits into effective instakills on even very tough PCs

A lot of these problems were attributable to the whole VP/WP system being tacked on to standard d20 with profoundly insufficient thought and testing, and to the interaction of VP/WP with all sorts of other, equally broken and dysfunctional aspects of that game. But not all of them were.

As far as dysfunctional death spirals - I actually don't mind the Bloodied mechanic from 4e to be honest. Just having a nice simple single threshold that can be used to trigger positive or negative special effects or conditions or whatever - that's a nice extra design feature that spells/monsters/abilities can be designed to key off, without getting too deep into the weeds.


Follower of the Way
We already had a wound/vitality system in D&D.

It was in 4e. They called wounds "healing surges." It worked really well. But people decried it as "unrealistic" and weird, so it was abandoned.

Now we have hit dice, which look superficially like healing surges, but at this point people know quite well that hit dice cannot serve as a "wounds" system without heavy rewriting.

Voidrunner's Codex

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