So, the "4e healing is best" thread has turned into the old "Are hit points meat?" argument, which will never be solved because it is about fundamental differences of approach to the fiction of the game. I started writing this in there, but it's clearly its own question (and will probably devolve into its own argument, if people notice it at all, but it's 4am and I'm thinking about potential D&D mechanics again, so this is going to get written down, damnit). Therefore...
I am reminded of something I was thinking of a while back for a... sort of half-way house gritty-ish storytelling houserule. Based on the idea that D&D is generally a game about talented adventurers who get into life-threatening situations, what if we go with the trope of "People running on adrenaline can shrug off fatal wounds, at least for a while" and try this:
(5e mechanics, easy to use in any edition with minor tweaks)
1. If you are dropped to half your hit points, you have taken a wound
2. If you are dropped to 0hp, you take another wound
3. Wounds do not take effect until after the encounter they are obtained in (you're pumped up on adrenaline)
4. Wounds are based on the damage you took, and provide some hindrance (penalty to attack with both hands, subtraction from speed, drop your max HP, etc)
5. Wounds have a healing threshold and a DC to cure. You can make a CON save to try to recover from one wound every time you finish a long rest. Any time a single source heals you for the healing threshold value or more, you can make a CON save against one wound. Let's say something like threshold 10 and DC 10 as an initial thought.
6. A successful medicine check (same DC as the wound) gives advantage on the next attempt to cure it.
6a. Anything else the DM says cures a wound cures it. Obviously.
(Not playtested, although I think I know a group who would love this sort of thing)
Mostly, I'm wondering if anyone has tried something like the above? It seems like an obvious thing that someone must have tried in some d&d variant (and therefore, is there a variant with a better implementation than mine?
)
It's not exactly simulationist; it's presenting a storytelling trope of the heroes who finish the fight, then fall over. I think it would be fun to play (I'd definitely play in a group that used something like this, although the numbers could do with some work). I'm sure there are people who would hate it, but I know a lot of people who like horrible complications being thrown in to their game - as long as they feel fair. I am certain there are plenty of people who would hate this - but I'm very interested in constructive feedback.
Just for ease, let's throw in a couple of examples:
(Again, I'm using 5e mechanics; this would be very easy to translate or (for something like 4e) reword into a more keyworded form. There should also, of course, be a good few more of these)
A simple one:
Contusion
Damage types: bludgeoning, force, thunder
You have massive bruising across the wound, with possibly broken bones. Movement is painful - your speed is reduced by 5' and you cannot take the Dash action. You may attempt a DC 10 Constitution saving throw any time a single source of healing restores 10hp or more to you (this can include a long rest).
On a successful roll, the wound is cured. You can only cure one wound each time you are healed.
Something nastier:
Disfiguring burn
Damage types: acid, fire, lightning, radiant
Your face has been badly burned, and your senses are impaired. You have disadvantage to Wisdom (perception) and Charisma (persuasion) checks, although your fearsome appearance gives you advantage on Charisma (intimidation) checks. In addition, your hit point maximum is reduced by 5 while you have this wound. You may attempt a DC 20 Constitution saving throw any time a single source of healing restores 20hp or more to you (this can include a long rest).
On a successful roll, the wound is cured and you gain an additional 5hp. You can only cure one wound each time you are healed.
And something more specific:
Lightning twitch
Damage types: lightning
Your recent brush with the power of lightning has left your muscles twitchy and uncoordinated. You have disadvantage on ability checks, attack rolls and saving throws using Dexterity. You may attempt a DC 5 Constitution saving throw any time a single source of healing restores 10hp or more to you (this can include a long rest).
On a successful roll, the wound is cured. You can only cure one wound each time you are healed.
Okay, there you go. Is there something better out there? If you would use something like this, what do you think wouldn't work? As a caveat (that I'm sure many people won't get far enough to read, but oh well!), I'm going for some rules that support telling a story in which the PCs get lingering wounds and deal with them (or, of course, meet people who have such wounds and perhaps lack the resources to cure them themselves). It's not intended to be accurate to life, and there are plenty of edge cases that I don't think would detract from the idea - for instance, the length of the fight isn't taken into account, and I'm not trying to mimic specific conditions.
I am reminded of something I was thinking of a while back for a... sort of half-way house gritty-ish storytelling houserule. Based on the idea that D&D is generally a game about talented adventurers who get into life-threatening situations, what if we go with the trope of "People running on adrenaline can shrug off fatal wounds, at least for a while" and try this:
(5e mechanics, easy to use in any edition with minor tweaks)
1. If you are dropped to half your hit points, you have taken a wound
2. If you are dropped to 0hp, you take another wound
3. Wounds do not take effect until after the encounter they are obtained in (you're pumped up on adrenaline)
4. Wounds are based on the damage you took, and provide some hindrance (penalty to attack with both hands, subtraction from speed, drop your max HP, etc)
5. Wounds have a healing threshold and a DC to cure. You can make a CON save to try to recover from one wound every time you finish a long rest. Any time a single source heals you for the healing threshold value or more, you can make a CON save against one wound. Let's say something like threshold 10 and DC 10 as an initial thought.
6. A successful medicine check (same DC as the wound) gives advantage on the next attempt to cure it.
6a. Anything else the DM says cures a wound cures it. Obviously.
(Not playtested, although I think I know a group who would love this sort of thing)
Mostly, I'm wondering if anyone has tried something like the above? It seems like an obvious thing that someone must have tried in some d&d variant (and therefore, is there a variant with a better implementation than mine?

It's not exactly simulationist; it's presenting a storytelling trope of the heroes who finish the fight, then fall over. I think it would be fun to play (I'd definitely play in a group that used something like this, although the numbers could do with some work). I'm sure there are people who would hate it, but I know a lot of people who like horrible complications being thrown in to their game - as long as they feel fair. I am certain there are plenty of people who would hate this - but I'm very interested in constructive feedback.
Just for ease, let's throw in a couple of examples:
(Again, I'm using 5e mechanics; this would be very easy to translate or (for something like 4e) reword into a more keyworded form. There should also, of course, be a good few more of these)
A simple one:
Contusion
Damage types: bludgeoning, force, thunder
You have massive bruising across the wound, with possibly broken bones. Movement is painful - your speed is reduced by 5' and you cannot take the Dash action. You may attempt a DC 10 Constitution saving throw any time a single source of healing restores 10hp or more to you (this can include a long rest).
On a successful roll, the wound is cured. You can only cure one wound each time you are healed.
Something nastier:
Disfiguring burn
Damage types: acid, fire, lightning, radiant
Your face has been badly burned, and your senses are impaired. You have disadvantage to Wisdom (perception) and Charisma (persuasion) checks, although your fearsome appearance gives you advantage on Charisma (intimidation) checks. In addition, your hit point maximum is reduced by 5 while you have this wound. You may attempt a DC 20 Constitution saving throw any time a single source of healing restores 20hp or more to you (this can include a long rest).
On a successful roll, the wound is cured and you gain an additional 5hp. You can only cure one wound each time you are healed.
And something more specific:
Lightning twitch
Damage types: lightning
Your recent brush with the power of lightning has left your muscles twitchy and uncoordinated. You have disadvantage on ability checks, attack rolls and saving throws using Dexterity. You may attempt a DC 5 Constitution saving throw any time a single source of healing restores 10hp or more to you (this can include a long rest).
On a successful roll, the wound is cured. You can only cure one wound each time you are healed.
Okay, there you go. Is there something better out there? If you would use something like this, what do you think wouldn't work? As a caveat (that I'm sure many people won't get far enough to read, but oh well!), I'm going for some rules that support telling a story in which the PCs get lingering wounds and deal with them (or, of course, meet people who have such wounds and perhaps lack the resources to cure them themselves). It's not intended to be accurate to life, and there are plenty of edge cases that I don't think would detract from the idea - for instance, the length of the fight isn't taken into account, and I'm not trying to mimic specific conditions.