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Hi,
Well, the rules look well put together, but I'm afraid my comments are pretty negative overall. I'll start with the good bits
As an aside, I've put together some (alpha at this point) rules for what I term "felling blows", some of your ideas match quite closely with mine, some don't.
I liked the account taken of the relative sizes of creatures for hit location; its very important to preserve believability for hit location (how does a gnome decapitate a cloud giant with a dagger? for example).
I used a slightly different system to get this size modifier into the location roll, I added the attacker's size modifier, and the "victim's"
grappling size modifier. This makes a larger target have more impact than a smaller attacker (the attacker can use an overhead swing, after all). I then used the following table;
<= 2 Head
3-5 Shoulder
6-9 Chest
10-11 Upper Arm
12 Lower Arm / Hand
14-17 Abdomen
18-19 Upper Leg
>= 20 Lower Leg
So smaller hitters and larger defenders give lower strikes to the body. (like I said, same concept)
Getting back to the point, the main thing I dislike about this system (and about most "grittier" damage rules) is that you change so
much in order to get this slightly grittier feel.
Changing healing times, altering the balance of different weapons, altering the effects of healing spells...
The "footprint" of your critical effects system is, relative to its goal, huge: changing all those sundry areas (which aren't related to criticals) makes it harder for a DM to simply "slot in" your system.
I also dislike the manner in which the severity of the critical effect is A; random (without any modifiers) and B; unrelated to the severity of the blow landed.
The key abstraction of HP in DND has always been that HP represent more than the simple physical resilience of the character. This means that reducing a character from perfectly healthy to dying, taking no account of whether they took 95% of their total hit points in damage or 1%, totally contradicts this underlying abstraction.
That in turn alters fundamentally the balance between the survivability of a Wizard and a Fighter in melee (by severely weakening the fighter when partaking in his core activity)
Note that although using a Fort save (which might have redressed the balance for the fighter), the totally random determination of the severity means that the victim's state is not taken into account for the harsher effects (specifically thiose which disable even on a save - a bad thing anyway...its called a saving throw for a reason)
How does the Fortification ability of armor affect your system? What about regeneration or fast healing effects? (because you have strayed from the normal healing rules, these effects become undefined)
Finally, as someone stated early in the thread; making damaging effects harsher is disproportionately severe in effect on the player characters, since they actually usually need to play through their healing time, the same is not true of monsters (in the general case - i mean, how many DM's treat their monsters as alive after 0hp? make stabilisation rolls for orcs do we? I know I don't!)
This effect is confounded when A; the chance of gaining a critical effect is unrelated to skill (natural 20 on roll option) and B; severity is unrelated to damage dealt or to health of the victim.
Since I've harped on about it, I'll give the gist of my system.
Its intended to give a "gritty" feel to the end of a combat, without altering the surrounding rules.
Basically, when a character moves from positive to negative HP due to a hit (it covers only ranged or melee combat damage at this point) a specific effect is rolled. The generation of the location is modified as noted above, the severity of the effect is a d20 roll modified by the victim's hit points after this blow (multiplied by -1 to give a positive modifier, so more negative gives higher results). Finally the type of strike is generated using a d20 roll modified by the amount of damage dealt (meaning that the system accounts for victims having been whittled down).
The key difference is the assumtion that the rest of the rules continue unchanged (well, actually whether you fall unconcious or not is determined by the final effect), the system just generates a theatrical description.
Weapon balance is not affected, spells have their written effects, characters die and heal at the normal rate. I.e. game balance is preserved. It also makes it a stand-alone variant, which can be dropped in or not on a whim; nothing else needs accommodate it, nothing will conflict with it.
IMHO, more house rules could do with being that clearly fenced off.