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Message: <blockquote data-quote="Primitive Screwhead" data-source="post: 4336934" data-attributes="member: 20805">I like Ken's revised and simplified, but I am not sure the damage numbers could be fit into a wound track well. However I think the only thing you need to add to 4e's mechanic to get a gritty feel if to implement a house rule that goes something like:Each major wound you take, your max healing surge is reduced by 1. You can regain the lost healing surges through long term healing care, at a rate of 1 point per timeframe *.Major wounds are: when first bloodied during an enounter, receive a critical hit, and when taken to negative hit points.* The timeframe can be adjusted for how gritty you want. Anything from one day (24 hours) to a week or a month. This method maintains the rest of the math and provides the players with a choice of pushing forward despite not being able to completely rest up or finding some place to hole up.</blockquote>