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lowkey13
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But the HP rules say nothing at all about pain. They just say you regain HP after a night's rest, so you're no longer close to death. It would be totally compatible with RAW to ask your players to track the amount of HP damage taken over the past week (completely ignoring healing) and use that as a guide to how much pain a PC is in right now.
If a centaur guts you with his lance for 30 points of damage, and then you fall off a 30' bridge for another 10 points of damage, a night's rest may give you back all your HP, but it's perfectly fair and consistent with RAW to say that your gut still hurts a few days later. And it might leave a scar.
I don't have the DM guide (for optional rules) but I would add a feature like HP thresholds to lingering wounds. Once a hp threshold value is exceeded for a character (like their starting hit points + level) then you automatically go to lingering wounds without reaching zero hit points. Critical hits could do the same thing. The trick is to try to keep hit points generic, and then add in after zero rules, or bypass to after zero rules.I dislike that approach because it doesn't kick in until too late. Getting stabbed should be unpleasant even if you do have fifty HP left, or else every fighter would be twentieth level from constant fighting.
NB: I don't want to hijack this to muse on the intent of HP, but since we've gone there...
I think you just hit on the head an issue which could use some official clarification. In most cases, I don't think HP signify real wounds. Rather, they signify fatigue. The more fatigue you suffer, the more sloppy your guard.
I don't think you can square "HP as fatigue" with the observable facts of D&D combat, such as the way poisoned weapons take effect on a hit
but even if you could it wouldn't be relevant to problem I identified (and outlined a solution for), which is that PCs are remarkably willing to take HP damage, compared to real human beings, because HP return after a long rest.