House Jorasco and the Mark of Healing (Patreon)

The Mark of Healing is a wondrous thing, my students. With a touch you can sense whether a patient’s humors are in balance, and it takes the smallest expenditure of energy to set things right. It’s the work of a moment to cleanse a wound or soothe an ache. But mundane maladies are the least of the challenges you’ll face. Khyber has unleashed many plagues on the children of Eberron, and these may return at any time. Consider the Red Mist. It looks like a crimson fog, but it’s formed from tiny demons, each one smaller than a mote of dust. If you breathe them in, they’ll tear you apart from within, crafting more fiends from your blood and expelling them out into the world with each breath. Khyber isn’t the only source of magical contagions, and not all are instantly deadly. Consider the Bile-Curse of the Shadow Marches—the Drip, as it’s often called. It clogs your nose and scratches your throat, but never that badly; it’s an annoyance, but not a mortal threat. And yet, it cannot be cured as easily as a mundane malady. It resists simple balancing charms. The Marchers say that it’s the touch of a vile spirit, that the phlegm is a conduit to the Prince of Slime! Now, I’ve treated a thousand cases of the Drip, and only once did it turn out to be a parasitic ooze. But you need to be prepared for that possibility! And that brings us to today’s lesson. 

Ask anyone in the Five Nations which of the Dragonmarked Houses has the deepest internal division, and most will say Phiarlan and Thuranni. Some might argue House Cannith, saying that as Phiarlan and Thuranni have fully split, they are no longer one divided house. And yet, the rivalry of the Cannith heirs was born in this century. And while House Thuranni and House Phiarlan have split, both conduct the business of entertainment and espionage in much the same way; they’ve simply divided up the territory that they cover. There is another Dragonmarked House with a deep philosophical rift dating back to its earliest days, and yet it is a feud outsiders know almost nothing about. This is House Jorasco. 

Everyone in the Five Nations relies on Jorasco services, yet there’s always resentment about having to pay for them. No one expects House Cannith to give away swords or House Ghallanda to offer free room and board at the Gold Dragon Inn, but when Jorasco turns away a patient who can’t pay there’s a usually bitterness. There’s a vital difference between the three examples, of course. A Cannith sword and a Ghallanda meal are luxuries; people can live without them. When a Jorasco healer turns away because there’s no gold on the table, people may die. Most people imagine this is callous and cruel, a simple matter of greed. And for some members of House Jorasco, it is. The halfling lords of Vedykar may speak of limited resources and the need to prioritize the survival of their House, but it has been many centuries since House Jorasco was in any real danger, financial or otherwise. Perhaps if Jorasco laid its roots in different soil things the House would be kinder today. But Jorasco built its citadel in Karrnath, and Karrnath is cruel. The first lords of Jorasco had to be ruthless to survive. They had to learn to wield their power as a weapon… and once they learned what a weapon it could be, they were never willing to lay it down. It’s well known that every chirurgeon who trains at Resthold takes an oath to protect Jorasco and to never use their gifts without payment.

These are simple facts. Almost every heir of Jorasco serves the Healers Guild, and every chirurgeon takes this oath. But not every healer is a chirurgeon. The Jorascos served as healers long before they developed the Mark of Healing, traveling with other tribes and keeping them strong. The tribes of the Talenta Plains never minted gold coins, and the first Jorascos were paid for their services in a multitude of ways, shifting their demands to take into account the needs and means of their patients. You can still find a Jorasco healer with every tribe today, and they continue to be flexible with their demands. The same is often true of Jorasco healers who serve small towns and villages; if gold isn’t available, they may be willing to exchange a cleansing ritual for a dozen eggs and a pound of Tribex bacon. Chirurgeon is a title that commands respect within the House, indicating a true mastery of the medical arts. But an heir can choose not to pursue this rank, and in so doing avoid the oath that comes with it. The heirs who follow this path are called Mura, “Poor Wanderers” in Tal. In Common it is formally translated as mendicant, or more casually mender. While a mender may be just as skilled as a chirurgeon, only chirurgeons hold positions of authority within the House or Healers Guild, and only chirurgeons can maintain full healing houses. Menders may serve at healing houses, but there will always be a chirurgeon in charge who enforces the payment structure. Menders are most typically encountered as traveling healers serving small communities that have no Jorasco house; because of this, they aren’t directly competing with the official healing houses and thus significantly impacting the profits of the House and Guild. Some menders settle down and run their own clinics, again in communities that have no Guild presence; The Patchery in Frontiers of Eberron: Quickstone is just such a mender’s clinic. And menders continue to serve in the Talenta Plains, traveling with the tribes. Vedykar accepts the menders out of respect for their ancient tradition—so long as they don’t threaten the business of the Healers Guild. 

Having said all that: even the menders demand a price for healing. A mender doesn’t demand payment in gold, and they are usually willing to provide services in advance of payment. When a mender travels with a party of adventurers, it’s typical to settle up at the end of the day, when people are preparing to rest. Unlike the houses of the Healers Guild, there is no set list of fees for the mender; it is something that must be resolved between the healer and their patient. Because it’s not actually about profit. Even before they carried the Mark of Healing, the Jorasco helped people cheat death. The act of healing keeps a spirit from Dolurrh and fate, and Jorasco has always believed that one who receives healing must make a sacrifice to acknowledge this, placating the spirits. The only constant is that the sacrifice must be meaningful to the one who makes it. So when your party is preparing for a long rest, the fighter who’s been healed earlier in the day should give something to the Jorasco healer. It could be a trinket that has no monetary value, but which has meaning for the warrior. It could be the warrior’s dessert, especially if it’s a meal they truly love. It could be a secret, which they are now giving up to be known. It could be taking on the healer’s chores. The point is that it’s a sacrifice, and a moment at which the person who’s been healed appreciates the gravity of that act—the fact that they are still alive when they could have died. Is there more to this than superstition? Consider that even Vedakyr chirurgeons won’t perform Raise Dead without first casting an Augury to see if the spirits approve of it—and the stories of mighty Dolurrhi maruts devastating Healing Houses in the past. Healing is a gift, and it should never be taken for granted.  

What does all of this mean for you? When creating a Jorasco character or NPC, consider which path they follow. The chirurgeons form the majority of the House. They have been tempered by the harsh crucible of Karrnath, and learned to be ruthless. They know that sacrifices must be made, that they can’t save everyone, and that the good of their House—which is the same as the wealth of their House—must come before all else. On the other side you have the menders, who strive always to retain empathy and mercy and to help where they can, but who also believe that there is a balance between life and death that must be respected. Whichever path you follow, a key question is why are you adventuring? Why aren’t you serving in a healing house or helping needy communities? The simple fact is that your gifts are a limited resource. You can’t heal everyone. So why is it that adventuring is the proper focus for you? A few options to consider…

You owe a deep personal debt to one of the adventurers, and you’ve sworn to keep them alive.

You’re pursuing a particular path of research on behalf of the House—looking for a rare component, a secret technique, a healing artifact, or something else that could trigger a medical breakthrough. The goals of the adventurers coincide with yours, and as they’re helping you achieve your goal you can heal them freely and the House will consider it a business expense.  

A wealthy patron has paid the House (not you personally!) for your services. It could be that the patron has hired you to protect the entire party, or they could have only covered your costs for a particular individual—a noble heir, another Dragonmarked scion, etc. 

You’re medicant, and you believe that wherever the adventurers go people will get hurt. You assist your companions, but you also try to help any innocents who get hurt because of their actions. Alternatively, you’re a chirurgeon, and you believe that wherever the adventurers go people will get hurt, and that’s a chance for you to make some money! 

You’re an excoriate who was expelled from Vedakyr for defying your oath to save innocents. In order to get excoriated, this was surely more than simple free service; perhaps you were a firebrand who advocated for the abolition of the oaths. 

You’re a foundling, entirely unbound by the rules and customs of the House. Jorasco scions have sought to recruit you but you want nothing to do with them. 

Whether you’re a chirurgeon, mendicant, excoriate or foundling, consider what it feels like to carry the Mark of Healing. You have an intuitive bonus to Medicine checks; perhaps you can feel the flow of life energies in your patients. Beyond that, you carry the power to cure and to restore. Some Jorasco heirs feel an empathetic connection to the people around them; when someone nearby is hurt, they feel the Mark charging up, ready to provide aid. Do you have this sort of empathy, or are you unaffected by the pain of others? 

THE MARK OF LIFE

The Mark of Healing allows its bearer to channel positive energy, healing injuries and bolstering their own life force or that of their allies. The base powers of the Mark are quite straightforward, and in contrast to many dragonmarks, all heirs of the House have access to every Spell of the Mark; there’s no narrow specializations. However, far more than any other house, the members of House Jorasco have developed a number of very different techniques for channeling their powers. 

Chirurgeons are very clinical, wielding threads of magic energy like scalpels. They may Cure Wounds with a touch, but when performing Lesser Restoration or Greater Restoration they are performing arcane surgery. Most Vadykar-trained chirurgeons are mechanically magewrights and cast their spells as rituals, meaning that they take more than one round to cast. A talkative chirurgeon may describe their actions, invoking techniques named for first chirurgeons of Vedykar: “There’s a sanguine clot caused by this buildup of Khyberian essence. I’m going to try Nola’s Bypass and drain the choler with a Kodron Twist.” Vedakyr doctrine maintains that the energy of the Mark of Healing flows from Irian. 

Mendicants still respect the old traditions of the first Jorasco. They believe that the life energies of the Mark are drawn from the collective lifeforce of all of the heirs that carry the Mark. This is another reason that it’s important to maintain balance; when a mendicant heals you, they are giving you the life of their family. Mendicant healing is less outwardly dramatic than the techniques of the chirurgeons, typically appearing as a simply laying on of hands; however, the mendicant perceives the malady they’re treating in their mind, and battles it in their thoughts. Some mendicants will call on local spirits to guide them, or speak to the malady they’re treating as if it was an evil spirit (and in the case of magical contagions, it might be!). When casting Aura spells, they may present them as calling on the aid of the local spirits. The power flows from the Mark of Healing and a mendicant doesn’t HAVE to invoke spirits; and to be clear, the “local spirits” are typically eddies of energy rather than coherent fae or anything like that. The point is that where chirurgeons are clinical in their approach, mendicants are more spiritual. 

Faith Healers believe that the Mark of Healing is a gift of the Sovereign Olladra, allowing them to change the fortunes of those they treat. Many faith healers are trained and licensed as Vedykar chirurgeons, but in the practice of their craft they are more likely to praise Olladra than to discuss Dolan’s Principles of Choleric Resurgence. Other faith healers want nothing to do with Vedykar and perform their healing as if praying, often dramatically and joyfully. 

Foundlings have to discover the gifts of the Mark in isolation, and develop their own framework for channeling its power; each foundling may have a different style. 

Most professionals of the Healers Guild are magewrights. Exceptional chirurgeons are often mechanically Alchemist Artificers or Life Clerics, though they draw their powers from the Mark of Healing. Faith healers also tend to be Life Clerics. Remarkable mendicants tend to be Spirits Bards or Druids. In the Talenta Plains, most mendicants travel with a particular tribe, but those with druidic talent may wander the Plains in dinosaur form, searching for people in need. 

Kanon vs Canon. I haven’t included it above because I don’t like changing canon mechanics unless I have to. However, in MY campaign, I change the Spells of the Mark list by replacing Arcane Vigor with Enhance Ability. Arcane Vigor is largely redundant when you have the ability to cast Healing Word. The idea behind Enhance Ability is that the caster is able to stimulate points in your body to create a flow of energy—a cross between acupuncture and giving you an adrenaline shot. This gives them a little more versatility and also presages the ability of the Nosomantic Chirurgeons to cause harm by altering your body chemistry. 

Beyond mechanics, however, with Jorasco my main break with canon is in the lore—the addition of the mendicant tradition. I’ve never loved Dragonmarked’s presentation of the absolute insistence on payment, and I’ve tried to mitigate that here by concentrating it on the chirurgeons who, after all, are based in the harsh nation of Karrnath. Meanwhile, the mendicants also believe that a price should be paid, but they’re far more versatile in what form payment can take… which can be useful when you’re part of an adventuring party. For the record, in my mind the healer Jode was originally a mendicant; they don’t have to dramatically invoke spirits even if they respect them. 

FOCUS ITEMS

If a magic item relates to healing, there’s a decent chance that it comes from House Jorasco or that they have a focus item version of it that draws on the Mark of Healing—for example, the Jora Charm, which draws on the Mark to replicate the power of a Periapt of Wound Closure. Working in concert with the Edoro family of House Cannith, Jorasco is the primary source of Potions of Healing and other mass produced magical medicines. The legendary Altar of Resurrection will be discussed later in this article. Here’s one more common tool of the House. 

Chirurgeon’s Gloves

Wondrous Item, Common 

If you possess the Mark of Healing, you may use a Magic Action to cast Spare The Dying while wearing these gloves. 

MODERN MEDICINE

When using Jorasco in a story, it’s useful to understand the state of modern medicine in Eberron. Why do normal people go to Jorasco? What services do they provide? How does Jorasco medical treatment compare to the history of medicine in our world—do they have antibiotics? Do they understand germ theory? There’s a few major things to address here: The nature of long-term injury and disease, how to represent those things in a system that doesn’t currently do so, the nature of plagues and the greatest maladies in Eberron, and finally, how Jorasco approaches these things. As always, this is how I handle these things in my campaign; you can always take a different approach. 

Player Characters are Action Heroes. In approaching the state of medicine and healing, it’s crucial to recognize that player characters are fundamentally different than normal people. A player character is like the action hero in a movie who gets shot, stabbed, walks on broken glass, shot again, falls off a landing, and still gets up and keep on moving. Setting aside conditions, player characters exist in a binary world: they have hit points and are fully operational, or they don’t have hit points and they’re down. Unless an adversary has a specific effect that changes the rules, player characters don’t have to worry about blood loss, going into shock, wounds getting infected, concussions, pulled muscles, or any of the countless things real people would worry about over the course of a vicious combat with melee weapons. You might DESCRIBE these things happening for color—You feel a rib crack as the juggernaut strikes you with his maul for 20 points of damage—but it doesn’t actually DO anything; like the action hero, we’ll probably forget about it by the next scene. Beyond this, under the current rules player characters are fully healed when they take a long rest. There’s never a need for a player character to spend a week convalescing. And that’s fine, because most of those things aren’t FUN. The current version of D&D isn’t supposed to be an accurate simulation of reality; it’s designed for swift cinematic action. But look at any action movie. The primary villains may be just as tough as the heroes, but the innocents and minions go down and stay down. The same principle applies here. If it suits your story, you could do any of the following things. 

When an unremarkable NPC is dropped to zero hit points and not slain outright, you could say that they have suffered a grievous injury—a broken bone, a torn muscle, blindness, a severed limb. Restoring hit points will return them to consciousness but won’t heal the wound. If they regain hit points, you could use the rules suggested for grievous injuries later in this section, but you could also simply say “They’re alive but they’re in shock—they’re not going anywhere.”   

You can reduce the hit point maximum of a seriously injured NPC until they get proper care or treatment such as Lesser Restoration. On the one hand, this means that the brave guard captain who’s helping you with the Boromar Clan just can’t keep up with you… after a few fights he’s on the edge of collapse. On the other hand, this could also allow the adventurers to wear down a powerful foe with multiple hit and run attacks; that dire bear is too tough to fight toe to toe, but it won’t heal much through rest. 

Adventurers could encounter an NPC who’s already suffering from a grievous wound, limiting their actions until treatment, or meaning that they’re in isolation recovering. The guard captain has three broken ribs and a concussion and you’ll have to go talk to him at the healing house.  

The main point of this is that just because player characters don’t get torn muscles doesn’t mean that muscles can’t be torn. Player characters aren’t the primary customers of House Jorasco, because they are so durable; but Jorasco treats broken bones, torn muscles, internal bleeding, concussions, and so on and so on all the time. 

Lingering Injuries and the Power of Magic. So, the current edition of Dungeons & Dragons doesn’t have rules for lingering injuries—concussion, infection, shock, broken bones. It also doesn’t have rules for mundane disease; notably, the spell Detect Poison and Disease detects the location of “poisons, poisonous or venomous creatures, and magical contagions.” In dealing with this, I personally make a bold jump. Eberron is a magical world. It is fundamentally different from our mundane world. In my version of Eberron, healing magic does more than merely restore hit points; that’s basically a side effect. Healing magic instantly cures most mundane maladies. In my campaign, any spell that restores hit points will also instantly banish any infection and sterilize a wound. Cure Wounds will get rid of a cold, and Lesser Restoration will wipe out any mundane virus. We don’t hear about many mundane diseases in Eberron, because mundane communicable diseases have been almost entirely eradicated. Remember the Children of Winter complaining about how civilization is screwing up the natural order? They’re right. People in Eberron simply aren’t worried about COVID. This goes even farther. Greater Restoration can turn someone from stone to flesh again. Its spell level puts it on par with spells that can turn a person into a frog and restore life to the dead. In MY campaign, if magic can turn a person into a frog, it can also turn a person who has cancer into a person who doesn’t have cancer. Generally we say that Eberron is on par with Earth in 1900, but when it comes to healing, Eberron is VASTLY SUPERIOR TO US because healing magic is magical. Because of this, most cultures don’t know about germ theory or antibiotics or vaccines, because they don’t need to understand those things to banish a virus with magic. They approach medicine from a fundamentally different perspective than we do. 

With that in mind… can they instantly cure all ailments? Not at all. People in the world should get concussions, pulled muscles, and broken bones. Player characters can potentially suffer these consequences as well, if you want, because the game does have a simple way to handle things: Exhaustion. Just as a Barbarian’s Rage doesn’t have to involve getting angry, Exhaustion doesn’t have to mean that you’re tired. Each level of Exhaustion reduces your speed and applies a penalty to all d20 tests, and if you acquire six levels of exhaustion you die. But WHY are you slower and less effective? It’s entirely up to you to describe these effects narratively. It could be a brutal fever; your speed is reduced because you’re unsteady, your rolls penalized because you can’t focus or because you’re hacking and coughing when you try to act. One level of Exhaustion can easily represent a concussion. A broken leg could be represented by three levels of exhaustion; your movement is severely handicapped and you’re taking major penalties to your rolls. Another useful tool is the Poisoned condition, which gives you disadvantage on attack rolls and ability checks. Yes, the name is “Poisoned”, but you can use the CONDITION to represent any number of other things that are causing you to be broadly ineffective. Mechanically, Poisoned can be removed by Lesser Restoration, while Exhaustion requires Greater Restoration and that only removes a single level. Likewise, a Long Rest restores all hit points but only one level of exhaustion. 

So: Poisoned and Exhaustion are a decent way to represent long term injuries, but it’s still up to you to decide when and how to apply them. Again, you can use Exhaustion to represent a broken leg, but there’s no situation under which player characters GET broken bones. One option is to add these effects to an adversary’s attack. A warforged titan could have a maul strike that requires you to make a Con Save or suffer a level of exhaustion. When you apply this, emphasize the nature of it. That blow broke three of your ribs. Every breath is agony. You have a level of exhaustion. You could apply a grievous injury to a character who’s reduced to zero hit points, but I’d personally only do so if it’s dramatically appropriate. Did they drop to zero falling from a tower in Sharn? Did an iron golem land a critical hit? A grievous wound is a way to say that was much more serious than the majority of injuries you’ve suffered and will require special attention. You can also use Poisoned and Exhaustion for plagues and such… though more on that below. 

Overall, I categorize lingering wounds as follows. Again, player characters generally don’t deal with these, but it gives a sense of what’s out there. 

Minor injuries are simply annoying. The early stage of an infected wound. A headache. A cold. A typical case of the flu. Stubbing your toe. These can be described cosmetically but don’t have any mechanical effect. This is also the case where an NPC might suffer loss of maximum hit points due to repeated minor injuries. These ailments will be alleviated by any spell that cures one or more hit points. And yes, this means a Goodberry will cure any simple mundane disease. 

Severe injuries have a more serious impact. Badly pulled muscles. A single broken rib. A strong fever. You’re going into shock. This is the level of the typical serious “disease,” though see notes on this below. You could be temporarily deafened by a loud explosion. The Poisoned condition is an easy, simple way to represent this, but you may think of a different effect that’s logical, such as Deafened. This degree of ailment can be healed with Lesser Restoration or any other effect that can remove the Poisoned condition, such as a Paladin’s ability to Lay On Hands. 

Grievous injuries can often be represented by Exhaustion, temporary penalties to ability scores, or reduction to maximum hit points. They can vary wildly in intensity—one level for a concussion, three or more for a broken limb—but the key element of the severity is how difficult they are to heal. Lesser Restoration has no effect on a grievous injury; only Greater Restoration can help. Greater Restoration can remove any effect that’s reducing an ability score or reducing hit points, but it only restores one level of Exhaustion; it may take significant treatment to recover from such a blow. 

Some afflictions don’t have debilitating mechanical effects, but it can still be useful to assign them to these categories. For example, I’d call any form of cancer a grievous injury. Even if it’s early and not showing obvious symptoms, it’s still difficult to remove.  

Bed Rest. A long rest usually restores you completely and eliminates a level of Exhaustion. When dealing with lingering wounds, a DM can assert that typical rough rest won’t remove the injury—that it requires a full day without strenuous activity and in peaceful conditions to have an impact on the injury. Alternately, the DM could say that the character can make a Con save to try to eliminate the affliction, or to remove a level of Exhaustion… and I’d personally allow a character with Medicine to help with a successful Wisdom (Medicine) check. The point is that PLAYER CHARACTER generally just keep going and going, but that broken leg won’t just get better in three days if you keep using it; you actually need to rest. Typically, though, this is something that only NPCs have to worry about.  

Magical Contagions. Wait a second…  Didn’t Karrnath suffer terrible plagues? How’s that work with this? It did! The point is that I’m saying mundane disease is trivially easy to cure and that’s why we don’t have rules for it. But we do have rules for MAGICAL CONTAGIONS. Because, again, Eberron isn’t our world. It’s a place where fiends are all around us, where fey may smite you with withering curses, where daelkyr are creating diseases that do things we’d never even believe, like the cold that is actually a sentient ooze gestating in your lungs. The people of Eberron don’t worry about the diseases we face because they deal with things that are FAR WORSE. And the point is that these magical contagions typically can’t be cured by mundane means. When you’re being eaten from within by the Red Mist, you need an exorcism, not penicillin. And because of this, the healers of Eberron work with principles of supernatural medicine. They’re concerned with the balance of your humours and the flow of your energy, because those are what help you resist demonic infections. The take away here is always remember that Eberron is a MAGICAL world. Don’t limit yourself to the mundane miseries we face everyday. When you’re introducing a plague, it can eat people from within and then animate their corpses! And if you want to fight it, you’d best have access to the proper spells. 

The Challenges of Supernatural Medicine. If all meaningful maladies are magical, then what’s the point of the Medicine skill? Per the Player’s Handbook, it helps to diagnose a disease or reveal information about an injury. I’m happy to take it a step further than that and say that there are many magical contagions that can’t be cured just by casting a spell. This comes back to the idea that many spells are a simplified abstract representation of a complex set of spells. Greater Restoration allows you to remove a level of exhaustion, eliminate the Petrified condition, remove a curse or a reduction to an ability score, and more. I’m suggesting that while a player character does all of these things by casting “Greater Restoration”, the ability to cast that spell means you can actually cast a dozen different spells. When you use Greater Restoration to remove a curse and when you use it to remove Exhaustion, you’re casting two entirely different spells. When you remove a reduction to Strength it’s a different ritual than when you remove a reduction to Dexterity. The point is that this difference is ENTIRELY COSMETIC. In THEORY you’re casting a different spell and using different components. “I need to drain his choler! Get me a vial of Irian water, stat!” In practice, you’re still just casting Greater Restoration. However, this is where I’d consider a few possibilities…

There may be magical contagions that simply can’t be cured with any form of Restoration unless the caster is proficient with Medicine. Proficiency alone is sufficient; no role is required. Proficiency represents your medical training, allowing you to know the proper approach. 

Other contagions may require you to make a Medicine roll in addition to casting the spell, with a difficulty representing the fact that the caster is doing more than just saying words; they are essentially exorcising the contagion, using different techniques and precise energy and timing. “If I don’t get every single drop of the Red Mist out of her system, it will be back within minutes.”

The Price of a Life. As noted before, the Jorasco mendicants believe that healing alters fate and that there needs to be some sort of sacrifice to restore this balance. This could be pure superstition, but there is the canonical precedent of bad things happening when Raise Dead is used casually. If I was running a campaign with a Jorasco adventurer who believed in this, I might say that if no price is paid, there’s a chance that I will impose Disadvantage on the character with the unpaid debt at a key moment or that I’ll grant an enemy a critical hit when attacking them. Or I may not! But there’s always a CHANCE that the spirits will act to balance the scales. Again, in this case I’d allow people to settle accounts when they take a long rest, not requiring them to pay for healing in the middle of the battle—and again, “payment” could be a trinket, a secret, a chore. It’s an opportunity to develop the story when you’re pausing for a long rest and frankly, for people to show a little gratitude to the person who keeps them alive. 

In Conclusion. Summing up this wall of text, here’s the core concepts.  

Player characters and exceptional adversaries are far more durable than everyday NPCs and you can reflect this by having NPCs suffer a wider range of lingering maladies. 

Lingering injuries can be represented mechanically by reskinning the Poisoned condition and Exhaustion. It’s still Exhaustion, but it doesn’t mean the victim is tired; they may be concussed, in shock, suffering from a plague or broken bones, and so on. Victims might have to have a period of full bed rest to recover. 

Healing magic can remove lingering injuries and contagions. Any spell that restores hit points can also cure most mundane diseases and infections. Lesser Restoration can cure most maladies represented by the Poisoned condition. Greater Restoration can heal more grievous injuries, though in the case of an injury represented by Exhaustion, it will only partially restore it. 

In Khorvaire, most serious health risks aren’t natural. They’re supernatural, magical contagions caused by fae, fiends, daelkyr, manifest zones, and more. Their effects can be far more colorful than mundane diseases. The plagues that ravaged Karrnath were supernatural afflictions tied to Mabar, not mundane disease. 

Restoration spells may represent a wide array of magical tools and subrituals that need to be deployed effectively. To represent this expertise, a GM could say that curing a particular contagion requires proficiency with Medicine or a successful Wisdom (Medicine) check. 

Because of all this, when most common folk pay a spellcaster to cast Cure Wounds they aren’t doing it because they need 5 hit points. They’re doing it to get rid of the flu or to cleanse an infected wound.