Introduction
This section deals with all the troubles that can assail a character's health. It quantifies causes, effects and countermeasures, i.e. healing.
Health damage
Health can be damaged in many ways: by wounds, injuries, diseases, poison, dehydration, starvation, overheating or undercooling, and so on. Many of these cases are detailed in the sections below. Totte quantifies all kinds of health damage in generic pain points. These represent not pain but actual damage to a character's body, though pain often mirrors that.
Every time a character is in danger of suffering health damage, a health attack is revolved. This is quite similar to a contested feat, but with a few differences. The ability of the attack is its strength, which is a single factor. The difficulty is often equal to the health score of the character, or his dexterity. In most cases the damage is not set in stone and randomness is applied. This is not symmetrical like with most normal feats, but asymmetrical. A 1 or 2 on a d8 roll signals a decrease; 3 - 7 no changed and only 8 an increase:
| Randomness | Die value | |||||||
| health | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
In some cases, when damage is precisely dosed and unavoidable, randomness is not applicable. Combat is another exception. Combat wounds are so unpredictable that normal, symmetrical randomness is used.
The feat result tells how severe the damage is on a scale from 0 to 6. Many severities give penalties to all kinds of physical feats. For example a character whose leg is hurt cannot run so fast as she is used to, is slower in combat, more clumsy in sneaking and prowling, and so on. Totte does not take into account which part of the body is damaged; instead stiffness, pain and the need avoid further damage are translated into a general penalty to all physical feats. GMs may divert from this rule and apply more detailed and specific penalties instead.
Healing
Most health damage can and is repaired by the body through regeneration. Healing helps this process. The effect of healing depends on the type of damage. Totte discerns two kinds:
- Fixed: For example a bruise, that is more or less instantaneous and will gradually heal. Each type of health damage has a healing interval. After a healing interval, multiplied by (10 - character's health score) / 10, has passed, 1 pain point is recovered. This goes on until the character is fully healed. A successful healing feat, applied soon after the damage is suffered, immediately lowers the severity by 1 pain point. After that, the normal healing rate applies. Healing is useful as long as no pain points have been recovered. Once one or more points have been healed naturally, healing does not add anything to the process anymore.
- Progressive: For example bleeding wounds or a spreading infection, where the damage actually gets worse over time. Each such type of damage has a progression interval next to the healing interval. After such an interval has expired, another pain point is added, making the trouble worse. If not treated, the damage will eventually lead to death. A successful healing feat stops the worsening of progressive damage and sets the character on a trajectory to recover full health; it does not instantly repair some of the damage.
Damage vs. healing
The more severe the damage, the worse the effects and the more difficult it is to heal, i.e. the more time and ability is required:
| Pain points | Effect | Healing difficulty | Treatment time | |
| 0 | minor | none | 1 | a minute |
| 1 | light | -1 penalty | 4 | a few minutes |
| 2 | moderate | -2 penalty | 7 | ¼ - ½ hour |
| 3 | serious | -4 penalty | 10 | an hour |
| 4 | critical | -8 penalty | 13 | a few hours |
| 5 | lethal | incapacitated | 16 | many hours |
| 6 | devastating | instant death | impossible | |
Damage lower than 0 means no damage at all; more than 6 is just more devastating, up to cutting bodies into pieces or grinding them to pulp.
Treatment time denotes the time that a healer needs to set the recovery process in motion; it is not the recovery time itself.
The latter depends on the type of damage and the health score of the character.
See the sections below for details.
Penalties from multiple damages are cumulative.
Fortunately, they heal in parallel.
There is only so much damage a character can take. A total of penalty of 12 or more will incapacitate a character, if even they are accumulated from less than lethal wounds.
Characters who suffer damage are not always in a position where they can be healed right away, for example in the middle of combat.
Still it is important to try to get proper healing soon.
Even a minor bleeding wound will progress to a heavier wound over time.
A crippling wound, if not treated, may heal but leave the character with a permanent -1 cripple penalty!
Characters with healing ability can heal themselves as well as others, but if they themselves have suffered health damage,
the physical feat penalty applies to some of their physical medical feats like surgery.
Types of health damage
Wounds
Wounds can be inflicted by accidents, traps, weapons and many other phenomena.
Normally the strength of a wound attack is fixed and countered by the difficulty, which is determined by the dexterity score of the character.
An exception is combat, where dexterity plays a part in evading an attack and armor is the main component in absorbing damage.
See the section on combat for details.
There are two types of wounds: open (cuts and punctures) and closed (bruises).
Open wounds are progressive; if not healed, their progression interval is 1 hour.
Many GMs will shorten this interval if the wounded character remains physically active.
Also, open wounds may get infected if dirt gets into them.
Closed wounds are not progressive.
The healing interval of both open and closed wounds is 1 week.
Falling
Falling is dangerous business in Earth gravity.
Falling attack strength is 2¼ * √ falling distance (measured in meters from lowest point of the body to the landing surface);
difficulty is the dexterity score of the character.
This assumes the fall is unexpected, on a hard surface and the character has to use his dexterity to break as much of the fall as he can.
Low but thick vegetation or a gym mat will subtract 1 point of damage, a thick mattress 2, a bush 1 to 3, depending on its size and sturdiness and number of sharp branches and thorns.
Snow can absorb 0 to 5, depending on its thickness.
Water subtracts 1 point, though several more if the character can make a controlled dive.
Trees subtract about 1 point per 2 meters of height on average.
Advanced absorbtion devices, like nets, inflated cushions etc. may absorb many pain points.
On a slope a falling character will not fall free, but roll and slide.
This inflicts about 2 points of damage per meter of height loss, regardless of the angle of the slope.
NB: Vertical distance is of course smaller than rolling/sliding distance.
This rate assumes that the descent is a rough ride with many small obstacles, causing bumps and grazing.
If it is a slide down a snowed or otherwise smooth slope the character will not suffer significant damage,
unless he is stopped violently at the bottom, in which case damage can be nearly as great as free falling the same vertical distance.
Falling damage results in wounds.
These are closed, unless the character slides down a slope with cutting objects or falls into a pit with stakes.
Disease
The attack strength of a disease depends on its type.
The common cold has a strength of about 4; severe influenza like the Spanish flu of 1918 CE around 7; bubonic plague 8 to 9.
The difficulty of a disease attack is equal to the health score of the character.
Most infectious diseases have an incubation period in which little harmful effects are suffered, then quickly build up in strength and gradually subside.
Others are progressive, slowly eating away a character's health.
The healing interval of disease varies wildly, from half a day to weeks.
Poison
Like disease, poison comes in many varieties.
Some attack the nervous system, others cause tissue damage.
Some poisons cause mental rather than physical damage, in the form of dazing, sleepiness or hallucinations.
Should the damage become critical and not be healed properly, the resulting -1 penalty is mental rather than physical too.
Note that in this regard, alcohol and other drugs and acids can also be considered poisons.
Poisons can be applied in different ways: ingestive (by drinking or eating), insinuative (directly into the blood stream, for instance through weapons), by (skin-) contact and through inhalation.
Some poisons work immediately, but others take minutes, hours or even days to work into a body.
The attack strength of poison is determined by the strength of the poison itself and the size of the dose.
This size of the dose must be compared to the size of the body of the character.
The result varies wildly, from mild poisons with a negative ability to lethal ones with 10 or more.
The difficulty is equal to the health score of the character.
Almost no kinds of poison are progressive.
The healing interval of poison is 1 day.
Some poisons can be countered by anti-poisons that dramatically speed up healing.
Starvation
Adult humans need between 8 MJ and 16 MJ of energy from food per day.
The first 8 MJ is just for keeping the body and mind going; the second half for exertion.
Women on average need slightly less than men; children significantly less.
12 MJ is a good average for characters who are physically active.
Our ancestors, used to small diets, could do with somewhat less.
In a European medieval diet, 80% of the energy comes from grain-based foodstuffs (mostly bread), 20% from meat, dairy products, vegetables and beer.
Without food, starvation sets in, though slowly and also steadily slower.
The first pain point of starvation damage is suffered after 0.4 * (4 + health score) days;
the second after 0.8 * (4 + health score) days; the third after 1.2 * (4 + health score) days; and so on.
Starved character who receive meals once more recover fairly quickly.
One day of normal eating negates three days of starving.
Note that these figures are made up for humans. Animals with big fat layers like bears and camels, or with slow metabolisms like cold-blooded reptiles, can often go for months without eating and still suffer only very mild damaging effects.
Thirst
An adult human needs about 2 liters of water per day, double that amount when doing hard labor or in hot weather and even more in desert environments.
Again women cope with thirst a little better than men and children need significantly less.
On the other side of the scale, water intake for somebody who spends the day resting in comfort is halved.
Deprived of water, a character suffers one point of thirst damage every (4 + health score) * 2 hours on average.
This is based on the assumption that the character remains active; if he lies down to suffer, the lower need for water can extend the period.
Restoring thirst damage with fresh drink is rapid:
A half-day complement of water will restore all thirst damage within one hour.
Again the numbers for animals are different.
Most amphibians require a moist environment at all times; camels are famous for their ability to preserve water in the desert.
Suffocation
A breathing character can hold her breath only for a limited period:
1 minute on average, 2 minutes with practice, up to 20 minutes for experts, all provided that exertion is minimal to preserve oxygen.
When this period has passed, consciousness is lost and the character starts suffering damage.
For humans, 1 pain point of damage is inflicted per 2 minutes.
If the victim is saved before he dies, recovery is quite fast: 1 point of suffocation damage is restored per minute.
Crippling damage is often mental instead of physical: brain damage gives a permanent -1 penalty to mental feats.
Strangulation can cause damage by asphyxia (suffocation) but also by constricting blood circulation; drowning by ingesting water into the lungs.
Both can hasten the damaging process somewhat.
Temperature
A character who is unprotected in a very cold environment will suffer damage from frostbite (to exposed body parts) or hypothermia (to whole body).
Likewise, very hot environments can cause burns or sunstroke.
The ability of the attack ranges from less than 0 in mild weather to 4 in bitter arctic cold or fierce tropical sun.
It is countered by difficulty that is determined by the health score of the character.
Though damage is usually little, prolonged exposure to heat or cold will inflict it again and again.
A good rule of thumb is to apply one heat or cold attack every hour that a character is in danger.
Humans protect themselves against temperature damage with appropriate clothing.
Animals usually rely on fur in the cold and have a variety of strategies to deal with heat.
Protection like this adds to the difficulty of a cold or heat attack, often fizzling it out.
The healing interval for temperature damage is 1 day for point of frostbite / burning damage and only 1 hour for hypothermia / sunstroke damage.
Fatigue
Fatigue comes from from overexertion. While exerting, a character suffers 1 point of damage every (2 + health score) * interval. The length of the interval depends on the intensity of the exertion:
| Exertion | Example | Interval | |
| 0 | sleep | sleeping | none |
| 1 | rest | lounging, rummaging about | none |
| 2 | light | light work; slow walk | 5 hours |
| 3 | moderate | active work; brisk walk | 1 hour |
| 4 | heavy | heavy labor; jogging | 10 minutes |
| 5 | intense | running fast; hand-to-hand combat | 2 minutes |
| 6 | very intense | sprinting; lifting maximum weight | 20 seconds |
| 7 | extreme | sprinting at top speed; lifting maximum weight | 4 seconds |
Note that light exertion is so mild that people of average health or higher will be overcome by thirst, hunger and/or the need for sleep before they get tired.
Recovery from fatigue by resting is proportional to the speed at which fatigue damage accumulates, i.e. the healing interval is the same as the attack interval.
Recovery by sleep is twice as fast as resting awake.
The bookkeeping for fatigue damage can become quite complicated if different exertion levels are mixed,
for instance a long march that is interrupted by a sprint to get away from an angry bear.
For fatigue, some GMs will insist on precise measurement, while others apply intuition or even ignore its effects altogether.