Hit Points-Injury

This house rule is a modified version of the Wounds and Vigor optional rules from Ultimate Combat, as well as Strain/Injury optional house rule from the Paizo Messageboards. These rules will help when the party is low on clerics, and gives the Heal Skill a bit more importance. Note: As Strain/Vigor are essentially the same as the current hit points (in function), they will not be renamed. We will call Vigor and Strain “Hit Points.”

Quick Overview

  • All creatures have both Hit Points and Injury Points. Hit points do not represent wounds. Injury points represent wounds.
  • Most damage will go against your Hit Points.
  • Any damage from critical hits, special attacks, or the “final blow” which puts you below zero hit points represent injuries that do not heal without treatment. Treatment can be the “Treat Deadly Wounds” application of the Heal skill, or magical healing.
  • All Hit Points will replenish automatically with a quick rest and refit (see below). If you don’t proceed to the next encounter immediately, but take a few minutes to get your act together, catch your breath, and gird your loins, all the Hit Point damage that doesn’t represent physical injury is recovered.
  • Curing magic is applied differently to Hit Points and Injury Points (but in general is less effective when used to cure Injury Points – see below).


The concept of Hit points are an abstraction. When a fighter gains a level, his body does not suddenly become more resistant to damage. A sword’s strike does not suddenly do proportionately less damage. Rather, hit points suggest that the fighter has undergone more training, and while he may have improved his ability to deal with wounds to a small degree, the hit points gained at higher levels reflect less his capacity for physical punishment and more his skill at avoiding hits, his ability to dodge and twist and turn. Each loss of hit points, in this case, suggests that he is becoming progressively less nimble over the course of combat—in other words, that the decreasing hit points are a marker for his overall endurance and condition. It’s not quite as satisfying, however, to roll a critical hit and then tell a player that his opponent ducked out of the way, but that the sword’s slash made the enemy a little less lucky.

This system for tracking Injury Points and Hit Points should help to remedy that. Additionally, this system should help to speed combat up a bit. A creature who has taken a significant amount of Injury Point damage may well end the combat before running out of Hit Points, either by fleeing, surrendering or initiating a desperate attack.

Determining Injury Points and Hit Points

Instead of using the traditional hit point system, creatures using this method have a pool of Injury points and another pool of Hit Points. These two scores are kept track of separately, and represent different ways a character handles the damage inflicted on him. The following are descriptions of these scores and how they work within this system of damage tracking.

Hit Points

  • Your character will still have a Hit Point pool. This Hit Point pool works EXACTLY like the current system, except that bonus hit points from Constitution and Favored Class are no longer added (those are now your Injury Points). These hit points may also be called Vigor or Strain, but I prefer to call them Hit Points.
  • Hit Points represents a creature’s ability to avoid the majority of actual physical damage it might take from an attack. When a creature takes damage, the damage typically reduces its Hit Points first. Some special attacks either deal Injury Point damage directly or deal both Hit Points and Injury Point damage (see Critical Hits).
  • Creatures with one or more full Hit Dice or levels gain Hit Points. With each level gained or each Hit Die a creature has, it gains a number of Hit Points based on its Hit Die type. Use the creature’s Hit Dice to generate its “Hit Points,” just like you used to, but without adding the creature’s Constitution modifier. A creature gains maximum Hit Points on its first Hit Die if it comes from a character class level. Creatures whose first full Hit Die comes from an NPC class or from their race roll their Hit Dice to determine their starting Hit Points. A creature with less than one Hit Die has no Hit Points; it only has Injury Points.
  • When a creature no longer has any Hit Points, any additional damage it takes reduces its Injury Point total.

Injury Points

  • Your character will also have an Injury Point pool. Typically a creature has a number of Injury Points equal to twice its Constitution score. It also has a Wound Threshold equal to its Constitution score. Furthermore, any Hit Points gained from taking levels in a character’s favored class are added to your Injury Point total.
  • Injury Points represent the amount of physical punishment a creature can take before it dies. When a creature’s Injury Points drop to or below its Wound Threshold, that creature becomes Wounded. When a creature is Wounded, it gains the staggered condition until it is no longer wounded. Furthermore, when a creature is Wounded, if that creature takes any standard or move action on its turn, its remaining Injury Points are reduced by 1 and it must make a DC 10 Constitution check. The character takes a penalty on this roll equal to the Injury damage that exceeds his Wound Threshold. If the creature fails that check, it falls unconscious.
  • On the character’s next turn after becoming Wounded (but not dead) and on all subsequent turns, whether they are conscious or not, the character must make a DC 10 Constitution check to become stable. The character takes a penalty on this roll equal to the Injury damage that exceeds his Wound Threshold. A character that is stable does not need to make this check unless they exert themselves and/or take additional damage. A natural 20 on this check is an automatic success. If the character fails this check, his remaining Injury Points are reduced by 1. A character may spend an Action Die to become Stable if they are unconscious, or spend Action Dice to heal themselves if they are able (this is a standard action, so the healing result will be reduced one point).
    • Characters taking continuous damage, such as from an acid arrow or a bleed effect, automatically fail all Constitution checks made to stabilize. Such characters lose 1 Injury Point per round in addition to the continuous damage.
    • You can keep a Wounded character from losing any more Injury Points and make him stable with a DC 15 Heal check.
    • If any sort of healing cures the Wounded character of even 1 point of Hit Point or Injury Point damage, he becomes stable and stops losing hit points.
    • Healing that raises the Wounded character’s hit points above his Wound Threshold makes him conscious. A spellcaster retains the spellcasting capability she had before dropping below their Wound Threshold.
    • A stable character who has been tended by a healer or who has been magically healed eventually regains consciousness. If the character has no one to tend him, however, his life is still in danger, and he may yet slip away.
  • When a creature reaches 0 or fewer Injury Points, it is dead.
  • Injury Points and Constitution Damage, Drain, and Penalties: A creature’s Injury Points and Constitution score are intrinsically linked. For each point of Constitution damage a creature takes, it loses 2 Injury Points, but this damage does not affect the creature’s Wound Threshold. When a creature takes a penalty to its Constitution score or its Constitution is drained, it loses 1 Injury Point per point of drain or per penalty for the duration of the penalty or drain. A penalty to Constitution or Constitution drain has no effect on the creature’s Wound Threshold.

Attacks that deal Injury Point damage

Some attacks can be used to deal Injury Point damage directly.

  • Critical Hits: When a creature is subject to a critical hit, the critical hit deals the damage normally, reducing Hit Points first, and then reducing Injury Points when Hit Points are gone. It also deals an amount of Injury Point damage equal to its critical multiplier (for example, 3 Injury Points for a weapon with a ×3 modifier), on top of any Injury Point damage the creature might take from the critical hit.
  • Negative Energy Damage: When a creature deals negative energy damage to a creature with a spell or effect, it can choose to deal Injury Point or Hit Point damage (but not both) with the spell or effect. If that creature chooses to deal Hit Point damage, the spell or effect deals negative energy damage normally, and that damage reduces Hit Points only, even if it deals more damage than the target has Hit Points. If the spell or effect deals negative energy damage to Injury Points directly, it deals an amount of Injury Point damage equal to the number of dice the creature would roll for that effect; if the effect deals a number of points per caster level (such as the harm spell), it deals a number of Injury Points equal to the caster level of the spell.

Other Considerations

The following are a few other considerations to take into account when using the Injury Point and Hit Point system.

  • Temporary Hit Points: When a creature would normally gain temporary hit points, it still gains temporary Hit Points. When that creature takes damage, it loses these temporary Hit Points first. If an attack deals damage to Injury Points only, these temporary Hit Points are not lost.
  • Nonlethal Damage: When a creature takes nonlethal damage, it takes that damage in Hit Points only, even if the attack deals more damage than the creature has Hit Points. If the creature has no Hit Points (and no temporary Hit Points), each time that creature takes damage from an attack that deals nonlethal damage, it takes either 1 Injury Point of damage, or a number of Injury Points of damage equal to the attack’s critical hit modifier if the attack is a critical hit.
  • Spells or Effects with hit point Triggers: When using this system, if a spell or an ability has an effect that occurs when you reduce a creature to 0 or fewer hit points (such as the disintegrate spell), that effect is instead triggered when a creature is Wounded. In the case of the harm spell or a similar effect where a creature cannot be reduced below 1 hit point by the spell or effect, a creature’s Injury Points cannot be reduced to or below that creature’s Wound Threshold.

Regaining Injury Points and Hit Points

A creature can regain Injury Points and Hit Points in a number of ways, but in general it is easier to regain Hit Points.

Healing Spells and Effects

Edit: 7/2013

After consideration, the following replaces the original rules regarding cure spells. Whenever an injured creature receives magical healing, the die rolls are always applied to hit points. The bonus points for caster level are always applied to injury points, with any remaining applying to hit points. For instance, a 4th level character casts cure light wounds on his ally who has taken 6 hit points and 2 injury points. The die roll would be applied to the hit points, and the target’s 2 injury points would be cured as well, with an additional 2 points of curing (the cleric gives 1d8+4) being applied to hit points. So if the roll was a 4 (+4), the cleric would bring his target to full hit points.

Channelling energy: Because there is no bonus for caster level, curing granted by channelling positive energy only applies to hit points. If the injured party’s hit points are at full, only then will any remaining channelling be applied to injury points. Channelling negative energy is treated the same way. Only when the victim is out of hit points will the channeling damage be applied to injury points.

Level dependent healing: Any healing ability which is level dependent, such as a paladin’t lay on hands, or a monk’s healing ability, is applied first to injury points, with any remaining going to hit points.

When casting healing spells or using an ability with a healing effect (such as channeling holy energy on living creatures or the paladin’s lay on hands ability), the creature casting the spell or using the effect must choose whether it wants to heal Injury Points or Hit Points. The creature decides this before casting the spell or using the ability. When that creature decides to heal Hit Points, the healing spell or effect acts normally, replenishing a number of Hit Points equal to the number of hit points the spell or effect would normally heal. If the creature decides to heal Injury Points, it heals a number of Injury Points equal to the number of dice it would normally roll for the healing spell or effect. In the case of effects like the heal spell, where a spell or effect heals 10 hit points per caster level, the creature heals its caster level in Injury Points.
-For instance, if a 12th-level cleric uses her channel positive energy power to replenish Injury Points to living creatures, she would typically heal 6 Injury Points for all living creatures with her channel energy burst. If she casts the heal spell, she would restore 12 Injury Points to the creature touched.

Rest and Refit

If a character has sustained Hit Point damage during an encounter, this damage can be recovered with a rest and refit.

  • The character must have five to ten minutes where they are neither threatened by further encounters nor suffering additional ongoing Hit Point damage (e.g. thirst, starvation, extreme heat or cold). During this time, characters regain their composure, perform minor armor and weapon repairs, and catch their breath.
  • A character may tend to another’s Injury damage through use of magic or the Heal skill during the rest and refit without compromising their own recovery.

Night’s Sleep

When a creature has a full night’s rest (8 hours of sleep or more), that creature regains all its Hit Points (which it had done after about 10 minutes) as well as 1 Injury Point. If there is a significant interruption during a rest, the creature does not regain any Injury Points. If a creature undergoes complete bed rest for an entire day, it regains half its level in Injury Points. The use of Long Term Care described in the Heal skill doubles these numbers.

Restoration and Similar Effects

When a creature regains Constitution points by way of the restoration spell or a similar effect, that creature regains 2 Injury Points for every Constitution point regained. Relieving a Constitution penalty or Constitution drain regains any Injury Points that were lost from that penalty or drain.

Injury and Hit Point Variant Feats

The following feats are either new for the Injury and Hit Point system or work differently in that system.

Deathless Initiate (Combat)

For you, impending death is a call to wrath.
Prerequisites: Str 13, Con 13, Diehard, Endurance, base attack bonus +6, orc or half-orc.
Benefit: You are not staggered when your Injury points reach your wound threshold, but you lose 1 Injury Point if you take any action during your turn. You only take 1 Injury Point each round when you take actions. Furthermore, you gain a +2 bonus on melee attacks and damage rolls when your Injury Points are at or below your wound threshold.

Deathless Master (Combat)

Even if you suffer a grievous wound, you can shrug off the damage and continue your relentless assault.
Prerequisites: Str 13, Con 15, Deathless Initiate, Diehard, Endurance, Ironhide, base attack bonus +9, orc or half-orc.
Benefit: When your Injury Points reach your wound threshold, you do not take 1 Injury Point when you take an action.


You keep on going, even when your Injury Points are lower than your wound threshold.
Benefit: When your current Injury Point total is below your wound threshold, you do not need to succeed at the DC 10 Constitution check to stay conscious.


You have enhanced physical stamina.
Benefit: You gain 1 Injury Point for every level or Hit Die your character has.

First Rule Changes
House Rules

Hit Points-Injury

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