So one of the oddest things in Pathfinder is the existence of the spell, Regenerate. This spell is odd because there are no established rules around the loss of “fingers, toes, hands, feat, arms, legs, tails, or heads”. This ties into another problem I have with Pathfinder best explained by an example:
Bob, the example character opens the trapped door and a scythe whips down and crits, almost killing him. 18 seconds later and with a little divine help, Bob is back at 100% despite almost dying to a scythe crit…
Why can’t that result in a severed limb? A lost hand? Instant death due to shock? I have recently picked up Privateer’s Press’s RPG system “Iron Kingdoms” and there’s a table in there for disfiguring and crippling injuries when severely hurt. I’m proposing to the Eberron group that I’m a part of (and GM-ing right now!), that we adopt a “severe injury table”.
Whenever a creature takes damage equal to 50% or more of their maximum hit points (and survives), roll 3d6 and consult the severe injury table.
Severe Injury Table
3 – Dead (GM decides instantly dead or time enough for gasping a few final words).
4 – Critical Injuries (Bleeding out, must have another character com stabilize. Heals at half the normal rate but cannot benefit from magic that heals hit point damage. The damage is too severe/dark magicks/etc. Also, does not regain consciousness until at 1hp from natural healing).
5 – Broken Limb (Roll a d6, on a 1-3 broken arm. On a 4-6 broken leg. Arm: Can’t be used. -2 to all skills that would require 2 arms. Leg: Can’t be used. -2 to all skills that would require 2 legs. Character is staggered until limb is set which cannot be done in combat).
6-8 – Internal Bleeding (Staggered until stopped. -1 hp a round, has to be stabilized out of combat).
9 – Battered (Shaken and sickened until the end of combat).
10-11 – Concussed (Stunned for 1d4 rounds).
12 – Battle Scars (-2 to all social skills due to disfiguring scars).
13-15 – Internal Bleeding (Staggered until stopped. -1 hp a round, has to be stabilized out of combat).
16 – Lost Eye (Stunned from pain for 1d4 rounds, -2 on attack rolls and perception checks. Rolling this again makes a character blind).
17 – Critical Injuries (Bleeding out, must have another character com stabilize. Heals at half the normal rate but cannot benefit from magic that heals hit point damage. The damage is too severe/dark magicks/etc. Also, does not regain consciousness until at 1hp from natural healing).
18 – Lost Limb (One limb is severed/completely destroyed. Roll a d6, 1-3 arm, 4-6 leg. Character takes 1 point of Constitution bleed and is staggered until stabilized by another character. Arm: -2 to all skills that would require 2 arms. Leg: -2 to all skills that would require 2 legs.
The most common result is getting stunned for several rounds. Straight up death and Loosing a limb are the rarest of results. A couple of the common complaints about implementing such a system “it’ll slow down combat!” and “it’s OP at lower levels!”. My counters to both of these are wonderfully simple; almost every thug, minion, creeper, mob, or other trash that isn’t a main villain is just disposable. Anything that can take a 4x crit from a two-handing strength based power house and survive it, should be rolling on the table. At low levels, adventuring is tremendously dangerous already, I might create a more limited table with other effects (such as becoming prone, getting shoved around, etc) but the loss of a limb can be almost as defining as the back story that describes a character (especially when in a setting where prosthetics can be megaman gun arms!).