Harm and its treatment

Everything in the two catalogs has a cost, and the cost arrives after the effect does. This chapter is what a practitioner does about it.

There are four ways the substances in this book cause harm. They are not versions of one another and their treatments do not substitute for one another, so they are separated first. Then the ladder of care, which is the order in which things are tried. Then each of the four in turn, and last what the spells in the Basic Rules reach.

Four things, and telling them apart

What arrives at a shop door is one of four things. They are told apart by two questions: whether the harm ends on its own, and how long there is to decide.

• The morning. A creature has drunk past its capacity and is coming down through the four levels of Intoxication. It ends on its own at one level an hour whatever anybody does, so the work is comfort and nothing else.
• The comedown. A simple has ended and what it was holding off has arrived — the sleep it deferred, the pain it covered, or both. This also ends on its own, but over days rather than hours, and it is the one most often mistaken for illness.
• The wanting. A body has begun to expect a substance, which the first chapter counts as Craving. It does not end on its own, and left alone it converts to an addiction, which then deepens by degrees until the creature is arranging its life around the substance.
• The overdose. More of a substance in one sitting than the entry’s threshold allows, still acting. It is the only one of the four that is an emergency, it is measured in minutes rather than hours, and it is the only one where the wrong first move can kill.

The first question in every case is the third of the three things she asks in the first chapter: know what the person in front of you has already taken, how much, and when. All four arrive as a creature that is not well, and three of the four look much alike at the door. Without the answer a practitioner is guessing which of them this is, and the treatments do not overlap enough for a guess to be harmless — the emetic that saves an overdose does nothing whatever for a comedown, and the days of attendance that answer a craving are time an overdose does not have.

The ladder of care

Care is a ladder. The rungs are ordered by what they cost — in coin, in preparation, and in somebody’s time — rather than by what they achieve, and a practitioner climbs from the bottom and stops at the first rung that answers the case. Most cases stop on the second.

1. Water, warmth and time. A blanket, a quiet corner, and somebody looking in every hour. It is the whole treatment for the morning and most of the treatment for a comedown, both of which end on their own and need only to be survived comfortably.
2. The kitchen. Purl for a bad morning, caudle for somebody who has been cold, broth for somebody who has not eaten, willow tea for an ache, chamomile for the night after. The first two are in the fourth chapter and the rest in the third, all of them cost coppers, and between them they answer more of what comes through a door than every rung above them together.
3. The bench. Preparations made for the purpose rather than for pleasure: the emetic, the charcoal, and a strong infusion of whatever the entry names. These need an apothecary rather than a kitchen, and they are the rungs that decide an overdose.
4. The hand. Keeping a body warm, turned, and breathing. It needs no preparation, no spell and no coin, and it needs one person doing nothing else for as long as it goes on. It treats nothing. It keeps a creature alive long enough for anything else on the ladder to be tried, which in an overdose is often the only thing that matters.
5. Magic. What the spells reach, set out at the end of this chapter, and the remedies in the eighth chapter, which were written for the cases the Basic Rules leave alone.

One term is used throughout the rest of this chapter and is defined here. A day of attendance is a day a creature spends fed, watered, warm and rested, out of reach of the substance, with somebody sober keeping the count. It is the second rung applied for a whole day rather than for an evening. It appears three times below — against a comedown, against Craving, and against an addiction’s saving throws — and it means the same thing in each.

An overdose in progress is the one case that does not start at the bottom. It starts at the third rung or the fourth, according to whether the dose has taken hold yet, and the first two rungs are what happens afterward, once the emergency is over.

The morning

Intoxication comes down on its own at one level an hour, and food and water halve that hour; both rules are in the fourth chapter. Nothing on the ladder shortens that clock by more than a single level, so the work is making the hours tolerable rather than removing them, and what it takes is cheap.

What is worth having on hand:

• A tankard of purl reduces Intoxication by 1 level, once between Long Rests. It is the only preparation in this book that takes a level off directly, which is why the fourth chapter gives it a rule of its own rather than a line in a table.
• Broth, bread and water carry a creature through the remaining hours faster than a bed alone, because food and water halve each hour, and because a creature that is being fed is being looked at every hour as well.
• A creature that reached the fourth level gains 1 Exhaustion level when its Intoxication ends. That level is removed by a Long Rest like any other, and nothing below the fifth rung removes it faster, so a creature that drank itself insensible loses the day after.

The morning is also where drink’s own count is kept. A day on which a creature reached the third or fourth level of Intoxication adds 1 to its Craving for drink. A practitioner who treats the same creature’s morning repeatedly is watching that count climb.

“

I am asked for a cure for the morning perhaps twice a week, and I sell purl, and I say what purl is: a bitter drink that takes one level off and no more. There is no cure for the morning. The morning is the account being read back, and I have never known a body to be argued out of its arithmetic.

The comedown

A simple of the waking gives a body nothing it did not already have. It moves what the body had forward, and the entries say so in the same words each time: a creature under one of them gains no Exhaustion level from going without sleep. That clause defers the Exhaustion rather than cancelling it. The hours a creature did not sleep are still hours it did not sleep, and they are counted when the simple ends.

A creature that takes kindleseed at dusk and works through one night has missed one Long Rest; it gains 1 Exhaustion level when the 6 hours are up, sleeps, and the level goes. A creature that takes nightsmith for four nights running has missed four, and gains all 4 levels at once when the last dose ends. A creature dies at 6, so the sixth consecutive night is the one to count, and what kills is the missed sleep rather than the simple. This is ordinary Exhaustion, and a run of Long Rests removes it.

The quieting family comes down differently. What returns is pain rather than tiredness, and it returns at once rather than over an hour, because the simple was covering it rather than treating it. A creature that spent 6 hours under hushcap has, at the end of the sixth, exactly the injuries it had at the start plus whatever it did to itself in between, and it will have done more than it otherwise would, because hushcap is taken to stop a body reporting injury. This is not a new rule. It is the entry’s own duration running out.

Treatment for either comedown is the first rung and the second: sleep, food and warmth, for as long as it takes. Nothing on the bench shortens either. A waking simple given to a creature coming down off a quieting one does not cancel the quieting. Both run at once, each on its own duration, and the practitioner has two cases instead of one.

The wanting

Craving is the count kept in the first chapter: it rises by what each entry names, it falls by 1 for each full day a creature goes without a measure, and at 6 it converts to an addiction and resets to nothing. Everything a practitioner can do before that conversion is done in days, and attendance is the only lever.

A day of attendance lowers Craving by 2 rather than 1, which halves the time: a creature at 5 Craving is three attended days from clear and six unattended days from the same place.

The fall only applies on a day the creature goes entirely without. A creature taking a measure daily never has a falling day at all, so every entry accumulates at its full rate — six days to an addiction on drover’s cud, which adds 1, and two nights on nightsmith, which adds 3. The count rises until something stops it.

Addiction, and how it ends

The cure is abstinence, and there is no other. An addiction ends the way the first chapter sets it out: a saving throw at the end of each day the creature goes without a measure — Constitution for the first 3 days and Wisdom from the fourth — with successes equal to 1 plus its degree, at a Difficulty Class of 15 on the first day that falls by 1 for each consecutive day after it. A creature at the first degree needs two and can go the days without much trouble. A creature at the third needs four, and is the one least able to stay away from the substance long enough to make them, which is the difficulty this section is about.

The Difficulty Class falls because the first days are the worst and each day after is easier than the one before. What does not get easier is the substance being in the room. Taking a measure at any point sends the successes back to none and the Difficulty Class back to 15, and after the addiction has ended a single measure restores it whole at the degree it left off, so a practitioner’s work continues after a creature is well.

An addiction does not kill. Withdrawal from anything in this book is one bad day repeated — Disadvantage on Wisdom and Charisma checks throughout, and from the second degree 1 Exhaustion level that does not lift while the addiction lasts and does not accumulate. A creature a fortnight into going without has that one level and no more. It is miserable and impaired, and in no danger from the withdrawal itself.

The danger is the third degree’s excess, which each entry names: the money spent, the night not slept, the cup that ends a bad day and is followed by the second cup that kills. A practitioner treating an addiction is treating the excess, and the treatments below are aimed at it rather than at the count.

• Attendance. A creature attended for the whole of a day makes that day’s saving throw with Advantage, and — because attendance means a day spent out of reach of the substance — is not called on to refuse one at all. The second effect matters more. A creature at the third degree has to refuse every time a measure is in the room, so the practitioner’s work is emptying the room rather than improving the odds inside it.
• The taper. A measure taken under a practitioner’s hand — on a day set aside for it, at a dose the practitioner is reducing — costs that day’s saving throw, because the day was not gone without, but does not undo the successes already made and does not return the Difficulty Class to 15. It is the one exception to the rule above. A measure taken any other way is a relapse. The same measure out of the same bottle counts differently according to whether a practitioner is reducing the dose.
• What magic does here. Greater Restoration removes the Exhaustion level a second- or third-degree addiction lays down. That makes one day bearable and does nothing else: the level returns the next day the creature goes without, the saving throws are unchanged, and no spell in the Basic Rules reaches the addiction itself.

Nightsmith is the case the sixth chapter said would be set out here, and every number in it comes from that entry. A measure adds 3 to Craving, so a scholar taking one a night is at 6 on the second and Addicted, and at the third and deepest degree by the sixth. He notices none of it, because every degree describes a day without a measure and there are no such days while the work lasts. The fortnight it buys is real, and the work gets done.

When the work stops he has four saving throws to make, the first at DC 15 and each of them easier than the last, a bad day every day he goes without, and 1 Exhaustion level that will not lift until he takes a measure or finishes. He also has nightsmith’s excess, which is work: he takes a measure before anything he cares about doing, and has come to believe he cannot do it otherwise. A scholar who believes that will not make four saving throws in a row on his own, which is what attendance is for. The next commission he accepts, a year later, brings the relapse rule into play.

“

People ask me for something that ends the wanting, and I tell them what I have: a bed, a fortnight of my attention, and a bitter fortnight it is. They are disappointed, and then they ask whether there is a spell, and I tell them there is not, and they are disappointed again in the same quarter of an hour.

What there is, is somebody sitting up. I have not found a way to sell that, and I have stopped trying to.

The overdose

An overdose is measured against the entry’s own threshold — the third measure, the second cup — and what a practitioner can do about one divides at the entry’s own Onset. Both numbers are printed in the catalog’s tables for this reason.

Before onset

Before a simple takes hold, a swallowed measure is still in the stomach and can be brought back up. A creature made to vomit before the Onset in the entry has passed has not taken that measure at all: no effect, no overdose saving throw, and nothing added to Craving. The emetic is salt water, or a strong infusion of mustard, and it works within a minute of going down.

This rung is narrower than it looks. It does nothing for a measure that was smoked or rubbed in, neither of which goes through the stomach, and nothing for one whose Onset has already passed. Onsets in the sixth chapter run from immediate to an hour, so whether the rung is available at all is decided by which simple was taken, before the practitioner arrives.

After onset

Once a simple has taken hold, charcoal is the bench’s answer: hardwood burnt, ground fine, and given in water. A creature that swallows it within 10 minutes of a measure makes that measure’s overdose saving throw with Advantage. The charcoal is inert in itself and does no harm at any dose, which is why it is kept made up in a jar rather than prepared when it is wanted — the 10 minutes do not allow for preparing it.

When the breath goes

Milk poppy, sister’s ease and sleepwrack stop a body breathing. A creature dying this way is not wounded, there is nothing to stanch, and nothing on the first three rungs reaches it. The fourth rung is the whole treatment, and it requires a person rather than a preparation.

The work is not a cure. It holds a creature where it is until the overdose passes on its own or until a slot arrives, and it occupies whoever is doing it completely for as long as it lasts.

What cannot be caught

Four entries in the sixth chapter kill outright rather than by degrees, and each says so in its own entry. Three of them — milk poppy, sister’s ease and sleepwrack — kill by stopping the breath, and the rung above is what answers them. The fourth does not. Nightsmith’s third measure gives no window at all. There is the saving throw, a failure is a death, and nothing before it for anybody to catch.

Where a creature does die, Revivify reaches back 1 minute. A practitioner who has been working somebody’s chest for 20 minutes is 19 minutes outside that window, so the spell answers a death that happens in front of a caster and not one that happens while somebody goes to find one.

“

Of what to do at three in the morning

One will find out what was taken, and how much, and when, and one will ask the people who carried them in rather than the one lying down.

If it is not yet in them, one will bring it up. If it is, one will give charcoal in water. If the breath has gone, one will breathe for them and one will go on breathing for them, and one will send the fastest person in the room for anybody with a slot to spend.

And one will not give a waking simple to a body that has stopped breathing, whatever one has been told by whoever is shouting. It does not answer the quieting. It only means there are two things in them.

What magic does, and where it stops

Magic reaches this craft in three places: what is in the cup, a short list of named conditions, and telling one prepared thing from another. In all three it stops at the same line. A spell can destroy a dose, and it can end a condition a dose caused, and it cannot reach the fact that a body has taken one — not the Exhaustion, not the Craving, not the addiction, and not a creature whose breathing has stopped. The rulings below follow what the spells in the Basic Rules actually say.

Purify Food and Drink

The spell takes the harm and the virtue together, because in everything in this book they are the same substance: there is no part of a simple that does the good and some other part that does the damage, so a spell that removes what is harmful removes the preparation. It works every time and needs no check, and what it leaves behind is inert:

• Cast on a plant, growing or gathered, it is no longer that plant. The leaf is safe and worth nothing, and nothing can be prepared from it.
• Cast on a prepared dose, the dose is harmless. It is also inert — no measure, no effect, and nothing added to Craving.
• Cast on a strong water, the drink goes out of it. What remains is water, or tea, or wort: safe, drinkable, and worth no Intoxication at all.
• Cast on what has already been swallowed, it does nothing, because the spell has food and drink for its target and never a creature.

The last of those is the one the rest of this chapter rests on. A 1st-level spell slot destroys the cup and cannot touch the person who has already drunk from it, and every rung of the ladder below the fifth exists because of that.

“

It is a fine spell and I have used it on a barrel that came back from a wedding, and there is nothing wrong with it that is not in the reading. It does not take the harm out and leave the good. There is no seam between them to cut along. What one has afterward is a clean cup of nothing, which is a fair price for a barrel and a ruinous one for a month’s tincturing.

And it will not chase a thing that has been drunk. I have watched a young man of the cloth cast it four times over a woman who had taken milk poppy, at a shilling a slot by his own accounting, and what saved her was a girl of eleven holding her mouth open.

The restorations, and what they miss

Three spells end the Poisoned condition, which is the consequence a good many entries in the sixth chapter name, and that is all they do here:

• Lesser Restoration ends Poisoned, as a Bonus Action, on a touch. Against this catalog it answers exactly the consequences that name the Poisoned condition — a good many second measures and overdoses across the six families do — and nothing else a simple does: not the Exhaustion, not the visions, not a breath that has stopped. One case earns its own line: cast on a creature that drank against its oathbane, it ends the hour’s sickness and does not touch the tincture, so the day’s disagreement stands and the next serving calls the next saving throw.
• Heal ends Poisoned as well, alongside its healing, and is worth naming here only because a creature that has overdosed is frequently also hurt.
• Protection from Poison ends Poisoned and, for 1 hour, gives Advantage on saving throws to avoid or end it. Against this catalog that Advantage applies wherever a saving throw is made against being Poisoned — the overdoses that name the condition, and a creature drinking against its oathbane — and nowhere else, because the catalog’s other saving throws are against damage, Exhaustion, unconsciousness and the rest of what an overdose does, rather than against being Poisoned. Its Resistance to Poison damage is worth nothing here at all: nothing in the sixth chapter deals Poison damage. What these simples do, they do by driving a body past what it will take, so the entries that deal damage deal Psychic and Necrotic.

None of the three touches an Exhaustion level, the Unconscious condition, a Craving, an addiction, or a creature that has stopped breathing. Greater Restoration removes 1 Exhaustion level, which is one day of an addiction and no part of the addiction itself.

Detect Poison and Disease is the spell a practitioner is most often offered for diagnosis, and it answers a different question than the one being asked. It finds prepared measures within 30 feet and names what each of them is, which settles what is in a bottle, a cup, or on a shelf. It does not read a creature that has already swallowed one: a dosed creature is neither a poison nor a poisonous creature, so the spell has nothing in it to find. The bottle can be identified by a spell and the person cannot, and what a creature has taken is established by asking — the creature, or whoever carried it in, as the first chapter says.

The remedies in the eighth chapter were written for what is left after all of the above: the craving, the comedown, the overdose still in progress, and the hands that will not steady.