Diseases and Afflictions: Death by a Thousand Coughs

Plague, Pestilence, and Poor Hygiene

The Old World's Medical Reality: Leeches and Prayer

In the Empire, medicine consists mainly of bloodletting, suspicious herbs, and desperate prayers to Shallya. Disease is as common as mud and twice as deadly. The average citizen is more likely to die from an infected splinter than a Chaos warrior's blade. Think of it as medieval healthcare, but worse—because at least medieval doctors didn't have to worry about their patients growing tentacles.

graph TD A[Disease Sources] --> B[Environmental] A --> C[Contagion] A --> D[Magical] A --> E[Divine Punishment] B --> F[Bad water/food] B --> G[Poor sanitation] C --> H[Infected creatures] C --> I[Sick people] D --> J[Chaos taint] D --> K[Cursed items] E --> L[Angry gods] E --> M[Breaking oaths] F --> N[Bloody Flux] I --> O[The Plague] J --> P[Neiglish Rot] L --> Q[Divine Afflictions]

Common Diseases: Your Daily Dose of Misery

Contraction and Spread: The Mathematics of Misery

Disease Contraction (suggested modifiers) Direct Contact • Touching infected: Test at +0 • Treating wounds: Test at -10 • Sharing food/drink: Test at -20 • Intimate contact: Test at -30 Environmental • Swamp/marsh: Test daily at +0 • Slums: Test weekly at +10 • Battlefield: Test at -10 • Chaos sites: Test at -30 Disease Progression Exposure Incubation Symptoms Full Effect Recovery or Death Contagion (house rules) • Contagious Period: Usually starts with symptoms • Close Contact: Anyone within 2 yards for extended time must test • Quarantine: -20 to spread if properly isolated • Epidemic: If 10+ infected in small area, all residents test daily

Treatment Options: From Bad to Worse

Magical and Chaos Diseases: When Normal Plague Isn't Enough

graph LR A[Chaos Diseases: mostly this guide's inventions] --> B[Nurgle's Gifts] A --> C[Warpstone Sickness] A --> D[Mutation Plague] B --> E[Nurgle's Rot: Soul corruption] B --> F[Bone Ague: Skeleton visible] B --> G[Greenrot: Become plant] C --> H[Warpstone Pox: Glowing boils] C --> I[Stone Sickness: Petrification] D --> J[Chaos Flux: Random mutations] D --> K[Beast Plague: Animal transformation]

Afflictions: Long-Term Suffering

Chronic Afflictions (house rules) Bone Ache Cause: Age, damp, old injuries Effects: -10 Agility in cold/damp Treatment: Warmth, spirits, complaining Duration: Life (gets worse) Common in: Veterans, elderly Tomb Rot Cause: Undead exposure Effects: -1 Toughness per month Treatment: Morr priests, holy water Duration: Until cured or death Common in: Grave robbers Consumption Cause: Poor air, overcrowding Effects: daily Endurance test Treatment: Fresh air, rest (ha!) Duration: Years of decline Common in: Cities, mines Soldier's Heart Cause: Battle trauma Effects: -20 to Cool tests vs Fear Treatment: Time, alcohol, more war Duration: Permanent Common in: Veterans The Madness Cause: Chaos, trauma, syphilis Effects: Progressive insanity Treatment: Asylum (torture) Duration: Until death Common in: Scholars, nobles Various Addictions Cause: Coping mechanism Effects: -10 all tests without fix Treatment: Willpower, replacement Duration: Life struggle Common in: Everyone Disease Prevention (suggested) • Cleanliness: +10 to resist (who can afford it?) • Avoid sick people: +20 to resist (good luck in cities) • Blessed items: +10 to resist | Quarantine: Effective but economically devastating

Epidemic Rules: When Plague Comes to Town

Using Disease in Your Campaign

Disease as Plot Device:

  • Mystery Source: Why is everyone getting sick? Investigation time!
  • Race Against Time: Find cure before important NPC dies
  • Moral Dilemmas: Medicine for 10, but 100 are sick
  • Social Commentary: Rich get treatment, poor die in streets
  • Chaos Corruption: Disease is first sign of cult activity
  • Character Development: PC catches chronic condition

Quick Disease Generator

Roll or Choose:

Name (d10): 1-2: [Color] + [Symptom] | 3-4: [Place] + Pox | 5-6: The [Adjective] Death | 7-8: [Saint]'s Curse | 9-10: [Animal] Flu

Transmission (d6): 1: Airborne | 2: Contact | 3: Vermin | 4: Water | 5: Food | 6: Magical

Primary Symptom (d8): 1: Fever | 2: Boils | 3: Cough | 4: Madness | 5: Paralysis | 6: Bleeding | 7: Transformation | 8: Rot

Severity (d6): 1-2: Mild (-10 tests) | 3-4: Moderate (-20 tests) | 5: Severe (-30 tests) | 6: Deadly (Endurance tests or die)

Special Feature (d6): 1: Highly contagious | 2: Targets specific group | 3: Magical origin | 4: Creates carriers | 5: Seasonal | 6: Divine punishment

Memorable Disease Descriptions

Bringing Disease to Life:

Visual: "Your skin takes on a greyish pallor, like old parchment left in the rain."

Auditory: "Each breath rattles in your chest like dice in a cup."

Tactile: "Your joints feel filled with ground glass, grinding with each movement."

Olfactory: "A sweet, cloying smell follows you—the scent of rot barely held at bay."

Psychological: "You know you're dying, but worse, you can feel your mind going too."

"In the Empire, we have a saying: 'The plague that doesn't kill you
probably just hasn't finished with you yet.'"
- Sister Bertha, Shallyan Healer

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Warhammer and Warhammer Fantasy Roleplay are trademarks of Games Workshop; the 4th edition is published by Cubicle 7. This guide is an unofficial fan resource.