Last week's discussion of how the Cause Disease spell worked in first edition AD&D would be incomplete if we didn't at some point look at the mechanics for non-magical diseases.

Last week's discussion of how the Cause Disease spell worked in first edition AD&D would be incomplete if we didn't at some point look at the mechanics for non-magical diseases. Just as I argued that that Cause Disease was a more elegant spell than later versions of Contagion, AD&D did what was in many ways a much better job of coming up with mechanics for diseases than any edition of D&D since.

The AD&D Dungeon Masters Guide rules for diseases take up about a page and a half, but a lot of information is crammed into those pages. Perhaps what I liked most is that no specific diseases are listed. My complaints with the disease lists in many role-playing games has always been that the invented fantasy diseases make no logical sense and the real-world disease descriptions tend to be inaccurate; I'd rather have no list of illnesses than a bad one. AD&D makes neither one of these mistakes, simply because no specific diseases are presented. Instead, the rules first distinguish between "diseases" and "parasitic infestations," then explain how often to randomly check if your players characters contract diseases depending on whether they're in an environment more likely or less likely to cause infections, then provides tables to determine whether an illness is mild, severe, or terminal and which of the body's organ systems are affected. The body system affected determines the effect of the illness: strength and dexterity loss from muscle disease, strength and constitution loss from blood disease, charisma from skin disease and so forth. The upshot of all this is that instead of saying that a character contracts hepatitis or cackle fever, the AD&D rules provide a mechanism for deciding that, for example, a character develops a mild brain disease, a severe ear parasite, or a terminal genitourinary affliction. Each body system is briefly explained, and each system specifies that a terminal illness takes a different period of time to kill. The rules are far from perfect and they make a few mistakes -- leprosy, for example, is given as an example of a connective tissue disorder when it really ought to be either neurological or skin-related -- but it's still a great system for generating illnesses. The storyteller is left with the responsibility of coming up with flavour text and an illness' description, but the game tries to ensure that there's a nearly endless variety of afflictions to choose from. It's less exciting than, say, an entire book full of diseases described in exhaustive detail, but it's the second best I've ever seen.

The Guide contains some delightfully unnecessarily complex rules for intoxication. A storyteller can track how a drinking character's bravery increases towards the state of being "foolhardy" even as penalties to intelligence, wisdom, dexterity and charisma accumulate. Attack dice drop but hit dice increase, which is one of the best descriptions of drunkenness that I've ever read. A simple table outlines how long it takes for an intoxicated character to sober up, and it matches up with reality quite nicely.

The one thing that really disappointed me about the AD&D rules, however, was the poor handling of mental disorders. Very few rule books have ever done a good job of providing mechanics, or even decent descriptions, of mental disorders, and AD&D does no better. Of course, the book was written at the end of the 1970's, so if every more recent book I've read had bad rules, I knew that AD&D wouldn't be superior, but I still had hope. The book has a respectably broad list of mental disorders, but most of the explanations are, quite simply, wrong. The book starts by making the classic silly mistake of equating schizophrenia with multiple personality disorder and goes downhill from there, giving nonsensical descriptions of such constructs as schizoid personality and pathological lying. The major redeeming feature that made me forgive everything else, however, was a little blurb that Gygax put at the end. He ended his section on mental disorders by writing that "naturally, these forms of insanity are not clinically correct. They are designed to conform to game terms and situations." This simple admission that "we've taken creative liberties" is obvious, and yet is something I've always thought is sorely lacking in newer books. 

More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on October 12, 2014. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system.