I would like to start by reinforcing the concept of what Hit Points represent. They are a system designed to track a heroes stamina, fortitude, and luck. Not every hit draws blood. Often times a hit represents the one hit being forced off balance or losing the will to continue the battle as they can see their death in the outcome.

We will be using a new sub system called Vitality. Vitality represents the physical side of combat. The first thing you will need to determine and track is your Vitality Score. The seconded thing you will need to track is your level of fatigue. Use the following points to due so.

These rules are a modification of the Vitality rules released by WoTC. The * are additions or modifications. There are modifications to the basic rules on Fatigue found in the PHB.

  • Your max Vitality score equals your Constitution.
  • You lose one vitality for every ten HP you take from a single hit or effect.
  • You lose an extra vitality from a critical hit.*
  • Your max HP is reduced by your level at every odd vitality (eg. Calculate your max HP as though your vitality score is you Constitution)
  • If you are reduced to 0hp any remaining damage is applied directly to vitality and you remain conscious until your vitality is reduced to zero.
  • If your vitality score is reduced to zero reduce your hp and max HP to zero.
  • A stabilized creature will regain consciousness after 1d4 hours with one vitality.*
  • You regain 1+ your Constitution modifier in vitality per long rest.
  • Change the sixth level of exhaustion to unconscious and dying.*
  • All spells which restore HP loss will now have the additional wording; Undergoing healing requires the creature healed and the creature healing to experience the pain of injuries acutely. When a healing spell is cast and the spell heals ten or more HP in a single casting the creature healed also regains one vitality for every ten points healed. If the creature healed has levels of exhaustion they will also have one level of exhaustion removed. If a level of exhaustion is removed in this way the caster of the spell must succeed at a DC 15 con save or gain the level of exhaustion themselves.*
  • All effects which restore lost HP will gain the following; for every ten HP this effect heals it also restores one vitality. If the effect is magical in origin it will also remove one level of fatigue.*

Fatigue from Vitality loss

As your vitality decreases you find it harder to keep pushing forward. At every odd level of vitality below ten you gain one level of exhaustion.*

If you have no levels of exhaustion the progression is as follows;

Vitality Level of Exhaustion
8-9 one
6-7 two
4-5 three
2-3 four
1 five
0 six


Sword and Sorcery (5e) benjamin_shanafelt