Combat: Injury and Death
Your hit points measure how hard you are to kill. While exotic monsters have a number of special ways to hurt, harm, or kill you, usually you just take damage and lose hit points. The damage from each successful attack and each fight accumulates, dropping your hit point total to 0 or below. Then you're in trouble. Luckily you also have a number of ways to regain hit points. If you have a few days to rest, you can recover lost hit points on your own, and divine magic includes a number of spells for restoring lost hit points.
Loss Of Hit Points
The most common way that your character gets hurt is to take damage and lose hit points, whether from an orc's battleaxe, a wizard's lightning bolt, or a fall into molten lava. You record your character's hit point total on your character sheet. As your character takes damage, you subtract that damage from your hit points, leaving you with your current hit points. Current hit points go down when you take damage and go back up when you recover.
What Hit Points Represent: Hit points mean two things in the game world: the ability to take physical punishment and keep going, and the ability to turn a serious blow into a less serious one. A 10th-level fighter who has taken 50 points of damage is not as badly hurt as a 10th-level wizard who has taken that much damage. Indeed, unless the wizard has a high Constitution score, she's probably dead or dying, while the fighter is battered but otherwise doing fine. Why the difference? Partly because the fighter is better at rolling with the punches, protecting vital areas, and dodging just enough that a blow that would be fatal only wounds him. Partly because he's tough as nails. He can take damage that would drop a horse and still swing his sword with deadly effect. For some characters, hit points may represent divine favor or inner power. When a paladin survives a fireball, you will be hard pressed to convince bystanders that she doesn't have the favor of some higher power.
A 10th-level fighter who has taken 50 points of damage may be about as physically hurt as a 10th-level wizard who has taken 30 points of damage, the 1st-level fighter who has taken 5 points of damage, or the 1st-level wizard who has taken 3. Details at this level, however, don't affect how the dice roll. When picturing a scene, just remember that 50 points of damage means different things to different people.
Damaging Helpless Defenders: Even if you have lots of hit points, however, a dagger through the eye is a dagger through the eye. When a character can't avoid damage or deflect blows somehow, when he's really helpless, he's in trouble (see Helpless Defenders).
Effects of Hit Point Damage: Damage gives you scars, bangs up your armor, and gets blood on your surcoat, but it doesn't slow you down until your current hit points reach 0 or lower.
At 0 hit points, you're disabled.
At from -1 to -9 hit points, you're dying.
At -10 or lower, you're dead.
Massive Damage: If you ever sustain damage so massive that a single attack deals 50 points of damage or more and it doesn't kill you outright, you must make a Fortitude save (DC 15). I this saving throw fails, you die regardless of your curtent hit points. This amount of damage represents a single trauma so major that it has a chance to kill even the toughest creature. If, however, you take 50 points of damage from multiple attacks, none of which dealt 50 or more points itself, the massive damage rule does not apply.
Disabled (0 Hit Points)
When your current hit points drop to exactly 0, you're disabled. You're not unconscious, but you're close to it. You can only take a partial action each round, and if you perform any strenuous activity you rake 1 point of damage after the completing the act. Strenuous activities include running, attacking, casting a spell, or using any ability that requires physical exertion or mental concentration. Unless your activity increased your hit points, you are now at -1 hit points, and you're dying.
Healing that raises you above 0 makes you fully functional again, just as if you'd never been reduced to 0 or less. A spellcaster retains the spellcasting capability she had before dropping to 0 hit points.
You can also become disabled when recovering from dying. In this case, it's a step up along the road to recovery, and you can have fewer than 0 hit points (see Stable Characters and Recovery).
Dying (-1 to -9 Hit Points)
When your character's current hit points drop to between -1 and -9 inclusive, he's dying.
He immediately falls unconscious and can take no actions.
At the end of each round (starting with the round in which the character dropped below 0), roll d% to see whether he stabilizes. He has a 10% chance to become stable. If he doesn't, he loses 1 hit point.
If the character's hit points drop to -10 (or lower), he's dead.
You can keep a dying character from losing any more hit points and make him stable with a successful Heal check (DC 15).
If any sort of healing cures the dying character of even 1 point of damage, he stops losing hit points and becomes stable.
Healing that raises the dying character's hit points to 0 makes him conscious and disabled. Healing that raises his hit points to 1 or more makes him fully functional again, just as if he'd never been reduced to 0 or less. A spellcaster retains the spellcasting capability she had before dropping below 0 hit points.
Dead (-10 Hit Points or Lower)
When your character's current hit points drop to -10 or lower, or if he takes massive damage (see above), he's dead. A character can also die from taking ability damage or suffering an ability drain that reduces his Constitution to 0. When a character dies, his soul immediately departs. Getting it back into the body is a major hassle (see Bringing Back the Dead).
Stable Characters And Recovery
A stable character who has been tended by a healer or who has been magically healed eventually regains consciousness and recovers hit points naturally. If the character has no one to tend him, however, his life is still in danger, and he may yet slip away.
Recovering with Help: An hour after a tended, dying character becomes stable, roll d%. He has a 10% chance of becoming conscious, at which point he is disabled (as if he had 0 hit points), if he remains unconscious, he has the same chance to revive and become disabled every hour. Even if unconscious, he recovers hit points naturally. He is back to normal when his hit points rise to 1 or higher.
Recovering without Help: A severely wounded character left alone usually dies. He has a small chance, however, of recovering on his own. Even if he seems as though he's pulling through, he can still finally succumb to his wounds hours or days after originally taking damage.
A character who stabilizes on his own (by making the 10% roll while dying) and who has no one to tend for him still loses hit points, just at a slower rate. He has a 10% chance each hour of becoming conscious. Each time he misses his hourly roll to become conscious, he loses 1 hit point. He also does not recover hit points through natural healing.
Even once he becomes conscious and is disabled, an unaided character still does not recover hit points naturally Instead, each day he has a 10% chance to starr recovering hit points naturally (starting with that day); otherwise, he loses 1 hit point.
Once an unaided character starts recovering hit points naturally he is no longer in danger of losing hit points (even if his current hit point total is negative).
After taking damage, you can recover hit points through natural healing (over the course of days) or through magical healing (nearly instantly). In any case, you can't regain hit points past your hit point total.
Natural Healing: You recover 1 hit point per character level per day of rest. For example, a 5th-level fighter recovers 5 hit points per day of rest. You may engage in light, non-strenuous travel or activity, but any combat or spellcasting prevents you from healing that day. If you undergo complete bed rest (doing nothing for an entire day), you recover one and one half times your character level in hit points. A 5th-level fighter recovers 7 hit points per day of bed rest.
Higher-level characters recover lost hit points faster than lower-level characters because they're tougher, and also because a given number of lost hit points represents a lighter wound for a higher-level character. A 5th-level fighter who has lost 10 hit points isn't seriously wounded, but a 1st-level fighter who has taken 10 points of damage is.
Magical Healing: Various abilities and spells, such as a cleric's core spells or a paladin's lay on hands ability can give you back hit points. Each use of the spell or ability restores a different amount of hit points.
Healing Limits: You can never get back more hit points than you lost. Magical healing won't raise your current hit points higher than your hit point total.
Healing Ability Damage: Temporary ability damage returns at the rate of 1 point per day of rest (light activity, no combat or spellcasting). Complete bed rest restores 2 points per day.
Temporary Hit Points
Certain effects, such as the aid spell, give a character temporary hit points. When a character gains temporary hit points, note his current hit points. When the temporary hit points go away, such as at the end of the aid spell, the character's hit points drop to that score. If the character's hit points are already below that score at that time, all the temporary hit points have already been lost and the character's hit point score does not drop.
When temporary hit points are lost, they cannot be restored as real hit points can be, even by magic.
For example, Jozan casts aid on Tordek. Tordek (now a 3rd-level fighter) normally has 30 hit points, but he's wounded and only has 26. Jozan rolls 1d8 for aid's temporary hit points and gets a 6. Tordek's current hit points rise (temporarily) to 32. A little while later, Tordek takes 3 points of damage from an arrow shot, leaving him with 29 hit points. When the aid spell ends, his current bit points drop back down to 26.
Increases in Constitution Score and Current Hit Points: Note that an increase in a character's Constitution score, even a temporary one, can give him more hit points (an effective hit point increase), but these are not temporary hit points. They can be restored, such as with cure light wounds, and they are not lost first as temporary hit points are. For example, Krusk (now a 3rd-level barbarian) gains +4 to his Constitution score and +6 hit points when he rages, raising his hit points from 31 to 37. If Krusk rakes damage dropping him to 32 hit points, Jozan can cure those lost points and get him back to 37. If Krusk is so wounded at the end of his rage that he only has 5 hit points left, then when he loses his 6 extra hit points he drops to 1 hit points and starts dying.
Sometimes you get roughed up or weakened, such as by getting clocked in a fistfight or tired out by a forced march. This sort of trauma won't kill you, but it can knock you out or make you faint.
If you take sufficient nonlethal damage, you fall unconscious, but you don't die. Nonlethal damage goes away much faster lethal damage does.
Dealing Nonlethal Damage: Certain attacks deal nonlethal damage, such as a normal human's unarmed strike (a punch, kick or head butt). Other effects, such as heat or being exhausted, also deal nonlethal damage. When you take nonlethal damage, keep a running total of how much you've accumulated. Do not deduct the nonlethal damage number from your current hit points. It is not "real" damage. Instead, when your nonlethal damage equals your current hit points, you're staggered, and when it exceeds your current hit points, you fall unconscious. It doesn't matter whether the nonlethal damage equals or exceeds your current hit points because the nonlethal damage has gone up or because your current hit points have gone down.
Nonlethal Damage with a Weapon that Deals Lethal Damage: You can use a melee weapon that deals lethal damage to deal nonlethal damage instead, but you take a -4 penalty on yout attack roll because you have to use the flat of the blade, strike at nonvital areas or check your swing.
Lethal Damage with a Weapon that Deals Nonlethal Damage: You can use a weapon that deals nonlethal damage, including an unarmed strike, to deal lethal damage instead, but you take a -4 penalty on your attack roll because you have to strike only in the most vulnerable areas to inflict lethal damage.
Staggered and Unconscious: When your nonlethal damage equals your current hit points, you're staggered. You're so roughed up that you can only take a standard action or a move action in each round. You cease being staggered when your current hit points once again exceed your nonlethal damage.
When your nonlethal damage exceeds your current hit points you fall unconscious. While unconscious, you are helpless (see Helpless Defenders).
Spellcasters who fall unconscious retain any spellcasting abilities they had before going unconscious.
Healing Nonlethal Damage: You heal nonlethal damage at the rate of 1 hit point per hour per character level. For example, a 7th-level wizard heals 7 points of nonlethal damage each hour until all the nonlethal damage is gone.
When a spell or a magical power cures hit point damage, it also removes an equal amount of nonlethal damage.