So, I'm going to take a little different stab at Vitality/Wounds than j0lt did. I love the idea of V/W, but there are a few items I dislike. I'll admit, however, that I like some of the changes j0lt did make (the natural healing rate, for example).
Vitality/Wounds
[spoiler]
Vitality PointsWound Points
Wound points measure how much true physical damage a character can withstand. Damage reduces wound points only after all vitality points are gone, or when a character is struck by a critical hit or special attack. A character has a number of wound points equal to her current Constitution score.
Critical HitsInjury and DeathNonlethal Damage
I'm tempted to have some added effect, such as being sickened [maybe cutting it to a -1 penalty] if the nonlethal damage exceeds your vitality points, but not the sum of your vitality and wounds points. I haven't worked it out yet.
0 Vitality Points
At 0 vitality points, a character can no longer avoid taking real physical damage. Any additional damage he receives reduces his wound points.
Taking Wound Damage0 Wound PointsBleeding OutIf it becomes too difficult to remember the varying Bleeding Out threshold for each character, I may just switch it to -1 to -9 is Bleeding Out, and -10 to -19 is Dying, and -20 is Dead. That's how I had originally written these V/W rules for a Wheel of Time game.
DisabledDying
Once a character's negative wound points exceeds his Constitution modifier, but not his Constitution score, he is dying. A dying character is unconscious and near death. Each round on his turn, a dying character must make a DC 20 Fortitude saving throw to become stable, otherwise he loses one wound point, regardless of any remaining vitality points.
Another character can make a dying character stable by succeeding on a DC 15 Treat Injury check as a standard action (which provokes attacks of opportunity).
Dead
When your character's current wound points drop below a negative number equal to his Constitution Modifier (or when they reach -10, whichever is most beneficial to the character), he is dead. A character can also die from taking ability damage or suffering ability drain that reduces his Constitution score to 0.
Stable Characters and RecoveryRecovering without Help
A severely wounded character left alone usually dies. He has a small chance, however, of recovering on his own.
Each round, a dying character makes a Fortitude saving throw (DC 20). If the save fails, the character loses 1 wound point and must make another save on his or her turn the next round.
If the save succeeds, the character becomes stable. A stable character stops losing hit points every round, but remains unconscious.
If no one tends to the stable character (see below), he or she remains unconscious for 1 hour, at which point he or she makes a Fortitude save (DC 20). If the save succeeds, the stable character regains consciousness, becoming disabled (see above). The character's current hit point total remains where it is, however, even though it's negative. If the save fails, the character remains unconscious and loses one wound point.
An unaided stable, conscious character who has negative wound points (and is disabled) doesn't heal naturally (this includes characters who stabilized while bleeding out). Instead, each day the character makes a Fortitude save (DC 20) to start recovering hit points naturally that day; if the save fails, he or she loses 1 hit point.
Once an unaided character starts recovering hit points naturally, the character is no longer in danger of losing additional hit points (even if his or her current hit point total is still negative).
Recovering with Help
A dying character can be made stable with a DC 15 Treat Injury check (a standard action that provokes attacks of opportunity). One hour after a tended, dying character becomes stable, he or she makes a Fortitude save (DC 20) to regain consciousness, at which point he becomes disabled. If he remains unconscious, he makes the same Fortitude save every hour until he becomes conscious. Even while unconscious, he recoveres wound points naturally, becoming conscious and able to resume normal activity when his wound points rise to 1 or higher.
Special Damage Situations
The vitality point system changes the way some special damage effects work.
Coup de GraceMassive DamageHealingNatural HealingAssisted Healing
A character that provides long-term care doubles the rate at which a wounded character recovers lost vitality and wound points.
Creatures without Constitution Scores
Some creatures, such as constructs, do not have Constitution scores. If a creature has no Constitution score, it has no vitality points. Instead, it has wound points equal to the number of vitality points it would have based on its HD and type. Such creatures are never fatigued or stunned by wound damage.
Bonus Hit PointsDamage ReductionFast HealingRegeneration
Regeneration works normally. Damage dealt to the creature is treated as nonlethal damage. The creature automatically heals nonlethal damage at a fixed rate per round, as given in the entry. Certain attack forms, typically fire and acid, deal lethal damage to the creature's vitality and wound points, just as it would to any other creature, which must be healed naturally at a much slower rate. Critical hits do not deal damage to a regenerating creature's wound points unless the attack form deals a damage type that overcomes the regeneration ability.[/spoiler]