If a surgical operation is botched does the patient take Con damage or hit points damage?


Rules Questions


A Xill has laid eggs inside an adventurer and an NPC tries to cut them out using heal skill. It says each surgical attempt, successful or not, causes 1d4 damage. It seems fair to assume that the 1d4 damage here is damage to Con and not to hit points, because it says if the Xilldren eat their way out then the damage is 1 Con each hour. Surely it is the same kind of damage, to internal organs. Thus Con damage rather than simple hit points.
This leads on to ... from such internal Con damage how would you recover the the Con, both naturally and magically?
I assume Cure Wound spells just affect hit points, which are mainly in reality kind of fatigue points. Also a restoration spell, for example, dispels magical effects from monsters that drain ability scores. So I assume that would not heal the internal Con damage.
I would think that only a powerful spell like Heal would work to restore damage to Con done by botched operations, or broken limbs, or fractured skulls. Am I correct? Where are the rules?


I read the 1d4 as HP damage not Con damage. The Con damage can be healed with restoration like any other ability damage.


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If it doesn't say Con damage, it's hp. And Con damage heals at a rate of 1/day as natural healing.

Shadow Lodge

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If the rules just say "damage," they mean HP damage. The entry could have specified that surgery did Con damage, but it doesn't - presumably because the surgeon is being careful not to hurt internal organs.

And there's no difference between healing damage from magical or mundane sources, whether it's HP or ability damage. Lesser Restoration cures d4 points of ability damage, and Restoration cures all ability damage.


Gallant Armor wrote:
I read the 1d4 as HP damage not Con damage. The Con damage can be healed with restoration like any other ability damage.

A few more points ...

Thanks Gallant Armor, I see about the restoration spell. I misread it. It can heal 1d4 of any kind of Con damage.

Still not sure where or why internal damage switches from hit points damage to Con damage? i.e. Xilldren do 1 Con damage per hour eating their way out of the gut, but the surgical operation does hit points damage. (I assume it's because Xilldren are doing a more severe type of damage as they are ravenously going about their business; but why wouldn't this simply translate as 1d10 or 2d6 damage to hit points or something)

Also, previously one of the adventurers had one of their kidneys cut out during torture and I ruled they lost 1 Con until they got it regenerated. So would people here say that a simple restoration spell should have fixed the missing kidney problem or was I fair in saying -1 Con until regeneration?


Erkenbard the Eyeful wrote:
Gallant Armor wrote:
I read the 1d4 as HP damage not Con damage. The Con damage can be healed with restoration like any other ability damage.

Still not sure where or why internal damage switches from hit points damage to Con damage? i.e. Xilldren do 1 Con damage per hour eating their way out of the gut, but the surgical operation does hit points damage. (I assume it's because Xilldren are doing a more severe type of damage as they are ravenously going about their business; but why wouldn't this simply translate as 1d10 or 2d6 damage to hit points or something)

Given that the entry mentions remove disease, they could exude some infectious substance as long as they are implanted.


I guess I am clutching at straws. So the xill's brilliantly terrifying impregnation attack is basically useless against anything but very low-level characters, which it wouldn't be fighting in the first place. Just about anyone can eventually cut out those eggs given a bit of time and the chance of the incubating adventurer dying is virtually zero.
By the way my group is around 4th level. The dwarf fighter level 5 and elf rogue 2/wizard 1 in the party were impregnated before the Xill was killed. They are really worried approaching the next session, which is fun. I was hoping for them to just about avoid death, or at least be in some degree of danger, as is what the game is all about. But if it's hit points of damage rather than Con then they obviously have nothing to fear. About 15-20 heal skill checks would have to fail for one of them to die (and that's without them any cure light wounds when they need it).
* NOTE: There is a chance Remove Dsease will not be available, so they might need the surgery, so I was hoping there would be some degree of danger in that


Each attempt takes 10 minutes. Assuming they each have around the average of 7 eggs implanted in could take hours to remove all of the eggs depending on how many are performing surgery. A lot could happen in 2 hours.


Gallant Armor wrote:
Each attempt takes 10 minutes. Assuming they each have around the average of 7 eggs implanted in could take hours to remove all of the eggs depending on how many are performing surgery. A lot could happen in 2 hours.

But basically it would require a random encounter tossed in for no other reason than to mess up their healing, which is a bit on the cruel side.

Shadow Lodge

Keep in mind that they need to cut out the eggs one at a time - with 2d6 eggs implanted that's an average of 7 separate Heal checks, and as many as 12. The patient takes damage even if the Heal check is successful, so even if every check succeeds it's still a significant amount of damage, particularly for the rouge 2 / wizard 1. If the party can't make a DC 20 heal check while taking 10 - or if they are prevented from taking 10 - the patient could easily take 20d4 points of damage.

And as Gallant Armor suggests, you can use other threats to up the danger. Interrupt the surgeries, introduce delays so they might not have time to get all the eggs out, or attack while they are still recovering and have expended their healing. Just don't push it too hard - keep in mind the total damage they surgeries will deal as described above.

EDIT: Cruel - maybe? I think it depends on a few things. How plausible is the new threat - are they in an area that should be safe or one that is known to be dangerous? How high is the risk of death from the eggs alone, keeping in mind the number of eggs implanted and the party's Heal check? And do you think the game would be more enjoyable because of the increased tension from the increased danger, or will describing the grueling nature of the surgery (and perhaps not letting the party know at first exactly how many eggs they have to remove - thus increasing uncertainty about the risk) be sufficient even if there is no risk the PCs will actually die?

Erkenbard the Eyeful wrote:
Also, previously one of the adventurers had one of their kidneys cut out during torture and I ruled they lost 1 Con until they got it regenerated. So would people here say that a simple restoration spell should have fixed the missing kidney problem or was I fair in saying -1 Con until regeneration?

Specific effects can always be harder to heal than usual.

However I would be cautious about inflicting conditions on PCs that they are unable to fix for long periods of time.


Erkenbard the Eyeful wrote:
Gallant Armor wrote:
Each attempt takes 10 minutes. Assuming they each have around the average of 7 eggs implanted in could take hours to remove all of the eggs depending on how many are performing surgery. A lot could happen in 2 hours.
But basically it would require a random encounter tossed in for no other reason than to mess up their healing, which is a bit on the cruel side.

If each attempt takes 10 minutes, and they burrow out causing Con damage in 1 hour... then anything over 6 eggs will automatically result in SOMETHING hatching won't it? Any failed checks would only increase that... Which also ends up causing loss of HP from a dropping Con...

So it sounds to me like burning the candle at both ends...

Granted I've never fought a Xill's but I did have a character die in 2E from Phaerrum eggs.. It was both not fun... and extremely funny at the same time.. yay memories!!


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Personally, I love the rush of barely scraping through an encounter. If a character dies, that's a bummer. If a character almost dies that can get everyone on edge now that there are stakes.

It depends on the group and your style how you want to run it.

Shadow Lodge

phantom1592 wrote:
If each attempt takes 10 minutes, and they burrow out causing Con damage in 1 hour... then anything over 6 eggs will automatically result in SOMETHING hatching won't it?

The eggs take 24 hours to hatch.


Erkenbard the Eyeful wrote:

Still not sure where or why internal damage switches from hit points damage to Con damage? i.e. Xilldren do 1 Con damage per hour eating their way out of the gut, but the surgical operation does hit points damage. (I assume it's because Xilldren are doing a more severe type of damage as they are ravenously going about their business; but why wouldn't this simply translate as 1d10 or 2d6 damage to hit points or something)

Why would using a scalpel deal con damage while shoving 3 feet of steel in someone's gut cause HP damage? it's not something that we should try to make TOO much sense about ;)

Personally I prefer the stat damage to be really rare and not used for things like heal checks and such... undead attacks and stuff like that are my preferences..

But yeah, in this case anything rooting around trying to eat its way out... I could see that as being especially tough to heal.


Weirdo wrote:

Keep in mind that they need to cut out the eggs one at a time - with 2d6 eggs implanted that's an average of 7 separate Heal checks, and as many as 12. The patient takes damage even if the Heal check is successful, so even if every check succeeds it's still a significant amount of damage, particularly for the rouge 2 / wizard 1. If the party can't make a DC 20 heal check while taking 10 - or if they are prevented from taking 10 - the patient could easily take 20d4 points of damage.

And as Gallant Armor suggests, you can use other threats to up the danger. Interrupt the surgeries, introduce delays so they might not have time to get all the eggs out, or attack while they are still recovering and have expended their healing. Just don't push it too hard - keep in mind the total damage they surgeries will deal as described above.

EDIT: Cruel - maybe? I think it depends on a few things. How plausible is the new threat - are they in an area that should be safe or one that is known to be dangerous? How high is the risk of death from the eggs alone, keeping in mind the number of eggs implanted and the party's Heal check? And do you think the game would be more enjoyable because of the increased tension from the increased danger, or will describing the grueling nature of the surgery (and perhaps not letting the party know at first exactly how many eggs they have to remove - thus increasing uncertainty about the risk) be sufficient even if there is no risk the PCs will actually die?

Erkenbard the Eyeful wrote:
Also, previously one of the adventurers had one of their kidneys cut out during torture and I ruled they lost 1 Con until they got it regenerated. So would people here say that a simple restoration spell should have fixed the missing kidney problem or was I fair in saying -1 Con until regeneration?

Specific effects can always be harder to heal than usual.

However I would be cautious about inflicting conditions on PCs that they are unable to fix for long periods of time.

They are near a tiny druidic settlement but it will be in the middle of the night when they get there and the druids don't like strangers much, are not much interested in gold, and the party have been bothering them for small things twice in the near past already. Arriving in the middle of the night claiming to have eggs in their stomachs won't go down too well and they will need a luck check to see if there is a druid available with a remove disease spell immediately available and if not then a Diplomacy check to try and convince a druid to get up in the night and perform what could be 2-hour surgery. So I think the risk is in not having any druids to help. Then, with only two of them there, would have to operate on one another and then

it gets tricky!


Make sure the players can't be certain of how many eggs there are. After removing 8 do they keep searching? Give a character a nightmare that one was missed. They don't have to be in real danger to be disturbed.

Shadow Lodge

It sounds like there are enough complications and thus tension already involved, then. Not having another party member with a +10 or higher Heal modifier makes it significantly more difficult to remove the eggs.


Erkenbard the Eyeful wrote:

I guess I am clutching at straws. So the xill's brilliantly terrifying impregnation attack is basically useless against anything but very low-level characters, which it wouldn't be fighting in the first place. Just about anyone can eventually cut out those eggs given a bit of time and the chance of the incubating adventurer dying is virtually zero.

By the way my group is around 4th level. The dwarf fighter level 5 and elf rogue 2/wizard 1 in the party were impregnated before the Xill was killed. They are really worried approaching the next session, which is fun. I was hoping for them to just about avoid death, or at least be in some degree of danger, as is what the game is all about. But if it's hit points of damage rather than Con then they obviously have nothing to fear. About 15-20 heal skill checks would have to fail for one of them to die (and that's without them any cure light wounds when they need it).
* NOTE: There is a chance Remove Dsease will not be available, so they might need the surgery, so I was hoping there would be some degree of danger in that

The rules for Pathfinder don't really set the game up to be a "surprise you're dead" type game. It's not Call of Cthulhu.


You can always introduce a save vs a disease if needed if the operating theater is particular bad such as operating in the woods.


There's also nothing stopping a Xill from laying more that one coutch of eggs in a host. Since it's a standard action to lay 2d6 eggs, and the paralysis lasts a minimum of 1hr, that's 600 rounds, or 1200d6 eggs..right?

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