Curses, Diseases, and Madness

Curses

Minor Detrimental Properties

• 01-05. While attuned to the artifact, you have disadvantage on saving throws against spells.
• 06-10. The first time you touch a gem or piece of jewelry while attuned to this artifact, the value of the gem or jewelry is reduced by half.
• 11-15. While attuned to the artifact, you are blinded when you are more than 10 feet away from it.
• 16-20. While attuned to the artifact, you have disadvantage on saving throws against poison.
• 21-30. While attuned to the artifact, you emit a sour stench noticeable from up to 10 feet away.
• 31-35. While attuned to the artifact, all holy water within 10 feet of you is destroyed.
• 36-40. While attuned to the artifact, you are physically ill and have disadvantage on any ability check or saving throw that uses Strength or Constitution.
• 41-45. While attuned to the artifact, your weight increases by 1d4 × 10 pounds.
• 46-50. While attuned to the artifact, your appearance changes as the DM decides.
• 51-55. While attuned to the artifact, you are deafened when you are more than 10 feet away from it.
• 56-60. While attuned to the artifact, your weight drops by 1d4 × 5 pounds.
• 61-65. While attuned to the artifact, you can't smell.
• 66-70. While attuned to the artifact, nonmagical flames are extinguished within 30 feet of you.
• 71-80. While you are attuned to the artifact, other creatures can't take short or long rests while within 300 feet of you.
• 81-85. While attuned to the artifact, you deal 1d6 necrotic damage to any plant you touch that isn't a creature.
• 86-90. While you are attuned to the artifact, animals within 30 feet of you are hostile toward you.
• 91-95. While attuned to the artifact, you must eat and drink six times the normal amount each day.
• 96-00. While you are attuned to the artifact, your flaw is amplified in a way determined by the DM.

Major Detrimental Properties

• 01-05. While you are attuned to the artifact, your body rots over the course of four days, after which the rotting stops. You lose your hair by the end of day 1, finger tips and toe tips by the end of day 2, lips and nose by the end of day 3, and ears by the end of day 4. A regenerate spell restores lost body parts
  
• 06-10. While you are attuned to the artifact, you determine your alignment daily at dawn by rolling a d6 twice. On the first roll, a 1-2 indicates lawful, 3-4 neutral, and 5-6 chaotic. On the second roll, a 1-2 indicates good, 3-4 neutral, and 5-6 evil.
  
• 11-15. When you first attune to the artifact, it gives you a quest determined by the DM. You must complete this quest as if affected by the geas spell. Once you complete the quest, you are no longer affected by this property.
  
• 16-20. The artifact houses a bodiless life force that is hostile toward you. Each time you use an action to use one of the artifact's properties, there is a 50 percent chance that the life force tries to leave the artifact and enter your body. If you fail a DC 20 Charisma saving throw, it succeeds, and you become an NPC under the DM's control until the intruding life force is banished using magic such as the dispel evil and good spell.
  
• 21-25. Creatures with a challenge rating of 0, as well as plants that aren't creatures, drop to 0 hit points when within 10 feet of the artifact.
  
• 26-30. The artifact imprisons a death slaad (see the Monster Manual). Each time you use one of the artifact's properties as an action, the slaad has a 10 percent chance of escaping, whereupon it appears within 15 feet of you and attacks you.
  
• 31-35. While you are attuned to the artifact, creatures of a particular type other than humanoid (as chosen by the DM) are always hostile toward you.
  
• 36-40. The artifact dilutes magic potions within 10 feet of it, rendering them nonmagical.
  
• 41-45. The artifact erases magic scrolls within 10 feet of it, rendering them nonmagical.
  
• 46-50. Before using one of the artifact's properties as an action, you must use a bonus action to draw blood, either from yourself or from a willing or incapacitated creature within your reach, using a piercing or slashing melee weapon. The subject takes 1d4 damage of the appropriate type.
  
• 51-60. When you become attuned to the artifact, you gain a form of long-term madness (see chapter 8, "Running the Game").
  
• 61-65. You take 4d10 psychic damage when you become attuned to the artifact.
  
• 66-70. You take 8d10 psychic damage when you become attuned to the artifact.
  
• 71-75. Before you can become attuned to the artifact, you must kill a creature of your alignment.
  
• 76-80. When you become attuned to the artifact, one of your ability scores is reduced by 2 at random. A greater restoration spell restores the ability to normal.
  
• 81-85. Each time you become attuned to the artifact, you age 3d10 years. You must succeed on a DC 10 Constitution saving throw or die from the shock. If you die, you are instantly transformed into a wight (see the Monster Manual) under the DM's control that is sworn to protect the artifact.
  
• 86-90. While attuned to the artifact, you lose the ability to speak.
  
• 91-95. While attuned to the artifact, you have vulnerability to all damage.
  
• 96-00. When you become attuned to the artifact, there is a 10 percent chance that you attract the attention of a god that sends an avatar to wrest the artifact from you. The avatar has the same alignment as its creator and the statistics of an empyrean (see the Monster Manual). Once it obtains the artifact, the avatar vanishes.

Diseases

The following diseases can affect giants and humanoids. Remember that lesser restoration and similar magic can cure a disease.

Dungeon Master's Guide

Cackling Fever

This disease targets humanoids, although gnomes are strangely immune. While in the grips of this disease, victims frequently succumb to fits of mad laughter, giving the disease its common name and its morbid nickname: "the shrieks." Symptoms manifest 1d4 hours after infection and include fever and disorientation. The infected creature gains one level of exhaustion that can't be removed until the disease is cured.
Any event that causes the infected creature great stress-including entering combat, taking damage, experiencing fear, or having a nightmare-forces the creature to make a DC 13 Constitution saving throw.
On a failed save, the creature takes 5 (1d10) psychic damage and becomes incapacitated with mad laughter for 1 minute. The creature can repeat the saving throw at the end of each of its turns, ending the mad laughter and the incapacitated condition on a success. Any humanoid creature that starts its turn within 10 feet of an infected creature in the throes of mad laughter must succeed on a DC 10 Constitution saving throw or also become infected with the disease. Once a creature succeeds on this save, it is immune to the mad laughter of that particular infected creature for 24 hours.
At the end of each long rest, an infected creature can make a DC 13 Constitution saving throw. On a successful save, the DC for this save and for the save to avoid an attack of mad laughter drops by 1d6. When the saving throw DC drops to 0, the creature recovers from the disease. A creature that fails three of these saving throws gains a randomly determined form of indefinite madness.

Sewer Plague

Sewer plague is a generic term for a broad category of illnesses that incubate in sewers, refuse heaps, and stagnant swamps, and which are sometimes transmitted by creatures that dwell in those areas, such as rats and otyughs. When a humanoid creature is bitten by a creature that carries the disease, or when it comes into contact with filth or offal contaminated by the disease, the creature must succeed on a DC 11 Constitution saving throw or become infected.
It takes 1d4 days for sewer plague's symptoms to manifest in an infected creature. Symptoms include fatigue and cramps. The infected creature suffers one level of exhaustion, and it regains only half the normal number of hit points from spending Hit Dice and no hit points from finishing a long rest.
At the end of each long rest, an infected creature must make a DC 11 Constitution saving throw. On a failed save, the character gains one level of exhaustion.
On a successful save, the character's exhaustion level decreases by one level. If a successful saving throw reduces the infected creature's level of exhaustion below 1, the creature recovers from the disease.

Sight Rot

This painful infection causes bleeding from the eyes and eventually blinds the victim. A beast or humanoid that drinks water tainted by sight rot must succeed on a DC 15 Constitution saving throw or become infected. One day after infection, the creature's vision starts to become blurry. The creature takes a -1 penalty to attack rolls and ability checks that rely on sight. At the end of each long rest after the symptoms appear, the penalty worsens by 1. When it reaches -5, the victim is blinded until its sight is restored by magic such as lesser restoration or heal.
Sight rot can be cured using a rare flower called Eyebright, which grows in some swamps. Given an hour, a character who has proficiency with an herbalism kit can turn the flower into one dose of ointment. Applied to the eyes before a long rest, one dose of it prevents the disease from worsening after that rest. After three doses, the ointment cures the disease entirely.

Tomb of Annihilation

Mad Monkey Fever

A magical mist creeps through the jungles of Chult. Contact with this thin, blue, odorless mist can infect giants and humanoids with mad monkey fever. A dispel magic spell destroys the mist in a 20-foot square starting at a point chosen by the caster within the spell's range. An encounter with this mist typically covers 1d6 such areas (400-2,400 square feet).
A giant or humanoid that comes into contact with the mist must succeed on a DC 13 Constitution saving throw or become infected with mad monkey fever. The infected creature gains a random form of long-term madness (roll on the Long-Term Madness table in chapter 8 of the Dungeon Master's Guide) that manifests 1d6 hours after infection and lasts for the duration (1d10 × 10 hours). If the madness is allowed to run its full course, the creature must repeat the saving throw at the end of the madness. If the second saving throw fails, the creature suffers another bout of long-term madness (roll again on the table) that lasts for the normal duration. The madness symptoms continue until the disease ends.

Shivering Sickness

Insects native to the jungles and marshes of Chult carry this disease, shivering sickness. The easiest protection against it is a coating of insect-repelling salve on all exposed skin (for the cost of insect repellent, see "Buying a Special Item".
A giant or humanoid that takes damage from insect swarms or from giant centipedes, giant scorpions, or giant wasps is exposed to the disease at the end of the encounter. Those who haven't applied insect repellent since their previous long rest are exposed to the disease when they finish a long rest.
A giant or humanoid exposed to the disease must succeed on a DC 11 Constitution saving throw or become infected. A creature with natural armor has advantage on the saving throw. It takes 2d6 hours for symptoms to manifest in an infected creature. Symptoms include blurred vision, disorientation, and a sudden drop in body temperature that causes uncontrollable shivering and chattering of the teeth.
Once symptoms begin, the infected creature regains only half the normal number of hit points from spending Hit Dice and no hit points from a long rest. The infected creature also has disadvantage on ability checks and attack rolls. At the end of a long rest, an infected creature repeats the saving throw, shaking off the disease on a successful save.

Throat Leeches

Minuscule parasites known as throat leeches infect the water in Chult's forests, swamps, and rivers. Any giant or humanoid that swallows tainted water must succeed on a DC 12 Constitution saving throw or be infested with throat leeches. Immediate symptoms include throat inflammation and shortness of breath. After 1d6 hours, the infected character gains 1 level of exhaustion that can't be removed (except as described below) until the disease is cured. At the end of each long rest, the infected creature must repeat the saving throw. On a failed save, the creature's exhaustion increases by 1 level; on a successful save, the creature's exhaustion decreases by 1 level. If a successful saving throw reduces the infected creature's level of exhaustion below 1, the creature recovers from the disease.
Explorers can avoid contracting throat leeches by drinking only rainwater or water that's been boiled or magically purified.

Madness

Short-Term Madness

(lasts 1d10 minutes)

• 01-20. The character retreats into his or her mind and becomes paralyzed. The effect ends if the character takes any damage.
  
• 21-30. The character becomes incapacitated and spends the duration screaming, laughing, or weeping.
  
• 31-40. The character becomes frightened and must use his or her action and movement each round to flee from the source of the fear.
  
• 41-50. The character begins babbling and is incapable of normal speech or spellcasting.
  
• 51-60. The character must use his or her action each round to attack the nearest creature.
  
• 61-70. The character experiences vivid hallucinations and has disadvantage on ability checks.
  
• 71-75. The character does whatever anyone tells him or her to do that isn't obviously self-destructive.
  
• 76-80. The character experiences an overpowering urge to eat something strange such as dirt, slime, or offal.
  
• 81-90. The character is stunned.
  
• 91-100. The character falls unconscious.
  

Long-Term Madness

(lasts 1d10 × 10 hours)

• 01-10. The character feels compelled to repeat a specific activity over and over, such as washing hands, touching things, praying, or counting coins.
  
• 11-20. The character experiences vivid hallucinations and has disadvantage on ability checks.
  
• 21-30. The character suffers extreme paranoia. The character has disadvantage on Wisdom and Charisma checks
  
• 31-40. The character regards something (usually the source of madness) with intense revulsion, as if affected by the antipathy effect of the antipathy/sympathy spell.
  
• 41-45. The character experiences a powerful delusion. Choose a potion. The character imagines that he or she is under its effects.
  
• 46-55. The character becomes attached to a "lucky charm," such as a person or an object, and has disadvantage on attack rolls, ability checks, and saving throws while more than 30 feet from it.
  
• 56-65. The character is blinded (25%) or deafened (75%).
  
• 66-75. The character experiences uncontrollable tremors or tics, which impose disadvantage on attack rolls, ability checks, and saving throws that involve Strength or Dexterity.
  
• 76-85. The character suffers from partial amnesia. The character knows who he or she is and retains racial traits and class features, but doesn't recognize other people or remember anything that happened before the madness took effect.
  
• 86-90. Whenever the character takes damage, he or she must succeed on a DC 15 Wisdom saving throw or be affected as though he or she failed a saving throw against the confusion spell. The confusion effect lasts for 1 minute.
  
• 91-95. The character loses the ability to speak.
  
• 96-100. The character falls unconscious. No amount of jostling or damage can wake the character.
  

Indefinite Madness

Flaw (lasts until cured)

• 01-15. "Being drunk keeps me sane."
  
• 16-25. "I keep whatever I find."
  
• 26-30. "I try to become more like someone else I know—adopting his or her style of dress, mannerisms, and name."
  
• 31-35. "I must bend the truth, exaggerate, or outright lie to be interesting to other people."
  
• 36-45. "Achieving my goal is the only thing of interest to me, and I'll ignore everything else to pursue it."
  
• 46-50. "I find it hard to care about anything that goes on around me."
  
• 51-55. "I don't like the way people judge me all the time."
  
• 56-70. "I am the smartest, wisest, strongest, fastest, and most beautiful person I know."
  
• 71-80. "I am convinced that powerful enemies are hunting me, and their agents are everywhere I go. I am sure they're watching me all the time."
  
• 81-85. "There's only one person I can trust. And only I can see this special friend."
  
• 86-95. "I can't take anything seriously. The more serious the situation, the funnier I find it."
  
• 96-100. "I've discovered that I really like killing people."

Curing Madness

A calm emotions spell can suppress the effects of madness, while a lesser restoration spell can rid a character of a short-term or long-term madness. Depending on the source of the madness, remove curse or dispel evil might also prove effective. A greater restoration spell or more powerful magic is required to rid a character of indefinite madness.