Secrets of the Plague Doctors - The Pharmacopeia.

A medicinal miscellany suggested by the Plague Doctor class, or that turned up in the research.

Gary Chalk/ Flight from the Dark/ 1984

No price tags attached, because the Plague Doctors will charge as much as they think you can afford - though not as much as for clerical healing (until they've safely toppled the temples).

Usual * for extra-optional.

Anaesthesia and Pain Relief.

These certainly put you in an Altered State.

Ether/Chloroform: roll 3d6 each round to beat unwilling patient's Constitution (or save vs. poison) to KO them for 1 hour; grapple/Strength to administer via rag or mask.

Patient cannot normally be woken by damage/pain while in effect.

Paralytic: equal to Ghoul's touch. Save vs. coma if two doses overlap.

It's optimistically described as an anaesthetic. At least the surgery can be performed undisturbed. 

*If actually derived from Ghouls, recipients risk exposure to the corpse-eating sickness and/or rising as Ghouls if they die while under the effect.

Sleeping Draught: patient sleeps for 2d4 hours in 3d4 rounds; they are allowed a save each turn if resisting the effect (*slowed and immune to fear during this time).

Double dosing puts the save at disadvantage/penalty and a crit fail leaves the patient in a coma. 

A triple dose is proof against nightmares, dream intrusion and spirit possession. While awake you are temporarily immune to non-lethal damage and are subject to post-hypnotic suggestion.

If you take 3 or more doses in a week, save vs. addiction. If you take 6 or more doses in a week, save vs. addiction at disadvantage/penalty.

If you take triple doses 3 or more times in a week, save vs. coma for each triple dose thereafter.

Double and triple doses are considered effective anaesthesia; a single dose is aftercare. 

Soma: Commandeered from the Druids in the name of science. Makes you feel immortal.

A full dose has the following effects: halves non-lethal/subdual damage taken; -1 hp lethal damage per damage die; +4 save vs. stun, and fight on at 0 hp (to whatever is the negative hp limit used at your table), but make all Dexterity-based rolls at -4.

They will attempt to strip off their armour/clothes and drop their carried equipment if not restrained. 

Lasts d3+1 hours.

If you take it 3 or more times in a week, save vs. each dose or lose 1 Constitution permanently. 

You can take it twice in a day, but must save vs. hallucinations (or second sight). If you take it thrice, save vs. overdose at disadvantage/penalty (effects as for cough medicine, immoderately used, or purgative, plus Constitution loss).

A normal dose (barely a pinprick in a sugar pill) is enough to ease general aches, pains and fevers for d3+1 hours with no other mechanical effect. You couldn't fit enough pills in you to get anything resembling a full dose.

*Possibly derived from a dangerous and/or intelligent mushroom monster (e.g. Violet Fungi, Myconids).

Healing Herbs.

Whatever occurs naturally, that would be processed and prescribed by your setting's herbalists, folk healers and apothecaries, is potentially available to the Plague Doctors.

Some iterations of the Plague Doctor organisation will condemn folk remedies etc. as being superstitious nonsense, and/or perceive them and the practitioners to be a threat.

Healing Salve.

I generally think of healing salve as giving +1 to natural healing, even when active/adventuring (or doubling the effect). Even in a high(er) magic setting, it's a non-magical medical treatment.

You decide whether this stacks with or is already abstracted into the Plague Doctor's Treatment ability.

Or, if you prefer, the more potent version from 2e Sages & Specialists: 1 hp per day active/adventuring, d4 hp per day resting, d4+2 hp per day complete bed rest (*or these could be increments of efficacy, black mummia to alicorn to golden mummia).

Alicorn (Unicorn Horn): whether this actually contains any Unicorn will depend on your setting, but that's what it's branded as.

One dose is equal to a half-strength purify water spell (a 6-inch cube) and, applied to an infected wound, gives a new save vs. infection.

It's also an active ingredient of healing salve (see black mummia), though not necessarily in purity/concentration enough to purify water and fight infection in addition.

Black Mummia: extract of mummy (post-mortem process).

Touted as a general cure-all, but principally an active ingredient in healing salve.

If it has been harvested from an undead Mummy, after 1 week of use you must save vs. addiction. 

Once addicted, you must save after each week of continued use or contract Mummy/Tomb Rot. 

Once this kills you, you rise as one of the undead (d8; 1-5 Zombie, 6-7 Ghoul, 8 Mummy).

Golden Mummia: extract of mellified mummy (pre-, para- and post-mortem process). 

Touted as a sovereign cure-all, but principally an active ingredient in healing salve.

It is no more effective than black mummia, but significantly more expensive and renowned.

If it has been harvested from an undead Mellified Mummy (approximately, Mummy + Adherer), after 3 consecutive uses you must save vs. addiction. 

Once addicted, you must save every 3 uses or contract Honey Rot (as Mummy Rot, but also produce 2 pints of Killer Bee honey per day - anyone consuming this must save vs. disease).

Once this kills you, you rise as one of the undead (d8; 1-5 Ghost, 6-7 Mellified Mummy, 8 Vampire with bee affinity/abilities).

Prophylactics.

An ounce of prevention and all that.

Graverobber's Balm: goes by a number of other names, such as Four Thieves Vinegar.

Gives advantage/bonus to saves vs. disease for d6+6 turns. Additional doses extend duration, but are not cumulative.

It gives an additional small bonus (c. 5% or +1 or equivalent) to saves vs. diseases and parasites carried/spread by the undead. 

*Depending on your setting assumptions, this could be applied to Ghoul paralysis, too.

Mithridate: advantage/bonus on saves vs. disease/poison for 3+d3 hours.

If doses are overlapped, you are nauseated for that time.

If you take theriac while taking mithridate, they neutralise each other.

Remedies.

Tried and tested. No snake oil here. Some of them might put you in an Altered State.

Cordial: new save vs. non-magical conditions (excluding disease and poison); +1 save vs. non-magical cold for d4+4 turns.

Once per night, a dose of cordial allows you to ignore the effects of fatigue for d4 turns. It will also delay the effect of sleeping draught for the same amount of time. Further doses feel restorative but have no mechanical effect. 

More than 3 consecutive doses in 1 hour is emetic. Pace yourself.

Cough Medicine: gratifyingly effective.

Used immoderately, for d8 hours the patient suffers weakness, has second sight and must roll for astral/ethereal/psionic random encounters. Save vs. poison or lose 1 Constitution permanently.

Probably an opiate of some kind.

Elixir: restores patient to 1 hit point if at 0 hp/Casualty State, and/or down to -10 hp if administered within 6 rounds (use your judgment).

Gives advantage/bonus vs. aging damage and on non-magical death saves for 6+d6 turns.

Emboldening Vapours (Smelling Salts): immediate recovery from unconsciousness (including sleep) and nausea, and you get a new save vs. non-magical shock, stun, fear (including any secondary effects such as paralysis or weakness), and confusion.

It will restore 1 hp to someone currently reduced to 0 hp by non-lethal and/or subdual damage.

Patient is staggered (later-edition condition if no rules) for the round in which vapours are administered. 

They may also ignore any effects of fatigue for the next d3 rounds, and each dose delays sleeping draught for 1 turn.

Emetic: if taken within half the onset time of ingested poison (or within 6 rounds if not using onset time), patient gets an extra/new save (or save at advantage/bonus).

You are nauseated for 2d6 rounds (as the later-edition Poisoned condition, if you don't have rules already).

Also works on some internal parasites, and could be ruled helpful vs. certain magical potions (and other consumables).

Nepenthe: medicine for sorrow and post-surgery trauma; patient must fail their save in order to forget (the last 24 hours, or 3d8 hours if you prefer dice rolling).

Combine with hypnotic suggestion to suppress specific memories

After the 3rd effective dose, patient must save vs. addiction (or use some rules for opiates).

Panacea: effective against any non-magical negative condition.

New save if administered while suffering (oral or injection). 

Save at advantage/bonus if administered in the same round as the condition is bestowed/takes effect (injection only - Plague Doctors can do this automatically as long as they are not incapacitated/restrained and are within range; other characters must roll Dexterity or Initiative to do so).

Purgative: save vs. poison; success=weakness d6 hours, failure=sickness (as Centipede, Giant).

Even if you make the save, you're narratively shitting and puking for the duration.

Works on some poisons (see emetic) and some internal parasites, but it's mainly used as part of a general treatment programme (regardless of whether it's useful).

Allows a new save vs. addiction when you first become addicted.

Theriac: gives a new poison /venom save if administered within one-third of onset time (or within 6 rounds if not using onset times).

Multiple consecutive doses can be administered.

Supplements.

Not every discovery has a clear medical use.

Ambrosia (Beauty Cream): the economic cornerstone of the pharmacopeia.

One dose gives +1 to Comeliness, and if you use it consistently for 10 days, then daily thereafter, the bonus is +2.

As nobody uses Comeliness, this is meaningless.

*Source is 2e Sages & Specialists and it's a Charisma bonus (cf. philtre).

Aphrodisiac: it contains enough emboldening vapours (stimulant), nepenthe, sleeping draught and soma to make you think that it's doing something - particularly when taken in the appropriate circumstances (at a party, in the boudoir). 

Social overuse mechanics can be reskinned drunkenness rules.

*Aphrodisiac is also a commercial euphemism for abortifacients, contraceptives and bogus fertility treatments.

Emboldening Vapours (Stimulant): ignore levels of fatigue for d6 hours at a cost of temp. -1 to Wisdom, Dexterity, Charisma per dose.

You can hold off fatigue for max. 36 hours before needing to save vs. d6 temp. Strength and Constitution damage per dose.

After 3 consecutive doses, save vs. addiction per dose.

Once the effect has worn off, you immediately suffer all levels of fatigue at once and you need +50% recovery time from normal.

Cancels out sleeping draught.

Philtre: once taken, the next person to communicate with you has 2d4 temp. Charisma (to you only) for the next 4+d4 turns.

Once the effect wears off, you can roll Intelligence to realise you were influenced. Even if you don't, prior low-regard for the influencer might be intensified by the sudden contrasts in Charisma.

This is no more effective that the friends spell.

Availability and distribution is clandestine, on a par with poison (and at least twice the price).

Spagyric: one dose will increase the effectiveness of 1 attribute of another pharmaceutical by 50%.

By itself, purgative.

Weird Alchemy.

The processes of extraction and production are jealously guarded secrets. 

Luminiferous Ether: two substances in a vessel that, when mixed, produce a light source as good as a jar of glow worms that fades over d4 turns.

If you pay more, you can get one guaranteed to last 3 turns.

It is not extinguished by exposure to water, nor lack of air. It is not fire, so unaffected by magic etc. working on that element.

Counterintuitively for some, it does not contain/require phlogiston.

Manna ('Drow Lembas'): alchemical food that is instantly destroyed by exposure to sunlight.

Exposed to air, but kept in darkness, properly wrapped, it will last 60 days before disintegrating. Eat it darkness or low light conditions, quickly.

Lightweight and nutritionally dense (equal to one day's ration), it is not appetising. The same property that prevents it being poisoned, putrefied or diseased (including parasites) means it cannot be seasoned.

Kept in an unopened packet it is good for a year.

Manna is not a cost effective way to feed oneself, let alone end world hunger.

*It can be fed to constructs/undead to quell their appetite for human flesh/life energy, if it seems appropriate in context.

*The process of creation exposes the Plague Doctor to mild radiation poisoning.

Miasma: the quintessence of disease. 

It has the general properties of stinking cloud cast at minimum level (3rd), plus exposure to the disease it is derived from.

Neutralised by universal solvent. 

Phlogiston: the quintessence of flammability. 

Exposed to air, it instantly burns up as bright flame, so can be used to dazzle or ignite low flash-point material. 

It is unstable and cannot be stored for any length of time or in quantity in its elemental form. 

Stored in airtight darkness, it deteriorates in 30+d20 days; 2d6 days once exposed to air and light.

Universal Solvent: discovered while attempting to develop a cheap substitute for holy water, this is a broad spectrum disinfectant, cleaning solution and weedkiller. 

Applied directly to a wound, it causes 1 hp lethal damage but will neutralise any disease in there. It will also neutralise parasites and poison if administered in time (if no rules for this, then no later than the end of the next round).

It inflicts d8 lethal damage to plant, filth and disease monsters.

It is a poison if drunk (min. effect purgative) but there's no way you could disguise it in food or drink (effectively putrefying it).

It can be used to purify water, but makes it poisonous.

Commentary.

Nothing here is meant to be as good as or to directly compete with magical healing. That's the point.

None of them are magical of themselves (i.e. they do not detect as such), but they probably require a magical background environment to exist.

All can be administered as pills, potions, injections, and liquid, smoke or powder pumped into various bodily openings. Some can be smoked, whether or not mixed with newly-discovered, precious, life-sustaining tobacco.

For some more pseudo-historical/thematically appropriate general medicine, plus henbane, opium, and all the other good stuff in the doctor's bag, I direct you to the Ghastly Affair Presenter's Manual.

Same overall acknowledgements for source material as for the Plague Doctor.

I always liked that the Citadel/Warhammer Plague Elemental was a sub-type of Air Elemental (and the Life and Death Elementals as sub-types of Earth) - at least until they were re-branded as daemons.

Tony Ackland/ L - R: Life, Death and Plague Elementals, plus Balrog (Baalrukh?)

Beowulf Rolls a 1

Wiglaf hearing about Beowulf's 1.
J.R. Skelton (1908)

Something of a shower thought, this one.

If a 20 is ruled/house-ruled as a crit, it often follows that a 1 is a fumble.

Very reasonably, higher level Fighters complain that this means they end up fumbling more often than less-skilled characters.

When a non-Fighter rolls a 1 to hit, it's a fumble, and they drop/break their weapon or wound themselves or trip over an imaginary invisible turtle.

When a Fighter rolls a 1, it's goddamn heroic:

• At 1st level, they break their weapon (causing normal damage) and all unlevelled and max. 1 HD/level monsters/NPCs who witness it must make a Morale Check.
• At 4th level, they break their weapon (full damage) and all max. 3 HD/level monsters/NPCs who witness it must make a Morale Check; unlevelled and lower than 1 HD/level NPCs/monsters auto-fail the Morale Check.
• At 8th level, they break their weapon (crit/double damage) and all max. 4+1 HD/level monsters/NPCs who witness it must make a Morale Check; all max. 3 HD/level monsters/NPCs auto-fail their Morale Check; unlevelled and lower than 1 HD/level NPCs/monsters auto-fail their Morale Check and must save or be rooted to the spot in awe/fear for d3 rounds.

Alternatively (or in addition), instead of the Morale Check on witnesses, you could bestow some later edition Barbarian Rage on the Fighter (1 round at 1st level-3rd level, 4 rounds at 4th to 7th, 8 rounds from 8th).

This should be enough to pull off a monster's arm or wield a giant-forged sword.

Magic weapons can be exempt from this rule, although I'm happy to see them shatter. Furthermore, the heroically shattered weapons of 4th and 8th level Fighters make suitable materials for making other magic items/weapons (cf. Narsil/Anduril).

As a general rule, if a monster can only be hit by special and/or magical weapons it's not likely to be affected mechanically even if the broken weapon is magical. 

At lower character levels and/or lower-magic settings, a non-magical weapon broken on a 1 could be ruled to cause to damage to otherwise invulnerable monsters and be eligible for re-forging as a magical weapon.

Commentary.

This is because of Beowulf, but he's not the only one to break a sword on the hero's journey.

Beowulf as foundational fantasy rpg text, via The Lord of the Rings, and as an OSR exemplar via The Eaters of the Dead/ The Thirteenth Warrior.

In a combat-focussed d20 system, this is going to happen often enough to add a dimension of the ridiculous - so you could either a) save it up for narratively significant fights or b) boringly make non-Fighters fumble on a 1, but Fighters only miss.

Not Quite Canon: BYAKHEE for Old School Fantasy & Horror

Byakhee/ Lisa Free

A re-model rather than a conversion; * for optional.

The TLDR/Basic Byakhee.

Hybrid winged things composed of conventional material. Summoned by mortal sorcerers as guardians and mounts. Called by cultists to receive sacrifices. 

Have the ability to probability travel anywhere in the universe in 1-12 hours. They cannot enter a planetary atmosphere this way, but they can leave - vanishing without trace.

They can carry a single adult human and their equipment on these journeys. They always arrive hungry.

Armour Class: As Leather.

Hit Dice: 4 (Medium/ Human-sized; wingspan comparable to Gargoyle or Harpy).

Movement: 50% of Normal Human on the ground; x2 Normal Human in flight in the lower atmosphere; x3 in upper atmosphere; x6 through space (if not using probability travel).

If carrying an adult human at the same time, reduce flying speed to x1 in lower atmosphere and x2 upper atmosphere. Encumbrance does not affect space flight or probability travel.

Attacks: 2 per round (all +1 for Strength):

• Claw/hoof/paw d3 damage.
• Bite/ram/slam d6 damage.
• Horn/spike/sting/tail d4 damage.

Special Attacks:

• If both claws hit, auto-bite or carry off (max. adult human) next round.
• If bite hits, can drain d3 pints of blood etc. per round. Will continue until you're empty, not just dead.
• If sting hits, save vs. venom as for Centipede, Giant. You will have nightmares of flight and space and cold *and Carcosa while sick.
• Swoop with surprise for double-damage; crit/natural 20 to carry off (max. adult human).
• Victims carried off can be dropped from height for falling damage.

Special Defences:

• Immune to cold (magical and normal), disease, poison, radiation, sleep and vacuum/asphyxia.
• *blink away (as Blink Dog) if it uses probability travel to escape.
• *can see invisible, ethereal, duo-dimensional and out-of-phase things.

*Spells: 40% chance of 1-4 spells. These can be blur, light, mage hand and minor illusion, if you like.

Morale: 9 (*10 vs. Mi-Go; 12 if commanded by Hastur).

Alignment: Neutral Hungry, or compatible with Hastur.

*Traditional association with Hastur as worshipper-servitors and co-inhabitants of Carcosa.

Grenadier Byakhee.

Advanced Byakhee.

They were not altogether crows, nor moles, nor buzzards, nor ants, nor vampire bats, nor decomposed human beings; but something I cannot and must not recall.

…hybrid winged things that no sound eye could ever wholly grasp, or sound brain ever wholly remember.

Bits in bold are more important than the rest of the description.

While Byakhee are composed of conventional material, they are not anchored in conventional space-time.

Not being anchored in conventional space-time means they exhibit certain characteristics of hyperspace entities. This accounts for the mortal inability to absolutely perceive their objective physicality; also the wild variations in size and appearance from encounter to encounter.

You do not wholly see Byakhee, you interpret them: ‘winged’ is an abstraction, much like ‘hound’ is for the tindalosi.

Byakhee visually de-code as devils, hippogriffs, bees, wasps, valkyries, youwarkees, skeletal butterflies with stone knives on their wings, harpies, imps, bats, angels, nightgaunts, tyranids, pterodactyls, pegasi, wyverns, star vampires, shantaks, flying polyps, jabberwockies, and -men (hat-, moth- and shadow-).

And they can also look like whatever you are primed for a Byakhee to look like (whether you've been reading The Festival or The House on Curwen Street).

Byakhee are immune to enlarge/shrink and polymorph. Neither can they be dismembered or decapitated. Certainly, not by mundane mortals.

They are affected by spells etc. as are summoned creatures - even in Carcosa.

Intelligence: Average (human-level), but rarely credited.

Telepathic and understand all languages, but communicate only in clicks, croaks, screams, squawks, squeals and whistles. Traditionally respond to whistled directions and simple commands.

Capable of mimicking a surprising range of sounds, including laughter, weeping, and incomprehensible muttering, as well as following (and formulating) complex plans.

They are unconcerned with the morality of actions they are bound/commanded to perform, as well as ethical concerns over their choice of sustenance. They mostly (privately?) find humans to be ridiculous things - fragile, limited, pliable.

Size: Roll d4:

1. Small: imp

• HD 1-1 (or d6 hp)
• 1 attack per round
• reduce damage dice increments by one step; no damage bonus for Strength
• drains 1 pint of blood in d6 rounds
• if sting hits, save vs. poison or d3 non-lethal/subdual damage
• Swoop with surprise for x2 damage, but cannot carry off targets

2. Medium: gargoyle

• as the Basic Byakhee
• if it's carrying you off, you are at -2 to hit it and score only minimum damage, but it is at -2 to hit you

3. Large: wyvern

• HD 6 to 7
• 3 attacks per round; can split between 2 targets
• +2 to damage for Strength/size
• does not drain blood, but auto-bites/continuous damage
• if sting hits, save or 0 hp/Casualty state
• can carry an armoured adult human without flying movement penalty
• Swoop with surprise for x2 damage; crit/natural 18-20 to carry off (max. armoured adult human)
• can carry off in its jaws as well as its claws
• if it's carrying you off, you are at -2 to hit it and score only minimum damage, but it is at -2 to hit you

4. Giant: dragon

• HD 10 to 12
• 4 attacks per round; can split between 3 targets
• +4 to damage for Strength/size
• does not drain blood, but auto-bites/continuous damage
• if sting hits, save or die and d3 acid splash damage to everyone within 5' of the target
• can carry up to three armoured adult humans without flying movement penalty
• Swoop with surprise for x2 damage; crit/natural 16-20 to carry off (max. armoured horse)
• can carry off in its jaws and tail as well as its claws
• if it's carrying you off, you are at -2 to hit it and score only minimum damage, but it is at -2 to hit you
• Morale +1

Their size changes relative to mundane mortals because they are arriving from fourth-dimensional hyperspace - the Byakhee is always the same size from its own perspective.

Armour Class: Roll d6:

1. Tough hide (as Leather)
2. Scaly hide (as Leather + Shield)
3. Chitinous (as Chain + Shield)
4. Hard carapace (as Plate)
5. Equivalent of descending Armour Class 0
6. Invulnerable Monster/ magic weapon to hit, and reroll for AC; any additional 6s increase the + of the weapon needed to hit

Tactile feedback does not necessarily correspond to visual expectation.

*Personal Reality Distortion: Roll d8 (except when encountered in space or Carcosa):

1. blurred (-4 to hit it the first time, then at -2 thereafter; Byakhee gets +1 to all saves)
   
2. displacement (it appears to be 3’ from where it actually is; -2 to hit it; Byakhee gets +2 to all saves)
   
3. duo-dimension (as the spell, but no portion of the Byakhee extends into or is vulnerable from the Astral Plane)
   
4. ethereal (can only harm and be harmed by other ethereal beings, but can use its spell-like abilities; can semi-materialise for feeding only; cf. Ghost)
   
5. gaseous form (as the spell, but can use its spell-like abilities; can semi-materialise for feeding only)
   
6. improved invisibility (-4 to hit, +4 to saves)
   
7. mirror image (recasts d6 rounds after images destroyed/dispelled)
   
8. statue (as the BECMI spell; the Byakhee cannot move except by probability travel, but gets AC equivalent to descending -4, plus immune to normal and magical fire; can use its spell-like abilities; can partially de-petrify for feeding only)

Stacks with and/or overrules Armour Class results.

Tactile feedback does not necessarily correspond to visual expectation. 

*Spells: 40% of 1-4 spells from this list (taken from A Ghastly Affair). Roll d10:

1. bewitch cattle

2. blacken sky

3. blast crops

4. change/steal gender (only 1 per day)

5. obtain oracle (on another's behalf)

6. protection from bullets/normal missiles (depends on milieu)

7. rain of blood/ fish/ frogs/ flesh/ shower of stones (only 1 per day)

8. raise storm

9. steal milk

10. witch’s mount (on another's behalf)

All spells are supplementary effects of the ability to probability travel - they detect as psionics rather than magic, but are vulnerable to dispel magic.

It can know spells other than these, and is able to grant a casting to, as well as perform them on behalf of, another - given the right incentives.

*The Black Man at the witches' sabbat is not Nyarlathotep.

Loic Muzy/ Byakhee vs. Shantak - not much between them, eh?

Space Mead.

Whatever space mead is and however it is made/obtained (sometimes a bee-like by-product of the Byakhee themselves), it is an absolute requirement for mortals accompanying Byakhee when they probability travel. As well as protecting the imbiber from the physical effects of space travel, it also places them in a hypnotic stupor that lasts until they arrive at their destination.

The journey takes 1-12 hours (depending on distance and/or random factors) for purposes of strict time records, but for anyone travelling without space mead it will be longer than you think and they must immediately retire the character on arrival at their destination, either dead or irrevocably, self-destructively insane.

There are theories as to why and what, but no-one alive knows for sure.

*Maybe space mead is only the best known and most widely available product for surviving probability travel with the Byakhee, and there could be rare/unique alternatives.

Erol Otus/ 1e AD&D Deities & Demigods

Commentary.

Visual shorthand is space bees and alien vultures. General consensus is that they're the things described in The Festival, but otherwise they're extrapolations in the Derleth-Petersen tradition.

I'm going to guess that they're not many people's Mythos favourites, but only the most fervent Lovecraft purist would leave them out of the bestiary - how else are you getting to Carcosa?

The RAW CoC rpg Byakhee is at the lower end of the threat range (for comparison, my conversion comes out at 3+3 HD, AC as Leather), and has no special defence against a hail of bullets, so you too could exterminate a genuine sapient extra-terrestrial in your own back yard with a few of your friends.

The Byakhee in A Happy Family (Adventures in Arkham Country). It's only pretending to be bound. I misremembered it as having chosen to do so for comfort and security - my foundation for their psychology.

Tiny B & W photograph of the Grenadier miniatures in White Dwarf had me de-coding Byakhee as winged humanoids, wearing beaded skirts and clawed gauntlets before I ever opened the CoC 2e rulebook.

In Biblical Carcosa, they de-code as Pre-Colombian Meso-American cyber-Skeksis.

A PLAGUE DOCTOR Class for Old School Fantasy & Horror.

The modern archetype - Plague Doctor from Darkest Dungeon (II) - a self-medicating, grenade-tossing, trailblazing young woman and general badass.

Approximately early edition D&D-ish system agnostic; * means optional. 

Description: A sub-class of the Assassin and the Cleric, the Plague Doctor is a pioneer and practitioner of scientific medicine in a world with magical healing, the harbinger of a scientific and technological revolution that will never come.

They seek to oppose and dismantle the exclusionary racket of magical healing (see 1e DMG pp. 103-104) - to replace it with their own rational and enlightened exclusionary racket based on cutting edge science (leeches, miasmas, humoral theory, astrology, phrenology, haruspicy etc).

Despite their alien appearance and grisly reputation (the traditional regalia is believed to date back to the first Plague Doctors who tended to the dying and tallied the dead when epidemic outpaced cure disease), Plague Doctors are serious professionals attempting to fill a gap in the landscape of healing.

Sometimes known as Leeches, Tallymen, or whatever their mask most resembles. They prefer you address them as Doctor or Master.

XP, attack matrix, saving throws:  As Cleric.

Hit Dice: d6 (*or 2d4 at 1st level, d4 each level thereafter for monastic Plague Doctors).

Prime Requisites: Dexterity and Intelligence.

Armour: Anything they like but it will hamper them as it would a Thief.

Plague Doctors prefer the distinctive and traditional uniform of their profession (equal to Leather plus closed helm, gauntlets and protective boots). Here's some unflavoured mechanics:

• Mask: Advantage/bonus to save vs. airborne disease, stench, smoke, poison gas, foul air etc. and/or doubles minimum safe time in those conditions. Also protects the eyes as (game) logic dictates.
• Surprise, listening and perception-type checks penalised by c. 20% due to restriction of hearing and peripheral vision. Can't detect anything by scent.
• You need to replenish the supply of medicinal herbs/neutralising substances in the mask daily and/or after exposure (1 unit of common currency every time) or the mask loses its protective properties.
• Depending on the tech level of the setting, the mask can be connected to an air pump or tank.
• Robes: Pre-modern hazmat suit. Advantage/bonus to save vs. splash, touch and other contact effects and/or doubles minimum safe time in applicable conditions.
• Protective, not indestructible.

Weapons: Knife and grenade-like missiles.

*Syringes, clysters and reinforced bellows for administering gaseous and liquid cures; surgical instruments (such as the cleaver, dagger, hand axe, and notched heavy cutting blade); firearms (for dispersing miasmas and frightening disease spirits); mancatcher, staff, club, spear, blackjack, net, whip, blowgun (for subdual and crowd-control); close range bolt guns (air, string, spring or powder) for administering end of life care. Flame-throwers. Burning oil and flaming torches. Poison and venom. Chloroform-soaked rag.

*Magic: Plague Doctors affect a pose of 1e Unearthed Arcana Barbarian detestation of magic (though they hold Clerics in lower regard than Magic Users).

But in reality they're not averse if it gives them an advantage, as long as they can plausibly ad/or stealthily deploy it while maintaining their public professional stance.

*XP awards for destroying magic items as part of their mission; incorporation of Barbarian First Aid to the Plague Doctor special ability.

Alignment: Any Evil - sub-class of the Assassin; in opposition to the healing gods.

The older, satirical archetype - Dr. Beaky.

Special Abilities.

Autopsy: Spend 2-4 hours (-1 turn for each level over 3rd; minimum 2 hours) dissecting and otherwise examining a corpse, and you have a 60% + 2% per level of accurately determining time and cause of death.

Sometimes cause of death is obvious/commonplace and will not need a roll/take the usual time. The older the corpse, the less accurate the results.

*% penalties if the corpse is non-human, non-humanoid and/or magical. Though you might learn something anyway.

Diagnosis: INT check to determine the medical problem (and the methods of treatment): mundane wounds, disease, poison, diet, age, madness etc. Cumulative +1 at 3rd, 6th and 9th level. Situational bonus or auto-success for having appropriate medical treatise/specialist diagnostic tools at hand. 

Sometimes the problem is obvious/commonplace and will not need a roll. Sometimes the doctor will make something up.

Sometimes the diagnosis cannot be made without communication and cooperation from the patient.

*In a magical world, a medical doctor may also be able to diagnose whether the problem is magical in nature, if not the specifics.

*Disadvantage/penalty if the patient is non-human, non-humanoid and/or magical.

First Aid: Term of convenience - tweak to suit your setting if it breaks immersion. This is bandaging or sewing wounds, applying ointment, irrigating, applying tourniquets, cauterising etc.

In combat, heal d3 with a DEX check; after combat, heal d4 without a check; within an hour, heal d2 (no check). 

It's a round action in combat, up to an exploration turn afterwards. You might need to make a check out of combat if you are under some other kind of pressure (e.g. field hospital under fire; ongoing natural disaster; demonic incursion; exam conditions; your patient is the king).

Max. once per per person per day at 1st level; twice at 4th level; thrice at 8th level. Only new wounds from combat or accident, not hp farming during downtime. Not cumulative with giving aid to 0 hp/Casualty state characters, or special assistance laid out in (e.g.) individual monster rules.

You can treat poison/venom up to the end of the round after it was administered (or within half the onset time, if using those rules), and you and the victim must sit out the next d4 rounds (d3 @ 4th level, d2 @ 8th). At the end, roll a new save. Success is equivalent to slow poison (1 hour/level). Max. per person per day as for First Aid.

*Nausea, sickness, stun, bleeding, choking, disease, parasitic infestation etc. could be treatable by a Plague Doctor in combat.

*Depending on the background logic of the setting, things such as Ghoul paralysis and lycanthropic transmission might also be dealt with this way. 

Kate Sherron. If you're in an Altered State, they look like moths/mothmen.

Knife Specialist: Automatically proficient at 1st level; automatically specialised at 4th level.

From 3rd level, you cause a bleeding wound on a crit or scoring 4 over the target number. 

A pint is lost every d3 rounds unless the wound is treated. Every pint past the 1st, lose one-third hp and 2 CON.

Only vs. approx. humanoid/human-sized targets with circulating blood.

You Backstab as a Thief of the same level.

*It might be cool to be able to use this on Vampires.

Languages: You are able to learn ancient/dead languages from 1st level.

If your INT is 15+, from 4th level you can learn the special languages of other alignments, druids, and thieves. 

In addition, if they exist in the setting, you can also learn the tongue of ghouls, the cant of grave robbers, the priestly languages of the cults of the dead and the undead.

This is to access obscure medical treatises and privately discuss treatment with reticent patients, so we are told.

Leechcraft (Bleeding): Remedial bloodletting, including application of leeches. It is recommended for a broad spectrum of disorders of the body, mind and soul.

Bleeding is rarely more than a few ounces at a time (max. damage = d3 non-lethal, d6 if you're prone to fainting). Otherwise, use rules for bleeding wounds.

It doesn't work.

Placebo Effect: Base 1% per level, plus your CHA modifier.

This is the chance an ineffective medicine or procedure has a beneficial material effect on the patient's condition.

*Further adjustments for renown of the remedy or the professional, expensive treatments, rare ingredients, how it's administered (e.g. placebo pills of different colour, placebo injections/enemas > pills, cutting you open, rummaging around and sewing you back up > injections), time spent, cultural factors, hypnotic suggestion etc.

Surgery: INT check, and the number rolled is the number of rounds/turns/hours of surgery, and the number of DEX checks you'll need to make. +1 bonus at 4th level; +2 at 8th.

If you roll a critical fail, you cause a bleeding wound and d6 appropriate Ability Score damage.

Every normal fail causes d3 lethal damage. Any surgery always cause min. d3 lethal damage.

If you succeed in all (or most, or enough) of your DEX checks, then the procedure was a success - but what does success look like in the pseudo-historical milieu of your choice?

As a starting point, think about what surgical procedures were carried out in the ancient to pre-modern period: trepanning (actually prehistoric), bone-setting, amputation (judicial and medical), circumcision, various degrees of castration, cataract removal, lancing and draining, abortion, cutting for the stone, a surprising amount of what we would now call reconstruction, aesthetic and remedial body-modification, prolonged torture.

Simple and commonplace procedures don't need multiple DEX checks, except if you want to roll for critical fails.

*Assistants, whether just an extra pair of hands or another trained professional, can improve chances of success and/or reduce the negative consequences.

*Transplants and grafts may be possible, if that works for the game/setting.

*This is also a Torture special ability - successful checks indicate the victim survives, not that they tell the truth.

The Vivisect - surgical possibility in a magical world. From The Talisman of Death. Art by Bob Harvey.

Thief Skills: You Pick Pockets, Move Silently, Hide in Shadows, Read Languages and Hear Noise as Thief of 2 levels lower (min. 1). You need to take your mask off to Hear Noise, unless using a stethoscope.

*You can never get one over on a Thief of the same (full/Plague Doctor) level as you, but you can an Assassin.

Treatment: Being cared for/treated by a Plague Doctor with at least basic kit/resources improves natural healing:

• +1 hp per day of normal activity (adventuring)
• +2 hp per day of light activity (downtime between adventures)
• +3 hp per day of complete rest (deliberately recuperating)
• +4 hp per day in an actual hospital (or equivalent)

In lieu of promoting natural healing, if the Plague Doctor makes an INT check, care/treatment allows a +2 to a save vs. disease or poison/venom, if allowed. +3 with access to decent medical supplies and conditions, +4 in an actual hospital (or equivalent).

Soft cap max. 6 patients per day (-1 hp for everyone for each patient over 6; penalty also applies to relevant supplies and ability checks).

*With assistants, decent medical supplies and ideal conditions you can offset some of the penalties for more than 6 patients.

*Concentrating on one patient at the expense of the others gives advantage/bonus for them, disadvantage/penalty for everyone else. If you only have one patient, you can't concentrate on them any more than you already are.

Actually Slough Throt, a skinless sorcerer from 2000AD's Slaine, but I think the character design illustrates another visual possibility, or one for a pseudo-historical time period significantly earlier than quasi-medieval/early modern. Art by Mike McMahon.

In Practice.

Research/Training.

You must perform dissections equal to your current/old level in order to progress to the next level.

If not, then:

• you do not gain a level (you do not lose the XP)
• all your ability checks, saves etc. for medical practice are at disadvantage/penalty
• lose specialisation bonus with knife; cannot inflict bleeding wounds
• no level bonus for autopsy (and roll at disadvantage/penalty)
• all treatment inc. First Aid only 50% effective

To regain these abilities, you need to do twice as many dissections as you failed to do.

Dissections must be of a intelligent humanoid cadaver and take 2-4 hours each (not including prep time; autopsy time saving for level doesn't count).

Autopsies carried out do not add to this total.

The Price of Knowledge.

In a magical setting, your explorations converge with those of the Necromancer, and intimacy with death elides with undeath. Meaning that you are vulnerable to arcane corruption.

*Ravenloft Powers Checks could also apply, or be used as an alternative corruption system.

10% chance at 3rd level, 30% at 4th. Otherwise, you get your first at 5th level, then one every level thereafter: roll d10. 

Everything advances a Stage on rerolls. Living Death trumps Cadaverous Appearance. Allergies will be to things that are hard to avoid in your professional practice, your darker nature, the façade of a normal life, adventuring.

1. Allergy: Stage 1: save vs. contact/exposure or -1 to all rolls for d4 turns per contact/turn of exposure; nausea (-2 all rolls) 1 day if consumed; Stage 2: auto-fail save vs. contact/exposure for -1 to all rolls for d6 turns per contact/round of exposure; sick as per Cave Locust spit if consumed. Stage 3: any contact/exposure and -3 to all rolls for d3 days; save or die if consumed.
2. Animal Aversion: Stages: -1, -3 then -6 Reaction Roll for animals and children; at Stage 3 any roll of doubles means carnivores attack, herbivores stampede.
3. Cadaverous Appearance: Roll d8 and count up the scale from Skeleton: that's the type of Pseudo-undead you're going to start resembling (min. 3 Stages).
4. Exposed to a Disease: Stage 1 is just a normal exposure (though most likely to be Mummy/Tomb Rot); Stage 2 is especially virulent/the previous exposure compromised your immune response - saving/recovery rolls at disadvantage/penalty; Stage 3 you'll always be a carrier - treat regularly to halt/reverse symptoms and prevent spread (*these might be two separate problems).
5. Living Death: Roll d8 and count up the scale from Zombie: that's the type of Undead you're going to start resembling (min. 3 Stages). Weaknesses, compulsions/diet/habits first, then immunities/resistances, then special abilities. You are Turned as a Special, but you are not fully undead until you die.
6. Morbidity: Stages: -1, -3 then -6 to Charisma, and cumulative +1 save vs. horror per Stage - so obsessed with wounds, disease, death, dying, surgery, questionable medical paradigms, and ethically-challenging thought experiments that you're not pleasant to be around.
7. Nocturnal/ Heliophobic: Stages -1, -3 then -6 as a Goblin/Orc vs. sunlight. In addition, at -3 you are also at disadvantage/penalty vs. light-based attacks; at -6, you gain dark-/infra-/night-vision, you auto-fail saves vs. light-based attacks and will be blinded until you recover for d4 hours in total darkness.
8. *Unholy Compulsion: Look up the Sacrifice table from the Necromancer class by Lew Pulsipher in White Dwarf issue 35 - this is your new (additional) dissection schedule. Same penalties for not doing these as Research/Training dissections, and you need to do twice as many to make up. Compulsive dissections do not count towards Research/Training. These are neither medically necessary nor possible to pass off as such.
9. Weakness/ Fatigue: +1 level of permanent Fatigue unless you take progressively more addictive, expensive and hard to source drugs.
10. Weakness/ Stat Damage: -1, -3 then -6 (d3) CON, DEX or STR, unless you take progressively more addictive, expensive and hard to source drugs.

If Unholy Compulsion as written is too strong a flavour, how about you pique the interest of the Order of the Gash, or the Practice (Book of Unremitting Horror/ Invasive Procedures for Fear Itself rpg) instead?

Another visual possibility. Art by Alberto Ponticelli.

What Was Left Out.

Masks: Different types and philosophies based on their masks/regalia.

Granbretan Beast Orders; various Egyptian deities (and Stargate); the Order of the Fly; Dream's Helm (from Sandman); Venetian/masquerade masks; the early masks/helmets of fire-fighters and diving suits; things that resemble bad taxidermy elephants, rabbits (floppy eared), ducks, foxes and koala bears; single and multiple tentacle-trunk-faces; ballooning throat pouches.

Hazmat Robes: straw raincoat-style, feathers, hair, hides (like Slough Throt), waxed cloth, oiled silk, monster skins, rubber.

Special Materials for Surgical Instruments: silver (anti-bacterial properties), obsidian (still used today), jade.

Specialists: the alchemists, the apothecaries, the alienists, the anatomists; warrior-surgeons and war criminals; actual assassins; medical martial artists; perfumiers.

Organisation: Practices, Colleges, Orders, Guilds. The infirmary; the hospital; the asylum; the sanatorium.

More in common with 1e AD&D Assassins and Monks gaining followers than a sensible community health recruitment policy.

How prestigious (as compared to folk and clerical healers)? Ancient establishment or recent disruptors?

Medicine: remedial and recreational (see the Apothecary and both Chiurgeons, below).

Apothecarial Arsenal: poison gas, Greek fire, smoke bombs, flash pellets, zombie powder, extreme hygiene flame throwers, a cheap alternative to holy water.

Anonymity/Secret Identity: That Plague Doctors rarely to never allow themselves to be seen unmasked or unrobed; that the regalia can take on the attributes of the wearer, that these can persist and be transmitted.

Commentary.

Someone's done Darkest Dungeon heroes for LotFP. The Plague Doctor is a Cleric with vial bombs and remove fear memorised. I think that's pretty good.

The Treatment special ability is mostly the Medicine NWP from 2e Masque of the Red Death. Because Medicine is better than Healing? (The Plague Doctors certainly think so)

Some of the other Plague Doctor homebrew out there: for B/X; 5e Darkest Dungeon conversions; for Ye Olde School Games (and Black Hack) - this one both minimalist and flavoured. 

The Apothecary and the Healer NPC classes from 2e's Sages & Specialists. The Apothecary is a minor Magic User with a laboratory for identifying and brewing potions, also a number of other interesting things (including stimulants and painkillers, as well as an aphrodisiac that makes you think your Charisma's raised and beauty cream that apparently underwrites their whole business). The Healer has a herb garden and can heal more people better by filling NWP slots with duplicates of Healing and Herbalism.

Andrew Wyatt's Chiurgeon class from the 2e Ravenloft Book of Secrets was a really useful foundation - thank you.

There's also a 3.5e prestige class (con)version (which I only just found while looking for the link to Wyatt's).

Both are more effective at what they do than my Plague Doctor, as they're more in the Victor Frankenstein/Dr. Moreau/Herbert West direction, whereas I'm leaning into the pseudo-historical - "the procedure was a success, but the patient died" - and extrapolation in an implied setting.

A Ghastly Affair has questionable medicines (including mercury for your syphilis) that would fit right in here. And drugs on the edge of medicine/magic which might also. And a bit of the Mad Scientist class.

Sub-class of the Cleric, because so is the Pulsipher Necromancer - a thematic ancestor.

Also ancestors, (barely) the dead alchemist from The Philosopher's Stone 1e AD&D scenario (White Dwarf #66) and (in outlook) the 1e AD&D Artificer class from White Dwarf #68.

Sub-class of the Assassin. It just seems appropriate - I originally wondered if I could use the 1e Assassination table for a medical procedure or something. 

(Table for payment by level of 1e Assassin vs. level of victim could be used to determine how much a Plague Doctor charges for how grand a patient)

Obligatory #BOSR reminder that the implied setting of D&D is an American one, right down to your expensive life-saving medical care being denied by an unassailable power.

Back to Basic - Vampire.

Reconstruction of Zosia, 17th Century Polish Vampire.

What is a Vampire?

You already know. You'll be able to fill in all the blanks I've left (apologies if you hate that kind of negative space).

This treatment is companion to the Werewolf posts (this and this) I made the other year - trying to draw more on the folklore tradition than on media.

No-one wants to become a vampire; it's not sexy and it's not cool. But it's also traditionally quite an easy thing to do.

The vampire has an affinity with night hags and other sleep paralysis demons, as well as poltergeists, and ghouls.

As system agnostic as old fashioned D&D-ish, with no hard lines between editions and simulacra.

*indicates it's optional.

Appearance.

They look like the people who have died. No fangs. No pointy ears. Not even pale. 

Often look healthy, even chubby (particularly in contrast to their victims). Well-fed, they become rosy, then ruddy, then dark and swollen with blood, skin taut like a drum, blood spilling out of not-just-their-mouth-and-nose.

Alignment: Neutral Hungry (original edition Warhammer) with at least a parenthetical 1e AD&D Evil.

That thing in the cellar is not your mother.

Faerie Fire: 5% chance of being wreathed in faerie fire (even if invisible).

*This rises to 35% in some places (Bulgaria and parts of China, for example). 

Invisibility: 15% chance the Vampire is permanently invisible.

*It turns visible when helpless/resting in its lair.

I'd say Timmy Baterman from Pet Sematary (1989) fits the bill. Killed with fire in the end (and morphine works, too).

Basic Statblock.

As a Zombie (2 HD, Move 50% Normal Human) or Ghoul (2 HD, Move 75% Normal Human) or even just a Normal Human.

Base AC as Unarmoured, or as undead type.

They can have a d12 for their Hit Die, so significantly more hp than when they were alive.

Ability Scores: If Strength was below 16 in life, raise to 16.

No Dexterity adjustment, positive or negative, but keep the score.

20% chance of retaining its intelligence, memories, languages and abilities from life. 

If not, 25% chance of Animal to Semi- (1-4) Intelligence. Can't talk; doesn't understand what's being said.

Otherwise, Low (5-7) Intelligence (AD&D Ghoul). Limited comprehensible speech, but understands what's being said.

Attacks: Unarmed attacks, including grappling and choking. Improvised weapon attacks, including thrown objects.

Bite for d2, d3 or d4 damage. Attacks vs. a biting Vampire are at +4 (tweak for system). 

A successful grapple can be followed up with an auto-bite.

Claw for d2, d3 or d4 damage vs. Unarmoured targets (only crits hit vs. armoured).

Invulnerability.

Vampires are Invulnerable Monsters, and otherwise only harmed by fire or magic; all damage reduced by half.

Special vulnerabilities will bypass immunity, but not usually damage reduction.

Killing/Laying a Vampire: use any traditional method(s). These vary region to region, culture to culture - only fire is universal; otherwise, everyone has more than one opinion. 

The Vampire gets a death save; success means that the method is partly or wholly ineffective in killing it, but if it would logically render it helpless then it does.

If a second/follow-up method is ineffective, then the third one will work (and this sequence of methods will work on others of this strain). 

Total destruction by fire or similar is always effective (no save). Magical methods will also be effective, depending on how magic and undeath works in the setting.

*It takes a lot of fuel and a long time to cremate a corpse in pre-industrial times/IRL.

Regeneration: a Vampire in its grave/lair recovers 7 hit points per rest period. 

*It can even reattach/regrow lost body parts.

Special Vulnerabilities: there's so many to choose from - any or none might work.

*Vampires are nocturnal for the same reasons Thieves are nocturnal. They are no more vulnerable to the sunlight than Orcs and Goblins - unless you choose to make it a special vulnerability.

Undead Immunities: Vampires are entitled to all traditional (logical?) in-game immunities/resistances of the undead monster type.

Worth remembering that the undead category is only so neat in-game - it's a lot looser when folklore motifs come into play (drunken slumbers, drownings, poison etc).

You Cannot Kill That Which Is Already Dead: at 0 hp, the Vampire falls prone/helpless or is driven off (back to its lair).

A helpless/resting Vampire's invulnerability can by bypassed for purposes of killing/laying it.

Special Rules.

Blood Loss.

Feeding on a helpless victim, the Vampire will drain d2 pints of blood over a 10-minute turn.

Basic requirement is 2-3 pints per night, with a soft cap of 7 pints.

Loss of the 1st pint has no mechanical effect on the victim, but every pint thereafter causes the loss of one-third of their hit points and d3 each of CON, DEX, STR and WIS. 

Once 4-5 pints are drained, the victim must make death saves/recovery rolls or be reduced to 0 hp/Casualty state.

Once 6 pints have been drained, it's save or die. Any more than that and it's death, no save.

*Adjust thresholds by +1 for CON and/or STR of 14 or more, and by -1 if 7 or less. Not terribly realistic when it comes to pints per person, but this is for a game.

*You can transfer these rules to other blood loss scenarios, but these have been written specifically for a Vampire feeding on a human(-oid/-sized) victim.

Blood drinking in combat: 1 pint in d3 rounds, and the Vampire cannot defend itself except to resist being pulled from the victim (feats of strength).

*Blood Vomit.

Close/melee range missile attack (save to evade or ranged touch attack), with target as centre of splash: d3 acid damage and effects as Cave Locust spit.

You are also exposed to disease and at risk of becoming a Vampire after death (see below).

Clerical Turning.

As a Vampire (unless you want to do it by Hit Dice).

Astral Vampires (see below) are Turned as Specials; Ghost Vampires (see below) are Turned as Ghosts.

*Contagion.

Anyone killed by a Vampire rises as a new Vampire in d4 days.

Anyone who dies of the disease that accompanies a Vampire must make a death save or rise as a new Vampire in d4 days.

Anyone who has been injured by a Vampire has a % per point of damage of becoming a Vampire when they die (rise in d4 days). This is cumulative across your life (max. 97%).

Anyone who has had contact with the blood of a Vampire has a d4% per incident (+10% for a Blood Vomit target, +3% for a Blood Vomit splash) of becoming a Vampire when they die (rise in d4 days). This is cumulative across your life (max. 97%); 

*(Successful) Vampire hunters are virtually guaranteed to become Vampires on death, which is why they always train successors.

*Preventative Measures: various traditional methods that might work, might not, or might make it more likely you'll become a Vampire on death (esp. eating Vampire grave earth and drinking Vampire blood). 

Some fairly commonplace burial practices are effective/ have anti-Vampire roots.

*Vampire Spawn: new Vampires will be similar to the original one in basic details of stats, abilities, special vulnerabilities (i.e. invisible Vampires spawn more of the same; those that retain their intelligence etc. likewise).

Creating new Vampires can be accidental or deliberate.

New Vampires are not necessarily under the control of their creator, though sire and get will usually at least tolerate each other, if not actively cooperate.

*Disease.

Disease frequently forms the backdrop to a Vampire walking abroad.

It is otherwise normally communicable (and treatable), but those who see, hear, have physical contact with the Vampire or are splashed with its blood, make all relevant rolls at disadvantage/penalty.

Cholera, plague, yellow fever and tuberculosis are all suitable for a Vampire epidemic. Less commonly, smallpox.

Mystery Vampire Disease: symptoms of anaemia, lassitude, thirst, loss of appetite, narcolepsy, catatonia/coma, hydrophobia, photosensitivity, feelings of being choked or stifled, somnambulism. In the later stages, hallucinations but also the ability to see invisible Vampires.

*Favoured Enemy of Dogs and Wolves.

Dogs and Wolves have benefits vs. Vampires as a Ranger vs. humanoids/Favoured Enemy. 

*Attacks bypass invulnerability.

*Horrible Stench.

As a Ghast/Troglodyte. Sometimes it's just their breath.

*Sometimes mistaken for the 'odour of sanctity', and the Vampire mistaken for a saint.

*Paralysis.

If you are alone and see a Vampire, save vs. paralysis or be helpless until d3 rounds after the Vampire moves out of sight, or the arrival/intervention of an intelligent living being.

Invisible Vampires paralyse by touch, and you do not need to be alone.

*Save at -2 if it's staring directly into your eyes.

This one from 1977's not even (un)dead.

Astral Vampires.

Sometimes the Vampire is a projection, a sending. It looks like a Vampire, maybe a little translucent or wispy.

The projection is semi-material, with equivalent of descending Armour Class 0, and is otherwise the same as a Vampire in stats and abilities. It is not an Invulnerable Monster, but still reduces all damage by half.

If the projection suffers damage while abroad, it immediately withdraws and returns to its grave. It may not go abroad until days have passed equal to the hit points it lost.

If the projection is destroyed before it can return to its grave, then make a death save to see if this kills/lays the Vampire. If not, it may not go abroad until days have passed equal to its total hit points.

The corpse remains in the grave and is physically vulnerable (though it is still an Invulnerable Monster). Damage to the projection does not affect the corpse and vice versa. 

If the grave is discovered/disturbed, the projection immediately returns to defend itself, arriving in up to d100 rounds (or as many as necessary for realism or drama, depending on how you do these things).

The Vampire can choose to have the projection defend the corpse, or merge with and reanimate it to defend itself (as a corporeal Invulnerable Monster with a round of helplessness). If the Vampire merges, then it can use the better hit points of the body or projection.

*Some astral vampires are projections of the living. The behaviour of the projection will at best be put down to an impostor, at worst be seen as deliberate acts by the individual. Projections of the living may go out without the awareness, consent or control of the projector.

Elder Vampires.

I don't mean ancient bloodlines and mythical sires. 

I mean that most Vampires are lucky to survive months, seasons, before they are dug up and dealt with.

There are two main reasons why a Vampire might survive longer than usual.

First, ineffective destruction/disposal methods can trap the helpless Vampire in its grave, awaiting future revival by accident or design. Sometimes this is long enough for fading of the memory of the threat it poses and the methods to deal with it properly. 

Second, depopulation and abandonment of the territory following disease and predation. Vampires don't like or think to range very far, so it will just go back to its grave. It will roam its old haunt for want of anything else to do, and eagerly fall upon passing prey, but must mainly subsist on the Renfield diet or slip into a restless and miserable torpor. 

If it can survive longer than a mortal lifetime, then it will start to exhibit weird physical changes.

Consult the tables for Hordlings (1e and 2e AD&D) and Appendix D from the 1e AD&D DMG, for ideas or to roll on. You can be as traditional or as outrageous as you want.

*An Elder Vampire drains 1 pint of blood per round, more if has outsize fangs, tusks etc.

*Per Legacy of Kain: Soul Reaver, wings on a Vampire is a rare and prestigious thing.

*Per Buffy the Vampire Slayer, cloven (pincer?) hands and feet are the sign of a very old Vampire. But how do you define 'very old'?

*Elder Vampires feed off other Vampires, including their spawn.

Ghost Vampires.

Sometimes the Vampire is a Ghost.

Stats etc. remain the same, but it is incorporeal and can only be harmed by magic (or on the Ethereal Plane equivalent for the setting). 

It must become semi-material to feed (or otherwise interact physically), at which point it has the equivalent of descending Armour Class 0.

The corpse remains in the grave and is physically vulnerable (though it is still an Invulnerable Monster). Each round the grave is open and the body exposed, roll an additional d6. Any 1s (or if hit point damage is caused) and the Ghost rushes back to defend its tie to the material world.

All damage cause to the corpse is also suffered by the Ghost (bypassing its incorporeality or AC 0).

Destroying the Ghost (except by special method) without also dealing with the body will only neutralise it for d6 days before it reforms and gets back to business.

Methods of disposal must generally be applied to the corpse to kill/lay the Vampire - you can't stake even a semi-material heart, for example.

Commentary.

The common rpg Vampire (and certainly the D&D-ish version) is Dracula - book, movies, comics.

Maybe the rulebook Vampire should be renamed the Dracula. There's already precedent - it's why they are Pegasi and not Winged Horses. 

The Vampire is one of the Important Monsters. It's the model of the monster-supervillain, and the first monster (give or take the regenerating Troll) that you can't just fight to death. It also often has one of the most in-depth entries in a bestiary.

The vampire is the ancestor of the zombie flesh-eater (via I Am Legend, then Night of the Living Dead).

There are so many ways of putting yourself at risk of becoming a vampire after death that it's a wonder we aren't overrun.

Paul Barber's Vampires, Burial & Death (1988 and 2010): the vampire is a corpse behaving normally.

It was rarely a mystery who and what the vampire was, and everyone knew how to recognise and deal with them. 

The D&D-ish convolution of blood-drinking vampires being a variant of the energy-drainer.

Note that it doesn't matter how much blood you have in your (character's) body, but how much you lose, and that it's intended to bypass the extreme survivability of high level characters.

In China Mieville's Bas-Lag setting, vampires are the lowest class of undead in the city-state of High Cromlech, forced to beg on the streets for blood - basically junkies. 

I know almost nothing about Vampire: the Masquerade. Should I remedy that?

In some folklore, blood is the last thing on list of things the vampire eats and only after normal food, livestock, other corpses, even bits of itself. The Dark Sun Fael is not far off this kind of thing.

See also: Croglin Vampire.

BFRPG for giving the Vampire an awkward bite attack - thank you.

A Ghastly Affair for blood-letting rules - thank you.