Blood Toxins are fast-acting diseases that function much like poisons and are used by the plague doctor. Blood toxins are created through the Craft (poisonmaking) skill from otherwise-mundane resources.


1st Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Eye of Light
1 round
5 rounds
1 round
15 gp
16
Slime Cascade
1 round
5 rounds
1 round
15 gp
16
Trembling Chills
1 round
5 rounds
1 round
10 gp
14
Volcanic Pox
1 round
5 rounds
1 round
12 gp
15
Winter Heart
1 round
5 rounds
1 round
20 gp
17

Eye of Light

This toxin affects the connections between a creature's eyes and its mind, dazzling it. On a failed save, the target of this toxin begins to see spots, which rapidly brighten into painful points of light. The target is initially treated as being dazzled, but each failed save increases the penalty to attack rolls, Spot checks, and Search checks by an additional point (to a maximum of -5) as the toxin forces the target's eyes to dilate further and further. Sightless creatures are immune to the effect of this toxin.

Slime Cascade

A particularly disturbing toxin to be on the receiving end of, slime cascade instantly causes the afflicted creature's mouth to begin producing vast quantities of thick slime. Each round that this toxin remains in effect, the affected creature must spend a move action to clear its mouth of the slime or begin suffocating, as if it were drowning. Creatures that do not need to breathe are immune to the suffocation effect of this toxin.

Trembling Chills

A creature infected with this toxin loses its ability to sense warmth, instantly feeling as though it were bathed in ice. Creatures without immunity to cold take a -2 penalty to attack rolls, damage rolls, saving throws, skill checks, and ability checks while the toxin remains in effect.

Volcanic Pox

This toxin causes coin-sized pustules to rapidly bubble up across the creature's flesh, bursting a moment later. Each round the toxin remains in effect, the creature takes 1d12 damage as its body explodes bit by bit.

Winter Heart

A tame toxin by some standards, winter heart can still prove quite deadly if allowed to run its course. Each round that the toxin remains in effect, the afflicted creature takes 1d2 Constitution damage.


2nd Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Acidic Lesions
1 round
5 rounds
1 round
45 gp
19
Electric Necrosis
1 round
5 rounds
1 round
45 gp
19
Ghostly Abscess
1 minute
5 minutes
1 minute
55 gp
20
Horrible Bile
1 round
5 rounds
1 round
50 gp
20
Incandescent Veins
1 round
5 rounds
1 round
55 gp
21

Acidic Lesions

As the name implies, this toxin causes open sores to spring up across the unfortunate victim's body, which secrete a thin acid that sears the flesh around each lesion. Each round that this toxin remains in effect, the victim takes 2d6 acid damage and 1 point of Constitution damage.

Electric Necrosis

A creature afflicted with electric necrosis instantly begins to experience sharp subdermal electrical jolts as its body releases stored bioelectricity at a thousand times the normal rate. Each round that this toxin remains in effect, the afflicted creature takes 2d6 points of electric damage. Each time the afflicted creature takes damage from this toxin, its base movement speed decreases by 5 feet, to a minimum of 5 feet. A creature with its movement speed so impeded only recovers this lose movement speed when all damage dealt to it by this toxin has been healed.

Ghostly Abscess

A slower toxin than many, ghostly abscess is appropriately more powerful than toxins of similar potency. The toxin derives its name from the transparent gray covering that spreads over the afflicted portion of the victim's body, which appears as a spectral copy of dissolved organs when the disease runs its course. Each minute that this toxin remains in effect, the afflicted creature takes 1d6 points of Constitution damage.

Horrible Bile

A creature afflicted with this toxin immediately begins vomiting a combination of toxin-enhanced stomach acid and whatever else might be in its stomach at the time. The first failed save against this toxin sickens the creature for one round; the second nauseates for one round; each subsequent failed save nauseates the creature for an additional round and also deals 1 point of Constitution damage.

Incandescent Veins

Sabotaging the body's natural defenses, this toxin causes the victim to experience something akin to a high fever, only much stronger. Each round that this toxin remains in effect, the victim takes 2d6 points of fire damage; resistance to fire does not protect from this damage, but immunity to fire does. If a victim fails two consecutive saves against this toxin, it immediately falls unconscious until the toxin runs its course or is removed.


3rd Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Acid Belly
1 round
5 rounds
1 round
70 gp
22
Blood Blindness
1 round
3 rounds
1 round
75 gp
23
Rampant Decay
1 round
5 rounds
1 round
70 gp
23
Searing Agony
1 round
5 rounds
1 round
70 gp
23
Wayfarer's Bane
1 round
5 minutes
1 minute
80 gp
23

Acid Belly

A toxin renowned primarily for being exceptionally painful, acid belly rapidly dissolves portions of the afflicted creature's stomach lining, causing digestive fluids to spill out into the surrounding portions of the creature's body, mixing with the toxin as they go. Each round this toxin remains in effect, the afflicted foe takes 4d6 points of acid damage. For each round after the first that this toxin remains in effect, the afflicted creature takes 1 point of Constitution damage.

Blood Blindness

By disrupting the normal flow of blood to the afflicted creature's eyes, this toxin temporarily causes the victim's vision to fade to a murky black. Each round that this toxin remains in effect, the afflicted creature is blinded for one round. If the toxin runs into full course, the sudden resurgence of blood flow to the eyes bursts several critical bits of ocular anatomy, permanently blinding the creature until they receive the effects of a Remove Blindness spell or similar magic. Sightless creatures are immune to the effects of this toxin.

Rampant Decay

A very obvious and visible toxin, rampant decay causes large sections of the afflicted creature's flesh to experience rapid necrosis, blackening and releasing a foul odor. Each round that this toxin remains in effect, the victim takes 1d4 points of Constitution damage.

Searing Agony

Similar to the incandescent veins toxin, but much more potent, searing agony deals 3d6 points of fire damage each round that it remains in effect; resistance to fire does not apply to this damage, though immunity to fire does. Each time the afflicted creature takes damage from this toxin, it is rendered helpless for one round from the agony of feeling liquid fire in every vein of its body.

Wayfarer's Bane

A curious toxin in that it deals no damage of any kind, wayfarer's bane can nonetheless be extremely disruptive. Each time a creature fails a save against this toxin, it experiences extreme disorientation for one minute. While disoriented, the creature has a 50% chance to be rooted in place from vertigo whenever it tries to move in any fashion, including charging and 5-foot steps.


4th Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Blinding Rage
1 round
3 rounds
1 round
225 gp
26
Madness Fugue
1 round
1 minute
2 rounds
200 gp
24
Mutagenic Venom
None
Instant
Special
150 gp
24
Spitting Boils
1 round
1 minute
2 rounds
200 gp
24
Wasted Limbs
1 round
3 minutes
1 minute
225 gp
26

Blinding Rage

It is surprisingly simple to force a creature to experience indiscriminate rage with the proper serum. Blinding rage does just that, overstimulating the portion of an afflicted creature's mind that feels anger, while numbing every other emotion away to nearly nothing. Each round that this toxin remains in effect, the afflicted creature mindlessly attacks the nearest creature to the best of its ability, full-attacking if possible, or charging if not; if neither of these options are available, the creature moves as fast as it is able until it can make attacks through whatever means it possesses.

Madness Fugue

Similarly to the blinding rage toxin, madness fugue numbs away all reason and thought from an afflicted creature, causing it to act wildly. Each time the afflicted creature fails a save against this toxin, it is Confused (as the spell) for two rounds.

Mutagenic Venom

An exceptionally subtle toxin, this serum is incomplete on its own. As part of the creation process, the Plague Doctor mixes in a poison of his choice of any type, including inhaled poisons. This combined serum is then mixed into another of his toxins, to create a single dose of a double-layered toxin. You cannot mix mutagenic venom into any other mutagenic blood toxin.
While combined with the second toxin, mutagenic venom lies completely inert. Once the toxin to which it is attached is finished, whether by running its course, being overcome by the victim's body, or removed by a Remove Disease spell or similar, mutagenic venom flares to life, instantly subjecting the victim to the effects of the attached poison. Mutagenic venom is not removed by an initial application of Remove Disease, Heal or similar spells, only the toxin to which it is attached. A Wish, Miracle, or Limited Wish spell can remove both mutagenic venom and the toxin to which it is attached without triggering the effects of mutagenic venom.
The poison mixed into the mutagenic venom uses either its normal save or that of mutagenic venom, whichever is higher.

Spitting Boils

A gruesomely effective toxin, spitting boils causes palm-sized pustules to erupt across the afflicted creature's entire body, which spurt jets of toxin-laced pus at irregular intervals. Each time the afflicted creature fails its save, it takes 1d4 Constitution damage and the boils across its body erupt immediately and at the beginning of the next round, infecting all creatures within 10 feet of the victim unless they succeed on a Reflex save at the same DC as the toxin. A creature infected with spitting boils cannot be infected again while the toxin remains active, though it may be infected again after the disease has run its course.

Wasted Limbs

Brutally effective against those who rely on physical might to accomplish their goals, this toxin both dissolves muscle and wearies the body at the same time. Each round that the victim succumbs to this toxin, it takes 1d6 Strength damage. If the victim fails two or more consecutive saves, it is exhausted for one round in addition to taking the strength damage.


5th Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Delayed Assassin
1 round
Special
1 minute
350 gp
27
Flesheater
1 round
5 rounds
1 round
400 gp
28
Prismatic Death
1 round
4 rounds
1 round
400 gp
28
Rapid Palsy
1 round
3 rounds
1 round
450 gp
29
Stinking Miasma
1 round
5 minutes
1 minute
350 gp
27

Delayed Assassin

Unlike a normal toxin, this infection grows stronger the longer its victim holds out against its insidious effects. Each time the afflicted creature successfully saves against this toxin after its incubation period, its effects are delayed for 1 minute but the toxin is not negated. This toxin persists until the afflicted creature fails a save, at which point it takes 2d12 points of damage plus an additional 1d12 points of damage for each successful save it has made against this toxin.

Flesheater

Specially crafted to rot away the heavy armor of those who are protected by thick hides or durable flesh, this toxin corrodes the body's natural defenses. Each round that the victim succumbs to this toxin, it takes 2d12 points of damage. Each time the afflicted creature takes damage from this toxin, its natural armor bonus is reduced by 1 point, to a minimum of 0. This toxin has no effect on an enhancement bonus to natural armor (such as that granted by the Barkskin spell). A creature with its natural armor bonus reduced by this toxin only recovers this lost natural armor bonus when all damage dealt to it by this toxin has been healed. A creature that has no natural armor bonus (either naturally or as a result of this toxin) instead takes 1 point of Constitution damage each time it takes damage from this toxin, regardless of whether it has an enhancement bonus to natural armor.

Prismatic Death

This toxin creates an unstable biological anomaly that torments its victim. Each round, prismatic death deals 1d12 points of damage from each of four energy types (acid, cold, electricity, and fire), for a total of 4d12 points of damage; resistance to these energy types does not apply, but immunity does apply to the appropriate portion of the damage.

Rapid Palsy

Brutally effective against anyone who relies of speed or accuracy to accomplish their goals, this toxin quickly destroys the victim's fine motor control. Each round that the victim succumbs to this toxin, it takes 1d6 Dexterity damage.

Stinking Miasma

A curious toxin in that changes the inherent chemistry of the victim's body but deals no damage of any kind. Each time a creature fails a save against this toxin, it is sickened for one minute and exudes an extremely nauseating smell. While exuding the smell, all creatures that begin their turn within 10 feet of the victim are nauseated for 1 round unless unless they succeed on a Fortitude save at the same DC as the toxin.


6th Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Death's Knocking
1 day
Special
1 day
650 gp
30
Mutagenic Catalyser
None
Instant
Special
550 gp
30
Prototype Scythe Virus
1 round
1 day
Special
800 gp
31
Wrack and Ruin
1 round
5 rounds
1 round
750 gp
32

Death's Knocking

A victim infected with this toxin initially experiences nothing but a faint knocking sound; the sound has no negative effect, but is the first sign of the blood vessels in the target's brain contracting. A day later, the target hears another, louder knock, this one accompanied by intense pain as the blood vessels in his head spasm, knocking him unconscious for 24 hours. This process repeats again each day, until the victim fails three saves in a row, at which point the blood vessels in the victim's brain explode, killing him instantly. Unlike most toxins, death's knocking requires two consecutive successful saves to be removed. It is also exceptionally resilient; Remove Disease, Heal and similar spells merely revert the disease to its incubation period; a second application of disease-removing magic during the incubation period is necessary to completely eliminate the toxin.

Mutagenic Catalyser

This toxin functions as an advanced strain of mutagenic venom, with the same effects, except that the Plague Doctor may choose to use either a poison or one of his other blood toxins when making a dose of mutagenic catalyser. You cannot use a mutagenic blood toxin when making a dose of mutagenic catalyser, and you cannot mix mutagenic catalyser into any other mutagenic blood toxin.

Prototype Scythe Virus

A highly conspicuous toxin, this potent concoction has a delayed effect, but is far more virulent than most toxins of a comparable potency. After infection the subject breaks out in a large, itchy rash and develops a persistent, wracking cough. The toxin has no immediate effect, instead building in the victim's body for a full day. Any creature that touches the victim in this time is instantly subjected to the effects of the toxin; these secondary victims make their own save against the toxin, and if they fail their save they continue the cycle. After one day, the true power of the toxin takes effect, ripping through the immune system of the host with massive virulence, dealing 3d6 Constitution damage. The prototype scythe virus is an incomplete attempt at creating a true plague however, and cannot reduce a creature's Constitution score below 1.

Wrack and Ruin

With each failed save, the victim of this potent toxin spasms violently as every muscle in their body experiences tearing agony. The disorientation caused by this intense pain imposes a -5 penalty on attack rolls, damage rolls, saves, skill checks, ability checks, and caster level checks for one round on each failed save.



7th Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Assassin's Grin
None
5 rounds
Special
1000 gp
33
Dance of Agony
1 round
5 rounds
1 round
950 gp
33
Pyre's Touch
1 round
5 rounds
1 round
1,000 gp
34
Jaundiced Torture
1 round
5 rounds
1 round
1,100 gp
35

Assassin's Grin

A favorite blood toxin for anyone who seeks to inflict certain death, this serum nevertheless deals no damage or negative effects on its own. For the duration of this toxin, any damage dealt to the victim by a blood toxin, disease, or poison, including ability damage and energy damage, is considered vile damage.

Dance of Agony

XXX

Pyre's Touch

XXX

Jaundiced Torture

XXX


8th Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Blackwing Rot
1 round
3 rounds
1 round
1,450 gp
36
Mutagenic Pestilence
None
Instant
Special
1,500 gp
37
Scythe Virus Alpha
1 round
1 day
Special
1,750 gp
38

Blackwing Rot

The target of this toxin is filled with a joint-seeking corrosion, though the joint in question depends on the place of injection. On the first failed save the victim's skin begins to blacken as it is filled with an internal corruption that deals 1d6 Constitution damage. On a second failed save, the corruption is intensified and localized, focusing on a single major joint; in addition to taking another 1d6 Constitution damage, one of the victim's limbs rots away from the inside, bone and flesh alike turning into a foul sludge. Roll 1d4 to determine which of the victim's limbs (left and right arms, left and right legs) is destroyed. If the victim has more than four limbs, use an appropriately higher-sided die, though a creature with a very large number of limbs may not be notably inconvenienced by this effect of the toxin. If the victim loses a leg, its base speed is reduced to 5 feet and it always provokes attacks of opportunity whenever it tries to move in any fashion, including charging and 5-foot steps. If the victim fails a third consecutive save, the corruption shoots through its body, dissolving organs, bone, and flesh with equal impunity, killing the victim and reducing its body to a pile of sludge.

Mutagenic Pestilence

This toxin functions as an advanced strain of mutagenic catalyser, except that in addition to its normal effects, the mutagenic pestilence toxin mimics the toxin to which it was attached. When Mutagenic Pestilence activates the target is subjected to the original toxin again as well as the new, secondary toxin. You cannot use a mutagenic blood toxin when making a dose of mutagenic pestilence, and you cannot mix mutagenic pestilence into any other mutagenic blood toxin.

Scythe Virus Alpha

A more sophisticated version of the prototype scythe virus, this potent concoction also has a delayed effect, but is even more virulent than its predecessor. Unlike the prototype, a victim of this toxin shows no more symptoms of infection than a slight fever and a sniffle, less even than a common cold. The toxin has no immediate effect, instead building in the victim's body for a full day. Any creature that touches the victim in this time is instantly subjected to the effects of the toxin; these secondary victims make their own save against the toxin, and if they fail they continue the cycle. Unlike the prototype, others may also be infected by breathing the same air as the victim in an enclosed space, or by eating after them. After one day, the true power of the toxin takes effect, ripping through the immune system of the host with massive virulence, dealing 3d6 Constitution damage. The alpha scythe virus, while more powerful than it's prototype, shares one key flaw of the former's design, carrying with it the inability to reduce a creature's Constitution below 1.



9th Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Angel of Death
1 round
5 rounds
1 round
2,750 gp
40
Ceramic Necrosis
1 round
5 rounds
1 round
2,500 gp
39
Internal Decomposition
1 round
5 rounds
1 round
2,500 gp
39

Angel of Death

On a failed save, the target of this toxin feels not pain but incredible weakness as their vitality is drained, taking 2d6 Constitution damage. The victim's skin becomes gray and tight, and their body becomes gaunt and hairless as they rapidly waste away. The body of a victim that dies while this toxin is active, whether as a result of the Constitution damage from this blood toxin or by other means, curls upon itself with its hands clenched before it, appearing to all the world as a petitioner seeking his final judgment. With death the effects of the toxin fade, restoring the original palor of the creature. However, the toxin does not leave the body, instead remaining behind as an undetectable contact poison (Initial damage 3d6 Con, secondary damage Death) on the skin of the victim. This contact poison has the same Fortitude DC as the original Angel of Death toxin and lasts for up to a week after the original victim's death, or until the body receives the effects of a Neutralize Poison spell or similar magic.

Ceramic Necrosis

This insidious toxin seeps into the target's bloodstream painfully, calcifying veins as it goes, sinking down the body until it reaches the bones of the victim's legs. Each failed save against this toxin dissolves the bones of the victim, and the residue is spread through its veins and out of its pores before hardening, giving his skin an ivory luster. A creature that fails a save against this toxin has their base land speed halved, as well as any movement speeds that relying on their legs, and takes 2d6 Dexterity damage. This movement speed returns to normal only when the Dexterity damage caused by this toxin is healed entirely. If the victim's Dexterity drops to 0, it is considered ceramic as per the Glass Strike spell, as its skin and blood network is entirely coated with hardened bone.

Internal Decomposition

A horribly complex toxin, internal decomposition is nevertheless brutally simple in its execution. As the name implies, the toxin causes the victim's organs to rapidly decompose, turning into so much fetid waste. Each round that the toxin remains in effect, the victim takes 1d6 points of Constitution drain.


10th Tier Toxins


Toxin Name
Incubation Period
Duration
Effect Interval
Creation Cost
Craft DC
Final Hour
1 round
Special
1 round
5,950 gp
41
Mutagenic Neurotoxin
None
Instant
Special
6,000 gp
42
Scythe Virus Omega
1 round
1 week
Special
10,000 gp
45

Final Hour

XXX

Mutagenic Neurotoxin

Like the other toxins in the mutagenic line, mutagenic neurotoxin must be attached to a second toxin to have any effect. The toxin functions like other mutagenic toxins, except that it functions as its own standalone toxin, flaring to life when the attached toxin is removed or runs its course. You cannot mix mutagenic neurotoxin into any other mutagenic blood toxin.
When mutagenic neurotoxin is activated, each and every synapse and blood vessel in the victim's brain comes under attack from a viral assault; if the victim succeeds on its save, it takes 1d6 Intelligence damage. If it fails, its brain is immediately disintegrated within its skull, killing it instantly.

Scythe Virus Omega

The pinnacle of disease and poison, the scythe virus omega can kill entire populations with none knowing how or why. The initial target displays no symptoms on a failed save; indeed, they may even feel a bit livelier than before they were infected. For the next week however, anyone that touches them, breathes the same air as them in an enclosed space, or eats after them must save against the toxin or become infected themselves and begin the process anew. After a week inside the target the toxin takes effect, shattering their immune system and internal cycles, dealing 4d6 Constitution damage. The scythe virus omega overcomes the inherent flaws in the scythe virus line, gaining the capability to reduce Constitution scores to 0.


(Note: Though I have made many changes, edits, and additions, the original credit for these blood toxins and the companion class, the plague doctor, goes to Circle of Life - the original concept can be found in this thread here)