The Plague Doctor
| Level | Proficiency Bonus | Features | Cantrips Known | 1st | 2nd | 3rd | 4th | 5th | 6th | 7th | 8th | 9th |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1st | +2 | Spellcasting, Medicinal School | 3 | 2 | — | — | — | — | — | — | — | — |
| 2nd | +2 | Medicinal Charges, Infection | 3 | 3 | — | — | — | — | — | — | — | — |
| 3rd | +2 | Medicinal School Feature | 3 | 4 | 2 | — | — | — | — | — | — | — |
| 4th | +2 | Ability Score Improvement | 4 | 4 | 3 | _ | _ | _ | _ | _ | _ | _ |
| 5th | +3 | Cleanse | 4 | 4 | 3 | 2 | _ | _ | _ | _ | _ | _ |
| 6th | +3 | Medicinal School Feature | 4 | 4 | 3 | 3 | _ | _ | _ | _ | _ | _ |
| 7th | +3 | Creeping Shadow | 4 | 4 | 3 | 3 | 1 | _ | _ | _ | _ | _ |
| 8th | +3 | Ability Score Improvement | 4 | 4 | 3 | 3 | 2 | _ | _ | _ | _ | _ |
| 9th | +4 | Abrasive Smoke | 4 | 4 | 3 | 3 | 3 | 1 | _ | _ | _ | _ |
| 10th | +4 | Medicinal School Feature | 5 | 4 | 3 | 3 | 3 | 2 | _ | _ | _ | _ |
| 11th | +4 | Improved Cleansing | 5 | 4 | 3 | 3 | 3 | 2 | 1 | _ | _ | _ |
| 12th | +4 | Ability Score Improvement | 5 | 4 | 3 | 3 | 3 | 2 | 1 | _ | _ | _ |
| 13th | +5 | _ | 5 | 4 | 3 | 3 | 3 | 2 | 1 | 1 | _ | _ |
| 14th | +5 | Medicinal School Feature | 5 | 4 | 3 | 3 | 3 | 2 | 1 | 1 | _ | _ |
| 15th | +5 | Improved Cleansing | 5 | 4 | 3 | 3 | 3 | 2 | 1 | 1 | 1 | _ |
| 16th | +5 | Ability Score Improvement | 5 | 4 | 3 | 3 | 3 | 2 | 1 | 1 | 1 | _ |
| 17th | +6 | _ | 5 | 4 | 3 | 3 | 3 | 2 | 1 | 1 | 1 | 1 |
| 18th | +6 | _ | 5 | 4 | 3 | 3 | 3 | 3 | 1 | 1 | 1 | 1 |
| 19th | +6 | Ability Score Improvement | 5 | 4 | 3 | 3 | 3 | 3 | 2 | 1 | 1 | 1 |
| 20th | +6 | Medicinal School Mastery | 5 | 4 | 3 | 3 | 3 | 3 | 2 | 2 | 1 | 1 |
The Plague Doctor
The town has been muddied. Stench like that of sewage runs rampant in the air. A lone person in a beaked mask walks through. In one hand, a bag filled with various medicinal tools. In the other, a cane to help them examine the area without directly touching anything. This is the Plague Doctor.
A Reminder of One's Mortality
For some, the plague doctor is seen as a sign of salvation in places long since abandoned by the Clergy. For others, the Plague Doctor is a sign that it's their time to go.
The Bastion between Health and Disease
Each doctor will either heal the sick, or cause their enemies to become sick. Treat the Plague Doctor with the proper kindness and caution, and they'll be happy to help you.
Creating a Plague Doctor
One thing very important to the Plague Doctor is the reason for your practice in Medicine. Did you want to learn and master the diseases and the manipulation of them? Or were you more interested in the way the blood flows in the body? To become a Plague Doctor means to put yourself in the way of disease, and to study how the body is altered.
Quick Build
When creating a Plague Doctor, follow these suggestions: First, your highest ability score should be Intelligence; Dex or Constitution should follow. Then choose the Sage background.
Class Features
As a Plague Doctor, you gain the following class features
Hit Points
- Hit Dice: 1d8 per Plague Doctor level
- Hit Points at 1st Level: 8 + Constitution Modifier
- Hit Points at Higher Levels: 1d8 (or 5) + Constitution Modifier per Plague Doctor level after 1st
Proficiencies
- Armor: light armor
- Weapons: all simple weapons, finesse weapons
- Tools: Alchemist's Supplies, Herbalist kit, Poisoner's kit
- Saving Throws: Intelligence, Constitution
- Skills: Choose three from Sleight of Hand, History, Investigation, Nature, Medicine, Perception, Survival, Intimidation, and Persuasion
Equipment
You start with the following equipment, in addition to the equipment granted by your background:
- (a) a Rapier or (b) Whip
- Leather Armor
- (a) a light crossbow and 20 bolts or (b) 2 throwing daggers
- A staff
- A Plague Doctor's Mask
- A Medicinal Censer
- A Staff
- (a) a Priest's Pack or (b) a Scholar's Pack
Plague Doctor's Mask
The Mask is an essential part of the Plague Doctor's outfit. While wearing it, you have advantage on saving throws against Poison, Disease, and Infection, but disadvantage on Perception (Smell) checks due to the herbs stuffed into the beak.
Spellcasting
As part of your training as a Plague Doctor, your spells aid in either the quelling or spread spread of injury and disease. Refer to the end of the document for the Plague Doctor spell list.
Cantrips
At first level, you know 3 cantrips of your choice from the Plague Doctor Spell list. The number of Plague Doctor cantrips you know will increase as you level up based on the Plague Doctor cantrip table.
Preparing and Casting Spells
The Plague Doctor table shows how many spell slots you have to cast Plague Doctors 1st level and above. Casting a spell will expend the spell slot. All spell slots spent will be regained upon a long rest.
You prepare the list of Plague Doctor spells available for you to cast, based upon the Plague Doctor spell list. When doing so, choose a number of Plague Doctor spells equal to your plague doctor level + Intelligence modifier (minimum one). You must have slots for the spell level to select it from the Plague Doctor spell list.
For example, if you are a 3rd-level Plague Doctor with an Intelligence of 16, you have four first level spell slots, two second level spell slots, and have up to six spells of either level prepared. Furthermore, casting a spell in either level will not remove it from your list of prepared spells.
You can change the list of prepared spells each long rest through. To prepare a spell for the day, you are presumed to have packed your medicinal censer with various herbs and and spices.
Spellcasting ability
Intelligence is your spell casting ability for Plague Doctor spells. You are able to use these spells through your knowledge of the body, mind, and training from your Medicinal school. Whenever a spell refers to your spellcasting ability, you use Intelligence. Your intelligence modifier will also be used as a part of your Spell Save DC whenever you cast a Plague Doctor spell that requires a spell saving throw.
Spell Save DC
Spell attack modifier
Ritual Casting
You can cast Plague Doctor spells as ritual spells if your spell has the Ritual Tag, and you have that spell prepared.
Spellcasting Focus
Your Medicinal Censer is your spellcasting focus.
Medicinal School
Choose one of two Medicinal schools to come from: Plague Warden, or Blood Cleanser. Both Medicinal Schools have their own focus, which is detailed in their respective School. Following a school will give you traits unique to that school.
Medicinal Charges
The first skill all Plague Doctors learn at second level is how to create Medicinal Charges. These charges can either help or harm your allies or enemies. As an action, Choose a target within 30 ft of you, and choose one of the following effects:
| Effect |
|---|
| Restore current HP |
| Cure Poisoning |
| Cure Infection |
| Cure Blindness |
| Effect |
|---|
| Reduce current HP |
| Cause Poisoning |
| Cause Infection |
| Cause Blindness |
You can perform this ability up to half of your Intelligence Modifier + Your Plague Doctor level.
You can regain one use of this ability during a short rest by expending one of your hit dice, and all expended uses will be regained upon a long rest.
HP Effects
Restoring or Reducing HP at this ability starts at 1d4. This gets increased to 1d6 at 5th, 1d8 at 9th, 1d10 at 13th, 1d12 at 16th.
If this ability is used to Reduce HP, make a ranged spell attack roll as normal.
Conditions
To cause a condition, the target creature must make a Constitution saving throw against your Spell DC. To cure a condition, you must make an Intelligence saving throw against your Spell DC.
Infection
Also starting at 2nd level, you have studied the way flesh reacts to disease long enough to cause or cure infection in a target creature. See the Conditions and table above to see how to cause or cure.
Condition: Infected
While a creature is infected, it suffers minor adverse effects such as a cough or fatigue, and is unable to gain advantage by any means. Many of your plague doctor unique spells and class features interact with the infected condition. This infection is unique to you, therefore you should track infections from other sources separately. The infected condition can be removed with lesser restoration or similar healing magic.
Ability Score Improvement
When you reach 4th, 8th, 12th, 16th, and 19th levels, you can improve either one ability score by two, or two ability scores by one. You cannot get an ability score above 20 this way.
Cleanse
Starting at 5th level, when you reach the appropriate Plague Doctor levels, you can restore one condition affecting a friendly character.
Due to the intense preparation and performance of casting spells this way, this can only be performed once per long rest.
Creeping Shadow
At 7th level, as an action, you create a trail of smoke from burning incense that tracks down one target creature within 60 ft. The target creature must make a Dexterity saving throw or become restrained. Once restrained, it must make a strength saving throw on each of its turns to break out. The saving throws must be done against your Spell DC. This can be done once per long rest.
At 10th, 14th, and 20th levels, you can target one additional creature.
Abrasive Smoke
At 9th level, as an action, you can burn poison ivy, or similar plants, you create a wall of smoke 15 feet wide and 5 feet high in front of you that lasts for 1 minute. Creatures that pass through or stop in this wall of smoke must make a Constitution saving throw vs your Spell DC. If a creature is infected when they pass through or stop in the smoke, they have disadvantage. Upon a failed saving throw, they take 4d6 acid damage, and half as much on a successful saving throw.
This can be performed up to three times per long rest.
Medicinal Mastery
Upon reaching 20th level, the Plague Doctor has become a luminary of their Medicinal School. These masteries can be performed once per long rest and will be detailed in the Medicinal Schools.
Medicinal Schools
Plague Doctors will subscribe to the philosophy of the Medicinal School that they believe they will learn the most from.
Plague Warden
Plague Wardens are the Plague Doctors that most likely tend to the sick and wounded. They believe that the best way to represent their profession is by spending time with the public, even if their presence is not always welcome. They take the basics of their profession, and go above and beyond with what they've been taught.
Greater Resilience
At first level, by willingly subjecting themselves to harmful situations, they gain advantage in saving throws against Poison, Infection, and Disease. By continuing to subject themselves to these situations, they gain full immunity by 10th level.
Infectious Casting
When you cast spells that deal Acid, Disease, Poison, or Necrotic damage, you can force the target creature to make a Constitution saving throw to avoid being infected. When you reach 9th level, this will also apply to Abrasive Smoke.
Grave Infection
At 3rd level, saving throws vs Infection will become Spell DC + 2.
Carrier
At 6th level, Choose yourself or one non-hostile creature within 60 ft. That creature becomes a carrier. If the carrier makes a melee attack against a hostile creature, or if the hostile creature makes a melee attack against the carrier, the hostile creature must make a Constitution saving throw vs your Spell DC. If you are the carrier, the Spell DC + 2. If the hostile creature fails, it becomes infected. This takes an action, and can only be done once per long rest.
Scalding Abrasion
At 10th level, the DC for Abrasive Smoke become Spell DC + 2, and deals an additional 2d6 acid damage.
Cloak of Fog
At 14th level, as an action, you can create a cloud of fog surrounding you for 10 feet. This lasts for one minute.
If a friendly creature comes in range, they regain 6d6 + Intelligence Modifier HP.
If a hostile creature comes in range, they must make a Constitution Saving throw vs your Spell DC + 3. If the creature fails the saving throw, they become infected.
Furthermore, any attack made against you has disadvantage while you're in the fog.
Medicinal Mastery
The effects of your restore and reduce HP medicinal charges have become doubled. Furthermore, you automatically succeed your restorative medicinal charges, and your target creature fails their saving throws against your medicinal charges.
Blood Cleanser
While studying under this school of medicine, Plague Doctors learn the way blood flows, and how to best extract it. The more blood that flows, the better for them to study, after all.
Deadly Smudging
By bathing your weapon in smoke, your attack against a creature forces them to make a Constitution save against your Spell DC. If the creature fails, they become infected. This can be done once per short rest.
Bloody Smudging
Starting at 3rd level, If you previously used the Deadly Smudging ability this turn, you can make a bonus attack this turn against that creature.
Blood Sample
At 6th level, when a Blood Cleanser makes an attack against a creature using a finesse weapon, they gain an additional 1d4 to add onto either their attack or damage rolls. This increases by 1d4 at 10th, 14th, and 20th levels. Alternatively, if the creature is infected, the 1d4 can be replaced by 1d6 at 6th, 1d8 at 10th, 1d10 at 14th, or 1d12 at 20th levels if this ability is being used for the damage roll.
This can be once per long rest.
Abrasive Smudging
At 10th level, if you use the Abrasive Smoke ability, you can alternatively use it to use deadly smudging ability instead. However, instead of dealing 4d6 acid damage as per normal, you deal 1d6 acid damage in addition to your regular damage roll. The target creature must then make a Constitution saving throw vs your Spell DC. If it fails, it suffers the infected condition.
Extraction from the Trapped
At 14th level, if you use Creeping Shadow, and the target creature fails their Dexterity saving throw, you gain +5 to your damage roll against that creature as long as it is held by Creeping Shadow.
Medicinal Mastery
Attacks made against an infected or restrained creature are treated as if you rolled a 20 naturally.
Cantrips (0 Level)
- Acid Splash
- Chill Touch
- Frostbite
- Infestation
- Mage Hand
- Mending
- Minor Illusion
- Poison Spray
- Prestidigitation
- Resistance
- Spare the Dying
- Toll the Dead
1st Level
- Bane
- Cause Fear
- Chaos Bolt
- Charm Person
- Chromatic Orb
- Color Spray
- Command
- Create or Destroy Water
- Cure Wounds
- Detect Evil and Good
- Detect Magic
- Detect Poison and Disease
- Dissonant Whispers
- False Life
- Fog Cloud
- Healing Word
- Identify
- Illusory Script
- Inflict Wounds
- Miasma
- Protection from Evil and Good
- Ray of Sickness
- Searing Smite
- Silent Image
- Sleep
2nd Level
- Aid
- Blindness/Deafness
- Blur
- Continual Flame
- Crown of Madness
- Darkness
- Darkvision
- Dragon's Breath
- Enhance Ability
- Expunge
- Gentle Repose
- Healing Spirit
- Hold Person
- Invisibility
- Lesser Restoration
- Locate Animals or Plants
- Locate Object
- Mirror Image
- Misty Step
- Pass Without Trace
- Phantasmal Force
- Protection from Poison
- Ray of Enfeeblement
- Shadow Blade
- Silence
- Suggestion
- Warding Bond
- Warding Wind
- Web
3rd Level
- Animate Dead
- Aura of Vitality
- Bestow Curse
- Call Lightning
- Catnap
- Conjure Animals
- Counterspell
- Create Food and Water
- Dispel Magic
- Elemental Weapon
- Enemies Abound
- Fear
- Feign Death
- Glyph of Warding
- Hypnotic Pattern
- Life Transference
- Magic Circle
- Major Image
- Mass Healing Word
- Nondetection
- Plant Growth
- Protection from Energy
- Remove Curse
- Revivify
- Slow
- Speak with Dead
- Stinking Cloud
- Vampiric Touch
- Vermintide
4th Level
- Aura of Life
- Aura of Purity
- Blight
- Death Ward
- Freedom of Movement
- Giant Insect
- Phantasmal Killer
- Shadow of Moil
- Sickening Radiance
- Vitriolic Sphere
- Wall of Corpses
5th Level
- Cloudkill
- Cone of Cold
- Contagion
- Creation
- Danse Macabre
- Deadly Pathogen
- Dispel Evil and Good
- Dream
- Enervation
- Far Step
- Greater Restoration
- Insect Plague
- Negative Energy Flood
- Steel Wind Strike
6th Level
- Circle of Death
- Contingency
- Create Undead
- Disintegrate
- Eyebite
- Harm
- Heal
- Investiture of Wind
- Maddening Haze
- Mental Prison
- Mass Suggestion
- Soul Cage
- Tenser's Transformation
- Wind Walk
7th Level
- Divine Word
- Etherealness
- Finger of Death
- Forecage
- Mirage Arcane
- Nebulous Form
- Power Word Pain
- Primsatic Spray
- Project Image
- Regenerate
- Resurrection
- Sequester
- Simulacrum
- Symbol
8th Level
- Abi-Dalzim's Horrid Wilting
- Antimagic Field
- Antipathy/Sympathy
- Clone
- Dominate Monster
- Feeblemind
- Glibness
- Illusory Dragon
- Incendiary Cloud
- Maddening Darkness
- Namtar's Revulsion
- Power Word Stun
9th Level
- Imprisonment
- Invulnerability
- Mass Heal
- Pandemic
- Power Word Heal
- Power Word Kill
- Prismatic Wall
- Psychic Scream
- True Resurrection
- Weird
- Wish
Notation Meaning
Spells that are indented are spells from Xanathar's Guide to Everything. Spells that are bold are spells that Luke Mortora graciously allowed me to use.
Miasma
1st Level Conjuration
- Casting Time: 1 action
- Range: 60 feet
- Components: V, S, M (a piece of blue toadshade mushroom)
- Duration: Concentration, up to 1 minute
You make a swirling motion with your hands and conjure a barely visible pale green cloud, riddled with all manner of toxic substances.
You create a 5ft radius cloud of poisonous gas centered on a point within range which lasts for the duration. The cloud spreads around corners. When a creature enters the spell's area for the first time on a turn or starts its turn there, that creature must make a Constitution saving throw or take 2d4 poison damage and become infected for 1 hour. If the creature succeed, they take half as much damage, and do not become infected.
Whilst concentrating on the spell, you can use your bonus action to move the area up to 20 feet to a point within range you can see.
At Higher Levels: When you cast this spell using a spell slot of 2nd level or higher, you can increase the radius that miasma covers increases by an additional 5 feet per spell level beyond the 1st, up to a maximum of 10 additional feet.
Expunge
2nd Level Evocation
- Casting Time: 1 action
- Range: 120 feet
- Components: V, M (a dried leech)
- Duration: Instant
A sickly wave of energy erupts from your hand, accelerating the effects of nearby infections and causing them to burst violently from their hosts.
You target any number of creatures within range that are currently infected by you. The target creatures and any creature within 5ft of each target must make a constitution saving throw or take 1d6 poison damage. If a creature would be subjected to multiple instances of this effect, they make this saving throw only once, and all sources of damage apply. Creatures that pass the saving throw take half damage. Targets of the spell are no longer infected.
At Higher Levels: When you cast this spell using a spell slot of 3rd level or higher, the damage of expunge increases by 1d6 for each slot level above 2nd up to a maximum of 3d6 additional damage.
Vermintide
3rd Level Conjuration
- Casting Time: 1 action
- Range: 12 fet
- Components: V, S, M (a small rodent's skull)
- Duration: Instant
You target a creature within range that is currently infected by you and conjure a swathe of rats and vermin which overwhelm it. The creature must make a dexterity saving throw or become incapacitated and take 4d4 piercing damage at the start of each of its turns.
A creature incapacitated this way can make a dexterity saving throw at the end of each of its turns to end this effect.
If it succeeds on this saving throw it instead takes half damage and is only incapacitated until the end of it's next turn.
A creature that is incapacitated by this spell by any means has its speed reduced to 0.
Once the effect ends the rats disperse and vanish.
Deadly Pathogen
5th Level Evocation
- Casting Time: 1 action
- Range: 120 feet
- Components: V, S
- Duration: Instant
You point at a creature and a streak of pale green energy shoots from your hand and strikes it.
A target within range must make a constitution saving throw. If it is infected by you, it makes this saving throw with disadvantage. On a failed save, the creature takes 4d10 + 20 poison damage and becomes poisoned for 1 minute.
A creature poisoned this way takes 2d10 + 10 poison damage at the start of each of its turns.
On a successful save, the creature takes half damage and is not poisoned.
At Higher Levels: When you cast this spell using a spell slot of 6th level or higher, the damage of all effects caused by this spell increases by 1d10 for each slot level above 5th.
Maddening Haze
6th Level Enchantment
- Casting Time: 1 action
- Range: 300 feet
- Components: V, M (a drop of mercury)
- Duration: Instant
You must be concentrating on a miasma spell in order to cast this spell, otherwise the spell fails.
Your miasma turns a shade of purple as you magically infuse it with hallucinogenic toxins.
All creatures within the area of effect of your miasma must succeed on a Wisdom saving throw or take 6d8 psychic damage and use its reaction to immediately move up to its speed and make a melee attack with advantage against a random creature also within the miasma. On a successful save, a creature takes half damage and does not use its reaction.
Nebulous Form
7th Level Transmutation
- Casting Time: 1 action
- Range: Touch
- Components: V, S, M (a small vial of poisonous gas)
- Duration: Concentration, up to one hour
You transform a willing creature you touch, along with everything it's wearing and carrying, into a gaseous plague cloud for the duration. The spell ends if the creature drops to 0 hit points. An incorporeal creature isn't affected. While in this form, the target's only method of movement is a flying speed of 50ft. The target has resistance to nonmagical damage, and has advantage on Strength, Dexterity and Constitution saving throws.
The target can pass through small holes, narrow openings, and even mere cracks, though it treats liquids as though they were solid surfaces. The target can't fall and remains hovering in the air even when stunned or otherwise incapacitated.
While in the form of a gaseous plague cloud, the target can't talk or manipulate objects, and any objects it was carrying or holding can't be dropped, used, or otherwise interacted with. The target can't attack or cast spells.
The target can enter and occupy the space of another creature - if it chooses to do so at any point, that creature must make a consitution saving throw or take 8d8 poison damage and become infected for 1 hour. On a successful save, the creature takes half damage and is not infected.
Namtar's Revulsion
8th Level Illusion
- Casting Time: 1 action
- Range: 120 feet
- Components: S, M (psilocybin mushrooms)
- Duration: Instant
You conjure up vile false images and smells which attempt to overwhelm a creature's senses.
Choose any number of creatures within range that are currently infected by you. These creatures must succeed on a wisdom saving throw or take 8d6 psychic damage. On a successful save, a creature takes half damage. On a failed save, the creature falls prone and is incapacitated as it begins vomiting profusely if it is able to vomit.
At the start of each of its turns it succeed on a constitution saving throw or take 4d6 psychic damage, and be incapacitated and fall prone as it continues to vomit.
A creature incapacitated by this spell has its speed halved.
Pandemic
9th level Enchantment
- Casting Time: 1 action
- Range: 120 feet
- Components: V, S, M (A Plague Doctor's mask, which you are wearing)
You start a worrying Eulogy which resigns the irredeemably sick to death, intended to open the gates to the afterlife.
You target any number creatures within range that are currently infected by you. If the target has 50 hit points or fewer, it dies. If the target has more than 50 hit points, it must succeed on a constitution saving throw or take 5d10 + Intelligence Modifier in poison damage. Any creature that dies expels noxious fumes to a range of 10ft. All creatures within this area must succeed on a constitution saving throw or become infected by you for 1 hour.
Credits
- Again, thank you to Luke Mortora for allowing me to use the Infected Condition, as well as the spells created specifically for his version of the class.
Plague Doctor Art: Doctor Schnabel of Rome