Damage

Characters can suffer three types of damage. Fists and feet, along with other kinds of low-impact trauma, deal bashing damage.
Brass knuckles, knives, and speeding trucks deal lethal damage.
Human characters always take lethal damage from weapons.
Some horrifying scenarios may deal aggravated damage. When something deals aggravated damage directly, it’s quite obvious. Flesh bubbles and sloughs away.
Foaming pustules taint the victim’s flesh. Blackened veins streak out from the site of the injury.
A character’s Health track contains a number of boxes equal to his Health, determined by his Stamina + Size.

Marking Damage

When a character suffers bashing damage, mark it with a slash (/) in the leftmost empty box of his health track.
When a character suffers lethal damage, mark it with an X in the leftmost box of his health track that doesn’t contain lethal or aggravated damage. If you mark over a point of bashing damage, it moves one box to the right.
When a character suffers aggravated damage, mark it with a large asterisk (*) in the leftmost box that doesn’t already contain aggravated damage. If you mark over a point of bashing or lethal damage, it all moves one box to the right.
Always mark the most severe injuries at the left of a character’s health track, and push any less severe injuries to the right. Characters heal their rightmost health boxes first and progress left.

Wound Penalties

As a character takes damage, it impairs her ability to act.
When one of her three rightmost Health boxes has damage marked, she suffers a penalty accordingly. Subtract this penalty from every action she performs, including rolling for Initiative, but not including Stamina rolls to stay conscious.

Full Health Tracks and Upgrading Damage

If a character’s Health track is filled with bashing damage, each point of further bashing or lethal damage upgrades the leftmost point of bashing damage to lethal — turn one of the slashes into an X. When a character’s rightmost Health box has bashing damage marked in it, his player must make a reflexive (lower of Stamina or Resolve) roll each turn for him to remain conscious. If a character’s Health track is filled with lethal damage, each point of further damage upgrades an existing point of lethal damage to aggravated. Turn the leftmost X into an asterisk. When a character’s rightmost Health box has lethal damage marked in it, he takes another point of damage each minute (upgrading existing lethal damage to aggravated) until he receives medical attention, mundane or supernatural. If a character’s Health track is filled with aggravated damage, he's dead.

Disease

Outside of combat, a character who suffers from a disease suffers damage over a period of time. Resisting the damage inflicted by a disease requires a reflexive Stamina + Resolve roll. This roll is not contested but the roll is modified by the severity of the disease. Only one success is necessary to avoid damage each time.
Some diseases are the kind that people don’t heal from. A character’s cancer could go into remission, or he can hold his HIV back with medication, but time alone won’t cure them. The Storyteller should set a benchmark of how many rolls the character has to succeed at in a row for the disease to go into remission. Medical treatment can offset any penalties to the Stamina + Resolve roll applied by the disease — but might inflict penalties on other rolls, as the cure is almost as bad as the disease.

Drugs

A character who has taken drugs, willingly or not, must fight off the effects of the drug. Resisting the effects requires a reflexive Stamina + Resolve roll. This roll is not contested but is modified by the potency of the drug ingested. Only one success is necessary for a character to regain her senses. In the case of some drugs, this roll must be made once per hour, once per scene — or even once per turn, in the case of strong hallucinogens or narcotics.
Characters who overdose on drugs treat the drug like a poison, with a Toxicity somewhere between 3 and 7. The overdose deals damage once per hour until the drug has run its course — if a character’s spent eight hours drinking, then the poison takes another eight hours to fade, with a Toxicity between 3 (beer or wine) to 5 (rubbing alcohol). A character who injects stronger heroin than expected takes damage for (eight minus Stamina) hours, with a Toxicity of 7.

Electricity

Electrocution automatically causes bashing damage per turn of exposure. No attack roll is made.
such as there’s a constant flow such as through power cables, a victim may not be able to escape. His muscles contract, which can prevent him from pulling away. Roll Strength as a reflexive action during each turn of contact. Failure means your character is still connected to the source and suffers its damage each turn until a successful roll is made.

Worn armor provides no protection against electrocution, although specialized, nonconductive clothing can reduce or eliminate the hazard.

Extreme Environment

The human body is not conditioned to withstand extreme heat, cold, air pressure, or other extreme weather conditions. These harsh conditions hinder and endanger unpre- pared characters. When exposed to a harsh environment, the Storyteller assigns a level to the environment, using the chart below as a guideline. Survival gear can reduce the effective environment level.
As long as characters are exposed to these conditions, they suffer the level of the environment as a penalty to all actions. After a number of hours equal to the character’s Stamina, he takes bashing damage, once per hour. In the case of a level three exposure, the damage is lethal. Fourth level environments cause lethal damage each turn after a number of turns equal to the character’s Stamina.
Any damage caused by level two through four exposure leaves lasting marks, scars, and tissue damage. Damage caused by extreme environments cannot be healed until the character is back in a safe environment.

Falling

Falling inflicts one point of damage per three meters fallen. This is bashing damage, unless the character falls on something that would inflict lethal damage, like a sharp fence post or broken glass. If a character falls 30 meters or more, he reaches terminal velocity, and instead takes a flat 10 lethal damage, regardless of the total distance he falls. If the character has the opportunity to slow his fall, for example by grabbing an awning, or to soften it, such as by twisting to land on soil rather than concrete, his player may make a Dexterity + Athletics roll, with each success on the roll reducing the damage the character takes by one point. It’s typically not possible to slow or soften a fall at terminal velocity.

Fire

Fire automatically inflicts lethal damage per turn of exposure (no attack roll is required). The damage inflicted depends on both the size and intensity of the flames.

So, a fire the size of a bonfire (2) and with the intensity of a torch (+1) inflicts three damage per turn of contact.
In general, if exposure to fire persists for more than a turn, it catches anything combustible. A burning character continues to take full damage, even if he escapes the original source of the flame. Depending on the accelerant involved, the size of a fire can be reduced by one point per turn by means such as a hose or extinguisher. The Storyteller may rule that a fire goes out immediately under some circumstances (local oxygen is removed with a controlled explosion or your character is completely immersed in water). Or, a fire could continue to burn despite efforts to put it out, as with a grease fire when water is poured on it. Most armor can block its general rating in fire damage automatically for a number of turns equal to that rating.

Poison

Outside of combat, a character who is the victim of a poison or toxin suffers lethal damage over a period of time equal to the poison’s Toxicity. Some substances deal this damage only once. Others deal this damage once per turn or once per hour until purged, or until the poison has run its course. To resist the damage, make a reflexive Stamina + Resolve – Toxicity roll. Each success reduces the damage taken by one. This roll must be made every time the poison deals damage, unless the character stops fighting and gives in.