Combat in the Archetype System, like all other aspects of the game, is heavily dependent on the use of skills. The two primary skills used during combat encounters are Attack and Defense, with occasional use of Casting and, rarely, other skills, and actions in combat are resolved by contested rolls between them.
Structure of Combat
Combat in the Archetype System uses two measurements of time; a tick is the minimum amount of time for a turn to resolve, and a cycle is a round of twelve ticks. A cycle takes roughly six seconds. Each character gets to resolve one action per turn, but the type of action determines the minimum length of that turn. At the start of combat, each player determines what tick they begin their first turn on, begin an action on that turn, and then begin tracking from there based on the length of their action. Any actions that happen on the same tick are considered simultaneous, though by necessity they may have to be described in sequence.
Surprise Actions
Sometimes, a character or group of characters manage to surprise others with an attack that initiates combat. This action is considered to occur on Tick Zero; it is resolved just like any other action, but is considered to begin one tick before Tick One. Any characters that do not have protection against surprise actions begin combat on Tick One. Any characters that do have protection against surprise actions may begin an action on Tick Zero alongside the surprising parties. Any characters that act on Tick Zero have already begun combat and begin counting their action lengths as normal.
Initial Actions
Any characters that do not act on Tick Zero, either because they were surprised or because there was no surprise action, determine their first tick by subtracting their Cunning score from 13, with a minimum result of 1. So a character with a Cunning score of 6 that did not act on Tick Zero would begin their first turn on Tick Seven, because 13-6=7. A character with any Cunning score at or above 12 would begin their first turn on Tick One.
Tracking Turns
Each action in the game has a certain duration measured in ticks. Some are variable while others are preset. Please see the Actions List for action lengths, with the understanding that Fate may have to determine the length of any action not provided. When a character takes an action, that action occupies a number of ticks equal to the action length, and they may take another action on the tick following the end of that action. So if a character draws an accessible weapon on Tick Five, since drawing an accessible weapon is a one-tick action, they may take another action on Tick Six. However, if they cast a four-tick spell on Tick Five, they would not be able to act again until Tick Nine. The character is considered to be performing the stated action during the entire time between turns, and may not make additional actions during that time unless they have an Augment or Occupation feature that permits it. The effects of an action are not applied until the last tick of the action length. The cycle is a true cycle; Tick Twelve of Cycle One is immediately followed by Tick One of Cycle Two. Action lengths do not reset at the beginning of a cycle, it is simply easier to count to twelve and start over than to count every single tick in an encounter as a constantly-increasing number, and certain long-duration actions may be measured in cycles.

Characters may hold their turn indefinitely. Because timed effects are measured in ticks rather than in turns, holding a turn does not interfere with timed effects already in progress. There is no consequence for holding a turn except that the character waits longer to take an action. This is useful for characters that want to time an action with another character or respond quickly to a trigger.
Players may track their turns any way they choose, as long as the whole table is using the same system. The easiest ways to do this are to use a d12 to indicate the tick of a character's next turn, or to use a combat wheel like the one shown here. If using a wheel, players should have tokens that represent their characters and move them around the wheel to indicate what tick they will act on, with a Fate token moving to indicate the current tick.
Players may track their turns any way they choose, as long as the whole table is using the same system. The easiest ways to do this are to use a d12 to indicate the tick of a character's next turn, or to use a combat wheel like the one shown here. If using a wheel, players should have tokens that represent their characters and move them around the wheel to indicate what tick they will act on, with a Fate token moving to indicate the current tick.
Interrupting Actions
Any character taking a turn during another character's action length may attempt to interrupt the existing action. This will always involve some action capable of distracting, disabling, or redirecting the actions of the other character, which the first character can attempt to ignore with the relevant Resist check, which uses Endurance and has a DC equal to 10 + damage dealt. For instance, if Susan is casting the four-tick spell mentioned above, Dave may choose to use his turn on Tick Six to attempt to interrupt the spell. Dave already has a knife drawn and is in melee range, so he elects to use a basic attack (a two-tick action) to stab Susan and distract her. If the attack resolves in Dave's favor and he deals five points of damage (see Resolve the Action below), Susan must succeed on a Resilience (Endurance) check against a DC of 15. If she fails this check, her action ends in failure immediately on Tick Seven (when Dave's attack resolved), and both Susan and Dave may act again on Tick Eight. If she succeeds on this check, she takes the damage but continues casting the spell.
Characters may choose to interrupt themselves. Usually this is a result of changing conditions, such as the death of an action's target. If this happens, the character may either redirect the action to a new target and continue it without any additional length added, or can simply drop the action (which results in an automatic failure) and begin a new turn on the following tick. Using the same spell example as before, if Susan's target suddenly moved out of line of effect on Tick Seven, she may immediately choose to either select a new target and continue the spell, or cancel the spell and begin a new action on Tick Eight.
Characters may choose to interrupt themselves. Usually this is a result of changing conditions, such as the death of an action's target. If this happens, the character may either redirect the action to a new target and continue it without any additional length added, or can simply drop the action (which results in an automatic failure) and begin a new turn on the following tick. Using the same spell example as before, if Susan's target suddenly moved out of line of effect on Tick Seven, she may immediately choose to either select a new target and continue the spell, or cancel the spell and begin a new action on Tick Eight.
Movement
Movement is not on the Action Length list because its distance varies by character. During each movement action, a character may move a maximum number of feet equal to the mean average of their Strength and Agility scores, rounded down. So if a character has a Strength of 8 and an Agility of 5, they may move (8+5)/2 feet, which rounds down to 6 feet per movement action. Each movement action is a two-tick action.
Taking An Action
Each action that is not automatic is resolved by way of a die roll that happens on the last tick of the action. If the action affects any other character(s), that character may choose to oppose the action with a contested roll. Automatic actions are those that have a reasonable expectation of success; this includes things like drawing an accessible weapon (like a sword in a sheath on the player's belt or a pen clipped neatly in a shirt pocket), moving over smooth and stable terrain, or normal conversation. Most automatic actions are one-tick actions (such as movement) or nonactions (actions that do not occupy their own block of time, but happen during other actions, such as speech). All other actions follow the process below.
While combat is the only time when counting ticks is required, using them for other scenes is permitted when deemed appropriate by an agreement among the table.
While combat is the only time when counting ticks is required, using them for other scenes is permitted when deemed appropriate by an agreement among the table.
Declare the Action
A player must inform Fate of the action they seek to attempt. Any cost required to perform the action must be spent immediately and is not recovered if the action fails for any reason (although ammunition may be recovered if the attack is never completed, if Fate rules that the shot has not yet been fired). The character is then considered occupied for the entirety of the action length.
Resolve the Action
If an action requires a roll, the roll is performed on the last tick of the action. So Susan, casting a four-tick spell on Tick Five, would complete the spell and roll for its effect on Tick Eight. If the rolled action affects any other character, that character can choose to immediately roll to prevent that action from affecting them. The action is resolved through the following steps:
Example: Susan has cast a four-tick spell targeting Dave, and declared that spell on Tick Five. The spell is designed to deal 2d8 Systemic damage, through poisoning, using Life magic. Fate has determined that the particular way she's using the spell will run on her Intelligence. On Tick Eight, Susan rolls Life (a branch of Casting) and adds her Intelligence score as a modifier to that roll. Her result is 21. Dave is unaware he is the target of the spell, so she rolls against his passive Dodge, which is a 12. With this success, she rolls 2d8 + 9, the nine coming from the difference between 21 and 12. She rolls a 3 and a 5, for a result of 17. Dave now rolls Fortitude; unfortunately, he doesn't have any ranks in Fortitude, so he rolls his three ranks of Resist instead, which gives him 3d8 plus his Endurance rank, which is 4. If he rolls a total of 15, he takes 2 Systemic damage; if he instead rolls a 20, he takes no damage.
- The attacker rolls the skill they are using for their effect, and the defender rolls either Dodge (if they are trying to move out of the way), Parry (if they are trying to redirect the attack away from themselves), or a relevant skill on either the Dodge or Parry branches. If the defender cannot actively dodge or parry the effect (usually because they have no way to know the effect is coming), the attacker instead rolls against a DC equal to the character's passive Dodge (defender character level + defender Dodge rank + defender Agility rank).
- If the defender rolls a higher result, the effect is successfully avoided, and the action is resolved. If the attacker rolls a higher result or exceeds the defender's passive Dodge (when relevant), then the difference between the attacker's roll and the defender's roll (or value) is applied as a damage modifier on the attack.
- If the effect was successful, the attacker rolls the damage for the attack with the damage modifier added to the result of the die roll. The defender then rolls Fortitude (for systemic damage), Resilience (for bodily damage), or Willpower (for mental damage). The defender subtracts the result of their roll from the result of the damage roll, with a minimum result of zero, and applies the remaining amount of damage to their character (see Recovery and Types of Damage below). This resolves the attack.
- If the attack has a lasting effect, the attacker and defender repeat step 3 at the effect's stated interval until the effect ends. Effects do not end prematurely when the attacker falls unconscious or dies, unless the effect was actively maintained by the attacker. Some effects do not end until the defender receives medical attention or successfully heals.
Example: Susan has cast a four-tick spell targeting Dave, and declared that spell on Tick Five. The spell is designed to deal 2d8 Systemic damage, through poisoning, using Life magic. Fate has determined that the particular way she's using the spell will run on her Intelligence. On Tick Eight, Susan rolls Life (a branch of Casting) and adds her Intelligence score as a modifier to that roll. Her result is 21. Dave is unaware he is the target of the spell, so she rolls against his passive Dodge, which is a 12. With this success, she rolls 2d8 + 9, the nine coming from the difference between 21 and 12. She rolls a 3 and a 5, for a result of 17. Dave now rolls Fortitude; unfortunately, he doesn't have any ranks in Fortitude, so he rolls his three ranks of Resist instead, which gives him 3d8 plus his Endurance rank, which is 4. If he rolls a total of 15, he takes 2 Systemic damage; if he instead rolls a 20, he takes no damage.
Recovery and Types of Damage
The Archetype System allows for a variety of damage types, which fall broadly into three categories. These are bodily damage, systemic damage, and mental damage. While the process of resolving an attack is the same for all of them, the actual effects and process of healing from them are distinct for each category. All categories will, to some degree, require the character to rest for any active attempts at healing.
Rest is any recreational or restorative activity. A character at rest is not required to be asleep; they may instead engage in light hobbies, hang out with friends, read a book, play a video game, or any number of other similar activities. The important thing is that the character is not pushing their body or mind beyond what could be considered casual activity. There is some degree of interpretation that will need to be applied, based on the character and the kind of damage they are recovering from; while a short hike is absolutely not considered restful for someone recovering from a broken leg, it may be restful for the mind if the character is inclined to view it that way. The fact that rest does not require the character to be stationary or asleep means that game can continue during periods of rest, even if they must continue with a lower level of pressure.
Rest is any recreational or restorative activity. A character at rest is not required to be asleep; they may instead engage in light hobbies, hang out with friends, read a book, play a video game, or any number of other similar activities. The important thing is that the character is not pushing their body or mind beyond what could be considered casual activity. There is some degree of interpretation that will need to be applied, based on the character and the kind of damage they are recovering from; while a short hike is absolutely not considered restful for someone recovering from a broken leg, it may be restful for the mind if the character is inclined to view it that way. The fact that rest does not require the character to be stationary or asleep means that game can continue during periods of rest, even if they must continue with a lower level of pressure.
Bodily Damage
Bodily damage is the most common type of damage in all settings. It covers basically any kind of damage not addressed by the other two types, and includes slashing, piercing, burning, or other damage types applied directly to the body of the defender. Bodily damage is subtracted from a character's Hit Points. When a character reaches 0 Hit Points, they fall unconscious. If their Hit Points drop below 0, they die.
Weakened: It is assumed that the speed and natural defense processes involved in a combat encounter hold off some effects of damage until the character has a chance to come down from the heightened state they were in during combat. When combat ends, if a character is at or below half their maximum Hit Points, they are Weakened. Calculate half the total Hit Points the character has lost (rounded down), and apply that much Systemic and Mental damage to the character. The character may roll to resist these as per step 3 of Resolve the Action. The character does not recover Hit Points at this time.
Recovery: As a base process, Hit Points are recovered at a rate of 1 point per day. The player can roll the Body skill (a branch of Defense), adding their Endurance rank as a modifier, once per 12 hours of continuous rest against a DC equal to 10 + the current damage (the difference between their current Hit Points and their maximum Hit Points). If the roll exceeds the DC, the character heals a number of Hit Points equal to the difference between the roll and the DC.
Assisting Recovery: If a character uses a relevant Medicine or Casting check to help the character heal, they roll against the same DC as described under Recovery above. A character using Medicine or Casting in this way may roll once for every 12-hour span, as long as they have attended to the recovering character (or cast healing magic on the recovering character) at some point during that 12-hour span. Unlike the Body check, the attending mage or doctor may roll their check at the end of their attending action instead of waiting for the 12 hours to end. Any points healed from the attending mage's or doctor's roll is applied immediately, and the difference between their roll and the DC they rolled against is applied as a bonus to the next Body check the patient rolls.
Example: Dave is at 27 Hit Points out of his maximum of 50 at the end of an encounter. Because he's still above half, he does not risk additional Systemic or Mental damage. Dave goes to the hospital immediately, rests in the waiting room for an hour, and then Tom assess his wounds and gives him stitches before sending him home to recover. The process of assessing, numbing the area, and applying the stitches takes a half hour, at the end of which, Tom rolls Emergency Care (Dexterity) against a DC of 33 (10 + (50-27)). He rolls a 40, so Dave regains 7 Hit Points, bringing his current Hit Points to 34. Dave goes home and rests for the remainder of his 12 hours, sleeping 8 hours overnight during that time. Because a new day has started, Dave regains 1 Hit Point, bringing his current Hit Points to 35. At the end of that first 12 hours, he rolls Body (Endurance) against a DC of 25. His Body score allows his to roll 3d10, to which he adds his Endurance score (6) and the healing modifier from Tom (7). He rolls a 3, 6, and 8, which brings his total to 30. He recovers another 5 Hit Points, putting his current to 40. If he rests the next 12 hours, he will be able to roll another 3d10 + 6, but will no longer get the bonus from Tom's check; however, he will now only be rolling against a DC of 20, and a result of 30 is perfectly feasible, which means he has a good chance to successfully heal all the remaining damage.
Weakened: It is assumed that the speed and natural defense processes involved in a combat encounter hold off some effects of damage until the character has a chance to come down from the heightened state they were in during combat. When combat ends, if a character is at or below half their maximum Hit Points, they are Weakened. Calculate half the total Hit Points the character has lost (rounded down), and apply that much Systemic and Mental damage to the character. The character may roll to resist these as per step 3 of Resolve the Action. The character does not recover Hit Points at this time.
Recovery: As a base process, Hit Points are recovered at a rate of 1 point per day. The player can roll the Body skill (a branch of Defense), adding their Endurance rank as a modifier, once per 12 hours of continuous rest against a DC equal to 10 + the current damage (the difference between their current Hit Points and their maximum Hit Points). If the roll exceeds the DC, the character heals a number of Hit Points equal to the difference between the roll and the DC.
Assisting Recovery: If a character uses a relevant Medicine or Casting check to help the character heal, they roll against the same DC as described under Recovery above. A character using Medicine or Casting in this way may roll once for every 12-hour span, as long as they have attended to the recovering character (or cast healing magic on the recovering character) at some point during that 12-hour span. Unlike the Body check, the attending mage or doctor may roll their check at the end of their attending action instead of waiting for the 12 hours to end. Any points healed from the attending mage's or doctor's roll is applied immediately, and the difference between their roll and the DC they rolled against is applied as a bonus to the next Body check the patient rolls.
Example: Dave is at 27 Hit Points out of his maximum of 50 at the end of an encounter. Because he's still above half, he does not risk additional Systemic or Mental damage. Dave goes to the hospital immediately, rests in the waiting room for an hour, and then Tom assess his wounds and gives him stitches before sending him home to recover. The process of assessing, numbing the area, and applying the stitches takes a half hour, at the end of which, Tom rolls Emergency Care (Dexterity) against a DC of 33 (10 + (50-27)). He rolls a 40, so Dave regains 7 Hit Points, bringing his current Hit Points to 34. Dave goes home and rests for the remainder of his 12 hours, sleeping 8 hours overnight during that time. Because a new day has started, Dave regains 1 Hit Point, bringing his current Hit Points to 35. At the end of that first 12 hours, he rolls Body (Endurance) against a DC of 25. His Body score allows his to roll 3d10, to which he adds his Endurance score (6) and the healing modifier from Tom (7). He rolls a 3, 6, and 8, which brings his total to 30. He recovers another 5 Hit Points, putting his current to 40. If he rests the next 12 hours, he will be able to roll another 3d10 + 6, but will no longer get the bonus from Tom's check; however, he will now only be rolling against a DC of 20, and a result of 30 is perfectly feasible, which means he has a good chance to successfully heal all the remaining damage.
Mental Damage
Mental damage is the result of any effect that strips a character of their own will, limits their mental functions, or severs their connection to the real world. Characters that suffer Mental damage accumulate that damage in a pool on their sheet. For every 2 points of Mental damage they have, they suffer a cumulative -1 to all checks involving one Mental trait. The player rolls 1d4 each time they take Mental damage to determine which trait suffers the damage (1: Intelligence, 2: Awareness, 3: Memory, 4: Cunning). Effects that deal Mental damage have three phases; the first happens when the character first takes Mental damage, the second happens if and when all four Mental traits have some negatives applied, and the third happens when any one trait is reduced to a functional score of 0.
Mental damage effects tend to have recurring damage that continues after the initial effect is resolved.
Recovery: As a base process, Mental damage is healed at a rate of one point per month. The player can roll the Mind skill (a branch of Defense), adding their Endurance rank as a modifier, once a week against a DC equal to 10 + the current Mental damage. This roll requires the character to spend one full interrupted hour in meditation or rest, and the player makes their roll at the end of that meditation or rest. If the roll exceeds the DC, the character heals an amount of Mental damage equal to the difference between the roll and the DC. The cumulative minuses are recovered at every odd-numbered amount of Mental damage.
Assisting Recovery: If a character uses a relevant Medicine (usually a form of therapy) or Casting check to help the character recover, they roll against the same DC as described under Recovery above. A character using Medicine or Casting in this way may roll once each week, as long as they have attended to the recovering character (or cast healing magic on the recovering character) at some point during that week. The difference between their roll and the DC they rolled against is applied as a bonus to the next Mind check the patient rolls, but does not immediately heal the patient; Mental damage requires active involvement from the patient.
Medicine: If the character is expressing a mental disorder that can be addressed with medicine, that medicine will provide a bonus to the patient's Mind check. See individual medicines for the amount of their bonus.
Example: Ernest is at 12 points of Mental damage, suffering a -3 to Intelligence, -2 to Awareness, and -1 to Memory checks, at the end of an encounter; this includes some damage suffered from having fewer than half his total Hit Points at the end of the encounter. The condition he received in combat deals an additional 3 points per week. Ernest takes a couple hours the next day to clear his mind while painting, and rolls Mind (Endurance) against a DC of 22. His Mind score and Endurance score allow him to roll 3d10 + 6, and he rolls a result of 23. He loses one point of Mental damage, and since this puts him at an odd number, he recovers one minus; he now suffers -3 to Intelligence, -1 to Awareness, and -1 to Memory checks. A few days later, he has a scheduled appointment with his psychiatrist, Laura, who talks through Ernest's experience and helps him refocus. Laura is not specifically trained in the nature of Ernest's recent encounter, so she rolls Psychology (Empathy) against a DC of 21. She rolls 29, which means that next time Ernest rolls, he may add 8 to his check. The following week, he gains 3 more points of Mental damage, returning Awareness to -2, and goes to sit by a local waterfall for an hour and commune with nature. At the end of this hour, he rolls Mind again, this time rolling 3d10 + 6 + 8. This time, he rolls a 30 against the DC of 24, so he removes 6 points of Mental damage, lowering his total to 8 and removing 3 more minuses. When he sees Laura again a few days later, she will be rolling against a DC 18 to help him.
Mental damage effects tend to have recurring damage that continues after the initial effect is resolved.
Recovery: As a base process, Mental damage is healed at a rate of one point per month. The player can roll the Mind skill (a branch of Defense), adding their Endurance rank as a modifier, once a week against a DC equal to 10 + the current Mental damage. This roll requires the character to spend one full interrupted hour in meditation or rest, and the player makes their roll at the end of that meditation or rest. If the roll exceeds the DC, the character heals an amount of Mental damage equal to the difference between the roll and the DC. The cumulative minuses are recovered at every odd-numbered amount of Mental damage.
Assisting Recovery: If a character uses a relevant Medicine (usually a form of therapy) or Casting check to help the character recover, they roll against the same DC as described under Recovery above. A character using Medicine or Casting in this way may roll once each week, as long as they have attended to the recovering character (or cast healing magic on the recovering character) at some point during that week. The difference between their roll and the DC they rolled against is applied as a bonus to the next Mind check the patient rolls, but does not immediately heal the patient; Mental damage requires active involvement from the patient.
Medicine: If the character is expressing a mental disorder that can be addressed with medicine, that medicine will provide a bonus to the patient's Mind check. See individual medicines for the amount of their bonus.
Example: Ernest is at 12 points of Mental damage, suffering a -3 to Intelligence, -2 to Awareness, and -1 to Memory checks, at the end of an encounter; this includes some damage suffered from having fewer than half his total Hit Points at the end of the encounter. The condition he received in combat deals an additional 3 points per week. Ernest takes a couple hours the next day to clear his mind while painting, and rolls Mind (Endurance) against a DC of 22. His Mind score and Endurance score allow him to roll 3d10 + 6, and he rolls a result of 23. He loses one point of Mental damage, and since this puts him at an odd number, he recovers one minus; he now suffers -3 to Intelligence, -1 to Awareness, and -1 to Memory checks. A few days later, he has a scheduled appointment with his psychiatrist, Laura, who talks through Ernest's experience and helps him refocus. Laura is not specifically trained in the nature of Ernest's recent encounter, so she rolls Psychology (Empathy) against a DC of 21. She rolls 29, which means that next time Ernest rolls, he may add 8 to his check. The following week, he gains 3 more points of Mental damage, returning Awareness to -2, and goes to sit by a local waterfall for an hour and commune with nature. At the end of this hour, he rolls Mind again, this time rolling 3d10 + 6 + 8. This time, he rolls a 30 against the DC of 24, so he removes 6 points of Mental damage, lowering his total to 8 and removing 3 more minuses. When he sees Laura again a few days later, she will be rolling against a DC 18 to help him.
Systemic Damage
Systemic damage is the result of any attack that hinders the body's ability to function properly. This is usually either poison or disease, but some curses or rare effects may also deliver Systemic damage. Characters that suffer Systemic damage accumulate that damage in a pool on their sheet. For every 2 points of Systemic damage they have, they suffer a cumulative -1 to all checks involving one Physical trait. The player rolls 1d4 each time they take Systemic damage to determine which trait suffers the damage (1: Strength, 2: Endurance, 3: Dexterity, 4: Agility). Effects that deal Systemic damage have three phases; the first happens when the character first takes Systemic damage, the second happens if and when all four Physical traits have some negatives applied, and the third happens when any one trait is reduced to a functional score of 0; the third phase is always death.
Systemic damage effects tend to have recurring damage that continues after the initial effect is resolved.
Recovery: As a base process, Systemic damage is healed at a rate of one point per week. The player can roll the System skill (a branch of Defense), adding their Endurance rank as a modifier, once per day against a DC equal to 10 + the current Systemic damage. This roll requires the character to spend six hours at rest, and the player makes their roll at the end of that rest. If the roll exceeds the DC, the character heals an amount of Systemic damage equal to the difference between the roll and the DC. The cumulative minuses are recovered at every odd-numbered amount of Systemic damage.
Assisting Recovery: If a character uses a relevant Medicine (for poison) or Casting check to help the character recover, they roll against the same DC as described under Recovery above. A character using Medicine or Casting in this way may roll once each day, as long as they have attended to the recovering character at some point during that day. The difference between their roll and the DC they rolled against is immediately healed by the patient. For disease, a successful relevant Medicine check can identify the source of the Systemic damage and determine the best course of medicine, but does not itself offer any healing to the patient.
Medicine: Medicines that address Systemic damage offer bonuses to the patient's System check, and often stop recurring damage from happening after a certain period of use. See the individual medicine for the amount of this bonus.
Example: Frank is at 12 points of Systemic (disease) damage, suffering a -2 to Strength, -2 to Dexterity, and -2 to Agility checks, at the end of an encounter; this includes some damage suffered from having fewer than half his total Hit Points at the end of the encounter. The disease deals 3 more points of damage per day. Frank goes to the hospital, where Tom assesses him and admits him for overnight observation. Once admitted, Diane administers a +4 antibiotic to help his body fight the disease. Six hours after arriving at the hospital, Frank rolls a System check, which is 3d10 + 6, +4 from the antibiotics, against DC 22. He rolls 24, which means he heals 2 points of Systemic damage. This puts his new total at 10, and he now only suffers -2 Strength, -1 Dexterity, and -2 Agility. Come morning, after 8 hours of sleep, he takes 3 points of Systemic damage and again rolls 3d10 + 6 + 4, this time against DC 23. He rolls a result of 24, healing 1 more point; this puts his remaining Systemic damage at 9. He is released from the hospital with a prescription to continue addressing the disease, and will be rolling against DC 19 the following day. That antibiotic will prevent further recurring damage if he takes it for 72 hours.
Systemic damage effects tend to have recurring damage that continues after the initial effect is resolved.
Recovery: As a base process, Systemic damage is healed at a rate of one point per week. The player can roll the System skill (a branch of Defense), adding their Endurance rank as a modifier, once per day against a DC equal to 10 + the current Systemic damage. This roll requires the character to spend six hours at rest, and the player makes their roll at the end of that rest. If the roll exceeds the DC, the character heals an amount of Systemic damage equal to the difference between the roll and the DC. The cumulative minuses are recovered at every odd-numbered amount of Systemic damage.
Assisting Recovery: If a character uses a relevant Medicine (for poison) or Casting check to help the character recover, they roll against the same DC as described under Recovery above. A character using Medicine or Casting in this way may roll once each day, as long as they have attended to the recovering character at some point during that day. The difference between their roll and the DC they rolled against is immediately healed by the patient. For disease, a successful relevant Medicine check can identify the source of the Systemic damage and determine the best course of medicine, but does not itself offer any healing to the patient.
Medicine: Medicines that address Systemic damage offer bonuses to the patient's System check, and often stop recurring damage from happening after a certain period of use. See the individual medicine for the amount of this bonus.
Example: Frank is at 12 points of Systemic (disease) damage, suffering a -2 to Strength, -2 to Dexterity, and -2 to Agility checks, at the end of an encounter; this includes some damage suffered from having fewer than half his total Hit Points at the end of the encounter. The disease deals 3 more points of damage per day. Frank goes to the hospital, where Tom assesses him and admits him for overnight observation. Once admitted, Diane administers a +4 antibiotic to help his body fight the disease. Six hours after arriving at the hospital, Frank rolls a System check, which is 3d10 + 6, +4 from the antibiotics, against DC 22. He rolls 24, which means he heals 2 points of Systemic damage. This puts his new total at 10, and he now only suffers -2 Strength, -1 Dexterity, and -2 Agility. Come morning, after 8 hours of sleep, he takes 3 points of Systemic damage and again rolls 3d10 + 6 + 4, this time against DC 23. He rolls a result of 24, healing 1 more point; this puts his remaining Systemic damage at 9. He is released from the hospital with a prescription to continue addressing the disease, and will be rolling against DC 19 the following day. That antibiotic will prevent further recurring damage if he takes it for 72 hours.