This book provides good information for introducing diseases into any RPG. However it is written from a modern perspective, so insights in how healers of the Middle Ages viewed diseases and would have treated them are not included. That has left me a bit disappointed, but it wasn't promised. The author also has a very high powered world as default setting, where fifth level clerics are abundant even in small communities and fifteenth level clerics common enough for the Heal spell to be considered a standard treatment. As such all magical healing is focused on what really are powerful spells being abundant and no magical treatments short of these spells are included. Again, nothing else was promised, but it's an opportunity lost.

The shortcoming that made me consider giving the product a lower rating was the complete lack of diagnosis section; sure, symptoms are discussed, but some guideline of how likely a doctor is to diagnose the disease correctly or how he could miss-diagnose it would be useful. Likewise treatments for some diseases like Malaria are listed as poisonous, but the health effects of that poison are not discussed.

As such the book falls short of being the definitive work for diseases in fantasy settings, but it remains the best work I have found to date.

Insults & Injuries is one of those rare 3.5 supplements that, instead of adding outlandish one-off mechanics to the game, actually makes a game world feel more like a living, breathing world. Disease is a major part of our daily lives, it's in the news, and I'm currently getting over a head cold. Yet its a vastly under-developed concept in most fantasy games.

I like to run a down-to-earth, nitty gritty game. My player characters aren't super heroes, and I really like for them to feel vulnerable to the world around them. Disease and injury are one of those things that I've always wished I could do more with. Any athlete, be they recreational amateur or full blown professional knows how hard it can be to perform at their best when feeling under the weather, and to me a well trained fighter should be no different. Players that run around with un-healed hit points just because they feel they are at an arbitrary "safe" threshold are essentially running around with open wounds. I've had splinters turn into nasty infections, I can't imagine what would happen to some of the gaping wounds my players have run around with for extended periods in a dungeon environment.

Insults & Injuries handles injuries and diseases of all sorts, and it's pretty clear that it is being written from the perspective of a practicing medical doctor - which is a pretty cool perspective in a book like this. The descriptions avoid being dry or over technical, and they do a good job of making the content relevant to a fantasy game - the real life medical anecdotes are a nice touch too. The book covers so many types of disease that it would be tough to give my opinion on all of them in this review, but suffice it to say the book is very thorough.

All in all it's very easy to recommend this book, it's well written, the content is intelligent, and the material is useful in almost all fantasy settings and situations.

First off I want to say I recieved this product for free. Skirmisher didn't officially ask me to review it, but after reading it, I wanted to do so. I work in healthcare in real life so the book's topic was of interest to me. It basically adapts real world maladies, diseases and illnesses to the OGL. The author is a real world MD and from my perspective it shows. The diseases are quite true to their real world equivalents, at least as much as adapting a disease to a game can allow. It also includes some real world drugs, so if you want/need rules for what Cocaine, Cannabis and Opium can do to your Campaign's PC's and NPC's this books has that info also.
Pros: Allows you to insert some real world diseases and maladies into your games. Cons: Some folks might not want such a high level of real world afflictions in their fantasy games. Also the art wasn't for me, it seemed to be mostly of the old medieval medical text book variety, which while conveying the books content didn't really inspire me.
Rules for creating Fantasy Diseases aren't in this book, maybe he will do a future tome that has that, I'd definately buy such a product and feel the author would do a good job at it. Overall: I'm glad I was sent this, I will definately use some of it in my games, but not sure I want to go all out on some of the diseases.
Thanks for reading!