Also known as Battle Wounds, Afflictions are the game's way to portray permanent side effects of grievous bodily harm. Units recover their health every turn; Afflictions show the lasting consequences of battle injuries, Old Age, and other dangers of the world. Afflictions vary widely in their effects.

The odds of getting an affliction from an injury is determined by how much HP was lost, relative to the max HP.

Just for an example, say a fellow with 100 max HP took 20 damage from an attack; they would have a 20% chance to get an affliction.

Certain traits modify the rate of being afflicted, and these are listed in order of application to the odds:

• Being Cursed adds a flat 15% to the chance of permanent injury. This is terrible for units who will be taking a large amount of hits, or for situations where damage is guaranteed.
• Regeneration divides the chance of receiving an affliction. 5% Regeneration or lower has no effect, but every 5 percentage points above it adds 1 to the base denominator of 1. (For example, 10% Regeneration halves the rate of affliction.)
• Affliction Resistance has a chance to set the chance of receiving an affliction to 0.5%. The probability of an affliction chance change is 1/2 for 1 point, 2/3 for 2 points, 3/4 for 3 points, et cetera.

Note that it is possible for an over 100% chance to get an Affliction; in this case, the unit may gain an additional one. If a human with 10 HP took a 15 HP hit, they would be guaranteed one Affliction and have a 50% chance of gaining another; which would only matter for the purposes of Bolt of Unlife, Life after Death, Twiceborn, and other forms of coming back from zero HP, of course. One can only imagine how mangled a body would be after receiving Gifts from Heaven, for instance, or how handicapped a Dragon would be after their human form took a bite from another Dragon.

Hit area is very important, as you can't lose an eye by being hit in the toe, or lose an arm through a cut to the face. The areas are Head, Arms, Legs, and Torso. The Torso is the most likely area to be hit and the Head is the least likely to be hit, if both the attacker and the defender are the same Size; bigger attackers have an easier time attacking the Head, however, smaller attackers have an easier time attacking the Legs, (unless their weapons are long enough to adjust).

The following afflictions can be accrued by a hit in any area:

• Battle Fright, also known as "shell shock", PTSD, or good sense, reduces Morale by 5.
• Profuse Bleeding is actually a temporary condition, but one that uses the affliction formula. The sufferer gains 10 Fatigue and loses HP equal to 5% of their max, (rounded randomly), each combat round; it stops on its own with a 10% chance plus the victim's Regeneration, divided by 2 when underwater. Survivors of the battle stop bleeding.

The following afflictions can be accrued by a hit to the Arm. Note that a unit has only a 1-in-3 chance of obtaining an underlined affliction, and a 2-in-3 chance of obtaining one of the others. This is a categorical likelihood, however; for example here, an Arm affliction has a 2-in-9 chance to be Weakness, a 2-in-9 chance to be Battle Fright, a 2-in-9 chance to be Profuse Bleeding, and a 3-in-9 chance (~33%) to be the loss of said limb.

• Weakness, whether through muscle damage or serious pain when swinging, reduces Strength by 4.
• A Lost Arm deprives the subject of one of their item slots: a hand slot. Also, both commanders and troops lose the use of their shield (if they have one) or, if they were using a 2-handed weapon, they switch to their fallback attack (usually a Fist). If someone runs out of arms, they'll be reduced to "uselessly" kicking foes.
  • One interesting note is that, if a unit would take more than half their max HP in damage from a blow to the arm, it is capped at half their max HP. If the damage is from a Slash, however, the arm always pops off.

The following afflictions can be accrued by a hit to the Legs:

• A Limp, generally understood as having one bad or broken leg (or foot), is a miserable condition. Those with a Limp have their Combat Speed halved and lose 1 Attack Skill, 1 Defence Skill, and 4 Map Movement. The Map Movement penalty is ignored by commanders of troops with a Limp, but this has a 25% chance to mature into something more serious if they're forced to march through more than one province in a turn.
• Being Crippled by having structurally screwed legs is not fun. Crippled units have their Combat Speed capped at 2, their Map Movement reduced by 75%, and their Attack Skill and Defence Skill reduced by 4. Again, the Map Movement penalty is ignored by commanders of Crippled troops, but this has a 25% chance to kill them, increased to 75% if the forced march is across more than one province.

The following afflictions can be accrued by a hit to the Head:

• Losing an Eye, or vision from that eye, sucks. The loss of depth perception comes with a -2 penalty to Attack Skill and Defence Skill, and a -3 penalty to Precision. This stacks, but only as many times as the person has eyes; once they are out of eyes, they are Blind. If a creature has additional eyes for some reason, they can't possibly lose more stats from missing eyes than what they would lack through Blindness.
• Speaking of, Blindness from either brain damage or an unfortunate strike across the face comes with a -9 penalty to Attack Skill, Defence Skill, and Precision. A Blind mage can still engage in magical Research, somehow, but certain magic is forbidden to them; The Eyes of God, for example.
• Muteness from brain damage (or a damaged tongue) reduces all of a commander's Leadership scores by 75%, and applies a negative "pathboost" penalty to each of their magic paths; this "boost" is half of their skill in each path, rounded up. If the ability to speak is restored, the old magic skill is restored.
• Dementia, or absentmindedness, weakens the subject's mind and their connection to things as they are. The demented fellow has a -2 penalty to Magic Resistance, both their Leadership and their Research ability reduced by 50% (indicating time wasted staring at nothing), and occasionally waste their time in battle to stare at nothing.
• To be "Feebleminded" is to suffer either serious brain damage or a severe cut in one's sense of self, such that spellcasting is impossible. Becoming feebleminded also breaks whatever Global Enchantments or Battlefield Enchantments you were upholding. Other effects include -5 Magic Resistance and -1 penalties to Attack Skill, Defence Skill, and Precision.
• Losing your Head is technically an affliction, yes, but the effect is death for most units. It's only attainable in the same fashion as the guaranteed arm loss; being hit with more than half your max HP's worth of damage in the area, by a Slash.

The following afflictions can be accrued by a blow to the Torso:

• A "Chest Wound", presumably damage to the heart or lungs, reduces Strength by 1 and increases Encumbrance by 5.
• A "Never Healing Wound" reduces maximum HP by 20%, since healing magic and Regeneration can't fix it. Likewise, this makes future Afflictions 25% more likely to occur.
• Disease from an infected wound is a horrifying fate, one that acts slowly but catches rather quickly in battle. The body becomes fixated on trying to fight the Disease, and thus does not heal outside of battle, though healing magic and Regeneration work during the heart-pounding thrill of combat. Every month, a diseased being slowly withers away, losing HP (though not maximum HP, fortunately) equal to 10% of their max. Lastly, new Afflictions may form each turn on Diseased units. You'll be happy to know that units in Dominions are very good at quarantining; Disease never spreads between units.
  • Units who are old have a chance to get Diseased at the start of the eleventh month of the year (Turn 10, and every 12th turn after that). The chance of this happening increases with Death scales in their province, and decreases with Growth scales.

Afflictions are chronic; they can be removed, but they don't go away on their own. Three things remove Afflictions:

• Recuperation is a unit trait that allows units to "recuperate" (self-heal) from afflictions. They have a chance to recover from one or more of their afflictions at the start of each month. Old units with Recuperation don't have Recuperation, however.
• Healers can "heal" afflictions on themselves and on others in their province, but only as many as their trait's point value indicates. The Healer trait does not work on the Undead, nor on Inanimates. There's also a version that only heals Diseases.
• Resurrection through the Immortal trait, or through being recalled (as a Pretender God), comes with a single burst of Recuperation. Alternatively, some units change shape instead of dying in battle; in most cases where they cannot do this freely, this counts.

Interestingly, the Never Healing Wound is the most difficult affliction to recover from.