Here follows a 'heroic injuries' system for when a Player Character hits 0HP in OSR games. It was designed for use in my Water Margin game of Blueholme. It creates situations more akin to those that befall the heroes of the novel and, as Chris McDowall has noted, a wounded party member is dramatically more interesting than a dead one anyway.
Also, if you find it problematic that attributes in Blueholme don't do 'enough' – and in the case of Strength, only have an effect in the long term due to XP adjustments – this may be something of a fix for that.
Enough preamble, here's the thing:
- When you hit 0HP, further damage comes off your CON score.
- Whenever an attack takes you to 0HP or below, save against your class's prime requisite to avoid being Gravely Wounded.
- 'Save' means roll equal to or less than the ability score on 3d6 (or 1d20 if you want things to be more swingy)
- At 0 CON, you die.
- If harmed again when Gravely Wounded, you die.
- If you remain Gravely Wounded for 1d6 hours without care, you die.
One possible issue here is that this rule maybe over-values Constitution. Because it functions as a kind of reserve bank of not-dying as well as modifying total HP, it's arguably being applied twice.
There's also the question of whether you want this free second chance for the PCs. I think it's about right for the level of 'hero' in The Water Margin – they survive, often improbably, but they're not superhuman. But it's not gritty realism, that's for sure.
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