The Malady Codex—A DMs Guild Review

A lot of times afflictions, diseases, and, sometimes, even conditions are all afterthoughts in many a roleplaying game. The Malady Codex by Jason Bakos and Themis Paraskevas is a great supplement that helps you bring diseases off the sidelines and not only make them consequential, but also memorable. If you use this supplement sparingly and effectively your players will talk about it for years to come.

Malady Codex
The Malady Codex

The Malady Codex: The Guide to Diseases

Writer: Jason Bakos and Themis Paraskevas (edited by Marcus Santos)
Publisher: DMs Guild
Cost: $2.95
Product Length: 25 pages

The Malady Codex presents 11 diseases you can use in your campaign that includes deadly conditions such as “druid’s curse” and nonlethal ones like “ISTD”. That last one is best suited for that one player who always wants to visit the brothel anytime the part goes into town. It’s not deadly, but it has consequences to the character that may make the player think twice about his promiscuity the next time they go to town.


Having a background as medical students definitely gives the authors an advantage when it comes to creating these diseases. Most of them are based on real world conditions but the added fantasy elements help them stand out from the generic conditions you may find in other source books. The authors have done a great job with these conditions as well as their effects.


Despite having two authors, this supplement is written with a consistent voice and tone. I never read a passage which had a style that felt different from any other. It is easy to read while maintaining a “high brow” style that you may expect with any medical journal that is written for public consumption.


The Malady Codex has a professional quality. The background doesn’t overwhelm the reader and the organization for each entry makes each of them easily digestible and quickly referenced. The art is consistent with a good blend of color fillers and watercolor blends. I do wonder if some of them are missing artist credit though as I could not find any others aside from Anthony DePietro listed. Speaking of DePietro, his cover art is perfect for this supplement and really sums up the content nicely. There are a few spelling and grammar errors but this is not overly distracting.


Rather than just provide us with a list of diseases, the authors have given us brief origins, how they’re caused, what the symptoms look like, how to diagnose and cure them, and plot hooks for each one. They also gave us a section on how handle them and reminders of which spells and magic items may be useful in treating them. In essence, they are each and every one more than just flavor text. They will impact how a player runs his or her character and can lead to side quests…or the need to roll up a new character altogether! Additionally, this supplement introduces two new maladies that could manifest if the players kill someone afflicted by the “mad mage virus.” So the players may think the fight is over once they’ve killed the host when in reality it has only just begun.

Final Thoughts

I think this is a great supplement to use in any gaming group at least once. Diseases should have a small roll in campaigns often enough. But the ones in The Malady Codex should be more of a focal point. They could be epidemics in a city that serve as hooks for major adventures or they can be used for character development or backstory. However, if you overuse it I suspect players will grow tired of it. But, again, this is a wonderful element to introduce to your group. You should do so at your earliest convenience.

4.6 stars

Malady Codex
The Malady Codex is available on DMs Guild
Thanks, Jason, for the review copy of The Malady Codex.

Author: Patrick

Journeyman. Melancholiac. Stoic. A rebel and a runner. I think chocolate and caffeine are over-celebrated and I believe hot sauce pairs nicely with ice cream.

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