Lamps Light Sanitarium v2

by Matt Corley
with Donathin Frye

Welcome to
Lamp’s Light Sanitarium
Enjoy your stay...
W
ithin the walls of Lamp’s Light Sanitarium, you will find all manner
of medical marvels. The sick are healed, the lame walk again, and the mad
regain their senses... but the cures and miracles hide a horrifying truth. Are
your players ready to uncover it, and risk becoming patients themselves?
What you’ll find within this book:

• Comprehensive optional sanity rules that incorporate both roleplaying and mechanics
• A sprawling estate with dozens of rooms all beautifully mapped and fully described
• Two full ready-to-play adventures
• Dozens of adventure hooks, story arcs, and campaign ideas
• Dedicated advice on incorporating Lamp’s Light into existing campaigns from other publishers
• Dozens of evocative NPCs, creatures, and esoteric items
Lamp’s Light
Sanitarium
©2019 Matt Corley
Written by Matt Corley with Donathin Frye
Cover art by JL Giles
Illustrations by Jack Kaiser, JL Giles, Journeyman, Matt Corley, Matt Ray,

Samantha Darcy, Toby Lancaster, Victor Hugo
Maps by Toby Lancaster of Dark Realm Maps
Editing & Layout by Craig Judd
Printer-Friendly PDF
Images can be turned off in the Layers panel of your PDF viewer.
1
D edication
This book wouldn’t be possible without the efforts and support of countless people. From my family,
friends, and gaming partners to anyone and everyone that shared a post during the campaign. A few
deserve a little extra recognition.
Kelly — your support never wavered, and I wouldn’t have even considered going down this road
without you at my side.
Harper and Lilly — you’re both too young to read this!! But when you’re older I hope you like
it. You two are a source of constant inspiration and motivation.
Toby Lancaster — you kept from giving up on this project, and egged me on until I couldn’t
put it off any longer. Thank You!!
Donathin Frye — you provided invaluable advice, support, and help. The content you’ve
contributed is amazing! Can’t wait until our next project together.
Wolfgang Bauer — you gave me a chance, and started me down this path. Thank you?!?!
Sandy Petersen and Petersen Games — the folks at Petersen Games have supported this
project every step of the way, and it wouldn’t be possible without you.
Bob Geis — you and the folks at You Too Can Cthulhu are awesome, ‘nuff said.
The Sunday Nerds — Wags, Josh, Rob, KC, Brian, and Zach. You let me torment you every
other week for the last 2 years. I couldn’t have done this without you.
The Inner Circle — Michael Turbe (aka Nyfuir), Nathan Corley (aka Japhi), Edward Wallace
(aka Mr. Mielace), and Todd Cooper (aka Dr. Todd).
Roll Sanity!
—Matt
2
3
K ickstarter B ackers
Philanthropists Frenetic Patients

Guest 1580889347, miles, Rikki Ballengee, The @marycray, @NerdCant, Aaron B., afbeer, AJ
Creative Fund Fritz, Andreas Loeckher, Andrew F, Bethany
Graham, Bill Ashbaugh, Blaine McNutt, Bob
Curious Observers Corley, Breanna kurth, Brent G. Walker, Brian
Davis, Brian Lemieux, Chris Ess, Chris M
Charlotte Welch, JEREMY D. KLEINHANS, Hartman, Chris Parsons, Christian, Craig,
John Larrimore III, Kelly, Richard, Richard Damion Meany, Dan Dillon, Dan Layman-
Poteat, Ryan Clarke, Tigrannosaurus Kennedy, Dan Perrine, David JACQUET,
Dennis S, Derrick Bergeron, Donathin Frye,
Edmund Lee, Erika Promislow, Etienne, Filipe
Tibério, Gatts Righteous, Greg Finfrock, Guest
969076119, Hannah Stull, Hari Bhanu, Heath
Robinson, Heine Stick, incandescens, Ivan
Vasilinin, james, Jason Hennigan, Jason Le,
Jay Grime, Jeff Villanueva, Jester, JHewett, Jim
Mangiameli, John Robinson, John Szasz IV,
Jon Terry, Jorah Kai, Kalit, Kesiah, killervp,
l3m, Lachlan Anderson, Lawrence K, Leonard
Lee, Lloyd Moore, Lucas Fuzzbang Kuntz,
MA Roxas, Magfurul Abeer, Mark W., Mark
Weis, Marley D, Martin Krans, Matthew
Capell, Micah Watt, Michelle Shambrook,
Mike Brown, Mnemonic, Morgan Bolton,
Neil Mahoney, Oscar Matos, peter allen, Peter
Medrano, Péter Sasvári, Philippe A. Vandeperre
Venegas, RenzoJuken, Richard Green, Robert
J Schwalb, Robert McKavanagh, Robert West,
Rudy Thauberger, Russell Ventimeglia, Russell
white, Sam de Jong, Sarah Fell, Shane White,
Soup, Stuart Edmond, Sybil, ThrustBomb,
Todd Seitz, Tsai Ping-Heng, Victor Serrano,
XyrixDraws, Yannis
4
Devoted Alienists Faculty Consultations
Aaron F Stanton, Adam, Andrew Hurley, Andrew Alex Draconis, Ashton Sewell, Chase Street,
Smallwood, Andy Hatton, Andy Simmons, Angus David Summers, jchawley, Mike Brummett,
Abranson / Chronicle City, Anna Ognibene, Robert Jazo
Arch DeLux, Artemis, Arthur Diennet, Bayard
Bell-Martinez, Ben McFarland, Ben Trefethen, Tasters of Madness
Benjamin L. Eastman, Bethany Duck, Blake
Morrison, Bob Geis, Brandon Astrodust, Brian Ben Armitage, Corey Gonzalez, Trent Ramseyer
Southworth, Brian Suskind, Bridger Winter, Buck
Deatherage, calixus, Cathi Gertz, Cato Vandrare, Lamp’s Light Inner Circle
Chad, Chris Opinsky, Christopher David
Ainsworth, Christopher Lackey, Christopher Diane Corley, Edward, Guest 1555052744,
Matulewicz, Churchill, Cody Kearney, Craig Michael Turbe, Todd Cooper
Parent, Dana Mison, David Dierks, David Jaxon,
Egoitz Atzogaurtabeti, Emily Mahar, Eric S,
ethan Fischer, Florence Blea Andrews, G_Q,
Glen, Glen Taylor, Graham Cheshir, Grakulen,
Guest 1315705670, ian Fjeldvig Antonsen, Ian
Spencer, Jacob, James, james burke, Jasmyne
Jensen, Jason, Jason Conlon, Jeff Robinson, Jeff
Workman, Jeremy Hochhalter, Jeremy Huggins,
Jeremy Welker, Joey Outten, John “johnkzin”
Rudd, John Bowlin, John Diffley, John R, John T,
John Wagner, Jordan Kruger, Joseph, JP Patterson,
Julian, Junsheng, Justinas Marozas, Knitdeer,
Kristen MacLean, Kyle Cress, Lawrence Greer,
Leon C. Glover III, Lydia MacLauchlan, Marc-
André Landry, Mark, mark hutton, Mark James
Featherston, Martin Wikborg, Mathew Knowlton,
Matt Duffy, Matthew Chau, Mike, Mr. Shiny
(Jeff Carey), Nate Laleman, Nethescurial, Patrick
Kelleher, Paul Aparicio, Paul Gibbs, Paul Glenn,
Paul Holden, peter farsang, Peter Fawcett, Peter
Steedman, philip hindley, Pizzadahuttt, Rich
Hickman, Robert Cousineau, Robert Eason,
robert kim, Roberto Correlli, sammo21, samuel
ellis, Sandy Petersen, Sean Owen, Sean Werner,
Shane Berends, Shane Brogan, Silas McDermott,
Stephane Gelgoot, Steve Campbell, Terry Herc,
Tonda, Tony Black, Travis Herman, Trevor Scurr,
William Fisher, Zach Jones
5
I ntroduction
Lamp’s Light Sanitarium deals in subject matter that may be upsetting, disturbing, and/or a trigger
for certain readers. Prior to using the material contained within please be sure to discuss with your
group what you plan to include in your game.
Lamp’s Light was written for mature audiences. It is designed to portray a gritty, unsettling, and
evocative setting so you and your players can delve into aspects of the game that are not typically
explored. Our intent is not to shock, offend, or demean anyone. That said, this supplement explores
many behaviors and situations that may not be suitable for all audiences.
There are many ways to react to horror: revulsion, disgust, fear, resolve, and a need for justice
being the ones I hope to elicit with this book.
I do not take this subject matter lightly, as I’m sure you do not either. If you need help, or know
someone that does, please use the resources available. You’re not alone. I promise.
“Being Kind is a Free Action.”

— Paige @DnDnPaige on Twitter
In the United States:

• 1(800)273-8255 – Suicide Hotline
• 1(877)226-3111 – Addiction Hotline
• 1(844)228-2962 – Eating Disorder Hotline
• 1(877)455-0628 – Self-harm Hotline
• 1(888)640-5174 – Depression Hotline
In the UK: https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/
In Australia: https://www.beyondblue.org.au/
6
7
T able of C ontents
Dedication 2 What Incites a Sanity Check? 132
Kickstarter Backers 4 Getting Better 134
Introduction 6 Sanity Cheat Sheet 137
Prologue 10 Appendix B: Items of Interest 138

Horror and RPGs 10 Beiwe’s Pendant 138
Cerebri Mimos (aka The Spike) 138
Making It Lamp’s Light 14 Essence of Somnolence (aka Hypnos) 139
General Guidelines 14 Juxta Personalis 140
Making it an Anachronism 18 Madness Scrolls 141
Making it Mythos 20 Prosper’s Camisole 142
Making It Midgard 22 Revelans Malum 143
Making it Ravenloft 23
Making it Ravnica 26 Appendix C: Persons of Interest 144
Making it Eberron 28 Alienist, Staff 144
Making it Weird Victorian 30 Borden, Agatha Dr. 146
Gneigel 148
Lamp’s Light Sanitarium 32 Hahn, Quintus Dr. 150
A Brief History of Lamp’s Light 33 H’awouahoua, The 152
The Grounds 36 Hergus, Rolund 154
The Sanitarium 38 Japhi 156
The First Floor 40 Keller, Otto 158
The Basement 48 Lowbrow, Milo 160
The East Wing 54 Meri 162
The West Wing 62 Mielace, Ed “David” 163
The Second Floor 70 Myttong, Jon (aka Mad Jak) 166
The Third Floor 78 Nantanye, Bok
(aka Patient 11, The Grey Man) 168
Adventuring in Lamp’s Light 84 The Grey Man 169
A Population in Flux 86 Nimbus 170
Tabula Rasa 90 Nyfuir 171
Apotheosis of Nightmares 102 Orderly 173
Emancipation 117 Patient 174
A Friend In Need 119 Peeper 175
Baby Jayne 121 Renwick, Orson Dr. 177
Baby Jayne 122 Riot of Lunatics 179
Rose, Florence 181
Appendix A: Optional Sanity Rules 123 Sleeping Phantasm 184
The Descent Into Madness 123 Todd, Dr. 186
Going Insane 125
8
Appendix D: Maps 188
Main House — Level 1 189
The West Wing 192
The East Wing 193
The Basement 194
Appendix E: Character Sheet 195
Open Game License Version 1.0a 199
9
Prologue
Horror evokes many types of fear: primal,
H orror and RPG s emotional, esoteric, and/or intellectual. Horror
is predicated on the emotional investment of
“The oldest and strongest emotion of the participant in the story and subsequently
mankind is fear, and the oldest and strongest kind of on their dread of things to come. Elements of
fear is fear of the unknown.” other genres are folded into good horror, namely
—H.P. Lovecraft. mystery, thriller, action, and drama. The ultimate
goal of the horror author and gamemaster is to
H
orror has been an integral part of use the successful interplay of these elements to
storytelling since the beginning. The create a sense of dread in the players.
oldest known story in the English
language, Beowulf, is firmly rooted in horror. 5th Edition and Horror
Grimms’ Fairy Tales are known the world over,
and the originals, at least, are fantastic examples The classic tropes and creatures of horror are
of horrific tales. The allure of a horror story is widely used within the 5th edition of the world’s
that you are able to experience visceral fear and most famous roleplaying game and yet few
unsettling behaviors, and explore uncomfortable would consider it a “horror” game. Why is that?
situations from a safe vantage. The heroes are larger than life, their actions do
The function of horror in writing, gaming, not generally have long-term consequences, and
and media is different for many people. We a horde of flesh-eating ghouls is little more than
each view the world through our own lens, and a momentary distraction. So clearly copious
a genre as evocative as horror will be heavily amounts of blood, violence, and gore do not
influenced by that perception and viewpoint. make a game a horror game. To instill a sense
Unlike many styles of entertainment, horror of horror, or more accurately dread, in a 5th
is dark, it is unsettling, it is often violent, edition game other modalities must be explored,
depressing, painful, and gory. It asks you to and to that end I created Lamp’s Light and the
confront your fears and foibles. It asks you to insanity rules included within.
place yourself in a situation that you may not Lamp’s Light focuses primarily on
want to be in. Why would we do that? two things: the horrors that are inflicted
You have your own answer to that. I upon others, in particular the mentally ill,
find horror to be challenging, mentally disadvantaged, and forgotten; and the slow loss
and emotionally; facing those challenges is of control of oneself as psychic, intellectual, and
invigorating and, in the case of a game such emotional scars accumulate over a lifetime of
as this, overcoming them is an intellectual conflict.
exercise that I find rewarding, and quite Within the walls of Lamp’s Light Sanitarium,
simply fun. It may be cathartic, adrenaline- you will find all manner of medical marvels.
inducing, or escapism for you and yours. The sick will be healed, the lame made to walk
Horror is personal. again, the mute will regain their voices, and
10
11
P rologue
miracles are seemingly an everyday occurrence. the small chips, cracks, and erosion wears away
The facility’s reputation amongst the wealthy the outer protection until all that’s left is the
is spotless. The staff is educated, knows their exposed, raw core. Lamp’s Light introduces the
place, and most importantly are discreet. The concept of the long-term consequences that may
academic elite view Lucien Prosper’s legacy as the occur as a character is exposed to these stresses.
pinnacle of research and cutting-edge treatments As the character grows in power the psychic
for maladies that cannot be cured by other scars left behind change a character.
means. The poor know that Lamp’s Light helps As a player you know that no matter the
them when it is able, taking in ailing children adventure and game you have complete control
and afflicted adults who have nowhere else to over one thing, and one thing only, your
turn. The religious orders of the city publicly character. The adventure may go sideways but
praise Lamp’s Light for their philanthropy, while you are the ultimate arbiter of your actions and
privately condemning them for their reliance on choices. The optional rules regarding sanity and
the arcane arts of science and technology. madness presented within this supplement attack
These wonders come at a price, one that Dr. that relationship and explore a very private and
Orson Renwick has paid countless times over intimate form of horror: the slow degradation
his tenure. Dr. Renwick has been experimenting of mental faculties, persona, and subsequent loss
on himself, and his patients, since shortly after of control. The loss of control of your actions,
the asylum opened its doors. All in the name emotions, and reactions is truly unsettling and
of science, progress, and the greater good. The unnerving. The way that your character acts to the
horrors he’s inflicted upon countless patients all stimulus in front of you has changed, probably for
began with the best intentions. the worst, since the last time it happened.
Lamp’s Light will introduce your players, For some it may represent a reversal of
and their characters, to the full range of growth and maturity. Your character’s typical
tragedies of mental illness and more unsettling response to stress has changed and the
how the unscrupulous and callous treated character’s first inclination is now a tantrum
them. Regardless of the intent of the alienists, or unreasoning anger where before it may have
experimentation or seeking a cure, the methods been cool calculation. The fact that the reaction
were often cruel, inhumane, and debilitating may change yet again the next time leaves
both mentally and physically. you with dread and uncertainty. Never quite
knowing what’s going to happen, even with a
Make It Personal familiar situation, makes you feel as if you’re
playing a new and unfamiliar character.
In the course of a lifetime of adventure, intrigue, Are the players as worried about the solution
and exploration our heroes face challenges that to the mystery as they are the mystery itself?
would break a normal man or woman. Luckily, Are they agonizing over the consequences of
they are made of sterner stuff and weather the their actions (or inaction)? Are they concerned
storm to fight another day. The adventurers not just with surviving the next fight physically
have been a part of countless battles, exposed but also emotionally? Are they faced with
to effects that cause direct injury to their mind, unsettling situations that they are sympathetic
met creatures whose very presence instills primal to or complacent with? Give them something to
terror, and are targets of mind-affected magic. talk about long after they’ve left the table and
Like a mighty mountain exposed to the elements gone home.
12
H orror and RPG s
Maintain the Mood D escribe A ctivities N ot M echanics

• “You are hit for 13 slashing” is not evocative.
The subtle horror of Lamp’s Light depends What if instead you said, “the shadowy
heavily on the mood of the table, and as the figure dropped to its knee, slashing upwards
DM this is something that you have control at your chest while its ally distracted you.”
over. Work with your players to establish the Describe the severity of the wound based on
mood that you want for your games. Below are a the damage rolled. Very easy and much more
few easy and simple tips. engaging.
• Saving throws and spell effects should be
T he G ame E nvironment handled in the same manner. “You failed
• Technology. Removing cell phones, tablets, your DC 12 Charisma save and are now
and computers is an easy and logical way to frightened”; again, not very suggestive of
subtly affect your game. Even if you normally what’s actually happening. “Your heart
use these devices, switch to old-fashioned begins to pound in your chest, ice water
pen and paper for a change of pace. flows through your veins, and your wobbly
• Ambiance. Background music is a painless legs refuse to take a single step closer.” More
and free way to add atmosphere to your engaging and hopefully it gets your player’s
session. There are great apps out there like heart rate up a bit too.
Syrinscape, Pandora, Spotify, and YouTube.
There are dozens of playlists by mood and R oll I n F ront of the S creen
setting, any of which are a great addition to • I’m a huge fan of rolling in front of your
your game. I like to run horror movies and players. Let the dice fall where they may
shows in the adjoining room. and play out what happens. The look of
• Lighting. Nothing kills the mood like apprehension and the visceral reaction from
bright fluorescent lighting. Try a session by your players when they see you grab handfuls
candlelight, or with dimmed lights. This of die and drop them to the table is more
works great when you’ve put away all the than worth the occasional TPK.
electronics.
13
Making It Lamp’s Light
T
he first and most important rule
to inserting Lamp’s Light Sanitarium G eneral G uidelines
into your campaign is to do what
you want to do, and what works best for your Species
group! You have our express permission to mix
and match, edit, adjust, borrow, adjust some What species are there in the world of Lamp’s
more, and reskin to make this supplement Light? There are no species that are inherently
work for you! That said, here are a set of tools off-limits, or that must be included either. The
and guidelines for you to make the most out of majority of the NPCs within this product are
Lamp’s Light. You may also notice that I tend humans, but there is also a halfling, half-elf,
to suggest a light hand whenever possible. As and automaton too. If you wish to maintain
a Lazy DM™ (check out Sly Flourish’s books if a humancentric campaign, virtually all races
you get a chance, they’re excellent), and a busy can be “humanized” with minimal cosmetic
one, I tend to err on the side of simplicity. changes. Dragonborn may be a little tougher
14
but the others are easily updated by attributing power of a sorcerer. The warlock’s willingness to
their characteristics, skills, and abilities to bargain with their very soul is universally viewed
cultural differences. Physical and cosmetic as an abomination.
differences, too, can be attributed to regional
genetics and unique upbringing. V irtually U nique
Barbarians, druids, and monks are so rarely
Classes seen as to be considered virtually unique.
Each of these classes should be accompanied
The classes that you’ll find in the Lamp’s Light by a backstory to explain their character’s
setting draw heavily on Victorian literature, exposure to those pathways. Were they
the pulps of the early twentieth century, and abandoned to the wilds and grew up as a feral
of course the plethora of options that Wizards child? Was the PC left on the doorstep of a
of the Coast and other third-party publishers hermit following the Old Ways and discovered
have provided. This section will deal primarily druidic powers from their mentor? Perhaps
with content from the SRD, and will give you they are a member of a fitness club, and have
a framework that will serve you well. Note that learned the ancient and esoteric art of Bartitsu
in most cases PCs should be allowed to choose from their fellows?
freely from the classes listed below.
Armor
C ommon
Fighters and rogues come from all walks The use of armor by civilized folk is more
of life, and are seen in all strata of society. a question of social acceptance than it is of
The variety of skills, feats, and backgrounds availability. In the world of Lamp’s Light all
allows them fulfill a wide variety of roles. As armor and shields are available for purchase, and
such these two classes are the most commonly there are no tangible differences, as far as the
encountered. game mechanics are concerned, from the higher
level of technological sophistication.
U ncommon
Bards, clerics, and wizards are less common Light Armor: PCs wearing light armor may
not only due to their connection with arcane get a few odd looks but are not otherwise
and divine magic, but also due to their scholarly socially hindered while wearing padded,
requirements and extensive training. There are leather, or studded leather armor.
few citizens with the background, freedom, Medium Armor: A good rule of thumb for
finances, and opportunity to explore these heroes wearing medium armor during social
occupations. interactions is to assess a -1 penalty on
Charisma-based skill checks. Alternatively,
R are the penalty may be negated with creative
Paladins, rangers, sorcerers, and warlocks roleplaying.
are rare, almost to the point that they are seen Heavy Armor: A hero walking the streets in
as outsiders by the population. The everyday heavy armor is an anomaly and treated as
citizen cannot fully grasp the dedication such. They may not be allowed admittance
and piety of a paladin, the abandonment of into businesses, temples, homes, and other
civilization of a ranger, or the inherent eldritch dwellings. To reflect this all Charisma-based
15
M aking I t L amp ’ s L ight
skill checks should be rolled with a -2 penalty. Arms and Armor

There may be exceptions to this rule, such as At the GM’s discretion, the penalty to Charisma-
during martial ceremonies. based interactions due to inappropriate arms
Shields: As medium armor when it is and armor can be altered to exclude Charisma
equipped for use. A shield stored on the (Intimidation) skill checks. Alternatively, with
hero’s back is ignored. The penalty combines appropriate roleplaying and circumstances that very
with others. same gear may grant a similar bonus on a Charisma
(Intimidation) skill check. The adjustments
Weapons delineated in these optional rules would typically
apply only when in an urban setting.
Openly carrying and wielding weapons is
frowned upon by members of polite society
in the Lamp’s Light campaign setting. That Heavy and/or Two-Handed Weapons: Much
said, there are exceptions to this rule of the same as heavy armor, any weapon with
thumb. Weapons with the light and/or finesse the heavy or two-handed property is not well
quality are generally accepted by the gentry. thought of by polite society. A PC brandishing
The aristocrats, nobility, and other wealthy such arms is telling one and all that “I’m here
citizens often embellish these types of weapons to kick butt and eat pizza….and I’m all out
with such elaborate filigree and jeweled pizza”. As such, a -2 penalty applies to all
ornamentation that they are better described as Charisma-based skills for characters wielding
jewelry than arms. or prominently displaying these weapons.
16
G eneral G uidelines
Magic Items
There is no reason that any particular magical
item can’t or shouldn’t be found in a setting
that includes Lamp’s Light Sanitarium. The
strange, wondrous, and esoteric are a hallmarks
of gothic stories, and your game should reflect
that. In many cases a simple reskinning allows
you to use an item without fear of affecting the
thematic feel of your game.
• A combination of cutting-edge scientific

manufacturing processes and incorporating
newly discovered alloys can duplicate the
effects of magical damage and to-hit bonuses.
Insulation provides resistance to all manner
of damage, as well as mimicking the inherent
properties of adamantine, mithril, and elven
chain mail.
• Clockworks, lenses, and alchemical
treatments augment the inherent physical
characteristics, skills, and senses of those
fortunate enough to have access to these
scientific marvels.
• Portable batteries allow a cunning inventor
to imbue weapons with electricity and
overwhelming heat, adding extra stopping
power. There are even rumors of mad
geniuses who have learned a method to
project the energy from walking sticks, canes,
and similar.
• Potions, elixirs, and poisons are the stock
in trade of the alienists, apothecaries, and
alchemists, and can mimic a vast array of
effects. Their efficacy is generally transient,
and the side effects can be debilitating.
• Private, public, and university libraries
abound in the world of Lamp’s Light.
There is no shortage of tomes, grimoires, or
books detailing the esoteric, obscure, and
forbidden.
17
M aking it an A nachronism
I will preface this section by saying that all things institutions cultivated quickly proved to be
being equal this is the simplest for the GM, and unfounded as their partnership blossomed
the one that I would recommend for a lot of under the watchful eye of Dr. Renwick.
groups. Campaigns are set in the shared fantasy Renwick’s willingness to push the
world of the folks on both sides of the screen, experimental envelope, lack of scruples
and the suspension of disbelief that allows magic, when finding subjects, and manic passion
mythic monsters, and other incredible things can for discovery propelled Lamp’s Light to the
be extended to cover a sanitarium, city, or country forefront of the scientific community. There
which has evolved along its own unique path. are grumbles and mutterings of ill-advised
procedures, and “acceptable losses”, but the
A Seat of Higher Education rapidity of progress has been sufficient to keep
the concerns to a minimum.
Master Prosper’s long-standing relationship to the
area’s universities, colleges, and private centers of Adventure Hook: An acquaintance of the
learning allow Lamp’s Light to have access to all PCs — a figure from their past, an informant,
manner of assets. Cutting edge techniques, new or other person of lesser means — is nowhere to
technology, the sharpest minds, and even subjects be found the next time their services are needed.
for experimentation flow in and out of the While searching for their friend the heroes see
sanitarium with regularity. The purpose of their flyers in the poorer sections of town saying,
endeavors, of course, is the betterment of their “Subjects wanted to further the scientific process.
fellows, and the reputations of their institutions. A hot meal, bath, and 1 copper provided for
The college professors’ fear that Prosper’s your troubles.” The flyers have an address and an
death would signal an end to the kinship the ornately embossed “LL” on them.
18
M aking it an A nachronism
An Alternative to Temples death from a diseased leg, she made her way
to Lamp’s Light Sanitarium where she was
Administrator Rose, Dr. Renwick, and the welcomed with open arms by Meri and Dr.
host of alienists at the sanitarium offer a wide Hahn. A week later she left the hospital,
range of services to all comers — services that miraculously healed of her injuries. Especially
are not widely available elsewhere. For those observant PCs notice that she still has a bit
who can afford treatment, the accommodations of a limp, but otherwise moves with amazing
are luxurious and the stay is quite pleasant. agility. If they are somehow able to get her to
Treatments are still available for the poor and show them her leg (a bribe works best), they see
outcast, but allowances are made due to the that it clearly is not the one she was born with,
patient’s social standing. and there is a scar at her upper thigh indicating
Unlike the priests and clerics of the temples, where it was grafted onto her.
the sanitarium cares not what god the patient
venerates, or if they worship at all. Publicly, A Front For Criminal Activities
Lamp’s Light is a center for healing and altruism.
Privately, the staff relish the opportunity to treat With Master Prosper’s untimely demise
— and experiment on — their patients. The the inner workings of Lamp’s Light have
dynamic between Lamp’s Light and the local changed to suit the needs, views, and ideals of
temples is strained to say the least. Administrator Rose, and to a lesser extent Dr.
In a city with strong religious ties, the Renwick. These two malcontents have used
sanitarium is openly scorned, ridiculed, and their connections, opportunities, and lack of
distrusted. In such a city, Administrator Rose scruples to insinuate themselves into numerous
goes to incredible lengths to maintain what nefarious plots, and line their pockets in the
little positive reputation they have within the process.
community. If located in a more metropolitan
city with an open-minded populace, the aid the Adventure Hook: It is an open secret among
alienists provide is grudgingly acknowledged by the social elite that their wayward children,
the local priesthoods. Lamp’s Light’s freedom spouses, and extended family members can
from religious dogma is viewed favorably by the be admitted to Lamp’s Light for treatments to
community, and Dr. Renwick has more freedom remove aberrant and embarrassing personality
to perform his new treatments. traits. A figure from the group’s past, a
rambunctious and garrulous bard or rogue
Adventure Hook: The heroes are in need perhaps, has agreed to a stint of rest at the
of significant healing in the form of greater sanitarium at the urging of her family.
restoration, regeneration, or the like and have A week later their friend is released and
been turned down by the local temple either for returns home. When next called upon, the PCs
lacking the funds to donate to the clergy, or due learn that not only is her personality drastically
to a difference in faith. Upon leaving the church different, but she no longer remembers her close
they are approached by a beggar that overheard friends except as hazily-recalled acquaintances.
their troubles. As disturbing as her new personality is, what’s
She tells the PCs that she too was in the even more disconcerting is that the information
same situation, and that the sanctimonious the heroes are seeking has disappeared with her
fools at the temple refused to aid her. Near old persona.
19
M aking it M ythos
Sandy Petersen’s Cthulhu Mythos for 5e (published ripe for mind switching. The Yith inhabits the
by Petersen Games) goes hand in tentacle with vessel, gathers all manner of experiential data,
the material contained within this book. Lamp’s and when they have completed their mission,
Light provides setting, adventure ideas, NPCs, returns to their distant home. While the Yith
and expanded sanity/madness mechanics to get inhabits the body the dispossessed mind lives
you started in your campaign. SPCM expands in the alien’s form. What few memories they
on that with a comprehensive supplement retain of the experience takes the form of poorly
of Lovecraftian creatures, cults, magic items, recalled dreams and nightmares.
classes, feats, skills, and so much more. The
optional rules for dread, in particular, can be Adventure Hook: An inordinate number of
added to the sanity mechanics contained herein incurable patients have, inexplicably, been cured
to challenge your players and their PCs. The of their afflictions. Publicly, Dr. Renwick and
Great Old Ones, Outer Gods, and other mythos Administrator Rose have taken credit for these
entities view the moon-touched minds within “incurables” who return to their families and
Lamp’s Light with ravenous eyes, slavering celebrate their unexpected recovery. Privately,
mouths, and searching tentacles. Dr. Renwick’s insatiable thirst for knowledge
must be slaked, and he has been stymied in all
Watchers from Without his efforts to learn the cause behind the patients’
sudden change.
The Great Race of Yith have discovered, in the The truth of the matter is that the patients’
patients of Lamp’s Light, a stable of empty vessels minds have not been healed; they have been
20
M aking it M ythos
replaced by Yith explorers. The oddities in the stars are right for them to make themselves
speech, mannerisms, and behavior exhibited known. The combined political and financial
by the aliens in their new bodies have been power of the members of the group, known as
brushed off as the natural side effects of their The Darkness Before Dawn, is such that they
prior condition. Dr. Renwick has enlisted the are able to retain any necessary mercenaries,
heroes to investigate and determine the cause spies, or soldiers. And of course, there’s always
of the patients’ newfound competence. He will Patient 11.
undoubtedly have additional work for them as
the truth of the matter unfolds. Lost Knowledge Revealed
Chaos Unleashed Sages the world over lament the knowledge

lost to the ages. Books are burned, tablets
The cults of the Crawling Chaos can be found shattered, and grimoires destroyed. Other
in any corner of the world. The Outer God’s tomes are simply lost to the ravages of time. Or
willingness to share forbidden knowledge, are they?
regardless of its inherent dangers, ensures that There are things that once released into
there is always a willing audience. A city, such as the world cannot be taken back, cannot be
the one housing Lamp’s Light, is nigh irresistible unlearned, and leave an indelible mark on
to Nyarlathotep, and the veneer of benevolent society. The knowledge contained within lingers
scientific discovery clothing the sanitarium is an on, parasitic in its infestations of scholarly
ideal womb to nurture a nascent cult to the god minds, and yearns to be shared. The truth will
of a Thousand Forms. find a way.
Adventure Hook: The entity posing as Adventure Hook: All existing copies of
Administrator Florence Rose is in fact a high- The King in Yellow have been destroyed,
priestess and devotee of Nyarlathotep. At her and yet this eldritch play’s hold on reality is
patron’s direction she slew the real Ms. Rose such that the patients of Lamp’s Light have
and insinuated herself into the good graces of inadvertently pulled the details from the
Lucien Prosper. With Prosper’s passing, Rose aether and transcribed by their cracked minds
has taken an active role in the rehabilitation of onto whatever media are available to them.
the patients, with a particular focus on those Gathered and organized by persons unknown,
of considerable means. Rose’s therapeutic the disparate pieces were collated into a near-
process has yielded promising results, and in complete copy of the hateful play.
many cases the patients continue to visit her A member of the cleaning staff, Lucretia
on an outpatient basis. Additionally, graduates Waitely, stumbled upon the manuscript, and
of her protocol meet together monthly to hoping to help the patients has organized a
share their experiences and support one read-through. Parts have been assigned to
another. patients, staff, orderlies, and even a few alienists.
Rose has parlayed her connection to the The heroes are visiting Lamp’s Light for their
upper-class patients of the sanitarium into a own reasons when they hear a commotion
small, but incredibly powerful, cult of followers in the common room, and stumble upon
worshipping Nyarlathotep in his Ebon Man the coterie of actors midway through the
aspect. The group has been biding its time, but production.
21
M aking I t M idgard
Midgard is hands down my favorite third- They’ll Never Be Missed
party setting, and their vast catalog contains
more incredible material than I can easily list The folk of Midgard know fey for what they
here (they can be found at KoboldPress.com). truly are: malevolent creatures of undying
There are a number of cities within Midgard mischief, spite, and chaos. They fill their
that could contain Lamp’s Light. The adventure centuries with all manner of depravity to fend
hooks in the previous sections can be added to off the crushing boredom and ennui that comes
the ones listed here to provide countless sessions with their ageless existence. Lamp’s Light offers
of horrific delight to your players. many opportunities for their enjoyment. Some
of their more benign activities include merely
Esoteric Insight observing the antics of the patients, witnessing
experimental treatments, and instigating riots
The gods, old and new, are active throughout of madness. Their enjoyment of these cruelties
the realms of Midgard. In the lands to the south pales before their most revered pastime:
they walk amongst their followers. Ancient, hunting.
primeval forests of antediluvian intelligence dot
the wilds. The very fabric of reality is said to thin Adventure Hook: The fey have an
at its borders. This is the land that the peoples of arrangement with the orderlies of Lamp’s
Midgard call home. Throughout it all there are Light. For a nominal fee the orderlies “allow” a
countless cults and secret societies gathering in select patient, or patients, to escape the facility
the shadows to forward their own agendas. into the nearby forest at night, where the
waiting fey hunt the escapees down. As long
Adventure Hook: The last remnants of as the bodies do not turn up inconveniently,
an ancient cult have completed their Grand the patients aren’t of noble birth, and the
Working and called forth a long forgotten being escapes are kept infrequent, Dr. Renwick, and
of terrible power. Every step was followed, every Administrator Rose turn a blind eye to the
sacrifice made according to the liturgical rites of activity.
their order. And nothing happened. The heroes are traveling the streets late at
Meanwhile, in Lamp’s Light, something night in close proximity to Lamp’s Light. They
has infiltrated the mind of Bok Nantanye. It’s hear a rush of commotion in the nearby forest,
groggy from eons of slumber, but is quickly and a figure in a hospital shift bursts from the
regaining its wits and powers. A PC, a priest or foliage. Seeing the heroes, and obviously fearing
devotee to an enemy of the newly-awoken deity, for their lives, they take a step towards their
is sent portents and omens of a great evil that saviors only to be pierced by an arrow, and then
must be stopped at all costs. another, and another.
22
M aking it R avenloft
By Donathin Frye
It’s very easy to imagine Lamp’s Light Lamp’s Light as a Domain of Dread
Sanitarium as the setting for a horror-fantasy
tale in Ravenloft. To make the most of the Lamp’s Light can easily be imagined as its own
setting for a long-term Ravenloft campaign, small Domain of Dread, with just a few surreal
focus on the horror of madness and despair. touches to make the characters feel trapped
No matter where the characters go after leaving and hopeless. Change the backgrounds of any
Lamp’s Light, they are forever scarred by the NPCs tied to a specific city or town, and instead
insanity of their experiences in the sanitarium, consider partial amnesia; patients who spend too
and their plagued dreams are haunted by the long at Lamp’s Light can no longer remember
twisted experiments and secret terrors they where they came from. Even the player characters
witnessed within its walls. In Ravenloft, the may begin to forget details from their past as they
characters can never truly escape Lamp’s Light; spend more time on the sanitarium grounds.
it will always remain a part of them. Whether it is day or night inside the
For more information on Ravenloft as a sanitarium, whenever the characters step
campaign setting, read up on Curse of Strahd through its doors to the outside, it is always
published by Wizards of the Coast, or the many a cloudy night and the moon is always full.
Ravenloft adventures and sourcebooks available Any attempts to escape the grounds will
on the DM’s Guild online. result in the characters being swallowed up
23
by Ravenloft’s infamous thick, cloying mists. Matt on Ravenloft

When they finally pass through the mists, The mood, spirit, and lethality of Barovia and
the characters find themselves returned to the the other Domains of Dread are an excellent
sanitarium’s front gates, where a single lamp’s springboard for the gothic locations, NPCs,
light shines eerily through one of its front and items contained with the Lamp’s Light
windows. They cannot escape Lamp’s Light, Sourcebook to shine as major players in your
not easily. campaign. The subtle and persistent loss of one’s
Begin with the adventure Tabula Rasa. faculties from the stress of adventuring within the
When the players finish the adventure, demi-plane of Dread offers countless roleplaying
Ravenloft’s mists engulf them and they find opportunities, and even for those that somehow
themselves returned to their beds, locked into escape they will carry those mental scars until the
their restraints. Allow the players time to meet end of their days.
the other inhabitants of Lamp’s Light and
explore the grounds, and then run Apotheosis of
Nightmares as the setting’s climactic adventure. them to suicide, and Count Strahd is worried
Over time, the characters can uncover the that Elys may be next.
true fiendish nature of Administrator Florence To amp up the horror and give characters an
Rose, the Darklord of Lamp’s Light Sanitarium. early, terrifying encounter with Strahd, replace
If the characters are able to stop Florence from Dr. Renwick with the Darklord himself in the
summoning her dark patron into the realm, and adventure Tabula Rasa. Like all who dwell in
thus save the patients and staff at Lamp’s Light, Barovia, Administrator Rose secretly serves
they may finally be able to escape from the at the whims of the Darklord. She offers to
sanitarium’s grounds. The domain’s mists will release the characters from their captivity and,
finally part for them, allowing the characters in return, asks them to investigate the suicides.
to travel to other worlds for further dark She hopes that they will be able to save Elys’s
adventures in the Demiplane of Dread. mind and life, so that Strahd can continue his
experiments on the poor, doomed girl. How
First Steps into Barovia the characters conclude the adventure will
determine how their relationship with Strahd
Alternatively, the cursed, sleepy town of Barovia develops, and may very likely result in the
is a perfect place to set Lamp’s Light Sanitarium. Darklord blaming the characters for the loss of
The events of Tabula Rasa make a compelling his beloved Tatyana.
alternative to Death House as an introduction to
a Curse of Strahd campaign. Future Adventures in the Domains of
The Darklord of Barovia believes that Dread
a girl from town named Elys is the newest
reincarnation of his eternal love and tormenter, While any Domain of Dread could be the next
Tatyana. Count Strahd has stolen Elys away stop for the characters after they escape from
to Lamp’s Light, where he has been invasively Lamp’s Light, one perfect location to explore
experimenting on her mind in hopes of next is the sophisticated city of Port-a-Lucine.
unlocking memories of her past life. However, a The cultural heart of Ravenloft, Port-a-Lucine
dark entity known as a nimbus is feeding off of is the capital of the Renaissance France-
the madmen in Lamp’s Light, ultimately driving inspired domain, Dementlieu, and is led by the
24
political puppet, lord governor Marcel Guignol.

However, the domain is truly ruled by the
powerful and manipulative psychic, Dominic
D’Honaire. Dominic is Dementlieu’s secret
Darklord, but his power is contested by his
greatest nemesis: a powerful entity known only
as The Living Brain, and the entity’s psychically-
controlled organized crime ring.
The experiments and maddening horrors
experienced by the characters in Lamp’s Light
Sanitarium could have made them immune to
both Dominic D’Honaire and the Living Brain’s
psychic powers, allowing them to become
embroiled in the struggle to control Port-a-
Lucine, and perhaps even save the city from its
wicked puppet-masters.
25
M aking it R avnica
By Donathin Frye
Ravnica is a singular worldwide cityscape ruled A Cog in the Interlocus

by powerful, politicking guilds willing to take
extreme measures to gain even the smallest scrap In the territory of the Izzet League, Lamp’s
of territory or leverage; and it’s that high stakes Light Sanitarium exists to serve the strange
political powder keg that might make Ravnica and unimaginable machinations of the ancient
the perfect companion for your adventures into dragon founder of the Izzet guild, Niv-Mizzet.
Lamp’s Light Sanitarium. Certain NPCs within Dr. Renwick is a secret agent of Niv-Mizzet,
the asylum are secretly acting on behalf of an Izmagnus, one of a handful of leaders that
specific guilds, and how the characters navigate answer only to their draconic leader. Whatever
Lamp’s Light could have unpredictable results Niv-Mizzet’s plans are, most other guilds that
on the vicious guild wars that ravage the world are aware of the dragon’s meddling believe
around them. Be sure to show your players the they can only bring ill to the rest of the world.
consequences of their characters’ actions, how Consider that Dr. Renwick’s wild experiments
their choices are shaping the world of Ravnica in the adventure Tabula Rasa could bring more
around them. power to the Izzet League if the characters do
For more reading on Ravnica as a not stop them, or might instead spark a war
campaign setting in Fifth Edition, pick up the between Izzet and other clans if some of the
Guildmasters’ Guide to Ravnica published by worst atrocities of Lamp’s Light are revealed to
Wizards of the Coast. the rest of the world.
26
M aking it R avnica
The Grim Feast Matt on Ravnica

I absolutely love the use of Lamp’s Light
Of course, the Izzet League may not be the Sanitarium behind the scenes and as a location
only guild with secret machinations within that is embroiled in the machinations and
the sanitarium. Consider that Administrator Machiavellian plots and intrigues of the guilds.
Rose’s secret patron might be an ancient Moroii Lamp’s Light’s position as an institution of
Vampire that feeds on the youth and psychic learning, healing, and philanthropy is the ideal
energies of the patients at the asylum. It’s façade to obfuscate the true powers behind the
possible that Rose, working as a secret agent scenes. In Ravnica, Lamp’s Light may play a
of House Dimir, is attempting to resurrect the subtle yet nonetheless crucial role as the site of the
previous guild leader: Szadek, a 10,000-year- countless battles in their cold war.
old Moroii vampire powerful enough to
threaten the freedom of everyone in Ravnica.
The characters could find themselves fooled
by Rose’s trustworthy demeanor, working to
undermine the Izzet League in the adventure
Tabula Rasa only to be blindsided by the greater
threat of House Dimir, Administrator Rose, and
her secret patron in the adventure Apotheosis of
Nightmares.
Shaping the Future of Ravnica

The best way to build off of your adventures
within Lamp’s Light Sanitarium to play into
a longer Ravnica campaign is to focus on
the characters’ actions and the long-term
consequences of their choices. What Ravnica
Guilds have they made unwitting allies of, and
how? What Guilds will become bitter enemies
because of the secret plans the characters have
foiled? How have the power dynamics of
the world changed because of the characters’
actions?
As your campaign into Ravnica progresses,
find ways to bring back old patients and other
NPCs from Lamp’s Light to further obfuscate
the shadowy machinations of Ravnica’s Guilds.
It’s that constant power struggle and shadowy
war that defines the setting so spectacularly — a
shadowy war in which your players will now
find themselves forever a meaningful part.
27
M aking it E berron
By Donathin Frye
While Eberron’s war- Eberron, balance

torn history is likened exciting action
to the period of shaky scenes with slower-
peace between World paced mysteries: lead
War I and World your players to red
War II, the setting’s herrings, or NPCs
pervasive low-magic that seem guilty or
world is inspired suspicious but may
by pulpy adventure actually be innocent.
movies: Brotherhood For more reading
of the Wolf, Indiana on Eberron in Fifth
Jones, Casablanca, The Edition, check out
Mummy, and Pirates the Wayfinder’s Guide
of the Caribbean. to Eberron by the
Eberron is a loving setting’s original
amalgamation of creator, Keith Baker.
film noir, pulp, and
steampunk — and On the Edge of
you can use any the Crying Fields
of these genres to
bring a unique flair Give NPCs like
to running Lamp’s Otto Keller and
Light Sanitarium in Administrator Rose
Eberron. access to simple
Remember that magic cantrips, as
simple magic is magewrights. Play
commonplace in Eberron due to the NPC class up Dr. Renwick as your red herring, an obvious
“magewright”; the locksmith down the street villain unaware of a greater evil taking place
uses simple magic to do their job, as much as at the sanitarium. In Eberron, Renwick is an
the janitor uses low magic to clean the asylum artificer of no noteworthy reputation, who has
and fix its machines. While powerful magic recently been rejected for the third time by
is very rare in Eberron, add flavor to Lamp’s Arcanix, one of the greatest institutes of arcane
Light by allowing your NPCs to make use of learning in the world. Desperate to further his
simple magic spells. To nail the pulpy aspects career, Renwick has taken a position at Lamp’s
of the setting, portray your villains as larger Light Sanitarium, a secluded compound far
than life characters by spending extra attention from the great city of Sharn. Lamp’s Light is
on describing what makes them weird, scary, on the border of the sleepy town of Ghalt in
or powerful. And to play up the noir spirit of Aundair, and the Crying Fields — a crimson-
28
M aking it E berron
Matt on Eberron In Xoriat, daelkyr have created legions of

I’m going to admit a little secret. At one point abhorrent monsters to serve them: beholders,
in the creation of Lamp’s Light, it was set in mind flayers, parasitic oozes, and far greater
Eberron. Several of the NPCs were actually horrors.
written with Keith Baker’s amazing setting For seven thousand years, Xoriat has been
in mind. I don’t think you’ll have a hard time out-of-sync with Eberron, and Belashyrra is
making it fit there at all. It was a great sandbox one of the only daelkyr to be imprisoned in the
that, unfortunately, I didn’t get much time to play subterranean realm of Khyber. When you run
in. Lamp’s Light has mad scientists, inhuman the adventure Apotheosis of Nightmares, allow
creations, and alien monstrosities. Perfect for any Administrator Rose to be a secret agent of the
pulp adventure. Cult of the Dragon Below, who is worshipping
Belashyrra in exchange for a promise of power.
If the characters do not stop her over the
bladed, largely uninhabited grassland shrouded course of the adventure, Administrator Rose
in fog and said to be haunted at night by the will break Belashyrra free from the daelkyr’s
ghosts of soldiers and battles past. underworld.
Dr. Renwick’s desperation for a breakthrough
worthy of notice by the wizards of Arcanix have Unleashing the Realm of Madness
caused him to be willing to hurt the patients
of Lamp’s Light. That desperation and his Should Belashyrra be able to bring Xoriat into
obsession with his career should be uncovered sync with Eberron once again, even temporarily,
as you run the adventure Tabula Rasa. While the world will be invaded by maddening
the player characters will eventually face the creatures and alien geography that defies all
nimbus and perhaps confront Dr. Renwick logic and reasoning. The characters may see
himself, consider revealing a plot twist found in massive drifting entities the size of mountains,
Renwick’s secret diary or elsewhere: the nimbus rivers of a milky white liquid washing over the
is a creature from Xoriat, a hellish underworld plains, rains of blue globes falling from unseen
dimension. That it was able to find its way to heights only to burst and release horse-sized
the characters’ plane of existence should be ticks on impact, and other horrors. The insanity
terrifying. of the Realm of Madness may be a natural
next step for your characters after the events of
The Lord of Eyes Lamp’s Light.
If the characters are able to stop
The true threat rising in Lamp’s Light Administrator Rose and Belashyrra from
Sanitarium comes from the machinations of permanently merging the two worlds, they
an immensely powerful daelkyr known to only would no doubt become famous heroes, giving
a handful of scholars as Belashyrra, the Lord them access to powerful allies in Sharn and
of Eyes. Daelkyr are an immortal and god- elsewhere in Eberron in their future adventures.
like race that appear like handsome humans Of course, victory against Belashyrra would
bearing armor and weapons made from chitin also make the characters enemies to the other
and raw muscle. Daelkyr rule over Xoriat, the five daelkyr lords trapped in the underworld
Realm of Madness, a terrifying dimension that of Khyber, and to their agents on Eberron: the
exists just out-of-sync with the rest of Eberron. Cult of the Dragon Below.
29
M aking it W eird V ictorian

By Donathin Frye
If you want to run Lamp’s Light Sanitarium national confidence and supremacy led to a
in a more modern, Earth-like setting, look no time of finding comfort in romanticism and
further than Victorian-era England, which mysticism with regard to religion, social values,
spanned the period of Queen Victoria’s reign and the arts.
from 1837 until her death in 1901. At this Characters in a Victorian setting would
time, Britain embarked on a global imperial have to approach problems with a certain
expansion, particularly in Asia and Africa, which thoughtfulness and subtlety that such a fine
made Britain the largest empire in history. This society might require. For example, one simply
does not wear plate mail to a dinner party,
Matt on Weird Victorian and in fact, wearing plate mail and carrying
a greatsword around London at all would
There are countless weird Victorian adventures very likely see you thrown in jail for being a
that can be run in the world of Lamp’s Light suspected terrorist or madman.
Sanitarium. The original Sherlock Holmes books, Also consider whether or not you want
and their countless more modern homages, will magic spells to exist in your Weird Victorian
provide campaign fuel for years. Perhaps Rose game. One option is to reskin, or re-imagine
(or Renwick) assume the role of the archvillain, your standard magic spells and abilities to be
unleashing experiments and patients on the the results of characters using strange, maybe
unsuspecting public? As Don mentions below, the unstable inventions that would fit right into a
change in your game isn’t so much mechanical Weird Victorian campaign.
as it is social and via roleplaying. Embrace the For more ideas on running a Weird Victorian
challenges and the roleplaying opportunities they campaign in 1800s Britain, consider Cthulhu by
present! Gaslight, published by Chaosium.
30
M aking it W eird V ictorian
Surviving Jack the Ripper to hear rumors of more mysterious deaths and
strange happenings.
There are few more iconic historical figures A few small changes to the adventure
during the Victorian era, and perhaps no more Apotheosis of Nightmares make it a perfect fit for
iconic mystery, than the never-found serial your Weird Victorian setting. Administrator
killer Jack the Ripper. Consider that he may Rose isn’t a shapeshifter, but instead a good
have never been found because he ended up as a woman possessed by the demon Balthazar.
patient in Lamp’s Light Sanitarium. When you Balthazar has concocted a plan to unleash Hell
run the adventure Tabula Rasa, Dr. Renwick’s on Earth by summoning the Devil, Lucifer
patients slated for his weird experiments aren’t himself, to London.
committing suicide; rather, they are being
viciously murdered, their throats and bellies Agents of the Queen
cut open by a jagged blade, and Administrator
Rose is desperate to find out who is behind the The characters have many approaches to
killings. stopping Balthazar’s hellish plan. If they work
Instead of the enemy being the nimbus, as with Otto Keller, they may even come to
per the original adventure, allow it to be Bok believe they could perform an exorcism to cast
Nantanye, known to most as Patient 11. When the demon out of Administrator Rose without
Patient 11 snaps out of their catatonic state, taking her life. Should the characters save both
the demon that possesses them urges them London and Administrator Rose’s life during the
to murder women chosen for Dr. Renwick’s adventure Apotheosis of Nightmares, she will be
experiments using a scalpel that he’s stolen eternally in their debt.
from Renwick himself. If the characters are able As a wealthy, well-connected woman, the
to find the murder weapon, they may suspect true Administrator Rose could connect the
Renwick, but he’s just a red herring. To save characters with other historic figures for more
Elys, the characters will have to stop Patient 11. weird historical adventures — maybe even
Dr. Renwick or Administrator Rose may give Queen Victoria herself.
them access to his patient file, including the
previous Jack the Ripper victims from history.
The Devil’s Handmaiden

Patient 11 isn’t the only NPC at Lamp’s Light
Sanitarium that is possessed. Administrator Rose
is also possessed by the demon Balthazar, and
Balthazar has been very careful and patient in
serving his master, the Devil. After the events of
Tabula Rasa, it’s very likely that Administrator
Rose does what she can to free the characters
and help them leave Lamp’s Light; after all, they
could become a problem. If they decide to stay,
or if they return to Lamp’s Light to check in on
Otto or some of the patients, they may begin
31
“There are times in your life that you will need a sanctuary.
It is my sincerest hope that Lamp’s Light is the illumination in the darkness for you.”
— Lucien Prosper
L
amp’s Light Sanitarium has been philanthropy, kindness, and compassion
providing expert and discreet medical towards those less fortunate than himself.
care to upper-class citizens for much of Prosper ran Lamp’s Light tirelessly until
the last century. The institution offers a variety his untimely death. Upon his passing
of mundane medicinal services, but they are the sanitarium fell into the able hands
known for their specialization in treating manias, of Administrator Rose. In her tenure the
melancholias and dementias. Lamp’s Light has facility’s reputation has evolved somewhat,
become the de rigueur convalescence home for and many former patients feel such a strong
the city’s ruling elite and merchant princes. bond with one another that they continue
The sanitarium is located at the edges of the friendships and relationships that began
the university district near many institutions while institutionalized. Administrator Rose has
of fine learning, and enjoys a close association continued Prosper’s tradition of altruism, and
with the most respected professors, sages and the sanitarium typically has scores of patients
antiquarians of the district. that are being treated gratis. As is only proper,
Lamp’s Light is the product of the vision these patients are housed in their own wing of
and drive of Lucien Prosper. Master Prosper the asylum and are treated separately from the
was well known in the community for his more affluent guests.
32
From the Journal of Lucien Prosper,
A B rief H istory of 40 years ago
On my walk today with Governess Winsome we
L amp ’ s L ight had the most discomfiting experience. As is our
custom on the first day after the new moon we
Lucien Prosper was the only son of Margery and went to a less savory neighborhood. As nervous
John Prosper. Margery was the only daughter as these trips make my teacher, I find them
of a family of nobles that had fallen on hard exhilarating and endlessly stimulating to the
times, and John was a young man who pulled mind. To see, and experience, that part of the city
himself up by his bootstraps to make a name for and see how others must live.
himself. Their marriage was one of convenience Halfway through our stroll we came upon a
and alliances. Margery’s family would receive a man, or woman; I can’t really say. The figure
much-needed infusion of gold from their new was sheathed in rags, what skin I could see was
son-in-law, and John would gain the last piece covered in filth, and his matted hair sprouted
of respectability he’d worked so hard for: a title. erratically from his head. All signs of gender, and
At the end of their second year of species for that matter, were hidden from sight.
matrimony, Margery welcomed Lucien into No sooner had we come across the unfortunate
the world. She did not survive the experience; than he began to gesticulate queerly, and speak to
John relegated his newborn son to a wet-nurse, an unseen person.
and later a governess and string of tutors for “Is he some kind of magician or prophet?”, I
his education and rearing. For his part, John asked questioningly. I knew of prophets from my
Prosper worked himself to death, making certain books, and that they sometimes saw, and spoke to,
that Lucien would never want for anything. the unseen. Had we stumbled upon a holy man in
the gutters?
The derisive laugh from Ms. Winsome told
me more than her reply. “Hardly. Come along,”
she answered curtly, “this person is broken, and
there’s nothing anyone can do for them.”
Before I could ask her what she meant
by “broken”, the figure turned to shouting at
the invisible irritant, and grew violent. Ms.
Winsome practically dragged me from the quarter,
and in our wake, I heard the poor soul pounding
on the ground, and ripping at his remaining hair.
With his father’s death Lucien was at a

crossroads. He had no interest in his father’s
affairs, and enough funds to choose his own
destiny. Like so many of his contemporaries he
chose to pursue higher education and attend
university. It was there that he met a man who
would become his most steadfast friend and ally.
33
L amp ’ s L ight S anitarium
From the Journal of Lucien Prosper, From the Journal of Lucien Prosper,
25 years ago 20 years ago
I’ve met someone, whom I dare say will be a Lamp’s Light has opened and already the local
friend and confidant for years to come. Our constabulary recognize the expertise and assistance
studies have crossed paths, but I never felt an that we offer. Earlier today Orson and I were
urging to introduce myself. Fate took hold, as it called to the city in regards to a “enraged lunatic,
often does, and while looking for a copy of the De destroying everything in its path.” With all
Humani Corporis Fabrica Libri Septem I came haste we answered the summons, and to our great
face to face with Orson Renwick. shock found a creature of unliving construction.
I have never met another with such interests! Renwick’s fascination overrode what sense he has,
We spent the rest of the day, and evening, in deep and somehow, we calmed the creature and brought
conversation. It was as if every repressed feeling, it with us to the facility.
thought, and action of the prior decade came Cleaned, clothed, and with a purpose, the
rushing out in a torrent I could scarcely contain. being has dubbed itself Gneigel, and to my shock
begun construction of a wall around the grounds.
Orson has posited that the being’s rampage was
Dr. Orson Renwick and Lucien Prosper were caused by its lack of direction and purpose. Gods
nigh inseparable after that initial chance help us if he loses his purpose again.
encounter. Lucien had never met a man of
such brilliance, let alone someone that shared
his near obsession with the scientific treatment The years have been kind to Lamp’s Light,
of the mentally ill. For his part, Renwick its staff, and truthfully the majority of its
recognized a kindred soul, and a patron with patients and the community as a whole.
deep pockets. By the end of their didactic From the day they opened their doors,
education they had become true friends, as well the sanitarium has insisted on treating all
as colleagues. patients, regardless of their social status or
When their time at university came to an end means. This groundbreaking idea was not
it was only natural that the two continue their initially well received, but as their reputation
association, and thus Lamp’s Light Sanitarium grew, and folk of importance were treated
was born. The funding for the facility strained successfully, the philanthropy was accepted by
Lucien’s resources nearly to their limits, but the the city.
final results speak for themselves. With acceptance came closer ties to the
universities, and a constant stream of students
came to Lamp’s Light to learn under the
watchful eyes of Master Prosper and Dr.
Orson Renwick. Against all expectations the
facility became financially solvent through a
combination of donations, fees for services,
and selling of discoveries made by the staff.
The years turned to decades, and Lamp’s Light
Sanitarium became a respected institution of
learning and healing.
34
A B rief H istory of L amp ’ s L ight
From the Journal of Lucien Prosper, In short order Rose proved invaluable in
3 years ago cultivating and strengthening the bonds the
Lamp’s Light shines even brighter with our sanitarium has with the community, and in
newest addition, Ms. Florence Rose. Her doing earned the grudging respect of Renwick.
exuberance, patience, and inquisitive nature Rose’s willingness, and aptitude, at tasks that
are a balm to the patients and staff that I’d not Prosper and Renwick were uninterested in,
known was needed. She takes a great interest in cemented her place in the tribunal of leaders of
the efforts of the staff to assuage the torment of Lamp’s Light.
our most ill guests, and through sheer kindness,
compassion, and perseverance has made inroads. Last Year
In the short time since our introduction “The sudden death of Master Lucien Prosper
I’ve grown very fond of her, and I must say shakes the community. His remains have been
that despite our difference in ages I find myself interred in a mausoleum on the grounds of
thinking of her often, and feeling younger for Lamp’s Light Sanitarium, his life’s work. He
it. Renwick is unimpressed with her, but I am leaves behind no family; only grieving friends,
enthralled by this lovely young woman. colleagues, and this epithet written upon his tomb.
Long-time colleague and assistant, Florence Rose,
has vowed to continue her mentor’s work with the
For the first time in decades Master Prosper’s patients of Lamp’s Light Sanitarium.”
attentions were diverted from his work. The I leave Lamp’s Light in the capable hands of
alienists and staff of Lamp’s Light took note of those that toil within it.
their benefactor’s improved mood and lighter All who have loved me, now in my passing,
step. All but Dr. Renwick, who saw the girl as a love those who need it most.
distraction at best.
35
T he G rounds
The Entrance to the Compound The gate can be opened either with brute
force (DC 15 Strength [Athletics]) or by picking
The grounds of Lamp’s Light are the lock (DC 12 Dexterity [Thieves’ Tools]).
encompassed within a wall of natural stone.
The workmanship is somewhat primitive, The Grounds
as if constructed by someone with only
a rudimentary knowledge of masonry. A meandering cart path leads inward from
Regardless, it is sturdy, well maintained, the gate. While the path is well-maintained
and at a height of 7 feet affords the facility a the density of the vegetation within the walls
semblance of privacy. There is a single break is in stark contrast with the surrounding city.
in the wall; an entrance large enough for a As you round the second bend the trees thin
horse and cart to drive through. The gate out and the vegetation takes on a manicured
consists of two simply-constructed fence appearance. The path leads you directly to a
doors that swing outward when opened. When sprawling three story manse.
closed, a pair of iron rods anchor them to the
ground and a lock prevents casual passersby The estate covers several acres, and with the
from entering the compound. exception of the road and the immediate
vicinity of the sanitarium it has been left to its
The wall encircling Lamp’s Light was wild state. The estate is maintained by Gneigel,
constructed by Gneigel (see Appendix C, page and the only other manmade structures on the
148) shortly after the institution was opened. grounds are his one-room cabin and Lucien
The wall is easily climbed (DC 8 Strength Prosper’s sepulcher.
[Athletics]) for those not wishing to use the PCs wishing to explore the woods find
gate. The gate is opened by Gneigel at dawn, numerous game trails. The lack of predators
and closed when he returns at dusk. and abundance of food have created a haven
36
T he G rounds
for game animals such as deer, rabbits, and investigating the cabin at night have a 1 in 6
pheasants. Any attempts to hunt game within chance of encountering the groundskeeper.
the property are made with advantage. Other than the books there is nothing of
interest in the cabin. It is drafty, filthy, and
Gneigel’s Cabin has no personal
touches. The books
A well-worn game on the floor are
trail leads from The Chants of Flesh,
Lamp’s Light The Enchiridion of
into the forest. A Tonoca, and The
hundred yards Codex of Haeri.
into the forest is a The books change
ramshackle cabin periodically as he
nestled between borrows or acquires
three trees. new ones.
The cabin looks
almost as if it was Lucien’s
grown from the Mausoleum
forest, or perhaps
the resident The primeval
has chosen to forest abruptly
encourage the gives way to a
forest to take the manicured lawn,
cabin back into in the center of
itself. which stands the
There is a single door, an opening on the final resting place of Lucien Prosper. The
eastern wall, a patchwork thatched roof, and mausoleum has a single stone door, and a sky-
no chimney. The door hangs loosely in the blue crystalline roof sits atop a ring of doric
frame and looks ready to fall if disturbed. columns. There are no signs of weathering,
damage, or wear anywhere on the structure. It
Characters investigating the building are able looks as if it was finished very recently.
to enter it with ease. Read or paraphrase the
following when they enter the dwelling: The mausoleum is the final resting place of
Lucien Prosper. The crypt was sealed at the
Whomever, or whatever, calls this place home time of his death, and by all accounts has
must eat and sleep elsewhere. There is no not been disturbed since. The immediate
pallet for sleeping, no signs of an eating area, surroundings are meticulously maintained by
and no fire pit. There is a single chair and a the groundskeeper and it has been imbued with
stack of three books on the floor next it. subtle preservation magic to fend off the effects
of time and the elements.
Gneigel is never in the cabin while the sun is
up, and only there at night when he does not
have other errands to attend to. Characters
37
T he S anitarium
Lamp’s Light is a sprawling three story The Main House is the public face of the
structure constructed of hand-cut masonry, institution and is used for greeting visitors and
copper gutters, and a slate roof. The gothic new patients to the facility. The staff offices fill
architecture is enhanced by turrets at the far much of the first floor, along with a cafeteria
reaches and a smattering of gargoyles atop the and a large common room. These rooms are the
roof of the Main House. At the apex of the Main only places at Lamp’s Light in which patients
House there is a small bell tower; the clapper from disparate backgrounds could potentially
has long since been removed, and a blackened intermingle. The upper floors are more private;
copper spire is the target of frequent lightning treatment rooms for the patients can be found
strikes. on the second floor, and housing and staff
Palladian style windows can be seen offices on the third.
throughout the Main House and provide The asylum itself is spotless and meticulously
ample light to the facility’s guests. Perhaps appointed. The entryway and other rooms
the most striking feature of the facade is the that are open to the public are plush, luxurious
large circular attic window centered on the even, and give the impression of a grand hotel
entryway below. The covered entryway of the more than a sanitarium. In keeping with the
asylum features four supporting stone pillars, decorum of the rest of the Main House the
a simple pediment, tiled floor and slate shingle treatment rooms in this section of Lamp’s Light
rooftop. Two enormous heavy doors provide could easily be mistaken as a parlor room in any
entrance to the facility. aristocrat’s home.
38
T he S anitarium
The East and West Wings are arranged in them is not possible for any but the tiniest of
a staggered formation off of the Main House. creatures.
The design maximizes the amount of sun and At full capacity the asylum is able to care for
fresh air that the patients are able to experience. as many as 100 souls.
The grand windows of the Main House are
replaced by simpler, ribbon style windows. The DM’s Note: Unless otherwise noted the doors
windows are large enough to allow light into of Lamp’s Light are constructed of solid oak,
the wing but small enough that egress through have AC 15, and 17 hit points.
39
T he F irst F loor
1A. Parlor A woman in a simple, pristine white

uniform sits behind the desk, greeting visitors
A simple, elegant room lies before you. warmly as they enter. A table to her left has a
Its wooden floor gleams and well-placed pitcher of water and cups for those waiting in
everburning lamps illuminate every corner the lobby.
giving the room a sense of warmth and “Welcome to Lamp’s Light! I’m Meri. How
comfort. may I be of assistance?”
To your immediate left is a desk. On your
right a bench sits against the wall, and another Visitors to Lamp’s Light are greeted with a smile
chair is placed near it for those waiting. and a kind word by Meri (see Appendix C, page
The north of the room includes wide 162). She directs visitors to the cafeteria or to
hallways traveling east and west the breadth the bench as they wait for an escort. Under no
of the Main House, as well as a set of swinging circumstances are unauthorized visitors allowed
double doors directly in front of you. to roam freely on the first floor.
40
T he F irst F loor
41
If the situation calls for it, Meri can summon 1C. Admitting Office
a pair of orderlies (see Appendix C, page 173)
every round. The orderlies begin arriving within The admitting office is often the first room that
1d4 rounds. Alternatively, she can call a staff guests see when they visit Lamp’s Light. The room
alienist (see Appendix C, page 144) within serves many purposes, but chief among them is
2d6 rounds. When as a place for the
summoning an families of potential
alienist there is a patients to discuss
1 in 6 chance that the treatment of
Administrator their loved ones.
Rose (see Appendix
C, page 181) Walking into the
or Dr. Renwick room you see a
(see Appendix secretary’s desk
C, page 177) is immediately to
summoned. The your left, two
parlor door is writing desks
locked (DC 17 nestled against the
Dexterity [Thieves northern wall, and
Tools]) every evening at dusk by Dr. Renwick or an expansive executive desk on the far wall in
Administrator Rose and unlocked the following the southwestern corner of the room.
morning at dawn. The bustling sounds of the hallway fade to
nothing as the door closes behind you.
1B. Main Hallway
At any given time 1d3-1 staff alienists occupy
The hallway extends the length of the Main this room, consulting with a visitor to Lamp’s
House and is the main thoroughfare of traffic Light.
within the facility. Alienists, orderlies, and other Wealthier patrons and members of the
staff can be seen walking from room to room as nobility are usually seen in a more private
they go about their day. location (1H) for discussions with Dr. Renwick
Visitors may glimpse the occasional patient or Administrator Rose.
(see Appendix C, page 174). Patients that
are more presentable, both physically and 1D. Western Stairway
behaviorally, are given some freedom and
allowed to use the common room (1L) during The door to the stairwell up to 2A is kept
specified hours of the day. locked at all times and anyone that appears to
The hallway terminates in two doors, one be taking an interest in it is quickly redirected
to the east and one to the west. Characters who to other areas of the main floor. The lock is of
walk down both ends of the hallway notice the moderate quality (DC 15 Dexterity [Thieves’
exit doors are similar but not identical. Tools]).
42
T he F irst F loor
A flight of plain stairs leads to the floor above. The doors are simply constructed, heavy,
They curve around the hallway just as they and made of oak. A brass locking mechanism
end in a landing. stands in stark contrast to the darkly stained
wood.
This stairwell is used to transport unruly
patients to the 2nd floor with as little If the characters have examined both sets
disturbance to the rest of the asylum as possible. of doors, read or paraphrase this additional
The staff alienists have a key to this lock upon description:
them at all times. Select orderlies (1 in 3) also
have a key. Compared to their counterparts across the
room, the doors at the end of the western
1E. Doorway to the West Wing hallway are heavier and have subtle iron
banding worked into them to provide
At the western end of the lobby, past the extraordinary strength. The brass locking
swinging double doors of the cafeteria, another mechanism and bolt are likewise heavier.
set of double doors are inset within the
western wall. PCs examining the lock on the doors to the
West Wing see that it is of moderate quality
43
(DC 15 Dexterity [Thieves’ Tools] unlocks) two seated across from one another, dot the
and that when the bolt is engaged there is room. A family-style table, large enough for
no clear way to retract it from the other side. half a dozen to eat comfortably at, dominates
Opening the door with brute force would take the western corner of the room.
tremendous effort (DC 20 Strength [Athletics])
and be certain to draw the attention of everyone The cafeteria is the social hub of the Main
nearby. Due to its reinforcements this door has House, and is rarely without a least a few
AC 17 and 27 hit points. patients, staff, or staff alienists taking their meals.
Meals are served by one of a trio of half-elven
1F. Stairs to the Basement brothers: Mezin, Suix, and Vei. The brothers
(commoners) oversee all aspects of the cafeteria.
The door to the stairwell down to the Basement The pantry is unlocked and contains enough
(area BA) is kept locked at all times and is food to feed everyone in Lamp’s Light for a
monitored by the staff. Any who appear to week before they begin to run short on supplies.
be taking an interest in the door are quickly Master Prosper’s dietary advice is still
redirected to other areas of the main floor. followed within the facility. Breakfast is a
Those that wish to examine it more carefully light soup or broth. Lunch is fresh fruit, raw
(DC 20 Intelligence [Investigation]) notice that vegetables, and the only meal of the day to
iron bands are cleverly integrated into the door, include meat. The final meal is served at dusk
and that the locking mechanism is much more and is a portion of bread with soup. Under no
complex (DC 20 Dexterity [Thieves’ Tools]) circumstances are wine, ale, or spirits served.
than the other doors in the facility. When
opened, the door is easily twice as thick as a 1H. Alienist’s Office
typical door and the iron reinforcements are
easily seen from this side. The internal brass lock This office is furnished in a simpler manner
requires a key on both sides of the door. than you have seen elsewhere in the asylum.
There are plain desks, with a partition
1G. Cafeteria between them to foster a semblance of privacy,
and a table with the remnants of previous
Two swinging doors open to a well-appointed meals strewn atop it.
cafeteria. Your eyes and nose immediately
draw your attention to a wooden bar a dozen The door has a simple lock (DC 12 Dexterity
feet in front of you. Platters of steaming food [Thieves’ Tools]) that is always engaged. All
are laid out beckoning you forward. A young of the staff alienists have keys, as do many
half-elf, in the same uniform as the woman of the staff members (1 in 4). This room is
who greeted you, makes eye contact and used exclusively by the alienists for meals and
silently asks if you’d like refreshment. discussing patients before and after rounds. Dr.
The layout, furnishings, and atmosphere Renwick comes into this room occasionally
remind you of some of the finest inns that when looking for a student. The room is used at
you’ve visited in your travels. Several small all hours depending on the alienists’ schedules
tables large enough for a single occupant, or and the census of the facility.
44
T he F irst F loor
1I. Receiving Office 1J. Doorway to the East Wing

An ornately carved door with etched A set of simple, heavy double doors at the
glass opens to a spacious office. There are end of the long hallway are all that marks the
bookshelves lining the walls, and an expansive entrance to the East Wing. As you get closer
mahogany desk immediately in front of you. you can’t help but notice that there is a brass
The room is tasteful and elegant, even more so locking mechanism and a bolt on the lobby side.
than the parlor.
If the doors to both the East and the West Wing
This office is used by Administrator Rose have been examined, the characters notice that
and Dr. Renwick when discussing Lamp’s this door lacks the reinforcements that the other
Light business with wealthy and important door has.
personages. The door is kept locked at all The door is locked during evening hours
times (DC 12 Dexterity [Thieves’ Tools]). (DC 12 Dexterity [Thieves’ Tools] to open).
To ensure the privacy of their guests Lucien
Prosper enlisted the aid of a local wizard; the 1K. Eastern Stairway
entire room and its occupants are protected as if
wearing an amulet of proof against detection and The eastern stairway serves as the main point of
location. access to the second floor, leading to location 2G.
45
1L. Common Room appropriate based on his or her physical, mental,

and emotional status. The alienists know full
There are two entrances to the common room, well that they are responsible for their patients
one on the eastern wall and another directly and the punishment for embarrassing the
opposite it on the western wall. The chairs, institution is swift and severe for both patient
divans, tables, and furnishings are clean but and alienist. Giving or rescinding access to this
show signs of heavy wear. area is a popular reward, or punishment, for
All conversations stop as you step into the patient behavior.
room, and the sudden silence is almost jarring. The common room is rarely empty and
After a few heartbeats the patients turn back to during the day there are as many as 2d4 patients
whatever had occupied their attention and the within the room. An orderly or two (see
indistinct susurrus of their words begins anew. Appendix C, page 173) stands in the corner at
None acknowledge your presence any longer. all times watching over the patients as they go
about their business. Mad Jak (see Appendix C,
The common room is one of the few places page 166) and Rolund Hergus (see Appendix
that patients from all classes and castes may C, page 154), in particular, make frequent use
intermingle. The criterion for admission is of the common room and can be found there at
that the patient’s alienist deems access to be all hours of the day or night.
46
T he F irst F loor
47
T he B asement
Lamp’s Light’s most radical and experimental reinforced wooden plank on hinges. There is
treatments are conducted in the depths of the no handle or locking mechanism that can be
sanitarium away from the prying eyes of visitors. seen from this side.
These treatments are reserved for the most
demented subjects, or those who will not be The treatment board contains the names of
missed should the experiment go awry. the patients scheduled for treatment, and may
include the names of the PCs or their allies if
BA. Reception Area the situation calls for it. The chair and table are
seldom used, and not as sturdy as the ones on
The stairs descend to a small waiting room the upper floors. They can be broken apart with
of sorts. The only adornment in the room is a a successful DC 12 Strength check.
large chalkboard on the western wall covered The only other feature in the room is the
in small, neat script. On the board is a list door. There is no way to open the door from this
of names; next to each is a room number, room; it is always kept locked, and is especially
a psychosis, and what you assume is the strong (DC 25 Strength check to break down).
procedure scheduled for the patient.
A battered table and chair sit in the T riage R ooms
northeastern corner. There are iron rings on The three rooms off the hallway are used
the chair’s arms and legs, and it is securely to house patients prior to treatment, and for
bolted to the ground. long-term observation afterwards. The doors are
A hallway leads to the east, and in identical, each made of stout oak and reinforced
the southeastern corner is an unmarked with iron bands. The doors can only be opened
door. The door is little more than a heavily with a key (DC 18 Dexterity [Thieves’ tools])
48
T he B asement
49
and the locking mechanism cannot be accessed sheet lies crumpled on the bed. The only other
from the interior. object in the room is the odorous privy in the
The only member of the Lamp’s Light southeastern corner.
family to always have a key to these cells is
Dr. Renwick (see Appendix C, page 177); Hidden in the privy, easily found if the PCs
otherwise, an alienist (see Appendix C, page search in the black, viscous liquid, is a serrated
144) or orderly (see Appendix C, page 173) bone dagger. Its immersion in the unspeakably
that is assisting him in his treatments has a 1 in vile contents of the privy have hardened it
4 chance of having been temporarily entrusted sufficiently that it makes a serviceable weapon.
with a key. The doors can be smashed with Additionally, any creature wounded by the
brute force through a tremendous effort (DC dagger must succeed on a DC 11 Constitution
20 Strength [Athletics]). These reinforced doors saving throw or contract sewer plague.
have AC 17 and 27 hit points.
BC. Cell
BB. Watchers
The bed in this room is nothing more than a
Your eyes are immediately drawn to a crowd wooden board affixed to the wall, with a privy
of crudely—drawn silhouettes surrounding in easy reach. Scratched into the wall, next to
an unoccupied cot. Each figure — there are the bed, are tick marks. There are 42.
nearly a dozen — looms as if in anticipation
over the cot. A threadbare, stained, and stiff There is nothing of interest in this room.
50
T he B asement
BD. The Last Room room is valuable, it is not portable or easily

plundered.
There is little to differentiate this room from
the others that have been examined. A bed, a BF. Storage Room
surprisingly clean sheet, a basket, and a small
chair. The chair is the twin of the one from the The door opens easily, with a small creak, at
reception area. the merest touch. Barrels, crates, and supplies
line the walls in this storage room.
Any creature coming within 5 feet of the chair
must make a DC 10 Charisma or be compelled The storage room contains linens, medical
to sit in the chair. The target repeats the save supplies, and unexpectedly two rolls of sharp
at the end of their turn, ending the effect on wire fencing similar to that normally seen on a
a success. While sitting in the chair the target farm.
must answer any question asked of it. The
answer can be truthful or false, but the question BG. Recovery Room
must be answered.
Opening the door, you see two clean cots on
BE. Workshop your left, a cluttered desk in the far corner,
and curtains acting as a privacy screen in
The door to the workshop is similar to the ones front of you. The curtains aren’t quite pulled
just passed, though it lacks the reinforcing iron all the way to the wall.
bands. The lock uses the same key as the other
doors in the basement, and can be bypassed The recovery room is used immediately
with a successful DC 16 Dexterity (Thieves’ before and after treatments for patients that
tools) check. have been heavily sedated and need to recover
their senses after the ministrations of Dr.
The door opens smoothly and quietly on well- Renwick. The patients are held in this room
oiled hinges. The room is dominated by a work until Renwick deems it appropriate for transport
area, and there is just enough space for one to their own room, or to one of the triage
person, possibly two, to tinker and fiddle with rooms.
their experiments. The desk is not locked and contains notes on
The shelves, and the cubbies underneath, any patients that are scheduled for treatment.
are neatly organized with everything within The patient’s notes include the treatment they
easy reach. There is a mechanical precision to are being subjected to and, for those who have
the layout, and you can almost see someone completed therapy, their response.
standing in the corner efficiently going about
her works. Adventure Hook: Under the table the heroes
find a paper with a name that they recognize
The workshop is well stocked with all manner — a figure of political prominence. The paper
of esoteric, hard to find materials. The items can is obviously a page from a much larger chart,
be used to provide advantage on a skill check but one phrase catches their eyes: “behavior
using a character’s artisan’s tools, herbalism kit, modification complete. Trigger is…” and the
or poisoner’s kit. While the stock within the rest must be on the next page.
51
BH. Laboratory A metallic chest lies on a nearby table.

There is no obvious manner to open the chest;
The large room is divided into two distinct two metal handles protrude from the front of
areas. The front area, just past the privacy the apparatus and a helmet has been tethered
curtain, contains a cluttered desk, pair of to the rear. The other tables are covered in
chairs, and a table immediately to your right. more easily identifiable tools. Tools used in
Past that the room opens into a large operating surgeries, taxidermy, and butchering.
theatre. At the far end of the room are a pair of
closed double doors. The desk is overflowing with charts, papers,
The operating theatre has a tiled diagrams and notes. Unlike the desk in the
floor with drains placed discreetly and previous room these notes are not related to
strategically throughout the room. Two patients, but to procedures and experiments.
tables, complete with leather five-point Within the drawers are the complete records of
restraints and canals to channel leakage, all the experiments Dr. Renwick has performed
are bolted to the floor and dominate the on his subjects. A PC studying the doctor’s notes
room. Every surface is immaculate and the (a task that takes months) gains proficiency in
cool air smells faintly of lye, excrement, and Medicine. Additionally, she must make a DC 12
ammonia. Sanity check or lose 1d4 Sanity.
52
T he B asement
The tables contain the equipment needed to There are instances in which Dr. Renwick
complete the day’s procedures including several fabricates his own test subjects, and the
cerebri mimos (see Appendix B, page 138) and immersive studies room is his most effective
the juxta personalis (see Appendix B, page 140). method for accomplishing that task. A
There are 2d4 doses of essence of somnolence (see prospective patient, usually a criminal or
Appendix B, page 139), and 2d4 doses of essence vagabond, is sedated, restrained in a mobile
of ether. chair, and brought into the room. When the
subject awakens, they find themselves trapped
BI. Immersive Studies in the room with a caged gibbering mouther
(which can be found beneath the canvas
The doors open into this large room. There covering).
is an unmistakable, yet unidentifiable, smell The mouther, unable to physically assault
permeating the room. There are bones in its prey, is relegated to subjecting them to its
the near corner, and a pristine white canvas incessant gibbering. With each wailing shriek
covering a square shape in the southwestern the subject’s sanity is frayed until there is
corner. The rest of the room is completely nothing left.
empty, save another small table in the
northwestern side. Adventure Hook: Dr. Renwick, no longer
satisfied with the gibbering mouther, is looking
The double doors leading to this area do not have to expand his experiments to other non-physical
a locking mechanism, but once closed they can be attacks. The PCs are hired by Lamp’s Light to
barred from the outside (area H) to prevent them capture creatures with attacks that are auditory
from being opened. Breaking the bar to escape and/or visual in nature. A bonus is paid out for
requires simple brute strength (DC 22 Strength). creatures whose ministrations affect the mind.
53
T he E ast W ing
The East Wing houses the guests that are able to guests, and some have freedom throughout the
pay for their treatment and lodging. At Master day and night.
Prosper’s suggestion the furniture and fixtures The locks are of moderate quality (DC 13
in this wing are simple, elegant, and of master Dexterity [Thieves’ Tools]). The staff alienists
craftsmanship. In addition to the everburning (see Appendix C, page 144) have a key to these
sconces, there are a smattering of paintings locks upon them at all times (they all use the
— both landscapes and still lifes — in gilded same key). Select orderlies (1 in 3) also have a
frames lining the halls. key.
The doors into the patient rooms are of
similar construction as the Main House. The EA. The Hallway
doors are equipped with locking mechanisms
that requires a key to both lock and unlock. The doors open to a wide hallway that extends
Every morning at dawn, an orderly (see the length of the wing. A lush carpet runner
Appendix C, page 173) patrols the hallway bisects the floor. Doors are set periodically
unlocking each door, and at lights out an along both walls, and strategically-placed
orderly completes a bed count and locks the lamps ensure that the hallway is well lit at all
patients into their rooms. Unlike the West times.
Wing, exceptions are made for the paying
54
T he E ast W ing
55
There are five doors on each side of the hallway; treatment of ill humors. Neither the desk nor
each door is mirrored on the opposite wall. The the armoire can be locked, and are in use by
only distinguishing feature between the doors the room’s current occupants, Mr. Mielace (see
is the color of the door knob. Each knob is Appendix C, page 163). Mr. Mielace, in his Ed
porcelain, egg-shaped, and a single, solid color. persona, is often in his room during the day (1 in
2 chance) and is almost always present at night.
EB. Red Room
Adventure Hook: The journal of Mr. Mielace,
A pair of beds, suitable for a child or small hidden beneath Ed’s bed, contains hints and
adult humanoid, are placed against the clues to his sordid past. The diary is written in
northern wall. An armoire and desk are in the a cipher and not easily transcribed, but with
opposite corners. The room is meticulously sufficient time it could reveal the origins of
clean, and a faint odor of lemons hangs in Ed’s arcane powers and, more importantly, the
the air. The eastern wall has a still-life of a process by which David came to be.
vibrantly red poppy hanging in a gilded frame.
The bed on the left is made with geometric EC. Yellow Room
precision. The pillow is in exactly the right
place, corners perfectly creased, and the Opening the door, you see a small bed in the
folds mechanically precise as if they’d been far corner of the room. Opposite the bed is
measured. The bed on the right is a riotous, a writer’s desk, and in the interior corner a
confused jumble of soiled sheets entwined on chest of drawers. The furniture is of excellent
one another, and you can’t help but think of it quality. An unframed portrait has been
as a nest. tacked to the wall. The subject of the work
is unidentifiable due to the artist’s overly-
The Red Room is typically reserved for when enthusiastic brush strokes, but you are able
a pair of family members are admitted to to ascertain that it is a nude of indeterminate
Lamp’s Light. The alienists believe that keeping gender.
family together is of utmost importance in the
56
T he E ast W ing
This room is currently occupied by Rolund metal and cannot be broken. There is a second
Hergus (see Appendix C, page 154). The bed door leading to the lavatory:
is recently made, but the sheets are soiled from
Rolund’s recent activities. The writer’s desk, A wash basin, toilet, and faint smell of
which cannot be locked, contains his journal. It excreta greet you when the door is opened.
is a combination of bad poetry, dirty limericks, Considering its function the room is
and meticulous notes on folks he’s met. The remarkably clean.
painting is his as well.
The room is usually unoccupied during The staff take great pains to keep this room
the day (1 in 6 chance he’s present). Any time clean but there is a 1 in 4 chance that the room
Rolund is in the room there is a 1 in 4 chance has been defiled by a patient.
he has a guest, which may be another patient,
member of staff, orderly, or rarely a staff alienist. Adventure Hook: The patients of the East
Wing have been known to hide contraband in
Adventure Hook: Rolund’s journal contains the washroom. The cleaning staff is aware of
the sordid details of his liaisons with countless this, but don’t generally bother with it unless
others. The notes include commoners, they have reason to look. A character with a
merchants, and minor nobles. Men and women passive Perception of 16 finds a stiletto dagger
are equally represented; each entry includes hidden in the lavatory. The stiletto is rusted... or
the subjects’ preferences, quibbles, and foibles is that blood?
in explicit detail. The heroes could use this
information in a number of ways including a EE. Green Room
blackmail scheme, or to have an advantage in
social interactions with the folks described. Opening the door, you see a chest of drawers
to your immediate left, a writing desk to your
ED. White Room — Communal Washroom right, and a large overstuffed bed in front of
you against the northwest wall. In the corner
The door opens inward revealing a small opposite the bed is a door leading to the privy.
room and another door on the north wall a The door is slightly ajar. The linens, furniture,
few steps farther in. The east and west walls and accoutrements are of excellent quality.
are occupied on each side by matching sinks, While clean, there is an air of mustiness
shelves, baskets, and a mirror. indicating that the room is not currently in
With a closer look at the mirrors you see use. The vase on the dresser containing wilted
faint indentations suggesting rough use by flowers confirms this suspicion.
the inhabitants. The baskets contain brushes
and an assortment of ribbons in all colors. The This room is currently unoccupied and reserved
shelves are lined with clean towels and linens. for important guests. It is the smallest of the
three suites, the others being areas EF and EG.
This is the only door in the East Wing that has
no locking mechanism on it. The bathroom is EF. Grey Room
shared by patients lodging in the four rooms
that do have their own private facilities (see areas The well-appointed room before you appears
EB, EC, EJ, EK). The mirrors are burnished much like the bedroom of a wealthy merchant
57
or noble. There is a door in the center of the soiled. The walls have letters, pictographs, and
eastern wall. The armoire, desk, and bed are symbols covering them. These writings are a
all of matching cherry, elegantly carved, and of combination of ink, charcoal, a reddish-brown
master craftsmanship. There are fresh flowers liquid, and other less-identifiable substances.
on the bedside table.
From the doorway you’re able to see the Moving into the privy the heroes see:
finest quality linens and sheets adorning the
bed. There are several pieces of fine art on A riot of discarded clothes, trash, and other
the walls. The cherry furniture is a matched detritus covers the floor. The scrawlings from
bedroom set. the previous room have been carried over into
the bathroom with a fervor only the mad can
The door on the eastern wall leads to the privy: attain. Not a single inch of the walls is free of
the insane ramblings of the room’s occupant.
A bear skin rugs covers the floor near the The smell of excrement permeates the room,
tub and washbasin. The room is simply and coming surprisingly from the walls as much as
elegantly laid out. The fixtures and furniture the privy.
shine with cleanliness, the aroma of citrus fills
the air, and the basins are empty. The Navy Room is occupied by Milo Lowbrow
(see Appendix C, page 160), an adventurer
The Grey Room is the second most plush whose exploits have damaged his psyche
suite in Lamp’s Light, behind the Navy Room to breaking point. Milo’s mind is filled to
(area EG). The room, and all of its contents, overflowing with alien words, concepts, and
would not be out of place in the home of a maths that he cannot comprehend. The graffiti-
wealthy merchant, and the staff take great pains covered walls are his attempts at getting those
to maintain this room, even when it is not concepts out of his mind and into the world.
occupied. It is not occupied at present.
EH. Purple Room
EG. Navy Room
The room’s nauseating reek assails your
Nearing the first door in the hallway you senses, and is a combination of sweat, wine, and
notice that there is a lock on the exterior of vomitous bile. Hand over your mouth and nose,
the door. Inside the room there’s a faint smell you see that the desk’s chair has been knocked
of wood polish, lemon, and something else that over, and looking down you see that in opening
you’re not able to place. the door you have pushed a “nest” of sorts to
A stained-glass ribbon window at the top of the side. Discarded bedding, dirty clothing, and
the far wall allows the afternoon sun to stream loose blankets are arranged in a sleeping pallet.
through. A walnut bed, armoire, Davenport A stained pillow, and comparatively clean bed,
desk, and matching chair are the only pieces of indicate that the room’s occupant seems to
furniture in the room. The room is opulent to prefer the floor to its bed.
say the least.
The affluency is marred by the disregard This room is occupied by Jon Myttong, aka
that its current occupant has for these Mad Jak (see Appendix C, page 166). In
luxuries. The silk linens are wrinkled and his drunken excesses the room is perpetually
58
T he E ast W ing
trashed, and the staff have given up on EI. Black Room

maintaining any semblance of propriety.
They have come to terms with his activities, From the exterior:
and periodically remove the used linens and
blankets, replacing them with clean ones that The heavy, iron-banded adamantine door is
are placed on his desk. shockingly out of place compared to the other
PCs investigating the room from dawn to rooms in the East Wing. A deeply scarred
midday have a 1 in 2 chance of finding Mad Jak wooden slat serves to reinforce the lock. The
asleep in the pile of clothing and blankets on crude, utilitarian door has a single portal
the floor. He rarely uses the bed, saving it for his window at eye height. The window is barred,
infrequent guests. and can be sealed from the exterior.
59
60
T he E ast W ing
From the inside: EJ. Orange Room

No light. No sound. No sensory input of any This room serves as the East Wing’s common
kind come to you as the small window in the room and is used by the occupants for
door closes. The silent darkness is so total and socializing and relaxing with each other and
complete that it has a palpable presence. their visitors. Most patients prefer the common
From memory and feel you can find the room in the Main House for their free time, but
sleeping pallet, and the small hole that serves for those without permission to use that room,
as your toilet. this is their only other option.
The furniture is simpler than that found
Solitary confinement is the worst punishment in the bedrooms, largely because Mad Jak and
that most of the wealthy inhabitants of Lamp’s David tend to break it in their shenanigans, and
Light can expect to be subjected to, and those it is sparsely decorated. Any of the East Wing
that have occupied this room will do virtually patients can be found in this room at virtually
anything to prevent a second trip. any time of day.
The room has the following permanent
magical effects, both of which are triggered by EK. Brown Room
closing the viewing portal window: silence and
darkness. The effects are limited to the 10 foot The door opens smoothly on well-oiled hinges,
by 10 foot area of the room. and you see a comfortable bed with heavy
Any creature that takes a long rest within the blankets and pillows. A walnut armoire rests
room while the viewing portal is closed must against the southeast wall facing the bed,
make a Sanity check or lose 1d2 Sanity. The DC and a potted plant occupies the northeastern
for the check is equal to 8 plus the number of corner. The only other piece of furniture is a
days that the creature has been in solitary. matching well-crafted utilitarian writing desk
with paper, quill, and ink pot neatly arranged
Stays in Solitary on it.
The amount of time that a patient must spend in
solitary is at the discretion of the treating alienist. The Brown Room is the room used by Dr.
The length varies based directly on the infraction Renwick and Administrator Rose as an example
committed and the importance of the patient’s of the fine care and living conditions that their
family. A stay is typically 1d4 - 1 days, with patients enjoy. The room is kept unoccupied
results of 0 resulting in a stay of 2d4 hours. whenever possible for this very reason.
There are instances in which an orderly has
placed a patient into the Black Room without
permission, but these are few and far between;
Dr. Renwick has a tendency to force the orderly
to take the patient’s place when he learns of their
indiscretions.
61
T he W est W ing
Not all patients are able to afford the luxuries The wooden floor is clean, well-worn, and
found in the East Wing. Those unable to meet shows signs of damage that have since been
their financial obligation to the sanitarium, and repaired. Doors line the hallway, each of which
patients treated gratis, are typically housed in the has a knob of a different color. Other than the
West Wing. There are eight patient rooms (many knobs, the doors are all identical, save a single
of which are equipped with bunk beds for double iron door a few steps down on your right.
occupancy), a communal bathroom, holding cell,
and pair of treatment rooms at the hall’s end. If the PCs have been in both wings the smell
Depending on the time of day and census of that they can’t place is the same in both wings. It
the hospital, any number of the rooms in the is stronger in the West Wing. The locks to these
treatment wings may be occupied. That said, rooms are of high quality (DC 17 Dexterity
the administrator seems to be perfectly content [Thieves’ Tools] to unlock), and can only be
running the asylum well below capacity, and it unlocked from the hallway.
is not uncommon for there to be no one in the
hallway during certain parts of the day.
Patient Rooms
WA. The Hallway The West Wing patient rooms are laid out in
pairs of identical rooms that face each other. The
The doors open to a wide hallway extending
differences between rooms WC and WL, for
the length of the wing. The faint and
instance, are due solely to the occupant and their
unmistakable odor of the unclean makes its
activities. Rooms WD and WK are likewise
way to you within moments of entering the
identical, as are rooms WE and WJ.
West Wing. The staff of Lamp’s Light have
GMs are encouraged to choose or roll
tried, unsuccessfully, to cover the odor with
additional features from the Additional Room
a citrus cleanser. There is another smell
Details table below to customize the rooms beyond
underneath the others that you’re unable to
the brief descriptions provided.
identify.
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T he W est W ing
63
Additional Room Details

d10 Detail
1 The sheets on the bed have been removed, and lie on the floor twisted tightly into a rope-like
configuration.
2 Scuff marks on the floor indicate that the bed has been moved repeatedly about the room.
3 A PC examining the bed (DC 12 Intelligence [Investigation]) notices gouges in the wooden
frame. A successful DC 14 Wisdom (Survival) indicates that they are fingernail and bite marks
from a human or half-elf.
4 The bed is neatly made, and the room in order. If the sheet on the bed is removed, brownish-red
stains cover the mattress hidden underneath.
5 A PC succeeding a DC 18 Intelligence (Investigation) check notices faint, indecipherable writing
on the walls. It’s unclear if they’re unable to be understood due to the lack of details, or because the
writing is nonsensical.
6 The bed is perfectly made, the sheets are pressed, a faint citrus smell hangs in the air, and there are
no signs of foul play or violence.
7 Sheets, covered in rust-colored stains, are haphazardly placed on the bed. There is a pillow on the
bed, which is somewhat unusual. If the pillow is examined (DC 10 Wisdom [Medicine]) the PCs
realize that it’s filled with humanoid hair, roots still attached in many cases.
8 With your first step into the room a chill overtakes you, and goosebumps sprout on your flesh.
Something unspeakably horrific occurred in this room, and the psychic scream echoes faintly. Any
Sanity checks made in this room incur a -2 penalty.
9 A thorough search of the room reveals nothing but the niggling feeling that there’s something just
out of reach, just beyond your ability to perceive it.
10 A crudely built doll, little more than sticks and cloth scraps bound together with string, sits in the
corner of the room.
WB. Grey Room If the PCs venture farther into the room, read or
paraphrase the following:
Violent patients are an unfortunate fact of life
within the sanitarium, and this room has been Your first and second step into the room
set aside for them. are like any other, and then as you near the
manacles all sounds — not just those of your
The large room is empty save for a set of five- passage — disappear completely.
point restraints embedded in the floor. The
restraints are heavy black iron, and the chains Prosper quickly learned that the guests within
are short enough that the captive’s mobility the West Wing did not respond as well to their
would be severely limited. treatments when their sleep was disturbed by
the manic cries and wails of a bound patient.
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T he W est W ing
At Renwick’s suggestion, the room was imbued a DC 8 Constitution save or be stunned for
with a permanent silence effect, as the spell of one round from an upswell of nausea and
the same name, that is localized in the center involuntary gagging.
of the room. The spell can be temporarily The exact identity of this unfortunate being
dispelled, but always returns the following day is left to the GM’s discretion, but whomever it
at dusk. is has been in the Green Room for a very, very
The chains are sturdy (DC 19 Strength to long time.
break) and all five must be broken to release
the prisoner. Anyone restrained by them has Adventure Hook: An adversary from the
disadvantage on Dexterity and Strength checks heroes’ past is being held in this room. Despite
and saves until at least two restraints are broken. the impossibility of it, they appear to have been
here for decades, despite having interacted with
WC. Yellow Room the heroes in much more recent times.
A bunk bed has been pushed against the wall WF. Padded Room
directly opposite the door. The walls are a
pallid, dirty yellow. A three-tiered shelf, devoid The padded room is a room within a room.
of books, stands next to the bed on the rear The interior room, marked by a metal door
wall. with an oak knob, is reserved for patients that
are at great risk of harm to themselves and
others. The exterior room, marked by a wooden
WD. White Room door like the rest in the hall with a mahogany
knob, surrounds the padded room, facilitating
A bunk bed has been installed in the corner, observation of the patient.
and a three-tiered bookshelf stands next to it. There are no arcane effects to dampen the
To the immediate right of the entry door is a sounds issuing from this cell. The padding
desk. of the room, additional walls, and relatively
infrequent use of the room serve well enough to
The desk contains 1d4 pieces of paper and a soft keep the disturbances to a minimum.
charcoal pencil.
Oak Knob
WE. Green Room
The door, iron with banded reinforcements,
The long, narrow room is barely wide enough has a shuttered porthole on the top third to
for the bed and matching table within. The allow observation of whomever, or whatever,
walls are a sickly green, matching the door is locked within the room. The door is clearly
knob. An outline of a humanoid shape can be incredibly strong, and would take the strength
seen under the thin sheets; a soft groan comes of a giant to break.
from the figure as it shifts in its bed.
PCs that open the shutters or the door see the
The occupant of this room is an emaciated and following:
catatonic figure. It smells of rotting, scabrous
flesh, urine, and feces. PCs must succeed on
65
The long, narrow room would be it. There is nothing within the frame, only bare
indistinguishable from many others you have wall. PCs that have found area 2L recognize the
explored were it not for the quilted padding frame for what it is.
covering the walls, floor, and ceiling. The frame radiates divination magic for those
able to detect it. When activated it allows the
The room can be occupied by any numbers viewers to see into the padded room as if it were a
of NPCs, but is usually reserved for those clear window. The activation word for the frame
experiencing a psychotic break, or an especially is “waeccende”, which is known by the alienists.
aggressive outburst. The patient, bound in a
Prosper’s camisole (see Appendix B, page 142), is WG. Navy Room
thrown into the cell to rage in seclusion, until
they are physically and psychically exhausted. Mr. The door opens into the room revealing two
Mielace, in his David persona (see Appendix C, small beds and a desk. The room is clean,
page 165), is a frequent occupant of this room. tidy, and of serviceable quality. The walls
are painted a deep navy, and are bare of
Mahogany Knob ornamentation.
This long and narrow hallway is used to observe This room, and its twin across the hallway,
patients within the padded room. There is a are ones that visitors are often shown when
single chair, and the interior walls are empty Administrator Rose wishes to demonstrate
save a 2-foot by 4-foot pewter frame affixed to the quality of care that even indigent patients
66
T he W est W ing
receive while at the sanitarium. As such, it is

always kept clean and in good repair, and the
patients occupying it are presentable.
Dr. Todd (see Appendix C, page 186),
despite having sufficient wealth for a room
in the East Wing, occupies this room as
punishment for impersonating an alienist.
WH. Purple Room

Opening the door, you see a desk to your
immediate left, and a pair simply crafted beds,
one in each corner. The room’s interior is
lavender.
This room is often kept unoccupied, and is used

intermittently by staff that need privacy to catch
a quick nap or for other activities.
Adventure Hook: An orderly and a member

of the staff have taken to using this room for
rendezvous in the wee hours of the night. Their
activities have not gone unnoticed, and Dr. Todd
is blackmailing them for access to the East Wing.
WI. Crystal Room — Communal

Bathroom moisture from the basin has caused the paint
of the grey-green walls to bubble, flake, and
There is no locking mechanism on any of fall away.
the bathroom doors. The need for privacy is
secondary to the safety of the patients, and the Bars of harsh soap, threadbare washcloths,
alienists’ need to protect them from themselves. and rough brushes including metal scouring
pads, can be found in the nearby baskets. The
The smell leaves no question as to the purpose scouring pads are typically new as they rust
of these rooms. The entry opens to a small quickly from the humidity and heavy use.
hallway with doors on the immediate left, and
a few steps farther down. The door to the left WJ. Orange Room
is the privy, complete with burnished metal
mirror, and wash basin. The smell of urine and excrement threaten
The far door opens to a larger room, nearly to overwhelm your senses as you open this
filled up by a shallow, tiled basin. A rusty door to find a woman, clothed in stained rags,
drain has been set into the center of it, and a curled in on herself, sitting in the corner
crusty spout of metal protrudes from wall. The farthest from the door.
67
This room is occupied by Nyfuir (see Appendix Bok Nantanye (see Appendix C, page 168)
C, page 171), who rarely leaves the room, even lives in this room. He does not share the
to perform the most basic functions of self-care. room with other patients, no matter how full
Nyfuir has used excreta to draw and scribble the sanitarium is, due to strict orders from
eldritch formulae on the walls. Administrator Rose.
WK. Brown Room WM. Metallic Room — Treatments Room

This bunk bed — the top bunk is rumpled and The heavy door opens into a spacious room
the bottom a bare mattress — has been placed containing a treatment chair, raised wooden
in the corner. A two-tiered bookshelf, covered table, coil of rope, and work table. The warm
with loose papers, stands next to it. To the air smells heavily of ozone, burnt hair, and
immediate left of the door is a desk. another odor — one that permeates the facility.
Five-point restraints have been incorporated
The desk contains dozens of charcoal pencils of into the table and the treatment chair. The
various lengths, and an equal number of pieces restraints are leather; cracked, supple, and
of heavy paper suitable for sketching. The papers shiny from frequent use.
on the bookshelf are all drawings in various
stages of completion, and depict the same Dr. Renwick’s basement laboratory is reserved
shadowed, abstract face. Characters examining for patients and treatments of special interest
the art with an Intelligence (Investigation) or to Lamp’s Light’s chief alienist. All other
Wisdom (Insight) check learn the following: treatments and procedures occur in this room.
• DC 10: The eyes are the fathomless black The room is in regular use, and rarely goes
of the void, as if the artist pressed down more than a few days without seeing a patient.
especially hard on that area of the paper. The faint smell permeating the facility is an
• DC 15: After examining the drawings you amalgam of the volatile chemicals used in this
notice differences in the style and ability that room.
cannot be ascribed to the evolution of an artist’s The restraints, on the chair and table, are
work in progress. These drawings have been strong (DC 17 Strength to break). All five
created by at least three different sets of hands. must be broken to release the patient. Anyone
restrained by them has disadvantage on
WL. Black Room Dexterity and Strength checks and saves until at
least two restraints are broken.
There are no sheets, pillows, or linens on The chair serves the dual purpose of juxta
the bunk beds. The occupant of this room personalis (see Appendix B, page 140) and
has removed them, folded them with expert revelans malum (see Appendix B, page 143).
precision, and placed them at the foot of the Other items, as required for the scheduled
bed. Charcoal, blood, and other unidentifiable patients, are splayed on the table. There
materials have been used to write “11” on are 2d4 doses of essence of somnolence (see
every inch of the walls, floor, and ceiling, in Appendix B, page 139), and 1d2 doses of
various sizes and styles. essence of ether.
68
T he W est W ing
69
T he S econd F loor
The second floor of Lamp’s Light is dedicated The only other features of the stairwell are
to the treatment of its guests. There are two doors on the northern and eastern walls. While
large rooms for groups to meet and a series of clean, the floors are not as lustrous as the ones
smaller rooms used for private sessions and on the first floor.
alternative treatments. All the doors on this
floor are unmarked and unadorned. The notable
exception is a door at the western end of the 2B. Lavatory
hallway that leads to the 3rd floor which has a
simple lock (DC 12 Dexterity [Thieves’ Tools] The smell of cleaning supplies isn’t quite
unlocks). This door can be barred from the other enough to disguise the true nature of this
side and should that occur it can only be opened room and the faint smell of excrement is
by breaking it down (DC 20 Strength check). unmistakable.
2A. Western Stairwell The second-floor lavatory contains a private

toilet, three urinals, and two wash basins.
Reaching the top of the stairway you see
another stairway leading to the third floor.
70
T he S econd F loor
71
2C. Group Treatment Room A of the lever is slightly discolored as if by

frequent use.
Dull wooden floors covered in scuff marks
and occasional dark stains suggest rough and When discovered the lever is in the center
frequent use. Your eyes are quickly drawn to position. If the lever is moved to one of the four
a dozen iron rings that are mounted into the cardinal directions an image appears on the
floor. A short chain attaches each ring to a opposite wall. The image is silent and displays
wooden chair. whatever activity is taking place in the room
The chairs themselves are fashioned with being observed.
leather restraints for the arms and legs; two
of the chairs have additional buckles to secure • Up — views 2K (Discussion Room)
the patient’s neck. The only piece of furniture • Down — views 2C (Group Treatment A)
not chained to the floor is a lectern positioned • Right — views 3F (Dr. Renwick’s Office)
to look over the chairs. • Left — views 2E (Immersion Treatment
The northwest corner of the room is Room)
blocked from view by a privacy curtain.
2E. Immersion Treatment Room
The doors to this room have simple locks
that can be opened with a successful DC 10 Opening the door, you see a wash basin that is
Dexterity (Thieves’ Tools) check. large enough to completely immerse an adult
The echoes of violent patients and the human. The floor is tile, presumably for ease
resultant responses by orderlies can almost be of cleaning. There are chairs, and a sink. Two
felt by those entering this room. Characters separate pipes, each with a spigot, lead to the
examining the floor note that the stains basin.
are consistent with blood (DC 12 Wisdom The northwest corner of the room is
[Medicine/Survival]). dominated by a large metallic box. The box has
The chains and restraints are sturdy (DC 15 a tightly fitting lid, and is waist high. You’ve
Strength to break). Anyone restrained within the never seen anything like it before.
chairs would be at disadvantage on Dexterity
and Strength checks and saves until at least two The immersion room is where many of the
restraints are broken; each restraint requires its staff ’s more esoteric treatments take place. The
own check to break free. staff use the basin for hydrotherapy, leaving
the patient partially submerged in the basin for
2D. Private Hallway hours, sometimes days, to treat their psychosis.
Warm baths are typically used for insomnia,
This private observation room can be accessed excitable behavior, and patients that are at risk
via the secret room adjacent to Administrator of harming themselves. Cold baths are reserved
Rose’s private residence (3E). It is physically for manic depressive patients or those that are
identical to 2I. particularly agitated.
The two faucets above the basin supply hot
The long and narrow room is empty but for a or cold water respectively. There are bars on
single lever protruding from a ball and socket the side the basin for use with restraints, and
joint in a plate mounted to the wall. The end a heavy canvas covering can be fastened to the
72
T he S econd F loor
top of the basin to keep out light (or to keep a longer periods can induce sanity-shattering
patient trapped within). hallucinations and disassociation from reality.
The box in the northwestern corner can be A character spending at least 10 minutes
easily opened. If the characters do so, read or within the tank, and less than one hour, may
paraphrase the following: experience any of the following:
Opening the container releases a waft of warm, d12 Effect

humid air, and with it the briny smell of the
1–2 Gain the benefits of a short rest
ocean.
3–4 Regain 1d3 Sanity
The water within the container is very salty, 5–6 If the subject is suffering from insanity
warm (body temperature), and used as a she may re-roll to suppress it
rudimentary sensory deprivation tank. The
7–10 No effect
utility of the sensory deprivation tank is largely
dependent on the time that the character 11 Lose 1d2 Sanity
spends within it. Short periods of immersion 12 Gain the benefits of a long rest
(less than an hour) are usually restorative, while
73
A character spending at least one hour within 2F. Equipment Closet

the tank may experience any of the following:
The plain oak door is locked. You can hear a
d12 Effect faint hum from the other side.
1 The subject is affected as if she cast

The door to this room is always kept locked. It
contact other plane
can be picked with a successful DC 12 Dexterity
2 Gain the benefits of a short rest (Thieves’ Tools) check.
3 Regain 1d4 Sanity The room is empty with the sole exception
of the mechanical pump that is responsible for
4–5 Lose 1d6 Sanity
distributing water throughout the facility.
6–7 No effect There is no discernable way to stop the
8–9 Develop a short-term madness device and characters wishing to disable it must
make a DC 15 Intelligence check to do so.
10–11 The subject has disadvantage on all
Alternatively, the pump has AC 12 and 15 hit
Charisma checks until completing a
points and can be destroyed with a few well-
short or long rest, or being targeted by
placed blows.
a lesser restoration spell (or similar)
12 The subject gains proficiency in 2G. Eastern Stairwell
Charisma saves until completing a
long rest The stairs lead up to a foyer and an unlocked
door.
Any character or patient using the sensory 2H. Group Treatment Room B
deprivation tank loses all sense of time and cannot
extricate themselves from the device without a This large treatment room is notable for its
successful Charisma save. The DC for the save is polished wooden floors, expansive windows,
8 + 1 per 15 minutes in the tank. On a failure the and lush rugs. The room is spotlessly clean,
character may try again after 30 minutes. and has comfortable chairs arranged in a
horseshoe with a single chair at the focal
Adventure Hook: A patient, the youngest point.
scion of an influential merchant family, has
been found dead within the sensory deprivation Administrator Rose (see Appendix C, page
tank. The Dr. Renwick wants to know how this 181) often shows guests and potential patients
happened, and bring those at fault to justice this treatment room as an example of the fine
before the family realizes that a tragedy has care and accommodations to be expected at
occurred. The good doctor’s sense of justice may Lamp’s Light. There is no locking mechanism
not quite align with the heroes’. on the door.
74
T he S econd F loor
2I. Private Hallway 2K. Discussion Room

This private observation room can be accessed The room is roughly twice as long as it is
via the secret room adjacent to Dr. Renwick’s wide, and sparsely furnished. A chair sits
office (3F). It is physically identical to 2D. against the western wall, near the southern
corner. The only other furnishing is a
The long and narrow room is empty but for a crudely made table, heavily constructed of
single lever protruding from a ball and socket unstained wood, and a matching chair at the
joint in a plate mounted to the wall. The end head of it.
of the lever is slightly discolored as if by
frequent use. The discussion room is used when the staff
feel that a patient needs to be exposed to a
When discovered, the lever is in the center more forceful means of interviewing. The table
position. If the lever is moved to one of the four is affixed to the floor and cannot be moved
cardinal directions an image appears on the wall without a herculean effort (DC 20 Strength
opposite. The image is silent and displays whatever check). Similarly, the chair can be fastened to
activity is taking place in the room being observed. bolts in the floor. A large iron ring is mounted
on the underside of the table. The ring bears
• Up — views 2H (Group Treatment Room B) shiny wear marks from manacles being run
• Down — views 3B (Staff Common Room) through it.
• Right — views 1L (Common Room) The customizations to the table and chair
• Left — views 1C (Admitting Office) are not readily noticeable unless looked for,
in which case a successful DC 12 Intelligence
2J. Counseling Room (Investigation) check reveals them. Characters
examining the table find signs of heavy wear and
Two comfortable chairs sit side by side, their scratch marks.
backs to the door. They face an overstuffed
leather chair as if in audience to an unseen 2L. Observation Room
proctor. A thick carpet covers almost the
entire floor. To the left and right of the This long and narrow room is used to observe
entryway are two partially filled bookcases. patients within the containment room (2M).
There is a single chair, a door, and the western
The counseling room is used frequently by the wall is notable for an empty pewter frame
staff of Lamp’s Light when treatment includes affixed to it. There is nothing within the frame,
a pair of patients. The room is also used for only bare wall.
impromptu meetings between junior and senior The frame radiates divination magic for
alienists. those able to detect it. When activated it allows
The door to this room can be locked from the viewers to see into the containment room
the inside with a deadbolt. When the bolt is in (2M) as if it were a clear window. The activation
place there is no way to open the door from the word for the frame is “waeccende”, which is
outside without damaging the door (DC 20 known by most of the alienists.
Strength [Athletics]).
75
2M. Interrogation Room 2N. Hallway

The room is almost twice as long as it is wide. A long, well-lit hallway extends before you.
Your eyes are drawn to the chair in the center Aside from the entry doors at the east and
of the room, and shortly afterward the chains west terminus of the hall there are four
mounted to the floor beneath it. doors on the northern wall and four more on
Your breath speeds up and catches with the the southern wall. The spacing of the doors
realization of this room’s purpose. After a few suggests rooms of different sizes and you’re
inhalations you notice the faint smell of human able to hear an indistinct susurrus from some
refuse, something metallic, and ozone. of the doors.
Any who enter the The hallway is clean

interrogation room are and well-traveled. A
subjected to the effects character succeeding
of an altered zone of a DC 15 Intelligence
truth spell. The spell (Investigation) check
functions as normal while examining the
for any who fail their western end of the
Charisma save (DC hallway notices a torn
12); however, any who fingernail embedded
succeed their save and in the frame of the
choose to tell a lie door leading to room
must make a second 2L.
save or take 1d2
psychic damage. This
save must be repeated
each time a lie is
spoken.
The magic of
the room does not
affect Administrator
Rose, Dr. Renwick,
or the late Master
Prosper. Additionally,
constructs and undead
are not affected by the
spell.
The heavily reinforced door to this room
can only be locked from the outside with a
deadbolt. When the bolt is in place there is no
way to open the door from the inside without
damaging the door (AC 17, 36 hit points).
76
T he S econd F loor
77
T he T hird F loor
The top floor of Lamp’s Light is dedicated to The wide hallway leads down the breadth of this
staff offices, living quarters, and storage. Neither floor. There are two nondescript doors on the
patients nor the public are allowed on this floor southern wall. The doors at the eastern end of
without an escort. the hallway, one on the north and the other at
the end, are much heavier and of higher quality
3A. Stairway and Sitting Room than any other door in the asylum.
The books found on the shelf are scientific
Rounding the top of stairs, you are greeted texts on anatomy, physiology, and mental
by a long hallway with doors staggered along health and include Leech Book of Bald,
the north and south walls. A door, more finely Compendia Mediq, and De Gradibus. To
crafted than the others, can be seen at the the right buyer the books would be worth
eastern end of the hall. There is writing on it but 10gp each. A character using the books as
from this distance you are not able to read it. a reference in conjunction with a Medicine
To your right is a reading nook, complete skill check would receive a +2 bonus on their
with chairs, rug, and bookshelves. check.
78
T he T hird F loor
79
3B. Staff Common Room of game time to determine if an alienist or staff

member enters the room.
This large room is well-appointed, or what
many would consider lavish; the chairs, Adventure Hook: The desk in the staff
divans, tables, and desks that fill the room common room once belonged to Master
would be at home in the finest parlors of the Prosper. Upon his passing it was taken from his
city. office (now Administrator Rose’s office) and
There is an enormous coffee table on the placed here for the staff alienists to use. The
left with a ring of comfortable chairs around it. desk is much abused but if examined may still
The chairs are all well worn and appear to see contain some of its former master’s secrets.
much use. A character spending at least 10 minutes
Directly across from the door is an antique examining the desk may make an Intelligence
mahogany desk. The desk has seen better (Investigation) check to see what secrets are
days, and while clearly a valuable piece, it is discovered:
marred with stains, scratches, and debris. • DC 15: you find an unlocked secret
There is a door in the northeast corner compartment; the compartment is empty.
of the room that appears to lead to a storage • DC 20: you find a locked compartment
area. (DC 20 Dexterity [Thieves’ Tools]); it
contains a letter to Dr. Renwick concerning
The common room is heavily used by the Administrator Rose.
alienists and staff of Lamp’s Light, and is rarely • DC 25: you find a locked compartment (DC
empty. During the daytime there are 1d6 25 Dexterity [Thieves’ Tools]); it contains a
occupants; during the evening hours it is 1d4 - key that works on every lock within Lamp’s
1. If the room is empty re-roll every 30 minutes Light.
80
T he T hird F loor
3C. The Lab • DC 10: There is not a speck of dust or dirt

on the desk. The papers, blotter, and other
This small room is used for alchemical and writing implements on the desk are precisely
medical experiments. Characters taking the time placed.
to search (at least 10 minutes) are able to find • DC 18: A slight discoloration under the
everything that they need to fashion any one of objects indicates that they are always placed
the following: alchemist’s supplies, healer’s kit, in exactly the same way.
or poisoner’s kit. The search may be repeated up
to twice for each type of kit. If the characters examine the objects and do not
explicitly state that they are putting everything
3D. Administrator Florence Rose’s Office back as it was found, Administrator Rose will
know someone was in her office.
A heavy mahogany door with a brass lock, All four drawers are locked (DC 13 Dexterity
decorative iron bands, and a nameplate on [Thieves’ Tools]). They contain paperwork and
it stands before you. The nameplate reads treatment notes on current and former patients
“Admin. Florence Rose” in flowing copperplate. which, in the wrong (right?) hands, could be
very valuable.
The door is always locked when Administrator The contents of the drawers are placed as
Rose (see Appendix C, page 181) is not present; meticulously as the items atop her desk, and if
a successful DC 20 Dexterity (Thieves’ Tools) disturbed Administrator Rose will know. There
picks the lock. If the characters enter the room, is nothing in the desk that would seem out of
read or paraphrase the following: place or unusual for her to have.
Opening the door, a waft of dry, odorless air 3E. Florence Rose’s Personal Quarters
rushes out of the room. There is a door to your
immediate left. The room is spotlessly clean The administrator’s personal living space is
with every book, paper, knickknack, and item much the same as her office. It is clean, sparse,
meticulously placed. and orderly. Her bed, bookshelves, and writing
A bookcase runs across the southern wall, desk are all matching teakwood and lack any
wrapping around the corner and continuing ornamentation. There is a measured and
along the western wall. The northwestern systematic aspect to the hard lines and angles
corner is dominated by a divan facing the of the room.
prominently displayed desk. The divan is large There are two fine rugs, one near the bed
enough to sit at least four comfortably. and another in the reading nook.
The focal point of the room is a simple desk The only personal touch in the room is a
of unmistakably high quality. A chair is placed vanity in the southwest corner of the room. An
in front of it, and behind the desk sits another ivory handled brush, powder jar, and puff sit
chair. atop it.
The desk has four drawers, two on each side, Every character within Rose’s private room must
that are locked. Characters examining the make a Dexterity (Stealth) check upon entering,
desk notice the following on an Intelligence leaving, and when interacting with any object in
(Investigation) check: the room. If any of those Stealth checks are less
81
than 15 Rose will know that someone has been The manuals, pamphlets, and books on the
in her room. desks are related to medicine, anatomy, and a
A secret door (DC 18 Intelligence surprisingly large collection on constructs. If the
[Investigation]) is hidden on the eastern wall players make a systematic search of the room
near the reading nook. The door can be unlocked they find a madness scroll (see Appendix B, page
with a successful DC 17 Dexterity (Thieves’ 141) of magic jar.
Tools) check. If the characters travel through the The door next to the work table leads to a
secret door, read or paraphrase the following: lavatory.
A secret door (DC 18 Intelligence
The door opens to a small room. There is [Investigation]) is hidden on the western wall
nothing in the room save a staircase leading near the reading nook. The door can be unlocked
downward to the second floor. with a successful DC 17 Dexterity (Thieves’
Tools) check. If the characters travel through the
The staircase leads down to room 2D. secret door, read or paraphrase the following:
3F. Dr. Orson Renwick (3rd Floor) The door opens to a small, empty room, with
a staircase leading downward to the second
A heavy oak door with an iron lock, decorative floor.
iron bands, and a nameplate on it stands
before you. The nameplate reads “Dr. Orson The staircase leads down to room 2I.
Renwick” in flowing copperplate.
Adventure Hook: A character examining the
This door is very similar to Administrator books may make a DC 18 Intelligence (Arcana)
Rose’s, albeit of lesser quality. The door is check. On a success they determine that Dr.
always locked when the room is not occupied; Renwick’s notes represent an almost complete
a successful DC 17 Dexterity (Thieves’ Tools) manual on how to create a unique flesh golem. The
check picks the lock. If the characters enter the notes suggest that he has additional research on the
room, read or paraphrase the following: subject at another location within the asylum.
Somewhat hidden by folding privacy panels 3G. Alienist Office

you see a large working table in the northeast
corner of the room. The surface of the table The door opens to a room with three utilitarian
is heavily scarred and scorched in several desks. The desks are covered in paper, writing
places. Thin metallic strands, gears, and implements, and other detritus.
other esoterica are scattered about. A smaller There are several discarded white smocks
bookshelf is nearby, overflowing with books hanging on a rack in the southeast corner.
and manuals of all shapes and sizes. To the Some of the coats have splatter marks from
right of the desk is a door leading to a smaller recently performed procedures.
room.
A heavily-used writing desk can be seen to The door to this room does not have a lock
your right as you walk in. The surface of the and there is little of interest other than scattered
desk is obscured with a disorganized mess of notes on current patients within the facility. The
papers and books. office is used periodically by staff alienists (see
82
T he T hird F loor
Appendix C, page 144) looking for additional The third-floor storage room has been adopted
privacy. During the daytime there are 1d3 by Lamp’s Light’s janitor, Otto Keller (see
occupants; during the evening hours it is 1d3 - 1. Appendix C, page 158) and converted into
A character wearing an alienist smock has a a makeshift office. Otto has added a desk,
+1 to any Charisma-based skill checks against a personal effects, and cleaned out the room
patient. sufficiently for a bedroll to be laid out.
3H. Otto’s Office Adventure Hook: Characters rifling through

the desk (DC 10 Intelligence [Investigation])
The goods and artifacts stored within this find his diary. The book weaves a fantastical
room have been cleaned and organized to tale of travel through terrible dimensions,
make room for a makeshift desk in one corner unspeakable acts by his companions, and his
and a workbench in the other. The areas have unending quest to find his mother. See Otto’s
the appearance of heavy use, and both pieces NPC entry for further details.
of furniture have been cobbled together from
pieces of broken and discarded planks of wood.
The rest of the room is dedicated to its
original purpose: storage. Boxes, barrels,
shelves, and containers are full of the
mundane supplies you’d expect to find in a
facility the size of Lamp’s Light.
83
Adventuring in Lamp’s Light
W
hen originally conceived, Lamp’s relatively low power of the asylum’s inhabitants,
Light Sanitarium was to be the focal their political power and the environment itself
point of an ongoing campaign. As the are intended to challenge players well into the
characters grew in power their interactions with second tier of play. In this chapter you will find
the guests, staff, and powers behind the asylum two complete adventures, an adventure skeleton,
would change to match their new abilities and and two story arcs.
influence within their home city. Despite the
84
• A Population in Flux, patients come and • Emancipation (Adventure Skeleton), a
go with alarming frequency, and the only simple job turns into something so much
constant is change. more as an unexpected adversary is unleashed
• Encounters with Patients should be within the confines of the sanitarium.
unusual and run the gamut of possible • A Friend in Need (Story Arc), in which
experiences. The PCs should never be a trusted friend stumbles upon a secret best
completely sure who they’re interacting with, left unlearned, and is now a mindless shell of
or the repercussions of their deeds. their former self. Can the heroes learn why
• Tabula Rasa (levels 1 thru 2) introduces and how such a thing occurred, and in doing
your characters to the horrors and so preserve the knowledge their friend has
personalities of Lamp’s Light Sanitarium, and paid so dearly for?
sets the tone for a dark campaign. The heroes • Baby Jayne (Story Arc), in which the
are the unwilling pawns of the asylum’s staff, patients of Lamp’s Light have become
and must make the best of their situation. increasingly restless, resulting in the
There are no easy answers, and their actions inconvenient deaths of a few patients. The
may follow them for many sessions to come. administration wants to know what’s going
• Apotheosis of Nightmares (Levels 3 thru on, and more importantly to stop it and
5) can be played as a follow-up to Tabula prevent additional embarrassment. Are
Rasa. An ancient, fiendish intelligence is the fatalities due to random violence, or a
imprisoned, and the cracked minds of Lamp’s malevolent intelligence?
Light contain the key that will loose it from
its cage. Administrator Rose has hatched a
plan to gather this eldritch knowledge and
call forth the devil. The PCs are the lynchpin
to her success. Will they aid the nefarious
being for promises of power, or serve the
greater good and thwart its machinations?
85
A dventuring in L amp ’ s L ight
A P opul ation in F lux

The population of Lamp’s Light is in a state of a hospital for citizens that prefer to seek healing
constant change as new patients are admitted outside a temple. Any given patient may be a
and old ones leave, expire, or disappear. DMs vagrant or a member of the upper class. She may
are encouraged to use this dynamic to set up be an adventurer seeking tranquility between
storylines and NPCs, and engage their players. dungeon delves or a scion of the local nobility.
Each patient has her own story, and each story While it may be obvious in some cases, a
can be a hook for an adventure. patient’s mental and social status should be
Underlings and contacts that your players a point of uncertainty. The telltale tics and
have come to rely behaviors of the
on may disappear insane patients
into the depths can often be
of the sanitarium suppressed and
for treatment, and may only be
in doing so come apparent in times
back as completely of stress. Likewise,
different people. the patients of
Perhaps an ally of Lamp’s Light
the adventurers typically all wear
is searching for a the same clothing,
cure to a curse, making an obvious
condition, or cue of wealth
malady that has unavailable. To put
proven too strong it simply, keep the
for traditional players guessing
divine treatments? and on their toes.
The Patient’s A patient
Life Outside Of can express their
Lamp’s Light Sanitarium table below offers mental state in a wide variety of ways and the
additional examples for your campaign. severity of symptoms could differ significantly
too. The patient may be habitually anxious,
Encounters with Patients apathetic, aggressive, paranoid, or restless.
Patients often also have trouble following a
There are a number of different ways to portray conversation or train of thought. As the stress
the patients within Lamp’s Light. The players level around the patient increases, so too do the
and the characters should know that the asylum symptoms.
serves a variety of functions; it is not just an The tables in Appendix A, page 126
asylum for the mentally ill, it also serves as a spa onwards, offer dozens of additional examples to
of sorts for those with the means to afford it, and explore.
86
Patient’s Life Outside Of Lamp’s Light Sanitarium

d12 Background
1 Tontho is the eldest son of a local smith and has been admitted for night terrors. The terrors assail
the boy every evening, and his father will reward whomever can free his child of his torment by
crafting an exceptional (magical?) weapon as a sign of his eternal gratitude.
2 Cleo, an urchin informant who’s spent most of her life on the fringes of the criminal underground,
has been brought to Lamp’s Light to treat a fever. Her feverish mind cannot tell the difference
between confidant and stranger, and she tells all who will listen the secrets that she has learned
from her black-market contacts.
3 Yondu is an elderly man who has spent his entire life working the land. In his dotage, his mind
and body have begun to fail him. He has a kind word and smile for everyone he meets. On
moonlit nights he tells tales of the Black Thing Within the Wood. With each telling he grows less
lucid and weaker.
4 Peren (Monk 16, CN), bald and emaciated, stands in the corner counting to himself. He is but one
of many retired adventurers that pass through the doors of Lamp’s Light. If interrupted he begins to
count again; if asked what he’s counting he looks up with tears in his eyes — “So many lost souls.”
5 Griswald (Rogue 3, LN) keeps to himself, avoiding all contact with visitors and other patients.
He admitted himself to the care of Lamp’s Light for “uncontrollable hysterics”. Griswald is a
member of the local Thieves’ Guild and is searching for tomes of eldritch knowledge.
6 Emrys, a handsome woman of indeterminate age, wanders the facility freely. The staff, alienists,
and patients give her a wide berth in her perambulations. She is the illegitimate daughter of a
noble of prominence and is accustomed to getting what she wants.
7 An enemy from the heroes’ past, one thought long vanquished, was in fact rescued from death by
Dr. Renwick. She no longer remembers the PCs, or the events that led to their confrontation.
8 A dire wolf, its skull shaved and covered in a strange metallic helm, runs back and forth on
the lawn fetching sticks thrown by the orderlies. The creature sits dutifully after each retrieval
awaiting the next throw by its master.
9 A dirty, odorous man sits by himself. Mause spent a lifetime working the sewers beneath the streets,
and in those subterranean passages he lost not only his sense of smell, but also a portion of his sanity.
10 Gwyden, a common laborer, was admitted to Lamp’s Light when her mind was shattered in an
encounter with an unspeakable horror.
11 Yvgin (Rog 1, CN), encountered a creature so horrific and mind-meltingly terrifying that his
hair turned completely white, and he found himself unable to sleep without the powerful sleeping
draught only the staff of the asylum can provide.
12 Crio (Pal 9, LG) sits with his back against the wall most days vigilantly watching the goings on
around him. He sees devils and demons everywhere and bides his time waiting for the perfect time
to strike.
87
Patient Random Encounters

d12 Behavior
1 The patient immediately recognizes the character with the highest Charisma as a beloved
and long lost relative. Within 1d4 rounds the patient becomes agitated with the character for
abandoning her to the asylum, possibly becoming violent.
2 The patient stands off to the side of the room and will not react to any stimulus or interact with
any character.
3 A patient walks past the characters with seemingly unseeing eyes. An observant character (a
passive Perception of at least 13) notices small circular scars on the patient’s head under her patchy
hair.
4 A patient greets the characters by name, asks them how their day has been, and treats them as
trusted friends.
5 Two patients are playing patty cake with each other. They ignore everyone else and are docile
unless interrupted. If interrupted in any way they cry and wail as loud as they are able until
orderlies take them away.
6 A patient beckons the characters to a private corner of the room. “I need your help! They’re after
me. They found me from my dreams!”
7 A patient calmly approaches the characters requesting food. If the patient is given food she
immediately sits down and starts eating. If they refuse, and they have food on them, the patient
senses they are lying and becomes hostile.
8 A patient sits quietly muttering to herself. The language defies all attempts at deciphering,
including magical means. Should the characters be able to read the patient’s mind it too is
unintelligible.
9 A patient in fine clothing walks over to another patient and with no preamble slaps her.
10 A patient comes up to the most heavily armored character. Gesturing at the armor he says, “Is that
to keep everything in? Or keep everything out?”
11 A patient sits on the floor quietly rocking and crying to herself. A successful DC 12 Charisma
[Persuasion/Deception] check placates the patient. If placated the patient becomes friendly and
eager to help the characters.
12 The patient exhibits no discernable unusual behaviors.
88
89
T abul a R asa
A Lamp’s Light Sanitarium investigative adventure for 4 to 5 characters of levels 1–2
Synopsis Adventure Hooks

By chance or design the characters have become • There are worse things than a TPK. Your last
unwilling patients at Lamp’s Light Sanitarium. session with the big bad ended not with a
They have all been marked as future test victory but with a fade to black. Your players
subjects of Dr. Renwick (see Appendix C, page expect to roll new characters to begin their
177) as he continues to experiment with and journey anew. Instead, they find familiar
fine tune the juxta personalis (see Appendix B, characters in a situation worse than death.
page 140). The physical changes wrought • A campaign centered on Lamp’s Light begins,
by the device are minimal, but mentally and most appropriately, as a patient within those
emotionally the subjects are forever changed. hallowed halls. The players’ backgrounds
They may lose memories or portions of their should indicate why they ended up in Dr.
personalities, and could even change alignments. Renwick’s tender care, and this adventure is
In the midst of the confusion a friend appears best suited to those of a lower station or who
with an offer of aid. live on the fringes of polite society.
90
T abul a R asa
S etting the S cene bed and your feet to

• Prior to beginning its base.
the players’ first You are clothed
session in Lamp’s in a simple cotton
Light the DM shift, and from your
should explain vantage you are able
to the players to see a small barred
that this is an window opposite a
adventure in which heavy wooden door.
the characters’ Heart racing, you
actions may hear the struggles of
have long lasting others in the room
repercussions. and realize that you
Indiscriminate are not alone. There
violence may earn are other beds in the
the characters the room and in each of
enmity of powerful those beds a figure is
personages within and without the walls of bound to the frame. From the sounds of their
Lamp’s Light. A few possible consequences: struggling they are in the same predicament
• The character is bound, gagged, and as you are.
relegated to existence as a test subject until
her mind is broken. The characters have been remanded to the
• A scion of an important personage in the city care of Lamp’s Light Sanitarium. They are
is harmed (or killed) due to the actions of the unknown and unimportant in the grand scheme
characters. This influential figure will dog of things, and as such have been earmarked as
the heroes from the shadows until revenge is test subjects for Dr. Renwick’s experiments.
exacted. All characters are restrained, spell casters are
• The staff of Lamp’s Light brand the gagged (they are still able to talk but casting a
character(s) as criminally insane and spell with a verbal component is not possible),
untreatable. They are transferred to the and they are all without any equipment,
stockades to face punishment for their including spell foci or religious symbols.
crimes. The bindings have been expertly applied and
are very strong. A successful DC 18 Strength
Scene One — Rude Awakening check will break the buckle. If both arms are
bound the check is made at disadvantage.
Once the character has been freed of one
Awakening in an unfamiliar room, the first buckle she may use her action to unclasp a
thing you notice is that your back is aching buckle. In this manner she will be able to free
from the gentle caress of the bed. It is much herself completely within 3 more rounds. It
softer than the ground you normally sleep on. is not possible to remove the restraints by any
Trying to turn to your side you realize that means other than brute strength. If none of the
you cannot move freely. Buckled heavy leather characters are able to extricate themselves from
restraints bind your hands to the side of the the bonds proceed to Scene Two.
91
Should the characters manage to break C, page 144) and two orderlies enter the room.
even one restraint, orderlies (see Appendix C, Read or paraphrase the following:
page 173) immediately stream through the
door and head directly for any character that is A severe woman in a simple white overcoat
free. There are two orderlies for each character enters the room, looks you all over with an
that’s broken a restraint. The orderlies attack appraising eye, and after a few moments of
immediately, dealing subdual damage. Once the deliberation turns to the brawny orderlies
freed characters have been subdued the orderlies behind her, saying “that one” before leaving
methodically go to the other PCs and knock the room. The orderlies move with practiced
them out as well. efficiency, first placing an odorous cloth over
The battle is not meant to be lethal but the victim’s mouth. As consciousness slips
should make it clear that the characters are not away, they cover the head with a black hood,
in control of their environment. If the characters and finally remove the chosen from the room.
have fought with the guards please read or
paraphrase the following: This process will replay for each PC as they
are taken individually into the Basement
Men and women in white uniforms rush for treatment with the juxta personalis. Each
into the room, brutally beating you and the character that is taken returns, unconscious, an
others. They repeatedly attack your body hour later. The orderlies ensure that all returned
while taking great care to avoid your head. subjects are outfitted with Prosper’s camisoles
Unconsciousness comes swiftly as a relief from prior to putting them in their beds.
the pain. After the first person returns, have the
When you awaken again it’s to the feeling remaining conscious characters make a DC 10
of a wet towel on your brow and a striking Sanity check as they realize that they’re next. On
woman with a kind face in front of you. She a failure the character loses 1d2 Sanity. Once all
sees your eyes flutter and withdraws from the of the characters have completed treatment read
room silently before you’re able to question or paraphrase the following:
her.
Your head feels as if a burning spike has been
Administrator Florence Rose (see Appendix driven through your eyes, and concentration
C, page 181) has taken an interest in the is impossible. Half-formed thoughts stream
characters and should appear to them as through your mind, rarely stopping long
a beacon of hope in a dire situation. The enough for you to vocalize. As you try to form
characters’ situation is much the same as it was a coherent word drool fills your mouth and
before, only this time they have all been fitted dribbles onto your chest.
with Prosper’s camisoles (see Appendix B, page
142). The players now determine the permanent
side effects from their treatment with the juxta
Scene Two — You’ll Feel Better Soon personalis. Dr. Renwick has fine-tuned this
specific machine to target the personality of the
Within a few moments of Administrator Rose subject more so than prior versions.
leaving the room a staff alienist (see Appendix Please roll or choose an effect from the table
below.
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Juxta Personalis Side-Effects As the characters come to grips with their new
d10 Effect personalities, night falls and an uneasy sleep
claims them.
1 You are under the effects of the calm
emotions spell until you complete a
long rest
Scene Three — A Possible Ally
2 Change alignment one step on the law/
chaos axis Time is difficult to measure. You know that it
is dark from the moonlight entering through
3 Change alignment one step on the good/
the barred windows. The susurrus of screams
evil axis
and gibbering patients has died down too,
4 Choose a new personality trait at random indicating that your neighbors are asleep.
5 Choose a new Ideal at random The sound of the lock being disengaged and
the creaking of the door as it opens jars you to
6 Choose a new Bond at random
immediate wakefulness and you can’t help but
7 Choose a new Flaw at random shudder at the memory of what happened the
8 Roll or choose a new indefinite madness last time that door was opened.
9–10 No visible effect

Otto Keller (see Appendix C, page 158) has
come to visit the players on their first evening
The characters are only able to recall flashes and in Lamp’s Light. Otto offers a kind word,
impressions from their treatments. Their body encouragement, and the following advice:
aches from the extreme contractions, there is a • There are rules in Lamp’s Light and it’s
faint smell of ozone and burnt hair, their jaws easiest to obey them. The first rule is,
ache and a few teeth have been chipped from do what you’re told by the orderlies and
clenching their jaws. alienists.
The juxta personalis has temporarily allowed • You never know who you’re talking to. Otto
the characters to see one another’s auras. The has learned that there are patients from all
colors and strength of the aura walks of life and he has a very hard time
are signs of the character’s telling who’s lying and who’s telling
mental strength and health. the truth about where they come
from.
Looking at one another • If asked about Administrator
you notice a shimmering Rose or if the characters
aura around your describe the woman that
companions. The showed them kindness earlier
auras are a jumble Otto’s face visibly softens. “She’s
of dark colors with quite wonderful, isn’t she?” Otto
flecks of red and trusts her completely and urges the
deep ochre. They characters to do the same.
are especially • Patient suicide is not uncommon
intense around the at Lamp’s Light but there have been
person’s head. two recent suicides of patients that
93
hadn’t been depressed. Administrator Rose, The nimbus claimed its first victim without
in particular, is upset by this recent turn of attracting attention, but with its second dying
events. in less than a week Rose and Dr. Renwick
believe that an evil sentience is at work. The
Otto refuses to release the characters for fear third victim is from a family of note, and
that he, and they, will be discovered and should she succumb to the nimbus Lamp’s
punished severely by the orderlies. He tries to Light’s sterling reputation will lose some of its
assuage their concerns and reassure them that luster.
most patients are only treated the one time (this
is true), and if they behave they may be allowed “There is something feeding on our patients.
out of their restraints. To my shame we didn’t realize what was
occurring until we lost two patients. Dr.
Scene Four — Rose Renwick has informed me that many of
his recent subjects have gained a sort of
A stunning woman with a kind face enters the second sight. Whatever is harming the poor
room with a trio of orderlies. unfortunates has eluded all attempts at
observation. If you have this ability you may
The first thing that you notice is that the succeed where we have failed.”
auras you saw yesterday are still clinging to
you, and to everyone you see. The woman’s Rose has the following information to share
aura is brighter, warmer than the orderlies’ with the characters:
whose auras are much like your own — a
coruscant of dark colors with streaks of red If the pl ayers make a W isdom (I nsight )
and orange. check against R ose :
“I trust you’ve had an untroubled • DC 10: Rose is being completely truthful
evening? My name is Florence Rose and and honest with the characters. She is upset
I’m the administrator here at Lamp’s Light about the previous two fatalities and wants
Sanitarium. A darkness has infected my the creature stopped before it claims another
sanitarium and you, my friends, can save us patient.
all.” • DC 25: As above, and the character realizes
that the reason Rose is upset and concerned
A dark intelligence, drawn by chaotic minds is more about the damage to Lamp’s Light’s
within the asylum, has begun to feed on the reputation than it is about the deaths of the
patients of Lamp’s Light. The entity, an ethereal patients.
creature known as a nimbus (see Appendix C,
page 170), attaches to an unknowing victim I f asked about the previous victims
and over the course of several days drains her of • This has happened three times before, to
her will. The victim grows listless, melancholic, Sewyllen Tanga, Mary Tae and Thakad Alin.
and lethargic until eventually she enters a near- • The patients were of low status and the staff
catatonic state. When the nimbus is satiated it thought little of it.
causes the host to commit suicide and moves on • Rose suggests that the players investigate by
to its next victim. talking to other patients and/or staff alienists.
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T abul a R asa
W hat ’ s in it for us ? successful and that you’re all trusted patients.

• With a word Rose can have the PCs’ This will give you more freedom to explore the
restraints removed. sanitarium.”
• Rose can also grant access to the common “Only Dr. Renwick and I are aware of your
room, cafeteria, and select areas of the 1st true purpose and it should remain that way.”
floor.
• Rose promises (truthfully) to do what she can If the players make a Wisdom (Insight) check
to get the PCs released if they’re successful in against Rose regarding the treatment:
their mission. • DC 10: Rose believes that Dr. Renwick’s
treatment plan involves experimenting on
W hat about the treatments ? the patient with the juxta personalis. She has
• Rose claims (truthfully) that she was unaware no technical knowledge of the treatment and
that the PCs were going to be treated with comments will inevitably lead back to her
the juxta personalis. telling the characters that they have firsthand
• She does point out that while unpleasant experience with it.
there is a silver lining and that their
newfound (and temporary) ability to see Scene Five — Decisions
auras could be their way to freedom.
• She states (truthfully) that she can make
certain they aren’t subjected to the treatment Rose leaves the room, and the orderlies step
again. forward to remove your restraints. They work
with the quiet efficiency of someone that has
W hy us ? completed this particular task countless times.
• The creature is invisible to the naked eye and A moment later they too leave and you are all
Dr. Renwick hypothesizes that your jumbled left to yourselves in your room.
senses may allow you to see it.
• With an embarrassed shrug she will admit At this stage the players have a critical decision
that your lack of any connections to Lamp’s to make. Do they investigate the happenings
Light makes things tidier should you fail. within Lamp’s Light and try to save the patients?
Or do they pursue a more selfish path and
W hat do you want us to do ? escape with all due haste?
• Verify that something is, in fact, infecting the
patients of Lamp’s Light, and report back to E scape F rom L amp ’ s L ight
Rose any patients affected. • To escape during the day the characters must
avoid undue attention from the orderlies,
When the players agree to help, read or staff, and alienists. They must also somehow
paraphrase the following: get past Meri (see Appendix C, page 162),
the receptionist.
“Dr. Renwick has a treatment for the patients • If the characters choose to wait until nightfall
once you bring them to us. Gods be willing they do not have to contend with Meri.
it’s still only a single patient. Dr. Renwick However, the front door is locked and
and I have informed the orderlies, staff, and any orderlies or alienists are immediately
alienists that your treatment was completely suspicious of patients wandering the facility.
95
Elys • Each room is detailed in the relevant chapter.

Elys is the youngest daughter of the Rhodon Any rooms that contain staff or alienists may,
family and the apple of her father’s eye. By all at the DM’s discretion, require a skill roll to
accounts Elys is an exuberant young woman with hide the PCs’ true intentions. Each player
an easy smile, a ready laugh, and an abundance should describe her actions, and the group
of energy. She sees her stay in Lamp’s Light as chooses one character to make an opposed
an adventure, an opportunity to be part of the group skill check using the appropriate
fashionable group of former patients. She has skill against the NPCs’ Wisdom (Insight).
made the most of her short stay at the facility If the characters fail their check the staff is
befriending virtually everyone that she meets and hostile and will attack if the characters do
thoroughly enjoying herself. There are few in the not immediately retreat peacefully to their
asylum that have not talked to Elys or at the very rooms. Should that occur the PCs have a
least seen her flittering through the halls. visit from Rose the following morning; she is
The Rhodon family is well respected and, looking for reassurance that the characters are
behind closed doors, more than a little feared for investigating the suicides.
their suspected ties to the city’s Thieves’ Guild. • If more than half of the characters have
Her father, Thanik, placed Elys in Lamp’s training in a suitable skill the roll is made
Light for her own protection. Thanik has reason with advantage.
to believe that his enemies will be targeting his • If only a single character has training in
family — in particular his favorite daughter, Elys. the relevant skill the check is made with
disadvantage.
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• Otherwise the check is made as a regular roll. Clue #3: Elys has become virtually catatonic
• Characters attempting to sneak must succeed overnight.
on a DC 12 Dexterity (Stealth) check any • Known by: staff alienists (50% chance), Otto
time they enter the hallway or the parlor, (he has met Elys recently but doesn’t know
to avoid the notice of the orderlies. A failed her name. He remembers her because she
check in the morning results in a warning was so full of life. When he saw her today,
and redirection to their room. she didn’t acknowledge him or anything else.
• Failed checks in the evening result in an Otto knows where she is.)
escort to their room and a visit from Rose in
the morning as outlined previously. Clue #4: Elys Rhodon is the youngest
• The characters’ final obstacle will be escaping daughter of Thanik Rhodon, a prominent
the grounds. Regardless of the time of day member of the Thieves’ Guild.
that they escape they eventually encounter • Known by: Administrator Rose, Dr.
Gneigel (see Appendix C, page 148). He Renwick (see Appendix C, page 177),
immediately recognizes them as escaped Rolund Hergus, Mad Jak, and Otto (knows
patients and attacks. her family is important but that’s all).
Everyone but Otto knows that her father has
I nvestigating connections with the Thieves’ Guild.
The nimbus preferentially targets manic
patients, and once attached to the victim they E xploring
deteriorate rapidly. The players should discover • The patients and staff of Lamp’s Light are
the following clues to narrow down their search always moving and changing. The PCs can
and ultimately identify the correct patient. eventually find Elys just by looking for a
patient that is catatonic. If they go this route,
Clue #1: The patients that have recently and pacing allows, the PCs can explore the
committed suicide are: Sewyllen Tanga, Thakad facility and meet the inhabitants of Lamp’s
Alin, and Mary Tae. Sewyllen and Thakad Light. The players should understand that
were manic prior to their suicides. Mary was the inhabitants of the rooms, especially the
admitted for suicidal ideation. Cafeteria and Common Room, are fluid and
• Known by: staff alienists (50% chance), will change.
Rolund Hergus (see Appendix C, page 154),
Mad Jak (see Appendix C, page 166), and F inding E lys
orderlies (75% chance). • When pacing allows, the characters find
Elys in the Common Room (1L) via
Clue #2: Patients that are currently manic are investigation or through simple legwork.
Mad Jak and Elys Rhodon Read or paraphrase the boxed text from
• Known by: orderlies (75% chance), Mad Jak, the Common Room description and then
and staff alienists (50% chance). proceed to Scene Six.
97
Scene Six — Finding Elys Characters making a Wisdom (Insight/

Medicine) check regarding Elys’ condition note
Once the PCs enter the room with Elys read or the following:
paraphrase the following: • DC 15: Despite the antics of the manic
patients in the room Elys takes no apparent
A young woman matching the description of notice of them or their actions. Her eyes are
Elys sits on a shabby divan in the northeast shot through with blood-red streaks giving
corner of the room. She is flanked by two other her a discomfiting appearance.
patients who are talking nonsensically to her. • DC 17: Elys’ eyes are shot through with red
petechia from an unsuccessful attempt to
To successfully extricate Elys the players must hang herself this morning. Knowing what
placate both patients and change their demeanor to look for, you catch a glimpse of ligature
to friendly, or redirect their senseless babbling to markings on her neck.
another target.
The two patients (see Appendix C, page Elys is docile and allows herself to be led
174) sitting next to Elys are immediately peacefully by the players. If the characters
hostile to anyone talking to her or attempt to attack her or the nimbus directly all
interrupting their conversation with her. Any hell breaks loose as it incites a riot of lunatics
attempts to Intimidate incite an immediate (see Appendix C, page 179). If a riot breaks out
attack. Persuasion checks are made with the orderlies will immediately leave the room,
disadvantage, and if failed the patient or lock the doors behind them, and not open them
patients will attack. until the following morning.
The orderlies will not intervene until
someone is knocked unconscious, in which Conclusion
case they break up the fight; or someone
inflicts lethal damage, in which case they call in
reinforcements and join the fracas with merciless T he PC s D estroy the N imbus
abandon. The characters are able to defeat the nimbus
When Elys is free of the other patients the through martial and arcane prowess and with no
PCs are able to take a good look at her and small amount of collateral damage. They have
should make a Wisdom (Perception) roll: caused the demise of the patients that comprised
• DC 12: Elys’ aura is a swirl of dark colors, the riot of lunatics, and possibly others as well.
faded and thin. If Elys survived the battle she is freed of the
• DC 15: As above, and the character notices creature’s influence and is not subjected to the
the indistinct outline of a nodule at the base tender care of Dr. Renwick. Administrator Rose
of her neck. and Dr. Renwick are grateful that the creature
• DC 17: As above, and the nodule has has been defeated. A successful DC 10 Wisdom
extended pulsating tendrils into Elys. This (Insight) check suggests that Dr. Renwick is
character must make a DC 10 Sanity check, disappointed he’s been deprived of a new test
losing 1d4 Sanity on a failed save. subject. The DM should consider if any of the
deceased patients have family that could insert
themselves into the PCs’ lives at a later time.
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99
If Elys also perished, the PCs are relegated and treatment with the juxta personalis have
to a (short) life as the subjects of Dr. Renwick’s forever changed the young woman. She is all
experiments. Each is implanted with a spike but unrecognizable to her friends and family
(see Appendix B, page 138) and what happens when discharged. The family may fault Lamp’s
subsequently is at the DM’s discretion. Light for her condition, but more likely they
will blame the PCs. The enmity of the Thieves’
T he PC s L ead E lys to D r . R enwick Guild will dog the characters until they make
The PCs lead Elys to the treatment room and restitution or their perceived debt has been
find the stern woman from their first morning fulfilled.
in the room with a device that looks like a
highly polished box of dark hardwood with T he PC s E scape the A sylum
no ornamentation and no apparent means of Through luck, guile, and stealth, the
opening it. characters have managed to escape their
The juxta personalis is a handspan tall and incarceration in Lamp’s Light with their lives
deep, and twice that in length. Two copper hilts and their minds intact.
protrude from the front of the box and a length
of thin chain emerges from the opposite side. T he PC s are K illed
This chain is connected to a masterly-crafted If the PCs do not survive their encounters
leather helmet. The interior of the helmet is within Lamp’s Light their bodies are harvested
lined with precisely placed gold runes. As the by the staff and used in future experiments.
PCs walk away, the helmet is placed on Elys’ Whether they are technically alive or not for
head. Read or paraphrase the following: these endeavors is at the DM’s discretion.
Elys’ limp and docile form settles into the T he PC s take their time
chair. The young woman’s head only lifts when If the PCs dawdle, either through ill-planned
the leather restraints raise her downward escape attempts or through a general lack of
gaze. If she notices orderlies tightening the urgency, they awaken after the second night to
leather restraints around her arms and legs, find themselves once again restrained in their
she gives no outward cue. The last restraint beds.
fastened, they place a piece of thick leather
into her mouth. “Another patient committed suicide last night.
Their work completed, the orderlies quickly Her name was Elys Rhodon. Unlike Thakad,
step away and Dr. Renwick grasps the brass Mary, and Sewyllen, she MATTERED! It
handles of the box. Visible arcs of electricity breaks my heart that I must tell her father
course from his forearms, to his hands, and that she died at the hands of fellow patients.”
into the box. Elys violently arches against the Administrator Rose’s demeanor stands in
restraints, leather groaning from the strain. stark contrast to your previous encounters. All
As the door is closed you see her body go limp, traces of kindness and compassion have been
and the leather bit falls from her mouth. replaced with steely ice.
“Your failure is…unacceptable.” She turns
The PCs have saved Elys’ life, but at a cost. and walks out of the room, not waiting for a
The combination of infection by the nimbus response.
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All of the characters should make a DC 10 “They’re all yours, Renwick. Do as you wish
Wisdom (Perception) roll. On a success, the with their bodies, but their minds must not
character hears: remain intact.”
101
A potheosis of N ightmares
A Lamp’s Light Sanitarium Horror Adventure for 4 to 6 Characters of Levels 3–5.
by Donathin Frye
We lift our trembling voices to the Harvest Moon!

We raise up our lidless gaze to the Starless Sky!
Come Lord of Dreams, walk beside us!
Soothe our agony and free our wretched minds.
Lord of Dreams!
Show us the truth that lies beyond this world!
Our minds and our bodies are yours;
take them from us!
Oh great H’awouahoua, the lurker and the dreamer!

Feast on our madness, devour us whole!
We are nothing. We are nothing. We are nothing.
We are nothing. We are nothing. We are nothing.
102
Synopsis seen the characters in her dreams as of late and

believes this to be a sign that she needs their
Will the players stop help. If the characters
or usher in a great are meeting for the
evil on the brink of first time, it may
apotheosis? be that they all find
An imprisoned themselves on the
devil known as the same carriage riding
H’awouahoua (“ha- to Lamp’s Light, so
woo-ah-hoo-ah”) that they have time to
has been drawn to introduce themselves
the confluence of to each other.
dissonant minds This adventure
contained within provides exciting
Lamp’s Light. choices for both
Administrator Rose, altruistic parties and
at the behest of the those with a more
terrifying entity, has self-centered and
urged the residents of greedy approach to
the facility to record adventuring. In either
their mad dreams situation the group
within the pages of becomes the pawns
a dream journal. of an entity of great
Rose believes that power. A ghastly
the collected journals summoning ritual is
contain within being recreated by the
them the knowledge wretched minds of
needed to release the the patients at Lamp’s
H’awouahoua from Light Sanitarium.
its imprisonment on Its fate and the fate
another plane. of the characters are
intertwined to the bitter end.
Adventure Hooks Administrator Rose has gathered the dream
journals of the patients of Lamp’s Light in a
To accomplish her secret goal of summoning quest to recreate the ritual that will call forth
the H’awouahoua into the physical world, Rose the H’awouahoua; the devil has promised
has offered the player characters a job, with the the shapeshifter posing as Florence Rose
significant payment of 3,000gp, or a rare magic immortality in exchange for her service.
item, or access to key information that the The other staff are unaware of Rose’s
characters require for an ongoing campaign. ultimate goal with the journals. They believe
Rose has chosen the characters either because that she has the patients’ best interests at heart
they proved helpful to her during the prior and is exploring new therapies. With the
adventure Tabula Rasa, or because she has possible exception of Dr. Renwick, there is no
103
one at Lamp’s Light who would guess that Rose of the room. The room is spotlessly clean,
has an ulterior motive for studying the journals. with every book, paper, knickknack, and item
At the start of the adventure, Rose is still meticulously placed. Through the doorway,
missing the final two passages of the ritual. She you can see that the focal point of the room is a
believes that the lines have been written, but she simple desk of unmistakably high quality, with
has been unable to locate them in her patients’ a chair placed in front of it.
dream journals and believes they may be hidden Behind the desk is another chair, and
somewhere on the asylum grounds. there sits Florence Rose, gesturing for you
One of the remaining passages can be found to enter with a welcoming wave of her hand.
somewhere the characters are unlikely to look at Administrator Rose is an attractive, raven-
first: the passage is written down in the private haired young woman with a kind but weary
diary of Otto Keller (see Appendix C, page smile, wearing a simple black dress and a
158) the asylum’s kindly hunchback janitor name tag matching the nameplate on her door.
and handyman. “Oh! Thank goodness you’re here. I was
The final passage of the Apotheosis of worried you might have changed your minds.
Nightmares exists within the characters’ own Please, come in. I’m sorry that I do not have
subconscious minds, and can only be learned chairs for all of you.”
through exploring (and surviving) their own
devil-plagued nightmares. During the meeting, Rose is keen to strike
a deal with the characters. She claims to be
Getting Started: Meeting Florence Rose developing a new, non-invasive treatment for
the patients of Lamp’s Light that encourages
Regardless of how the meeting comes to creative writing and use of dream journals. She
pass, whether they were hired to come to tells the characters that she believes Mad Jak
Lamp’s Light or are patients being offered (see Appendix C, page 166), Patient 11 (see
their freedom, the adventure begins with the Appendix C, page 168), and Rolund Hergus
characters in the office of Administrator (see Appendix C, page 154) may have hidden
Florence Rose (see Appendix C, page 181) on some of the pages of their journal from her. She
the third floor of the sanitarium (area 3D). Read feigns concern that they may be victims of staff
or paraphrase the following: abuse, and wants to locate any missing pages
in hopes of proving her theory one way or the
A heavy mahogany door with a brass lock, other.
decorative iron bands, and a nameplate on Of course, the truth is that Rose believes
it stands before you. The nameplate reads the characters themselves are the ones that
“Admin. Florence Rose” in flowing copperplate. will unleash her devilish patron from its
From somewhere far off, in another wing of the imprisonment, and her “investigation” is merely
sanitarium, you hear the piercing shriek of one a wild goose chase meant to expose them to the
of the patients of Lamp’s Light. The scream is H’awouahoua’s psychic influence. During the
prolonged, lasting for five, ten, thirty seconds, meeting, Rose will offer the following to the
before it abruptly ends. characters in an effort to procure their help:
A heartbeat after the wail ends, the door
to Administrator Rose’s office swings silently • Payment in the form of their release from
open. A waft of dry, odorless air rushes out Lamp’s Light (if they are being held there
104
as “patients” against their will), 3,000gp, a to her; or else if they are patients at Lamp’s
rare magical item (it could be an item that Light, they have impressed her enough that
the characters have been searching for as she believes she can trust them with this very
part of another adventure or campaign), or a important task.
glowing recommendation to an organization • DC 14: As above, though Rose isn’t sharing
that the characters require access to. everything she knows.
• Freedom to explore the grounds of Lamp’s • DC 18: As above, except that Rose appears
Light as they will, with the exception of overly interested in the characters. She stares
treatment rooms and locked offices. If at them for just a second or two longer than
pressured by the characters, Rose will claim is comfortable.
that those rooms are off limits for legal and • DC 22: Rose is a liar who is trying to
liability reasons. manipulate the characters. But for what
• A free room to stay in at Lamp’s Light should reason?
their investigation last a few days. She will
admit that it is spartan and used to be a Of course, Administrator Florence Rose is
bunk room for some of the sanitarium’s not at all who she claims or appears to be.
more troubled patients, but she adds that it She is seeking the missing text from dream
has been renovated, redecorated, and given journals to use in a ritual to summon a devil,
soft beds and modest comforts to serve their H’awouahoua, into the world. It has promised
needs. the shapeshifter posing as Rose eternal life
• A list of staff that may be helpful with their and has shown her a vision of the characters
investigation: the receptionist Meri (see in her dreams. She will do anything to achieve
Appendix C, page 162), the handyman immortality, and believes that one of the
Otto Keller, the groundskeeper Gneigel (see characters themselves will be instrumental in
Appendix C, page 148), and Dr. Orson recovering the necessary ritual to summon the
Renwick (see Appendix C, page 177). devil.
• Very basic information on any of the Because of this, she will insist that the
staff or patients, avoiding any scandal characters sleep in the spare room at Lamp’s
or inflammatory gossip. For that sort of Light, so that the H’awouahoua’s nightmarish
information, Rose encourages the characters power will draw out the secrets of their
to befriend one of the more talkative staff subconsciouses. If the characters try to refuse
alienists. sleeping in the sanitarium, Rose will grow colder
and tell them that if they intend to take her up
If the characters make a Wisdom (Insight) check on her offer, they must stay at Lamp’s Light for
against Rose: legal reasons. If they continue to resist, Rose
• DC 10: Rose is being completely earnest will seem to give in. However, the first time the
with the characters. She is very worried that characters attempt to leave the sanitarium, she
some of the alienists are mistreating the will have 4 staff alienists (see Appendix C, page
patients, and she feels a responsibility to 144) and 12 orderlies (see Appendix C, page
protect the well-being of all the souls who 173) attempt to knock them unconscious, strip
stay at the sanitarium. Her nearby contacts them of their equipment, restrain them, and
(no, she will not give up their names for admit them as new patients at the sanitarium.
privacy reasons) recommended the characters The next time the characters meet Rose, all
105
pretense of kindness is sanitarium, she may

gone and she threatens slowly warm up to
them: help her with them over the course
her investigation and of the adventure.
be set free with their Each time a
belongings, or else character attempts
begin experimental to befriend Agatha,
treatments with Dr. allow them to make
Renwick. a DC 12 Charisma
(either Persuasion or
Investigating the Deception) check. A
Patients and Staff character that succeeds
of Lamp’s Light on three Charisma
checks in this way
After the characters’ manages to befriend
initial meeting with Agatha. She is much
Administrator Rose, more open to a
she proves to be rather befriended character;
elusive. Rather than a friendly Agatha is
deal directly with the happy to gossip about
characters and risk rumors and secret
outing herself, she information on any
assigns the alienist of the patients or staff
Agatha (see Appendix at the asylum. With
C, page 146) to another successful
be their guide and Charisma check, she
manage their needs may even be persuaded
within the asylum. to allow the characters
Agatha is a cold but properly-dressed elf. Her into rooms that they are not allowed to enter.
attitude towards the characters is helpful, Agatha will encourage the characters to
but aloof. A tricky DM may have Agatha act speak directly to the patients, but to be careful
suspiciously, even though she is innocent and a of triggering them. Should the characters
good person at heart, just to create an early red investigate specific patients, Agatha appears very
herring for the adventure. protective of the patients and helps to guide
Agatha will introduce the characters to the conversation to keep the patients from
anyone they wish to investigate, but will not becoming upset enough to hurt themselves or
allow them to enter into locked rooms or cause a scene. The beginning of the adventure is
treatment rooms. If the characters attempt to act a great time for the DM to introduce the various
against her, she will alert nearby orderlies of a patients of Lamp’s Light to the characters.
Code Red situation, and the characters may find Unfortunately, none of the patients are
themselves new patients of Lamp’s Light. Should hiding any pages or dream journals from the
the characters appear interested in Agatha’s staff. The dark truth is that Administrator Rose’s
hopes and dreams, and her life outside of the hellish patron feeds on the psychic energies of
106
lunatics, but only the characters’ nightmares Dr. Renwick believes that Rose’s investigation
hold the secrets to the ritual that will summon is a waste of time, and that any “tough love”
the H’awouahoua into the world. the patients receive at the hands of alienists or
Once the characters prove unable to learn orderlies is for their own good. If the characters
anything helpful from the patients, they can be ask about Rose’s experiments with dream
set on the right track to unravel the adventure’s journals, Renwick will tell them that her so-
mystery when Agatha offers to introduce them called “treatment” is a joke, and that Rose
to some of the more prominent staff members, should leave the patients’ care to those who are
or should they ask to visit specific staff. actually qualified.
The characters may visit the following staff Should a character succeed on a DC 16
members to further their investigation: Charisma (Persuasion) check, Renwick may
admit to them that he believes Rose to have
M eri ulterior motives, and offers a small reward
Meri can be found in the Parlor (area 1A). (250gp) should the characters uncover anything
Meri is very friendly, very chatty, and very of interest about her activities at the asylum.
willing to do what little she can to help the
characters in hopes that Administrator Rose G neigel
might promote her to a staff alienist position The groundskeeper may be encountered
soon. She knows a lot of rumors and ghost in Gneigel’s Cabin or tending to the grounds
stories of the asylum, and is the inventor of outside of Lucien’s Mausoleum.
some of the more dramatic gossip about some of Gneigel will only be found after the
its residents. characters experience their first nightmare,
Speaking to Meri provides an opportunity and should be a very intimidating encounter
for the DM to introduce a few scary kernels of for them. A living construct, Gneigel’s body is
truth about Lamp’s Light, obscured by plenty well-suited for his work around the grounds of
of false and mistaken rumors. After speaking Lamp’s Light, but can seem monstrous to those
to her, Agatha will appear annoyed by the girl not expecting such a strange groundskeeper.
and tell the characters that, though she is well- Gneigel refuses to speak except in extreme
intentioned, she lets her imagination run wild. circumstances, and is generally put off by
the characters’ presence, but he does know
D r . R enwick something of use to the characters.
Dr. Renwick may be found in the Alienist’s Should the characters mention the dream
Office (area 1H), the Lavatory (area 2B), Staff journals, Gneigel will slowly stretch out one of
Common Room (area 3B), or the Lab (area 3C). his limbs to point (through a window if they
Renwick refuses any official meeting with the are inside his cabin) to a nearby gazebo on the
characters, and so they are forced to catch him grounds. There, sitting on a wooden step, the
unawares if they wish to have a conversation. characters will spy Otto scribbling into his own
He will be busy and openly rude to them if they secret journal. Otto then looks around with a
corner him while he is out of his office, but will worried expression, doesn’t notice the characters,
entertain a very brief conversation about their and hides his journal beneath one of the gazebo’s
investigation. loose floorboards.
107
O tto K eller Otto’s Secret Dream Journal

Otto Keller could be found out in the Otto’s dream journal starts ominously and quickly
Grounds, in Otto’s Office (area 3H), fixing a descends into mad repetition. The first page
broken light in the Main Hallway (area 1B), or simply reads:
reading fairy-tales to patients in the Cafeteria
(area 1G) while they eat dinner. “After all of these years and everything I have
Of all the staff the characters speak to, Otto seen, why is it now that I have started dreaming
is the most immediately kind and helpful. While again? And my dreams, they are always the same.
he won’t spread rumors about the staff or the There I am, back at Horvath’s World Famous
sanitarium’s patients, as that wouldn’t be nice, he Show, wearing my monster mask again. Charity
will reassure the characters that Administrator is looking pretty and swooning from the top of
Rose is one of the kindest people he’s ever the tower, as I climb up after her. Like a million
met. He will also suggest that the characters be times before, I reach the top of the tower and
careful around Dr. Renwick and some of the throw her over my shoulder. Below me, through
orderlies, whom he thinks to be overly mean the flames, the faces of the crowd are leering,
and outright bullies at times. jeering at me, the circus freak, the monster. I
When asked about the missing patient reach for the rope so that I may swing Charity
journals, Otto will tell the characters that the and I to safety for the big finale…
patient Rolund Hergus knows the other patients “But in my dream, there is no rope. Charity
better than most of the staff, and that Rolund screams. The fire’s smoke stings my eyes, and the
has been acting strangely lately. stench of my own burning hair fills my nostril.
Should the characters ask Otto about his As the fire engulfs me and darling Charity, my
dream journal after having seen him with it in only friend, I can hear the excited whooping and
the garden, he’ll lie to them and tell them that hollering of the paying customers below. They are
he never remembers his dreams. If they press all chanting the same words, again and again,
him, he’ll admit that he was a circus performer and when I wake from the dream in a cold sweat
when he was a teenager and was bullied and — I can still hear those words ringing in my ears.
beaten by the other performers because of his I can hear them now, even now, as I write in this
appearance; since then, he’s stopped dreaming journal.”
entirely.
The rest of Otto’s journal simply repeats the
If the characters call Otto out on his lie and
same phrases again and again, scrawled vertically
succeed on a DC 14 Charisma (Persuasion)
and horizontally, in the corners of pages, stretched
check, he’ll hand over his dream journal to
across multiple pages, in every maddening
them, but beg them not to tell Administrator
configuration imaginable. The phrases are what
Rose that it belongs to him. He’s not crazy, he
the crowd chants at him in his dream, and they
swears, and his heart couldn’t bear Rose looking
are also the passages of the summoning ritual
at him like he was just another madman.
for the H’awouahoua. Otto’s dreams began the
same night as the characters’ first dream, and
whichever passage was most recently added to his
journal mirrors the passage the characters learned
in their most recent dream.
108
Important Events at the Asylum S econd D ay

On the Second Day of the investigation,
Apotheosis of Nightmares is meant to be a slow- before dinner, a staff alienist and two orderlies
paced adventure that uses dread and tension to try to discharge Mad Jak from the asylum,
build to scary moments, then relaxes its tension, claiming that he’s not taking his treatment
only so that it may build up to its next, even seriously by sneaking in whiskey. Mad Jak
scarier, moment. For this reason, the characters begins to scream, terrified of being set free,
need not be exposed to all of the secrets of begging for the staff to give him one more
Lamp’s Light immediately, and should instead chance to sober up. When the alienist refuses
learn about the corrupt institution over the Mad Jak, he will break a hidden bottle against
course of several days. the wall and use the shards to cut his own
From the first day of the characters’ throat.
investigation until the night of H’awouahoua’s If the characters get involved and save his
summoning, a series of loosely connected life, he weakly mumbles, again and again, some
events at Lamp’s Light show how the characters’ of the words from H’awouahoua’s summoning
choices help or harm the residents of the ritual. The characters may hear him whisper,
asylum. “Soothe our agony and free our wretched minds”,
again and again. Mad Jak then passes out and
F irst D ay is dragged away to the sanitarium’s treatment
On the First Day of the investigation, wing.
Rolund Hergus holds court in the Common
Room (area 1L) after dinner. Many of the T hird D ay
patients (Rolund calls them his subjects) On the Third Day of the investigation,
pay him respect by laying gifts of trash and late at night, the characters may hear a series
meaningless trinkets at the foot of his padded of loud noises that lead them to Administrator
chair. Rose’s Office (area 3D). There, they will catch
All of the named patient NPCs are present Otto Keller red-handed; Otto has broken into
for the court, as are a number of watchful Rose’s office because he believes she is somehow
orderlies and the handyman, Otto Keller. Otto behind his recurring nightmare, and that
is kindly reading the fairy tale book Sleeping some dark power may have a hold on Lamp’s
Beauty to a catatonic Patient 11, who stares back Light. When the characters find him, he is
at him with a vacant expression. shredding spell scrolls containing necromantic
Should the characters ask anyone present spells; the spell scrolls are disguised as patient
about the dream journals, they will get the files, however, and Otto is burning them in a
attention of Mad Jak. Before they leave, a very trashcan.
drunken Mad Jak will attempt to grab one Otto does not trust the characters, even if he
of the characters and ask them to share a sip did previously: they are agents of Administrator
from his whiskey flask. If they partake, he will Rose, and he’s discovered that Rose has an
whisper to them that they should investigate interest in evil magics. As soon as he sees the
the groundskeeper Gneigel, claiming that the characters, he burns the remainder of the spell
monster knows more than he lets on. scrolls and threatens them with his heavy
wrench, telling them to get out. The characters
may scare Otto out of the office with a DC 16
109
Charisma (Intimidation) check. Otherwise, he anything about it. Should a character lie to her to
will attack the characters if they refuse to leave. cover up Otto’s involvement, they must make a
If the characters try to talk Otto down DC 15 Charisma (Deception) check. Regardless
and earn back his trust, they may do so with of the results of the conversation, Rose appears to
continued effort by making two DC 12 calm down after a time, and claims that she’s just
Charisma (Persuasion or Deception) checks. glad that no one was hurt, before releasing the
Should either check fail, Otto will attack or try characters to continue their investigation.
to escape. If the characters are able to gain his That night, after dinner, Rolund Hergus
trust, he will share his suspicions with them, but holds court in the Common Room again. Otto
admit that beyond the spell scrolls, he has yet Keller is there, reading Sleeping Beauty once
to find any damning evidence. He enlists the again to a catatonic Patient 11.
characters to help him, if they seem willing. Should the characters have told
Administrator Rose about Otto’s break-in, or
F ourth D ay should they have failed their Charisma check
On the Fourth Day of the investigation, to cover up Otto’s involvement, Administrator
first thing in the morning, Administrator Rose Rose will have “programmed” Patient 11 to
summons the characters to her office. She is murder Otto. In the middle of Otto’s story,
livid about the break-in and asks if they know Patient 11 will suddenly snap out of his trance-
110
like state, produce a shiv from under his sleeve, long rest, they make a Charisma saving throw.
and attempt to murder Otto in the middle of The character or characters with the lowest
the room. This causes the lunatics to riot. While result experience a nightmare. Alternatively, for
four orderlies attempt to subdue the riot of a faster adventure, you may force each character
lunatics (see Appendix C, page 179), Otto is that does not succeed on a DC 8 Charisma
surprised by Patient 11 for one round before he saving throw to experience a nightmare.
is able to defend himself. Each of the NPCs in the nightmare is
Even should the characters intervene on actually a sleeping phantasm (see Appendix C,
behalf of the orderlies, the lunatics, Otto, or page 184) that will attempt to kill the character
even Patient 11, it is likely that people will if the phantasm is attacked. Should a character
die as a result of the sudden violence. When refuse to accept the reality of a nightmare, or
the event ends, all patients are locked in their attempt to wake up prematurely, they have
rooms, and Administrator Rose herself will ask a 50% chance of drawing the attention of a
the characters to retire for the night until the peeper (see Appendix C, page 175) that will
mess can be sorted out in the morning. relentlessly hunt them until the nightmare ends.
You may use the Table of Nightmares below
F ifth D ay to improvise a nightmare with the afflicted
On the Fifth Day of the investigation, the character. Roll 1d10 to determine the dream’s
asylum is unusually subdued and quiet. The mood, and then again for the dream’s location
characters may begin to hear eerie whispers and an important NPC that will accompany
and see shadows crawling across the corners of the character during the dream. With each roll,
rooms, but none of the other patients or staff ask the character’s player to describe how they
seem to hear or see such things. interpret the specifics of the result.
Should Otto Keller have been attacked the As the dream sequence continues, roll 1d10
night before and survived, he goes missing from to determine a plot twist near the beginning of
the asylum. His dream journal is missing from the sequence, and then again near the end of the
its secret hiding place beneath the gazebo, too. sequence. Do not share the results of this roll
No one saw Otto leave, though Administrator with the player; instead, introduce the twist in a
Rose will tell the characters that he resigned surprising way to change the tone and direction
from his duties due to the high stress nature of of the nightmare.
the job. If they ask for proof, she will produce The secret of conjuring a harrowing
a letter signed by Otto that claims as much. A nightmare is to first introduce set pieces and
successful DC 15 Intelligence (Investigation) elements that are familiar and mundane to the
check reveals that the letter’s handwriting characters, like a hobby or a seemingly normal
matches Florence Rose’s own handwriting. She conversation with a loved one, and then slowly
will, of course, deny any such accusation. introduce elements that do not make sense:
walls that breathe, shadows that seem to dance
Conjuring Nightmares whenever the character does not look directly at
them, and so on. Use this balance of the normal
Whether the characters sleep at Lamp’s Light and the surreal, along with the random plot
Sanitarium or elsewhere, the psychic corruption twists from the table below, to slowly increase the
of the H’awouahoua begins to haunt them tension until the nightmare reaches a horrifying
while they sleep. When the characters take a conclusion of your — and the player’s — design.
111
The Table of Nightmares

d10 Dream’s Mood Dream’s Location Important NPC Plot Twist
1 Tragic The character’s A parental figure The shadows are hungry
childhood home
2 Romantic The place where A close friend or The character is being followed
the character first sibling by the devil H’awouahoua in the
encountered violence guise of a faceless man wearing
a fedora and a black & white
pinstripe suit
3 Post-Apocalyptic Lamp’s Light A personal nemesis The character can fly, but cannot
Sanitarium control how high
4 Mysterious A battlefield A personal hero The important NPC is dying
5 Comedic A graveyard An eerie stranger The important NPC and the
character are inmates at Lamp’s
Light Sanitarium
6 Horrific The character’s A deity Zombies arrive
interpretation of Hell
7 Bizarre The character’s A present or past The character is pregnant and
interpretation of significant other will soon give birth to something
Heaven unexpected
8 Paranoid Out at sea One of the patients All of the other NPCs are secretly
at Lamp’s Light members of a death cult
Sanitarium
9 Epic A busy tavern Dr. Renwick The important NPC is possessed
by a demon
10 Happy A moonlit garden Otto Keller Another player character enters
the dream, and both of them
recall it when they wake up
When the nightmare ends, any characters or second passage of the summoning ritual
that experienced it must make a Sanity check, that will bring H’awouahoua into the physical
and then succeed on a DC 12 Constitution realm. The morning after the nightmare’s
saving throw or suffer one level of exhaustion. revelation, Otto Keller cannot get the passage
If a character fails their Sanity check, the final out of his own thoughts, and he adds it to his
moments of their nightmare reveal to them a own secret journal. Neither the characters nor
terrible truth. Otto know the true nature and meaning of
In the context of the adventure Apotheosis the ritual, or of the passages that plague their
of Nightmares, the revelation is either the first dreams.
112
T he F irst P assage When the nightmare is over, please read or

We lift our trembling voices to the Harvest Moon! paraphrase the following passage:
We raise up our lidless gaze to the Starless Sky!
Come Lord of Dreams, walk beside us! You open your eyes to find yourselves in the
Soothe our agony and free our wretched minds. gardens just outside of Lamp’s Light. You’re
standing beneath the laced awning of the
T he S econd P assage gazebo. It’s a dark, dark night, with only a
Lord of Dreams! blood red Harvest Moon and the dim light of
Show us the truth that lies beyond this world! flickering candles to illuminate the shadows.
Our minds and our bodies are yours; A few inches of slow, rolling fog creep over the
take them from us! ground beyond the gazebo, smothering the
grass and the flowers.
Rise, H’awouahoua! You cannot remember how you came to this
place, but you are all here together. Each of
Once the characters have learned the first two you holds a candle in front of you, and you are
passages of the H’awouahoua’s summoning all wearing baggy brown robes over your other
ritual from their nightmares, the harrowing equipment. You stand with your companions
conclusion to the adventure can occur as early in a circle around a large five-pointed star
as the following night. If the DM believes smeared onto the gazebo’s wooden floorboards
the characters or story would benefit from with messy streaks of white paint.
spending a few extra days at Lamp’s Light And you’re not alone, either. Administrator
Sanitarium first, they should continue to Rose stands in the circle with you, wearing
plague the characters with increasingly violent white robes and holding a wicked-looking iron
nightmares that repeat the first two passages of dagger in one hand. She looks down at a figure
the ritual. bound with rope in the center of the circle, on
When it is time to summon the their knees and with a burlap sack over their
H’awouahoua, all of the characters must be head. Rose begins to step towards the figure,
sleeping at the same time. Should they try to and as she does, her shadow dances along
avoid the entire party sleeping at the same time, the gazebo’s ceiling with a mad life of its own.
a supernatural tiredness comes over them that Florence Rose begins to chant:
causes them all to fall asleep. The characters
experience one last dream per the Table of “We lift our trembling voices to the Harvest
Nightmares, but this time they all experience Moon!
the same dream at the same time. At the end of “We raise our lidless gaze to the Starless Sky!
the dream, the final passage of the summoning “Come Lord of Dreams, walk beside us!
ritual is revealed: “Soothe our agony and free our wretched
minds.
T he F inal P assage
Oh great H’awouahoua, the lurker and the “Lord of Dreams!
dreamer! “Show us the truth that lies beyond this
Feast on our madness, devour us whole! world!
We are nothing. We are nothing. We are nothing. “Our minds and our bodies are yours;
We are nothing. We are nothing. We are nothing. “Take them from us!
113
“Oh great H’awouahoua, the lurker and the As the characters attempt to act, they must
dreamer! each make a decision. Reveal to them that they
“Feast on our madness, devour us whole! each feel a dark purpose in their hearts: a dark
“We are nothing. We are nothing. We are entity known as “the H’awouahoua” promises
nothing. to reward them with eternal life if they allow
“We are nothing. We are nothing. We are the captive to be sacrificed while they chant the
nothing.” words, “We are nothing!” again and again.
However, at least some of the characters
As Rose finishes her chant, she pulls the burlap are likely to try to interfere with the sacrifice,
sack off of the captured figure, revealing the triggering a combat encounter with Administrator
identity of Rose’s chosen sacrificial victim. If Rose, who will attempt to finish the summoning
the characters revealed Otto’s break-in to Rose, ritual by murdering the captive with her magical
either on purpose or accidentally, Otto Keller is +1 dagger (+6 to hit, 1d4+3 piercing damage).
the intended sacrifice as long as he is still alive. Rose has advantage on her attacks against the
Otherwise, the would-be sacrifice is Agatha if target while they are still bound, and a character
the characters managed to befriend her, or Mad may use their action to free the bound victim
Jak, or Patient 11 if Mad Jak is dead. No matter with a successful DC 14 Strength (Athletics)
who the sacrifice is, they are revealed to have check. Rose then turns to attack any of the
been badly beaten, and currently only have 10 characters who interfered with the ritual.
hit points. If the intended sacrificial victim is freed:
114
• Mad Jak flees to hide in the nearby gardens horns like a mountain goat’s, it has long,
until he knows it is safe to come out. dangling hair made of writhing snakes that
• Otto Keller will stay and fight Rose and half-cover its ape-like face.
the H’awouahoua, even if the characters tell As you stare at this creature from the
him to run away. abyss, the H’awouahoua stares back at you
• Agatha will stay and fight, but will also flee with baleful eyes of blazing hellfire. And then
if the characters tell her to run away. it begins to jerk forward, walking upon its
• Patient 11 will use a hidden shiv to slit his amalgam of appendages with a horrifying
own throat and complete the summoning efficiency.
ritual. Just before he dies, he snaps out of his
catatonic state and gurgles the words, “We are The H’awouahoua will attempt to drive
nothing!” into the night. everyone nearby insane, even its followers, as it
feeds off of their psychic energies. However, it
The H’awouahoua (see Appendix C, page will not attack Rose or any characters who chose
152) is summoned when a character is killed to participate in the ritual rather than try to stop
in the gazebo. Should the characters reduce it, unless they attack the H’awouahoua first.
Administrator Rose to 0 hit points without Facing Administrator Rose and then the
specifying a non-lethal blow, her blood spills H’awouahoua is a very deadly encounter, likely
onto the floorboards and summons the devil. If to result in characters dying or going insane.
the H’awouahoua is summoned, please read or Should the characters prove unable to defeat
paraphrase the following: the H’awouahoua, the DM may allow surviving
characters to run away from the asylum, but not
As blood mixes with the white paint of the without a terrible cost to the patients and staff
five-pointed star, the roof of the gazebo is of Lamp’s Light Sanitarium.
ripped from its support beams and levitates
several feet in the air above, as though held by Conclusion
a massive invisible hand. Suddenly, the roof
is thrown a hundred feet across the garden,
where it explodes in a shower of splintering T he C haracters S top the H’ awouahoua
wood as it slams into the ground. from R ising
The eerie light of the moon shines down If the characters defeat the H’awouahoua, it
on you from above, and its color begins to is engulfed and devoured by the fog from which
bleed across the gazebo, the fog, the dirt, and it came. It returns to its shadowy netherworld,
everything. Everything that you can see turns and the Harvest Moon’s color turns from red
red under the Harvest Moon’s terrible eye. to white. However, the entire scandalous affair
And it’s then that you see the H’awouahoua becomes a big problem for Dr. Renwick come
rise from the mist just beyond the gazebo. It is morning. He asks the characters to leave the
a maddening devil the size of an ogre, with a asylum and never return, and offers them
bony torso like the plastron of a turtle, the tail a bargain: if they agree to keep quiet about
of a scorpion, one leg from a donkey, another Administrator Rose’s bloody hobby, he will
leg like a panther’s, the claw of a giant lobster give them the payment Administrator Rose
where a right hand should be, and its left hand promised them, and allow them to take one of
is humanoid, but furry and grotesque. Beneath the patients or staff with them.
115
If Otto survives the adventure without being It is possible for the characters to stop Rose
reduced to 0 Sanity, he is haunted by what he’s from being able to summon the H’awouahoua
experienced, but not entirely broken. He will entirely, with quick thinking and some good
thank the characters and tell them his full story fortune. In this case, the rescued captive does
if they are interested. Otto will then decide to not go insane over time, and is able to lead a
stay behind to make sure the H’awouahoua happy and productive life.
does not return to the asylum. Now that Rose is
gone, Dr. Renwick offers Otto the newly vacant T he C haracters F lee the H’ awouahoua
position of Head Administrator; Otto accepts Should the characters escape Lamp’s Light
and proves to be a very kind and capable ally to after the H’awouahoua is summoned into the
the patients of Lamp’s Light. world, it will feed on the patients and staff of the
If the would-be sacrificial victim was Agatha asylum until they all go mad and die. The devil
and she survives, she suffers a psychotic break cannot leave the asylum, so Florence Rose or any
after the H’awouahoua is defeated. She becomes other staff that it is able to sway with its promise
a patient of Lamp’s Light and must be heavily of eternal life will begin to attract new patients
medicated so that she is able to sleep at night. to the sanitarium to feed their new master.
If the characters bring Agatha with them away The characters may be able to grow stronger,
from the asylum, she is incapable of caring for better prepare, gather help, and return to defeat
herself and will likely die from exhaustion and the devil, but it will prove significantly more
malnourishment without hospitalization. difficult, as the creature will have surrounded
If the would-be sacrificial victim was Mad itself with loyal servants to help protect it.
Jak, he gives up drinking alcohol and asks to
join the characters as an adventurer. He isn’t T he C haracters D ie … or D o T hey ?
much of a fighter, but often comes in handy in Should the final encounter result in the
social situations. Should one of the characters, deaths of the characters, the DM may instead
whom he idolizes as his heroes, ever die or choose to have each of them experience another
suffer a major injury, Mad Jak will fall off the dream from the Table of Nightmares. After
wagon and begin drinking again. Once he does, the nightmare, the characters then experience
he loses 1d4 Sanity per week of alcohol abuse. the events of Rise, H’awouahoua again, as
When Mad Jak reaches 0 Sanity, he will hang though they had never happened. Of course,
himself in the middle of the night, leaving a the characters remember each of their previous
suicide note for the characters apologizing for failures to stop the summoning of H’awouahoua
being a failure. with vivid and haunting detail.
116
E mancipation
E mancipation
Synopsis Adventure Hooks

Dr. Renwick’s early Unlike most of the encounters in this book,
experiments often Emancipation offers a way to introduce Lamp’s
include “acceptable Light as an institution of healing rather than a
losses” and den of hidden evil. The staff aren’t benevolent,
“temporary setbacks”. per se, but they aren’t actively trying to harm
The revelans malum the heroes either, and as presented they offer a
is no exception. valuable service to their patrons.
The patriarch of an
important merchant • Easy Gold. The characters are hired
family has been for guard duty. The patient has many
scheduled for treatment enemies, who would like nothing
with the revelans malum, more than to attack him while he’s
and to give his patient most vulnerable. A quick and easy
the best opportunity for job.
survival he has enlisted the • Support. When treating patients
aid of the heroes. Their job of importance, Administrator Rose
is simple: stand guard in the often calls in the services of a healer
treatment room, and provide to ensure that unforeseen
protection as needed. Easy complications are handled.
money for less than an Renwick has been unable to
hour’s work. secure a healer from the local
temples, and recruits the heroes to
serve the role.
Skeletons (not that kind) • A Connection. The patient is a figure
from the adventurers’ past, and they are
Emancipation is an adventure skeleton
called upon to support them in their time of
intended to provide a loose framework to quickly
need.
build a series of encounters. You’ll need a handful
of index cards for the NPCs, encounters, items,
and talking points. Add the maps for the 1st and Scene 1. The Job
2nd floor and you are good to go.
The heroes are called into the sanitarium,
This method relies heavily on improvisation
greeted warmly by Meri (see Appendix C, page
and flexibility from both the GM and the players,
162), and asked to wait for Dr. Renwick (see
but can result in some of the most memorable
Appendix C, page 177) to finish with a patient.
sessions you’ll ever have. For more details on using
Dr. Renwick tells the heroes that he wishes to
index cards is session prep be sure to look up Sly
hire them to protect his patient, and to provide
Flourish (aka Mike Shea).
minor healing should it be needed. He does not
117
lie, but is obviously hiding something (notably Scene 5. Aftermath

the potential aftereffects of treatment).
Renwick offers “the gratitude and support
of Lamp’s Light Sanitarium” to the heroes T he P atient D ies
as payment. If that’s not sufficient he will Dr. Renwick opens the door, and in a fit of
grudgingly resort to payment with gold. cataleptic rage ushers the PCs off the premises
with a stream of profanity the likes of which
Scene 2. Lamp’s Light they have never heard. He refuses to answer
any questions, and if the heroes do not comply
The heroes are given time to explore the a seemingly endless supply of orderlies force
first floor, meet some patients, and do some the issue.
snooping. The staff, orderlies, and alienists are What they later learn is that Dr. Renwick has
friendly, know that Renwick has hired the PCs, convinced the patient’s powerful family that their
and may have details on the patient and the beloved was killed as a result of the malevolent
treatment. actions of the PCs, and despite his best efforts he
was unable to save them. The facility’s reputation
Scene 3. Treatment has been saved, and the PCs have a politically
powerful enemy that they are unaware of.
The PCs are led to the treatment room (area
2M). Renwick straps the patient into the device, T he P atient L ives
locks them in the treatment room, and activates A pleased Renwick releases his charge,
the revelans malum (see Appendix B, page 143) leads the heroes from the sanitarium, and
from the safety of room 2L. fulfills his end of the bargain. The heroes have
The grisly treatment occurs, and the heroes allied themselves, intentionally or not, with
are called upon to provide on-the-spot healing the sanitarium. Did they glimpse anything
at the end of each round. It’s clear that without untoward while in the sanitarium? Will Renwick
healing the patient will not survive the full call on them again, now that they’re earned his
course of treatment. grudging respect?
Scene 4. Emancipation
The treatment successfully draws the insanity
from the patient, and in doing so summons
forth a demon that the heroes must dispatch.
The demon is of an appropriate CR to be tough
for the party. Only after the demon is defeated
will Renwick open the door.
118
A F riend I n N eed
A F riend I n N eed
brought to the facility for treatment. Their

What’s a Story Arc?
compatriot has become afflicted with what
A story arc is an enhanced adventure hook. It appears to be a feeblemind spell. The details
provides background material, the first scene, and of how they came to be ensorcelled have not
a handful of leading questions. The rest is up to come to light and the local priesthood has been
you and your players. unable to help. Lamp’s Light is their last and
best chance for recovery.
That was two weeks past, and word of their
Synopsis friend’s affliction has finally reached the ears of
the party. With the tragic news is a request from
Lamp’s Light’s reputation as a place of healing her family for their support in investigating
attracts all manner of visitors and patients. A the series of events that led to their friend’s
figure from the characters’ past, a loved one or condition, with the hope that additional
an ally from their previous exploits, has been information will help free her of this horrific
119
malady. Their friend’s condition has deteriorated ally result in bits and pieces of seemingly coherent
further while the heroes were in route, and information. When the PCs have been suitably
the alienists at Lamp’s Light recommend an informed, their friend’s condition visibly and
experimental treatment as the only recourse. quickly deteriorates. That is when Halwin (see
The PCs’ ally has seen something they were staff alienist, Appendix C, page 144) steps in.
not meant to see, and has paid the price for
it. What knowledge is locked away in their Looking down at her patient, Halwin turns
addled mind that is so critical as to warrant to you and says, “And this is one of the better
such an extreme response? Who did this to your days. I think that’s enough.” The alienist
friend — and, almost as crucial, how? Will the ushers you out of the room, and once everyone
knowledge be lost forever after treatment at is in the hallway latches the door again
Lamp’s Light? Will she be lost as well? without a word.
Getting Started The heroes’ friend is scheduled for a session

with the cerebri mimos (see Appendix B, page
138) tomorrow morning, a fact that they can
Shortly after entering the facility and learn by coercing it from Halwin via direct
identifying yourselves, you are greeted by a questioning (DC 12 Charisma [Persuasion
young half-elf in a white uniform. “You must or Intimidation]). Halwin will provide some
be friends of [insert the ally’s name]. I’m details as to the nature of the treatment, and if
Halwin, the alienist overseeing [insert name]’s pressed is willing to postpone treatment for a
condition. I regret that I must tell you that few days while the PCs investigate the cause and
they’ve deteriorated despite our best efforts. look for another cure.
I’d like to take you to them now. Sometimes a
familiar face can make a difference.” Possibilities to Consider
Halwin leads you through a heavy door,
down a secluded hallway to a simple wooden • Dr. Renwick (see Appendix C, page 177)
door with a heavy iron latch. She notices your and Administrator Rose (see Appendix C,
lingering gaze on the latch — “Just for their page 181) have their claws in illicit activities
safety”. Without another word she opens the throughout the city. Rose is better at hiding
door and you see a figure bound to the lone her involvement, and will do anything to
bed. Your friend is barely recognizable. Their divert attention from herself and the facility.
arms and face are covered in self-inflicted • The staff of Lamp’s Light do not know what’s
scratch marks, there are bloody bald spots hidden away in the damaged mind of the
from hair being torn out, and most unsettling patient, and several different parties may
is their drool-covered face, lacking any signs of assume that the lost knowledge pertains to
intelligence. them.
• Dr. Renwick is intensely interested in any
The PCs should be given an opportunity process or effect that can permanently
to interact with their friend. Extraordinary remove knowledge from a mind.
roleplaying and exceptional skill checks elicit brief • This may have nothing whatsoever to do
periods of near-lucidity. During these periods the with the sanitarium, and introduces Dr.
characters’ attempts to communicate with their Renwick as a brilliant and eccentric scientist.
120
B aby J ayne
B aby J ayne
Synopsis individuals to learn the origins of the recent

increase in riots, and to “resolve the situation”.
The patients of Lamp’s Light have a tendency A week before the trilogy of riots a young
to form riotous mobs periodically. In most woman was brought to Lamp’s Light, her care
instances the impetus for the occurrence can be paid for by a stipend from an anonymous
traced back to some source, be it a full moon, benefactor. The patient, known as Baby Jayne,
a perceived slight, or a malicious orderly. Truth in reference to the porcelain doll she carries
be told, Dr. Renwick and Administrator Rose with her at all times, is always near the swarms,
barely register the occurrences. Until now. but never a part of them, nor is she targeted by
There have been three riots in the previous them.
two weeks. The violent swarms of patients have
resulted in casualties among the staff, and two Getting Started
fatalities among the patients. The patients,
Montegue Hayne and Walter Tumblety, have The heroes’ presence is requested at Lamp’s
family that will miss them, and Administrator Light. This is, in and of itself, notable, and a
Rose has requested the services of discreet perfect chance for them to ingratiate themselves
121
with the ruling elite of the city, while banking Baby Jayne
some coin in the process. Wondrous item, unique (requires attunement)
A striking young woman greets you with The porcelain doll known as Baby Jayne is an
a smile, and motions for you to sit in the exquisitely crafted toy. The doll stands two
proffered chairs. handspans tall, has gleaming patent leather
buckled shoes, is clothed in a spotless black silk
Administrator Rose (see Appendix C, page dress trimmed in white lace, and topped with
181) has the following information: a glorious head of golden hair held back by an
ebony silk ribbon. Despite the care and beauty
• The two men who have died, Montegue of the figure, those in its presence are invariably
Hayne and Walter Tumblety, come from unsettled by it.
merchant families of moderate means. Contained within Baby Jayne is a shard of a
• The three incidents (she refuses to use the demonic fiend whose only purpose is to protect
word riots) began a fortnight ago. Each has its owner. Each doll has unique powers based
been more violent than the last. on the entity trapped within. Baby Jayne has
• Dr. Borden (see Appendix C, page 146) 10 charges and the possessing entity determines
was treating both victims since they came what action to take, if any. The doll may expend
to Lamp’s Light a month ago. In fact, Dr. one or more of its charges to cast the following
Borden has been taking the lion’s share of spells (spell save DC 15): fear (3 charges),
new charges since that time. sanctuary (1 charge) or silence (2 charges).
Possibilities to Consider Incite Riot. By expending 5 charges the doll

emits a dissonant psychic laugh. All creatures
• The entity within the doll knows what within 30 feet must succeed on a DC 14 Sanity
Administrator Rose really is. check or be compelled to form a riot of lunatics
• Nyfuir (see Appendix C, page 171) sees (see Appendix C, page 179). If the target of the
the doll as a surrogate for her lost patron. effect is suffering a bout of madness the check is
Alternatively, she sees it as a reminder of her made with disadvantage.
failings, lost power, and the atrocities she’s
committed.
• Dr. Hahn (see Appendix C, page 150) and
Dr. Borden have opposite views on the cause
of the riots, and once that’s been identified
will also disagree on the steps required to
resolve the situation.
122
Appendix A:
Optional Sanity Rules
“If you gaze long enough into an abyss, the abyss will gaze back into you.”
—Nietzsche
T
he sanity and madness rules Sanity Score
presented here are meant to enhance
role-playing, create challenges for the Your character’s Sanity score is equal to her
players, and bring more color to the character. Charisma score plus her Wisdom modifier. The
They are not intended as an inexorable march maximum Sanity score a character can achieve
to retirement and/or death. There are other is 25. The character’s maximum Sanity and her
games for that; and if you have the opportunity current Sanity should be recorded separately.
I highly recommend playing one sometime. You The character’s Sanity can change based on
may be surprised at how fun they can be. Sanity checks. In most cases, the character can
The characters in the 5th edition of the recover lost Sanity through either magic or the
world’s most famous RPG are, above all else, expenditure of downtime days. The character’s
exceptional. They are not regular folks thrust into Sanity score cannot exceed her maximum as
extraordinary circumstances by chance. They are determined by her Charisma and Wisdom scores.
capable of winning virtually any fight, overcoming
epic challenges, and creating miracles. These • Sanity Score = Charisma score plus Wisdom
rules keep that spirit in mind. As always, adjust modifier (Max = 25)
as needed to accommodate your players, your • Your max Sanity score changes as your ability
campaign, and your style of running the game. scores change
• The character should record their current
Sanity and max Sanity
• Your Sanity score uses the same modifier
T he D escent I nto scale as all other ability scores.
M adness Ability Scores & Modifiers

Ability Modifier Ability Modifier
Characters may begin their careers with certain
quirks, eccentricities, or foibles but none can be 1 -5 14–15 +2
said to be insane. That comes later. Each encounter 2–3 -4 16–17 +3
with an undead horde, gargantuan wyrm, or
4–5 -3 18–19 +4
overwhelmingly powerful aberration leaves its
mark upon their psyche. Taken singly their heroic 6–7 -2 20–21 +5
nature allows them to continue to live a life of 8–9 -1 22–23 +6
adventure, fight the good fight, and maintain some
10–11 +0 24–25 +7
semblance of normalcy. The indelible mark on
their psyche, however, can never quite be removed. 12–13 +1
123
A ppendix A: O ptional S anity R ules
Sanity Checks The player should compare the character’s

current Sanity to their maximum Sanity. If the
To make a Sanity check roll a d20 and apply your Sanity loss brings the character to ½ of her
current (not maximum) Sanity score modifier. max Sanity her madness will be long-term. If
If the roll is equal to or higher than the DC the Sanity loss brings the character to ¼ of
the character succeeds the check and is able to her max Sanity her madness will be indefinite.
maintain her mental coherence. If the roll is less A character whose Sanity reaches zero is
than the DC she fails the check. With a failed irrevocably insane and becomes an NPC.
check she loses a portion of her Sanity and rolls on
the madness table. Any madness that a character Madness
develops is transient unless otherwise noted. A roll
of a natural 1 is considered a fumble and always Unless otherwise noted any madness developed
fails. A specific encounter and/or named NPC/ by a character is transient. If a character fails
creature can only incite a single Sanity check. a Sanity check while afflicted with a transient
madness the subsequent insanity will be short-
Failed Sanity Checks term. If a character is suffering from a short-
term insanity and fails a Sanity check the newly
A failed Sanity check has two results. The first developed psychosis is long-term.
is that the character’s grasp on reality begins A madness will continue to afflict a character
to slip and she loses a portion of her Sanity. until she has had the opportunity to calm
Consequently, the character suffers a (usually) herself, steel her nerves, garner the support of her
transient form of insanity as her mind struggles compatriots, or in extreme cases seek treatment.
to process the situation. If a character must The greater the damage to her intellect the
make more than one Sanity check, each check more time and effort needed to suppress the
is handled independently and the effects are manifestation of her failed Sanity check.
additive. If the character fumbles her Sanity check Transient insanity will continue to affect the
roll, i.e. rolls a natural 1, she automatically fails the character until she has completed the encounter
check and the amount of Sanity lost is doubled. that caused the Sanity check. To quell the transient
insanity the character need only find a quiet place
Losing Sanity and spend a few minutes reassuring herself.
Short-term insanity afflicts the character
After failing a Sanity check the player must roll until she has spent a short rest garnering the
1d4. The result of that roll is the amount of support of her friends, regaining her nerve, and
Sanity that the character loses. rebuilding her mental defenses.
Long-term insanity persists until the
For example, Arkhos has a Charisma of 16 and a character is able to spend downtime to address
Wisdom of 8. His Sanity score is 15 (Charisma score the condition. If you are not using downtime
plus his Wisdom modifier of -1) and his modifier is in your campaign, it is after she has finished the
+2. He has to make a Sanity check upon facing an adventure or quest she’s on. She will need weeks
unspeakable horror. The DC for the check is 18. Arkhos of rest and support to quell the madness that has
rolls a 12, adds his modifier of +2, and has a final result her in its grasp. After that time has elapsed the
of 14. He fails the check. Arkhos rolls a d4 and loses 2 long-term insanity is resolved.
points of Sanity from his interaction with the horror. Indefinite insanity is permanent unless cured.
124
G oing I nsane
intervention. A character with a long-term and/

G oing I nsane or indefinite madness should still be playable and
can offer a great opportunity for role-playing.
“All it takes is ONE BAD DAY to reduce After each long rest the character must make
the sanest man alive to lunacy…Just one bad day.” a Sanity check to see if she is able to temporarily
—Joker suppress the effects of her condition until her
next long rest. If the check fails the character
The acute manifestation of the lunacy exhibited suffers the effects of her psychoses until her next
by the character should be thematically long rest, when she is able to repeat her Sanity
congruous with the situation that caused the check. If the check is successful the psychosis is
initial sanity check. That said, the link between held at bay until the next long rest.
the symptoms and the situation causing the The initial DC for suppressing a long-
behavior may not be immediately obvious. term or indefinite madness is 10*. With each
This is an opportunity for the player and the successful Sanity check it becomes harder to
DM to be creative and develop the character’s suppress her madness and the DC increases by
idiosyncrasies. 1 over the previous check, until the character’s
The tables provide a plethora of options for condition manifests and the process starts over.
the DM and player to explore for characters that
are experiencing transient, short-term, long- For example, Mal’s experiences in the Underdark
term, and/or indefinite insanity. When relevant haunt him daily, or more precisely nightly. His
the DM should roll or choose an entry from the particular form of indefinite madness manifests as
appropriate table below. night terrors. This morning he sets out for his next
adventure and he checks to see if night terrors will
Short-Term/Transient Madness affect him. He rolls a 7 and adds his Sanity modifier
of +4 for a total of 11. He makes his check and is
The acute nature of these manifestations means able to suppress the terrors. The next morning the
the character can quickly shake them off. In the DC is 11 and again he makes the check. By the third
case of transient madness, a few moments out of day the stress of the expedition is beginning to wear
combat is all that’s needed, and for short-term him down. The DC is now 12. He rolls a 6, adds his
insanity the character can resolve the condition modifier and fails his check. During tonight’s long
with a short rest. rest he suffers from night terrors.
Long-Term/Indefinite Madness If a character is unable to suppress their madness

after a long rest it will manifest as a persistent
The effects of long-term madness persist until effect and/or as an acute effect in times of stress.
a character is able to completely recover both In those situations, the character may experience
mentally and physically from adventuring. A an acute attack of lunacy. Stressful encounters
long-term condition ends after the character has include combat situations and may include
had at least a few weeks’ break from the stresses non-combat encounters such as negotiations or
of adventuring. interrogations with NPCs at the DM’s discretion.
The effects of indefinite madness are pervasive
and cannot be cured except through exceptional
intervention such as a wish spell or divine * If a character is suffering from multiple forms of
madness each instance is handled independently.
125
During a high-stress situation, the PC may her Wisdom modifier to the check. If the
attempt to control themselves for the duration character fails her check she suffers the Acute
of that encounter. This requires a DC 12 effect associated with her madness.
Charisma save, and the character should apply
Transient and Short-Term Psychoses

d100 Disorder Effects
01-05 The character fixates on a mundane The DM chooses an object(s) in the room and the
object within the room and begins to character must use her action to count the objects.
count all instances of it. She cannot do The character can only take reactions while counting.
anything until finished counting the Counting takes 1d4 rounds.
objects.
06-10 The character babbles unintelligibly. The character cannot communicate or cast any spells
Vocalizations are in her native language with vocal components for 1d4 rounds. Perception
and can be heard by any nearby checks against the character have a +2 modifier.
creatures.
11-15 The hairs on the character’s arms The character has a +2 bonus on initiative.
prickle, her heart races, and she break
out into a sweat as a feeling of dread
suffuses her.
16-20 The character is terrified of the object of The character must use her full movement to retreat
her Sanity check. from the object of her terror. She can still take actions
after her movement. The effect lasts one round.
21-25 The character’s mind redirects the terror The character will not willingly interact with the
of the situation to a random object in object that instigated the Sanity check for 1d4 rounds
the area. or until that object attacks her.
26-30 The character loses sight while her mind The character is blinded until the beginning of her
processes the weirdness before her. next turn.
31-35 The character falls prone and curls The character is prone and incapacitated until the
inward upon herself. She makes herself beginning of her next turn.
as small as possible, rocking gently with
her eyes closed.
36-40 A peal of crazed laughter escapes Perception checks against the character have a +2
the character’s lips before she regains modifier. Persuasion checks by the character have a -2
composure. penalty. The effect ends after one round.
41-45 Something inside the character breaks The character makes a melee attack against the nearest
and her vision turns red with rage. creature that is not an ally. If a creature is not within
melee range, the character uses her full movement to
get closer to her target and makes a ranged attack.
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G oing I nsane
Transient and Short-Term Psychoses

46-50 Anything is better than what is before The character cannot tell the difference between what
you. Hallucinations assail the character is real and what is not real until the beginning of
and she cannot tell reality from fantasy. her next turn. While hallucinating the character has
disadvantage on all actions.
51-55 The character’s stomach churns and The character suffers the poisoned condition for the
rumbles as her body reacts to the next 1d4 rounds.
unnatural scene before her.
56-60 The character retreats into her mind The character will not act without outside direction
waiting for someone to give her for the next 1d4 rounds. The character makes all
direction. saves vs charm effects and Charisma based skills at
disadvantage. Allies can use their reaction to give basic
directions to the character while she is affected.
61-65 A pervasive sense of fear penetrates the The character is frightened until the beginning of her
character’s psyche. next turn.
66-70 Nothing makes sense and the character The character is affected by the confusion spell until
has little control over herself. the end of her next turn.
71-75 A part of the character’s body is A leg or arm is paralyzed until the end of the
paralyzed with fear. character’s next turn. Leg – the character’s movement
is halved and she loses half of any AC bonus due to
Dexterity (minimum of 1). Arm – attacks made by the
character are at disadvantage.
76-80 Panic permeates every action and The character has a +2 bonus on initiative and a -2
reaction that the character takes. penalty on saves vs any fear effect.
81-84 The character’s mind refuses to record The Sanity lost from this encounter is reversed and the
the events of the encounter. character has no recollection of the encounter.
85-89 The character’s vocal cords are frozen The character is unable to speak or use any spell with a
and she is unable to make any sound. verbal component for the next 1d4 rounds.
91-94 Clarity and focus pervade the character’s The character has a +1 bonus on all skill and attack
senses. rolls for the next 1d4 rounds
95-98 Muscles tense and the character’s heart The character is hasted for 1d4 rounds. When the
races as everything around her seems to effect ends the character cannot take the move action
slow down. for 1 round as she catches her breath.
99-00 The character’s mind expands to take in The DM provides the player with the following
the madness before her. information about the creature that caused the Sanity
check: CR, resistances, vulnerabilities, and immunities.
127
Long-Term and Indefinite Psychoses

1-3 The character fixates on a Persistent effect: If the object of the character’s compulsion
mundane object and must is present the player has disadvantage on Perception,
count all instances of that object Investigation, and Insight checks until the object has been
when encountered. She cannot counted.
do anything until finished Acute effect: The character must use her action to count the
counting the objects. objects. The character can only make reactions while counting.
Counting takes 1d4 rounds.
4-6 The character has panic attacks Persistent effect: The character has a -2 penalty on initiative
as she is overwhelmed with and on saves vs any fear effect.
feelings of helplessness and loses
all hope.
7-10 The character is terrified of a Acute effect: The character must use her full movement to
creature. retreat from the object of her terror. She can still take actions
after her movement. This effect lasts 1 round.
11-13 The character is terrified of a Acute effect: The character must use her full movement to
mundane object in the area. retreat from the object of her terror. She can still take actions
after her movement. This effect lasts 1 round.
14-15 The character loses sight Acute effect: The character is blinded until the beginning of her
intermittently. next turn.
16-17 The character falls prone and Acute effect: The character is prone and has the incapacitated
curls inward upon herself. condition until the beginning of her next turn.
She makes herself as small as
possible, rocking gently with her
eyes closed.
18-21 A peal of crazed laughter Acute effect: Perception checks against the character have a +2
escapes the character’s lips when modifier. Persuasion checks by the character have a -2 penalty.
confronted with a stressful
situation.
22-26 The character’s instinctual Persistent effect: The character has a -2 penalty on Persuasion/
response to any problem is Deception checks and a +2 bonus on Intimidation checks.
violence. Acute effect: The character makes a melee attack against the
nearest creature that is not an ally. If a creature is not within
melee range, the character uses her full movement to get closer
to her target and then makes a ranged attack.
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G oing I nsane

27-30 Hallucinations assail the Persistent effect: The character has a -2 penalty on Perception
character and she cannot easily and Insight checks.
tell reality from fantasy. Acute effect: The character cannot tell the difference between
what is real and what is not real until the beginning of her
next turn. While hallucinating the character has disadvantage
on all actions.
31-33 The character’s stomach churns Acute effect: The character suffers the poisoned condition for
and rumbles as her body reacts the next 1d4 rounds.
to the memories that shattered
her mind.
34-36 The character retreats into her Persistent effect: The character has a -2 penalty to Insight
mind, waiting for someone to checks and to Initiative.
give her direction. Acute effect: The character will not act without outside
direction for the next 1d4 rounds. The character makes
all saves vs charm effects and/or Charisma-based skills at
disadvantage. Allies can use their reaction to give basic
directions to the character while she is affected.
37-40 A pervasive sense of fear Acute effect: The character is frightened until the beginning of
penetrates the character’s psyche. her next turn.
41-42 A part of the character’s body is Acute effect: The character is paralyzed until the beginning of
paralyzed with fear. her next turn.
43-48 The character must complete Persistent effect: After each rest (short or long) the character
her daily ritual before leaving must complete a specific series of mundane tasks prior to
camp. receiving the benefits of the rest. The ritual will take at least
30 minutes to complete. If she is unable to finish the ritual she
doesn’t gain the benefits of the rest.
49-54 The character’s thoughts are Persistent effect: The character has a -1 penalty against fear
filled with anxiety and dread. effects.
55-58 The character is startled by the Persistent effect: The character has a +1 bonus to Initiative
smallest sound and is constantly checks and a -1 penalty against fear effects.
reminded of past traumas.
59-61 The only way the character feels Persistent effect: The character must consume twice as much
better is by eating to the point food or feel the effects of starvation. If this is an indefinite
of excess. madness the character has a 5’ penalty to her movement.
129

62-64 The character is obsessive about Persistent effect: The character must make a DC 12 Charisma
cleanliness. save prior to placing herself in a situation that will cause her to
get excessively dirty. If she fails the save she may repeat it again
in 10 minutes.
65-67 The character is obsessed with Persistent effect: The character will not willingly place the
protecting a trinket from any object of her obsession in a situation that could cause it harm.
and all harm. The character can make a DC 12 Charisma save to override
this directive for 10 minutes. If she fails the save she may repeat
it again in 10 minutes.
68-70 The character retreats inward Persistent effect: The character reacts to social situations as a
and regresses to her childhood child would.
personality. Acute effect: The character is frightened of all enemies until the
end of her next turn
71-74 The character’s alternative Persistent effect: The character’s personality changes
personality surfaces. significantly. There are no changes to her skills, abilities, etc…
but her alignment may change and the way she reacts to things
should be different.
75-77 The character sleep walks. Persistent effect: During the character’s next long rest she sleep
walks, possibly getting away from camp completely. Regardless,
the character must make a DC 8 Constitution save or she only
gains the benefits of a short rest.
78-80 The character has horrific Persistent effect: During the character’s next long rest she
dreams and night terrors as screams in terror periodically throughout the night, possibly
she relives the horrors she’s attracting the attention of wandering creatures. If she is not
experienced. woken up and calmed down any characters near her must
make a DC 8 Constitution save to gain the full benefits of a
long rest. On a failure the character only gains the benefits of
a short rest. If the character with night terrors is woken, she is
only able to gain the benefits of a short rest.
81-84 The character has turned to Persistent effect: If the character is not under the effects of
drink and/or drugs as a coping her vice then she has a -1 penalty on all skill checks until
mechanism. she is. The penalty increases to -2 if she goes 3 hours without
indulging, and becomes disadvantage after 6 hours of being
sober.
130
G oing I nsane

83-85 The character’s madness Persistent effect: The character proselytizes at every opportunity.
manifests as religious zealotry She has a -2 on social skills with members of opposing religious
views.
86-88 The character’s demeanor shifts The player rolls a d2 after it is determined that this madness is
from mania to depression with manifesting. Both effects are persistent.
periods of normalcy. On a 1: The character is manic and prone to taking foolhardy
risks. She’s unable to contain her energy and enthusiasm. She
has a -2 penalty on any skill check that requires patience and/
or fine motor skills. She has a +2 bonus on Persuasion and
Performance checks.
On a 2: The character is depressed today, lost in her thoughts
and some actions are a struggle. She has a -2 penalty on all
Charisma skill checks and a +2 on Dexterity (Stealth) checks if
moving at half speed (or lower).
89-91 The character develops a quirk, The player and the DM work together to develop a unique
habit, or pervasive tic. quirk/tic/habit for the character. The effect is largely for role-
playing but could come into play during times of stress.
92-94 The character seems to be no There are no noticeable effects on the character.
worse for her experiences.
95-98 The character sees danger in Persistent effect: The character has a +2 bonus to Initiative
every shadow and thinks people checks and a -2 penalty to Insight checks. If the character fails
are plotting against her in every an Insight check she believes that the object of the check has a
interaction. nefarious motive and is plotting against her.
98-100 The character is a frenetic and Persistent effect: The character has a +5’ bonus to her
chattering bundle of energy at movement. The character makes any saves/checks for exhaustion
all times. at Disadvantage.
131
therefore does not need to make a Sanity check. On

W hat I ncites a S anity the third round Gor-Og saves against the spell and
its effects end.
C heck ?
E xamples of S pells T hat C ause a
“I knew who I was this morning, but I’ve S anity C heck
changed a few times since then” • Confusion (4th level, PHB, pg. 224)
—Alice • Contact Other Plane (5th level, PHB, pg. 226)
• Fear (3rd level, PHB, pg. 239)
Exposure to magic, esoteric knowledge, or • Feeblemind (8th level, PHB, pg. 239)
aberrant creatures may force the character to • Magic Jar (6th level, PHB, pg. 257)
question her understanding of the world and • Symbol (7th level, PHB, pg. 280)
can fray her mind. Additionally, situations of
extreme terror, confrontation with one’s own E xamples of S pells that D eal P sychic
mortality, and outside attempts to control your D amage
mind leave marks that may never heal. • Feeblemind (PHB, pg. 239)
• Geas (PHB, pg. 245)
Magic Attacks and Effects • Phantasmal Killer (PHB, pg. 265)
• Vicious Mockery (PHB, pg. 285)
Magic can affect the health of one’s mind in • Weird (PHB, pg. 288)
several ways. Merely casting some spells puts the
caster’s sanity at risk. More commonly, spells Forbidden Knowledge
cause psychic damage by directly attacking the
mind. Illusions and charms pose a risk as they Tomes and codices of unspeakable evil or
target the victim’s persona and perception. A unknowable truths have driven many sages
more insidious danger are spells that induce to lunacy. The histories, spells, and rituals
direct contact between the minds of the caster contained within such eldritch books as
and another creature. As a rule of thumb a Iggwilv’s Demonomicon, the Necronomicon,
spell must be of 3rd level or inflict 25 points and Nameless Cults attack the reader’s mind
of psychic damage in a single attack to cause with each page read and truth learned.
a Sanity check. If a spell deals damage over
multiple rounds each instance of damage is DC = 8 + the level of the highest
handled individually. spell in the tome*
DC = 8 + spell level *If the tome does not contain spells the DC is 12
for a rare item, 14 for very rare, 16 for legendary,
For example, Dexter casts Phantasmal Killer and 18 for an artifact
against Gor-Og. Gor-Og fails his save and takes 31
psychic damage. After the damage is dealt Gor-Og Unspeakable Horrors
must make a Sanity check (DC 12) to see if he loses
Sanity and is affected by transient madness. The Aberrations and fiends by their very nature can
following round Gor-Og fails his save against the crack the protective walls around a character’s
spell again but only takes 18 points of damage, and mind. Creatures of either of these types may
132
W hat I ncites a S anity C heck ?
induce a Sanity check at the DM’s discretion. 13). Immediately upon spying the fiend she must
The sight of a creature whose CR exceeds the make a Sanity check. The DC for the check is 11
character’s level by 3 or more always provokes a [8 + (rakshasa’s CR of 13 – Kairon’s level of 10)].
Sanity check. Kairon’s current Sanity score is 14. She rolls a 10
and adds her Sanity score modifier for a final roll of
DC = 8 + [creature CR – the 12; she succeeds at her Sanity check.
character’s level]
Mind-Numbing Terror
A berrations
• Gibbering Mouther (CR: 2, MM pg. 157) The activation of the hindbrain due to extreme
• Chuul (CR: 4, MM pg. 40) terror often causes an immediate effect on a
• Otyugh (CR: 5, MM pg. 248) character’s psyche. Few things incite that terror
• Cloaker (CR: 8, MM pg. 41) more than the sight of legions of undead razing
• Aboleth (CR: 10, MM pg. 13) everything in their path. An encounter in which
the characters are outnumbered by at least 5 to
F iends 1 induces a Sanity check.
• Lemure (CR: 0, MM pg. 76)
• Dretch (CR: ¼, MM pg. 57) DC = 8 + [Encounter CR* – the
• Imp (CR: 1, MM pg. 76) character’s level]*
• Quasit (CR:1, MM pg. 63)
• Bearded Devil (CR: 3; MM pg. 70) *For a horde of creatures use this table to determine
• Hell Hound (CR: 3, MM pg. 182) the CR of the encounter:
• Nightmare (CR: 3, MM pg. 235)
• Incubus (CR: 4, MM pg. 285) CR of the Creatures in the Horde
• Succubus (CR: 4, MM pg. 285) Number of Creatures Multiplier
• Barbed Devil (CR: 5, MM pg. 70)
• Night Hag (CR: 5, MM pg. 178) 1 x1
• Vrock (CR: 6, MM pg. 64) 2 x1.5
• Chain Devil (CR: 8, MM pg. 72)
3–6 x2
• Hezrou (CR: 8, MM pg. 60)
• Bone Devil (CR: 9, MM pg. 71) 7–10 x2.5
• Glabrezu (CR: 9, MM pg. 58) 11–14 x3
• Horned Devil (CR: 11, MM pg. 74)
15+ x4
• Erinyes (CR: 12, MM pg. 73)
• Nalfeshnee (CR: 13, MM pg. 62)
• Rakshasa (CR: 13, MM pg. 257) For example, Griswald (Rogue, 2nd level)
• Ice Devil (CR: 14, MM pg. 75) encounters a roving pack of 10 ghasts (CR 2). The
• Marilith (CR: 16, MM pg. 61) effective CR of the encounter is 5 (CR x 2.5) and the
• Balor (CR: 19, MM pg. 55) DC of the Sanity check is 11. Griswald must make a
• Pit Fiend (CR: 20, MM pg. 77) Sanity check. He rolls a 4, applies his modifier of +3,
and fails the check. The sight of the ghasts unhinges
For example, Kairon, (Fighter, 10th level) his mind. He loses sanity and must roll on the
comes face to face to with her first rakshasa (CR transient madness table.
133
The presence of an unholy greater undead has G etting B etter

the same effect. The sight of an undead creature
whose CR exceeds the character’s level by 3 or “She was always trying to hide, the beautiful
more provokes a Sanity check. chaos in her mind.”
— Joker
DC = 8 + [creature CR – the
character’s level] Recovering Sanity does not cure any madness
that was developed due to Sanity loss. The
The final way in which stark terror may affect underlying conditions resolve automatically
the stability of the character’s mind is if a after the character has taken the necessary time
character fumbles (rolls a natural 1) on a check to come to terms with her experiences or, in the
against a fear effect. If the character’s level case of indefinite madness, has it cured with a
is equal to or greater than the creature that wish or other similar magic.
generated the fear effect the DC is 8.
DC = 8 + [creature CR – the
character’s level]
Struggle for Dominance

The struggle for dominance between a sentient
item and its owner may damage the wielder’s
mind. If the wielder loses a Conflict between
herself and her item, and the item possesses
her, she should make a Sanity check as the item
overwhelms her mental defenses and forces her
to act as it wishes.
DC = 12 + the item’s Charisma

modifier
Character Death
Any character that fails their 3rd death save and
is subsequently brought back to life through
whatever means are available to her allies loses 1
Sanity point. This point cannot be restored by
any means short of a wish. If this change causes
the character’s Sanity to be ½ or ¼ of her max
Sanity she rolls on the long-term or indefinite
madness table respectively.
134
G etting B etter
Recovering Between Adventures • Charm Person (PHB, pg. 221) — as calm

emotions for the duration of the spell
The character may attempt to recover her • Dominate Beast/Monster/Person (PHB,
newly-lost Sanity between sessions. This attempt pg. 234-235) — as calm emotions for the
at treatment may only be done once, at the end duration of the spell
of the adventure in which the character incurred • Enthrall (PHB, pg. 238) — as calm emotions
the Sanity loss. for the duration of the spell
• The DC is dependent on how much Sanity • Geas (PHB, pg. 245) — as calm emotions for
was lost in the preceding adventure. a single psychosis for the duration of the spell
• DC = 8 + the total Sanity lost • Greater Restoration (PHB, pg. 246) — cure a
• The character should apply her current long-term (or shorter duration) madness
Sanity score modifier to this roll • Heal (PHB, pg. 250) — restore 1d4 Sanity
• Regardless of roll, the character may not or cure a long-term (or shorter duration)
increase her Sanity beyond her maximum madness
Sanity score. • Holy Aura (PHB, pg. 251) — advantage on
• Natural 20: always a success and regains 2d4 all Sanity checks; creatures that have failed
Sanity a Sanity check and are within the radius of
• Success: regains 1d4 Sanity the spell may repeat the check at the end of
• Failure: no change in Sanity their turn, ending the transient/short-term
• Critical Failure: loses 1d2 Sanity madness on a success
• Lesser Restoration (PHB, pg. 255) — allows
For example, Griswald’s encounter with ghasts the character to make an additional save
caused him to lose 3 Sanity points. Now that he has to end the effects of a transient/short-term
survived that harrowing experience and it is behind madness
him, he is able to spend the next month fishing and • Mass Heal (PHB, pg. 258) — as heal
relaxing to recover from the ordeal. After the month • Mass Suggestion (PHB, pg. 258) — as calm
Griswald makes a Sanity check. The DC is 11. He emotions for the duration of the spell
rolls an 11 and adds his Sanity score modifier of +2 • Mind Blank (PHB, pg. 259-260) —
for a 12. He succeeds. He rolls a d4 and recovers 2 automatically succeeds all Sanity checks
Sanity points, bringing his current Sanity up to 16. while the spell is active; the character is also
affected as calm emotions for the duration of
Treating Madness with Spells the spell
• Modify Memory (PHB, pg. 261) — the
A player cannot choose to fail a save against any target’s memories of a specific event causing
of the following spells. Sanity loss can be erased, reversing any Sanity
• Beacon of Hope (PHB, pg. 216) — the loss and/or psychoses that resulted from the
target(s) have advantage on Sanity checks original failed Sanity check
• Bless (PHB, pg. 219) — bonus can be • Suggestion (PHB, pg. 279) — as calm
applied to Sanity checks emotions for the duration of the spell
• Calm Emotions (PHB, pg. 221) — ends the • Wish (PHB, pg. 288-289) — can restore
effects of a transient/short-term madness or 2d4 sanity points or cure any single form of
suppresses long-term/indefinite madness for madness that a character is suffering from, up
the duration of the spell to and including indefinite madness
135
Optional Feats The combination of faith and inner strength

that clerics and paladins possess allows them
to add their proficiency bonus to any Sanity
R esilient P syche checks.
Choose one ability score, either Charisma or The force of will of monks allows them to
Wisdom. You gain the following benefits: use their Stillness of Mind feature to end a
• Increase the chosen ability score by 1, to a transient/short-term madness. Monks may also
maximum of 20 use this feature to suppress the acute effects of a
• You gain proficiency in Sanity checks long-term/indefinite madness for one encounter.
When a monk gains the Diamond Soul feature
C l ass U pdates she may add her proficiency bonus to Sanity
Some adventuring classes are more resilient to checks.
the mental strains and stresses of encountering Warlocks are able to use the strength of
these potentially Sanity-breaking scenarios. their pact and unique perspective to add their
proficiency modifier to Sanity checks.
136
S anity C heat S heet
S anity C heat S heet
Sanity Checks Causes of Sanity Checks

Roll a d20, apply any Sanity modifiers, and • Magic Attacks & Effects:
compare to the DC of the check. A natural 1 DC = 8 + spell level
always fails. Each encounter/creature can only • Forbidden Knowledge:
incite a single Sanity check. Additional checks in DC = 8 + level of highest spell in the tome
a single encounter could be from psychic attacks/ • Unspeakable Horrors:
damage, character death, struggle for dominance, DC = 8 + (Creature CR – PC’s level)
and/or exposure to forbidden knowledge. • Mind Numbing Terror:
DC = 8 + (Encounter CR – PC’s level)
Failed Sanity Check • Struggle for Dominance:
DC = 12 + item’s Charisma modifier
The character suffers a (usually) transient form • Character Death:
of insanity and loses 1d4 Sanity. If the player Automatic failure and loss of 1 Sanity
rolled a natural 1 on the check, the Sanity loss is
doubled. When your character’s Sanity is at ½ of Getting Better
her maximum the madness is long-term; when it
is ¼ of its maximum the madness is indefinite. Between Sessions: DC = 8 + the total Sanity
lost (note the character should use her current
Duration of Madness Sanity modifier).
• Natural 20: always succeeds (regardless of
Transient is until the end of the encounter, short- DC) and regains 2d4 Sanity
term until the end of a short rest, long-term until • Success: regains 1d4 Sanity
the character takes a break from adventuring, • Failure: no change in Sanity
and indefinite is until cured. • Rolls a natural 1: loses 1d2 Sanity
Short-term Madness: If a character fails Spells: numerous spells are available to prevent,
a Sanity check while afflicted with a transient treat, and/or suppress madness.
madness the subsequent madness will be short-
term. Class-Specific Updates
Long-term/Indefinite Madness: If a
character is suffering from a short-term insanity Paladins, Clerics, and Warlocks are all able to
and fails a Sanity check the newly developed add their proficiency bonus to Sanity checks.
madness is long-term. Long-term and Indefinite Monks may end a transient or short-term
madness may also be a result of decreases in the madness using the Stillness of Mind feature.
character’s Sanity score. Stillness of Mind can also suppress a long-term
Suppressing Long-term/Indefinite or indefinite madness for one encounter. The
madness: After each long rest the character may Diamond Soul Monk feature allows the monk
attempt to suppress the madness (DC = 10 + days to add her proficiency bonus to Sanity checks.
since previous bout) until her next long rest.
137
Appendix B: Items of Interest
Beiwe’s Pendant
Wondrous item, very rare (requires attunement)
The wearer of this white gold pendant gains proficiency in Sanity saves and
a +1 bonus on all Sanity checks. Alternatively, the wearer gains proficiency
in Charisma saves and a +1 bonus to Charisma checks.
Cerebri Mimos (aka The Spike)

Wondrous device, very rare
The most recent creation of Dr. Renwick, the cerebri mimos is

a work in progress and produces a variety of results in those
subjected to it. The device is, in essence, a small spike
with a reservoir and needle that delivers liquid directly to
the brain of the patient.
Dr. Renwick is the only person capable of successfully
ingrafting the device. The device permanently deceases
the subject’s Charisma by 1d4 points, and no magic short
of a wish or heal spell can reverse this loss. While under the
effects of the device the user makes all Intelligence based
skill checks and saves at disadvantage. The user can activate
the device as a bonus action. When activated, roll on the table
below to determine the effect, which lasts 1d6 rounds. After the
device is activated, refilling the reservoir requires a full action.
When the effect ends the user is stunned until the end of her
next turn and must succeed a DC 14 Con save or gain one
level of exhaustion. If the result of the Con save is a natural 1
the user is reduced to zero hit points.
Due to the strain the device places on the body it can only be used a number of times equal to the
user’s Constitution modifier (minimum 1). She regains all uses after a long rest.
138
Cerebri Mimos Effects
d12 Effect
1 The infusion causes you to sweat profusely with no other apparent effect.
2 You immediately enter a mindless rage. All melee attacks are made with advantage and you have a
+2 bonus to damage with melee weapons. All thoughts of defense are discarded and attacks against
you have advantage.
3 Your psyche has changed to something alien. You have advantage on saves against spells from the
enchantment school of magic.
4 Your metabolism is boosted to supernatural levels. Your speed is doubled, you have advantage on
Dexterity saves, and you gain 1 additional attack per round.
5 Your body is continually fortified. At the beginning of your turn you gain 1d8 temporary hit points.
6 Your muscles seize up and become leaden. Your speed is halved and you are no longer able to make
reactions.
7 The infusion renders you unconscious.
8 Your Strength is increased by 4 and your Dexterity decreases by 2 as your muscles strengthen faster
than your body is able to fully adjust to.
9 You dissociate yourself from reality and are immune to fear effects and the frightened condition.
10 You are wracked with unimaginable pain from a migraine and are stunned.
11 You gain vulnerability to slashing weapons due to thinning of your blood.
12 Roll twice, ignoring subsequent rolls of 12.
Essence of Somnolence
(aka Hypnos)
Potion, uncommon
Invented by Dr. Quintus Hahn (see Appendix C, page

150), essence of somnolence is used on virtually all of the
patients at Lamp’s Light at some time during their stay.
Hypnos calms the nerves, dulls the senses, and sedates
the body. When consumed it suppresses all madness effects
for 1d4 hours. The imbiber also suffers disadvantage on all
skill checks and saves until she completes a long rest.
139
A ppendix B: I tems of I nterest
Juxta Personalis
Wondrous device, very rare
The juxta personalis is the creation of Dr. Orson Renwick and he considers
it his biggest success. Its use within the facility is an open secret amongst
the staff. The device is a highly polished box of dark hardwood with no
ornamentation and no apparent means of opening it. It is a handspan
tall, twice that in length, and as deep as it is tall. Two copper hilts
protrude from one front of the box and a length of thin chain emerges
from the opposite side. This chain is connected to a masterly crafted
leather helmet. The interior of the helmet is lined with precisely placed
runes of gold.
To activate the device, one grasps the hilts and casts shocking
grasp into the box (no attack roll is necessary). The electrical
current is carried into the box through the attached
chains, and directed by the specially made helmet to
specific points in the subject’s brain. The wearer of the
helmet attempts a Constitution save using the caster’s
spell save DC. On a success, she takes no damage and
rolls on the table below. On a failure the subject takes full
damage and is incapacitated for 1d4 minutes.
Juxta Personalis Effects

d20 Effect
1–3 One indefinite insanity cured; amnesia of previous 1d6 + 1 days
4–6 Cure one indefinite insanity
7–9 No effect
10 – 11 Stunned for 1d4 – 1 hours
12 – 13 You are under the effects of the calm emotions spell until you complete a long rest.
14 Change alignment one step on the law/chaos axis
15 Change alignment one step on the good/evil axis
16 Choose a new personality trait at random
17 Choose a new Ideal at random
18 Choose a new Bond at random
19 Choose a new Flaw at random
20 Roll or choose a new indefinite insanity
140
M adness S crolls
Madness Scrolls
Scroll, very rare
The madness scrolls were originally created

by the damaged mind of Hywel Pharl, a
former patient of Lamp’s Light Sanitarium.
Hywel’s exposure to the inner workings of
reality allowed him to manufacture these
unique scrolls. Spells cast from the scrolls are
often more powerful, but frequently have a
cost. To a casual observer the scrolls appear
much the same as any other. They are all
written in the same frenetic script; comparing the script on multiple scrolls with a DC 10 Intelligence
(Investigation) check confirms that the same hand has written them all.
When identifying the scroll an Intelligence (Arcana) check (DC = 8 + spell level) indicates that
the spell is altered somehow and more powerful. If the check is made by at least 4 the exact difference
(per the table below) is noted. A character that can cast the spell inscribed on the scroll has advantage
on this check. A madness scroll may contain any spell and the scrolls cannot be transcribed into a
spellbook. When a madness scroll is cast roll on the table below. If a result is not applicable roll again.
Madness Scroll Effects

d12 Effect
1 Area of effect is increased by 50%.
2 The spell is cast twice; once as intended and a second time with the caster as the target.
3 The spell is cast with the highest spell slot available to the caster.
4 The casting does not expend a spell slot.
5 The spell’s damage type changes to psychic; if the spell’s native damage type is psychic it does
double damage.
6 In addition to the spell’s intended effect, targets are affected as if targeted by a fear spell.
7 The spell is not cast and the scroll is destroyed.
8 The spell is cast targeting the caster.
9 The spell is cast as normal. The caster takes 3 (1d6) psychic damage per level from psychic
backlash.
10 When the spell is cast every creature within 60 ft of the caster is affected as if targeted by
vicious mockery. The spell is cast as intended.
11 The spell’s visual effects are different than usual or intended, otherwise it works as intended.
12 The spell works as intended.
141
A ppendix B: I tems of I nterest
Prosper’s Camisole
Wondrous device, uncommon
Prosper’s camisoles, named after their inventor Lucien Prosper, can be

seen periodically at Lamp’s Light and are used primarily as a humane
alternative to manacles and other traditional restraints. These
garments are the preferred method for binding patients that
are a danger to themselves or others.
Camisoles are available for both small and medium-sized
creatures and consist of a jacket with exceedingly long arms,
numerous straps, and buckles in the rear. The sleeves are
pulled across the patient’s body, fastened to the buckles, and
the straps are used to tighten it to be as snug as possible. The
end effect is a patient with their arms crossed in front of their
body and virtually no room for movement of the upper body.
The camisoles at Lamp’s Light are made of white duck cloth
with leather reinforcements.
A creature wearing a camisole as outlined above has the
restrained condition. Escaping from the camisole requires a
successful DC 18 Dexterity check. Breaking free is possible
with a successful DC 20 Strength check. If the camisole is not
the correct size, i.e. a small creature in a camisole intended
for a medium creature or vice versa, the check is made with
advantage.
142
R evel ans M alum
Revelans Malum
Wondrous item, very rare
Crafted by Dr. Renwick, the revelans malum

operates on the principle that one’s inner
demons be faced, and overcome, for true
healing to be possible. The device, through a
series of eldritch alchemical processes, siphons
the ill humors from the patient and manifests
them physically as a demonic entity.
The strength of the creature is directly
related to the severity of the patient’s insanity
and, as such, great care is taken by Dr. Renwick
when using this device.
A patient subjected to the revelans malum is
restrained and grappled for the duration of her
treatment. The treatment takes 1d4 rounds, and
at the end of each round the subject takes 3 (1d6)
psychic damage. Additionally, at the end of the
treatment the patient must make a Charisma saving
throw with a DC based on the severity of their
illness as outlined in the table below. If the target is
a willing subject, she has advantage on this check. On a
successful saving throw they are stunned until the end of
their next turn, cured of their affliction, and their lunacy
is released in the form of a summoned demon. On a
failed save, the subject is stunned only.
If a demon summoned in this manner is slain,
then the madness it represented is cured. Any
demons not slain within one hour disappear and
the madness they represent is reinstated at one category
higher than its original type. If the character affected by the revelans malum is slain, any manifested
demons are loosed upon the world. A target can only be treated with the revelans malum once.
Category DC Demon Summoned

Short term 13 1d3 quasits
Long term 17 a vrock or hezrou
Indefinite 21 a nalfeshnee
143
Appendix C: Persons of Interest
Alienist, Staff Actions
Medium humanoid (any race), any alignment
Club. Melee Weapon Attack: +3 to hit, reach 5
Armor Class 10 (natural armor) ft., one target. Hit: 3 (1d4 + 1) bludgeoning
Hit Points 28 (8d6) damage.
Speed 30 ft.
Reactions
STR DEX CON INT WIS CHA
10 (+0) 11 (+0) 10 (+0) 14 (+2) 12 (+1) 12 (+1) Code Red (1/day). In response to an attack,
an alienist may summon 1d4 orderlies (see
Sanity (optional) 16 (+3) Appendix C, page 173) and 1d2 staff alienists
to her aid. If 4 orderlies and 2 staff alienists are
Skills Insight +3, Intimidation +3, Medicine +4, summoned, Dr. Renwick (see Appendix C, page
Perception +3 177) is also summoned. All summoned NPCs
Senses passive Perception 13 appear at the beginning of the next round.
Languages Common and any one language
Challenge 1/4 (50 XP) Staff alienists are responsible for the treatment
and well-being of the patients at Lamp’s Light.
Didactic Training. Medicine is an Intelligence These men and women come from all races
based skill for a staff alienist. and tend to be aloof, analytical, and egocentric.
They are all slightly in awe of Administrator
Spellcasting. A staff alienist is a 1st-level Rose, and universally defer to Dr. Orson
spellcaster. Its spellcasting ability is Intelligence Renwick, their chief of staff, of whom they are
(spell save DC 12, +4 to hit). The staff alienist terrified.
can cast the following spells:
At will: mending, message, shocking grasp
144
145
A ppendix C: P ersons of I nterest
Borden, Agatha Dr. modifiers, to all melee and ranged weapon

Medium humanoid (elf), chaotic neutral damage rolls for weapons with the finesse trait
(included in the stats below).
Armor Class 13 (16 with mage armor)
Hit Points 60 (8d8 + 24) Spellcasting. Agatha is a 4th-level spellcaster
Speed 30 ft. and her spellcasting ability is Intelligence (spell
save DC 15, +7 to hit with spell attacks). She
STR DEX CON INT WIS CHA regains expended spell slots after finishing a long
12 (+1) 16 (+3) 16 (+3) 18 (+4) 14 (+2) 11 (+0) rest. She knows the following spells:
At will: mage hand, minor illusion, fire bolt,
Sanity (optional) 13 (+1) shocking grasp
Insanity Cognitive dissonance; see For the DM 1st level (four slots): charm person, hideous
below. laughter, identify, mage armor, magic missile,
protection from good and evil, shield, unseen
Saving Throws Int +7, Wis +5 servant
Skills Arcana +7, History +7, Insight +5, 2nd level (three slots): darkness, detect
Medicine +8, Perception +5, Sleight of Hand thoughts, invisibility, misty step, ray of
+9 enfeeblement, suggestion
Senses darkvision 60ft., passive Perception 15
Languages Abyssal, Common, Celestial, Elvish Actions
Challenge 5 (1,800 XP)
Multiattack. Agatha makes three attacks with
Fey Touched. Agatha has advantage on saving her lobotomy needle.
throws against being charmed, and magic can’t
put her to sleep. Lobotomy Needle. Melee Weapon Attack: +6
to hit, reach 5 ft., one target. Hit: 8 (1d2 + 7)
Soporific Stare. As an action, Agatha may piercing damage. Agatha’s needle scores a critical
choose one creature that she can see, and that hit on a roll of 19 or 20. When the needle
can see her, within 15 ft. that must succeed on scores a critical hit, she may choose one of the
a DC 15 Wisdom saving throw or be stunned following effects:
until the end of her next turn. The stunned Enervate. The target’s Dexterity decreases
effect ends immediately if the target takes by 1d4 and she is unable to take reactions. The
damage, or another creature uses its action to effect lasts until the target completes a short
shake the target to its senses. rest, or is affected by lesser restoration or similar
magic.
Cunning Action. Agatha’s quick thinking and Allodynia. The target is stunned. She may
agility allow her to react without a moment’s attempt a DC 15 Charisma saving throw at the
hesitation. Agatha may use her bonus action end of each of her turns, ending the effect on a
to perform any of the following actions: Dash, success.
Disengage, or Hide.
Lobotomize. Agatha may lobotomize a willing or
Brainy Brawler. Agatha adds her Intelligence incapacitated target. If Agatha succeeds on a DC
modifier, in addition to other applicable 15 Wisdom (Medicine) check she chooses one of
146
B orden , A gatha D r .
ability score penalty can only be reversed by

greater restoration, regeneration, wish, or similar
magic.
Fortify. The target is cured of all current
charm and fear effects. Additionally, she has
advantage on all saving throws to resist such
effects until she completes a long rest.
Agatha Borden greets her patients, fellows, and

acquaintances with a timid smile. Her hair is
always coiffed in an updo and held in place by a
pair of unadorned metallic needles. She is the very
picture of politely timid grace and composure.
When working with her patients the façade alters,
revealing a steely determination and pertinacity.
Agatha presented herself to Dr. Renwick
three years ago in the belief that the work that
he, and the folks of Lamp’s Light, undertake
for the ill and disenfranchised is a cause worthy
of her support. In her time at the facility Dr.
Borden has learned much from her mentor, the
patients, and the hospital’s other staff. She is
particularly close to Administrator Rose, whom
she idolizes as an older sister.
For the DM: Agatha suffers greatly from

cognitive dissonance. When she began her
the effects listed below. On a failure the target’s training at Lamp’s Light she hoped that she
Wisdom, Intelligence, or Charisma (DM’s choice) would be cured of the affliction. And in a
is permanently reduced by 1d4. This ability score manner of speaking she has been, for she no
penalty can only be reversed by greater restoration, longer views it as a hindrance or impediment
regeneration, wish, or similar magic. to her work. Agatha is friendly, outgoing, and
Enervate. The target’s Dexterity decreases inquisitive, and once she sets her mind on a
by 1d4 and she is unable to take reactions. The goal she cannot be swayed, pursuing it with the
effect lasts until the target completes a short dogged determination of the demented.
rest, or is affected by lesser restoration or similar Agatha’s proclivity for using her magic to
magic. coerce patients (and others she deems ill) to
Allodynia. The target is stunned. She may acquiesce to procedures has not gone unnoticed.
attempt a DC 15 Charisma saving throw at the Dr. Renwick and Administrator Rose are both
end of each of her turns, ending the effect on a aware of her methods, and for the moment are
success. allowing her to test her limits without interference.
Simplify. The target’s Intelligence or
Charisma (DM’s choice) is reduced by 1d4. This
147
Gneigel its new life, and thus, Gneigel came to the

Medium humanoid (construct), neutral groundskeeper of Lamp’s Light.
Over his tenure at Lamp’s Light he has
Armor Class 15 (natural armor) enlisted the aid of the nearby mage’s college
Hit Points 52 (8d8 +16) to adapt his body to better suit his role as
Speed 35 ft. groundskeeper. The adaptions are primarily
cosmetic, to blend in with the environment and
STR DEX CON INT WIS CHA be less intrusive to the guests of Lamp’s Lights,
18 (+4) 15 (+2) 15 (+2) 10 (+0) 9 (-1) 12 (+1) and most recently include an integrated scythe
that he uses with brutal efficiency.
Sanity (optional) 11 (+0) Gneigel lives in a small ramshackle house
Insanity Gneigel is unable/unwilling to on the grounds and is never seen within the
communicate verbally except under the most walls of the asylum. He rises with the sun and
dire circumstances. spends his day slowly, methodically maintaining
the grounds. As the sun sets, he returns to his
Skills Athletics +6, Deception +3, Gardening outhouse only to emerge the following morning.
+4, Stealth +4, Survival +2 Gneigel is assumed, incorrectly, to be mute due
Senses darkvision 60ft., passive Perception 9 to his proclivity for silence.
Damage Resistances bludgeoning damage from
non-magical weapons; poison (Gneigel has For the DM: Gneigel is fully dedicated to
advantage on saving throws against poison) Lamp’s Light and its mission. His zealotry
Condition Immunities disease, magical sleep manifests as fanatical devotion to Lucien
Languages Common, Sylvan Prosper and now to Florence Rose. There is no
Challenge 2 (450 XP) task he would not undertake or any action he
would not do if she were to ask.
Actions
For High Level Games: The following
Multiattack. Gneigel makes two melee weapon changes can be made to increase the challenge
attacks presented by Gneigel.
Scythe. Melee Weapon Attack: +6 to hit, reach 10 • Increase Armor Class by +2.
ft., one target. Hit: 9 (2d4 + 4) slashing damage. • Increase Constitution by 3 (and hit points by
+16).
Shortly after opening the sanitarium Lucien • Add damage resistance to slashing and
Prosper was called by the local constabulary to piercing from non-magical weapons.
subdue a rampaging creature that was destroying • Gneigel’s scythe is a +2 weapon.
a nearby business in a blind rage. With great
effort, Prosper calmed the creature and, being
fascinated with its unique nature, invited the
sentient construct to make Lamp’s Light its
home. The creature’s memories of its creation
and name were lost to it. Dr. Renwick suggested
that the construct give itself a name to celebrate
148
G neigel
149
Hahn, Quintus Dr.

Medium humanoid (human), unaligned
Armor Class 9
Hit Points 65 (10d8 + 20)
Speed 25 ft.

8 (-1) 8 (-1) 14 (+2) 20 (+5) 13 (+1) 10 (+0)
Sanity (optional) 11 (+0)

Insanity Quintus is not insane per se. He
has an insatiable curiosity, and a complete
lack of interest in any activities, patients,
and situations that he deems beneath him.
When engaged, he brings an unsettling
fiery intensity to the object of his obsession,
otherwise his rudeness escalates as quickly as
needed to end any social interaction he finds
himself in.
Saving Throws Int +7, Cha +2
Skills Insight +5, Intimidation +2, Medicine +9,
Investigation +9
Condition Immunities charmed
Senses passive Perception 15
Languages Common, Elven
Challenge 3 (700 XP)
Didactic Training. Medicine is an Intelligence- Actions

based skill for Dr. Hahn.
Sword Cane. Melee Weapon Attack: +1 to hit,
Innate Spellcaster. Dr. Hahn is an innate reach 5 ft., one target. Hit: 2 (1d6 - 1) piercing
spellcaster and his spellcasting ability is damage.
Intelligence (spell save DC 15, +7 to hit with
spell attacks). He regains expended spell slots Reactions
after finishing a long rest. He knows the
following spells: Rectify. When a creature within 30 feet of Dr.
At will: guidance Hahn and visible to him attempts an attack
3/day: cure wounds roll or ability check and fails, he may use his
1/week: lesser restoration reaction to allow that creature to make a second
1/month: greater restoration, regenerate attempt.
150
H ahn , Q uintus D r .
In the wee hours of the night, a lone figure, For the DM: Dr. Hahn’s ego will not allow
limping and relying heavily on his cane, can be him to admit that there is a case he cannot solve,
found caring for the patients of Lamp’s Light or a patient he cannot cure. In Lamp’s Light he
after all others have gone home. There is a slight has found an institution with an endless stream
droop pulling his left eye down, his hair is in of such challenges. There are several patients
dire need of a wash and comb, and his scraggly that have piqued Hahn’s interest recently,
beard does little to hide the pockmarks on his notably Nyfuir, Bok, and Dr. Todd.
face. Hahn has been content to observe, and has
Dr. Quintus Hahn, more commonly known not yet taken an active role in their treatments.
simply as the nocturnist, prowls the hallways of But he keeps abreast of their activities and
the sanitarium every evening consulting on the goings on, biding his time until their inevitable
most challenging patients, giving esoteric advice, psychotic break.
and taking an active hand in the care of patients His observations and theories on Bok’s
that the other alienists cannot get a grip on. He condition have brought him to Administrator
has an uncanny knack for appearing suddenly Rose’s attention; Rose’s patron has taken a keen
when he’s needed, leaving just as quickly when interest in this hyperintelligent, damaged man.
his duty is done, the soft tap of his cane on the
floor and shuffle of a dragging foot receding
down the corridor.
When he deigns to speak to others his
conversations tend towards barking, expletive-
laden orders in a brogue so heavy as to be
nearly incomprehensible. The strength of his
accent is only matched by the abrasiveness of
his manners, and complete lack of concern for
social mores.
Despite his obvious shortcomings Dr. Hahn
is brilliant, and never turns away an interesting
case. He provides his own unique brand of
aid — strange protocols, esoteric advice, and
seemingly meaningless procedures — to any
who need it. The questioning looks of onlookers
turn to confusion and then awe as the patient
settles down, stabilizes, and against all odds
gets better. Dr. Hahn’s reputation for results is
second only to Dr. Renwick’s, and the two men
view one another with extreme contempt.
151
H’awouahoua, The Innate Spellcasting. The H’awouahoua’s innate

Large fiend, chaotic evil spellcasting ability is Intelligence (spell save DC
15). It can innately cast the following spells with
Armor Class 14 (natural armor) no material components:
Hit Points 114 (12d10 + 48) 3/day each: hold person, disguise self
Speed 40 ft. (including the form of a Medium humanoid),
misty step
19 (+4) 10 (+0) 19 (+4) 18 (+4) 10 (+0) 3 (-4) Actions
Sanity (optional) 3(-4) Multiattack. The H’awouahoua makes three

Insanity The H’awouahoua is insane with attacks against a creature with less than 6 Sanity:
hunger for the flesh of lunatics and one with its scorpion tail, and either two with
children. It pursues this hunger obsessively, its lobster claw, or one with its lobster claw and
abandoning any short term goals or thoughts one with its bite if it is able.
that don’t bring it closer to eating.
Scorpion Tail. Melee Weapon Attack: +7 to
Saving Throws Cha +0, Con +7 hit, reach 15 ft., one target. Hit: 11 (2d6+4)
Skills Deception +2, Perception +6 piercing damage and the target must make a
Damage Resistances necrotic, psychic; successful DC 15 Constitution saving throw or
bludgeoning, piercing, and slashing from be poisoned for one minute. At the end of the
nonmagical attacks target’s turn it repeats the saving throw, ending
Senses passive Perception 16 the condition on a success.
Languages Abyssal, Common, Draconic, Deep
Speech Lobster Claw. Melee Weapon Attack: +7 to
Challenge 6 (2,300 XP) hit, reach 5 ft., one target. Hit: 7 (1d6+4)
bludgeoning damage, and the target must make
Aura of Revulsion. Any creature that can see a successful DC 15 Strength saving throw or be
the H’awouahoua and begins its turn within 10 grappled.
feet of it must make a successful Sanity check
(DC 15). The first time a creature fails this Bite. Melee Weapon Attack: +7 to hit, reach 5
check during an encounter, they lose twice as ft., one target that is grappled or restrained.
much Sanity. Hit: 25 (6d6+4) piercing damage, and the
H’awouahoua regains half as many Hit Points.
152
H’ awouahoua , T he
The H’awouahoua is a monstrous devil with the For the DM: In combat, the H’awouahoua
tail of a scorpion, one leg from a donkey, one leg will first cast hold person or use its lobster claw
from a panther, the claw of a lobster as a right attack to restrain a creature so that its Aura of
hand, the hand of a monkey for a left hand, Revulsion can drive it insane. Once a character’s
the chest of a turtle, the horns of a mountain Sanity is low enough for the H’awouahoua to
goat, the face of an ape, and eyes of hellfire. Its use its multiattack, it immediately attempts to
long, dangling hair is made of writhing snakes. tear that creature apart and devour it to satisfy
Its long coat is patched from the clothing of its mad hunger.
children and lunatics that the H’awouahoua has When the H’awouahoua dies, its body does
devoured. The devil can offer its most devout not remain in our world. Instead, it is devoured
servants eternal life, so long as they are willing by hungry shadows that drag it back into the
to drink the blood of children and lunatics, and abyss, where it is imprisoned until the next time
never allow their loyalty to the H’awouahoua to it manages to break free. The current region of
waver. the material plane is immediately freed from
The H’awouahoua is a very manipulative the H’awouahoua’s nightmares and psychic
devil, but its machinations are for the simplest manipulations.
of motivations: hunger. The devil has an
insatiable appetite, and one that can only
be tempered for a few minutes at a time
by the flesh of children or madmen. When
the H’awouahoua’s body is killed, its soul is
imprisoned in a shadowy realm in the abyss,
where it is cut off from its food source. While
imprisoned thus, the devil goes mad, and
desperately seeks humanoids to turn to its
service, so that they may return to the material
plane and feed. Because of its preferred prey, the
H’awouahoua most often strikes bargains with
nurses, unhappy mothers, asylum doctors, and
alienists.
153
Hergus, Rolund lead him to virtually any room and area of the
Medium humanoid (human), chaotic good(ish) facility.
By all accounts Rolund is enjoying his stay at
Armor Class 10 (natural armor) Lamp’s Light tremendously, and sees no reason
Hit Points 4 (1d8) to leave. The patients are interesting, the staff
Speed 30 ft. attentive to his needs, and he wants for nothing.
He’s learned quickly who to avoid — namely
STR DEX CON INT WIS CHA the lunatic with an “11” on his shirt — and has
10 (+0) 10 (+0) 10 (+0) 9 (-1) 10 (+0) 14 (+2) built quite a network of friends on the outside
from the patients that stay only transiently.
Insanity Rolund is a narcissist and quickly gets For the DM: Rolund is thoroughly enjoying
bored of any situation that does not directly his stay at Lamp’s Light. When discovered by
involve him. He will insert himself, often the watch he had narrowly escaped discovery
foolhardily, into any activity (including by the spouse of a noble that he’d had a tryst
combat) if he feels left out. with. In his time at Lamp’s Light Rolund has
cultivated relationships with patients and staff.
Skills Deception +4, Seduce +4 He has no interest in being “cured” or ending
Senses passive Perception 10 his furlough in the sanitarium. For their part the
Languages Common folks of Lamp’s Light aren’t in any hurry for him
Challenge 0 (10 XP) to leave either.
Actions Adventure Hook: Rolund has made many

enemies amongst the nobles and merchant
Slam. Melee Weapon Attack: +1 to hit, reach 5 families of the city. The patrician of one of
ft., one target. Hit: 1 bludgeoning damage. Rolund’s discarded paramours has learned
that Rolund is a guest at Lamp’s Light and has
Rolund is a young man who has been remanded decided to make him pay for the emotional
to the custody of Lamp’s Light after he was turmoil he has caused.
found wandering in an upper-class quarter
without a stitch of clothing. He was non-
violent, disarmingly charming, and an ideal
candidate for treatment at Lamp’s Light.
Rolund’s affable personality and natural
charisma have made him a favorite of the staff
and his fellow patients. He finds men and
women of all types equally enticing, and has not
yet met a species that he doesn’t find intriguing.
Rolund spends his days on the first floor,
holding court in the common room, taking
his meals in the cafeteria, and enjoying a level
of access to the facility that few patients have.
As the sun sets, his thoughts and urges can
154
H ergus , R olund
155
Japhi At will: dancing lights, mage hand, minor

Tiny beast (cat), curiously ambivalent illusion, prestidigitation, shocking grasp
1st level (4 slots): charm person, disguise self,
Armor Class 16 (19 with mage armor) fog cloud, silent image, sleep
Hit Points 69 (18d4 + 24) 2nd level (3 slots): detect thoughts, enlarge/
Speed 30 ft., climb 15 ft. reduce, hold person, invisibility
3rd level (3 slots): fear, gaseous form, hypnotic
STR DEX CON INT WIS CHA pattern
6 (-2) 22 (+6) 14 (+2) 13 (+1) 9 (-1) 20 (+5) 4th level (3 slots): confusion, dimension door,
dominate beast
Sanity (optional) 18 (+5) 5th level (2 slots): animate objects, dominate
Insanity none; Sir Japhi is probably the most person, telekinesis
sane and stable intelligence within the walls 6th level (1 slot): mass suggestion
of Lamp’s Light. 7th level (1 slot): etherealness
Saving Throws Cha +8, Dex +9 Actions

Skills Deception +11, Insight +2, Perception
+5, Stealth +11 Claw. Melee Weapon Attack: +10 to hit, reach 5
Damage Resistances psychic ft., one target. Hit: 7 (1 + 6) slashing damage.
Condition Immunities charmed, frightened
Senses darkvision 60ft., passive Perception 15 Purr (3/day). Japhi’s purr permeates the room
Languages understands Common and Elven with its subtle and soothing vibrations. Up to
(cannot speak), telepathy 60 ft. five humanoids of Japhi’s choice within 30 feet
Challenge 9 (5,000 XP) that can see him must make a DC 17 Charisma
saving throw; on a failure, a creature is charmed
Hecate’s Blessing. Japhi’s alignment, attributes, until the end of its turn. On its turn, a charmed
and true nature cannot be ascertained by creature must use its movement to approach
magical means. Any attempts by mortal magic Japhi, and use its action to pet him.
to learn more of him indicate that he is nothing
more or less than an exceptionally intelligent Reactions
and long-lived cat.
Bad Luck (recharges 5–6). When a creature
Keen Smell. Japhi has advantage on Wisdom Japhi can see makes an attack roll against him,
(Perception) checks that rely on smell. he can use his reaction to change the target of
the attack to another creature within 10 feet
Subtle Caster. Japhi can cast spells without of him. If there are no other targets, he can
verbal or somatic components. instead impose disadvantage on the attack roll.
This feature can only be used before knowing
Spellcasting. Japhi is a 13th-level spellcaster and whether the attack hits or misses.
his spellcasting ability is Charisma (spell save
DC 17, +9 to hit with spell attacks). He regains The orange tabby known teasingly as Sir
expended spell slots after finishing a long rest. Japhi has been a fixture at Lamp’s Light since
He knows the following spells: its opening day. Japhi is a large cat, but not
156
J aphi
Lucien’s attention, virtually disappeared from the

grounds. He was still seen on occasion, usually in
the company of a favored patient, but he rarely
stayed long and had a habit of disappearing just
before Rose walked into a room.
With the death of his human, Japhi is once
again prowling and hunting the grounds of
Lamp’s Light. The staff think that he’s searching
for Master Prosper, and take pity on the grieving
beast. Despite his long tenure at the sanitarium
Japhi shows no signs of old age or physical
deterioration. When he chooses to be seen he
holds court from on high, preferably well out of
the reach of others.
For the DM: Japhi’s true motivations are

known only to himself, and his true mistress
Hecate. He has resumed his wandering ways to
learn more about Administrator Rose, whom he
does not trust and suspects to have played a part
in the death of his human, Lucien Prosper. He
also finds Dr. Renwick’s deteriorating mental
health equal parts amusing and interesting. He
views the doctor’s experiments in the same light
as a predator playing with its food — though
he’s yet to see Renwick eat a patient, and doesn’t
understand why he would subject himself to the
unnaturally so, with thick fur that is always experimental devices.
spotlessly clean. He has black stripes on his If Japhi learns Rose’s true nature, he and
head and flank — stripes that the patients swear his mistress will begin a cold war in which all
move of their own accord. His preternaturally of Lamp’s Light will be at great risk. Patients,
intelligent eyes unnerve some as their sweeping orderlies, and alienists will, quite literally, be
gaze takes in every detail. Around his neck catspaws in a game of deceit and intrigue. The
hangs a loose collar of scarlet leather, bearing a PCs may be drawn in as Rose (or Meri) seeks to
silver pendant the size of a small coin. learn who is sabotaging her sanitarium.
In the early years of the sanitarium the
feline followed Master Prosper everywhere he Hecate’s Pendant
went, and the two were rarely seen without Wondrous item, very rare (requires attunement by a cat)
one another. When asked about his pet Prosper
would smile cryptically and say, “He’s not my When used as a spellcasting focus, the pendant
cat. More likely, I’m his human.” replaces the need for material components
When Prosper’s affections shifted to Florence regardless of the cost associated with the
Rose in later years Japhi, no longer the center of components.
157
Keller, Otto
Medium human, neutral good

Hit Points 112 (15d8 + 45)
Speed 30 ft., climbing 20 ft.

18 (+4) 14 (+2) 16 (+3) 16 (+3) 11 (+0) 8 (-1)
Sanity (optional) 9 (-1), or 14 (+2) when

attuned to his +1 heavy wrench
Insanity Otto is obsessed with the occult,
inexplicable mysteries, eldritch deities, and
strange stories. He will always be drawn to
investigate such items and events, even if it
means risk to himself or others. However,
his willpower is strong enough to resist using
dangerous magics unless in the direst of
circumstances. These spells are noted below
with an *.
Saving Throws Str +7, Dex +5, Con +6

Skills Acrobatics +6, Arcana +8, Athletics +8,
Perception +2, Persuasion +3, Stealth +6
Languages Common, Abyssal, Deep Speech
Challenge 5 (1,800 XP) Innate Spellcasting. Otto’s spellcasting ability
is Intelligence (spell save DC 15) and he can
Brave. Otto has advantage on saving throws innately cast the following spells with no
against being frightened or charmed. material components:
At will: mage armor
Brute. A melee weapon deals one extra die of its 3/day: bestow curse*, counterspell
damage when Otto hits with it (included below). 1/day: circle of death*, teleportation circle
Circus Climber. Otto has advantage on ability Actions

checks involving climbing, so long as he can see.
Multiattack. Otto makes two melee weapon
Eldritch Survivor. Together, Otto and his attacks.
trusty wrench have faced horrors from beyond
the cosmos. While he has his +1 heavy wrench Heavy Wrench +1. Melee Weapon Attack: +8
equipped, he receives a +5 bonus to his Sanity to hit, reach 5 ft., one target. Hit: 12 (2d6 + 5)
score. bludgeoning damage.
158
K eller , O tto
“There’s so much power in stories, mister. den of vipers. Despite being treated as less than
The sorta power that can soften the most stony heart, human until he left the circus in search for a
silence the most wicked storm. The sorta power that better life, Otto never gave in to the meanness
can make even the smallest man act brave, no matter of the world around him. He truly has an
how scared they might feel down in their gut.” impregnable heart of gold.
— Otto Keller Otto is also far from what his timid and
ungainly appearance would suggest. He comes
Otto looks young for his age, partially due to from another world entirely, where he and his
his short height and medical condition. He is theatrical troupe escaped a hell called Carcosa
a hunchback, suffering from relatively severe and dared to face Hastur, the King in Yellow.
kyphosis. When painful bouts of his condition They managed to thwart the eldritch God’s
strike, his boyish face twists with perpetual mad machinations, and Otto escaped the
discomfort. He has become so used to the sudden encounter with both his life and his soul intact.
pain that he is mostly unaware of it when it occurs. Furthermore, his experiences in Carcosa have
Since tailors rarely make clothes for one such as he, gifted him a deep connection to the occult
Otto is almost always seen wearing a dingy brown and magic. His harrowing adventures have
coverall, oversized for easier mobility with his transformed him from a fearful victim into a
hump, with a tool-belt hanging from his hip. brave man willing to sacrifice himself for others.
Otto has served as the janitor and handyman More recently, a string of recurring
for Lamp’s Light for only the past few months. nightmares has led Otto to believe the King
He speaks little of his own past, other than to in Yellow has captured his mother and is
say that he has seen much cruelty in his life. His tormenting her as an act of revenge. The
quiet nature and deformity make most of the hunchback used the magic he has studied to
staff overlook him, and so Otto wanders the move through worlds, in hopes that he may find
facility with little restriction. He often enters the sanitarium that plagues his nightmares. This
patients’ rooms or common areas and attempts to foolhardy search brought him several months
cheer them up with a gentle voice, encouraging ago to Lamp’s Light. He has become drawn into
words, juggling tricks, and fantastic stories of far- the grim mysteries there, and is actively engaged
off realms passed down to him by his mother. in uncovering Lamp Light’s darkest secrets so
that he may help put a stop to its lurking evils.
For the DM: Otto grew up in The Flying Unfortunately for Otto, his closest friend at
Horvaths’ World Famous Show, a grimy circus Lamp’s Light, Administrator Florence Rose, is not
where he was treated very poorly at the hands at all who she appears. Soon, it is very likely that
of his fellow circus performers for being a he will stick his nose where it doesn’t belong, and
hunchback. His father protected him as well as may be caught in a dangerous trap set by Florence.
he could, until he was eaten by a lion in a grisly Though Otto is strong, clever, and a capable
accident. His mother was kind and doting, but spellcaster in his own right, his naive and trusting
became afflicted with dementia at a young age, nature may prove to be the end of him. Unless he
causing her to often forget who Otto was and finds another ally within the sanitarium, his string
act with a disturbing viciousness. of good luck as a would-be hero may soon run out.
When he was still a teenager, Otto’s mother
vanished mysteriously in the middle of the
night, leaving him alone to fend for himself in a
159
Lowbrow, Milo
Small humanoid (halfling ), chaotic neutral

Speed 25 ft.

8 (-1) 20 (+5) 14 (+2) 9 (-1) 10 (+0) 20 (+5)
Sanity (optional) 5 (-3)

Insanity Milo has disadvantage against fear
and charm effects. Additionally, when in
complete darkness Milo has advantage on
Initiative and Dexterity (Stealth) checks but
disadvantage on melee and ranged attack
rolls.
Saving Throws Cha +8, Con +5

Skills Deception +11, Insight +6, Intimidation
+8, Perception +6, Persuasion +11
Damage Resistances poison
Languages Common, Dwarven, Elvish, Giant,
Goblin, telepathy 30 ft.
Challenge 6 (2,300 XP) Innate Spellcasting. Milo’s innate spellcasting
ability is Charisma. He can innately cast the
Force of Personality. Milo adds his Charisma following spells (spell save DC 16) with no
modifier to the damage dealt on spell attacks. material components:
At will: mage armor (self only)
Death’s Door (2/day). When Milo is reduced
to zero hit points, as a free action he can Spellcasting. Milo is a 13th-level spellcaster and
choose a target within 30 feet to make a DC his spellcasting ability is Charisma (spell save
16 Constitution saving throw. On a failure that DC 16, +8 to hit with spell attacks). He regains
creature is reduced to zero hit points, and Milo expended spell slots after finishing a long rest.
drops to 1 hit point instead. He knows the following spells:
At will: chill touch, eldritch blast (3 bolts),
Aura of Misfortune. When Milo rolls a 20 on a friends, prestidigitation
d20 for an attack, ability check, or saving throw, 1st–5th-Level (three 5th-level slots): black
he must reroll the die and use the new roll. Any tentacles, calm emotion, charm person, command,
creature within 10 feet of Milo must succeed on compulsion, contact other plane, counterspell,
a DC 16 Wisdom saving throw or be affected by detect thoughts, dream, hideous laughter, hold
this aura in the same manner. person, suggestion.
160
L owbrow , M ilo
Actions with mortality from a surprisingly lethal clown.

In his next excursion he fared a little better,
Dagger. Melee Weapon Attack: +8 to hit, reach 5 escaping with his life and a bevy of scars for his
ft., one target. Hit: 7 (1d4 + 5) piercing damage. troubles. This series of events played out over,
and over, and over.
Reactions In the beginning his friends thought of it as
a joke, “the unlucky little one”. And then he
Uncanny Dodge. When a creature Milo can see died in a battle in which no ally was harmed.
hits him with an attack, he can use his reaction Not even a scratch! His resurrection changed
to halve the attack’s damage against him. him forever; the happy-go-lucky halfling
disappeared. In his place was a cowering,
Shortly before Lucien Prosper’s untimely passing, scarred, shell of a man, jumping at shadows,
an enormous half-orc appeared at the door of rarely sleeping, and mumbling to himself. In a
Lamp’s Light. The door veritably shook with routine skirmish with a ragtag squad of goblin
the creature’s furious pounding. Master Prosper bandits his friends realized that they too were
was quickly summoned, and led the man to his now the object of his aura of misfortune. Barely
private office. It was then that the staff present escaping with their lives, they sent their largest,
noticed that the half-orc was carrying a much strongest, and toughest member to deliver the
smaller bundle, the size and shape of a child. near-catatonic Milo to Lamp’s Light — far away
The conversation that followed has been lost from the dangers of the dungeons and lairs of
with Prosper’s death, but what is known is that their adventures, and most importantly, far from
the following morning Lamp’s Light had a new them.
patient. A patient that keeps to himself, is quite
literally afraid of his own shadow, and never
speaks in more than a whisper. The patient’s
name is Milo Lowbrow.
For the DM: Milo was poised to live a

charmed life in the countryside. He was born
with a plethora of natural gifts, the flair of
a natural born entertainer, and wanted for
nothing growing up.
A life with no challenges or excitement was
not to his liking, and in a fit of boredom-fueled
wanderlust he joined an adventuring company.
His new allies, seeing his potential and innate
skills, welcomed him with open arms as their
spokesperson, magician, and cutpurse. That
was when he learned that his preternatural luck
had a tendency to abandon him at the most
inopportune, stressful times.
Milo’s first adventure, an investigation into
a haunted funhouse, resulted in his first brush
161
Meri
Medium humanoid (half-elf), lawful neutral
Armor Class 11
Hit Points 4 (1d8)
Speed 30 ft.

9 (-1) 12 (+1) 10 (+0) 14 (+2) 12 (+1) 15 (+2)
Skills Insight +5, Persuasion +3

Languages Common
Challenge 0 (10 XP)
Astute Insight. Meri has advantage on any

check to determine if she is being told a lie.
Actions
Club. Melee Weapon Attack: +1 to hit, reach 5 His recent demise has left deep emotional
ft., one target. Hit: 1 (1d4 - 1) bludgeoning scars on the woman. She has found solace,
damage. purpose, and a sense of peace in her role at
the sanitarium and each day is a personal
Every visitor to Lamp’s Light Sanitarium, be dedication to the memory of her benefactor.
they patient, family, alienist, staff, or other, is There is nothing more important to Meri than
greeted by the smiling face of Meri. To many the reputation of Lamp’s Light and its deceased
visitors, Meri is as integral a member of Lamp’s founder. Nothing.
Light as Dr. Renwick or Administrator Rose.
Meri’s story began two score years ago, For the DM: Meri is Lucien Prosper’s child,
when she was left on the asylum’s stoop. In a fact that he recognized as soon as he saw her.
and of itself this is not a particularly unusual Master Prosper took this secret to his grave, but
or remarkable thing. The folk nearby know should it ever be revealed to her she will become
that children without parents often show up at obsessed with uncovering all of the details of
the sanitarium, and in time are found homes his death. When that mystery is solved, she will
through Master Proper’s many connections. doggedly pursue ownership of Lamp’s Light as
What was remarkable is that Meri never left. her birthright. This investigative line of inquiry
Master Prosper took an immediate and intense could expose the machinations of Dr. Renwick,
shine to the child, and she’s been a ward of Administrator Rose, and others. She will need
Lamp’s Light ever since. powerful allies and cunning to claim the asylum.
162
M iel ace , E d “D avid ”
Mielace, Ed “David”
“An interesting subject has been presented

for treatment today. The being known as Mr.
Mielace is a gestalt of two disparate personas. That,
in and of itself, is little of note. We have many
such unfortunates in Lamp’s Light. Mr. Mielace’s
condition presents to such an extent that he undergoes
a remarkable physical change with the transference of
control of his body to the other identity.”
— Dr. Renwick
“After one month of study and treatment Mr.

Mielace’s conditions continues to baffle and fascinate
me. The progenitor personality, “Ed”, has a meekness
of actions, countenance, and lack of vigor that lend
him the air of a cloistered academic. Mayhap one
that rarely strays from the fold. As “Ed” he possesses
a modicum of arcane talents that he has been, as of
yet, unwilling to divulge the origins of.
“Whereas “David” …he is something else
entirely. With the birthing of that personality and
the resulting transformation mounds of ill-formed
muscle adhere to a frame not suited for them,
giving him an altered gait, and the manners of a
beast. Despite his attempts to conceal it, I believe he
maintains the intelligence of “Ed”, though with a
predatory bent to it.”
— Dr. Renwick
“David has beaten two patients and an

orderly to death. Fortunately, they will not be
missed. He may have the constitution for the Spike.
Further study is warranted.”
— Dr. Renwick.
163
Ed Innate Spellcasting. Ed’s innate spellcasting

Medium humanoid (human), neutral good ability is Intelligence. He can innately cast the
following spells (spell save DC 12, +4 to hit)
Armor Class 11 with no material components.
Hit Points 39 (7d8 + 8) At will: light, mage hand, ray of frost
Speed 30 ft. 2/day: silent image, charm person, shield
STR DEX CON INT WIS CHA Of Two Minds. Ed’s binary nature gives him
11 (+0) 12 (+1) 12 (+1) 15 (+2) 15 (+2) 14 (+2) advantage on saving throws against being
charmed or frightened.
Insanity Ed’s psychosis prevents him from Transmogrify. As an action Ed loses control of
realizing that he and David occupy the same his body, and David emerges from the depths
body. Ed believes that David is his prodigal of his psyche. Ed cannot willingly initiate
brother, and black sheep of the family. Ed is this transformation due to his insanity. The
able to remember David’s actions, but only transformation occurs when triggered by his
as if he were witnessing them as a bystander. insanity, when Ed is in extraordinary danger, or
Attempts to “cure” Ed, or force him to accept when Ed is reduced to zero hit points. In the
his dual nature, result in his transformation latter instance, he immediately regains all lost
into his alter ego. hit points upon assuming the role of David.
Saving Throws Chr +4, Con +3 Actions

Skills Arcana +6, Medicine +6, Perception +4
Senses passive Perception 14 Dagger. Melee Weapon Attack: +4 to hit, reach 5
Languages Common, Elven, Dragon, Celestial, ft., one target. Hit: 4 (1d4 + 2) piercing damage.
Infernal
164
M iel ace , E d “D avid ”
David transformation occurs when David completes a

Medium aberration, neutral evil long rest, or when he is reduced to zero hit points.
In the latter instance he immediately stabilizes
Armor Class 16 (natural armor) with 1 hit point upon assuming the identity of Ed.
Hit Points 110 (13d8 + 52)
Speed 25 ft., climb 25 ft. Actions
STR DEX CON INT WIS CHA Multiattack. David makes three attacks per
20 (+5) 14 (+2) 18 (+4) 15 (+2) 8 (-1) 10 (+0) round.
Sanity (optional) 7 (-2) Pummel. Melee Attack: +10 to hit, reach 5 ft.,
Insanity Even were he interested in doing so, one target. Hit: 12 (1d10 + 7) bludgeoning
David is unable to rein in his baser, more damage. When a target is struck by David’s
bestial urges. He is a being completely driven pummel attack two or more times in one turn,
by his id, attacking everything and everyone he may use his bonus action to wrap his meaty
with gusto. Still, he is not a mindless beast, arms around a Large or smaller target, crushing
and uses his intelligence to maximize the them for 9 (2d6 + 2) bludgeoning damage and
havoc and carnage he can inflict. stunning them until the end of their next turn.
Saving Throws Str +8, Con +7 Reactions

Skills Athletics +8, Deception +3, Intimidation +6
Senses darkvision 30ft., passive Perception 9 Swipe. As a reaction he can make a melee attack
Languages Common at a creature that has attacked him.
For the DM: Heroes may interact with Ed or
All In. David’s attacks are made without David over an extended period of time before
hesitation or any efforts to control them. He becoming aware of the other personality. Ed is
has a +2 to-hit and damage for all melee attacks allowed to roam the first floor of Lamp’s Light as
(included below). a trusted patient. David is more likely to be met
due to a physical altercation that he is a part of.
Of Two Minds. David’s binary nature gives The staff, alienists, and most of the patients
advantage on saving throws against being have long ago learned that when interacting
charmed or frightened. with Ed they should not mention David lest
they run the risk of invoking his presence. Ed is
Reckless. At the start of his turn, David can friendly, if painfully shy and guarded.
gain advantage on all melee weapon attack rolls David has an uncanny knack for identifying
during that turn, but attack rolls against him like-minded individuals, and PCs with an
have advantage until the start of his next turn. insanity compatible with his own may be
parleyed with for brief alliances, or to extricate
Transmogrify. As an action David can release David from whatever situation his behavior has
control of his body, and allow Ed to emerge gotten him in. David has the attention of Dr.
from the mental cage he is kept in. David will Renwick too, and may find himself an alumnus
not willingly initiate this transformation. The of the good doctor’s extreme treatments soon.
165
Myttong, Jon (aka Mad Jak) “There is wisdom in wine and freedom in
Medium humanoid (human), chaotic neutral beer! Come my friends, join me in a journey of
debauched discovery!!!!”
Armor Class 9 — Mad Jak
Speed 30 ft. Jon Myttong is the third son of a minor noble
in a nearby province. Neither the eldest nor
STR DEX CON INT WIS CHA the youngest, Jon spent much of his childhood
17 (+3) 9 (-1) 15 (+2) 11 (+0) 9 (-1) 15 (+2) overlooked and ignored. That all changed when,
at his eldest brother’s wedding, he discovered
Sanity (optional) 6 (-2) wine for the first time, and in its inhibition-
Insanity Jon is an alcoholic. If Jon is not under abolishing grasp became the euphoric, manic,
the effects of alcohol, he has a -1 penalty and vivacious person he’d always wanted to be:
on all skill checks until he is. The penalty Mad Jak. The laughs and attention he earned
increases to -2 after 3 hours, and becomes with his shenanigans ensured that the evening’s
disadvantage after 6 continuous hours of debauchery was the first of many; such was the
sobriety. birth of Mad Jak.
Jon Myttong, conversely, is a sober, sullen,
Skills Deception +6, Persuasion +6 and quiet man. Introspective and brooding,
Senses passive Perception 9 he virtually disappears in any room he is in —
Languages Common quite a feat considering his imposing physicality.
Challenge 0 (10 XP) His demeanor, when combined with his physical
presence, ensure that few disturb him. Despite
Water Into Wine (2/day). Jon can procure this he has developed a friendship of sorts with
sufficient alcohol to inebriate himself Nyfuir. The two can often be found together,
by succeeding on an opposed Charisma seemingly oblivious to the outside word.
(Deception) check against any orderly, alienist, Mad Jak, the drunken poet, philosopher,
or Lamp’s Light staff member observing him. and orator, can only be described as manically
intense in his attentions and activities. His stern
Actions countenance is softened by frequent smiles
and infectious laughs. Jak is the happiest, most
Slam. Melee Weapon Attack: +1 to hit, reach 5 vivacious, and personable drunk you will ever
ft., one target. Hit: 1 bludgeoning damage. meet, the opposite of Jon by every measure. Jak
is friend to all, and has never met a stranger.
For the DM: Dr. Renwick has his eye on Jon

Myttong and Mad Jak. It is his supposition
that Jon’s fragmentary personality is similar to,
albeit less extreme than, Mr. Mielace’s. Renwick
believes having the two of them opens up a
wealth of options for experimental therapies and
is only waiting for Jon’s embarrassed family to
consent to the more aggressive treatments.
166
M yttong , J on ( aka M ad J ak )
167
Nantanye, Bok (aka Patient

11, The Grey Man)
Medium humanoid (human), lawful evil
Armor Class 13
Speed 30 ft.

10 (+0) 17 (+3) 12 (+1) 15 (+2) 10 (+0) 17 (+3)
Sanity (optional) 0
Insanity Bok is a sociopath and instinctually
responds to problems with violence. When
he is unable to suppress his sociopathic
tendencies, he has a -2 penalty to Persuasion/
Deception checks and a +2 bonus to
Intimidation checks. (These bonuses and
penalties are not included in the stats below).
Saving Throws Dex +6, Cha +6

Skills Deception +6, Insight +3, Perception +3,
Stealth +9
that isn’t incapacitated (and Bok does not have
Assassinate. During his first turn, Bok has disadvantage on the attack roll).
advantage on attack rolls against any creature
that has not yet taken a turn. Any hit scored on Actions
a surprised creature is a critical hit.
Multiattack. Bok makes three attacks
Evasion. If Bok is subjected to an effect that
allows him to make a Dexterity saving throw Shiv. Melee Weapon Attack: +6 to hit, reach 5 ft.,
to take only half damage, he instead takes no one target. Hit: 5 (1d4 + 3) piercing damage.
damage if he succeeds on the saving throw, and
only half damage if he fails. Patient 11 is virtually catatonic, moving only
when directed and never speaking. He is often
Sneak Attack (1/turn). Bok deals an extra seen standing by himself in a corner near a
10 (3d6) damage when he hits a target with a window. He is physically nondescript with
weapon attack and has advantage on the attack cropped grey hair, dull blue eyes, and a build
roll, or when the target is within 5 feet of an ally that is largely hidden by the loose clothing of
168
T he G rey M an
patients. An “11” is scrawled in charcoal on the

breast of his shirt. Saving Throws Dex +6, Cha +6
The man who would later become known Skills Deception +4, Insight +3, Perception +3,
as Patient 11 appeared at the doorstep of Stealth +11
Lamp’s Light with no preamble last year Senses passive Perception 13
on the morning of All Saint’s Day and was Languages Common, abyssal
subsequently admitted. He has no ties to the Challenge 7 (2,900 XP)
staff or patients of Lamp’s Light, most of whom
believe that his catatonia is the result of a Assassinate. During his first turn, the Grey
horrible trauma. Administrator Rose has taken Man has advantage on attack rolls against any
a special interest in his case and dedicates many creature that has not yet taken a turn. Any hit
hours reading to him in the evenings. scored on a surprised creature is a critical hit.
For the DM: Patient #11 is the current alias Evasion. If he is subjected to an effect that
for Bok Nantanye. Bok lived in ghettos making allows him to make a Dexterity saving throw
a meager living as a merchant and tinkerer. to take only half damage, he instead takes no
On the evening of All Hallows Eve his form damage if he succeeds on the saving throw, and
was occupied by an alien intelligence and the only half damage if he fails.
Grey Man emerged. For the next three nights
the Grey Man terrorized the denizens of slums. Sneak Attack (1/turn). The Grey Man deals
The intelligence released its grip on Bok on the an extra 10 (3d6) damage when he hits a target
final night, its thirst for violence slaked by the with a weapon attack and has advantage on the
11 victims left in its wake. The entity stirs again attack roll, or when the target is within 5 feet of
within Bok as Florence Rose coaxes it from the an ally that isn’t incapacitated (and he does not
recesses of his mind. have disadvantage on the attack roll).
The Grey Man Actions

Medium humanoid (human), lawful evil
Multiattack. The Grey Man makes three
Armor Class 13 attacks.
Hit Points 71 (10d10 + 16)
Speed 30 ft. Shiv. Melee Weapon Attack: +6 to hit, reach 5
ft., one target. Hit: 5 (1d4 + 3) piercing damage
STR DEX CON INT WIS CHA and 7 (2d6) psychic damage.
10 (+0) 20 (+5) 14 (+2) 12 (+1) 10 (+0) 17 (+3)
Sanity (optional) 0
Insanity The Grey Man is a sociopath and
instinctually responds to problems with
violence. He has a -2 penalty to Persuasion/
Deception checks and a +2 bonus to
intimidation checks. (These bonuses and
penalties are included in the stats below.)
169
Nimbus be compelled to form a riot of lunatics (see

Tiny aberration, chaotic evil Appendix C, page 179). If the target of the
effect is suffering a bout of madness the check is
Armor Class 15 made with disadvantage.
Hit Points 31 (9d6)
Speed 0 ft., fly 20 ft. (hover)

2 (-4) 20 (+5) 11 (+0) 12 (+1) 13 (+1) 14 (+2)
Sanity (optional) n/a
Skills Stealth +7
Damage Resistances necrotic, psychic
Damage Immunities bludgeoning, piercing,
and slashing from non-magical weapons that
are not silvered
Condition Immunities exhaustion, frightened,
poisoned, stunned
Senses blindsight 30 ft., passive Perception 11
Languages Aklo
Actions
Consume Will. Melee Weapon Attack: +7 to “There came to that room wild streams of
hit, reach 0 ft., one target. Hit: The target must violet midnight glittering with dust of gold; vortices
succeed on a DC 12 Charisma saving throw or of dust and fire.”
lose 1d4 points of Charisma. This save must — H.P. Lovecraft
be repeated every 6 hours. When the target has
lost a total of 8 or more points of Charisma For reasons unknown, the extraplanar parasites
she falls into a fugue state and is effectively known as the nimbus are drawn to areas of
incapacitated. When the target’s Charisma is great mental chaos and despair. The creatures
reduced to 3 or less, she must make a DC 14 are especially fond of the minds of maniacs.
Charisma save or be reduced to 0 hit points as Once an appropriate host is found these
she commits suicide. Lost Charisma points are invisible creatures attach their corpuscular body
regained at a rate of 1d4 per long rest. to the base of its neck and extrude ethereal
tentacles into the creature’s mind. The nimbus
Incite Riot (1/day). The nimbus emits a then feeds upon the psyche until satiated.
psychic scream that overwhelms the personas of When ready to find a new victim, the nimbus
anyone nearby. Those suffering from insanity emits a psychic pulse compelling its host to
are especially vulnerable. All creatures within commit suicide, which allows the nimbus to
30 feet must make a DC 12 Sanity check or free itself more easily.
170
N yfuir
Nyfuir Reactions
Medium humanoid (human), chaotic neutral
Share Nightmare (Recharge 6). In response to
Armor Class 12 being damaged Nyfuir can psychically invade
Hit Points 88 (16d8 + 16) the minds of creatures within a 30-foot radius,
Speed 30 ft. forcing them to make a DC 15 Charisma
saving throw. On a failed save, a creature takes
STR DEX CON INT WIS CHA 27 (6d6) psychic damage and is stunned and
8 (-1) 15 (+2) 11 (+0) 13 (+1) 14 (+2) 18 (+4) frightened until the end of their next turn. On
a successful save, the creature takes half as much
Sanity (optional) 5 (-3) damage, and is unaffected by the conditions.
Insanity Nyfuir cannot easily tell reality from
the hallucinations that constantly bombard
her. These hallucinations are often due to her
psychic link with Chem, but may manifest
at any time and in any manner. Nyfuir
has a -2 penalty to Wisdom (Insight) and
Wisdom (Perception) checks (taken into
account below). Additionally, she attacks at
disadvantage on the first round of any battle
as she struggles to discern what is real from
what is not.

Skills Arcana +4, Insight +3, Perception +3
Languages Common, Elven, Infernal
Spellcasting. Nyfuir is a 9th-level spellcaster and

her spellcasting ability is Charisma (spell save
DC 15, +7 to hit with spell attacks). She regains
expended spell slots after finishing a short or
long rest. She knows the following spells:
At will: eldritch blast (2 beams), friends, mage
hand, prestidigitation
Actions

ft., one target. Hit: 1 (1d4 - 1) bludgeoning
damage.
171
Nyfuir’s earliest memory is of shivering, hungry continuous stream of depravity, slowly eroding
and cold, in her root cellar, as she hid from an what little mental strength she has remaining.
invading horde of raiders. The screams of her During lucid periods, Nyfuir can articulate
friends, family, and neighbors penetrated her her past, her punishment, and the diseased bond
basement hiding place, and yet she kept silent that she shares with her former familiar. Sadly,
throughout it all, fear and self-preservation these periods are infrequent. Most days are spent
winning out over any thoughts she may have as a silent, helpless witness to the cankerous
had of running. Nowhere to go, Nyfuir used profanity of Chem’s existence, a small scream, a
the howls of pain to mask her excavation of the tear, or a string of mumbled words the only clue
earthen floor. The torture lasted for days, time outsiders have to the horrors she’s witnessing.
enough for the tunnel to grow to sufficient size
to engulf her with its dark embrace. For the DM: Nyfuir’s mind has been fractured
While in this dark and cramped tomb of her almost beyond repair. What she wants more
own creation, Nyfuir begged and prayed for than anything is for another patron to fill the
deliverance. Finally, a voice answered her. It was cavernous hole within her psyche, and to feel
this day that Nyfuir became a warlock, swearing the comforting closeness of that symbiotic
fealty to a fiendish patron in return for the relationship. Whomever, or whatever, extends
power to smite her enemies, and the services of an offer of patronage is sure to be accepted.
a rakish imp familiar called Chem. In doing she will regain much of her lost
Despite her thirst for vengeance, Nyfuir’s powers. The patron will gain an unwavering
heart never hardened to the savage violence she zealot to its cause. Nyfuir’s psychosis will shift
witnessed in her lord’s service. With the death to justify any action, no matter how abhorrent,
of each raider she grew more disenfranchised and she will be an eager puppet to be directed as
with her patron and the vengeful path she’d set it sees fit.
herself on. Her doubts crystallized into defiance
when she was charged by her patron with the
murder of a coterie of clerics from a rival faith.
Nyfuir tracked the clerics to their home, set
it ablaze to flush them out, and in a flash of
insight realized that she’d become the very image
of the invaders that stole her family years before.
Shaken by the revelation, Nyfuir rebelled against
the will of her patron.
No good deed goes unpunished, and in a fit
of hellish rage her patron violently withdrew
the gifts he’d bestowed upon her. Next, Chem
disappeared in wisp of sulfurous smoke. In the
wake of the sudden violation, Nyfuir regressed
to the trapped, powerless child she’d once been.
Her master’s cruelty wasn’t satisfied with
merely neutering her, and to this day she
maintains a psychic link to Chem. The imp’s
malicious, craven deeds are relayed to her in a
172
O rderly
Orderly Reactions
Call for Reinforcements (1/day). In response to
Armor Class 11 an attack an orderly may summon 1d4 orderlies
Hit Points 11 (2d8 + 2) to her aid. All summoned orderlies appear at the
Speed 30 ft. beginning of the next round.
STR DEX CON INT WIS CHA Not known for their personalities or intelligence,
13 (+1) 12 (+1) 12 (+1) 9 (-1) 10 (+0) 8 (-1) these bulky men and women in pristine white
uniforms instill order through the liberal
Sanity (optional) 8 (-1) application of force. Orderlies are the ubiquitous
staff of the asylum responsible for a wide range
Skills Athletics +3, Insight +2, Perception +2 of duties, and can be found in all areas of the
Senses passive Perception 12 facility. They are ever-vigilant and promptly
Languages Common respond to calls for assistance from Lamp’s
Challenge 1/8 (25 XP) Light staff. If needed there are always 1d4
orderlies within earshot of the staff alienists (see
Grappler. The orderly has advantage on attack Appendix C, page 144).
rolls against a creature it is grappling.
For High Level Games: The following
Actions changes can be made to increase the challenge
presented by the orderlies.
Club. Melee Weapon Attack: +3 to hit, reach 5 ft.,
one target. Hit: 3 (1d4 + 1) bludgeoning damage. • Double their hit points.
• Give them a second attack per round.
Pin. The orderly may use its action to try to pin • Increase Strength by 1.
a creature it has successfully grappled. To do so, • Increase Call for Reinforcements to 3/day.
the orderly must make another grapple check,
and if the orderly succeeds both the orderly and
the creature are restrained until the grapple ends.
173
Patient Actions
Slam. Melee Weapon Attack: +1 to hit, reach 5
Armor Class 10 (natural armor) ft., one target. Hit: 1 bludgeoning damage.
Hit Points 4 (1d8)
Speed 30 ft. As varied as the faces in a crowd, any sentient
being can be a patient at Lamp’s Light. Humans,
STR DEX CON INT WIS CHA elves, gnomes, and the occasional dwarf
9 (-1) 10 (+0) 10 (+0) 11 (+0) 10 (+0) 8 (-1) have graced its halls. Patients from all social
and economic stations are found within the
Sanity (optional) variable 1d4 - 1 sanitarium. Non-violent patients intermingle
Insanity Most patients show signs of some form regardless of their lot in life outside of the
of insanity (see Appendix A, page 123). asylum, and spend considerable time with one
another.
Languages Common
Challenge 0 (10 XP)
174
P eeper
Peeper
Small aberration, neutral evil
Armor Class 15 (natural armor)

Hit Points 27 (6d4 + 12) Saving Throws Cha +3, Wis +3
Speed 0 ft., fly 30ft. (hover) Skills Insight +5, Perception +5, Stealth +4
STR DEX CON INT WIS CHA Languages Abyssal, Common, Deep Speech,
6 (-2) 15 (+2) 14 (+2) 6 (-2) 12 (+1) 12 (+1) Undercommon
Insanity Peepers are obsessed with spying on Aggressive. As a bonus action, the peeper can
living creatures’ dreams. The emotions that move up to its speed toward a hostile creature
arise from the dream are addictive to them, that it can see.
like a drug. They will not act aggressively
towards a dreaming character they are spying Figment. The peeper can only exist in the
on unless that character attempts to reject the dreams of humanoid creatures. It is incapable of
dream’s reality. surviving in the prime material plane.
175
Mimicry. The peeper can mimic simple sounds A peeper is the psychic manifestation of a
of speech it has heard, in any language. A singular obsessive thought, empowered by the
creature that hears the sounds can tell they are reality-altering power of the H’awouahoua.
imitations with a successful DC 11 Wisdom When a character is near a location that the
(Insight) check. H’awouahoua hopes to use as a doorway from
its shadowy realm into the physical world, they
Actions may find their mind drifting towards obsessions.
When their thoughts linger too long on a
Bite. Melee Weapon Attack: +4 to hit, reach 5 ft., gripping idea, a peeper is created, resembling
one target. Hit: 6 (1d8+2) piercing damage. a small beholder with a single central eye, and
six fleshy tentacles each ending in a humanoid
Eye Rays. The peeper shoots two of the mouth. If one stares into the peeper’s eye, they
following magical eye rays at random (reroll will see reflected in it the obsessive thought that
duplicates), choosing one or two targets it can birthed the aberrant creature.
see within 60 feet of it. Peepers invade the dreams of those who
Confusion Ray. The targeted creature must sleep near the place where they were created.
succeed on a DC 11 Wisdom saving throw or be While in a dream, a peeper may even attempt to
confused until the start of the peeper’s next turn. interact with the dreamer by mimicking voices
Nightmare Ray. The targeted creature must that the dreamer knows. The peeper is obsessed
succeed on a DC 11 Charisma saving throw with watching dreams, and sustains itself from
or take 11 (2d10) psychic damage and have the psychic energy of a dreamer’s emotions.
disadvantage on attack rolls and ability checks The peeper will only attack the dreamer should
until the start of the peeper’s next turn. the dreamer become aware of it, or attempt to
Paralyzing Ray. The targeted creature must escape their dream before it’s meant to end.
succeed on a DC 11 Constitution saving throw
or be paralyzed for 1 minute. The target can For the DM: Should a peeper kill a dreaming
repeat the saving throw at the end of each of its creature, the dreamer’s physical body goes into
turns, ending the effect on itself on a success. a catatonic state, while their mind is forever
Insanity Ray. The targeted creature must trapped in a loop of the same dream they
succeed on a DC 11 Sanity check or suffer from were having when they died. Only a greater
a short-term psychosis. restoration or a wish spell may end the dream
and wake the dreamer from their catatonic state.
176
R enwick , O rson D r .
Renwick, Orson Dr. insults and disturbingly accurate insights. The

Medium humanoid (human), lawful evil target takes 2 (1d4) psychic damage and if the
target fails a DC 12 Charisma save it is stunned
Armor Class 10 until the end of its next turn.
Hit Points 54 (12d8)
Speed 30 ft.

8 (-2) 11 (+0) 11 (+3) 18 (+4) 14 (+2) 12 (+1)
Sanity (optional) 0
Insanity sociopath
Skills Arcana +8, Insight +4, Intimidation +3,

Medicine +10
Didactic Training. Medicine is an Intelligence

based skill for Dr. Renwick.
Spellcasting. Dr. Renwick is a 4th-level

spellcaster and his spellcasting ability is
Intelligence (spell save DC 12, +6 to hit with
spell attacks). He regains expended spell slots
after finishing a long rest. He knows the
following spells:
At will: friends, light, mage hand, shocking
grasp
1st level (4 slots): charm person, command,
illusory script, unseen servant
2nd level (3 slots): calm emotions, hold person,
suggestion “Be silent, watch, listen, and you may learn. I
do not want to see you. I do not want to hear you. If
Actions you have a question, ask someone else. Is that clear?
Just nod.”
Club. Melee Weapon Attack: +1 to hit, reach 5 — Dr. Orson Renwick
ft., one target. Hit: 1 (1d4 - 2) bludgeoning
damage. Dr. Renwick’s vitriolic enthusiasm has terrorized
the halls of Lamp’s Light for almost as long as
Berate. Dr. Renwick targets a creature he can anyone can remember. He is universally hated,
see within 30 feet and unleashes a torrent of
177
feared, and respected in equal parts by the staff For the DM: Dr. Renwick’s descent into
for his temper, sharp words, and brilliance. the person that he is now began with his
With the passing of Lucien Prosper, Dr. experiments upon himself with his inventions.
Renwick is the final remaining staff member As a young man he would not subject unwilling
from the asylum’s founding years ago. The man patients to his experiments with the juxta
that he once was has all but disappeared over personalis and resorted to using it on the only
the years and no one is quite sure exactly why. willing subject he could find: himself. It wasn’t
Dr. Renwick was markedly affected by the death long before the personality changes wrought
of his friend Lucien and his actions of late have by the device loosened his viewpoint enough
been driven by a pervasive sense of bitter anger. that he convinced himself that his experiments
Dr. Renwick is a brilliant man and is served the greater good and he began to
responsible for the treatment of the residents subject the patients of Lamp’s Light to his new
of Lamp’s Light. His breakthrough treatments treatments.
include the juxta personalis (see Appendix B, page
140), and cerebri mimos (see Appendix B, page
138) — also known as the spike.
178
R iot of L unatics
Riot of Lunatics Swarm. The swarm can occupy another

Huge swarm of medium humanoids (any race), any creature’s space and vice versa. The swarm can
chaotic alignment move through any opening large enough for a
medium creature. The swarm cannot regain hit
The chittering, gibbering sound of dozens points or gain temporary hit points.
of disharmonious voices assails your ears
before you see the writhing, pulsating riot of Actions
patients bearing down on you. The variegated
surface of the swarm makes visual examination Slam. Melee Weapon Attack: +5 to hit, reach 5
disorienting, hypnotic. Moving closer, a ft., one target. Hit: 10 (2d6 + 3) bludgeoning
screaming face issues forth abruptly and just a damage, or 6 (1d6 +3) if the swarm has half of
quickly submerges back within the pile of limbs. its hit points or fewer.
Armor Class 11 Reality Warp. Any creature that begins its

Hit Points 60 (8d8 + 24) turn or ends its turn in a space occupied by the
Speed 30 ft. swarm must make a DC 10 Charisma save or be
confused (as the spell confusion). The target may
STR DEX CON INT WIS CHA repeat the save at the end of its turn, ending the
17 (+3) 13 (+1) 16 (+3) 8 (–1) 10 (+0) 10 (+0) effect on a success.
Sanity (optional) 0 (insane)

Insanity see Appendix B

Damage Resistances bludgeoning, piercing,
slashing
Condition Immunities charmed, frightened,
paralyzed, petrified, prone, restrained,
stunned
Languages Common
179
180
R ose , F lorence
Rose, Florence Rose has advantage on any Charisma

Medium aberration (lawful evil) (Deception) check to avoid detection of her
disguise.
Hit Points 135 (18d8 +54) Innate Spellcasting. Rose’s innate spellcasting
Speed 30 ft. ability is Charisma. She can innately cast the
following spells (spell save DC 16) with no
STR DEX CON INT WIS CHA material components.
8 (-1) 14 (+2) 14 (+2) 13 (+1) 15 (+2) 20 (+5) At will: mage armor (self only)
1/day: confusion
Insanity Florence is obsessive about cleanliness. Spellcasting. Rose is a 9th-level spellcaster and
She will not willingly place herself in a her spellcasting ability is Charisma (spell save
situation that will cause her to become DC 16, +8 to hit with spell attacks). She regains
unclean. She compulsively tidies up around expended spell slots after finishing a short or
her, and when unobserved she makes long rest. She knows the following spells:
frequent use of prestidigitation to clean her Cantrips (at will): eldritch blast, friends,
quarters and office. prestidigitation
1st–5th level (two 5th level slots): animate
Saving Throws Cha +8, Con +5 object, black tentacles, calm emotion, charm
Skills Deception +11, Insight +5, Intimidation person, geas, compulsion, counterspell, detect
+8, Perception +5, Persuasion +11 thoughts, hideous laughter, hold person, suggestion
Damage Resistances fire, psychic
Condition Immunities charmed, frightened Subvocal Caster. Rose may choose to ignore the
Senses darkvision 30ft., passive Perception 15 verbal component of a spell when casting.
Languages Abyssal, Common, Deep Speech,
telepathy 30 ft. Actions
Mutable Form. As an action, Rose is able to ft., one target. Hit: 1 (1d4 - 1) bludgeoning
change her appearance (as alter self spell) to damage.
duplicate the appearance of a medium creature
she has previously seen; she does not need to Reactions
maintain concentration, however she does revert
to her natural form if she dies. Unsettling Visage. When a creature Rose can
She chooses the following: height, weight, see makes an attack roll against her, she can use
facial features, the sound of her voice, her reaction to impose disadvantage on the roll.
coloration, hair length, sex, and any other This feature can only be used before knowing
distinguishing characteristics. She can make whether the attack hits or misses. Using this
herself appear as a member of another race, trait reveals her shapeshifting nature to any
though none of her game statistics change. She creature within 30 feet that can see her. Once
cannot change her size category or basic shape. you use this trait, you can’t use it again until she
Clothing and equipment do not change. has finished a short or long rest.
181
182
R ose , F lorence
Legendary Action For the DM: Florence Rose is a creature of

hidden agendas, deep secrets, and elaborately
Florence Rose can take 1 legendary action at the layered deceptions. The creature posing as
end of another creature’s turn. She regains all Florence Rose is in fact a changeling that stalked
spent legendary actions at the start of her next and eliminated the original Florence Rose prior
turn. to her internship at Lamp’s Light Sanitarium.
The creature used the internship as the impetus
Summon Help. Rose may summon staff to sever her ties with Rose’s family and friends.
alienists (see Appendix C, page 144), patients, Starting fresh at Lamp’s Light, the creature
(see Appendix C, page 174), and/or orderlies ingratiated herself at the institute and eventually
(see Appendix C, page 173) to her aid. with Prosper himself. At an opportune time, she
She summons a total 1d6 of the previously engineered his demise, stepped up as the heir
mentioned creatures in any combination she apparent, and has ingrained herself in all aspects
chooses. All summoned creatures appear at the of Lamp’s Light.
end of the current turn. No one at Lamp’s Light has an inkling that
Administrator Rose is anything more or less
Ms. Rose is an attractive young woman than she appears to be. She works tirelessly,
exuding an aura of competence, kindness, and is loved by most, and respected by all for her
compassion. She has a ready, if weary, smile for work. She will not reveal herself under any
the patients and staff of Lamp’s Light and is seen circumstances and has endured injuries and
at all hours helping out however she can around assaults that she could have easily avoided had
the facility. Her tireless efforts to help even the she chosen to. Administrator Rose is never
lowest have earned her the love and admiration seen without her simple silver necklace with
of many. a pendant in the shape of a rose (an amulet of
Florence Rose has served as the administrator proof against detection and location).
for Lamp’s Light since the untimely death of its
founder, Lucien Prosper. Prior that unfortunate For High Level Games: The following
event Florence worked at Lamp’s Light changes can be made to increase the challenge
assiduously, eventually catching Prosper’s eye. presented by Rose.
Within a year she had become his aide-de-camp
and rarely strayed from his side. It was clear that • Legendary Resistance (3/day).
Florence had significant influence on the elder • Legendary Actions. Increase to 3 from 1.
Prosper. • Potent Caster. Rose may use a legendary
With Lucien’s passing Rose redoubled her action to cast a cantrip.
efforts at Lamp’s Light, determined more than • Escape. Rose takes the disengage action and
ever to realize the vision of Master Prosper. She then moves her full movement.
has not only kept up his good works, but also • Rose has a third spell slot.
continues to build the reputation of the facility • She has a ring of protection and a rod of the
as a leading center of care for all comers, and has pact keeper +2.
been largely responsible for the continued deep
sense of connection that the recent patients have
felt towards Lamp’s Light after leaving its halls.
183
Sleeping Phantasm
Medium undead humanoid, chaotic evil
Armor Class 10 Amorphous. The phantasm can move through

Hit Points 16 (3d8 + 3) a space as narrow as 1 inch wide without
Speed 40 ft. squeezing.
STR DEX CON INT WIS CHA Figment. The phantasm can only exist in the
6 (-2) 10 (+0) 12 (+1) 6 (-2) 8 (-1) 14 (+2) dreams of humanoid creatures. It is incapable of
surviving in the prime material plane.
Insanity The phantasms cannot tell the Shapechanger. The phantasm can use its
difference between the nightmarish illusion action to polymorph into any creature that
they are mimicking and their own true the dreamer has seen. Other than its size and
otherworldly nature. When they are active speed, its statistics are the same in each form.
within a character’s dream, they exhibit no Any equipment it is wearing or carrying isn’t
self-awareness at all. transformed. Because the phantasm has no true
form of its own, it vanishes entirely if it dies.
Skills Stealth +2, Deception +6, Insight +1,
Perception +1, Persuasion +6 Actions
Languages the languages spoken by the dreamer Identity Drain. Melee Weapon Attack: +4 to
Challenge ½ (100 XP) hit, reach 5 ft., one target. Hit: 7 (2d6) psychic
damage, and the target’s Charisma and Sanity
184
S leeping P hantasm
scores are reduced by 1d4. The target dies if this

reduces its Charisma to 0, and its body rises the
following morning, possessed by the phantasm
and in the service of the H’awouahoua.
Otherwise, the reductions end 1d4-2 days after
the target wakes from their nightmare.
Sleeping Phantasms are the undead spirits of the

H’awouahoua’s victims. The phantasm can only
exist in the dreams of possible victims of the
H’awouahoua, and as such, are not aware that
they are actually undead. They blend seamlessly
into the dreamer’s subconscious, appearing
as characters or even objects that the dreamer
knows. The phantasm will only turn aggressive
if the H’awouahoua wills it from its shadowy
prison, or if the dreamer becomes aggressive
against the phantasm.
For the DM: If the phantasm kills a dreaming

player character, the DM may consider turning
the character into an NPC possessed by the
phantasm. Alternatively, you may decide to
plant the seeds of a vicious betrayal in the party;
allow the player character to wake up as though
nothing had happened, and talk to the player
in secret after the current session about the
changes to their character. Rescuing a possessed
character from a sleeping phantasm through
magic or treatment could make for an excellent
storyline to explore after finishing Apotheosis of
Nightmares.
185
Todd, Dr. Abby has convinced Dr. Todd that true evil
Medium humanoid (human), chaotic neutral infiltrates the teeth, and with every extraction
he is making the world a better place.
Hit Points 44 (8d8 + 8) Saving Throws Int +5, Wis +1
Speed 30 ft. Skills Deception +5, Persuasion +5, Medicine
+8, Sleight of Hand +3
STR DEX CON INT WIS CHA Senses passive Perception 12
12 (+1) 12 (+1) 13 (+1) 17 (+3) 8 (-1) 16 (+3) Languages Common, Elvish
Insanity. Dr. Todd suffers from frequent and Didactic Training. Medicine is an Intelligence
persistent hallucinations that take the form based skill for Dr. Todd.
of a molar the size of a small cat. Abby, the
molar, is in fact very real and a manifestation Spellcasting. Dr. Todd is a 4th-level spellcaster
of Nyarlathotep that only Dr. Todd can see. and his spellcasting ability is Charisma (spell
save DC 13, +5 to hit with spell attacks). He
regains expended spell slots after finishing a long
or short rest. He knows the following spells:
At will: message, shocking grasp, mage armor,
comprehend languages
1/day: compulsion
1st–2nd level (two 2nd level slots): charm
person, disguise self, hold person, sleep, suggestion
Actions
Multiattack. Dr. Todd makes two attacks with

his dental pliers.
Dental Pliers. Melee Weapon Attack: +3 to

hit, reach 5 ft., one target. Hit: 4 (1d4 + 2)
bludgeoning damage.
Extraction. Dr. Todd may extract a tooth from

a willing or incapacitated target. If he succeeds
on a DC 12 Intelligence (Medicine) check
the tooth is successfully removed, the target
takes 1d4 slashing damage, and cannot speak
intelligibly for the next 2d4 rounds. At the
end of that time the target may make a DC 13
Constitution save to end the effect; on a failed
save the effect persists for an additional 1d4
186
T odd , D r .
rounds before ending. This penalty can only be only place he knows of that may be able to free
reversed before the end of the duration by greater him from his servitude, Lamp’s Light Sanitarium.
restoration, regeneration, wish, or similar magic.
For the DM: Dr. Todd is able to present
A product of the prestigious Miskatonic himself as a rational, thoughtful, and
University School of Dental Sciences, Dr. Todd’s conscientious man for extended periods of
initial forays into the world of dentistry proved as time, and has successfully passed himself as a
fulfilling and lucrative as his father’s own practice member of the staff to patients and more than a
was. Forging his own path, he took to the roads, few visitors. The ruse is invariably foiled when
serving as a wandering dentist and oral surgeon. he is no longer able to control himself, and his
As personally — and financially — rewarding as newfound acquaintance is deemed in need of an
his calling was, Dr. Todd’s activities had drawn extraction.
the ire of an eremite witch. Todd’s ministrations Due to his skill with enchantments he is
inflicted a pain in her like none she had ever rarely at a loss for willing patients. He has a
before experienced. Despite successfully removing pouch in his possession at all times in which he
the molar that had plagued her for years, the collects the evil-infused teeth he has extracted. It
witch’s words became a garbled mess and her is filled to overflowing.
powers greatly reduced as a result. In her desire for
revenge, she marked him for the attentions of the
Outer Gods and other beings Beyond All Things.
Soon thereafter, a figure of the blackest night,
flowing and ever-changing of form, visited
the good doctor in his sleep. Each evening the
Crawling Chaos chipped away at his sanity.
Reminders of past failures and the horrific pain
he’d inflicted on others played out over and over
in his dreams, with he himself the victim of his
own ministrations.
He was able to resist, initially at least, by
reminding himself of the good he’d done, and
that many of these patients later recovered fully!
But not all did. And their distorted faces drove
him to the brink of madness.
A gibbering mess, Dr. Todd called out for
aid, and waiting in the inky folds of space
was Nyarlathotep. The Black Pharaoh readily
answered his pleas and, for the small price
of a pact of service, relieved Dr. Todd of the
nightmares it had visited upon him.
And thus began Dr. Todd’s servitude to the
Crawling Chaos. Weary of his pact and the
duties it entails, he has checked himself into the
187
Appendix D: Maps
188
M ain H ouse — L evel 1
189
190
191
192
T he W est W ing
T he E ast W ing
193
194
T he B asement
Appendix E: Character Sheet
195
s
NAME CLASS and LEVEL BACKGROUND RACE ALIGNMENT EXPERIENCE
STRENGTH _( ) Proficiency Bonus Inspiration Personality Traits

 Saving Throws AC Initiative
 Athletics Speed Passive Perception
DEXTERITY _( ) Total HP
 Saving Throws Current HP Ideals
 Acrobatics
 Sleight of Hand Hit Dice
 Stealth Total Used
CONSTITUTION _( ) Death Saves Bonds
 Saving Throws
L
Successes  Failures 
INTELLIGENCE _( ) ATTACKS and SPELLCASTING
 Saving Throws Name Attack Bonus Damage Type
 Arcana Flaws
 History
 Investigation
 Nature
 Religion Features and Traits
WISDOM _( )
 Saving Throws
 Animal Handling
 Insight
 Medicine
 Perception
 Survival
CHARISMA _( )
 Saving Throws
 Deception EQUIPMENT
 Intimidation CP _
 Performance SP _
 Persuasion EP _
SANITY _( ) GP _
 Saving Throws PP _
LANGUAGES
L
AGE HEIGHT WEIGHT EYES SKIN HAIR
Emergency Contact Do Not Resuscitate  Organ Donor 

HISTORY:—
i
PERSONAL PROPERTY:—
APPEARANCE:—
ADDITIONAL FEATURES and TRAITS:—

h
S
SPELLCASTING CLASS SPELLCASTING ABILITY SPELL SAVE DC SPELL ATTACK BONUS
i
CANTRIPS LEVEL 3 SPELLS _/_ LEVEL 6 SPELLS _/_
 
 
 
a
 
 
 
 
 
 
 
1
LEVEL SPELLS _/_ LEVEL 4 SPELLS _/_ LEVEL 7 SPELLS _/_
  
  
  
  
  
  
  
  
  
  
LEVEL 2 SPELLS _/_ LEVEL 5 SPELLS _/_ LEVEL 8 SPELLS _/_

  
  
  
  
y
 
  LEVEL 9 SPELLS _/_
  
  
t
  
  
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Lamps Light Sanitarium v2

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by Matt Corley

with Donathin Frye

What you’ll find within this book:

©2019 Matt Corley

Written by Matt Corley with Donathin Frye

Cover art by JL Giles

Illustrations by Jack Kaiser, JL Giles, Journeyman, Matt Corley, Matt Ray,

Maps by Toby Lancaster of Dark Realm Maps

Editing & Layout by Craig Judd

Philanthropists Frenetic Patients

“Being Kind is a Free Action.”

In the United States:

In the UK: https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/

Prologue 10 Appendix B: Items of Interest 138

Appendix E: Character Sheet 195

Open Game License Version 1.0a 199

Maintain the Mood D escribe A ctivities N ot M echanics

skill checks should be rolled with a -2 penalty. Arms and Armor

• A combination of cutting-edge scientific

Chaos Unleashed Sages the world over lament the knowledge

by Ravenloft’s infamous thick, cloying mists. Matt on Ravenloft

political puppet, lord governor Marcel Guignol.

Ravnica is a singular worldwide cityscape ruled A Cog in the Interlocus

The Grim Feast Matt on Ravnica

Shaping the Future of Ravnica

While Eberron’s war- Eberron, balance

Matt on Eberron In Xoriat, daelkyr have created legions of

M aking it W eird V ictorian

The Devil’s Handmaiden

With his father’s death Lucien was at a

1A. Parlor A woman in a simple, pristine white

1I. Receiving Office 1J. Doorway to the East Wing

1L. Common Room appropriate based on his or her physical, mental,

BD. The Last Room room is valuable, it is not portable or easily

BH. Laboratory A metallic chest lies on a nearby table.

trashed, and the staff have given up on EI. Black Room

From the inside: EJ. Orange Room

Additional Room Details

receive while at the sanitarium. As such, it is

WH. Purple Room

This room is often kept unoccupied, and is used

Adventure Hook: An orderly and a member

WI. Crystal Room — Communal

WK. Brown Room WM. Metallic Room — Treatments Room

2A. Western Stairwell The second-floor lavatory contains a private

2C. Group Treatment Room A of the lever is slightly discolored as if by

Opening the container releases a waft of warm, d12 Effect

A character spending at least one hour within 2F. Equipment Closet

1 The subject is affected as if she cast

2I. Private Hallway 2K. Discussion Room

2M. Interrogation Room 2N. Hallway

Any who enter the The hallway is clean

3B. Staff Common Room of game time to determine if an alienist or staff

3C. The Lab • DC 10: There is not a speck of dust or dirt

Somewhat hidden by folding privacy panels 3G. Alienist Office

3H. Otto’s Office Adventure Hook: Characters rifling through

A P opul ation in F lux

Patient’s Life Outside Of Lamp’s Light Sanitarium

Patient Random Encounters

Synopsis Adventure Hooks

S etting the S cene bed and your feet to

9–10 No visible effect

W hat ’ s in it for us ? successful and that you’re all trusted patients.

Elys • Each room is detailed in the relevant chapter.