Dungeon World has a rule that tries to cover actual specific harm or wounds. This rule is borne out of the rules regarding health and the ever-present stance that all rules of the game are both “Prescriptive” and “Descriptive,” meaning that if something in the fiction happens to the character, then that thing should be reflected on the character sheet. Likewise if something is reflected on the character sheet, that thing should be reflected in the fiction as well.
So in the section on damage, the rules state:
“Damage is dealt based on the fiction. Moves that deal damage, like hack and slash, are just a special case of this: the move establishes that damage is being dealt in the fiction. Damage can be assigned even when no move is made, if it follows from the fiction.
HP Loss is often only part of the effect. If the harm is generalized, like falling into a pit, losing the HP is probably all there is to it. When the harm is specific, like an orc pull your arm from its socket, HP should be part of the effect but not the entirety of it. The bigger issue is dealing with the newly busted arm: how do you swing a sword or cast a spell? Likewise having your head chopped off is not HP damage, it’s just you being dead.”
This rule almost feels like a second thought – in comes early in the book and is not highlighted in any way, and it’s not referenced again by any of the GM moves. Still, the rule is clear about its intent. The GM has the capability of inflicting very specific types of damage – anything from a twisted ankle to a cut throat – and the fiction does not have to be generalized away as HP loss.
There are pros and cons to this approach. On the plus side, the game can be lively and there is no status or ongoing impact on a character that the rules can’t support, since this really allows the rules to support anything the GM can think up. On the other hand, this rule will require a fair amount of trust between the players and the GM. The players will have to be pretty understanding if the result of some series of actions actually ends up being that their character’s arm is permanently (or even temporarily) ripped from their body, causing them to lose the ability to defend themselves.
DW gives the GM another tool to inflict more general maladies on the players, specifically with Debilities. There are six Debilities, and each one reflects an injury to one of the six attributes: Weak (Str), Shaky (Dex), Sick (Con), Stunned (Int), Confused (Wis), and Scarred (Cha). The effect of debilities are simple. You suffer a -1 to your attribute modifier when making any rolls. Debilities don’t stack.
This makes debilities feel a little bit weak, but they’re clearly meant to stand in as a quick and easy way of applying some form of attribute damage without getting in the way of the flow of the game. Debilities are also harder to heal than HP, making them stick around a bit longer. Again though, the rules are still clear about the fiction coming first:
“Debilities don’t replace descriptions and using the established fiction. When someone loses an arm, that doesn’t mean they’re Weak, it means they have one less arm. Don’t let debilities limit you. A specific disease can have whatever effects you can dream up. Sick is just a convenient shorthand for some anonymous fever picked up from a filthy rat.”