What you get
This work contains a title page, credits page, one-page introduction including information on multi-stage diseases, eight pages of new diseases with fifteen new afflictions, a page with random adventure hooks, and a page for the OGL. The cover art is fairly simple but appropriate for the subject. Interior art is black and white, fairly simple, and reasonable quality, but the drawings do not always appear to reflect one of the specific diseases on the page; they seem to be there more for overall mood. One picture (on page 10) does not show up in my copy (it gives an error rendering the document there...not sure if it is a problem with my copy, my pdf reader, or the document in general).
What I like
This is overall just a FUN book, especially for GMs. First and foremost, it addresses one of the major problems with diseases in the d20 and Pathfinder systems: stages of a disease. Most real diseases don’t just incubate and then hit with a single effect until you recover or die; they progress through multiple stages, some worse than others. This work presents excellently thought out variant rules for multi-stage diseases, simple enough to be easy to impliment and remember, but robust enough to give a significantly more realistic portrayal of disease in a gaming setting. There are some really creative diseases in here, both multi-stage and single stage, and I especially like the traumatic mental diseases like Bald Man’s Bluff and Forgotten Pain.
What I’d like to see
While the ideas behind this book are thoroughly awesome, its editing leaves something to be desired. There are some places where, while the intent can be deciphered, the flow is disrupted by improper grammar and/or syntax. The errors are the kind of thing that a spell check won’t pick up on, and I have a feeling this is due to the common writer’s folly of already knowing what you are saying and thus not seeing your own glitches. Goodness knows I’ve had that problem enough in my own writing. However, it is distracting enough in this piece that I feel that at least one star should be deducted from the overall rating. That said, there is no editor listed in the credits, so this is not too bad for a one-man text.
I really enjoyed this work, and recommend it to any GM who is looking for expanded rules and options for diseases in D20 (thought written for Pathfinder, nothing prevents these from being used in the original 3.5 or D20 modern). My biggest issue with the rules as written (from an opinion standpoint, so feel free to ignore it) is that multi-stage diseases described here require multiple castings of remove disease to cure. However, the official spell specifies that it can remove all diseases afflicting a target, so I prefer to say that a single casting of remove disease has a chance to cure all stages of a multistage disease; it attempts to remove the current stage first and, if successful, can attempt to remove earlier stages at their respective DCs, but failure to remove one stage of a disease prevents that casting from affecting earlier stages. As I said, this is just a personal preference.
Overall, the concepts are solid and the layout is very good and quite printer friendly (if you’re into printing your own resources). As I mentioned, I would have liked to see some more editing, but my overall impression is still good. I think this is in the 3.5-4 star range, so I’ll give it 4 stars.