How does bed rest effect Unchained diseases?

Question

How does getting bed rest interact with the disease rules from Pathfinder Unchained?

I find the text in the relevant section to be ambiguous; it first mentions diseases, then poisons, and then bed rest. Because of this ordering, it is not clear whether the bed rest section applies only to poisons, or to both sections (emphasis mine):

In general, whenever a victim fails a saving throw against her affliction, she moves one step further down the progression track, gaining the effects of the next state and keeping all previous effects, until she reaches the end state. If she's afflicted with a disease, she moves one step back toward healthy whenever she fulfills the conditions in the disease's Cure entry (usually by succeeding at one or more saves). Once she reaches healthy, she is cured. Poisons work differently—fulfilling the cure condition removes a poison from the victim's system, but she remains at the same step on the track and recovers gradually. (Treat a poison that has exhausted its duration in the same way.) For every day of bed rest (or 2 nights of normal rest), a victim recovers one step; this recovery is doubled as normal by Heal checks, and tenacious poisons might require a longer recovery period.

If the section does apply to diseases, I am further confused by its power. Most diseases - even really terrible ones such as Bubonic Plague - call for saves to get worse once per day. If bed rest is able to heal one or two stages once per day (assuming perpetual rest, without or with a healer respectively) and the disease can only worsen at most once per day, then wouldn't it become impossible for the disease to ever get worse while resting?

Bubonic Plague
Type disease, injury or inhaled Save Fortitude DC 17
Track physical; Frequency 1/day
Cure 2 consecutive saves

Similarly, if bed rest is not allowed for diseases, then it makes no difference if you rest or not while sick, which is also unbelievable. Both possibilities seem weird, making it difficult to judge the actual intent.

Answer 1

That text is… jeez, I am not a fan of how it's laid out.

Maybe this'll help?

Based on the grammar of the quoted passage, here are the rules for disease:

• In general, whenever a victim fails a saving throw against [disease], she moves one step further down the progression track, gaining the effects of the next state and keeping all previous effects, until she reaches the end state.

• [The victim] moves one step back toward healthy whenever she fulfills the conditions in the disease's Cure entry (usually by succeeding at one or more saves). Once she reaches healthy, she is cured.

Based on the grammar of the quoted passage, here are the rules for poisons:

• In general, whenever a victim fails a saving throw against [poison], she moves one step further down the progression track, gaining the effects of the next state and keeping all previous effects, until she reaches the end state.

• Fulfilling the cure condition removes a poison from the victim's system, but she remains at the same step on the track and recovers gradually. (Treat a poison that has exhausted its duration in the same way.)

• [In the recovery stage — meaning, after you've fulfilled the cure condition only,—] for every day of bed rest (or 2 nights of normal rest), a victim recovers one step; this recovery is doubled as normal by Heal checks, and tenacious poisons might require a longer recovery period.

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Okay, what about bed rest and verisimilitude?

As far as I know, there's nothing special in the rules:

• I searched the SRD for some indication that bed rest should provide a bonus to your save or the Heal check of someone tending to you, but I didn't find anything.

• I also checked the Heal rules to see if any of the test applications were implicitly providing a character with a day of supervised bed rest (e.g. if the heal check to treat disease implies hours of rest for the victim). Nope.

You're certainly within your rights as a GM to house-rule a small circumstance bonus for rest in good conditions (or a small circumstance penalty for recovery while undertaking strenuous activity) without impacting much else. But keep @firedraco's point — that these diseases already enforce de-facto bed rest by incapacitating you — in mind as well.

Answer 2

Bed rest only affects poisons after they have been removed from your character.

This means that while a poison is "active" bed rest does nothing. Once it is gone (either via saving, outlasting it, etc.) then bed rest will speed up your recovery.

While you could make the argument that bed rest would work for some less serious diseases, note that all of the sample diseases are quite dangerous; none of them are simple like catching a cold or the flu where bed rest could help. I doubt bed rest would help for a disease like the Bubonic Plague (especially for the later stages where you would already be stuck in bed).