The variant Diseased Giant Rat (MM pg. 327) has a feature that when it hits with an attack and the target fails a saving throw, they contract a disease. The text says

Until the disease is cured the target can't regain hit points except by magical means, and the target's hit point maximum decreases by 3 (1d6) every 24 hours. [...]

Is this reduction permanent or will the character regain their original maximum HP when cured of the disease?

My confusion stems from the fact that all information about the effect follows the "Until the disease is cured" statement, which could mean that the reduction only lasts until the target is cured. On the other hand one could argue that it is only further reductions that are mentioned and thus prevented by curing the target and the previous ones are separate effects that has already taken place.

  • \$\begingroup\$ Are you asking if the decreasing keeps on going after the cure or if the target's max HPs return to the original value before the disease? \$\endgroup\$
    – Eddymage
    Commented Feb 20, 2021 at 10:50
  • \$\begingroup\$ @Eddymage Only if the max hp value returns to its original (as if the disease never happened) after being cured. From the description of the disease it seems clear that there will be no further decreases. \$\endgroup\$
    – Jave
    Commented Feb 20, 2021 at 10:55

1 Answer 1


It is technically ambiguous, but the intent is clear: Your hit point maximum returns to normal when the disease ends

The sentence structure can be parsed in two ways:

  • [Until A], [B and C]

  • [Until A, B] and [C]

This is technically ambiguous, though I would assume the first is the intended reading as this simply makes the most sense. Having the maximum HP reduction sit around permanently is extremely punishing. And from a CR 1/8 creature no less.

Do note, however, that in neither case is it actually permanent. There are effects that would specifically end the HP reduction even if it were somehow intended to never end naturally. For example, greater restoration:

[...] end one of the following effects on the target: [...]

  • One effect reducing the target's hit points maximum [...]

Other similar features are not permanent

The Specter's Life Drain ability states:

[...] The target must succeed on a DC 10 Constitution saving throw or its hit point maximum is reduced by an amount equal to the damage taken. This reduction lasts until the creature finishes a long rest. The target dies if this effect reduces its hit point maximum to 0.

This is a CR 1 creature, and I would not expect the CR 1/8 rat to have a significantly stronger effect that can only be ended by a 5th level spell. Something no party fighting a CR 1/8 creature would have meaningful access to. While, technically, its effect is more specific, in that it explicitly details how long the reduction lasts; I would say the rat's feature does as well, it lasts until the disease is cured.

Compare this to the fact that, a party fighting a CR 1/8 rat is far more likely to have access to methods of removing diseases, for example: the 2nd level lesser restoration spell and the Paladin's Lay on Hands feature.

  • 1
    \$\begingroup\$ I agree, and this is also what I ruled. Regarding the specter however, the effect actually spells out the "This reduction lasts until the creature finishes a long rest." Which makes it less ambiguous. \$\endgroup\$
    – Jave
    Commented Feb 20, 2021 at 15:41
  • 2
    \$\begingroup\$ +1 agree. Still, there is a potential for a good terror-of-the-rats campaign story... to watch the horror in the PC's eyes as a band of diseased giant rats pop up from a sewer. Reminds me of "permanent" Con damage in previous editions or losing XP or a level. \$\endgroup\$
    – Senmurv
    Commented Feb 20, 2021 at 19:42
  • \$\begingroup\$ +1 for "that would be extremely punishing from a CR 1/8 creature." That alone would (almost) make a satisfying answer as far as I'm concerned. \$\endgroup\$ Commented Feb 20, 2021 at 22:46
  • 1
    \$\begingroup\$ While the intent is proof enough as far as I'm concerned, I believe that even the "[Until A], [B and C]" reading doesn't technically say that the decrease in max HP reverts itself when the disease is cured—only that it stops decreasing further. \$\endgroup\$
    – user31662
    Commented Feb 21, 2021 at 3:54

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