Original Text (PHB1, page293): Over the course of a battle, you take damage from attacks. Hit points (hp) measure your ability to stand up to punishment, turn deadly strikes into glancing blows, and stay on your feet throughout a battle. Hit points represent more than physical endurance. They represent your character’s skill, luck, and resolve—all the factors that combine to help you stay alive in a combat situation. When you create your character, you determine your maximum hit points. From this number, you derive your bloodied and healing surge values. When you take damage, subtract that number from your current hit points. As long as your current hit point total is higher than 0, you can keep on fighting. When your current total drops to 0 or lower, however, you are dying. Powers, abilities, and actions that restore hit points are known as healing. You might regain hit points through rest, heroic resolve, or magic. When you heal, add the number to your current hit points. You can heal up to your maximum hit point total, but you can’t exceed it.
Healing: Original Text (PHB1, page293): Even in heated battle, you can heal. You can heal yourself by using your Second Wind (see page 291), an ally can use the Heal skill (see page 185) on you, and an ally can use a healing power on you. When a power heals you, you don’t have to take an action to spend a healing surge. Even if you’re unconscious, the power uses your healing surge and restores hit points. And some healing powers restore hit points without requiring you to spend a healing surge.
House Rules: For Player Characters and select NPCs and Elite Enemies, Hit Points are measured using two pools of ‘points,’ instead of one; Stamina and Wound. Stamina Points measure a character’s physical energy, strength, and level of fatigue. Stamina represents a character’s ability to avoid otherwise grievous physical trauma during the course of an adventure, representing their ability to dodge at the last possible instant or to ‘roll with the punches’ to reduce the impact of a blow. During combat, except under specific conditions, ‘damage’ incurred by successful attacks are deducted from the Stamina pool first. As Stamina Points are reduced, a character becoms more and more exhausted, less capable of avoiding physical injury. A character with zero Stamina Points is exhausted, but may be otherwise healthy.
Wound Points represent a character’s physical health. Under normal circumstances, Wound Points are only reduced after a character’s Stamina Points have been reduced to zero. Each time a character takes one or more points of Wound damage, they must succeed in a Saving Throw (Fortitude) to avoid being dazed. Failure dazes the character for 1d4 rounds. A character that has taken Wound damage is also considered ‘Wounded,’ and behaves as if weakened (attacks deal half damage) if they have zero Stamina Points. If a Wounded character regains one or more Stamina Points, they are no longer weakened, and their attack damage returns to normal. Depending on the severity of the Wounds, other effects might also be incurred, from being slowed (character movement reduced to 2), being blinded, or suffering temporary penalties to Strength and Dexterity.
Stamina Points are synonymous with ‘hit points’ as explained in the Core Rulebook. A character’s maximum Stamina Total is equal to their class ‘starting hit points’ plus their Constitution modifier, plus any racial or feat bonuses to hit points. As characters increase in level, they increase in Stamina equal to ‘hit point increase per level.’ When a character’s Stamina Points reach half, they are considered ‘tired,’ which, in 4th Edition mechanics, is the same as being ‘bloodied.’ Wound Points are equal to a character’s base Constitution score (not to be confused with their Constitution modifier). A character with 12 Constitution has 12 Wound Points. Temporary bonuses or items that grant additional bonuses to this ability score do not increase the number of Wound Points a character has, only their base score applies. While Stamina Points increase with each level, Wound Points do not. Wound Points reflect a character’s physical body, and so the maximum total can increase only by increasing the base Constitution score OR through a feat called ‘Seasoned,’ which grants 5 additional Wound Points, permanently. There are no prerequisites to take this feat, but it can only be taken once.
Lost Stamina Points can be regained through abilities that grant healing, select items and potions, and a character’s Healing Surges. Abilities that would normally return Hit Points apply to the Stamina Point pool instead, exclusively. Wound Points can not be regained in this way. As Stamina is a measure of a character’s physical strength and stamina, abilities that grant them immediate increases in this total represent a surge of physical energy, rather than a miraculous ability to repair physical damage. If a character has lost all of their Stamina points and suffers damage to their Wound total, and is later healed using their Second Wind or a cleric spell, their Stamina increases by the specified amount, but their Wound Points remain unchanged. Additional damage incurred is removed from the Stamina total as normal, until it is reduced to zero again. Regaining Wound Points is more difficult. Once per day, a character that suffers a loss of Wound Points may attempt a Heal Skill check (DC 15). This check may only be performed the day of the injury, and may not be used to heal long-term injuries (Wound Points lost previous to an extended rest). Alternatively, an ally or NPC may perform this check, instead. Success returns one Wound Point to the character and removes any ‘weakness’ or ‘dazed’ effects incurred by the injury. This check is a standard action, and provokes attacks of opportunity and grants combat advantage when attempted during battle. Outside of combat, a character is allowed Take Ten during a short rest for an automatic success (DC 15). Wound Points can also be regained through items, spells, and abilities that use the ‘Regeneration’ keyword. Such items and spells apply to the Wound Point total first, and then carry on to Stamina Points.
Stamina Points regenerate naturally during an extended rest. A character that begins their extended rest with their maximum number of Wound Points regains all of their Stamina. Characters that start an extended rest with fewer than their maximum Wound Total upon beginning an extended rest, however, only regain half of their lost Stamina. Healing Surges are regained as normal after an extended rest, which can be spent immediately to bring Stamina back up if the character chooses. Wound Points regenerate naturally at a rate of 1 per extended rest (one per day). An ally or NPC can attempt a Heal skill check (DC 15) to double this rate (the patient cannot make this check themselves).
When a character is reduced to zero or fewer Wound Points, they are knocked unconscious, and are dying. A character dies if their Wound Point total drops below the negative of their maximum (A character with 12 WP dies if their total reaches -12) or if they fail three saves versus death.