Did your party just find a Periapt of Health? Loreify records your session and writes the recap, including every magic item, NPC and loot drop your party picked up.
Periapt of Health 5e: Two Different Items Under One Name
The Periapt of Health in 5e is an uncommon pendant, and the 2014 and 2024 versions do completely different things. In the 2014 rules it makes you immune to catching any disease and suppresses diseases you already have, with no attunement. In the 2024 rules it requires attunement, lets you take a Magic action once per dawn to regain 2d4 + 2 Hit Points, and gives Advantage on saving throws to avoid or end the Poisoned condition. The verdict: a free, situational safety net in 2014; a modest item in 2024 that has to earn an attunement slot.
Ten sessions from now, will anyone remember who's carrying the Periapt of Health? Loreify turns your session audio into notes, NPC lists and quotes in 5-10 minutes.
Periapt of Health Rules Text
The 2014 card (SRD 5.1), then the 2024 card (SRD 5.2.1):
Periapt of Health
2014 rules
Wondrous item, uncommon
UncommonNo attunement
You are immune to contracting any disease while you wear this pendant. If you are already infected with a disease, the effects of the disease are suppressed you while you wear the pendant.
While wearing this pendant, you can take a Magic action to regain 2d4 + 2 Hit Points. Once used, this property can't be used again until the next dawn.
In addition, you have Advantage on saving throws to avoid or end the Poisoned condition while you wear this pendant.
While you wear it, you can't contract a disease. If you already have one, its effects are suppressed for as long as the pendant stays on. Take it off and the disease comes back, so the periapt isn't a cure. For that you still need Lesser Restoration or the disease's own recovery rules.
What counts as a disease in the 2014 SRD:
•Sample diseases. Cackle Fever, Sewer Plague and Sight Rot, each with its own saves and symptoms.
•Monster attacks. The Otyugh bite (DC 15 Constitution save against disease) and the Death Dog bite (DC 12) both inflict a disease that poisons the target and drains its Hit Point maximum. With the periapt on, you can't contract either.
•The Contagion spell in 2014 afflicts the target with a disease on a hit, so the periapt blocks it.
What it doesn't cover: curses that act like diseases. A 2014 mummy's rot is a curse, not a disease, and the periapt does nothing against it.
2024: a daily heal and poison resistance
The 2024 version has two parts.
The heal. Take a Magic action to regain 2d4 + 2 Hit Points, an average of 7. It works once, then recharges at dawn. That's exactly what a Potion of Healing restores, but a potion only costs a Bonus Action in 2024 while the periapt costs your action. Use it after a fight or when a turn isn't worth much, not in place of attacking.
The Poisoned saves. You have Advantage on saving throws to avoid or end the Poisoned condition. That covers the first save and any repeat saves. Against a DC 13 Constitution save with a +2 bonus, you go from 50% to 75%.
Poisoned on a hit with no save; DC 15 Con save after each Long Rest ends it
Advantage on the Long Rest save
Wyvern sting
Poisoned until the start of its next turn, no save
Nothing
The 2024 Contagion spell also works through the Poisoned condition, so the periapt gives Advantage against it as well.
What 2024 dropped: diseases. The 2024 version doesn't mention disease at all, and the 2024 SRD handles the old disease monsters (otyugh, death dog) with the Poisoned condition.
Periapt of Health: 2014 vs 2024
2014 (SRD 5.1)
2024 (SRD 5.2.1)
Rarity
Uncommon
Uncommon
Attunement
No
Required
Disease
Immune to contracting; existing diseases suppressed
Not mentioned
Healing
None
Magic action: 2d4 + 2 HP, once per dawn
Poisoned condition
Nothing
Advantage on saves to avoid or end it
Value
No price in the SRD
400 GP (uncommon)
What this means at the table: if your group mixes 2014 and 2024 books, decide which periapt you're using before the party finds it. They're different items with the same name. The 2024 version is more often useful, since Poisoned turns up in many more stat blocks than disease does, but it costs an attunement slot the 2014 version never did.
Is the Periapt of Health Worth It?
In 2014: yes, for someone. No attunement means it costs nothing to wear. It only matters in a campaign with disease (a plague city, sewers, an otyugh lair), and there it removes the threat outright for the wearer. A Paladin (Divine Health at level 3) or Monk (Purity of Body at level 10) is already immune and should give it to someone else.
In 2024: usually not, unless you have a spare attunement slot. Compare it with other attunement items that cover the same ground:
Immunity to the Poisoned condition and Poison damage
The cloak helps every round of every fight. The periapt helps once a day, plus a handful of Poisoned saves. It's a better pick for a character with a weak Constitution save who keeps getting poisoned, such as a wizard facing a chuul, or for a party with no healer, where a free 7 HP every morning adds up.
Periapt of Health for DMs
Placement. In 2014, put it where disease is a threat: a plague-hit town's physician, a sewer shrine, an otyugh's hoard. In 2024, anywhere you'd put a minor healing item.
What it changes. In 2014, it removes disease as a threat for one character, so make sure an outbreak plot still has stakes for the rest of the party. In 2024, it barely changes encounter balance: one extra healing potion's worth per day.
Pricing. The 2024 SRD values uncommon items at 400 GP. The 2014 SRD prints no prices; any 2014 figure comes from the Dungeon Master's Guide, not the SRD. The magic item rarity calculator and the uncommon item list help you place it.
Hooks.
•A village healer wears a Periapt of Health and has treated every plague victim without catching it. Now the healer is missing, and so is the periapt.
•A merchant sells "periapts" that are cut glass. The real one is in the bottom of the crate, and the merchant doesn't know which.
•A sewer cult guards a Periapt of Health as a holy relic. Their leader is the only one who's never fallen sick.
Who's carrying the periapt, and whether it's been used today, is easy to forget. Loreify records the session and keeps the recap.
Frequently Asked Questions
Does the Periapt of Health require attunement?
In 2014, no. In 2024, yes. The 2024 version is a different item that needs one of your three attunement slots.
What does the Periapt of Health do in 2024?
Once per dawn, you take a Magic action to regain 2d4 + 2 Hit Points. You also have Advantage on saving throws to avoid or end the Poisoned condition while wearing it. The 2024 version doesn't mention disease.
Does the Periapt of Health cure disease?
No. The 2014 version prevents new diseases and suppresses existing ones while you wear it; take it off and the disease returns. In 2014, the Lesser Restoration spell ends a disease.
Does the 2024 Periapt of Health heal like a Potion of Healing?
It restores the same amount, 2d4 + 2, but it costs a Magic action instead of a potion's Bonus Action, and you can use it once per dawn.
How much is a Periapt of Health worth?
400 GP under the 2024 SRD, the value of any uncommon item. The 2014 SRD gives no prices.
Item text: System Reference Document 5.1 (2014) and 5.2.1 (2024), Wizards of the Coast, CC-BY-4.0. Analysis, rulings and ideas are Loreify's own.
This page includes material from the System Reference Document 5.1 and 5.2.1 by Wizards of the Coast LLC, available under the Creative Commons Attribution 4.0 International License. Loreify is not affiliated with Wizards of the Coast.