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Maddening Strike (Combat)

Source Horror Adventures pg. 90
Your fists are weapons of mind-devouring madness.Q

Prerequisites: Wis 17, Cha 13, Improved Unarmed Strike, Maddening Style†, Stunning Fist, Knowledge (arcana) 8 ranks, ki pool class feature, nongood alignment.

Benefit: As a swift action, you can spend 1 point from your ki pool to imbue the next unarmed strike you make on this turn with the maddening power of the spaces between the stars. If that attack doesn’t hit, you take 2 points of Wisdom damage. If the attack hits, your opponent takes damage from your unarmed strike + 1d4+1 points of Wisdom damage. A successful Will save (DC = 10 + 1/2 your character level + your Wisdom modifier) reduces this to 2 points of Wisdom damage.

Special: If you are using the sanity system (page 12), when you miss with a Maddening Strike, you take 4 points of sanity damage. If you hit, the target takes damage from the unarmed strike plus 8 points of sanity damage (or 4 points of sanity damage on a successful Will save).