The risk of injury and death always hangs over the heads of the Garou as they fight their enemies. To measure injury, the game uses a system of Health Levels and Damage.

Health Levels

Your character has special Traits called Health Levels that represent your physical well-being. When your character gets hurt, you mark off these Traits. When you have no more Traits to mark off, death is on your doorstep.

An ordinary character has these Health Levels:

OO     Healthy x2

OOO   Bruised x3 (-1 on ties)

OO     Wounded x2 (lose on ties)

O        Incapacitated (out 10 min.)

O        Mortally Wounded

An undamaged character is Healthy. Whenever something damages you, mark off these Traits from top to bottom (first all the Healthy Traits, then all the Bruised, etc.). As your body accumulates damage, you begin to suffer penalties.

Additional Health Levels

You can add to the basic health levels listed above through various means when you build your werewolf, such as by joining the Get of Fenris tribe or taking the Merit Huge Size. There are Gifts that give you additional "Healthy" levels, but multiple uses of such Gifts do not stack -- apply only the best result. Similarly, physical armor and Gifts that provide levels of armor can provide protection, but these do not stack with one another either.

Damage

Damage to the body comes in three different flavors, depending on how it is delivered:

• Bashing damage comes from blunt attacks at relatively low speeds, like punches, kicks, and clubs. Draw a slash through a dot to mark off a Health Level lost to Bashing damage.
• Lethal damage comes from vicious attacks, easily capable of rupturing the body and spilling blood, like knives, bullets, and car collisions. Mark an X through the dot to indicate a Health Level lost to Lethal damage.
• Aggravated damage comes from powers of supernatural intensity like werewolf claws, vampire teeth, and black magic. Mundane sources that utterly disintegrate flesh -- fire, acid,and wood-chippers, for example -- also deal Aggravated damage. Fill in the dot to represent a Health Level lost to Aggravated damage.

Sources of damage may deal multiple levels of damage at once. A typical gun fires bullets that deal two levels of Lethal damage, for example; being hit, you'd mark off your next two Health Level Traits using X's.

Common Sources of Damage

• Unarmed attacks do one Bashing Damage.
• The teeth and claws of ordinary wolves and Lupus do one Lethal damage. Teeth and claws of Crinos and Hispo do two Aggravated damage.
• Blunt weapons do varying amounts of Bashing Damage; edged weapons typically do one or two Lethal.
• Guns typically do two levels of Lethal damage.
• Silver does Aggravated damage against Werewolves in many circumstances.
• Fire does Aggravated damage against just about everything.
• Falling and drowning and the like are never fun either. Such environmental hazards have their own rules.

Humans and Damage

Those whose biology is merely human (including Kinfolk) can't take the punishment that Garou can. In the first place, they cannot bid Stamina-related Traits to "soak" Lethal or Aggravated damage. When humans get hurt by a source dealing Lethal damage, they take one additional level of Lethal damage. When they get hurt by a source dealing Aggravated damage, they take two additional levels of Aggravated damage. (If a source deals multiple types of damage, apply only the worst of these increases.)

When hurt by lethal or Aggravated damage, a human must immediately win or tie a simple test. If they lose after taking Lethal damage, they are staggered and unable to act for one round. If they lose after taking Aggravated damage, they enter shock and cannot act for the rest of the scene.

Wound Penalties

When you mark off a Health Level, you take on the Wound Penalties for that Health Level:

• Healthy: When you mark off a Healthy Trait, you're still feeling okay -- the bullet just grazed you or you took a glancing blow from the club. Maybe it stings or aches, but it's nothing you can't ignore.
• Bruised: When you mark off a Bruised Trait, ignoring the pain has become difficult. You are one Trait down in all challenges (you must declare one less than you have when comparing totals).
• Wounded: When you mark off a Wounded Trait, you've become seriously maimed -- your mind and body just are not functioning properly. You lose all ties outright in Challenges -- you don't even compare Traits. (Unless both you and your opponent are losing all ties; then you compare as normal).
• Incapacitated: When you mark off your Incapacitated Trait, you fall unconscious for ten minutes. (Werewolves who fall unconscious automatically revert to their Breed form). During that time and even after you wake up, you lose all Challenges automatically. Unless you receive supernatural healing within three rounds of the end of the fight, your wound will earn you a Battle Scar.
• Mortally Wounded: When you mark off this Trait, you are not only unconscious, you're dying.
• If you have Bashing Damage on your sheet, you may upgrade those Traits to Lethal damage before you have to mark off your Mortally Wounded Trait.
• Stop marking off Health Levels once you reach Mortally Wounded. You can't "go negative." 
• An enemy may take an action to deal you a deathblow. You get no challenge to resist, so hopefully you have a friend close by to interfere. If the enemy is successful, you die.
• Once at Mortally wounded and if you are unable to Rage Heal, or choose not to, you have one round to be healed or death occurs.
• In the event of death, you may spend a Willpower to craft an exciting death for your character with the Storyteller. This can allow you to do something cool rather then then simply fade. It could allow you to affect the scene and make a difference as you die. It can allow you at the end of the scene to give your farewell speech as you lay dying. You get the idea.
• If you survive after having crossed off your Mortally Wounded health level, you must gain a Battle Scar when the fight ends. (Disregard the rules for a battle scar from Incapacitated health levels in this case.)

Avoiding Wound Penalties

You have some recourse to escape the side effects of a damaged body:

• Willpower: Spend a point of Willpower to ignore the effect of your Wound Penalties for the rest of the current combat round. 
• Rage-Healing: When you fall to the Incapacitated Health Level or worse, you may choose to "Rage-Heal," which keeps you conscious and in the fight. Spend one Rage and a Stamina related trait, and heal up to and including your Bruised levels. Once the health levels are healed, first test for a Battle Scar. This is a straight up and down chop, not comparing traits. On a win, you gain a superficial battle scar. On a tie, gain a minor Battle Scar. On a lose, gain a major Battle Scar. Then test for Berserk Frenzy You can continue to do this as long as you have a Rage trait and a Stamina trait to spend. 

Healing 

Healing takes time or supernatural power. When you heal damage, the most severe Health Levels recover before the less-severe ones. Incapacitated heals before Wounded, which heals before Bruised, which heals before Healthy.

Werewolves heal quickly. A Homid Garou in their human shape or a Lupus Garou in their wolf shape are considered to be in their "natural," Breed forms. These forms heal even Aggravated damage at the slow but still-remarkable pace of one Health Level per day.

In combat, a werewolf can also "Rage Heal" once they reach incapacitated. 

• Rage-Healing: When you fall to the Incapacitated Health Level or worse, you may choose to "Rage-Heal," which keeps you conscious and in the fight. Spend one Rage and a Stamina related trait to heal through your Bruised levels. Once the health levels are healed, first test for a Battle Scar. On a win, you gain a superficial battle scar. On a tie, gain a minor Battle Scar. On a lose, gain a major Battle Scar. Then test for Berserk Frenzy. You are limited to 2 Rage-Heals per scene and face almost certain death if you drop to Incapacitated or worse after exhausting your Rage-Heal.

When a Garou shifts out of their Breed Form, the truly supernatural healing powers of their bodies kick into gear. And these regenerative powers are always active for Metis Garou, no matter their shape. In such a state, Garou heal Bashing and Lethal damage at the rate of one level per round (about six seconds). Aggravated Damage still takes a full day to heal, though.

Kinfolk characters, being merely human, are not so robust. They heal at normal human rates, which are extraordinarily slow. Speak to a Storyteller about your Kinfolk character's injuries.

Some Gifts (most famously those of the Theurges and Children of Gaia) have the power to grant supernatural healing, easily repairing even Aggravated wounds.

Battle Scars

Some wounds won't heal: these are represented by Battle Scars. You usually get the Health Levels back, but you may suffer some other long-term side effects.

Armor Hierarchy 

You are allowed 3 types of armor and this is the order the armor levels are utilized when taking damage.

• Barrier (like a shield bubble around your person, first to take damage)
• Clothing (Bullet proof vest, padded armor, plate mail)
• Skin (Anything that adds health levels to your body)