Darkest Dungeon – A Plague Doctor Guide

“A doctor, researcher and alchemist who prefers to hang back, eating away at her foes with stacking damage-over-time abilities like toxic clouds & plague-filled grenades. She is equally effective in a support role, blinding and confusing foes while enhancing a party’s survival with damage-increasing tonics, and remedies for bleed and blight effects.” – Guild

October 28, 2019

A blight (get it?) upon the backline of your foes, the Plague Doctor is a great disrupter and support class that will consistently be of in use in most formations. Probably one of her best features is her access to blight, bleed and stun and she is especially effective at shutting down the backline stress dealers.

Alongside her curative ‘Battlefield Medicine’, you will always feel more secure and supported with her on your squad.

She combines crowd control and ally support; as a result, she will rely on a heavy-hitting frontline but in turn, she will keep them safe from the enemy and soften them up for the killing blows.

Like every character she has her weaknesses and different build options, so we have studied and tested the Crow Girl to help you get the most out of her fumes and medicines.

Character Overview

“Intent on remaining as far from melee combat as possible. From a distance she lobs toxic sachets that can blind, disorient, and eat away at her foes.” – The Blacksmith

Let us start with an overview of her strength’s and weaknesses, so you know how to compliment her in any formation:


  • Bleed/Blight Cure
  • Damage over time potential is high
  • Can reliably target and disrupt backline
  • Stun and reposition reliability
  • Fast


  • Low health
  • Restricted positions in formation
Both her weaknesses are tied to where she will sit in your formations – right on the backline. If she is pulled out of position, then she is not only in danger of being squished by enemy front-liners but she also unlikely to be of any use, due to the positional requirements of her abilities.

To keep her safe and useful, always use a turn to switch her back to the backline if your formations have been disrupted and she will be able to keep up her DoT and team buffs safely.

With that said let us examine each ability in turn before moving into strategies.


Noxious Blast

• Ranged
• Rank 4,3 or 2
• Targets 1 or 2
• Damage -80%
• Accuracy 95
• Critical mod 5%
• Blight damage of 5pts per turn for 3 turns

Noxious Blast is the single target counterpart to Plague Grenade in Doc’s blight arsenal, allowing her to assist your frontlines by whittling away at Rank 1 and 2 tanks with reliable blight damage. Also, unlike Plague Grenade, you have a crit modifier for a chance at some stress relief.

Plague Grenade

• Ranged
• Rank 4 or 3
• Targets both Rank 4 and 3
• Damage -90%
• Accuracy 95
• Crit Mod 0%
• Blight damage of 4pts per turn for 3 turns (both targets)

More likely to be an auto-include than noxious blast by virtue of its multi-target and backline utility. Keeps the stress dealers of your foes constantly under threat while your frontline hacks down the front. The economy of turns provided by the multi hit means you can quickly turn your attention to the front lines, healing your team or stunning and disrupting the lines.

Disorientating Blast

• Ranged
• Rank 4, 3 or 2
• Targets Rank 2, 3 or 4
• Damage -100%
• Accuracy 95
• Shuffle (100% base) & Stun (100% base)

The single target component of Doc’s stun capabilities that has the chance of shuffle to boot, as well as being able to target Rank 2. The potential for completely nullifying threats with DB is very high; you can stun and shuffle a Rank 2 to the bank, rendering them useless whilst bringing a stress dealer into the rank of your front ranks.

Blinding Gas

• Ranged
• Rank 4 or 3
• Targets both Rank 4 and 3
• Damage -100%
• Accuracy 95
• Stun (100% base) on both targets
• 3 uses per battle

The ultimate backline disrupter that gives you the chance to completely shut down the back-line stress dealer, while your front ranks smash their way within range. It misses the shuffle ability of DB but the multi-rank hit stun is invaluable and useful in almost every formation.


• Melee
• Rank 3, 2 or 1
• Targets both Rank 1 or 2
• Damage +0%
• Accuracy 85
• Crit modifier 5%
• Bleed (100% base) 2pts per round for 3 rounds

Incision is Doc’s only melee that is often overlooked but having access to a ‘bleed’ proc just increases her utility. Combined with the ‘Bloody Herb’ trinket increases the base damage, accuracy and the bleed chance, making the proc almost certain and giving it some decent base damage to boot.

Battlefield Medicine

• Rank 4 or 3
• Target ally; any position
• Single target
• Heal 1-1 pts
• Effect: Cure Blight/Bleed

Ironically the only curative function that Doc performs, but it is a powerful one that should always be a part of her build. The usefulness of curing blight and bleed will always be useful and removes any need to waste money on supplies.

Emboldening Vapours

• Rank any
• Target ally; any position
• Effect; +20% DMG (1 battle) and +3 Speed (1 battle)
• 2 uses per battle

A solid support ability that will be a cornerstone of a pure support build, boosting speed and damage by a decent amount. Couple with a Hellion or a Crusader and you are laughing.

Strategy and Synergy

“What better laboratory than the blood-soaked battlefield” – The Ancestor

Every single one of Doc’s abilities are useful in certain situations which means she can be built to either be an all-rounder or a specialised support, disrupter or melter. With incision she also has access to bleed and sitting in position 3 will allow her to proc most ranks with bleed or blight.

She is the ultimate antidote to enemies with high PROT, who are damage soaks for your frontline; Incision and Noxious Gas give you the option to target those heavy tanks and waste them away, saving precious turns.

No matter the option it is usually advisable to bring ‘Battlefield Medicine’ because no matter the build, the ability to nullify proc damage is priceless.

When it comes to team synergy, Doc is useful in any makeup – given the universal application of stun, bleed or proc she can be tweaked for any region, boss or situation. There are a few heroes she specialises very well with, such as the Occultist. Her Battlefield Medicine synergises well with Wyrd Reconstruction, because you essentially negate the risk of bleed that comes with this powerful heal.

Her ability to target the back line means you can stack up your frontline with tanks, like the Crusader and Leper, and not worry about their lack of options for hitting ranks 3 and 4. While they whittle down the enemy front liner, Doc can shut down and/or melt the back line.

Not only can she shut down the backline with Blinding Gas or melt it with Plague Grenade, she can also open and disrupt enemy ranks with Disorientating Blast. This could have the effect of bringing squishier stress dealers into the range of a crusader sword and nullify enemy front liners.

Ultimately, she should be used to deal with the back line, whilst also curing your team and if required wasting away especially resilient front-liners. To illustrate some of the potential havoc she can wreak, we have two potential builds for you to try out that are useful in many situations and will augment any team with disruption, DoT and cures.



Build 1: Doctor Tox

Doctor Tox is about wasting the backline, whilst opening and clearing the way for your stiffer front ranks.

The skills used for Doctor Tox are; Battlefield Medicine, Plague Grenade, Noxious Blast and Disorientating Blast.

Suggested Trinkets: Poisoned Herb (+40% Blight chance & -15 MAX HP)

Doctor Tox should open most fights with a Plague Grenade to start that DoT on the backline as soon as possible, afterwards she can think about disrupting the party with a disorientating blast, stunning and reshuffling as needed. Then she should consider if anyone in the party needs healing or if a frontline tank deserves a DoT with Noxious Blast.

Watch the clip below to see how this is applied perfectly, as she wastes the backline away, disrupts and heals the front-line leper:

In the video we see how Doc Blights several enemies to death, clears corpses with that same proc and moves a stress dealer up the field and exposing it.

Doctor Tox is just a suggested build, however you will find it applicable in most situations for melting the enemy with your DoT’.

Build 2: Doctor Support

Doc Support is completely focused in buffing and curing allies while keeping your party safe by keeping the enemy stunned. Her roles combine that of support and crowd control, nullifying the enemy and assisting her allies.

The skills used for Doc Support are: Battlefield Medicine, Emboldening Vapours, Blinding Gas and Disorientating Blast.

Suggested Trinkets: Witches Vial (+15% stun chance) or Blasphemous Vial (+10 ACC ranged skills, +20% Stun chance, +20% Blight chance and +25% Stress)

Ideally the Doc Support would spend her first turn blasting the back line with a Blinding Gas, followed by an Emboldening Vapours to speed up the pace at which your frontline cuts through. The Doc’s role would be to cure when necessary and keep the backline locked down and disrupt with Disorientating Blast as needed.


So, there you have it, our guide to the ultimate disrupter and lady of blight – the Plague Doctor. We hope our guide has inspired you to try her out for yourself, giving your teams a much-needed access to bleed, plague and stun. Don’t waste your time with damage soaks, let her burn their health down over time and watch them melt away.

Darkest Dungeon

RPG/Dungeon Crawler/Roguelike

Geoff SmoughTown

Geoff SmoughTown


My grandfather was a man way ahead of his generation, owning his first PC in the early ’90s. When I and my sister came to visit he would fire up ‘Rabbit Reader 2’, and I was transported to the world of ‘Wordsville’. Since then my tastes have developed finding myself attached to Lore rich games; the Souls series, Dead Space and any RPG with a good story. For me, Games can be forms of art to be dissected, analyzed and appreciated.



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