Darkest Dungeon II – The Plague Doctor Guide (Mastering Tokens, Skills, and Strategies)

Journey into the realm of nightmares as you delve into the secrets of the enigmatic Plague Doctor. Unveil the arcane knowledge that lies within this guide, whispered by ancient tomes and imbued with the otherworldly essence of cosmic horrors.

Guide to the Plague Doctor


Within these eldritch pages, you will discover the intricacies of the Plague Doctor’s skills, trinkets, and hero paths. Unleash devastating attacks infused with the power of blight and burn, manipulate tokens to control the battlefield, and unravel the mysteries of the Plague Doctor’s unique abilities. Dive deep into the unfathomable depths of combat strategies as you learn to exploit weaknesses and harness the dark forces that course through the veins of this enigmatic hero.


The Plague Doctor excels in applying damage-over-time effects, healing, and removing negative tokens. They have the ability to attack any rank and provide support to allies. However, they have low HP and lack defense, making them vulnerable to direct damage. The Plague Doctor is effective as a healer, support character, and damage dealer. In addition, they can apply and remove various tokens to control the battlefield.

Combat Skills

Tier S

  • Noxious Blast: Ranged attack that deals damage and inflicts blight on the target. Increased blight resistance piercing when the target has a combo token, making it highly effective in most situations.

Tier A

  • Blinding Gas: Ranged attack that applies blind and combo tokens on enemies, providing crowd control and damage amplification. With its crowd control and damage amplification through the application of blind and combo tokens, Blinding Gas proves to be a valuable skill.
  • Incision: Melee attack that deals damage and inflicts bleed on the target. Increased bleed resistance piercing when the target has a combo token. The ability to deal damage and inflict bleed, along with increased bleed resistance piercing against enemies with a combo token, places Incision in this tier.
  • Battlefield Medicine: Ability to heal and remove bleed, blight, and burn tokens from self or allies. Healing, removing negative tokens, and granting a 20-25% heal, Battlefield Medicine a versatile support skill.
  • Ounce of Prevention: Buff ability that increases resistance to bleed, blight, burn, and disease tokens. Provides additional strength and speed tokens making it highly beneficial.

Tier B

  • Plague Grenade: Ranged attack that damages enemies and inflicts blight in an area. Can clear corpses. Solid.
  • Emboldening Vapours: Buff ability that grants strength and speed tokens to self. Synergizes well with other abilities. Emboldening Vapours proves to be a valuable buff ability.

Tier C

  • Disorienting Blast: Ranged attack that shuffles enemy positions, applies daze and weak tokens, and stuns the target if they have a combo token.
  • Indiscriminate Science: Ability to heal and remove positive tokens from self or allies. The amount healed increases based on positive and negative tokens removed. The effectiveness of this skill varies depending on the presence of positive and negative tokens.

Tier D

  • Cause of Death: Melee attack that deals damage based on remaining bleed, blight, and burn tokens on the target. Removes those tokens as well. This melee attack’s effectiveness relies heavily on the presence of specific tokens on the target, making it situational.
  • Magnesium Rain: Ranged attack that damages enemies and inflicts burn. Can clear corpses. Its placement in this tier reflects its lower overall impact compared to other skills.

Tier F

  • Act-Out Attack: A chance for a team-up attack in response to an ally getting attacked or as a team-up attack with a respectful ally. The situational nature of this skill places it in this tier.

Hero Paths

The Plague Doctor has three unique paths:

  1. Surgeon: This path focuses on maximizing max HP and damage, which are crucial for dealing significant damage to enemies and surviving tough encounters. Sacrificing blight chance may limit some utility, but the emphasis on damage output makes it a strong choice.
  2. Alchemist: The Alchemist path enhances blight chance and resistance, providing valuable control over enemies through the infliction of blight. Additionally, the increased stun resistance and debuff resistance offer added survivability and flexibility in combat.
  3. Physician: Physician: While the Physician path provides a mix of increased max HP, damage, and healing potential, the reduced blight chance places it lower in the ranking. Blight is a key aspect of the Plague Doctor’s arsenal, and having a reduced chance to inflict it limits their effectiveness in certain scenarios.

Unique Trinkets

Annotated Textbook

Description: Melee Skills: +10% CRIT, If Medicinal Herbs is Equipped: +50% Healing Given, Turn Start: If First in Turn Order: Dazed

The Annotated Textbook is the best trinket for the Plague Doctor due to its increased CRIT chance and bonus healing when equipped with Medicinal Herbs. The downside of applying the Dazed is relatively minor. It aligns with the Surgeon path’s focus on maximizing damage and survival.

Early Experiment

Description: If Noxious Item is Equipped: +2 Blight Dealt, Apply on Hit Disorienting Blast Skill: Blight 2 (50%), Incision Skill: -100% Bleed Dealt

The Early Experiment trinket provides increased Blight damage and a chance to apply Blight with Disorienting Blast. The reduced Bleed damage on Incision is a downside, but it can be managed. It synergizes well with the Alchemist path’s emphasis on enhancing blight chance and control over enemies.

Storage Room Key

Description: Target: Ounce of Prevention Skill: Block, Target: Emboldening Vapours Skill: Regen 2, Battlefield Medicine Skill: -50% Healing Given

The Storage Room Key allows the Plague Doctor to apply the Block and Regen 2 with specific skills. However, the downside of reduced Healing Given with Battlefield Medicine should be considered. The increased healing and survivability align with the Physician path’s focus on increased max HP, and healing potential.

General Trinkets

S Tier

  • Clarifying Carcanet: Provides a significant boost to survival and offensive capabilities.
  • Shimmering Crown: Offers vital healing at the start of combat.

A Tier

  • Sacrificial Host: Provides valuable resistance against blight, a common and dangerous status effect.
  • Sparkleball: Applies various negative token status effects on hit, providing crowd control options.
  • Celebrated Chalice: Enhances offensive and defensive aspects with increased speed and critical hit chance.
  • Befuddling Sundial: Offers healing and a risk-reward dynamic with horror effects.
  • Pulsing Heart: Provides regenerating health or applies a bleed token status effect at the start of each turn.

B Tier

  • Obsidian Dronepipe: Offers a chance to stun an enemy at the start of their turn.
  • Guarding Gauntlet: Provides a chance to gain block at the start of your turn, with a potential weak debuff when hit.
  • Bouncer’s Belt: Increases healing received, but comes with a reduction in move resist.
  • Fate’s Forteller: Provides a chance to gain a critical token at the start of combat.
  • Skeleton’s Sight: Grants a guaranteed critical token at the start of your turn.
  • Bulwark Band: Provides a chance to gain a dodge token at the start of combat, but also a chance to gain a blind debuff when hit.
  • Buttressing Band: Offers a chance to gain a dodge token at the start of your turn.
  • Thrilling Tablet: Grants a speed token at the start of combat.
  • Proxy Doll: Increases damage dealt for each positive token but increases damage received for each negative token.
  • Faceless Visage: Shuffles enemy positions at the start of combat.
  • Curing Cuppa: Chance to apply blight and blight resistance if HP is over 75%.
  • Kitchen Knives: Provides benefits on a critical hit and against enemies with blight.
  • Ghastly Gruel: Triggers healing effect 33% of the time.
  • Hag’s Hoard: Offers a scaling boost to healing received based on positive tokens, but reduces maximum health if diseased.
  • Unwavering Standard: Provides block tokens to allies at combat start.

C Tier

  • Anchoring Charm: Provides a minor benefit of increased move and stun resistance.
  • Skeleton’s Sight: Applies a critical token at the start of your turn.
  • Buttressing Band: Applies a dodge token at the start of your turn.
  • Bulwark Band: Provides a chance to gain a dodge token at the start of combat and a chance to apply a blind token when hit.


The Plague Doctor’s ability to manipulate tokens allows them to control the battlefield by providing buffs to allies, debuffing enemies, and removing negative effects from themselves and their team. It is important to strategize and make the most of these token interactions to maximize the Plague Doctor’s effectiveness in combat.

Self and Allies

  • Strength 2: Grant strength tokens, increasing damage dealt.
  • Speed: Grant speed tokens, increasing initiative and turn order.
  • Positive Tokens: Remove all positive tokens from themselves and allies, cleansing any beneficial effects.


  • Blind: Apply blind tokens to enemies, reducing their accuracy.
  • Weak: Apply weak tokens to enemies, reducing their damage output.
  • Daze: Apply daze tokens to enemies, limiting their actions.
  • Stun: Apply stun tokens to enemies, temporarily incapacitating them.
  • Combo: Apply combo tokens to enemies, which synergize with certain skills and increase the effectiveness of other abilities.


The Plague Doctor has different resistances to various effects:

  • Strong (40% or higher): High resistance to blight, burn, and disease.
  • Average (30%): Average resistance to bleed.
  • Weak (20% or lower): Weak resistance to stun, move, debuff, and buff tokens.


So, adventurer of the darkest depths, heed the guide’s arcane whispers and tread cautiously upon the treacherous path. Unleash the Plague Doctor’s arsenal of affliction and redemption, for within lies the power to shift the balance of light and shadow. May your journeys through the harrowing realms be illuminated by the guide’s forbidden illumination, and may you emerge, bloodied but triumphant.

Egor Opleuha
About Egor Opleuha 6891 Articles
Egor Opleuha, also known as Juzzzie, is the Editor-in-Chief of Gameplay Tips. He is a writer with more than 12 years of experience in writing and editing online content. His favorite game was and still is the third part of the legendary Heroes of Might and Magic saga. He prefers to spend all his free time playing retro games and new indie games.

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