ELDEN RING: Shadow of the Erdtree - Plague Doctor / Profane Alchemist Build

Quick Guide to Plague Doctor / Profane Alchemist Build

The DLC has finally allowed me to really hone in on this dream build design I’ve been mulling about for (honestly) a year so this has been absorbing all of my time for a looooong time. I feel like this theme build is finally ready to share.

Focus on arcane and make all the weapons occult firstly. This is an item-assisted build so having high arcane helps you find more rare materials more consistently. Arcane also allows you to focus on all the fun status effects (bleed, rot, poison, sleep). Secondary focus generally leans towards dexterity, as a few damaging items scale off of dexterity. There are also fun ones which scale off of int and faith so that choice may also be up to you depending on “how” you want your alchemist’s backstory to fit. Glintstone consumable focus would assume a Carian background. Lighting would assume a background from Leyndell. Etc etc.

When designing this theme build, I didn’t want to have something “out of character” for a profane alchemist, so all of the weapons are of the DAGGER category. It might be assumed that this is a weakness, I assure it is not.

Primary Hand:

Main Gauche (Parry); A solid damage and defense tool rolled into one which can provide a layer of protection for the off-hand items. I think the parry frames are also better on the Main Gauche than the Parrying Dagger.
Wakizashi (Bloody Slash); One of the primary damage-dealing sources for chunks of burst damage and occult scaling gives good damage AR + bleed buildup.
Great Knife (The Poison Flower Blooms Twice) or (Poison Moth Flight); This one is also a must because you’re going to want extra bang for applying a super easy status debuff. Personally I use Poison Flower, but if you think it breaks character Poison Moth also exists and both are functionally the same.

Off-Hand:

Smithscript Daggers (Blood Tax); offhand range and pressure item which can be primaried for a health-stealing effect to help feed Bloody Slash. I like to think of it as the alchemist collecting blood, treating it in some manner, then using it as a weapon. Occult infusion does decent damage too.
Deadly Poison Perfume Bottle; A staple weapon. Applies deadly poison as easily as the next item but close range.
Serpent Bow; One of the only ways to get more bang for your buck for each of the arrows you’re going to craft. With a high enough arcane slot, a single Mighty Shot with a sleep arrow causes instant sleep on most enemies with a headshot. Thiollier has shown me that sleep is also a form of poison. Yay status.

Armor Set:

Mask of Confidence
Shadow Militiaman Armor
Leather Gloves
War Surgeon Pants

I wanted the set to look how it feels: Elden Ring’s version of a plague doctor. A mix of profane items which also mask the appearance, are sleek and stealthy, as well as all fitting in color scheme.

Talismans:

Greatshield (Leather is oddly squishy in this game)
Companion Jar
Kindred of Rot Exultation
Shard of Alexander

You can mix these up a bit in case your alchemist uses more perfume items. Honestly, you’re going to get a lot of mileage out of Kindred of Rot alone. Shard of Alexander makes Bloody Slash and Poison Flower 2x hit super hard.

Items of Interest / Items You’ll Use a Lot:

Boiled Crab/Pickled Liver – Defensive Consumables
Exalted Flesh – Offensive Consumable
Dried/Pickled Turtle Neck – Stamina Buff
Uplifting Aromatic/Golden Vow (item) – Aura-based damage buff
Freezing Pots – Source of Frostbite status (applies very quickly)
Fletched Sleep Arrow – Applies hilarious levels of sleep with Serpent Bow
Serpent Arrow – Almost guaranteed to instantly Deadly Poison any enemy with Mighty Shot on Serpent Bow
Hefty Fly Pot – Ludicrous AOE bleeding
Hefty Rot Pot – nigh-instantaneous rot

This build is a mechanically complex theme build. I like it, at least, and it treats me well. Plan your encounters.

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