Insults & Injuries is one of those rare 3.5 supplements that, instead of adding outlandish one-off mechanics to the game, actually makes a game world feel more like a living, breathing world. Disease is a major part of our daily lives, it's in the news, and I'm currently getting over a head cold. Yet its a vastly under-developed concept in most fantasy games.
I like to run a down-to-earth, nitty gritty game. My player characters aren't super heroes, and I really like for them to feel vulnerable to the world around them. Disease and injury are one of those things that I've always wished I could do more with. Any athlete, be they recreational amateur or full blown professional knows how hard it can be to perform at their best when feeling under the weather, and to me a well trained fighter should be no different. Players that run around with un-healed hit points just because they feel they are at an arbitrary "safe" threshold are essentially running around with open wounds. I've had splinters turn into nasty infections, I can't imagine what would happen to some of the gaping wounds my players have run around with for extended periods in a dungeon environment.
Insults & Injuries handles injuries and diseases of all sorts, and it's pretty clear that it is being written from the perspective of a practicing medical doctor - which is a pretty cool perspective in a book like this. The descriptions avoid being dry or over technical, and they do a good job of making the content relevant to a fantasy game - the real life medical anecdotes are a nice touch too. The book covers so many types of disease that it would be tough to give my opinion on all of them in this review, but suffice it to say the book is very thorough.
All in all it's very easy to recommend this book, it's well written, the content is intelligent, and the material is useful in almost all fantasy settings and situations.