I couldn't resist the Andy Summers reference for this piece. I'm sure it will all make sense once you have recovered from Police-related nostalgia and read the latest dispatch from my dungeon.
I wanted to bring back that hint of Lovecraft that appeared fairly  regularly in 1st Edition Advanced Dungeons & Dragons and fit so well  with the elements of the game's pulp fantasy appeal. Beyond the slimy  and tentacled horrors such as mindflayers, beholders, and aboleths,  players got to glimpse at the Elder Ones in any number of ruined (or  active and secret) temples and cults. A step further, we find gods like  Tharizdun (god of entropy and madness) and god-like elemental powers  playing well with the sphere of alien intelligences bent on spreading  destruction in the world. Pictured right is the cover to The Temple of Elemental Evil, the classic mixing of eldritch, elemental, and fiendish creepiness.
It's certainly easy enough to place those elements in a regular  dungeon-delving setting. On the group's first outing they took a  medallion shaped like a mindflayer head from leader of hobgoblin  mercenaries, so from the start they know that they face a faction of  horrific overlords and probably a mixed of sneaky and/or crazed  cultists. In time, they learn of an as yet-explored abandoned(?) temple  in the wilderness. Even better, they begin to piece together a  cult-driven conspiracy within the safety of the adventuring base, a  human/dwarven mountain enclave.
When it came time to expose the secret horrors playing in the lowest  levels of the town's ancient catacombs (built by dwarves and elemental  beings), I had to make it memorable without being too overpowering for a  low-level group. I re-purposed some game mechanics for traps and  monster powers and did some cosmetic things that gave the adventure more  personality. 
I reasoned that the corrupting influence of evil and alien powers could  certainly transform the faithful into sentient undead, so I used ghouls  as the local cult leaders. I thought about beefing the head honcho up as  a cleric, but I settled on letting him be a ghast (a ghoul with the  advanced template in the Pathfinder RPG) and substituted a cleric's  channel energy power for the normal stench ability. Instead of using two  claw attacks for these monsters, I had them used curvy, sacrificial  swords (short swords) instead - the damage was the same, but the image  made for a better fit. Once these creeps put on silver fish-faced masks  and some robes, they weren't just any old ghouls - they were devotees of  the Old Ones.
Their minions were simple skeletons as far as game mechanics go.  However, I determined that the skeletons were sentient - not because  they needed to do anything complicated, but because the players needed  to get an understanding of the madness and hate that drove them.  Furthermore, the skeletons were the remnants of skum (an aberrant race  of fishlike humanoids created by eldritch horrors long ago). These guys were dancing around a large black marble altar when the adventurers arrived. Yeah - I did fudge here - I really didn't want to beef up the skeletons to match Skum stats, but they were no less a challenge for all that. Like the ghouls, they gave the encounter the feel and power level it needed - both were memorable to the players. 
Lastly, the ghouls were served by zombie slaves - human and dwarven  victims of the cult. They were definitely playing the animated servant  role as defined by the game, but I did have them provide a disturbing  chorus as part of a summoning ritual the party intruded upon.
In the next post, I'll talk a little bit more about the elemental elements of the game.

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