From the introduction: Unlike most RPGs where your characters will become more fearsome and heroic as they progress, in the Altered World, your character will slowly become riddled with hideous mutations. This is a post-apocalyptic RPG system where death may be nobler fate... Featuring 36 mutations, character generation, stats for familiars, and all the other necessary rules, the Altered World rules pamphlet is all you will ever need when exploring the twisted tracts of these accursed lands.