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Similar to the more well-known Hand and Eye of Vecna, the Skinflute requires ritual amputation to access its eldritch magical powers. Provided that the amputee survives the six-hours required to perform the arcane stitchworking and solemn occult fondling, he or she will be able to access the true power found within these new and darkly radiant man-parts by moonrise.
Only a skilled master of onanism can keep the Skinflute of Vecna from overwhelming his/her mind with its phantasmal necromantic lustings. Hallucinatory snuff films involving all manners of debauchery -- some completely unfamiliar to even those of wide experience -- dance across the flute-bearer's vision, obstructing efficacy in melee (-2 to all attack throws).
Once per day, the flute-bearer can perform the Sinister Tune of Bemotherment, spontaneously impregnating 3d6 HD worth of N/PCs and monsters within a 40 foot radius. Not even the most barren spinster or manliest of centaurs is necessarily immune to this dweomer. All must save vs spell to avoid immediate lower belly distension and permanent stretchmarks. Childbirth occurs in 1d30 rounds and is preceded by intense labor pains, spontaneously babbled curses and unconcealed need for bizarre snackfoods and snackfood combinations. Needless to say, combat -- even self-defense -- is impossible during gestation and delivery.
Invariably the products of Vecna's Skinflute are emaciated, eyeless and handless infants with ravenous appetites.
[Inspired by Tales of the Grotesque & Dungeonesque]