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The spell produced a spectral fist that flew through the air to strike a chosen foe, delivering as much injury as the caster had suffered in the last minute or so, before disappearing. It was unavoidable and could go around barriers.
The Ilmater's fist spell was naturally associated with the god Ilmater. It appeared within the Tome of Torment, the holiest book of the church of Ilmater, which first appeared in the Realms in 848 DR.