When Isaac takes damage, a black ring briefly appears around him, dealing damage to all nearby enemies.
"Call to the void"
When Isaac takes damage, a black ring briefly appears around him, dealing tear damage at a rapid rate to everything touching it.
- Athame no longer has a chance to spawn black hearts upon killing enemies with the brimstone ring
Ipecac - Massively increases damage and poisons enemies.
Causes the ring to explode upon contact with walls or obstacles. The explosions can damage the player, causing the ring to appear again, damage the player, and cause a loop of damage.
Proptosis - The ring is much larger and deals 1.5x damage.
The ring deals normal damage.
The ring is now normal size.