In the Gehenna supplement, this is the power for all level 10 Disciplines. Basically, it does whatever the Antediluvian in question needs to do with the Discipline in question.
The scenario "Crucible of God" gives several example plot devices:
- Tremere, founder of his Clan, attempts to seize mental control of the entire human race but is deceived when the Tzimisce Antediluvian instead triggers an aspect of Vicissitude in everyone (Tremere included) and mutates them.
- Absimiliard unleashes enormous swarms of rats and stinging insects and uses them to diablerize by proxy.
- Malkav long ago became one with the Madness Network and now merges with every Malkavian that is part of it, as well as spreading derangements to anyone near his many new bodies.
- The Lasombra Antediluvian turns into a cloud of darkness that covers the entire planet for a month and drains the soul of every living thing that dies (an combined enhanced version of Ahriman's Demesne and Tchernabog) .
- Ennoia becomes one with the planet itself (a sort of jumped-up Earth Meld)