The Black Hand is riddle wrapped in a mystery wrapped in a conundrum to such an extent that most vampires don't even know that the True Black Hand exists. In modern nights, most vampires just call the Sabbat "the Black Hand" and that's as far as it goes. The trouble, of course, is that the Hand is much more complicated than that. The Hand is actually divided into two major sections. Most of the False Hand is made up of pawns who never really know what's going on or who they're really serving. The True Hand is comprised of those who know about the sect and support its goals. Most True Hand members are squirreled away in other factions like the Camarilla or Sabbat so they can manipulate the other sects more easily.
But what are the goals of this sect? What makes it different? Well, first off, they support the Antediluvians and they believe that the clan founders will spare those Kindred they find worthy. The sect believes that it has several Antediluvians sleeping in their city in the Shadowlands and they report that the ancient creatures contact sect members in dreams. This sort of personal attention leads the Hand to believe that the great elders will cut the numbers of Cainites down to such a degree that humans will be much better off. Although the True Hand uses and abuses mortals as much as any other Kindred, they staunchly feel that humanity must be protected overall, especially from the insidious influence of vampires.
The second major goal of the sect is to eradicate Souleaters. The True Hand teaches that Vicissitude is actually a disease that came from the Deep Umbra and once it infects a person, it takes over the host's body and mind permanently. The Storyteller's Handbook to the Sabbat already introduced the idea that Vicissitude might be a disease passed through vampire blood, making the Vaulderie an ideal way to spread the infection. That book, however, did not claim that the "disease" was some sort of self-aware entity. Dirty Secrets of the Black Hand took things one step further. Thus, the True Hand is rabidly devoted to hunting and destroying all those they deem to be Souleaters, but they're not entirely sure who is possessed and who isn't.
A lot of Vampire gamers seemed to hate this notion with all of their might, and I can understand why. Just because the Tzmisce have Vicissitude doesn't mean they're possessed by some sort of alien consciousness, right? But these gamers seemed to have missed the note on page 9 of Dirty Secrets of the Black Hand. That note reminds readers that the book only presents what the Black Hand understands and they could be mistaken and downright wrong. Wouldn't the Souleaters thing be a great way to get rid of those pesky Tzimisce? It's highly unlikely that the Black Hand has a group of Antediluvians sleeping away in their city, but it's entirely likely that some very twisted ancient vampires or spirits could be there, whispering all sorts of falsehoods.
The Black Hand is a small sect in any case and no one has to use it, but I think it could be a source of fun and interest . No one wants to be wrong about their most passionate beliefs but in the World of Darkness, blind spots appear all the time. Think about it. The Sabbat tells itself that it isn't controlled by the Antediluvians, that it's working against the clan founders. But is it? The Camarilla teaches that Gehenna is just a myth - but what if it isn't? What would happen if the Hand discovered it was being played? There are story ideas here, and good ones, too, if anyone cares to look.
The Del'Roh rules from a palace
deep within a reflection of the first city, Enoch, in the
Underworld. The currently Del'Roh is a woman who has ruled for
200 years. There is only one Del'Roh and she is at the heart of a secretive and mysterious sect. As such, it would probably be best if players never got to see the Del'Roh - but the threat of her attention should be enough to make folks shudder.
Seraphim: Ten vampires serve as lieutenants to the Del'Roh and they are collectively known as the seraphim. They get their orders directly from the Del'Roh herself, and are probably best left in the Storyteller's hands.
Liches: The liches are three Kindred who serve as judges and representatives of the Del'Roh. Together with the Seraphim they make up the Del'Roh's council of thirteen.
There are various dominions and three select groups below the liches and seraphim.
Below the dominions are the underling sect members, where player characters should be if they start out as members of the True Hand.
Altogether, the members of the True Hand number somewhere around 200. The False Hand, however, is probably much larger.