Guide to Medical

On round types that have specified doctors or surgeon jobs please only join these roles if you have had prior experience with Civilization 13 medical on other rounds, as they are limited and many people will be relying on you to act fast.

Severe illness

Plague, typhus, malaria and cholera deteriorate while the infected human is actively processed. Symptoms become debilitating after about three minutes, critical after fifteen, and fatal after twenty untreated minutes of nominal processing. Disconnecting pauses this progression. Other injuries and environmental hazards still matter.

Continuous appropriate treatment pauses deterioration and cures the illness after three minutes. Interrupting treatment resets course completion; provide a fresh complete course before the deadline. Flu and zombie infection use separate behavior.

Healing herbs are the early alternative. Activate a herb stack in hand while conscious and able to eat. One herb supplies 10 herbal remedy, lasting about three minutes twenty seconds. Take three herbs, redosing before the previous remedy runs out, for a continuous ten-minute course. Keep a separate herb for planting; a cultivated harvest starts at three herbs, so building a treatment reserve takes multiple harvests. Herbs come from their jungle-bush forage and herb-stack planting route, not random herb seeds.

For renewable penicillin, extract charcoal and ethanol: 1 charcoal + 2 ethanol makes 1 acetone, then 10 enzyme + 1 acetone makes 5 penicillin. Wood-derived charcoal avoids finite coal. The other carbon route uses a barrel: one charcoal item adds three carbon units; a beaker does not accept the item directly. Cinchona supplies quinine. See Chemistry for bench operations.

A grain or flour starter can ferment without existing yeast. Let the culture grow before withdrawing a yeast container if you want to retain it; each container holds 50 enzyme. Distilling 4 beer produces 2 ethanol. The starter jar needs glass and Pottery Storage; apothecary equipment follows Herbalism and Apothecary. The softwood ethanol-distillery recipe uses the legacy Economy & Production threshold of 45 where that research mode applies.

Susceptible healthy humans can catch plague, typhus or cholera near an infected source. Immunity and sterile-mask protection still apply. Malaria and zombie infection do not use this person-to-person route, and exposure does not reset an already infected patient's progression.

First-Aid

• The first thing you need to do is drag them (quickly hold CTRL then click, or right-click then select Pull) away from wildlife or people chasing/shooting them before they get finished off.

• SHIFT+click or right-click Examine at the person to look more closely at them, you might see where the bleeding is, but you should ask them as well as they can tell you about anything that is covered up (if they don't know how you can use LOOC chat to tell them that they need to click on their face icon on the right side of the screen). If you have a doctor's handbook you can use that on them to get fastest details for triage.

• Bandage or trauma-kit any bleeding as top priority, and get them buckled to a bed which will also help them stabilize. Don't take them any further than the closest bed unless you have to, and tell them to stay buckled to the bed and not try walking/crawling as moving around more with broken bones does more damage. Food and water help healing too, but do not stuff them full of dried meat as the salt in it can overdose and do more damage to an already near-death person, so fresh food is better.

• After main bleeds are stopped, the most injured body parts might also have internal bleeding, which is important to fix as soon as you can, but you should not operate while they are "incredibly wounded" when you SHIFT+click or right-click Examine at them and let bed rest and food make them slightly safer to operate on first as there's a chance to make mistakes and do damage. If your character does slip up due to lack of experience in medicine, poor tools or bad luck, examine them, and depending on how close to death you might need to stop operating, cauterise the opened (bleeding) wound and then bandage any bleeding you caused.

• If doctor's handbooks haven't been invented yet you're going to need to open this person up and check inside each body part (at bottom-right) that was bleeding with your bare hands like a true blood-covered witch-doctor/chiurgeon. Anyone can use proper tools that get invented later, but in dire situations if your character has had some previous experience in medicine (*Character tab at the top-right, Medical skill

• You can advance with practice or reading scientific stone slates/papyrus/books*) you will be able to fix internal bleeding with a simple knife to open an incision, hemp rope to clamp, wood handle to retract the skin, hemp rope again to tie the bleeding vein inside, and a burning torch to cauterise to close the incision back up again. You can fix broken bones with a wooden hammer or bone-setter after fixing veins but this is not advised if they are heavily wounded as the steps can fail and do damage when your top priority is getting the internal bleeding stopped first, and there might still be other body parts that have internal bleeding you haven't checked yet. If the chest is one of the body parts do that first and also try to bandage the heart just in case after the first incision, or if doing separately after fixing internal bleeding, simply cauterise again afterwards. Then try do the same for the brain which will also help with blurry eyes. You can RP this in ancient times as healing salves and ointments being applied, some of which might have been later forgotten by history.

• Now you have a person that will stay alive as long as they don't move. The next step is to check for any broken parts missed, as when someone moves with broken bones it will do them damage unless it is Splinted (which is only a temporary fix). Moving with broken skulls leads to blindness, brain damage and pain paralysis that will lead to eventual death from starvation/thirst, cold snow or rain, hot sandstorms or other hazards.

• In the absence of a doctor's handbook, to check body parts for broken bones click the yellow button at the bottom-right to go into Grab mode, click them, then double-click the Grab icon that appears in your hands in the bottom-middle of the screen to double it up and turn it into an "aggressive" grab - then change to green/help mode and click on the person with the body part you want to check selected at bottom-right, and the chat box will start telling you what your fingers find there. Now read about Surgery here, remind them not to start walking around again straight after while seriously wounded or the bone will just break again, they need to stay in bed and heal up before leaving (again, food and water helps with this). This time is a good opportunity to talk about the causes of the wound or illness and to get to know your patient.

Physical Healing

Bleeding

Applying Pressure: Used to stop or lessen the effects of bleeding. To perform this action use grab intent and then click on yourself while aiming at the body part which is bleeding. Be aware that if you use that same hand you will stop applying pressure. Useful for mild cuts and making it back to a doctor.

Healing Herbs: Mostly used by primitive peoples, it will not help stop the bleeding but will also clean the wound, so it is always preferable. Can be gathered from bushes with a knife.

Bandages: Quick and effective, most people should carry some all times, reduces the pain on most wounds and helps to treat bleeding as well.

Splints: A quick and easy solution to broken bones, will help to stabilize the victim until surgery.

Stimulants, pain relievers and cleansing agents.

Tea: Tea heals toxins and helps fight drowsiness and hallucinations! Cure for flu.

Charcoal: Charcoal heals toxins very effectively, slight anti-rad, but does not help with drowsiness and hallucinations.

Leech: Drains toxins and bloods from patients, good alternative to tea, can end up weakening the patient.

Coal: Removes any chemical in the blood.

Coffee: Will give you that extra caffeine and increase your speed!

Cocaine: A powerful stimulant. Very addictive. 2 times worse painkiller than opium.

Peyote Cactus: Stabilizes critical damage, slight painkiller, and makes you see many colors. Also using in tribes gamemode for communicating with gods

Orange Juice: Heals suffocation.

Iron: Helps replenish blood.

Alcohol: Used as a painkiller when there's no opium around. This includes beer, ale, and rum. Also makes for a great party drink!

Opium: Made from poppies and used as an extreme painkiller. Helps a lot when patients are mostly suffering from pain.

Potassium Iodide: Heals radiation. Cure for zombie virus.

Penicillin: Cure for typhus.

Advanced

Trauma Kit: Probably the Most useful and effective medical supply, this specialized kit for trauma wounds will take care of most of the wounds, stopping pain. Also used in Surgeries to repair Organ Damage.

Burn Kit: Mostly used to treat burn wounds, but can also help heal the area.

Continued Care

Without proper care, individuals may end up ill or even worse.

Diseases

There are currently 5 diseases. Try not to catch them, they will make your day a whole lot more miserable. Especially in early game, when advanced medicine doesn't exist.

Plague

The rarest and the most lethal disease. If you have it, you will probably die.

• Caught from eating raw mice. Or standing too long near one.
• Transmits from person to person.
• It can be spotted by the lumps on your skin and vomiting blood.
• If you survive, you will get immunity.

Malaria

A deadly disease caused by parasites.

• Transmitted by mosquitoes.
• Does not transmit from person to person.
• Will give you very high fevers with shivering and convulsions.
• Untreated, it will give you brain damage from the fever, and possibly kill you.
• Normally survivable without treatment, but won't give you immunity.
• Damage can be greatly reduced by taking quinine (harvested from the Chinchona plant).
• You will not get immunity.

Cholera

A disease caused by water-borne bacteria.

• Caught by drinking straight from puddles or water tiles without boiling it first.
• Cannot be transmitted in any way.
• Will cause you to convulse and vomit. This will dehydrate you fast!
• Vomiting will also cause you to lower the hunger level.
• Dehydration will kill you without treatment.
• Treatment is drinking plenty of water until the disease is gone. Any type of freshwater will do.
• TIP: You can remove the risk of catching cholera by building a well on a puddle. Well water is pure.
• You will not get immunity.

Flu

Just a normal flu.

• Caught from being dirty.
• Easily transmitted from person to person. A single person can contaminate an entire village!
• Will very probably not kill you, but can be an annoyance, causing blurred vision, blackouts, and fever.
• Untreated flu might give you brain damage from high fever.
• Manageable by eating and drinking until full, and resting (buckling to a bed).
• Brain damage can be prevented by drinking plenty of tea until the fever subsides.
• You might get immunity after surviving it.

Typhus

You've been covered with lice for days and now you feel sick.

• You might get it from wearing dirty clothes for too long. Watch out for the flea sprites.
• Throwing up randomly.
• Slightly transmittable from person to person.
• Untreated typhus will lead to your death.
• Treatment is through penicillin and tea.
• You might get immunity after surviving it.

Combating Illness

If you are a medical professional or just a beginner you may wish to learn how to keep people from ending up sick and useless.

• Salt overdose: Extreme dehydration from drinking sea-water (even boiled) or eating too much dried meat

• you might be able to save them by feeding them with a lot of water, and if you have tea that will help too.

• Cholera: Extreme dehydration and vomiting from drinking puddle/ river water (or a Well with fecies near it) that hasn't had the germs cooked out of it. Give them lots of clean water and cooked food.

• Food poisoning: Cooked food, clean water and healing tea.

• Flu: Causes victims to suffer from weakness or even fever, fevers will worsen depending on certain factors, weather and fullness. The flu can be cured, it can also cause people to become immune to it if they are sick enough.

• Plague: Take Infected individuals away from large groups, burn Infected Corpses and burry them far away.

Surgery

Besides the usual instruments (Scalpel, Hemostat, Retractor, Bone Setter, Bone Saw, Cautery) some alternative tools can be used, at the cost of decreased effectiveness or success.

Scalpel Alternatives: Knife, Bone Knife, Glass Shard

Hemostat Alternatives: Rope, Torch

Retractor Alternatives: Crowbar, Wood Handle, Fork

Bone Setter Alternatives: Wrench, Hammer

Bone Saw Alternatives: Hatchet, Tribal Hatchet, Bone Knife Alternatives for Amputation: + Battle Axe, + Machete

Cautery Alternatives: Cigar, Torch

Internal Bleeding

• Usual procedure: Scalpel > Retractor > Hemostat > Bonesaw > Retractor> Trauma Kit/Bandages > Retractor > Cautery

• Alternative (example): Knife > Wood handle > Rope/Cable coil > Torch

Broken Bones

• Usual procedure: Scalpel > Retractor > Hemostat > Bone Setter > Cautery

• Alternative (example): Knife > Wood handle > Wood hammer > Torch

Damaged Organs

• Usual procedure: Scalpel > Retractor > Hemostat > Bone Saw > Retractor > Trauma kit/Bandages > Retractor > Cautery

• Alternative (example): Knife > Wood handle > Rope > Hatchet > Wood Handle > Healing Herbs > Wood Handle > Torch

Amputation

Use the bone saw or a hatchet on the affected body part. Not to be used on the head or limbs, for obvious reasons.

Shrapnel removal

• Scalpel
• Retractor
• Hemostat
• Bonesaw
• Retractor
• Hemostat
• Retractor
• Cautery

Organ removal

• Scalpel
• Retractor
• Hemostat
• Bonesaw
• Retractor
• Scalpel
• Retractor
• Cautery

Tendons

• Scalpel
• Retractor
• Hemostat
• Hemostat
• Cautery

Rudimentary/emergency: Knife

• Wood handle
• Hemp rope
• Hemp rope
• Wood torch

Human bodies and remains

These mechanics describe the merged game source. A running server must include this update before they apply there.

An exposed dead human body starts to rot after 2 natural season changes and becomes remains after 4. On maps without an active seasonal cycle, the warning comes after 6 hours and retirement after 12 hours of running-server time. The remains then begin a fresh phase with the same warning and disappearance thresholds. Offline time does not count. Cleanup checks at most 32 candidates every 30 seconds, so busy worlds may take longer after a threshold.

The warning leaves time to recover or revive the body. Revival or rejuvenation clears its decay age. Moving a body or remains to a different location resets exposure; a movement action that leaves it in the same place does not. Bodies and remains inside containers or mobs are protected, including morgues, coffins, closets and vehicles. Pulled or thrown bodies and buckled bodies are protected when checked. Protection resets exposure, and remains containing objects are protected too.

When a body becomes remains, its actual gear drops at the body's location. Bags keep their contents, and guns keep their attachments and ammunition. Existing item identity and raid or insurance metadata stay with the items. Clothing removal can also release pockets, belts and IDs. Useful gear does not become abandoned rubbish because its carrier died, and a physical gear drop does not itself return insurance or credit an extraction loadout.

A body stays intact if gear cannot be dropped, an item is anchored, it carries a non-gear passenger or a loose organ outside its own anatomy, or it has more than 256 direct contents. A failed drop, revival or relocation cancels retirement before body deletion; gear already released may remain on the ground.

Saved corpses stay dead with their damage, nested inventory and accumulated exposure. Saved remains retain their phase progress. A restart does not add offline age or revive a saved corpse. Forced admin season changes keep decay age unless Advance decay age is explicitly selected.

On zombie maps, a headed corpse outside the Caribbean admin area reanimates as a zombie at retirement instead of leaving bones. Headless corpses leave remains. Static decorative remains do not expire through this process.

Circumcision

Use a Circumsion Knife on a naked individual.