Few low-tech societies have a single profession of “healer.” Instead, a variety of scholars, priests, and craftsmen coexist, each focusing on one group of illnesses or method of treatment. Generalists adept at most or all of these arts might be called “physicians,” but they don’t normally have what GURPS calls the Physician skill.
Medical equipment is usually LC4. If a society has medical licensure or a guild of healers, though, some articles may be LC3.
Low-tech diagnosis relies on the healer’s unaided senses. At TL3-4, it might include checking urine specimens for blood, sugar, or sediment. For many physicians, the most important function of diagnosis is determining whether a condition is treatable! To save their own reputations, practitioners may turn down hopeless cases, take them on without promising success, or advise simply keeping the patient comfortable.
A successful roll against Diagnosis (p. B187) identifies the patient’s condition, if it’s medically recognized, and predicts whether treatment is likely to do any good. Failure leaves it unidentified. Critical failure misidentifies it, leading to refusal of treatable cases or fruitless treatment of hopeless ones.
In many societies, some “diagnosticians” actually use Fortune-Telling (p. B196) to give the patient the answer he wants to hear. This may be based on astrology, consulting the I Ching, or similar methods. Even reputable practitioners might utilize these methods alongside empirical diagnosis.
A book or collection of scrolls listing medical conditions, visible signs, recommended treatments, and likely outcomes allows an unmodified Diagnosis roll. A diagnostician without this is at -2 when facing a condition with which he has no personal experience.
A large, comprehensive manual amounting to a medical encyclopedia, or a collection of multiple books, gives +2; an extensive medical library, +5. Either offsets penalties for rare diseases but can’t give a net bonus. At the GM’s option, these bonuses may be those under Time Spent (p. B346), with extra time representing research. In that case, extensive reference works are needed to profit from added time; checking a comprehensive manual takes four times as long, while consulting an extensive library multiplies time by 30.
Book prices and weights vary widely; see GURPS Low-Tech Companion 1. As a rough average, a printed diagnostic manual is $35, 2 lbs. A comprehensive one (+2 to skill for known conditions) is $175, 20 lbs. Hand-copied works are ¥10 base cost, ¥4 weight.
A glass vessel similar to a modern test tube, used to collect urine specimens, is standard equipment for TL3-4 diagnosticians. Without it, Diagnosis rolls for diseases affecting the urinary tract are at -2. $40, neg.
This summary expands and clarifies the one under Biotechnology/Medicine (p. B512), and lists the healing skills available at various TLs.
TL0 – First aid and field-expedient surgery for injuries, using common tools and materials rather than specialized medical gear. Other surgery includes amputation, bone-setting, and trepanning. Anesthesia, antisepsis, and sterile operating rooms are unknown. Pharmacy uses local herbs in their natural forms; treatment focuses on symptoms. Curing rituals, divination, and exorcisms are a large part of medical practice. Medical methods are based on practical folk knowledge or oral traditions. Skills: First Aid/TL, Fortune- Telling, Pharmacy/TL (Herbal), Religious Ritual, Surgery/TL (Trauma Surgery).
TL1 – Densely populated cities bring about a rise in infectious diseases. Literacy makes possible written manuals of diagnosis and recommended treatment, but medicine remains linked to magic and religion. Long-distance trade in medicinal herbs begins, along with preparation of herbal extracts. Skills: Add Diagnosis/TL.
TL2 – Speculative physiological and environmental theories of illness and health as natural processes; e.g., Greek and Roman humoral medicine. Surgical procedures and equipment become more sophisticated. Skills: Add Esoteric Medicine.
TL3 – Mainly a period of consolidation, as scholars compile encyclopedias of diagnosis and treatment. Religiously supported hospitals provide care for the poor and bring physicians together, encouraging exchange of knowledge. Skills: No change.
TL4 – Older theoretical frameworks coexist with new scientific investigations in medicine and physiology: anatomical dissections, microscopy, toxicology, and pharmaceutical use of toxic inorganic substances. Philosophers begin to describe the body as a machine. Skills: Individuals with Anachronistic Skill (p. 9) may learn Pharmacy/TL (Synthetic) and Physician/TL.
The most basic medical techniques don’t require specialized training – anyone can attempt them with a default First Aid roll (IQ-4). Some methods are available at any TL, but advancing technology makes superior treatments possible. While TL0 societies have little specialized equipment, they can adapt both general tools and materials from the natural environment to the task.
A cutting, impaling, or piercing wound causes bleeding. Whether or not the GM chooses to apply the optional rules for ongoing HP loss (see Bleeding, p. B420), part of first aid is stopping the bleeding. If the wound is on a limb, then a tourniquet is one way to accomplish this. If no tourniquet is available, see Blood Vessel Pressure (p. 11).
A length of cord long enough to tie tightly around a wounded limb, restricting blood flow to allow the surface of the wound to clot. This is effectively a garrote. See Rope, String, and Thread (pp. 23-24) and p. B288 for suitable cord. In societies that haven’t developed rope, a leather thong will do. $2, neg.
Improvised Tourniquets: In the wilderness, a length of vine can serve as a makeshift tourniquet. This gives -2 to First Aid skill. There’s no cost, but finding a suitable plant requires 5 minutes and a Naturalist roll. The GM may apply modifiers based on how likely the surroundings are to contain vines, from +5 for jungle to -5 for desert. He may rule that no attempt is possible in some environments – notably, arctic ones!
The GM may opt to use this rule alongside Bandaging (p. B424) and Bleeding (p. B420). Save it for emergencies – it’s too risky for minor bleeding! It works with standard tourniquets, but not with improvised ones.
A tourniquet can be tied exceptionally tightly, severely restricting blood flow. This gives from +1 to +5 to the First Aid roll to stop bleeding; the caregiver picks the bonus he wants. Even if the First Aid roll fails, leaving the tourniquet in place means its bonus cancels out penalties for wound severity when making HT rolls for bleeding to stop naturally, although this can never give a net bonus.
The risk of this technique is harm to blood-starved tissues. After the wound stops bleeding and the tourniquet is removed, the subject must make a HT roll at a penalty equal in size to the bonus claimed above. If the First Aid roll failed, this roll is at a further -1 per extra minute the tourniquet was left in place. Success indicates no ill effects. Failure means HT rolls for natural recovery, and medical skill rolls for faster healing, are at -1, plus another -1 per 2 points of failure. On a critical failure, the limb has suffered major tissue death; it’s permanently crippled, and the patient must roll to avoid infection (p. B444), at -3 to the usual HT+3 roll (that is, roll vs. unmodified HT).
Bandages are used to treat burning, cutting, impaling, and piercing injuries, and the split skin, small cuts, and abrasions included in crushing damage. They enter systematic use at TL1, with ancient Egyptian linen cloth; other fabrics, such as cotton and silk, are also suitable. Various substitutes exist at TL0.
Applying cobwebs to a wound is an old home remedy for bleeding. Treat cobwebs as improvised equipment for First Aid, giving -5 to skill. A successful roll stops bleeding and restores 1 HP – as for Bandaging (p. B424) – but provides none of First Aid’s other benefits. The web is too flimsy to provide lasting protection or keep out dirt. In fact, cobwebs are seldom sterile; the patient must roll for infection (p. B444), treating a fresh web as ordinary “clean” dirt (+0) and an older one as moderately unclean (-1). Cobwebs are free. Finding one requires a minute and a Housekeeping or Naturalist roll in a suitable environment. Success locates a fresh web; failure by 1 locates an old, moderately unclean one. Webs are too fragile to store for later use.
These are cloth wrappings for wounds. Benefits are discussed on p. B424; in addition, bandages can keep dirt out of a wound and prevent infection (see Infection, p. B444). A tight bandage can substitute for a tourniquet for basic First Aid rolls. A basket of precut clean cloth (typically cotton, linen, or silk) sufficient to dress half a dozen wounds, and which counts as basic equipment for First Aid, is $10, 2 lbs.
Improvised Bandages: At TL0, bandages can be made from the cloth manufactured by some Neolithic societies, or from barkcloth (see Paper and Its Cousins, p. 24). Broad, flat leaves are another option, where available; roll against Naturalist as described for finding vines under Tourniquet (p. 145), and note that some leaves have medicinal effects (see Drugs, pp. 150-152). At TL1-4, bandages can be cut from garments, bedding, etc. Primitive cloth bandages are half-price ($5); leaves and scraps are free. All give -2 to skill and are rarely sterile – roll for infection (p. B444), assuming ordinary “clean” dirt.
In addition to bandages, this kit contains medicinal substances (see Drugs, pp. 150-152) – raw materials for poultices, and infusions or decoctions suitable for making compresses. At TL2+, add ointments, and possibly soap (see Grooming, p. 36) for cleaning. Such gear gives +1 to First Aid rolls. $50, 2 lbs.
For broken bones to mend, the rejoined ends must be held together while they heal. Setting the bone requires the Surgery skill (see Surgical Techniques, p. 12, and GURPS Low-Tech Companion 1 for bonesetting rules), but anyone can use First Aid to create a rigid framework for an arm or a leg. A crippling injury won’t recover without at least this much treatment.
Flat strips of wood, thick enough for rigidity, placed against a broken limb and tied or strapped in place. Arm splints: $25, 1 lb. Leg splints: $50, 2 lbs.
A cast is made by wrapping a broken limb tightly with bandages and then plastering over it to provide support. Arm cast: $50, 5 lbs. Leg cast: $100, 10 lbs.
More effective treatment of injuries may be available at a long-term campsite, home, or military base. The challenge is getting the patient there without worsening his condition, and preferably without causing much added pain. Purpose-built transportation for the wounded is preferable; see the litter and horse litter under Litters (p. 136). Almost any vehicle in Chapter 8 could work, though – particularly a boat, cart, sled, or travois.
Low-tech surgery is a scary business! Without X-rays or ultrasound, surgeons must often work blind – and in civilizations that forbid dissection, they may have only a vague idea what they’re working on. Many surgical patients bleed to death or die of infection. And lack of anesthesia can mean pain comparable to that of torture. Few people visit a surgeon unless they’re desperate; some prefer to kill themselves.
The standard surgery rules (pp. B223, B424) resolve operations with a few quick dice rolls. These have modifiers that take into account certain details, but abstractly. Below are some further options to reflect the conditions of low-tech surgery. For optional rules that define all the grim details – treating surgery in about as much detail as combat – see GURPS Low-Tech Companion 1.
The GM may opt to apply these modifiers to applicable low-tech Surgery rolls:
Awkward Reach: A surgeon working without specialized instruments may need to reach into tight places with his fingers. This gives -3 for the mouth or other natural body cavities, or -6 for a piercing or impaling wound, or a surgical incision. To avoid these penalties, use forceps (p. 148) and other surgical equipment.
Tech Level Modifiers: Surgical equipment itself gives TL-dependent skill modifiers, as noted on p. B424. These are actually the sum of two different bonuses or penalties. One is for the general quality of the surgeon’s paraphernalia; for this, see Surgical Instruments (below). The other is for lack of anesthesia. Low-tech surgery always has an extra -2 for being done sans anesthesia – in part due to the surgeon’s emphasizing speed over accuracy, to minimize the patient’s suffering, and in part due to the difficulty of keeping the patient still.
Undiagnosed Conditions: An operation for an undiagnosed problem is performed at -5 to skill. This doesn’t apply to battle wounds; the surgeon can tell what type of injury he has to deal with and where it was inflicted. But wounds may include internal injuries, or bullets or arrows lodged inside the body. Surgery on such conditions has a lesser penalty: -4 if the surgeon is guessing at the problem, or -2 if he has probes (see Other Instruments, p. 148).
The patient, too, may face added complications at TL0-4:
Minor Surgery: The standard rules provide for injury due to a failed Surgery roll: 2d for a simple amputation, 3d for other procedures. Under low-tech conditions, even minor surgery that’s far less invasive than amputation may inflict 1d. Examples include cutting for the stone (surgical removal of bladder stones; see Surgical Techniques, p. 12), dental surgery, and extracting arrowheads or bullets. Eye surgery is technically minor – but it doesn’t take much damage to cripple the eye!
Infections: Low-tech societies don’t have sterile surgery; thus, surgical wounds may become infected. Use the rules on p. B444. Several techniques can modify the HT roll:
Cauterization (see Cautery, p. 149): +1
Treatment with antibacterial substances (see Herbs, pp. 150-151): +1
Washing wound and instruments with wine, vinegar, etc.: removes infected matter that might otherwise give -1 or -2
Surgeons use a lot of specialized implements. A small tool kit can hold from 12 to 20 instruments; a large one, from 30 to 60. Skill modifiers for such equipment derive from several considerations:
Tech Level: Basic equipment gives -4 at TL1, -3 at TL2-3, and -2 at TL4-5. This progression mainly reflects improvements in design, although the wider selection of materials extends what’s possible. These modifiers don’t include the -2 for anesthesia being unavailable; see Expanded Modifiers (above).
Size of Tool Kit: A small tool kit is basic equipment. A large one is good equipment: +1 to skill.
Superior Workmanship: Surgical instruments often have fine moldings on their handles. This isn’t just decorative; it gives a better grip: +1 to skill. Better-quality materials can also contribute to such a modifier; e.g., Roman smiths could carburize the surfaces of small tools such as scalpels, providing steel cutting edges. At the GM’s option, very expensive implements might give +2 to skill. These modifiers may be applied to either individual items or everything in a kit; in the latter case, quality modifiers for workmanship and kit size are cumulative, giving up to +3 in total.
Improvised Equipment: A surgeon without surgical instruments can operate with general-purpose tools. Ordinary, well-made tools of other trades – such as knives, razors, or pliers – give -2 to skill. If these items are themselves of improvised construction, then skill is at -5.
Specific Tools: Individual tools don’t normally modify Surgery rolls. Instead, they enable specific procedures. Many operations can’t be performed at all without the proper gear; others are at -1 per missing item. In some cases, one high-quality instrument useful for a particular task can give +1 to that Surgery roll. To this end, a number of equipment descriptions below name individual procedures. Most instruments lack such notes; they go into surgical kits and provide quality bonuses only as part of a bonus for the entire kit.
This modest collection of tools – knife, razor, scissors, small whetstone, spoon (TL2), tiny file (TL2), and one or two others – is mainly for shaving beards and cutting hair, but in an emergency, it’s useful for minor surgery. It gives -1 (quality) to Surgery, over and above the standard TL modifier. $100, 3 lbs.
Forceps are tools for grasping an object or a body part. They afford a better grip than unaided fingers. Treat this as the opposite of Bad Grip (p. B123): +2 to skill for fine tasks that benefit from a firm grip. They also eliminate penalties for awkward reach (see Expanded Modifiers, p. 147). $25, neg.
At TL2, several specialized varieties of forceps enter use:
Dental Forceps. Designed to grip a tooth and pull it out. This requires a ST-based Surgery roll; add the +2 for a firm grip. Basic forceps will work, but at -2, canceling out the bonus for a good grip. Critical success gets the entire tooth; ordinary success leaves 1d/2 splinters (round up) that must be extracted separately; ordinary failure leaves the tooth in place; and critical failure inflicts 1d-3 HP of injury to the face. $50, 0.5 lb.
Dental Splinter Forceps. Used to extract the roots of a broken-off tooth; no additional skill roll required. $50, neg.
Fixation Forceps. These have a sliding ring that can lock them shut. $50, neg.
Staphylagra. Fixation forceps with toothed jaws, used to crush chronically inflamed uvulas or hemorrhoids, allowing removal without risk of bleeding. $75, neg.
Hook (TL1). A rod with a sharp or blunt hook at the end, used to pull back the sides of a wound or an incision, or to manipulate a piece of tissue. $10, neg.
Needle (TL1). Designed to pull thread or sinew through flesh. Ordinary sewing or leatherworking needles count as improvised gear, giving -1 to overall Surgery skill. $5, neg.
Probe (TL1). A long, flexible rod – usually bronze – used to locate foreign objects in a wound or assess the body’s internal state by touch, reducing the penalty for undiagnosed conditions (see Expanded Modifiers, p. 147). $10, neg.
Scalpel (TL1). Used to make incisions. $30, neg.
Arrow Spoon (TL2). Used to extract an arrowhead without causing further injury in the process. $30, neg.
Catheter (TL2). A narrow tube that can be inserted into the bladder to displace a bladder stone and drain urine, providing temporary relief but not a cure. Roll against Esoteric Medicine, Physician, or Surgery to use it. $50, neg.
Speculum (TL2). Used to dilate a body cavity, giving a better view for Diagnosis and reducing awkward reach penalties to Surgery from -6 to -3. Different body cavities call for different designs. $60, 1 lb.
Trephin (TL2). A specialized drill used to cut plugs of bone out of the skull, in the form of a hollow metal tube with saw teeth at the end. See Surgical Techniques (p. 12). $120, 1 lb.
The Basic Set provides no Surgery modifiers for TL0, and Stone Age tribes didn’t have professional surgeons. Still, human remains give evidence of surgical procedures in this era – even healed holes drilled through the skull! Handle this with the following rules.
As always, TL decides the basic equipment modifier. Paleolithic instruments are mostly chipped from flint, with somewhat wavy edges (-6); however, some are obsidian, which takes at least as good an edge as steel (-4). Neolithic tools are ground to a smooth edge from either ordinary stone (-5) or dense stone such as jadeite (-4).
There are normally no specialized surgical instruments. Surgeons adapt ordinary tools: stone knives for cutting, bone needles for stitching, firebows (see Fire-Starting Gear, p. 35) for cauterization, etc. Therefore, the -2 for improvised equipment usually applies. However, the GM may assume that specialized gear does exist in a TL(0+1) society that’s advanced in medicine, or in a TL1 culture that hasn’t developed metallurgy. For instance, cauteries can be made of stone.
Before each major operation or day of minor surgical procedures, Paleolithic instruments must be made from raw materials, while Neolithic ones have to be reground. Obsidian is particularly fragile – each minor operation requires new tools, while major surgery consumes 1d sets. Each set of implements prepared calls for a Machinist/TL0 roll, plus two hours of labor to produce with Paleolithic methods or one hour to regrind with Neolithic techniques. Ordinary stone is free; superior materials such as jadeite or obsidian may need to be imported and paid for, at the GM’s discretion.
If the GM allows dedicated TL0 instruments, then a (Neolithic) ground-stone surgical kit costs the same as a set of metal tools. Chipped-stone (Paleolithic) implements cost 1/5 as much but must be replaced after use, as explained above.
Surgeons’ kits come in two sizes: small, portable sets and larger ones kept in an infirmary or a surgeon’s house.
Small Kit (TL1). A typical kit would have forceps, hooks, needles, probes, and scalpels, plus a supply of thread or sinew for stitching up wounds, and material for bandages. Basic equipment for Surgery. $300, 15 lbs.
Large Kit (TL1). A typical kit would include the equivalent of two small kits, with more specialized forms of the basic instruments, plus bone chisels and small hammers – and at TL2, arrow spoons, catheters, cauteries, and specula. Good equipment, giving +1 (quality) to Surgery. $1,500, 40 lbs.
An instrument for controlled burning of human tissue, with a sharp metal point at the end of a long rod with an insulated grip, designed to be heated on a brazier. It’s made of iron, which resists heat better than bronze; thus, cauteries are sometimes called “irons.” A heated cautery can inflict serious burns – most surgeons regard cauterization as a desperate measure!
Roll vs. Surgery to use a cautery. Critical success inflicts 1 point of burning damage. Ordinary success or failure causes 1d-3 damage, minimum 1 point. On a critical failure, roll damage as for a failure and double it.
Cauterization can end bleeding from wounds that don’t stop bleeding after a First Aid roll. Any success on the Surgery roll stops further HP loss. Any failure doesn’t. Cauterizing a wound destroys bacteria as well as flesh. If a wound becomes infected (see Infection, p. B444), cauterization may arrest the infection’s progress – usually with less damage than excising the infected tissue, and without amputation. Roll vs. Surgery, as above; an infection that has inflicted 3 HP or more, or any infection of an impaling or piercing wound, is internal and treated as an undiagnosed condition (see Expanded Modifiers, p. 147). Regardless of the outcome, the patient gets +1 on his next HT roll for infection. Success gives a further bonus equal to half the margin of success (rounded down). Critical success ends the infection without a HT roll. A cautery is $50, 0.5 lb.
Surgery rolls for eye surgery are DX-based and benefit from High Manual Dexterity. Standard surgical instruments give -2 to skill. To avoid this, eye surgeons use a variety of specialized tools:
Cataract Needles. A cataract needle is a very fine, sharp piece of metal, designed to pierce the eyeball with minimal injury. It can push a cataract away from the pupil, sever pieces of it, or press it down to fix it into place. See also Surgical Techniques (p. 12). $50, neg.
Eyelash Cautery. A fine iron needle with a handle, this is heated and used to burn out the root of an ingrown eyelash after the hair is plucked out. $125, neg.
Eyelash Forceps. A tiny set of grippers that can seize and pull out an ingrown eyelash (see Forceps, p. 148). $125, neg.
Recorded in ancient Greece as early as 500 B.C., this bench supports a patient and applies traction to a broken limb, making bonesetting independent of the surgeon’s physical strength. Compute the relative ST bonus (see Surgical Techniques, p. 12) as if the surgeon had ST 20. Ancestral to the rack (p. 131)! $600, 125 lbs.
At TL0-4, the Pharmacy skill (p. B213) is limited to the Herbal specialty – although a partial exception can be made at TL4 (see Inorganic Substances, p. 152). Pharmacy (Herbal) includes formulating, administering, and prescribing medicinal substances. It can be used alone, as an aspect of Esoteric Medicine (see Bleeding and Purging, p. 153), or in conjunction with other forms of Esoteric Medicine. It primarily treats symptoms – fever, headache, nausea, etc. – rather than underlying causes.
Herbal medicine may predate humanity. Chimpanzees suffering from gastrointestinal parasites have been observed swallowing leaves of plants that human communities in the same area use medicinally. At any rate, preindustrial societies’ knowledge of local plants definitely includes medicinal uses.
Herbal medicines can have diverse physiological effects. Several important categories are described below. Regardless of a drug’s specific action, though, a few general rules apply.
Medicinally useful herbs are physiologically active – taking them disturbs the body’s functioning. In game-mechanical terms, such disturbance amounts to mild toxic effects for medicinal doses. These cost FP, not HP. The pharmacist chooses to administer a low dose or a high dose, and then rolls vs. Pharmacy. Critical success delivers the therapeutic benefits without side effects. Regular success also inflicts 1 FP. Ordinary failure costs 1 FP and has no therapeutic effects for a low dose, or inflicts 1d FP and possibly other symptoms, but gives therapeutic benefits, for a high dose. Critical failure costs 2d FP and may cause other symptoms, and has no therapeutic value.
Larger doses or more potent herbs may inflict actual damage. See Poisons (pp. 128-130) for examples.
Raw herbs often contain several different physiologically active compounds. Apply -2 to Pharmacy rolls in such cases. Various parts of a plant may have different effects; Pharmacy includes knowing which part to use.
At TL0, herbs are mostly used singly, as simples. At any TL, though, it’s possible to combine different herbs, using one to neutralize another’s toxicity, or mixing plants that jointly produce the desired medicinal effect but that contain different toxins, so that the patient gets only a low dose of any one toxin. Treat such herbal preparations as Hard techniques based on the Pharmacy skill, with an upper limit of Pharmacy+4.
To gather fresh herbs, roll against Naturalist (p. B211) to find and identify the plant species. In Neolithic and higher-TL societies, an alternative is growing them; this calls for a roll vs. Gardening (p. B197). In societies with marketplaces, it may be possible to buy herbs; treat this like a search for a Pharmacist hireling (pp. B517-518), but at +1 to search rolls. Fresh herbs are only available during their growing season. Dried herbs may be available year-round, but they’re usually less potent: -1 to Pharmacy skill.
The usual way to take raw herbs is to chew them up and swallow them. But some are chewed and spat out, taken as snuff, or smoked (see Drinking and Smoking, p. 37). For other methods of preparation and use, see Herbal Extracts (pp. 151-152).
Important categories of herbs include:
Analgesic. Decrease the patient’s pain sensitivity, reducing the intensity of pain by one level (see Pain Control, p. 152). Local analgesics suppress the sensory receptors for pain; the main low-tech examples are taken orally for toothache. Central analgesics decrease the brain’s response to pain. Drugs that treat headache, especially migraine, have similar effects on headache pain.
Antiemetic. Counteract nausea (p. B428) and prevent vomiting, giving +2 to HT rolls to avoid retching (p. B429).
Anti-infective. Enhance infection resistance, giving +1 to HT to rolls to resist bacterial diseases and infections – and in some cases viral diseases, such as colds and influenza.
Anti-inflammatory. Decrease inflammation of the muscles and joints, reducing the intensity of pain due to conditions such as arthritis (see Pain Control, p. 152).
Aquaretic. Promote urination, helping to flush out bladder infections, and preventing the recurrence of kidney stones. Give +1 to HT rolls to throw off the infection.
Astringent. Counteract skin inflammation and suppress itching. Often contain tannin.
Calmative. Non-narcotic herbs that diminish anxiety or excitement, and encourage sleep, giving +1 to HT rolls to resist insomnia and +1 to Will for Fright Checks.
Carminative. Lessen abdominal pain from gas (see Pain Control, p. 152).
Cathartic/Purgative. Speed the passage of food through the digestive system, leading to rapid and/or voluminous excretion; see Bleeding and Purging (p. 153). Side effects include penalties equivalent to those for being nauseated (p. B428), but without the chance of vomiting, as well as the standard loss of 1 FP.
Cholagogue. Enhance the secretion of bile, reducing the intensity of pain due to inability to digest fatty foods (see Pain Control, p. 152).
Coagulant. Help stop bleeding, giving +1 to the HT rolls under Bleeding (p. B420).
Demulcent. Soothe throat pain from respiratory infections and prevent coughing, giving +1 to HT rolls to resist coughing.
Emetic. Promote vomiting. Make a HT roll at -6 to resist, if you wish to. Beneficial against many ingested poisons, but can lead to worse injury in some cases; see Treatment (p. B439).
Expectorant. Promote the flow of nasal phlegm, giving +1 to HT rolls against upper respiratory infections and acting as a demulcent.
Febrifuge/Antipyretic. Reduce the severity of a fever, giving +1 to HT rolls to throw off a fever.
Rubefacient. Applied to the skin, producing mild inflammation that counteracts muscle pain. This relieves temporary crippling after straining a muscle (for instance, due to a critical miss in combat; see pp. B556-557) and halves penalties for muscle pain (see p. B428 and Pain Control, p. 152).
Sedative. Suppress central nervous system activity, with the effects described for sedatives on p. B441. At TL1-4, the standard sedative is opium, which is also used as an analgesic. Large doses of opium have the effects described for painkillers on p. B441. Addiction to opium in sedative or analgesic doses develops only slowly; if a user does become addicted, opium is legal in most TL1-4 societies and not unusually expensive. Taken orally rather than smoked, opium risks irritating the stomach; roll vs. HT to avoid nausea.
Stimulant. Produce alertness and counteract sleepiness and fatigue. Mild stimulants give +2 to Will to resist drowsiness (p. B428), and restore 1 FP for (12 - HT) ¥ 10 minutes, minimum 10 minutes – but at the cost of 2 FP when the drug wears off. Strong stimulants act as described on p. B440.
Tonic. A term used for two different classes of herbs:
Vermifuge. Promote expulsion of worms from the digestive system, allowing a HT roll to be freed of the parasites. Treat the patient as nauseated (p. B428) for 1dx30 minutes after taking such herbs, but without the chance of vomiting.
Vulnerary. Applied externally to a wound to aid healing and resist infection, giving +1 to HT rolls both to resist infection (p. B444) and for natural recovery (p. B424).
Many herbal substances have nonmedical uses. A famous example is deadly nightshade or belladonna (p. 128). Its active ingredient, atropine, prevents the pupils from contracting. At TL5+, it’s administered in drops to dilate the pupils for eye examination and treatment. But dilated pupils are a sign of interest or attraction – and earlier in history, Italian courtesans used belladonna to look as if they found their male companions fascinating! A suitable extract is TL3.
Using belladonna drops requires a Pharmacy (Herbal) or Professional Skill (Courtesan) roll. Success grants +2 to Sex Appeal, and to Acting rolls to feign attraction. Failure has the consequences noted under Herbs (p. 150). Either way, the user suffers blurred vision, handled as Bad Sight (Farsighted). On a critical failure, treat toxic effects exceeding FP/3 as crippling injury to both eyes.
Starting in ancient Egypt (TL1), honey – sometimes mixed with salt – is used to treat wounds. While honey isn’t directly derived from plants, an herbalist may be able to exploit its natural bactericidal properties. Roll vs. Pharmacy (Herbal), as for herbal drugs. Success gives the patient +1 to HT rolls to resist infection.
Starting at TL1, pharmacists develop ways to extract active ingredients from herbs. Extracts are purer and may be absorbed more effectively. As the range of methods advances, healers enjoy a bonus to Pharmacy (Herbal) rolls for treatment: none at TL1, +1 at TL2, and +2 at TL3-4.
Preparing an extract doesn’t normally require a separate skill roll. If one seems called for (e.g., for an apothecary making up a preparation for later sale), roll against Pharmacy, Chemistry at -2, or Housekeeping at -4. Producing pure forms requires laboratory equipment and suitable media. Some specific techniques include:
Compresses (TL1). A cloth is soaked in an infusion or a decoction and applied to an afflicted area; e.g., a wound. Compresses must be used as soon as they’re prepared.
Decoctions (TL1). Roots, barks, and fruits must be simmered in boiling water to release their active principles. This takes an hour, which includes time to cut the material into small pieces; these solids are removed at the end. Decoctions can be taken hot or cold. Once prepared, they last a week.
Infusions (TL1). Dried or green leaves, stems, or flowers are soaked for 10 minutes in hot water. Infusions can be taken hot or cold. Once prepared, they last a week.
Poultices (TL1). Crushed fresh or dried herbs are mixed with a moist adhesive substance, such as flour mixed with water, and applied to the skin. Poultices must be used as soon as they’re prepared.
Syrups (TL1). To make them more palatable – especially for children – decoctions and infusions can be mixed with honey or sugar (if available). In addition to improving taste, the sweetness can lessen the pain of a sore throat. Once prepared, syrups last a week.
Creams (TL2). A mixture of oil or fat with water and an emulsifier, intended to be applied externally. It’s permeable, letting the skin breathe and sweat, and can moisten and soothe irritated skin. Either the oil or the water might carry the active ingredient. Once prepared, creams last three months.
Oils (TL2). Some active ingredients can be extracted with vegetable oils such as olive oil. The process may be hot (for hard parts) or cold (for leaves and flowers). This takes a full day or more. Oils keep for up to five years if stored properly.
Ointments (TL2). Made by heating herbs in solids such as beeswax, fat, or paraffin without water, ointments adhere well to the skin. They also seal it off, which can cause irritation; treat this as a possible toxic side effect. Once prepared, ointments last a year.
Essential Oils (TL3). Volatile oily substances extracted from aromatic plants by a variety of techniques: pressing, steam distillation, extraction with a volatile solvent that’s then evaporated, or effleurage (a two-step method using first animal fat and then alcohol). These are all long processes and produce a small amount of essential oil from a large volume of raw material. Essential oils keep indefinitely.
Tinctures (TL3). After the achievement of distillation, the active ingredients of herbs can be dissolved in alcohol, producing extracts, cordials, and similar substances. These can be applied externally, by massage, with a cooling effect as they evaporate, or taken internally. Tinctures keep for up to two years if stored properly.
Renaissance Europe (TL4) saw the beginning of a movement toward synthetic pharmacy, with the medicinal use of inorganic substances such as arsenic. This was primarily thanks to Philippus Aureolus Theophrastus Bombastus von Hohenheim (1493-1541), an alchemist and physician best known as Paracelsus. His work was based on scientific toxicology, whose principles he largely established – in particular, that every substance is toxic at a high enough dosage, but that a low dose of a poison may be harmless, even beneficial.
Inorganic drugs use the rules under Herbs (pp. 150-151), but require Pharmacy (Synthetic) and have more severe toxic effects than most herbal cures – they cost HP, not FP. For a typical treatment, success inflicts 1 HP but grants +1 to the patient’s next HT roll to recover from the disease; critical success means no toxicity and +2 to the HT roll. Ordinary failure causes toxic effects without curative ones. On a critical failure, treat the subject as having ingested 1d-3 doses (minimum one) of the poison. Physicians may attempt heroic cures with multiple doses; this increases both therapeutic and toxic effects in proportion to the number of doses, but is also riskier: -1 to skill per additional dose. In all cases, the patient receives the poison’s usual HT roll to resist its toxic effects, except after a critical success, when it isn’t required.
Taoist physicians and alchemists in China experimented with similar treatments, but without systematic testing, making them riskier. For patients treated under this tradition, failure counts as having ingested 1d-3 doses (minimum one) of the poison. On a critical failure, roll this number and double it.
In addition to herbal and inorganic medications, low-tech physicians employ a variety of other cures. The skill for most of these is Esoteric Medicine (p. B192), representing not mystical powers but what’s now considered “alternative medicine” – Ayurvedic medicine, Hermetic medicine, Taoist medicine, etc. Practitioners try to piece their chosen methods into the theories of their particular school; as a result, they may overgeneralize those theories, giving useless or harmful treatments. If something works, though, most healers will fit it in, explaining its success as best they can.
Note that general supportive care of the injured (see Medical Care, p. B424) is within the competence of low-tech practitioners. Either Esoteric Medicine or Pharmacy (Herbal) at 12+ can substitute for Physician at 12+.
Many low-tech therapies aim to decrease pain; some may actually succeed. Roll against Esoteric Medicine for nondrug treatments or Pharmacy (Herbal) for herbal ones. Critical success makes pain two levels less severe on the following progression: agony to terrible pain to severe pain to moderate pain to no pain. Success reduces pain by one level. Failure offers no relief. Critical failure causes some harmful effect; details depend on the treatment used. See Afflictions (pp. B428-429) for definitions of pain levels – and note that the “agonizing” severity of the Chronic Pain disadvantage (p. B126) corresponds to terrible pain, not agony.
Acupuncture is among the best-known of Chinese and Japanese medical techniques. Practitioners are taught about channels that conduct chi (vital energy) through the body, coming to the surface at points on the skin; one school identifies 365 of these. Inserting fine needles into these points is said to improve the functioning of internal organs. Some practitioners forego needles and press the points with their fingers; this method, known as acupressure, gives -2 to Esoteric Medicine.
In the related practice of moxibustion, small cones of dried mugwort (Artemisia vulgaris) leaves are placed on the same points and burned. This technique is often regarded as Japanese, but is used throughout East Asia. The best-established effect of all three methods is pain control (below); for instance, to treat conditions such as migraines. Acupuncture is also used for anesthesia during minor surgery; a successful Esoteric Medicine roll grants the patient High Pain Threshold (p. B59). The latter is a modern innovation (traditional Chinese medicine discouraged surgical methods), but might be part of a TL(1+1) through TL(4+1) society’s medical practices.
Numerous other benefits are claimed for such methods. If the GM accepts these, then a successful skill roll could give +1 to the patient’s next HT roll for almost anything.
Acupuncture Needles (TL0). Extremely fine needles used in acupuncture, made of bronze at TL1-2 or of steel at TL3+. Per 100: $50, 0.25 lb.
Moxa Bundle (TL1). A cone of dried mugwort leaves for moxibustion. Free, if leaves are gathered in the wild; this requires a Naturalist roll, followed by a Pharmacy (Herbal) or Esoteric Medicine (Moxibustion) roll at +2 to prepare them. A prepared bundle costs $1. Negligible weight.
There are ways to counteract poison at TL0-4, but most work against ingested toxins. Little can be done about blood or contact agents.
Geophagy (TL0). A very ancient method – used even by pre-humans and beasts – is eating clay, particles of which bind to toxic substances in the digestive system. This can be done either preventively, with foods known to be somewhat toxic, or curatively, after the first toxic effects occur. A dose of clay gives +1 to later HT rolls to resist the poison, but doesn’t restore any previously suffered HP or FP loss. To locate suitable clays, make a Survival or Poisons roll. Clay itself may irritate the stomach, if taken in amounts large enough to be effective; make a HT roll at +2 to avoid 2d fatigue from digestive upset, with nausea following if fatigue exceeds FP/3. Critical success on the Survival or Poisons roll finds high-quality clay without this effect.
Milk (TL1). Societies with domesticated milking animals may use milk against ingested poisons. Milk works like clay, but doesn’t cause digestive upset unless given to a lactose-intolerant adult. Treatment requires a Pharmacy (Herbal) or Poisons roll.
Immersion (TL2). Prolonged immersion in water can aid against poisons; see Immersion (p. 154).
Bleeding and purging were characteristic of Western medicine from ancient Greece until the 19th century. They began as trial-and-error methods, but humoral theory systematized them. Purging supposedly got rid of excess bile, while bleeding removed excess blood, associated with fevers and high blood pressure. Actual effectiveness is debatable. The bad effects described below certainly apply. The GM decides whether the proposed benefits are real. Regardless, critical failure on any of these treatments causes 1d fatigue and leaves the patient at -2 to HT overall until he recovers these FP through sleep.
Bleeding is done via incisions, cupping, or venesection. An incision is made with a scalpel, knife, or razor. The resulting cut is small, so a Surgery roll isn’t mandatory; an Esoteric Medicine roll at -2 will suffice. Cupping and venesection require specialized tools (below).
A related technique is applying leeches. These can be found in swampland with a Naturalist roll. They permit an unmodified Esoteric Medicine roll. Successful treatment might give +1 to HT rolls to resist injected poisons, fight local blood infections, and avoid heart attacks – or +2 on a critical success. Succeed or fail, blood loss causes fatigue, normally 1 FP, and may produce sedative effects (treat as drowsy, p. B428). Bleeding can be used deliberately for sedation, but critical failure means massive anxiety that costs an entire night’s sleep, in addition to its other effects.
Cup (TL1). This horn or metal cup is heated and then pressed against the skin over an incision. As it cools, a partial vacuum seals it to the skin and draws out blood. Roll vs. Esoteric Medicine roll to use it. A TL0 variant has a small hole; the user sucks out air through it and then seals it with wax. $25, 0.5 lb.
Lancet (TL2). A specialized knife for opening a vein. Use requires Surgery and Esoteric Medicine rolls. Failure at Surgery causes useless superficial bleeding. Critical failure opens an artery! Handle this using Bleeding (p. B420), with -2 to the required HT rolls. $25, neg.
Purging involves herbal preparations; see Drugs (pp. 150-152). The result, attained after 1d x 30 minutes, amounts to retching (p. B429). Treatment calls for a Pharmacy (Herbal) or Esoteric Medicine roll. Success might give +1 to HT rolls to resist ingested poisons and infections of the digestive system – or +2 on a critical success.
Many Esoteric Medicine specialties include observations of the physiological effects of foods. Healers will recommend suitable diets to improve the condition of the sick and injured. This counts as part of the “rest and decent food” mentioned in Natural Recovery (p. B424). A well-prepared meal of suitable foods (roll vs. Cooking or Housekeeping) can restore an extra FP; see Recovering from Fatigue (p. B427). Lack of a suitable diet gives -2 to HT rolls for natural recovery – although a caregiver with Esoteric Medicine, Pharmacy (Herbal), or Physician at 12+ can still bestow +1, for a net -1.
Ancient Roman physicians described the use of the torpedo (probably Torpedo marmorata, an electric fish related to sharks and rays) to deliver shocks to their patients. Treat this as a stunning electric shock, but with the desirable side effect of relieving certain types of chronic pain, such as headache and gout. Roll vs. Esoteric Medicine for pain control (p. 152). Critical failure means the subject suffers electromuscular disruption (p. B432).
At Neolithic TL0, Native American tribes built sweat lodges: huts that could be filled with steam by dropping heated rocks into water. Similar customs appeared in higher-TL societies; e.g., Finland’s saunas. Roman farmhouses favored dry sweating in front of a hot stove; as Rome grew richer, public baths offered both wet and dry heat. Sweating is often used simply to get clean, but the elevated body temperature and the flushing of the system give +1 to HT rolls to resist many infections.
Immersion is a TL2 method for flushing poisons from the body, developed by Greek physicians. It involves prolonged bathing, lasting at least six hours. Water is absorbed through the skin, diluting water-soluble poisons and later flushing them out. It can also help with toxemia: the generation of blood agents within the body during illness or late pregnancy. Make an Esoteric Medicine roll. Success gives +1 to HT rolls to resist poison or illness, rising to +2 after 12 hours. Failure causes no harmful side effects; the treatment is simply ineffective. The only equipment required is a tub (see Grooming, p. 36), water, and optionally a way to heat some of it.
Soaking in hot water, as in Roman baths, can give benefits similar to those of a sweat lodge; see Heat (above). It also lessens discomfort from strained muscles (such as from a critical miss in combat; see pp. B556-557).
Since the Stone Age (TL0), people have applied thick fat- or oil-based fluids to the skin for cleaning (see Grooming, p. 36), healing, and ritual (anointment means putting oil on someone). These can act as lubricants during massage (see Massage, below), serve as media for herbal medications (see Herbal Extracts, pp. 151-152), and soothe dry, irritated, or burned skin directly. Treat this last application as pain control (p. 152) for skin conditions – including skin inflammation caused by disease or contact poison.
Olive Oil (TL0). Oil pressed from olives has been used around the Mediterranean since the Neolithic. This is a high-quality oil, and thus expensive, but counts as basic equipment. Treat standard fuel oil (p. B288) as improvised, for -2 (quality) to skill. Per pint: $6, 1 lb.
Lanolin (TL1). A waxy substance extracted from sheep’s wool by washing it in water. It naturally penetrates human skin, giving +1 (quality) to creams and ointments prepared with it. It also gives +1 to HT rolls to regain lost HP after skin injuries. Per pint: $20, 1 lb.
Lotion (TL1). An emulsion prepared from water and some form of fat or oil. Herbal additives provide texture, scent, or therapeutic effects. Basic lotion gives the same benefits as olive oil; good or fine lotion gives +1 or +2 (quality) at +4 or +19 CF. Per pint: $8, 1 lb.
Massage has been used for therapeutic purposes over much of the world, starting at TL0. Its main effect is pain control (p. 152) – primarily for discomfort caused by tense or strained muscles, such as tension headaches and wrenched backs. It can relieve suffering from Bad Back (p. B123) and the crippling effects of straining a limb in combat (due to a critical miss; see pp. B556-557). Techniques based on massage play a role in midwifery (see GURPS Low-Tech Companion 1). Finally, massage can be used for acupressure (see Acupuncture and Moxibustion, pp. 152-153).
For effective massage, roll vs. Professional Skill (Masseur) or a suitable Esoteric Medicine specialty. Basic equipment is a massage table. Any flat surface can serve as improvised equipment (-2 to skill). More elaborate equipment can provide quality bonuses.
Massage Supplies (TL1). Includes a small brazier, vessels for heating oil and water, a towel that can be warmed and applied dry or wet, and a stock of consumables: oils and lotions to provide lubrication, scents, compounds to stimulate the skin, and fuel (usually charcoal) for heating. $50, 10 lbs. Replacement supplies: $10 after each day of use
Massage Table (TL1). A table large enough for an adult to lie on at full length, with a smooth surface. It normally has a pillow or a cushion to support the ankles (for someone lying prone) or the knees (for a supine subject). $150, 50 lbs.
Massage Chair (TL2). A chair designed to sit in while being massaged. It provides optimal exposure of the body to the masseur, and can be adjusted to different body sizes and postures. The typical posture has the subject leaning forward with his back exposed. Gives +1 (quality) to skill. $250, 30 lbs.
Variolation was developed in China in the 10th century (TL3). It wasn’t a treatment but a preventive measure: the earliest recorded method of immunization. It used material from smallpox lesions to infect healthy people with a milder form of the disease, either by putting it under the skin or by blowing powdered scabs up the nose. Roll vs. Esoteric Medicine or Physician to expose the patient. This is somewhat risky – the recipient must make a HT roll at +6 to avoid coming down with smallpox! If he succeeds, he’s immune to smallpox thereafter.
Low-tech societies had no truly effective treatment for someone who had stopped breathing. They equated respiratory failure with death – which may be why “breath” and “spirit” have the same root word in many languages. Still, occasional attempts were made to restart breathing: rolling the subject over a barrel to compress his lungs at TL3, or blowing air into his throat with bellows at TL4. If the GM wishes to be optimistic about such methods, he might let them work on a successful First Aid roll at -5 (the penalty for improvised equipment).
At TL5-8, technology offers increasingly dangerous manmade threats – guns, mines, fiery collisions, etc. – while opening the door to the world’s last frontiers, with their hazards and plagues. High-tech heroes can get hurt in all the old ways and dozens of new ones. Thanks to advances in medical gear, though, it’s also easier to get better!
The equipment in this chapter comes with many optional rules intended to add flavor to a scenario or even an entire campaign with a medical theme. The GM is welcome to use these when he feels they would be dramatic and ignore them when they seem burdensome. Those seeking extensive detail on medical procedures and biotechnology should see GURPS Bio-Tech.
This is an expansion of the list under Biotechnology/ Medicine (p. B512).
TL5 – Medicine is still fairly primitive; try not to get sick or hurt! There’s no dependable treatment for contagion or infection. Surgery is limited to amputation, bone-setting, trepanning, removing missiles from limbs, and cauterizing wounds (pressing a redhot iron to severed blood vessels to stop bleeding). Antisepsis and anesthesia appear very late on. Opium is known, but only as a painkiller. Most available “medicines” are ineffective; some are poisonous.
TL6 – More changes in medical technology take place at TL6 than during all previous TLs. Antisepsis and anesthesia are in wide use. The simple act of washing hands and sterilizing instruments before surgery means that most people who go into the hospital come back out. Late in TL6, sulfa offers the first actual cure for bacterial infection.
TL7 – Medicine advances so rapidly that most doctors can keep up only in one specialized field. As TL7 matures, almost any trauma is treatable if the patient is reached quickly. In developed societies, public hygiene and inoculation end all but a stubborn few epidemic diseases.
TL8 – Organs are regularly transplanted and severed limbs are routinely reattached. There’s a better than 95% chance of recovery from trauma, even battlefield injuries, if the patient enters surgery within the hour. Public health is so much improved that a difficult-to-spread disease impacting less than 0.5% of the population is a “terrifying plague.”
Almost anything in this chapter might be valuable in a medical emergency, but gear for providing the “ABCs of resuscitation” (airway, breathing, and circulation) and treating shock is essential – and highly visible in adventure fiction. Except as noted, this equipment requires a First- Aid or Physician roll to use. Remember that First Aid defaults to Physician at no penalty.
A simple First Aid roll will clear most airway obstructions (see Resuscitation, p. B425, and the notes for the choking affliction, p. B428). If a trauma victim is unconscious, it’s common procedure to intubate: insert a tube down his throat to prevent further airway complications. When this fails, rescuers must bypass the blockage, often by performing a tracheotomy. Left untreated, an obstructed airway is ultimately fatal; see Suffocation (p. B436).
This one-use kit consists of a large-bore needle that’s inserted into the windpipe – and, at TL6-8, a tube to which a bag mask or oxygen supply can be attached. The kit isn’t required to perform a tracheotomy, but improvised equipment gives the usual -5 to skill (see p. B345). $150, 0.5 lb. LC4.
This single-use kit consists of a selection of laryngoscopes, tubing, and other equipment used to extend a breathing tube down a patient’s windpipe. $200, 2 lbs. LC4.
Once the airway is established, the patient must receive oxygen in order to replenish the depleted blood supply and avoid brain damage and eventual death.
This is a rubber or plastic mask with an attached bulb or bag. It replaces rescue breathing techniques during CPR (p. 220). The rescuer holds the mask in place and pumps the bag by hand to deliver a steady flow of air to the patient. $15, 1 lb. LC4.
Oxygen was first used medically in the 1880s, when it was created by heating potassium chlorate and manganese oxide in a glass jar. From late TL6, oxygen is stored in metal cylinders and moisturized to reduce its drying effect on the mucous membranes. Switching from atmospheric air (only 21% oxygen) to pure oxygen is especially useful when treating victims of lung or throat injuries. Use the statistics under Air Tanks (p. 74) for oxygen tanks, but multiply the durations listed there by 10 for medical purposes. LC4.
This mechanical lung or “vent” provides the correct number of breaths per minute, freeing a rescuer to do things other than pump a bag mask. $6,000, 50 lbs., external power. LC4.
The heart circulates oxygen-carrying blood throughout the body. If this process fails, death soon follows. Healthcare professionals manage circulation in several ways.
The first successful human blood transfusion is commonly credited to British physician James Blundell, who transfused blood from husband to wife in 1818. The technique didn’t receive wide acceptance until WWI, however, when Britain created the first blood depots to treat the wounded coming from the trenches. Blood was stored in pint-sized glass bottles until the Korean War, when a unit of blood was likely to be in a thick plastic bag.
Since blood types were unknown until 1901, surviving an early transfusion experiment depended on a lucky match – or on the procedure failing to transfer blood! At TL6, blood-group testing is a laboratory procedure requiring refrigerated samples and either several hours of wait time or about 15 minutes and a centrifuge. At TL7-8, portable test kits produce results in minutes from a few drops of blood.
Blood or intravenous (IV) fluids can help stabilize a patient who has lost blood or become dehydrated. Most IV solutions consist largely of sterile water with small amounts of sugar and salt – although milk was used as a blood substitute in the late 1800s! An IV drip can also deliver drugs over the course of hours or days.
Blood or IV fluids are required for any First Aid gear to claim the +2 (quality) bonus for fine-quality equipment. Otherwise, the best possible quality modifier is +1. Additionally, each bag of IV fluid received counts as drinking a quart of water for hydration purposes (see Dehydration, p. B426). A sugar solution also counts as a meal for FP- and HP-recovery purposes – but long-term, a patient who can’t eat will need a stomach tube to receive food.
Starting an IV takes a minute. Most IV solutions are delivered over 4-6 hours.
IV Kit (TL6). The needle, tubing, regulator, etc., needed to get an IV solution from its bottle or bag and into the patient. $15, 0.5 lb. LC3-4.*
IV Stand (TL6). This is a stand that holds IV fluids and other related equipment. It may be the only weapon that a combative patient can easily lay hands on – treat as clumsy maul at -2 to skill and -3 to damage! $75, 15 lbs. LC4.
Plasma (TL6). Dehydrated; requires half a pint of water. Shelf life is one year. Per pint: $200, 0.5 lbs. LC3-4.*
Whole Blood (TL6). Lasts a week in the fridge at TL6; a little over a month at TL8. Per pint: $150, 1 lb. LC3-4.*
Dextrose (TL7). For meal replacement. $4, 2 lbs. LC3-4.*
Saline (TL7). For hydration. $3, 2 lbs. LC3-4.*
* LC3 where a prescription is required, LC4 elsewhere.
The fundamentals of cardiopulmonary resuscitation (CPR) are known at late TL6, but the technique isn’t commonly taught until TL7; see Resuscitation (p. B425). Make a First Aid roll to give CPR. Manual CPR – rescue breaths, chest compressions, etc. – costs the aid provider 1 FP per five minutes.
A critical advance in resuscitation is the defibrillator. This device electrically shocks the heart back into action or into a productive rhythm, greatly increasing the patient’s odds of survival.
On a successful Electronics Operation (Medical) roll, this device gives a bonus to resuscitation rolls (p. B425). It has a heavy-duty waterproof case (DR 4). If used to shock someone as an improvised weapon, the victim must make a HT-4 roll; failure produces the results described for Nonlethal Electrical Damage (p. B432).
Manual Defibrillator (TL7). Gives +2 to resuscitation rolls. Prints its output on a paper strip. $10,000, 60 lbs., L/20 uses. LC3.
Manual Defibrillator (TL8). Gives +3 to resuscitation rolls. Often has a digital readout. $10,000, 15 lbs., L/20 uses. LC3.
This miniature defibrillator has a dedicated computer that analyzes the patient’s heart rhythm and delivers a shock. The human operator need only hook it up to the subject by following audio instructions, cartoons, etc. (an IQ+4 roll). The AED then performs resuscitation with an effective skill of 12. It’s designed specifically not to allow abuse as a weapon! The internal battery is good for 30 shocks and has a five-year shelf life. $1,200, 3 lbs. LC4.
These are kits for providing medical assistance in the field. Their contents grow more advanced with TL, but the quality bonuses don’t change. Higher-TL kits are more effective in other ways, however; see Recovery (pp. B423-425).
Kits grow depleted after several treatments (GM’s decision). The reusable tools that remain let a depleted kit function at the next-lowest quality level. Grades are fine (+2), good (+1), basic (0), and improvised (-5); see p. B345.
This gear gives +1 (quality) to First Aid, and counts as basic equipment for Physician and improvised equipment for Surgery. At TL5, the major contents of a frontier doctor or field surgeon’s kit might be two dozen bandages (p. 221), four small boards for splinting, an otological reflector (p. 222), a percussor (p. 222), a stethoscope (p. 222), a suturing kit (p. 224), four doses of chloroform or ether (p. 224), 10 doses of quinine (p. 226), 20 doses of castor oil (p. 226), six doses of morphine (p. 226), and a notebook (p. 17) with a pencil, all in a leather handbag (p. 31). $200, 10 lbs. LC3.
Soldiers often carry small first aid kits. A medic can claim +1 for a full-sized kit or +2 for a crash kit while using consumables from the patient’s kit to avoid depleting his supplies.
Small First Aid Kit (TL6). This is basic equipment for First Aid. It can treat one major wound or a couple of smaller ones. At TL6, a soldier’s individual kit might contain a handful of bandages, an autoinjector with a dose of morphine (226), and two doses of sulfa drugs (see Antibiotics, p. 226). $10, 1 lb. LC4.
First Aid Kit (TL7). This kit gives +1 (quality) to First Aid. It contains more of everything in the small kit, plus foot powder (see box), insect repellant (see box), salt tablets (see box), ammonia inhalants (p. 226), analgesics (p. 226), antibiotic ointment (see Antibiotics, p. 226), antimalarial pills (p. 226), and water purification tablets (p. 59). $50, 2 lbs. LC4.
This gear is typical of what a military medic or a civilian EMT might carry. It gives +2 (quality) to First Aid, and counts as basic equipment for Physician and improvised equipment for Surgery. At TL8, typical contents are more of everything in the large first aid kit (above), plus splinting material, a bag mask (p. 219), an IV kit with a unit of blood, plasma, or other fluids (p. 220), a clinical thermometer (pp. 221-222), a stethoscope (p. 222), a sphygmomanometer (p. 222), a suturing kit (p. 224), and a microflashlight (p. 52). $200, 10 lbs. LC3.
Medics may find these items useful in emergency response situations:
Bandages (TL5). Lint at TL5, sterile gauze at TL6-7, or spray-on bandage at TL8. See Bandaging (p. B424). Enough for one wound: $1, 0.1 lb. LC4.
Litter (TL5). For carrying the wounded. $50, 25 lbs. LC4.
Body Bag (TL6). With full-length zipper and tiedowns. $5, 2.5 lbs. LC4.
Hemostatic Bandages (TL8). Bandages impregnated with a protein – derived from insect chitin – that promotes clotting. This significantly reduces bleeding. When bandaging a bleeding wound (p. B424), these give +1 (quality) to First Aid and reduce the time required to 30 seconds. Per treatment: $20, neg. LC4.
Lightweight Litter (TL8). This folding aluminum litter stows in a backpack. $500, 12 lbs. LC4.
Several day-to-day measures can prevent health problems – especially in hostile environments.
Soap (TL5). Daily use gives at least +1 to HT rolls for Contagion (p. B443) and Infection (p. B444). Month’s supply: $1, 0.25 lb. LC4.
Foot Powder (TL6). Gives +2 to resist fungal infection of the feet: “trench foot,” “jungle rot,” etc. Week’s supply: $4, 0.5 lb. LC4.
Insect Repellant (TL6). Gives +3 to resist insect-borne diseases. A 10-use bottle of “mosquito dope”: $2, 0.25 lb. LC4.
Salt Tablets (TL6). Prevent dehydration, giving +1 to HT rolls to avoid FP loss due to heat (see Heat, p. B434). Each tablet treats a quart of water. Bottle of 50 tablets: $1, 0.1 lb. LC4.
Sunscreen (TL6). Provides DR 2 vs. sunburn (see Heat, p. B434) for 2-4 hours. Four-use bottle: $2, 0.25 lb. LC4.
Vitamin Pills (TL7). Compensate for poor diets, allowing subsistence on nutritionally inadequate food. Month’s supply: $3, 0.1 lb. LC4.
Hand Sanitizer Gel (TL8). Kills most germs in seconds and then evaporates. Regular use gives at least +1 to HT rolls for Contagion (p. B443). Week’s supply: $1, 0.01 lb. LC4.
Hospitals and doctor’s offices are packed with specialized tools. Few are likely to matter to adventurers, but some are iconic – like a doctor’s stethoscope – while others are useful as scenery or plot devices. Much of this equipment requires rolls against Diagnosis and/or Electronics Operation (Medical) to operate, as indicated. Everything else uses the Physician skill.
These items – often found in a doctor’s bag, a medic’s pouch, or an ambulance – collectively constitute basic equipment for the Diagnosis skill. The GM might let a subset suffice, where appropriate; e.g., a stethoscope and a sphygmomanometer would be basic equipment for detecting a heart problem but not for diagnosing a hairline fracture of the left tibia.
A clinical thermometer measures body temperature – a useful indicator of the progression of some diseases. At TL5, such instruments are over a foot long and take almost half an hour to register a temperature. In use by the 1840s in Europe, they weren’t widely accepted in the U.S. until the late 1800s.
Mercury Thermometer (TL6). The familiar small glass tube filled with mercury. $10, neg. LC4.
Electronic Thermometer (TL8). This infrared sensor instantly reads temperature through the ear canal. $30, neg., 2¥T/1,000 readings. LC4.
This circular metal mirror is designed to reflect light from a nearby candle or lamp, thereby illuminating a patient’s ear cavity or mouth. The examiner wears it on a headband and peers through a tiny central hole.
Otological Reflector (TL5). $50, 0.25 lb. LC4.
Otoscope (TL7). The reflector’s modern replacement is a battery-powered penlight with a gooseneck viewer on one end. $150, 0.25 lb., 2¥S/10 hrs. LC4.
A percussor is a small, rubber-tipped hammer. When tapped on a pleximeter (a plate the size of a silver dollar) placed on the patient’s chest, the resulting sounds can reveal fluid in the lungs – a symptom of pneumonia. Used on the joints – the famous knee-jerk test – it can help diagnose neurological damage. $10, 0.25 lb. LC4.
The stethoscope allows an examiner to listen to the heart and lungs. Prior to its invention, physicians placed an ear directly to the patient’s chest. Early models were stiff and cumbersome. The recognizable modern instrument is a TL6 design. See also Electronic Stethoscope (p. 213). $15, 0.25 lb. LC4.
A sphygmomanometer measures blood pressure. Experiments in the 1840s were invasive – essentially controlled bloodletting wherein blood was fed to a pressure gauge. Noninvasive blood-pressure measurement dates to the 1890s. By the 1930s, the familiar “blood-pressure cuff” was a standard diagnostic tool. $20, 0.5 lb. LC4.
This coffin-sized chamber encloses the patient’s entire body below the head. Pumps expel air from the device, generating suction that pulls the subject’s chest outward to draw air into the lungs, and then reverse to force exhalation. A hand pump allows use during power outages. An iron lung serves the same purpose as the equipment under Breathing (p. 219), and is functionally a low-tech ventilator. $5,000, 700 lbs., external power. LC4.
Medical-imaging instruments look inside the patient’s body. A successful Electronics Operation (Medical) roll by the operator lets a medical professional – who needn’t be the same person – attempt a new Diagnosis roll at +TL/2 (quality) when diagnosing applicable conditions. Where appropriate, an endoscope (p. 209) or a subminiature video bug (p. 210) can be used instead, giving +2 (quality) to Diagnosis.
In 1895, Wilhelm Röntgen discovered X-rays. His research excited laymen and scientists alike. Early X-ray machines appeared in 1896, and were more often encountered on circus midways than at medical facilities! By the 1920s, though, most large cities had a hospital with X-ray equipment.
X-Ray Machine (TL6). This is little more than an X-ray source and a place to put a photographic film. At TL6, radiation isn’t well-understood; both patient and operator receive 1d rads per photograph (see Radiation, p. B435). $15,000, 1 ton, external power. LC3.
Portable X-Ray Machine (TL7). As above, but smaller and shielded for safety; the patient receives 0.01 to 3 rads from a series of X-rays. If deliberately set to maximum intensity, the machine could expose a victim to 1,000 rads per hour. $30,000, 500 lbs., external power. LC3.
Compact X-Ray Machine (TL8). The smallest X-ray machine is about the size of shoebox. It still requires a stand, a power supply, and a back plate for diagnostic use. $12,000, 14 lbs., external power. LC3.
These imaging devices allow doctors to diagnose patients in ways that simple X-ray machines do not. Computed tomography (CT), which dates to the 1970s, and magnetic resonance imaging (MRI), used clinically from the 1980s, combine computers with strong emitters to scan the body in thin slices. The resulting “pictures” are assembled into a detailed threedimensional image of the subject.
The two technologies differ most markedly in the emitters they employ: a CT scanner uses precise X-ray beams while an MRI device relies on pulses of radio energy in the field of powerful superconducting magnets. A CT scan has a higher resolution than MRI but doesn’t image soft tissue as well; MRI is a better choice for examining the brain and spine. Both sorts of devices also work on nonliving objects; archaeologists routinely use CT scans to study the internal structure of mummies, pottery, and other artifacts.
A basic scanner of either kind is $500,000, 3 tons, external power. LC3.
Ultrasound technology uses high-frequency sound waves to scan the body and generate an image of what’s going on inside. The first medical ultrasound was performed in 1953, with equipment that had been used for industrial materials testing for years.
Semi-Portable Ultrasound (TL7). Usually mounted on a cart. Takes five minutes to warm up. $150,000, 400 lbs., external power. LC3.
Portable Ultrasound (TL8). The size of a PDA. Used on the battlefield to assess internal bleeding and the like. $25,000, 1.6 lbs., S/2 hrs. LC3.
The drugs, bandages, syringes, and other consumable supplies available at TL6-8 give +1 (quality) to Physician. Without this gear, a TL6-8 doctor functions as if TL5 for the purposes of Medical Care (p. B424). Enough for 20 patient-days of treatment: $500, 5 lbs. LC3.
Made of flexible, airtight fabrics, this portable, coffin-sized pressure chamber is used to treat altitude sickness (see Atmospheric Pressure, p. B429) and the bends (p. B435). $2,500, 14 lbs., L/10 hrs. LC3.
This electronic device is the size of a large handheld remote control. A small quantity of blood is placed on a test strip ($5, neg.), which is then inserted into the unit. The analyzer returns immediate results for a collection of common blood tests (cholesterol, ketones, lipids, sodium, potassium, chloride, glucose, etc.); details vary by strip type. This gives +2 (quality) to Diagnosis where blood testing would be helpful. $5,000, 1.5 lbs., 2¥XS/300 tests. LC4.
Epidemiology is the study of diseases – chiefly epidemics – in human populations. The worst epidemic in modern history was the influenza pandemic of 1918-1919 (the “Spanish Flu”), which killed at least 30 million people worldwide. In the U.S., a third of the nation contracted the disease, crippling medical response, and there were over half a million deaths. Public gatherings were banned and the sick filled school gymnasiums. Coffins couldn’t be built fast enough. New graveyards were created across the country and city governments used prison inmates as grave-diggers.
Expert Skill (Epidemiology) (p. B194) addresses how and why diseases spread; make a skill roll to identify an obscure ailment from a live subject’s symptoms or by investigating the dwelling, water sources, clothing, etc., of a victim (living or dead). Use Physician (p. B213) to administer treatment in the post-identification phase. Designing vaccines requires Bioengineering (Vaccines) – a new specialty of Bioengineering (p. B180). Anyone dealing with an outbreak in the field needs NBC Suit (p. B192) for suits and masks, and Hazardous Materials (p. B199) to operate containment gear.
This is containment gear.
Decontamination Shower (TL6). This one-person shower catches contaminants and pumps them into drums. Set up at the edge of a HazMat safe zone, everybody coming in or out must move through it. $600, 150 lbs. LC3.
Decontamination Sprayer (TL6). Has enough decontaminant for 10 people or two vehicles. Halve weight at TL8. $500, 35 lbs. LC3.
Portable Isolation Dome (TL7). A light plastic dome with an airlock and glove inserts, for handling hazards. DR 3. $500, 5 lbs. LC4.
Quarantine Tent (TL7). A tent sealed against chemical and biological threats, with an airlock and a filter system. Has enough space for a couple of examination tables and ancillary equipment. DR 1. $2,000, 50 lbs., external power. LC3.
Stretcher Isolator (TL7). A sealed stretcher on wheels, with glove inserts, biomedical sensors (like those on p. 75, but not miniaturized), and an intercom. Requires air tanks (p. 74). $500, 500 lbs., L/10 hrs. LC3.
Casualty Bag (TL8). A sealed bag with a battery-powered filter, for short-term HazMat evacuations. $100, 5 lbs., M/2 hrs. LC4.
ply his trade, some of which is valuable to adventurers in general. These items and procedures call for Surgery rolls, unless noted otherwise. SURGICAL TOOLS The consequences of failure make improvised equipment especially undesirable for the Surgery skill. Surgeons normally work with the best tools they can lay their hands on. See Surgery (p. B424) for rules governing this hardware. Basic Surgical Tools (TL5)
These kits constitute basic equipment for Surgery – a minimalist setup that can fit into a large case or a backpack. Each has a built-in TL-dependent skill modifier. This is cumulative with Equipment Modifiers (p. B345), but note that high-quality tools use the prices under Surgical Theaters (p. 224) instead of 5¥ or 20¥ cost.
A well-maintained surgical kit can last a lifetime. Certain supplies – needles, scalpel blades, suturing material, sponges, etc. – require replenishment after each surgery, however. This costs 10% of kit price at TL5, rising to 20% at TL6-8.
Surgical Kit (TL5). Contents include scalpels, saws, chisels, shears, tweezers, sponges, retractors for holding wounds open, and a primitive rotary saw powered by pumping the grip. Many parts are crafted from wood, ivory, etc., rather than metal, making sterilization nearly impossible. Suturing material is “catgut,” made from bovine intestine; removal is unnecessary, as human tissue absorbs it. -2 to skill. $300, 15 lbs. LC4.
Surgical Kit (TL6). Instruments include precision locking forceps, small and specialized scalpels, and other allmetal tools that are easy to clean and sterilize. The reusable needles and scalpels require occasional sharpening. The included suturing material is sterilized. $300, 15 lbs. LC4.
Surgical Kit (TL7). These light, ergonomically designed instruments allow lengthy procedures that don’t fatigue the surgeon, and include micro-tools for dealing with tiny vascular problems. Many components are disposable; needles and scalpels, sharpened to a keen edge at the factory, are discarded after a single operation. Everything is hypoallergenic and easily sterilized. +1 to skill. $300, 15 lbs. LC4.
Surgical Kit (TL8). As TL7, but adds micromanipulators for handling nerves, plus scalpels and scissors with micronthin cutting edges. Rechargeable batteries power a sizable portion of the tools, allowing quicker, less labor-intensive, and more finely tuned work. Many items are constructed from titanium and exotic alloys. Interestingly, catgut is still used for suturing. +2 to skill. $300, 15 lbs. LC4.
Sometimes a surgeon needs more than just a bone saw and a scalpel. Generally, treating a major wound or performing reconstructive surgery (e.g., repairing a crippled limb) demands a surgical theater. Such equipment requires external power at TL6-8.
This is an entire room full of specialized gear – including the best anesthesia equipment (see Anesthesia, pp. 224-225) for the TL. It gives +2 (quality) to Surgery. $200,000, 1,000 lbs. LC3.
This complete surgical setup typically travels in a utility vehicle, a trailer, or a large hospital cart, and includes portable anesthesia equipment appropriate to the TL. The military often uses it as a mobile field surgery. Packing or unpacking it takes at least five minutes; half an hour is more typical. It gives +1 (quality) to Surgery and +2 (quality) to First Aid. $50,000, 500 lbs. LC3.
As Operating Theater (above), but dedicated to a single Surgery specialty; e.g., neurosurgery or heart surgery. It gives +TL/2 (quality) to that specialty but counts as basic equipment for other purposes. $1,000,000, 1,000 lbs. LC3.
Commonly found in paramedic bags and crash kits, and sometimes sold as a “surgical kit” by military surplus stores, this gear counts as basic equipment for simple applications of Surgery; e.g., stitching non-major wounds. It’s improvised equipment – giving -5 (quality) – for all other purposes, including treating major wounds. The GM decides which tasks are “simple.” $20, 1 lb. LC4.
This multi-purpose tool can cut flesh, debride a burn, or administer cosmetic surgery (p. 225), and counts as fine-quality Surgery equipment. It inflicts at most 1d-3 tightbeam burning damage. $100,000, 200 lbs., external power. LC3.
Adventurers in trouble might not have the option of seeking legitimate medical help – often because they’re short on cash or wish to avoid trouble with the authorities. Enter the “backyard doc.” This might be an unlicensed dentist operating out of a filthy tenement and preying on the poor . . . or a hotshot surgeon treating celebrities at a private mountain resort. Costs can run from cut-rate to exorbitant; quality, from first-class to quackery.
The best backyard doc is an able former professional with a troubled background. Perhaps he lost his license after a messy court battle, or was set up by a vindictive employee. Maybe he’s an immigrant whose foreign credentials aren’t officially recognized. He probably has a white-collar day job – but on the side he runs a tidy little medical practice, doing favors for licensed doctors in exchange for equipment and supplies, and providing services to those in the know at 10% of the going rate. He’s likely to have clean facilities and modern tools, but a limited supply of drugs. He might even have a key to a licensed doctor friend’s clinic in case some serious need crops up. It’s estimated that thousands of unlicensed doctors operate such businesses in the U.S., avoiding taxes and regulation, and gaining clients by word of mouth.
There are seedier options, of course. A washed-out alcoholic with shaky hands may be the only doctor who will treat a gunshot wound at 3 a.m., no questions asked. The risks are high: dirty, obsolete tools, antibiotics (if any) well past their expiration date, and a slug of whiskey as “anesthesia.” His sutures might look like the work of Dr. Frankenstein. He can, however, save a life and keep his mouth shut.
After 1850, anesthesia for surgery was commonly available in Europe and the U.S. – including at most American Civil War field hospitals, contrary to popular myth. Inhalant anesthetics are volatile, and require storage in airtight containers until shortly before use. It takes about a minute to put a cooperative patient under, or three to five minutes for an uncooperative one. If the roll to administer anesthetic fails, Surgery skill is at -2, just as for no anesthetic (see Surgery, p. B424).
These rules cover general anesthesia. Local anesthetics for minor surgery are available after 1885, and are included in medical kits that need them.
Make a Physician roll to use this device to administer chloroform or ether. Each dose costs $5. $50, 2 lbs. (plus anesthetic). LC3.
Make a Physician roll at +2 for this gear. A tank ($150, 25 lbs.) lasts four hours. $2,000, 40 lbs. (plus tank). LC3.
Cleanliness wasn’t strongly emphasized in medical care until the germ theory of disease gained acceptance, thanks principally to Louis Pasteur and Robert Koch’s work in the 1860s and 1870s. After 1870, antiseptic use greatly reduced mortality. The first widely used antiseptic was carbolic acid, an aqueous solution of phenol, with which Joseph Lister covered his operating theater in the mid-1860s. Alcohol, iodine, and hydrogen peroxide soon followed. In 1887, Robert Wood Johnson and his brothers created a small company, Johnson & Johnson, to produce the first antiseptic bandages.
Antisepsis is especially relevant to surgery: operations that were usually fatal in 1840 were routinely successful in 1900. Surgery in a non-sterile environment counts as “infected matter in the wound”; see Infection (p. B444). Surgery with properly sterilized equipment and antiseptic technology won’t normally result in infection.
Prior to antibiotics (p. 226), the only direct treatment for a contaminated wound was to flush it with antiseptic. Cleaning a wound with antiseptic removes -2 from HT rolls to avoid infection (p. B444) and requires no skill roll. A 10- use container of phenol, iodine, etc., as appropriate for the TL: $5, 1 lb. LC4.
Surgical body modification is beyond the scope of High-Tech. If it’s vital to the campaign, GURPS Bio-Tech is indispensable! Still, some procedures common in reality and fiction merit mention. The GM may wish to charge character points for beneficial changes; see Body Modification (p. B294).
The aim of cosmetic surgery – often called “plastic surgery” – is to alter one’s looks. Recovery takes from weeks to months, depending on the level of nip and tuck desired. Such operations aren’t without their dangers. Possible complications include infection, irreparable nerve damage, and one or more levels of reduced Appearance.
Removing Fingerprints (TL6). Bank robber John Dillinger dipped his fingers in acid in an effort to remove his fingerprints. Removing the skin from the fingers is effective . . . but leaves scars that are just as distinctive. It’s easier to wear gloves! In a cinematic game, surgically removing fingerprints costs $1,000 per hand. LC2.
Changing Body (TL7). Surgically removing fat tissue through such techniques as liposuction – or grafting it onto the body – can safely alter build (pp. B18-19) by one step in either direction. Allowed levels are Very Fat, Fat, Overweight, normal build, and Skinny, in that order. After the operation, adjust weight accordingly. Recovery takes a week. $5,000. LC4.
Improving Appearance (TL7). Starting in the 1950s, a variety of procedures – collagen injections, facelifts, etc. – can improve Appearance (p. B21) to Attractive (TL7, $4,000), Handsome/Beautiful (TL7, $8,000), or Very Handsome/Very Beautiful (TL8, $12,000). Each step is its own operation! Recovery takes a week per operation. LC4.
Laser surgery on the eyes can cure Bad Sight (p. B123). This costs $2,000 per eye. Recovery takes a couple of days. LC4.
Medical prosthetics are Mitigators (p. B112) that let the wearer partly “buy off” crippling disadvantages. Many give lesser disadvantages – they don’t eliminate the problem completely. If a PC acquires prosthetics to treat disabilities for which he claimed points, the GM may require him to pay back the point difference between his original condition and the replacement traits specified for his prosthetics.
Eyeglasses correct Bad Sight and provide minor eye protection as described for Glasses (p. 71), but are fragile. Roll 1d if struck in the head: on a 1, they break; on 2-3, they’re knocked off. Spares are advisable! Teddy Roosevelt routinely carried an extra pair or two . . . which was fortunate, because a pair was shot off his face during the Rough Riders’ famous charge up Kettle Hill in the Spanish- American War.
Eyeglasses (TL5). Replace Bad Sight [-25] with Bad Sight (Mitigator, -60%) [-10]. $150, neg. LC4.
Contact Lenses (TL7). These can’t get knocked off or broken, but provide no eye protection and may melt if exposed to harsh chemicals (the GM may assess -1 or worse to rolls to avoid eye injury). Otherwise, treat as glasses. $150, neg. LC4.
The best TL5 prosthetic limb (contemporary with the American Civil War) has a suction-fitted socket, hinges at natural locations, action controlled by catgut lines, and a rubber foot or hand. At TL6, the structure is aluminum rather than wood or iron; walking is possible, but arms can only crudely grasp. Well-designed TL7 models have electric- or hydraulic-powered joints, and sensors to detect and direct action, making grasping or running possible – but arms are still less-advanced than legs. By TL8, microprocessors, myoelectrics, and advanced alloys let prosthetic limbs work much like real ones.
Basic Arm Prosthetic (TL5). Replace One Arm [-20] with Ham-Fisted 2 (One Arm, -40%) [-6] and One Arm (Mitigator, -70%) [-6]. $2,000, 3 lbs. LC4.
Basic Leg Prosthetic (TL5). Replace Missing Legs [-20] with Missing Legs (Mitigator, -70%) [-6], and apply Mitigator, -70% to one point of reduced Basic Move. $2,000, 6 lbs. LC4.
Advanced Arm Prosthetic (TL8). Replace One Arm [-20] with One Arm (Mitigator, -70%) [-6]; 8 hours between recharges. $40,000, 2.5 lbs. LC4.
Advanced Leg Prosthetic (TL8). Replace Missing Legs [-20] with Missing Legs (Mitigator, -70%) [-6], and apply Mitigator, -70% to all reduced Basic Move; 30 hours between recharges. $40,000, 5 lbs. LC4.
Replace Hard of Hearing [-10] with Hard of Hearing (Mitigator, -60%) [-4]. $500, neg., T/400 hrs. LC4.
Wheelchairs let those who can’t walk retain some mobility. The muscle-powered version described on p. B142 is $300, 40 lbs. at TL8.
Electric Wheelchair (TL6). An electric wheelchair has Move 3 and can operate for two hours. $1,500, 150 lbs. LC4.
Advanced Wheelchair (TL8). This high-tech model can balance on two wheels (raising the occupant to eye level with a standing person) or cruise at Move 3 on four wheels. Its wheel arrangement lets it handle curbs and even stairs (a step per second). $30,000, 250 lbs., VL/6 hrs. LC4.
Substances with medical benefits – real or imagined – are “drugs.” Those used to kill are “poisons.” The distinction frequently turns on dosage and intent. Critical failure on a Physician roll to prescribe or administer medication, or on a Pharmacy roll to prepare it, may poison the patient! See Poison (pp. B437-441) for important rules relevant to drugs and poisons.
Most TL5 medications are experimental and dangerous. Starting at TL6, the situation improves greatly.
Waved under a stunned or unconscious person’s nose, “smelling salts” allow a HT roll to recover immediately. $0.20/vial (good for 20 uses). LC4.
This purgative – billed as a “cure-all elixir” in the 1800s and used as a punitive prescription for naughty children long afterward – might give +1 to HT rolls made to avoid the ongoing effects of some stomach ailments and digestive poisons. $1/10 doses. LC4.
Morphine became available in the early 1800s and saw widespread use during the American Civil War. It and similar powerful analgesics use the rules given for painkillers under Depressants (p. B441). $1/dose. LC3.
Quinine gives +3 to HT rolls to recover from malaria symptoms. At TL5, preventative use is understood: daily doses before, during, and after travel in a malarial area grant +5 to HT rolls to avoid contracting the disease. $1/dose. LC3.
Activated charcoal can help neutralize and limit further damage from many common digestive poisons, including arsenic and strychnine. It adds +3 to HT rolls for this purpose. $1/dose. LC4.
Aspirin and similar mild pain relievers negate -1 or -2 in penalties from pain (p. B428) after adjusting for High or Low Pain Threshold. They’re also useful against hangovers (p. B440). $3/100 doses. LC4.
Sulfa drugs are available starting in 1936; Penicillin, from 1944. Antibiotics grant +TL/2 to HT rolls against bacterial disease or infection (see pp. B443-444). Resistant bacteria reduce or negate the bonus! $0.50/dose to treat a wound, or $10/two-week course to treat an illness. LC3.
Antibiotic ointment (TL7) on a wound gives +TL/2 to HT rolls vs. infection. $5/10-dose tube. LC4.
A bitter yellow pill, Atabrine is similar in effect to quinine. Given weekly or daily, it may make the patient slightly nauseous. $5/30 doses. LC4.
This gives from +1 to +TL/2 to HT rolls against one specific poison. Available for many types of venom, but not for all toxins! $10-$500/dose. LC3.
This cocktail of drugs removes radioactive matter from the body; see Radiation Treatment (p. B436). It also eliminates metals such as antimony, arsenic, and lead, giving +TL/2 to HT rolls against poisoning. $500/treatment. LC3.
At TL7-8, drug therapy can keep many psychiatric and neurological problems at bay. Treat this as a Mitigator (p. B112) on the affected disadvantages. Candidates include Chronic Depression, Epilepsy, Flashbacks, Lunacy, Manic- Depressive, Paranoia, Phantom Voices, Short Attention Span, and Split Personality.
Drugs potent enough to banish such conditions completely often come with side effects, which can be as bad as the problem they treat. Sometimes, they’re worse! Possibilities include Absent-Mindedness, Addiction, Bad Temper, Confused, Extra Sleep, Impulsiveness, Indecisive, Insomniac, Killjoy, Laziness, Light Sleeper, Low Pain Threshold, Motion Sickness, Overconfidence, Overweight, Paranoia, Short Attention Span, Slow Riser, and Unfit. Some effects can be caused or treated! Price varies. LC3.
While these agents have medical applications, their sinister uses are of greater concern to adventurers.
Sedatives like Sodium Pentothal and Sodium Amytal are used for drug-assisted interrogation (narcoanalysis). After 30 seconds, the subject loses 1d FP. He must also make a HT-1 roll to avoid -2 to Will and to self-control rolls for mental disadvantages for the next (20 - HT)/2 minutes. $10/dose. LC2.
Dimethyl sulfoxide (DMSO), a solvent derived from wood pulp, is remarkable mainly because it can carry other substances through the skin. In game terms, one dose allows a dose of any blood or digestive agent to function as a contact agent. $0.20/dose. LC4.
Perhaps the best-known user of poisons in recent times was the Soviet Union. In 1954, Soviet assassin Nikolai Khokhlov defected to the CIA after warning the man he was assigned to murder. In his possession was a silenced gun, disguised as a cigarette case and loaded with cyanide-tipped bullets. Three years later, the KGB retaliated by slipping thallium into his coffee. Khokhlov survived – barely – despite losing all his hair, turning brown, and seeping blood from his pores. In the 1970s, several unrelated KGB assassination attempts involved umbrellas designed to deliver ricin-laced pellets.
High-tech assassins may use the toxins below or those under Poison Examples (p. B439). The effects of poisoning include coughing, nausea, choking, paralysis, retching, and seizures; for rules, see Afflictions (pp. B428-429).
Curare, long used by tribal cultures of the Amazon, is produced from the vine Strychnos toxifera. Scientists first observed its effects in the early 19th century. It’s a followup poison with a one-minute delay and a HT-6 roll to resist. It causes 2d toxic damage regardless of the roll; any failure indicates paralysis as well, and critical failure adds choking. This repeats at 30-minute intervals for four cycles. An antitoxin is available; it takes 30 minutes to work. $50/dose. LC1.
Ricin is a blood, digestive, and respiratory agent extracted from the seeds of castor beans (Ricinus communis). After an eight-hour delay, the victim must make a HT- 2 roll. Regardless of the roll, he suffers 3d toxic damage, nausea, and vomiting; failure means he also experiences coughing. This repeats at eight-hour intervals for 10 cycles; failure on both the initial roll and any future roll results in choking, which is potentially fatal. $1/dose. LC1.
Strychnine is a digestive agent with a 15-minute delay. The victim suffers seizures and must make a HT roll to avoid choking. This repeats at five-minute intervals for 2d hours. $5/dose. LC1.
These digestive agents are produced by the bacterium Clostridium botulinum. After a 12-hour delay, the victim suffers 4d toxic damage, nausea, and retching. At the next 12-hour interval, he must make a HT-1 roll to avoid paralysis, with each consecutive 12-hour cycle increasing the HT penalty by -1 (e.g., after 48 hours, the subject must roll HT- 3 to avoid paralysis). The neurological damage the paralysis represents heals as if a lasting crippling injury (p. B422) of the lungs and spine; the victim must be immobile and on ventilation for the entirety of the healing period. An antitoxin exists, and can prevent further effects if given before paralysis sets in. $200/dose. LC1.
Exposing thallium to high doses of radiation creates this insidious digestive poison. After a three-hour delay, the victim receives 1d toxic damage, repeating every 24 hours for 10 cycles. The victim also suffers gastrointestinal syndrome from the radiation (see Radiation, p. B435), and must make the usual daily HT rolls for that. $1,000/dose. LC1.