This thread is basically just to get corrections, comments and opinions about what people think about the infection rules. There are also a few questions and rules interpretations along the way.
I recently had occasion to read and really think about the infection rules, and boy are they brutal! If a character is wounded, and has lots of current damage, and there is a physician available, they are unlikely to suffer an infection. If there is medicine, but no physician, they stand a small chance of not dying from infection. If there is nether antibiotics nor a physician, they stand almost no chance of not dying by the RaW. What is more, the higher Current Damage you start out with, the more likely you are to die of Infection, thus characters with high Durability can avoid death by current damage for a while, but unless a physician and medicine is available, are almost certain to die of infection a few days later.
Now I know that one of the goals of 1879 was to be more gritty, dangerous, and realistic, and I know that prior to WWI, more soldiers died from infections or disease than died actually on the field of battle, but the RaW have practically zero chance surviving a wound and high damage without a physicians assistance, which I think is a bit too gritty. There ought to be SOME realistic chance of surviving without a physician and modern medicine.
Background: So we had a party provisioning for an extended jungle expedition. We had a large budget to stock up on what we needed, and we had a priest, who had physician skill, and he stocked up with physician kit refills and medicines, but nobody now knows how much of each. That player quit the campaign, and nobody really gave a thought to that character fading away with all the parties stock of medicines. In subsequent sessions we had a few players with single wounds, but the current damage was always low enough that the wound was cleared away before anybody bothered taking a closer look at the infection rules. Now we just finished a fight with one character having 40 points of current damage and two wounds. The character has durability, so is still conscious, but with no physician within a weeks travel, and no guarantee of that native village having anything like an antibiotic, he seems doomed according to RaW. We are not going to use the RaW in this situation, but still it seems like the lack of a physician should not be an automatic death sentence in the RaW..
Now if we played this out by RaW, the character, with TOU step 7, would make recovery tests, with a -2 to the result. This would result in an average result of 5 (sure, some rolls will probably be higher, but some will also probably be lower). Thus, on average, it will take 8 recovery tests to clear out the current damage. Thus 2 and 2/3 days of recovery tests. If I interpret the rules on page 240 correctly, The character takes his recovery tests for the day he was wounded, but does not risk becoming infected that day (Note that this is a generous interpretation of the rules, assuming that an infection test does not need to be made the day a wound is taken, and assuming that "+2 for each day after the first" is referring to days in which an infection test must be made, not referring to days in which you are wounded. Ether of those could be interpreted less generously, which makes the situation even worse). The next morning, he still has current damage so automatically takes a new recovery test, at that time (I assume it is at this time) he makes an infection test (TOU only since he does not have Stout Constitution), TN 7 (6 plus 1 for having a 2nd wound). Assuming the character has a step 7 TOU, he has about a 50% chance of making that. The character takes the remainder of that days recovery tests, which (assuming average results of 5 on each test), lowers current damage to 10. The next morning he makes another infection test, TN 9 (6, plus 1 for a 2nd wound, and plus 2 for it being the 2nd day he makes an infection test). He has about 1 in 3 chance of making this test. This 2nd mornings tests will on average clear all of his remaining damage. The third morning, he (finally) heals one of his wounds, but needs to make another infection test because he has a wound remaining, TN 10 (6 plus 4 for being the third day). At step 7 he has 1 in 4 chance of making that test. The 4th morning I presume he would heal his 2nd wound without needed to make another infection test.
If I did my math right, he has only about 1 in 24 chances of succeeding in all three infection tests. If he does get infected, then there is no way to clear up the infection without both antibiotics and a physician, and it is merely a matter of time (about 5 days assuming normal statistics - maybe a few days longer given some lucky rolls) before the infection inevitably kills him.So to sum up, if no physician and no medicine can be found, the character has 23 in 24 chances of dying within 6 to 10 days.
Lets look at the situation if medicine is available, but a physician is not. If clean bandages and powdered penicillin are applied to each wound each day, then the TN for the infection test is 6. In the example above, this would require (depending upon how the rules are interpreted) somewhere between 5 and 7 doses of penicillin @ 1/2 each and physician kit applications at £1/5 for 3. That probably works out to about 3 pounds sterling, but well worth it. The problem is that even with all that medicine, the wounded character still needs to make three infection tests, TN 6. Assuming a TOU step of 7, Each one has a 7 in 12 chance of succeeding, so the chance of making all three is only 20%. If even one is failed, a wound becomes infected and there is no way to cure it without a physician, thus there is a 4 in 5 chance of dying within 6 to 10 days if there is medicine, but no physician.
Lets look at the situation if a physician is available. The physician will make physician tests, one for each wound, TN 5. If he fails a test, he may attempt again (up to patents number of daily recovery tests per wound attempts per day). Once he eventually succeeds on both wounds, the patents recovery tests will no longer have the -2 due to the wounds. The physician can make additional physician tests to actively boost the recovery tests. This will probably knock at least one day off of the recovery time, healing the 2nd wound the 3rd day, rather than the 4th. It does not appear as if anything other than physician test refill usages need to be used up. Don't need additional antibiotics (maybe they were included in the physician kit refill).
The physician skill description says "Treating Wounds also eliminates most risks of infection." but does not define the term "most". I have decided to interpret that as "most of the normal risks of infection", which is to say the normal risks of infection described on page 240. Which is to say if the patent keeps to calm, dry, bed-rest, there is no risk of infection, you only need to make infection checks if the wound gets dumped into a swamp or in some other way increases the risk of infection such as not keeping the wound as clean and dry. There could however be differing interpretations of that rule.
Lets also look at getting an infected person to a physician. There is a great big logic bug in the rules for curing a person of infection. "In order to clear an infection, the character must be treated with antibacterial medication and receive medical care (a successful Physician Test by another character or a Gamemaster Character) for a number of days equal to the duration ofthe infection." Using this rule, it is clearly impossible to clear up an infection except upon the very first day. IE: you get an infection, and the doctor treats it the first day, and it is cured. If the doctor fails to treat it until day two, then the doctor can never catch up, the duration continues to grow until the infection is cleared up, but the infection is not cleared up until treated a number of days equal to the duration, which continues to grow during treatment. I think the obvious intent here is to replace the words "duration of the infection" with "number of days the infection was not successfully treated".
Also note that for some reason the rule quoted above specifically does not allow a character to treat their own infections. I personally feel that this is both unnecessary, and unrealistic. Sure it is harder to treat your own infections, but only because the infection lowers your own PER which will lower your physician test. But if you are the only physician available, the rules adding a gratuitous limitation that only "another character" can treat your infection seems both unnecessary and wrong.
Thus a better version of the rule would be wrote:In order to clear an infection, the character must be treated with antibacterial medication and receive medical care (a successful Physician Test per day) for a number of days equal to the number of days the infection was not successfully treated.
So to sum everything up, According to the Rules as Currently Written, having a physician available is not just handy or a luxury. Taking a wound and a lot of current damage absolutely requires access to a trained physician or wounds will almost certainly become infected, and because infections can only be cured with a trained physician test and antibiotics. Expeditions away from civilization ought to have two physicians along, since physicians can't cure their own infections.
I can't say that I disagree with the conclusion that expeditions away from civilization ought to have at least one person with some medical knowledge along, but the chances of infection and certainty of it killing seem unrealistically harsh. Not that millions of people have not died of infections, and that having a physician and antibiotics available are not greatly, greatly preferable. It is just that their lack should not be an automatic death.