The world of Rulers of the Sea is plagued by 15 diseases, ranging from the inconvenient Syphilis and Gripes to the very dangerous Typhus, Cholera and Bloody Flux. Each port and city carry a number of these diseases, depending on region, climate and hygiene. Any workers that are employed in these places, or any sailors or soldiers that pass through them, can get infected. If not properly treated, it can spread. The world is also a hazardous place, both in violence as in work. Workers, crew and soldiers can get injured. There are 8 injury types, ranging from musket balls, shrapnel, broken bones and burns and even frostbite. These depend on the activities and regions the people are engaged, and on how well organized the work place is.
All these inflictions have a mortality rate. If left untreated, the person either dies or survives and can work again. If treated by a Surgeon, the chances of the ill and injured improve, but they improve even further if that Surgeon is specialized in the particular affliction.
Each ship can choose to carry a ship’s Surgeon on board at high wages. Each port has a hospital where the sick and injured can also be treated. Treatment takes time, leaving a person at hospital comes at a cost but improves their chances considerably. If a character survives a disease they build up an immunity and can’t catch it again.
Gamers can purchase and run a port hospital as their family business. Hospitals earn their money from selling medicines, medical supplies, providing treatment and educating Surgeons. The basic hospital is just a clinic for treatment, but it can be expanded with a Pharmacy, a Medical Instrument workshop and a Surgeon Academy. Each hospital expansion is an investment but also reduces the number of port diseases. The Governors of ports might be willing to sponsor such investments to make their port more attractive to settle in or visit.
There are 30 different medical courses Surgeons (including the gamer) can follow to specialize in specific treatments or abilities. Surgeons that have followed all of them can become Professors and teach other Surgeons. Creating Surgeons is not straightforward because only few recruitable characters have the right personality and intelligence for the trade.