This pdf is 16 pages long, 1 page front cover, 1 page editorial/SRD, 1 page introduction,1 page back cover, leaving us with 12 pages of content, so let’s take a look!
The pdf kicks off with rules for chirurgery, which is portrayed as an unpleasant ability to modify bodies in ways they were not meant to be modified in a world where magical healing is the default. Basically, it requires the skill focus (heal)-feat or at least 5 ranks in Craft (alchemy). If you meet either prerequisites, you may learn chirurgical procedures in a way similar to spells – upon learning them, though, you can use them at will. Studying from a book or another practitioner is possible and learning from corpses is harder than from live subjects. The procedures also feature a chance that you learn an imperfect version of the respective procedure, imposing a permanent malus on your check to perform it until you manage a perfect success. These procedures do spend your kits, though. When using the madness-rules used by the Gothic Grimoire-series and first introduced in Tomes of Ancient Knowledge, these procedures might drive a recipient of the chirurgical procedures insane – a rule I suggest you drop when not using these in the context of a fantasy world where magical healing is readily available.
Now how are procedures handled rules-wise? Essentially, 3 skill-checks are required: Disable Device, Craft (Alchemy) and Heal. 3 successful checks mean a complete success, whereas two are a partial success and 1 means a failure – and there is the potential for catastrophic failures as well. Interactions with skill mastery and similar abilities as well as a lack of assistants is covered as well and beyond even that, the respective procedures have an associated synergy-skill that provides a +1 bonus to all skill-checks for every 3 ranks the practitioner has in the respective synergy skill.
A total of 11 such procedures are covered with DC, the amount of days it takes and the amount of healer-kit uses the procedure expends per ongoing day. It should also be noted that there are possibilities to reverse these respective procedures. At the very latest when reading the respective procedures, one realizes that Hippokrates would not smile upon these procedures since they indeed have a very sinister tint to them: Whereas changing the appearance might still be moderately common and neutral (though terrible things can be done with this), implanting phobias and multiple identities of your choice (including a list), enhance non-lethal damage healing, grafting vestigial or functional fins and wings, implanting suggestions, modify memories or erase memories of class abilities and similar tricks via Induce Amnesia, or get REALLY nasty. Want to implant drug reservoirs, lobotomize victims (though the repercussions of this one are not severe enough for my tastes) or even implant instant-kill-switches? Yeah, you can do that. You could of course also use these for healing purposes via the general surgery, but where’s the fun in that? "White" surgery to get rid of blindness/deafness, attribute damage and drain etc. are btw. not covered in here – while they wouldn’t fit with the theme, I maintain that more procedures in future supplements would help to make the complex subsystem more relevant.
After that, we are introduced to a beautiful full-colour one-page artwork of a new grimoire, On the Clockwork of Caterpillars, a grisly tome that includes the procedures featured in this book as well as access to two new feats as well as the pieces of information to create a variety of constructs. The Anatomical Precision-feat allows the character to use his anatomical knowledge to study foes and help criting/sneaking them. Anesthetist allows the user to improve unconsciousness-poisons or use your antidote/healer’s hits to ameliorate pain – either fast or slowly.
The final pages of the product are devoted to two new creatures – the first being the Cyberphrenic Tadpole (CR 1/3) that can invade others and telepathically manipulate those invaded by it and relay the creator’s commands – like in the Construct Codex, we get a one-page glorious full-colour artwork of the critter, easily producible as a hand-out to players. Beyond this, there is the CR 5 Cranial Dissectibot (CR 5) – essentially an operating table with saws etc. that can drill into the skulls of helpless creatures and restrain patients – a perfect companion for mad doctors who don’t want the clichéd Igor and rather make their own friends when operating.
Editing and formatting are top-notch, I didn’t notice any glitches. Layout adheres to Legendary Games’ 2-column, drop-dead-gorgeous full-colour standard and the pdf comes in two versions, one slightly more printer-friendly than the other. The pdfs come fully bookmarked and the original pieces of full color artwork are legendary indeed and rank among the finest pieces one can find in any roleplaying product out there.
The Mad Doctor’s Formulary provides a complex, yet easy to grasp non-magical system for surgical procedures of the more sinister kind and offers some really nasty options. That being said, they are not perfect. Perhaps due to the brevity or for playability’s sake, the potential for relatively simple reversal of the procedures means also that the procedures lack a bit of the gravitas they otherwise would have – catching characters alive is hard enough and being subject to such an operation should have characters steaming and the mad doctor cackling – since the procedures not even require a caster-level check versus the doc’s surgical skill to be reversed, they at least in my opinion lose some of their threat-potential and "we’re screwed/what have you monster done"-mentality.
There is a second thing you should be aware of when getting this – while the rules presented herein work as a rudimentary alternative to magical healing, this is not the liberating strike for non-magical healing it could have easily been, were this a longer book with benevolent surgery included. While I won’t hold that against the pdf, I still feel that this book’s potential transcends greatly its rather tight focus.
That being said, for what it is, for its tight focus on disturbing medicine, it works exceedingly well and rating it instead as a book that makes non-magical healing valid is simply not fair. Still, a sense of a missed opportunity, at least for now, suffuses my reception of this otherwise stellar offering and hence my final decision of settling on a verdict of 4.5 stars -still rounded up to 5, but short of the seal of approval. If evil medicine only moderately interests you as a concept, I still wholeheartedly encourage you to check this out.
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