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Slight aside, but Cain is a Hero of the Imperium, and also has the ear of a Sector Lord General and the Inquisition. I don’t think he would have any trouble organising a few more automatics for any regiment he was attached to. Also it was noted that the 597th in particular ended up with double the trickle reserves due to their amalgamation. I imagine that could also be applied to medical supplies.

Fair point. Not sure it would lead to higher end bionics/augmetics/prosthesis necessarily, but it is established they gain more materiel than usual because they’re merged, and someone somewhere did the paperwork a bit wrong.

Pulling numbers out my bum for hypothetical? Let’s say the Munitorum rations out medical supplies, up to and including bionics on a pro-rata basis. Let’s say 1 bionic leg per 10 Guardsmen.

If, so far as the Munitorum’s records state the constituents of the 597th as both full strength regiments? They’d now be getting around 1 in 5 or similar.

Which I’d argue such a relative abundance of supplies leads to a less exhausted surgical staff. Because Right Tool For Right Job leads to speedier and better results than “I’ll find a way to bodge my way round this”. Especially if we (not unreasonably assume) Proper Job patch ups lead to fewer operations trying to sort out a Bodge Job, and so fewer unnecessary repeat patients.

Fewer niggling injuries (incorrectly set bone type stuff) also prevents erosion of overall combat fitness, in turn potentially leading to fewer casualties in the first place. Not to mention if you can replace both of Cpl Jones’ legs, where another regiments might only be able to replace one? Cpl Jones isn’t pensioned off, allowing you to retain not only his or her raw skills, but experience and respect within the command structure.

Another thing to keep in mind is that the humans of 40k aren't the same as us - they've had 30-odd millennia of 'evolution' and genetic tampering. We know there are things on Necromunda & Catachan that will kill offworlders instantly but the natives are fine with.

Also, if anyone's seen the Fallout TV show - their bionic foot is how I imagine most 40k bionics work!

Thinking further, it seems not only do bionics of course increase the survival rate, but post-implantation recovery is pretty swift.

That I feel also tells us of hidden minutiae. That there’s a way past tissue rejection, and the bit where it’s joined to the body is also rapidly healed

We also don’t seem to be presented with much in the way of the recipient having to learn how to use the bionic, regardless of what’s been replaced.

That is suggestive even relatively primitive bionics (which don’t fully replicate the original’s range of movement) must have some kind of neural interface - though again I’d suspect of varying complexity.

I think this is where the STL style of technology creation comes from in the Imperium. It wouldn't surprise me if even fairly basic bionics are using very advanced interface setups that are insanely generic and produced en-mass (so that trickle down means that areas like underhives have some access to them).

So whilst the Bionic itself might be simple or basic, the interface is a standard issue design that's pretty advanced. Letting people get on with using the bionic without a long adaptation period or risks of rejection and the like.



So very much like the Fallout "new foot" attachment. It's fitment and function are brutal and functional, but the actual bits that make it work properly with the body, are very advanced.

The way technology is in the Imperium its very easily possible to have this kind of two tier level of technology in practical use around the Imperium.

The Guard (normally through the Departmento Munitorum) commonly sources materials locally.

So the supply of bionic replacements from off-world supply chains doesn't need to be particularly high if the world in question is sufficiently advanced to have bionics available (i e. not a feral or feudal world). Most Imperial worlds will have at least some bionics floating around, and the Guard would be able to requisition whatever is available as a priority in a warzone, civilians be damned.

In the Last Chancers series, Lt. Kage basically gets major PTSD and dissociative disorder that allows a daemon in later, but when the Biologis treats him, he basically says he suffers from "an imbalance of humours" and they had to trepan his skull to let the the vapors out. It works, but just goes to show again how backwards Imperial tech is, where ancient superstitions supersede any scientific method. This just goes back to Mechanicus problem as them revere all knowledge, but they can't separate old and defunct beliefs with what they have. There is also the fact that they are capable of miraculous things, like extending life/ bionics/ etc, but this is more due to the STC's doing what they do and the "machine spirits" also doing their jobs.

Well, Kage is

Whilst the biologis adept operating on him certainly didn't know that (or he would have been executed), there is a lot going on with Kage.

The surgery seems to be a kind of localised lobotomy. I am not going to discount that this could actually be effective in reducing psychiatric symptoms if you're willing to accept the side effects of localised brain damage. If all the organisation cares about is returning a "damaged" and otherwise useless soldier back to the meatgrinder as quickly as possible, I can see why they'd use such techniques.

I don't think we can make many strong inferences from the "vapours" part. That could easily be how the biologis felt they needed to word the explanation for an uninitiated commoner to understand the mysteries of medicine (and may well be a euphemism to disguise the fact they just deliberately damaged Kage's brain). The one delivering the explanation was a field surgeon, this was out of their area of expertise too.

Whilst going on a Fallout 4 rampage, with my recently acquired Explosive Assault Rifle, some thoughts on the ongoing impact of the STC shook loose.

I’ve long argued that the miraculous nature of the STC is the main reason, if not direct cause of, man’s short, sharp fall from grace.

TL/DR is that when a society has essentially genius level Industrial Replicators, the need for the wider population to properly understand said machines rapidly drops off. All you need is enough sense to be able to read any operators manual for the goodies being produced. If it breaks, the STC can repair it, or produce a robot to repair it.

But, for medical stuff? Maybe that’s all we really need. With genuine and undying respect to our medical professionals (without whom I’d be dead many, many times over.) if we had largely automated, self calibrating and attaching bionics and organ replacements, the years of study and career long ongoing learning and development of Doctors and Nurses could become a thing of the past. Because much of the knowledge needed for say, a successful heart transplant, is within the bionic heart you’re using as the replacement itself. It plugs itself in. Maybe even hoying out the old one as part of the process.

With that level of tech? You just need to know the heart is in the chest cavity and not the kneecap, and how to open that up with some level of efficiency. The really difficult and skilled bits are then taken care of by technology.

And so, whilst we clearly have highly skilled medical professionals in 40K? We have a clear route to surprisingly efficient first aiders and back street doctors. Because the knowledge barrier for successfully treating your general day to day injuries, owies, mutilations, boo-boos and manglings is much lower.

When I think of Medicine in the Imperium I usually think of one thing. The book storm of Iron. The cancer drugs that don't fight chancer but cause it. The one lone soldier climbing the mountains, scouting, reporting and eating rations, the best he'd felt in years and then, thank goodness he can start taking those meds again at the end of the book.

Human lives hold next to no value to the Imperium so good luck.
If they have real medicine I would imagine it is reserved for those people who live at the top of the spier or lead one of the houses and maybe their kin. I'm sure there ae mandatory vaccinations to keep Nurgle's "good works" from spreading too fast but I can't see it being more than a cost override thing. Humans are of nearly no value to their own rulers.

And yet we see even in the Underhive, the general populace surviving not only horrific conditions well into adulthood, but also horrific injuries.

So there’s must be some valuing of human life and efficient-if-you-can-get-to-it medical care going on.

Yeah, even far back as the black plague, without any knowledge of microbes/ penicillin/ infection vectors, etc; people knew if you took pus from the sores of those infected, you'd get a mild case and then be immune. Cotton Mather tried the first inoculation back, again, when he knew nothing of modern microbiology. (Me Dad's a microbiologist..) But yet the Imperium still manages to live in all these places with alien germs, so they have at least some way to combat them.. Then again, in Liber Xenologis, Darius Hinks includes a copy of the common maladies and the propaganda's answer is to "report to a Astra Militarium agent".. BLAM! No more diseased citizen= no more disease!

Both the Infantryman's Uplifting Primer and Xenology offer different views on medicine in the Imperium. The Primer states base things that everyone knows now like # of human bones, what a cut is, etc and again also states you have to have your humours and fluids in balance. Even basic things like applying a tourniquet require you to "Recite the Litany of Blockage". And Cowardice is a medical condition of the "feeble minded".. Then, you have a Xeons Biologis dissecting aliens and in his notes, it's like "Oh, yeah- take a look at this DNA strand"...

The latter I think is due to the Imperium's lack of communication and knowledge of the average citizen, so basic medical infantry needs are just that VERY basic, while the former is due to the Mechanicus's hoarding of tech/ knowledge. They may not even know what DNA is, since it could just be a machine they put blood into and go "oh, yeah, that strand looks different here". Like how

And I hate this being the #1 caveat in 40k background, but it depends on the writer and if they want to lean into the medieval/ gothic aesthetic or go space opera/ high tech future that is the mish-mash that is the 41 millennium..

The Uplifting Primer you mentioned seems the best lens.

It has useful information, like fairly basic biology to describe our Worky Bits to even the most ignorant.

That it sits alongside proven nonsense like the balance of humours? That I feel feeds into my argument that the medical care available is so advanced and use friendly (put on stump, pull red string, tell them to get up and sod off) that more advanced knowledge just isn’t as required as it is today,

Consider open heart surgery. The actual removal of the old and implant of the new is…arguably relatively basic knowledge. Start cutting here, start stitch there. As in if given a dead body and a replacement heart, the basics of “take that out. Put this in” I think a lot of people could do a decent enough job with not a huge amount of training.

Where the specialist knowledge really comes in is What Can Go Wrong, How Can We Avoid It Going Wrong, Identifiying Exactly What’s Gone Wrong, And How To Fix That.

And it’s that bit I argue the STC nature comes into play. The whole of the thing is designed to help establish a successful colony Who-Knows-Where, without requiring every would be colonist to be particularly specialist in any given area. I mean, such person would help. But it’s High Sci-Fi Rugged Frontiersmen based.

And so self locating bionics with in-built time release analgesics and antiseptics seems….really sensible and doable. And given the remarkable extent of DNA fiddling in the setting? It’s possible it has some tech wizardry way to mimic the natural organ, all but ruling out the body rejecting the implant as a foreign body, without requiring immune suppression.

Besides herbal remedies that might be discovered I think the base level of health care is good because of the STCs. The machinery used will be created by STC and will have been designed to provide auto doc level care from an untraditional user - like most STC equipment still in use.

Who can access said health care is still all wrapped up in the feudal and class systems in place across the imperium

This is just me spitballing an idea, but there is precedence:
It may be that certain families or planets have had self-replicating nanobots in their blood that helps them fend off all the major threats to health in 40k. We've seen Dark Age of tech can get VERY high tech, like the metal that repairs itself from Hammer & Bolter: Kill Protocol. In that, no one may know ('cept Emps, but he's not talking- heck, he may have implemented it!) that it's going about and saving lives. I'm not talking 100% health bot nanos like- say the Bloodshot movie, but more like "smart white cells" that help humanity out. This could go to explain how people colonized such s#!+holes like Catachan and survived in planets like Baal and Krieg after the fallout.

But of course there's 1 step forward, 5 steps back. Take the Afriel Strain as an example. This shows Ad mech CAN genetically manipulate regular humans, they're not good at it when it's not turning one into a space marine. The "luckless" trait of Afriel guardsman only heightens my whole fears that clones have no souls, so the Primaris could be big trouble. Cawl undoubtedly used traitor DNA in some chapters, so that could also tie in..

I digress though. I think we're all on the right track of "STC spits out our med-kits" which means citizens just need to know where to aim the needle. I'm sure other advanced races like Necrons or Eldar look at humanity in general and are like "WTF are you DOING!?" along with "Get off my lawn".