Suggestions to Patch the Chirurgeon


Homebrew and House Rules


Everyone seems to love to hate on the Chirurgeon alchemist. It's not just that the name is hard to spell and pronounce. Someone playing this particular version wants to be the go-to guy for healing, except they're handing them out ahead of time instead of doing it on the spot.

Problem is, they don't hold a candle to a cleric's ability to heal. Initially they look just fine, and perhaps at higher levels it works out to be good enough, but there's a critical point -- between levels 2 and 5 -- where the Chirurgeon simply isn't doing well enough.

For starters, the Elixir of Life. The 1st-level version heals 1d6 and gives a +1 bonus against diseases and poisons for ten minutes. It's an okay amount, only a little worse than a healing potion or a touch-based Heal spell. But for most characters, when they need some healing they're in bad shape, and getting out that elixir requires four actions -- stowing their weapon, getting out the elixir, drinking it, then readying their weapon again.

By comparison, a cleric can simply cast a two-action Heal and give that person 1d8+8 hit points, at range. Or even just a one-action Heal for 1d8 by touch, if they're already adjacent, and still have most of their round to do other things.

When a party has advanced to 3rd level, their hit points have doubled and their damage potential starts to scale up. But so have their opponents, so the amount of damage they're taking increases proportionately. And that 3rd-level alchemist is still handing out 1d6 healing elixirs. Only difference is he can maybe afford to give out a few extra.

Now, a lot of classes get some sort of special ability at 3rd level, but alchemists don't. They just get the usual feats like everyone. Granted, they also get access to new formulas, but that assumes they have the time to make things.

A Chirurgeon doesn't get anything extra, because by RAW they only have three formulas on their list -- antiplague, antitoxin, and healing elixirs. They can pick two of these to be signature, getting three doses per batch instead of two during their morning preparations... but the option to switch one out at every level is wasted on them. Especially once they hit 5th level and automatically get that benefit with healing elixirs. By RAW, they only have three formulas on their list, so they'll always have the same signature items.

Now, I've played around with the numbers a bit, and come to the conclusion that, when compared to a cleric's ranged Heal spell, an alchemist's healing elixirs are about half as effective -- but a Chirurgeon can crank these suckers out in significant quantities. At 13th level, for instance, a cleric probably has four or five free castings of Heal, while a Chirurgeon can hand out twenty-seven elixirs and only use up half of his allotment of reagents.

So half as much at a time, but over triple the amount overall.

Anyway, back to the thread title. What needs to be fixed?

First, the healing an elixir can give doesn't keep up with a party's needs for healing at middle-low levels (2-4). I suggest, at 3rd level, giving the alchemist the ability to add their Intelligence modifier to the random factor of any alchemical item they create -- the damage for bombs and poisons, the amount healed from elixirs. This gives them a needed boost at that level regardless of their research field, and isn't so much that it overshadows what they can do at higher level. This also balances out the effective loss of the healing elixirs' secondary benefit -- once a Chirurgeon reaches 7th level, they're going to be dumping antidote and antiplague into their allies' food, so the elixirs' save bonus is useless.

Second, the Chirurgeon doesn't get very many options. Let them have any non-mutagen elixir on the list of alchemical creations they can choose as signature formulas.

Third, expand on the base ability of the Chirurgeon, the ability to use a Craft check to Treat Wounds. Remove the need for medical supplies, assume they instead use alchemical means -- dumping strange powders into open wounds, asking the subject to drink something suspect, stuff like that. Let their Craft skill substitute for Medicine in all ways related to the Treat Wounds action, including meeting requirements for feats such as Battlefield Medicine, or using the higher DCs for the Treat Wounds action. Keep the requirement that they be trained in Medicine -- after all, they're not some hack who never even studied a medical journal. They just have... different methods.


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Sounds like this belongs in the Homebrew forum


Leaving aside the main issue with Elixir of Life (not having any intermediate form between lv1 and lv5, which makes Healing Bomb a terrible feat), Chirurgeon isn't in the most horrible of places in terms of lv5+ features. Elixirs of Life being maxed is fairly good, and antidotes/antiplagues are always useful (not to mention the Plagued Village scenario can be basically handwaved by a chirurgeon).

The big issue is their lv1. Using Crafting's bonus for Medicine checks has the following benefits:
- it keys off Int
- it applies Crafting item bonuses (Crafter's Eyepiece, Glaive of the Artist, Cognitive Mutagen, possibly Alchemist Goggles and Alchemist Lab depending on GM ruling)

As well as the following downsides:
- it does not allow to attempt Expert medicine unless you are also Expert in medicine, meaning it requires you to invest in both Crafting and Medicine
- it does not apply Crafting item bonuses related to specific Craft actions (which is most of them).
- Medicine item bonuses are just as good as Crafting item bonuses.
- you do not have another use for Crafting unless you choose to have one (but most compete against Treat Wounds and would benefit from split focus).

Try to write it down. You start at lv1 being Trained in Medicine (+3) and Crafting (+7). Neat. Then you become Expert in one. If it's Crafting, you now roll +11, but only on Trained DC (15). If it's Medicine, you now roll +9 on Crafting, or +7 on Medicine. By the time you're Expert in both, you're looking at +13 vs +10 (you're boosting Wis, aren't you?), and you spent 4 skill increases to get as much Medicine as a Druid or Cleric. It only gets worse from here, and it's a best case scenario (because personally I'd like Wis12-14).

The lv5+ benefits aren't great, but they're serviceable and useful in their context. The lv1 benefit is ridiculous, and needs to be severely uplifted (possibly to the point of making up for the relatively niche power of the higher level benefits).

One potential way to help might be to use Crafting in counteract checks from alchemical items, seeing as right now those items are in a pretty bad spot for some reason.


Christopher Mathieu wrote:
But for most characters, when they need some healing they're in bad shape, and getting out that elixir requires four actions -- stowing their weapon, getting out the elixir, drinking it, then readying their weapon again.

The action economy is no different from healing potions. . .

Christopher Mathieu wrote:
By RAW, they only have three formulas on their list, so they'll always have the same signature items.

Alchemist's Formula Book:
Quote:
Each time you gain a level, you can add the formulas for two common alchemical items to your formula book. These new formulas can be for any level of item you can create. You learn these formulas automatically, but it's also possible to find or buy additional formulas...

Alchemists are only restricted to common formulas for their level-up freebies. Otherwise, nothing prevents a Chirurgeon from automatically learning formulas other than Anitplague, Antitoxin, or Elixir of Life.

It is true that a Chirurgeon relying on Elixir's of Life, alone, doesn't scale up very well for healing. However, a Chirurgeon can get tremendous mileage out of Battle Medicine, Continual Recovery, and Ward Medic, and fares even better adding the Medic Dedication with Doctor's Visitation, Treat Condition, and Holistic Care. Treat Condition and Holistic care are both skill feats, so the Chirurgeon is only gives up two class feats for the Archetype.

I do believe that Healing Bomb should have splash that should also interact with Calculated Splash, Directional Bomb, and Expanded Splash. Since making and using a Healing Bomb is three actions, this would actually make Healing Bomb worth considering.


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for my houserules, for chirurgeon specific changes, i've added intermidiate elixirs of life for every odd level missing (so 3, 7 and etc)

i also added that their elixirs of life heal an additional +1/level

and i've modified that they not only use their crafting modifier instead of medicine modifier, but they also treat their crafting rank as their medicine rank for skill action and feat effects and requirements.

those 3 changes seem to help a lot with the probalems of the class/field.


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iNickedYerKnickers wrote:
However, a Chirurgeon can get tremendous mileage out of Battle Medicine, Continual Recovery, and Ward Medic, and fares even better adding the Medic Dedication with Doctor's Visitation, Treat Condition, and Holistic Care. Treat Condition and Holistic care are both skill feats, so the Chirurgeon is only gives up two class feats for the Archetype.

But he doesn't do any better than other classes: in fact, they are behind other classes like rogue and investigator with their extra skill feats and a Methodologies focused on battle healing. In fact, I'd sat they are behind other classes as they have to raise 2 skills while the other just raise one. So I don't think those feats really bring anything to the table on who heals more or better: replace Chirurgeon with literally any other class and your quote reads the same.

Liberty's Edge

graystone wrote:
replace Chirurgeon with literally any other class and your quote reads the same.

Where exactly are these other classes getting all of the free healing elixirs from?


Shisumo wrote:
graystone wrote:
replace Chirurgeon with literally any other class and your quote reads the same.
Where exactly are these other classes getting all of the free healing elixirs from?

Look at what I quoted once.

graystone wrote:
However, a Chirurgeon can get tremendous mileage out of Battle Medicine, Continual Recovery, and Ward Medic, and fares even better adding the Medic Dedication with Doctor's Visitation, Treat Condition, and Holistic Care. Treat Condition and Holistic care are both skill feats, so the Chirurgeon is only gives up two class feats for the Archetype.

PLEASE show me where there is even the slightest mention of elixirs? And you specifically cut out the part of the sentence that gives context. The full sentence is "So I don't think those feats really bring anything to the table on who heals more or better: replace Chirurgeon with literally any other class and your quote reads the same" which makes clear that it is the feats I'm talking about: they are a non-factor as every class can pick them up.


graystone wrote:
iNickedYerKnickers wrote:
However, a Chirurgeon can get tremendous mileage out of Battle Medicine. . .
But he doesn't do any better than other classes. . .

Strawman fallacy.

Nothing in the OP's post suggested Chirurgeon's should be doing as well or any better than other classes for healing.

graystone wrote:
So I don't think those feats really bring anything to the table on who heals more or better.

Doubling down on that strawman, huh?

The original complaint isn't that Chirurgeon doesn't "heal more or better than" [than other classes]. The complaint is that their in-class-only healing is lackluster. Correctly pointed out two avenues to supplement their class abilities for healing is perfectly valid.

graystone wrote:
replace Chirurgeon with literally any other class and your quote reads the same.

So? The original complaint isn't Chirurgeon should be a super duper second-to-Cleric healer on class abilities alone.

Your "contributions" to this thread are irrelevant; Strawmen neither refute nor support any arguments.


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Pathfinder Rulebook Subscriber

Er, what? OP specifically laments that chirurgeons "can't hold a candle" in their opinion to clerics. Don't really see how you can argue the comparison is irrelevant when it's literally the fourth sentence of the thread.

Battle medicine and the Medic archetype are both nice options, but given that they're class agnostic they don't really do anything to make the chirurgeon specifically more appealing, nor do they particularly enhance the issues the OP has with the chirurgeon's action economy or the gaps in their elixirs or anything else (and re: 'can't hold a candle to the cleric', they can take battle medicine too, just as well or better).

The hostility being projected doesn't really help you or anyone else either.

re: signature items. OP's right that nothing ever gets added to the list, but that appears to be intentional. It's a class feature that really just exists to make low level alchemists a bit more resource efficient.


iNickedYerKnickers wrote:

Strawman fallacy.

Nothing in the OP's post suggested Chirurgeon's should be doing as well or any better than other classes for healing.

You SPECIFICALLY call out how the "Chirurgeon can get tremendous mileage" out of the feats... To me that suggests that that they are good at those: If it doesn't, the statement is moot. Plus you'll note that I DID NOT comment on the OP's post: I commented on yours.

iNickedYerKnickers wrote:
The original complaint isn't that Chirurgeon doesn't "heal more or better than" [than other classes]. The complaint is that their in-class-only healing is lackluster. Correctly pointed out two avenues to supplement their class abilities for healing is perfectly valid.

It in NO way boosts their alchemist abilities: it boosts generic abilities everyone can get. It's not abilities that make just a Chirurgeon better but ones that makes EVERYONE better at healing.

iNickedYerKnickers wrote:
Your "contributions" to this thread are irrelevant; Strawmen neither refute nor support any arguments.

You are welcome to your thoughts, but the question was about patches to alchemist so I don't see how things outside alchemist specific things are much of a boon to the debate either. When the OP says "Problem is, they don't hold a candle to a cleric's ability to heal", the addition of skill feats is a 0 sum as both a cleric and an alchemist can take them so it means adding them gains the alchemist no ground.


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The healer that gets "tremendous mileage" out of Battle Medicine is the Forensic Medicine Investigator, who gets it for free and is better with it than anyone else. Chirurgeons don't get anything out Battle Medicine that Druids don't.

Which is to say that this is another Alchemist concept that you really should just use the Investigator chassis for.

Customer Service Representative

I've moved this to Homebrew.


I'd like to note that I have a Chiurgeon in my game who's leveled up from 1 to 3. So far the player is happy with the class. Now I think he invested some loot in formulas, and has certainly gone the feat route to shock me with his abilty to Treat Wounds. So sure, he's spent a lot of non-class-granted resources on being a non-magical party healer.

The only change to the rules that I made was that Elixers of Life get the same bonuses as healing potions, so the Minor one restores 1d6+1 HP. That +1 does add up, and prevents the utter disappointment at getting only 1 HP back. As for the higher-level elixers, it will have an even bigger impact. So this may be the change that the OP is looking for.

Meanwhile, in addition to Elixers, my Chiurgeon has always got bombs around, and hopefully also the right oddity off the alchemical lists that the party needs. I just introduced an NPC Rogue/Poisoner to the party--who is frustrated at only being able to make Level 1 poisons. The chiurgeon is chortling and looking forward to helping her out with UN-healing! And when it comes to Recalling Knowledge, it's hard to beat an Intelligence-based class. So the player is happy with the PC's class mostly because of the wide range of participation the PC can make, not just with how well the class does at healing.

The thing is, it seems like Bombers & Mutagenicists don't dish out the same damage as comparable damage-dealing classes, either. I want to thank Nonat1s for an excellent YouTube video explaining how the proper focus of the Alchemist class in general is to be defocused, prepared for a bit of just about anything.

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