RimWorld Blood Rot: Keep Quest Pawns Alive Without Glitterworld Medicine

What to do when blood rot patients arrive

1. Open each patient's Health tab and set Medical care. Choose industrial-tech medicine or worse for daily tends. Quest prisoners and animals start at herbal medicine or worse. Quest guests who join your colony get your colonist default, which is best quality medicine unless you changed it.
2. Have a doctor and a free medical bed ready. A human patient has to lie in a bed to be tended by someone else. Blood rot patients walk to a bed on their own when a tend is due, then get up again. They don't need bed rest between tends.
3. Get the first tend done within the day. Every untreated hour adds about 1.7 points of severity. A fresh arrival starting at 0.1% can wait a few hours, but not days.
4. Re-tend when the tooltip says so. Hover the disease. Can be tended in counts down to the next allowed tend (24 hours after a fresh tend). Tending expires in counts to the moment the full +40% rate returns.
5. Stock one medicine per patient per day, plus spares. A 15-day wait for three guests takes about 42 industrial medicine, so keep 45 or more.

How fast blood rot kills

Blood rot starts at 0.1% severity and gains 40 percentage points per day while untreated. At 100% the patient dies. From a fresh case that is about 2.5 in-game days. If you are reading an older guide that says 60% per day and 1.67 days, it describes the early Royalty build. Update 1.1.2654 cut the rate to 40%, and it is still 40% in 1.6.

While a tend is active, the daily change is +40% minus the tend quality. That gives you one line to watch:

A great tend still doesn't remove it. Severity can't drop below its 0.1% floor, so the disease stays on the Health tab until its own timer runs out or you cure it. Seeing "blood rot" after a 100% tend doesn't mean the treatment failed.

Stages

The patient also gets the −5 Sick mood thought for the whole illness. The penalties are mild, so a minor-stage guest can keep working between tends. If you see major or extreme, the tends aren't keeping up. Check the doctor's skill, the Medical care setting, and whether the last tend expired.

Why the severity bar is still climbing

The number that matters is the rolled tend quality shown when you hover blood rot. Here is how the game gets there:

1. Doctor: the doctor's Medical tend quality stat. With healthy sight and hands, Medicine 0 gives 20%, Medicine 6 gives 80%, Medicine 8 gives 100%. Above that it grows more slowly: 110% at 10, 120% at 12, 155% at 20.
2. Medicine: multiply by potency. None 0.3, herbal 0.6, industrial 1.0, glitterworld 1.6.
3. Bed: add the bed's bonus. Hospital bed +10 points; a powered vitals monitor next to it +7 more. Ordinary beds, bedrolls and animal beds add nothing.
4. Self-tend: ×0.7 if the patient tends themself.
5. Cap and roll: the result, the base tend, is capped by the medicine (70% for herbal or none, 100% industrial, 130% glitterworld). Then the game rolls ±25 points and caps it again.

Because high rolls get cut off at the cap, the real average can be lower than the base. A 65% base with herbal medicine averages about 61%.

Room cleanliness and lighting aren't part of this formula. A dark room only matters if it lowers the doctor's Sight. Cleanliness affects surgery and infection chances, not blood rot tends.

The lowest doctor that never rolls under 40%

The roll never lands more than 25 points below the base, so a base of 65% or more means every tend clears 40%. These are the lowest Medicine levels that reach it, for a healthy doctor who isn't self-tending:

Bed	Herbal	Industrial	Glitterworld
Ordinary bed	Medicine 10	Medicine 5	Medicine 3
Hospital bed	Medicine 8	Medicine 4	Medicine 2
Hospital bed + vitals monitor	Medicine 6	Medicine 3	Medicine 1

Without medicine, no doctor gets there. The best case, Medicine 20 at a hospital bed with a monitor, still misses about one tend in thirty.

Missing a few rolls is usually survivable

A tend that lands under 40% doesn't doom the patient. A Medicine 6 doctor using herbal medicine in an ordinary bed has a 48% base tend. About one tend in three lands low, but a bad roll only adds up to 17 points that day, and good days pull severity back down. Over a 25-day wait, severity usually peaks around 30%. Occasionally a long run of bad rolls pushes it past 55%, and in rare cases it kills. Industrial medicine, or a hospital bed with a vitals monitor, makes every tend clear 40%. A hospital bed alone raises the base to 58% but still leaves about one tend in seven under the line.

What actually kills blood rot patients is usually one of these:

• The tend lapsed. The doctor was drafted, asleep or busy, or the patient couldn't reach a bed. Each untreated day adds the full 40%.
• Care is set to herbal or no medicine and the doctor is weak. Medicine 3 with herbal has a 30% base, which fails over a long quest.
• Self-tending. The ×0.7 penalty can drop a borderline doctor under the line.
• Several patients, one doctor. Tends run late while the doctor works through the queue.

Check Medical care before blaming the doctor

Each patient's Medical care setting decides which medicine a doctor is allowed to use on them, for tends and for surgery. Quest pawns get a default based on what they are, and those defaults are the most common hidden problem with blood rot.

The same setting controls the cure operation. The operation accepts only glitterworld medicine, so it never starts while the patient is limited to herbal or industrial. Switch to best quality medicine before adding the bill, then back afterwards.

Blood rot tend and medicine calculator

Pick your doctor, medicine and bed, then copy the patient's current readings from the blood rot tooltip. The calculator shows the tend range, how severity moves, and how the patient is likely to do until the shuttle, assuming each tend happens as soon as the game allows it.

Skill values assume normal Sight and Manipulation. If the doctor is injured, read Medical tend quality on their info card and pick the skill row with the closest value. The medicine count assumes no tends are missed.

One tend a day, and 30–40 days to clear

A blood rot tend lasts 27 hours. You can re-tend in the last three hours. The first re-tend opens 24 hours after a fresh tend. After that, a doctor who re-tends as soon as allowed carries three hours over each time, so later tends come about every 27 hours. Plan on a little under one medicine per patient per day.

The disease has its own countdown, shown in brackets next to its name. It rolls once, between 30 and 40 days, when the patient catches it. There is no immunity bar, so these don't speed it up:

• Bed rest, hospital beds and Immunity Gain Speed.
• Penoxycyline. It only blocks malaria, sleeping sickness and plague, and never cures an existing case.
• Ideology's biosculpter medic cycle. Blood rot isn't on its cure list.
• Tending a lot. Unlike gut worms, blood rot doesn't disappear after enough total tend quality.

Every quest shuttle is due within 25 days, so guests almost always leave still sick. That's fine. Keep them alive until the shuttle picks them up.

The real cures: operation, healer serum, or waiting

Option	Cost and requirement	Catch
Cure blood rot operation	10 glitterworld medicine, a Medicine 5+ surgeon, 2,000 work. Works on humans and animals.	Surgery can fail. Success is capped at 98%, and a failed attempt uses up the medicine without curing. Medical care must be set to best quality medicine.
Healer mech serum	One serum (market value 1,300).	Fixes the single worst condition. Below 80% severity, blood rot waits behind someone about to bleed out, a brain scar, a missing body part at least hand-sized, an eye scar, or a deadly disease with an immunity bar. At 80% it joins the top-priority life-threatening group, but another whole-body condition in that group, such as heavy blood loss or a second disease near its lethal point, can still be picked first.
Wait it out	About one medicine per day for 30–40 days.	The standard answer for quest pawns, who usually leave before it clears.

For a quest guest who leaves in a week, ten glitterworld medicine (market value 500) is a poor trade next to seven industrial medicine (126). The operation makes sense when a colonist is sick and you don't want to spend a month on tends. That usually means a quest guest you later recruit, or a patient whose doctor can't reach 40%.

Cryptosleep isn't a cure. A pawn in a casket doesn't progress at all, so severity and the 30–40 day countdown both pause. A quest pawn in a casket also can't walk onto the pickup shuttle.

Should you take a blood rot quest?

Blood rot comes from the Royalty hospitality quests: guests to host, prisoners to guard, or animals to shelter. It doesn't appear as a random disease in normal play, because no vanilla biome includes it in its disease list. When the quest rolls blood rot, every lodger has it.

That's why quest prisoners at mid-game threat levels seem to always have blood rot or paralytic abasia: there's no condition-free option left. The quest can't give both at once in 1.6.

How long you host them

The letter tells you the wait. Most quests set it between 5 and 25 days; some threat versions use 5–15 or 10–25. Versions that send two or three raids in quick succession bring the shuttle in 12–36 hours. In those, raids are the real danger, and one or two tends cover the disease.

Reward vs. medicine

Blood rot raises the quest's reward budget by 70 per human lodger per day of waiting. That's about four times the 18-silver value of the industrial medicine that keeps them alive (animal lodgers count by body size). A quiet 15-day quest with three guests costs about 45 industrial medicine and a doctor's time. If you have the stock and a Medicine 5 doctor, it's usually a good deal.

What fails the quest

Skip the quest if you have no reliable doctor, fewer industrial medicine than patients × days, or a raid-heavy version while your defenses are thin. Five guests or ten prisoners use the same rules, just five or ten times the medicine and doctor time. Add a second doctor before accepting.

Quest pets: why the cure won't start

Animal lodgers join your colony as your animals for the quest. That gives them the tamed-animal default: herbal medicine or worse. Two things follow:

• The cure bill never starts. A doctor only fetches medicine the patient's Medical care allows. The operation needs glitterworld medicine, so it just sits there, even with ten in storage. If you force it, the reason can show as missing glitterworld medicine. Set the animal to best quality medicine.
• Tends are weaker. Animals can't use hospital beds, and animal beds add no tend bonus. With herbal medicine, a Medicine 6 doctor's base tend is 48%. Move the animal to industrial-tech medicine to get it clear of 40%.

Animals don't have to be in a bed to be tended. They just have to be lying down or downed, so a doctor can treat a resting pet in place.

Blood rot vs. lung rot

Neither disease has an immunity bar. Both are timers you tend through. Plague and sleeping sickness are different: they're races against immunity, and bed rest matters. The plague treatment guide covers that.

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