Pathologic 2 – Basic Guide

Pathologic 2 is not a game you play, it’s a game you go to war with. It’s never going to be easy, but here’s some help. Consider this an instruction manual with some swearing.

How to Survive in Pathologic 2

On Difficulty, Intended and Otherwise

The game will try, at the outset, to nag you into playing on Imago difficulty. Don’t do that on your first try. The game is a filthy liar and wants to hurt you. Yes, it’s not the “intended experience,” you can totally do that later. You’re here to have some fun and you don’t have time for this game’s nonsense. So start the game on Larva. It will be about as hard as Skyrim. In other words, normal.

If you want to try this on Imago, I wish you the best of luck. You’re going to need it. But at least if you already know how to do it, it’s somewhat less likely you’ll end up in a death loop and need to back up. This isn’t like Pathologic 1, there are no safety saves here. The save points are the clocks in named people’s houses, so do your best.

Care and Feeding of Your Artemy Burakh

You have several different meters to worry about in your care and feeding of Artemy Burakh (and yes, you have to feed him). On Larva difficulty, this is manageable and basically maps to a normal person. On Imago, you are a diabetic two steps from death. If your hunger meter turns all red, you will start taking gradual health damage. This is because you are starving. This will kill you. Although something or another will kill you (and that is built into the expectations of the game), try not to have it happen too much (this will be elaborated more in the Mark Immortell Will Hurt You section). Your thirst meter won’t kill you, it’s attached to your stamina meter. If you’re too thirsty, you aren’t going to be able to run or fight. This is pretty easily dealt with by water, which you will most likely have on you.

Do not under any circumstances eat nuts. They are currency, not food. Also they won’t do anything for your hunger because come in, if you’re starving a peanut isn’t exactly going to make a difference.

Food can be bought at stores, but this shouldn’t be your primary means of getting it. Inflation is a thing that’s going to happen to you after the first day. That’s okay, there’s more than one economy in this town. The secondary one is trade with people on the street. In this town, you can’t use money on street trade. (the tertiary one is the Dead Item Shop, which will be brought up later) That’s what the random garbage you find is for. Almost everything is valuable for something or another. Each type of townsperson has certain things they carry and certain things they want. This will be elaborated in the Trade section.

Artemy has to sleep. Aside from reducing your Exhaustion meter, you will need your dreams. Two of them are absolutely critical to the progression of the game. (Several achievements are linked to the various dreams, so you can pick those up if you feel like it) Artemy can sleep at the Shelter (Lara Ravel’s house), the Lump (Vlad Olgimsky’s house), Aspity’s hospice, Artemy’s lair (when you get it), and the Bachelor’s house when you know him well enough. Sleeping is how you regain your health, but only if you take morphine. If you just sleep, your recovery will be negligible. (Don’t worry about getting addicted or anything, it’s the nebulous early 20th century. Nobody thinks morphine is addictive. More to the point, it’s not a game mechanic so get lit my dude).

Immunity is exactly what it says it is, your ability to resist the plague. As long as you have any green, you have a chance to resist. Running through infected districts (ones with guttural voices and black soot rain) will gradually erode your immunity. When you’re in danger, transparent black patches will show up at the corners of your screen. If that happens, get out now. You are in danger of infection. If you get out of the infected area, your immunity will slowly recover. If you have immunity boosters or herbal tinctures, you can boost your immunity and be in the bad air longer. You can duck into a house for a breather, but only do this in houses that contain shops. Normal infected houses will contain plague victims and multiple Hunting Clouds, and those are incredibly bad news.

Aside from being in bad air, the other ways to get the plague are contact with plague victims (they will try to grab you) or contact with Hunting Clouds. These are the black clouds that chase people down in the streets. They can be dodged, but be warned that sometimes they form in transitional spaces like doorways and you won’t have a chance to get away. If your immunity is high enough (over 60%) you might survive one without getting infected. It will decimate your immunity, so gtfo. Once your immunity is worn down, your immunity meter will become an Infection meter (See: So You’re Infected: The Hell Do I Do Now?).

Protective clothing like masks and repellent cloaks give you a little more protection from the plague, but the bad air will eventually dissolve them. Once you have access to your Lair, you can sometimes repair these things.

Health is obvious. You don’t have a whole lot of it, you’re only human (and on Imago, a brittle diabetic). Sleeping with morphine is the best way to restore it, but in an emergency bandages will do (don’t throw away bloody bandages. See: Dead Item Shop: Garbage is Your Salvation) .Tourniquets also help, but not very much. You can acquire these things from pharmacies for ridiculous prices or from drunks on the street for 5 waters (more in Trade section).


There are several different kinds of citizens in Town-on-Gorkhon. These are who they are, how to recognize them, what they have, and what they want.


Men with beanies who are not overly pale or have dirty faces. Often found sitting around. Two can be reliably found by the Factory near the trash can fires.

  • Have: Bandages, tourniquets
  • Want: 5 waters

Young Men

Men in their 20s with scarves wearing nicer jackets and gloves. Usually found in the Atrium or richer parts of town.

  • Have: Coffee, lemons, kashk (cheeseballs)
  • Want: Matches, fingernails (flat coin with a hole in it)


Young women with scarves and fingerless gloves or Asian women with crown braids. Around parks in the Maw and Gut

  • Have: nuts, pins, thimbles, thread, needles, raisins, fruits, marbles, kashk (cheeseballs)
  • Want: bandages, immunity boosters, morphine


Middle aged men with leather hats and coats. Will be wandering the streets at night or standing by fires

  • Have: morphine, toast, immunity boosters
  • Want: lockpicks

Factory Men

Middle aged men with ask for repair option. Can be found in most areas

  • Have: candle stubs, nuts, metal scraps, springs
  • Want: matches


Asian adult man. Found all over

  • Have: matches, grindstones, fishhooks
  • Want: springs

Herb Brides

Mostly naked Asian women. Found by Aspity’s, in the Skinners, and Crude Sprawl. Sometimes in the steppe

  • Have: charms, spindles, rarely food
  • Want: tinctures, matches, thimbles, thread

Medicine Girls

Little girls in black dresses with white aprons. Can be blonde or black haired. The most important townspeople in the game. Found around parks or wherever playground equipment is.

  • Have: fingernails, morphine, shmowder
  • Want: chalk, bugs, marbles, nuts, raisins, buttons

Bullet Boys

Little boys in overalls. Found around parks and playground equipment

  • Have: bullets, eggs, fingernails
  • Want: chalk, bugs, nuts, marbles

Tinkerer Kid

Asian child with spots on their faces. Found around parks, playground equipment, Crude Sprawl

  • Have: calipers, fingernails, surprise packages, kashk
  • Want: marbles, needles, bugs, broken scissors

Soap Urchin

White child of indeterminate gender, probably boy. Found around parks and playground equipment.

  • Have: soap, immunity boosters, fingernails, morphine, egg, needle
  • Want: spring, nuts, marbles, bugs, broken scissors

Morphine Girl

Young teenage girls with pigtails. Found around parks and playground equipment.

  • Have: Morphine, dried fish
  • Want: Match, needle, broken scissors

Rebel Tween

Young teenage boy, hat doesn’t cover ears. Found around parks and playground equipment.

  • Have: immunity boosters, dried fish, fingernails
  • Want: matches, needles, broken scissors

Other people


Overly pale men, sometimes with beanies, sometimes Asian, sometimes with injuries. Always look dead. Found on the street randomly at night.

  • Have: money, sometimes food, sometimes lockpicks
  • Want: to murder you


Dirty men with beanies, don’t look dead. Found in Burned Districts and houses.

  • Have: money, food, lockpicks
  • Want: To murder you


Look like plague doctors with bones on their cloaks. Found in the theater and at the Stilwater.

  • Have: Tutorials
  • Want: To waste your time


White masks, black full body leotards

  • Have: advice, sometimes
  • Want: to mess with you

Rat Prophet

Looks like homeless Splinter

  • Have: terrible advice
  • Want: to drag you to hell

Combat: Don’t

You are a doctor. Realistically, you probably shouldn’t be fighting. However, Artemy Burakh lives like a stray tomcat and will unavoidably have to fight at some point. Combat in this game is heavily stacked against you, but it is doable. Ideally, learn how to stealth kill. Failing that, try to fight someone who’s fighting someone else. They may turn to attack you, but they aren’t always going to do that. Failing that, the way to fight is stab, back up, stab, back up. Do not mash the attack button. You are not Goku, you are Hawkeye Pierce, and you will die (small exploit: if it’s not going well, bail out and reload before you die).

Do not under any circumstances fight more than one opponent on intended difficulty. They will kill you immediately. Try to pick targets that are busy fighting someone else if you can’t. If they just spot you, duck into a house and wait a bit, or make a run for the guys in the leather caps. They’ll jump in and fight your assailant. Just don’t forget to get the killing blow and loot fast because the leathercaps absolutely will steal everything on the body. If you get to the part where the army shows up, you can loot anyone the army kills, they don’t loot. (You can also lure muggers to soldiers) Combat is never going to be a safe bet. Also, if you’re doing intended difficulty and trying to loot houses in the burned district, just run away if you run into a mugger. Don’t try to fight. The game will spawn him a buddy behind you and you will die (I said you were going to war with this game).

The game will give you audio cues if you have been spotted. The music will change, and your assailant will yell something at you. (what, I don’t know, because I played this in Russian). It is possible to outrun attackers. If you can break line of sight and get far enough away, they will **** off. Sometimes they stop at the edges of districts but don’t count on this.

Mark Immortell will Hurt You

So you ***ed up and died. Well, it happens. The game is built with the expectation of a certain number of deaths. There are some story bits that happen along with the deaths. But the master of the theater, Mark Immortell, is a rat-faced assassin of joy and he is here to make your life worse. He will resurrect you, but you will be punished. He takes a bit of your life permanently (sometimes hunger, sometimes exhaustion). You can talk to him after you’ve died, but I wouldn’t after the first few times. He’s just going to be a trash bag about everything.

Note: For the curious, the maximum penalty is -50% of your HP and -25% of your hunger. This happens after 33 deaths. After that, nothing much changes.

After nine or so deaths, the Fellow Traveler from the beginning will come back and offer you a deal. It is a horrible idea, do not do the thing.

Dead Item Shop: Garbage is Your Salvation

So there are occasionally items that the game calls “dead”: scrap names, broken ampoules, bloody bandages, that kind of thing. There is a shop that opens after midnight somewhere in the town (different every day) that will sell you things for these dead items. Mostly it’s food, but every once in a rare while they sell shmowders. Normally it’s 35 Trade, but at the Dead Item shop it’s 40. It is worth it. There are only two things in the game more important than shmowders. If you see one for trade or sale, drop everything and try to get it.

The dead item shop’s location will be revealed every night after the play in the theater at midnight. On the day it’s at the edge of the cape, drop literally everything and go. Go immediately. Buy candy wrappers, they will save your life.

The Plague: It Hates You

I’ve touched on how the plague works a bit before, so let’s go more in-depth. The number one infection vector is the Hunting Clouds. You’ll know them when you see them. They make a sound like a woman exhaling and they will track you. They spawn on streets in infected districts but are not in any way limited to those paths. In houses, they will track you. The game will tell you that they avoid fire and lanterns. The game is a ****ing liar. Do not rely on this.

Early in the game, Hunting Clouds will be fairly straightforward- just flying down the street ruining everything. Later, they will do annoying things like spawn in transitional areas or directly in front of you when you’re running. Later still, they will actively pop up to block your path. Sometimes, they will divert their course entirely just to **** your day up. Just RUN, and turn at 90 degree angles to try to shake it. If all else fails, duck into a building.

Subtler infection vectors come from corpses you have to dissect. If someone died of the plague, there is a decent chance that a Hunting Cloud will pop out of their corpse during surgery. You just have to take it if that happens. Touching containers in infected houses also carries a risk of infection. Don’t ever bother looting actively infected houses. It’s not ****ing worth it.

So You’re Infected: The Hell Do I Do Now?

Well, you’ve caught the plague. It’s fairly inevitable. There are certain decisions in the game that will lead to you being infected. Counterintuitively, you should do them. But you’ll know what that’s about when you get there. So a plague victim touched you or a hunting cloud spawned directly up your *** and decimated your immunity. Here’s how to deal with that.

Antibiotics (ferromycinium, monomycinium, neomycynium) will reduce your infection level. However, all the medicine in this jank-*** town is out of date so it will also hurt you. You should try, though, and keep your infection level low. The higher it is, the more health you lose (also, arsonists and flamethrower troops will attack you, when they’re a thing).

Shmowder, which I have been going on about, is one of the possible cures. However, it will ***ing brutalize you. Don’t take it until it’s time to sleep, because it will shred you down to a sliver of health. Pop some morphine and sleep it off.

If you have a lot of health and bandages and feel lucky, (and arsonists have spawned), you can use fire to cure the plague. It will hurt like a ***, but it does work. It’s a tricky needle to thread, but if you don’t want to use shmowders on yourself (you don’t), it’s doable.

Curing the plague is obviously the point of the game, so I’m not going to tell you what the cure is. You’ll know.

Everybody Hates You: What Now?

Reputation is also a mechanic that I haven’t touched on yet. When you start out, it’s going to drop like a ***ing rock. All adult male townspeople and guards will try to attack you on sight if they spot you with a low reputation (You are Hated Here). Women are safe, but they won’t trade or talk to you. Children are always safe and will always trade with you. The children of Gorkhon give absolutely zero ***s about anything.

Raising your reputation is part of the game itself, so I won’t tell you the story ways to do it. However, some general tips:

  • Talk to the townspeople when they stop attacking you. They all have problems and if you’re sympathetic and kind, they will like you better. (Dialogue options that have a diamond shape beside them are conversation enders.) Just don’t be a **** (except to Rubin, that’s only fair).
  • Trade at a loss. If you give them something more valuable than they give you, your reputation will go up.
  • Do not kill the people who are attacking you. They are just law abiding citizens trying to apprehend what they think is a dangerous criminal. You will suffer if you kill them.
  • Don’t autopsy unless you have to. You aren’t fully trained and your society forbids desecrating bodies unless you are. However, there will be some times when you have to get organs. Just do your best.
  • Don’t rob people who let you into their house.
  • Kill bandits, if you can. The Judge has permitted random murder, if it’s of criminals. Do with that what you will.
  • Work at the hospital when you can. This will also feed you.
  • In plague districts, you will sometimes find people lying on the ground in pain. Give them morphine so they can die in peace.
  • Help the Bachelor, when you can find him. He lives in the Stilwater and can sometimes be found in Town Hall or the Trammel. Yes, the Bachelor is a ***. Love him anyway.

General Advice

  • If you hear flies buzzing, that’s twyre, your magical medicine weed. Artemy can hear it during the daytime, but at night he can see glowing lights coming up from it. It’s best to hunt twyre in the Steppe.
  • There’s a twyre garden in Shekhen, but it takes a lot of time to get there.
  • Stack food on the first day. All day. It’s going to have to last you four days. Buy everything you can. Put food at the Shelter and the Lump. Put bandages at the Lump. Put some immunity boosters there too (the Lump is centrally located, that’s why).
  • Don’t bother buying food for the next few days, you’ll just waste all your money on inflation.
  • Kids play a game of hide and seek on day one, and the prize is a Shmowder for 5 trade. If you can do this, **ing do it. It will never be cheaper.
  • Stack shmowders. You never know who’s going to get infected.
  • The best way to get infected organs is by finding guards attacking plague victims and autopsying them after they die. Yes, that’s ***, but Artemy’s life is full of dirty compromises.
  • Carry tinctures once you can make them. The + tinctures don’t have an exhaustion penalty.
  • You can upgrade your inventory and fix weapons in the back of the Lair.
  • Use a walkthrough. It’s that kind of game, I’m afraid.
  • You don’t really need a map of the infected districts. It’s super obvious.

Critical Advice

  • Notkin is going to get infected at the end of Day 3. There is absolutely no avoiding this. Try to have a shmowder ready.
  • Fingernails are fast travel, but the price doubles in the late game.
  • Fix the big alembic ASAP.
  • Loot houses in the burned districts. Yeah, it’s dangerous, but that’s how you get that sweet sweet garbage. Don’t get too attached, though. If a mugger gets you, reload and try again.
  • Pay attention to Murky on Day 6. If you do nothing she will die.
  • Pay attention to Grace on Day 7. If you don’t resolve her issue, she will die.
  • Exploit: There is a spot to stand in the hospital on Day 8 that makes that mission super easy. Google ‘Day 8 hospital god spot (actually doing this is terrifying, but worth it).
  • Do not fight an odongh head on. You will lose. Stealth kill them, if you have to.
  • Have at least 8 cures by day 10. This is absolutely critical.
  • Don’t take the deal.
  • Get the candy wrappers.
  • You can’t save everyone, no matter what. Decide who you care about and do your best. Remember the children are your responsibility.
Written by kyselle

Be the first to comment

Leave a Reply

Your email address will not be published.