4. Health
This Concept was initially proposed by CYZ and refined in an interesting discussion.
4.1 General concept
- Each city has a base maximal population of 6 citizen.
- Each different bonus resource will grant an additional +2 max. population.
- If a city has more than one bonus resource of one type, this goes to a national pool.
- These bonus resources can be traded with other civilizations for money or other resources OR
- can be assigned to cities in the own empire, if this city is part of the national trading network (See: 1.2 National trade)
- Other factors that may raise maximal city size by +2 are:
4.1 Consequences of a reached maximal size
- Cities will not stop growing immediately, but every citizen beyond the limit will consume one or two additional food.
- In consequence, city growth will slow down first, but come to a stop later. This point of stagnation can be pushed by heavily investing in food production, though.
4.2 Allocating surplus bonus resources
- As Health is part of the new (national) trading concept, the corresponding screen is a tab in the new “Trade”-Screen.
Picture: The National Trade & Health Screen. There is one resource “fish” allocatable.
- Upper line: available (surplus) bonus resources.
- Dark, filled circles: resource can *not* be changed as it is “physically” located in the city radius.
- White, empty circles: City may receive this bonus resource. Simply click in the circle to do so. The resource will be decreased in the “Available” line, of course.
- White, filled circles: City receives this resource. Click to deallocate the resource.
- As “fresh water” is a map feature, it can not be changed.
- Numbers at the right side: Actual and maximal City size. Red numbers indicate a cities beyond their health limit.
4.3 Remarks
- If there are new bonus resources introduced in the future, it should be no problem to integrate these resources into the screen. Unfortunately, everything will be a little bit more condensed, but it should work nevertheless. The positive side: bigger cities will be possible with less effort.
- Cities with *all* bonus resources may grow to size 18 (even more with the new bonus resources). With fresh water and all buildings it will be 28 and with the national wonder 30 (or even more).
The introduction of the Penicillin Revolution frees “size fetishists”
of all limitations.
- It is not intended to have bonus resources in higher values (like strategic resources). Nevertheless, if play testing indicates that there are not enough bonus resources to allow a reasonable city growth, it is possible to introduce higher bonus resource values. I don't think, this should exceed values of 2 (just like uranium), though.
- As this concept is heavily based on CYZ's idea, I don't want to peculate his different approach according unhealthy cities:
CYZ proposes a “disease mechanism”, with plagues braking out in unhealthy cities (with a certain random factor) and spreading to other unhealthy cities. The effect of plagues should be a degreasing city size until a “healthy” size is reached again (and even below this point). The plagues would cease then, again with a certain random factor.
To be honest, I am not overly fond of this approach. My reasons:
For me, the intuitive [City reached health limit → slower growth rate up to a total stop] works best.
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This Concept was initially proposed by CYZ and refined in an interesting discussion.
4.1 General concept
- Each city has a base maximal population of 6 citizen.
- Each different bonus resource will grant an additional +2 max. population.
- If a city has more than one bonus resource of one type, this goes to a national pool.
- These bonus resources can be traded with other civilizations for money or other resources OR
- can be assigned to cities in the own empire, if this city is part of the national trading network (See: 1.2 National trade)
- Other factors that may raise maximal city size by +2 are:
- fresh water
- buildings: aqueduct, sewer (new building), hospital
- the “National Health Agency” a new national wonder. (May grant more than +2, though.)
4.1 Consequences of a reached maximal size
- Cities will not stop growing immediately, but every citizen beyond the limit will consume one or two additional food.
- In consequence, city growth will slow down first, but come to a stop later. This point of stagnation can be pushed by heavily investing in food production, though.
4.2 Allocating surplus bonus resources
- As Health is part of the new (national) trading concept, the corresponding screen is a tab in the new “Trade”-Screen.

Picture: The National Trade & Health Screen. There is one resource “fish” allocatable.
- Upper line: available (surplus) bonus resources.
- Dark, filled circles: resource can *not* be changed as it is “physically” located in the city radius.
- White, empty circles: City may receive this bonus resource. Simply click in the circle to do so. The resource will be decreased in the “Available” line, of course.
- White, filled circles: City receives this resource. Click to deallocate the resource.
- As “fresh water” is a map feature, it can not be changed.
- Numbers at the right side: Actual and maximal City size. Red numbers indicate a cities beyond their health limit.
4.3 Remarks
- If there are new bonus resources introduced in the future, it should be no problem to integrate these resources into the screen. Unfortunately, everything will be a little bit more condensed, but it should work nevertheless. The positive side: bigger cities will be possible with less effort.
- Cities with *all* bonus resources may grow to size 18 (even more with the new bonus resources). With fresh water and all buildings it will be 28 and with the national wonder 30 (or even more).
The introduction of the Penicillin Revolution frees “size fetishists”

- It is not intended to have bonus resources in higher values (like strategic resources). Nevertheless, if play testing indicates that there are not enough bonus resources to allow a reasonable city growth, it is possible to introduce higher bonus resource values. I don't think, this should exceed values of 2 (just like uranium), though.
- As this concept is heavily based on CYZ's idea, I don't want to peculate his different approach according unhealthy cities:
CYZ proposes a “disease mechanism”, with plagues braking out in unhealthy cities (with a certain random factor) and spreading to other unhealthy cities. The effect of plagues should be a degreasing city size until a “healthy” size is reached again (and even below this point). The plagues would cease then, again with a certain random factor.
To be honest, I am not overly fond of this approach. My reasons:
- At some point, most of your cities will have reached or excel “unhealthy size”. This is a necessary consequence of the proposed concept. Plagues would be ubiquitous in the result.
- Having to witness a random decline of your empire can be very frustrating for many players. (Civ4 water poisoning, anybody?)
- Negative game mechanisms, that can not be effectively counteracted by the player, are not very fun. You might shovel around bonus resources to raise city health and therefore make the plague more likely to end (maybe even at once!) - but this will lead to tedious micromanagement.
There might be a new building, like a “drugstore”, to fight plague effects. But if plagues are no thread any more, this would render the whole health concept useless, to some point.
For me, the intuitive [City reached health limit → slower growth rate up to a total stop] works best.
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