Firtho
The Medical Lancet
Doctor
★★★★
Profile last updated:
RadiatioSignature Weapon: Saw Cleaver + SyringesCombat Style:Survival & HealingIdentity:Guardian
Trait: Firtho's TraitBorn from the depths of the mind. Used to awaken Firtho's Psyche.A thought tinged with a bitter, medicinal taste...B tier (Good with a plan)
Second Heart is the only direct healing in the game, but the reason to field Firtho is what rides along with it: 1.5% team ATK per stack up to eight stacks for 40 seconds, while Pain Management cuts team damage taken by 20% across that same window. One button, three effects. Special Serum fills at 1 per second, and parrying while you hold the Skill triggers a fully charged release on the spot. She sits here because no Radiatio carry exists yet, so her attribute bonuses land on nobody.
See the full tier list
HP5,997
ATK441
DEF551About Firtho
"Dispensing drugs, performing surgeries, chemical analysis, forensics... I'm the only person in this city who meets all your needs, no?" Her official character title page, revealed July 30, 2026, tags her The Medical Lancet and calls her a reliable examiner, a doctor, and a close friend who lives alongside death day after day, bearing witness to the final testimonies of the deceased. An earlier title page carried a different line: "Life has not been kind to me. Death, on the other hand... has been a truer friend." Trace the Reaper's steps, and let the deceased spill the truth. A cold and mean doctor who conducts medical research in secret chambers within her clinic, Firtho is capable of applying her medical expertise in combat to deliver a fatal blow to adversaries. Due to a congenital illness she must wear a life-sustaining device at all times; she wants no pity and hates being a burden. In the endless river of death, life is only a coincidence along the way. She fights with a saw cleaver and syringes as a Radiatio Guardian, and Second Heart is the only direct healing in the game.
In the Dichotomy Beta story, Firtho is the Detective's blunt childhood friend and the coroner behind the corner clinic in a quiet, forgotten district, nicknamed 'Miss Mortis' for a reclusive childhood spent watching autopsies. She brews the stabilizer that holds the Detective's nightmares at bay, and quietly inoculates terrified gangsters against a contagious rash with an experimental serum rather than experimenting on them as they fear.
Her own quest is a locked-room 'vampire' case at Williams Manor. To prove a death was faked, she injects a tetrodotoxin nerve agent into her own arm and wears a mask through the night, counterfeiting death to expose the trick. The case cuts deep, since the culprit Baron Edgar was a colleague of her late father Irwin at the Royal Academy. Read the full case in the Silver Palace story recap.
In-game profile
The Corner Clinic's doctor, the daughter of the Royal Academy scholar Erwing, and my childhood friend.
She was stricken with a congenital heart condition throughout her youth. Yet the mechanical heart that now beats within her allows her a new lease of life.
She fixed me with a somewhat resentful gaze upon my return to Silvernia, perhaps disgruntled that I left for three years without so much as a goodbye.
- Personality
- A cold, exacting clinic doctor who patches people up and, when needed, takes the field herself. Her medical tools double as weapons.
- Appearance
- Closed beta footage shows her with a saw cleaver and syringe-based tools.
- Birthday
- 3rd of September
- Likes
- Medical research, scalpels, rainy days
- Dislikes
- Unwanted concern, failing to diagnose symptoms, heart abnormalities, death
- Skills
- Medical affairs, the usage of medicines and poisons, surgery and augmentations
- What Firtho calls you as Trust rises
- Childhood FriendHidden DesireHeartbeat Like None Other
Intel
- Elder Brother
- Lost touch due to differing values, not seeing eye to eye.
- Further Information: I
- Though she may come across as intimidating or even scary, it's usually just a means by which she masks her concern for me.
- Further Information: II
- She possesses two coexisting yet conflicting sides: one burning with an academic curiosity for medicine, and the other filled with fear of death.
- Further Information: III
- She's grown more determined, more independent too. Yet she'll always hold a special place in her heart for me.
Interactive investigation map
See where Firtho fits on the Detective Board
Trace Firtho's ties to other characters, factions, locations, and lore on Silvernia's interactive investigation wall. Drag cards, isolate a subject, and follow each string to its evidence.
Firtho Gameplay Showcase (Dichotomy beta)
Gameplay and ultimate footage recorded during the Silver Palace Dichotomy beta, 40 seconds.
Firtho's kit and ultimate in action, captured from the Dichotomy beta.
Skills
Levelling all 5 of Firtho's skills to Lv. 10 each, and unlocking every node, costs 221,810 Ounce plus Guardian's Instinct, Guardian's Insight, Guardian's Challenge, Guardian's Legacy, Everburning Chain Sword and Twin Argent Strands. Firtho's Identity is Guardian, which is what puts the Guardian line on this list rather than another Identity's.
Amputation Saw
Press the Basic Attack button to perform a combo of up to 4 hits, dealing Radiatio DMG.
Upon triggering a Perfect Dodge, press the Basic Attack button to immediately unleash a Lv. 2 Charged Attack, dealing DMG and interrupting enemies.
Charged Attack
Lv. 1: Hold the Basic Attack button to unleash an attack dealing Radiatio DMG. Lv. 2: Hold the Basic Attack button to unleash a powerful attack dealing Radiatio DMG.
Pursuit Attack
After Dodging or during a Dash, press the Basic Attack button to unleash a Pursuit Attack, dealing Radiatio DMG.
A surgical consent must be signed before an operation, but this does not apply to self-defence.
Values by skill level
| Level | 1st-hit DMG | 2nd-hit DMG | 3rd-hit DMG | 4th-hit DMG | Pursuit Attack DMG | Lv. 1 Charged Attack | Lv. 2 Charged Attack | Perfect Dodge Counter |
|---|---|---|---|---|---|---|---|---|
| Lv. 1 | 18.8% | 30% | 17.5% | 62.6% | 33.2% | 28.8% | 65.7% | 28.2% |
| Lv. 5 | 25.5% | 40.9% | 23.8% | 85.1% | 45.1% | 39.2% | 89.4% | 38.3% |
| Lv. 10 | 37.5% | 60% | 35% | 125.1% | 66.3% | 57.5% | 131.3% | 56.3% |
| Lv. 15 | 55.1% | 88.2% | 51.5% | 183.8% | 97.4% | 84.5% | 193% | 82.7% |
| Lv. 20 | 81% | 129.6% | 75.6% | 270.1% | 143.1% | 124.2% | 283.6% | 121.5% |
Nodes
Ultimate Charge Efficiency +3%
Ounce×1,695
Guardian's Instinct×2Ultimate Charge Efficiency +3%Ounce×1,440Guardian's Instinct×4Show upgrade costs by level
Ounce×1,250Guardian's Instinct×3Ounce×2,325Guardian's Instinct×5Ounce×3,400
Guardian's Insight×3Ounce×4,475Guardian's Insight×5Ounce×5,550
Guardian's Challenge×3Ounce×6,625Guardian's Challenge×5Ounce×7,700
Guardian's Legacy×3
Everburning Chain Sword×1Ounce×8,775Guardian's Legacy×5Everburning Chain Sword×2Ounce×9,850Guardian's Legacy×8Everburning Chain Sword×3
Twin Argent Strands×1
Second Heart
Press the Skill button to consume 2.5 Special Serum, dealing Radiatio DMG.
Hold the Skill button to consume 10 Special Serum, draining HP every 0.2s; releasing the Skill button deals Radiatio DMG and increases the ATK of all characters on the team by 1.5%. Stacks up to 8 times and lasts 40s. During this, all characters on the team are healed over time, and all but Firtho also receive an instant heal.
Parrying while holding the Skill button and draining HP immediately triggers a fully-charged Skill, consuming all Special Serum.
Max Special Serum: 10. Special Serum gained per second: 1.
"Life isn't simply a gift."
Values by skill level
| Level | Hold DMG | Press DMG |
|---|---|---|
| Lv. 1 | 53.5% | 14.1% |
| Lv. 5 | 72.8% | 19.2% |
| Lv. 10 | 107% | 28.1% |
| Lv. 15 | 157.1% | 41.4% |
| Lv. 20 | 230.9% | 60.8% |
Nodes
Ultimate Charge Efficiency +3%Ounce×1,440Guardian's Insight×2Ultimate Charge Efficiency +3%Ounce×1,820Guardian's Insight×4Ultimate Charge Efficiency +3%Ounce×1,945Guardian's Challenge×2Everburning Chain Sword×1Show upgrade costs by level
Ounce×1,250Guardian's Instinct×3Ounce×2,325Guardian's Instinct×5Ounce×3,400Guardian's Insight×3Ounce×4,475Guardian's Insight×5Ounce×5,550Guardian's Challenge×3Ounce×6,625Guardian's Challenge×5Ounce×7,700Guardian's Legacy×3Everburning Chain Sword×1Ounce×8,775Guardian's Legacy×5Everburning Chain Sword×2Ounce×9,850Guardian's Legacy×8Everburning Chain Sword×3Twin Argent Strands×1
Visage of Death
Upon reaching full charge, press the Ultimate button to swing the amputation saw in a powerful blow, dealing Radiatio DMG.
The mask suppresses contamination and the expression of emotion. Such is the mercy of Death.
Values by skill level
| Level | Skill DMG |
|---|---|
| Lv. 1 | 169.6% |
| Lv. 5 | 230.7% |
| Lv. 10 | 339% |
| Lv. 15 | 498.2% |
| Lv. 20 | 731.9% |
Nodes
HP % +4.8%Ounce×1,945Guardian's Challenge×4Everburning Chain Sword×1HP % +4.8%Ounce×2,135Guardian's Challenge×6Everburning Chain Sword×1Show upgrade costs by level
Ounce×1,250Guardian's Instinct×3Ounce×2,325Guardian's Instinct×5Ounce×3,400Guardian's Insight×3Ounce×4,475Guardian's Insight×5Ounce×5,550Guardian's Challenge×3Ounce×6,625Guardian's Challenge×5Ounce×7,700Guardian's Legacy×3Everburning Chain Sword×1Ounce×8,775Guardian's Legacy×5Everburning Chain Sword×2Ounce×9,850Guardian's Legacy×8Everburning Chain Sword×3Twin Argent Strands×1
Law of Exchange
Switch in the selected character while having sufficient Reactor Energy to deal Radiatio DMG.
"When two objects make contact, there is bound to be a transfer of energy between them."
Values by skill level
| Level | Skill DMG |
|---|---|
| Lv. 1 | 83.9% |
| Lv. 5 | 114.1% |
| Lv. 10 | 167.6% |
| Lv. 15 | 246.3% |
| Lv. 20 | 361.9% |
Nodes
HP % +4.8%Ounce×1,695Guardian's Challenge×8Everburning Chain Sword×1HP % +4.8%Ounce×1,440Guardian's Legacy×3Everburning Chain Sword×2HP % +4.8%Ounce×1,440Guardian's Legacy×6Everburning Chain Sword×2Show upgrade costs by level
Ounce×1,250Guardian's Instinct×3Ounce×2,325Guardian's Instinct×5Ounce×3,400Guardian's Insight×3Ounce×4,475Guardian's Insight×5Ounce×5,550Guardian's Challenge×3Ounce×6,625Guardian's Challenge×5Ounce×7,700Guardian's Legacy×3Everburning Chain Sword×1Ounce×8,775Guardian's Legacy×5Everburning Chain Sword×2Ounce×9,850Guardian's Legacy×8Everburning Chain Sword×3Twin Argent Strands×1
Pain Management
Reduces team's DMG taken by 20% during Second Heart's buff.
Rely properly on pharmaceuticals and others.
Nodes
Healing Bonus +6.5%Ounce×1,820Guardian's Legacy×9Everburning Chain Sword×3Healing Bonus +6.5%Ounce×1,945Guardian's Legacy×12Everburning Chain Sword×3Show upgrade costs by level
Ounce×1,250Guardian's Instinct×3Total to max every skill
Ounce×221,810Guardian's Instinct×41Guardian's Insight×38Guardian's Challenge×52Guardian's Legacy×94Everburning Chain Sword×38Twin Argent Strands×4Upgrade materials are published through Lv. 10, while the value curves above run to Lv. 20.
How to play Firtho
The only character who directly heals. Second Heart trades her own HP for team healing over time, and the healing carries an ATK buff, so the sustain and the damage buff arrive together.
- 1
Swap in and hold Skill for Second Heart
It drains her HP first, then returns it and starts the team heal over time
- 2
Let the buff stack
Each stack raises team ATK, and the Passive cuts team damage taken while it holds
- 3
Press Ultimate for Visage of Death
Respectable Radiatio damage plus a stun contribution, and it grants a team Radiatio damage bonus
- 4
Swap out
The heal and the buffs run on their own timer
Best Implements for Firtho
Implement stats are fixed rather than rolled, so a set is a decision you make once. The short answer is Hippocratic Oath. See the equipment guide for how the four slots and the Epiphany fit together.
Hippocratic Oath
BestIncreases the holder's Healing Bonus by 12%. When the character's Ultimate Charge Efficiency exceeds 150%, all other team members gain 8% ATK.
Why Firtho: The only set built for the only healer. Healing Bonus raises Second Heart's team healing directly, and the team ATK buff at 150% Ultimate Charge Efficiency arrives on the same button her own ATK buff does.
Retainer's Code
AlternativeHP % +12%Increases the holder's HP by 12%. When the character's Ultimate Charge Efficiency exceeds 150%, all other team members gain 6% DMG.
Why Firtho: Second Heart trades her own HP for team healing, so a flat 12% HP is both a bigger heal and more margin for paying that cost.
Best Epiphany for Firtho
One Epiphany per character, and the effect never changes: duplicates raise the substats and leave the effect text alone. The short answer is The Priest and the Bread Thief. See the equipment guide for where the slot sits, or all 30 Epiphanies.
HP % +24%Increases the holder's Healing Bonus by 16%. After the holder provides healing, all other characters on the team gain CRIT DMG (equal to the holder's CRIT DMG ×6% + 16%) for 30s, up to a maximum of 42%.
Why Firtho: She is the only character who actually heals, so the whole healer column is hers alone. 16% Healing Bonus makes Second Heart's HP trade cheaper, and every tick hands the rest of the team up to 42% CRIT DMG on top of the ATK buff her healing already carries.
The Castaway's Tale
Alternative
HP % +26%Increases the holder's Healing Bonus by 16%. After the holder provides healing, all other characters on the team gain Amplitude Multiplier (equal to the holder's Amplitude Multiplier ×6% + 16%) for 30s, up to a maximum of 42%.
Why Firtho: The same shape paying Amplitude Multiplier instead of CRIT DMG. Swap to it behind a Resonance DPS carry like Rex or Bentham, where CRIT DMG does nothing for the damage that matters.
Diamond Necklace
Alternative
HP % +20%Increases the holder's Max HP by 20%. When the holder's Ultimate Charge Efficiency exceeds 140%, providing healing effects grants all characters on the team 25% CRIT DMG for 30s.
Why Firtho: A Lv.20 stand-in for the same team CRIT DMG payout, at a flat 25%. It only fires once Ultimate Charge Efficiency is above 140%, so build for that before equipping it.
The Last Leaf
Alternative
HP % +20%Increases the holder's Max HP by 20%. When the holder's Ultimate Charge Efficiency exceeds 140%, providing healing effects grants all characters on the team 25% Amplitude Multiplier for 30s.
Why Firtho: The Lv.40 rung of the same healer ladder, paying Amplitude Multiplier like The Castaway's Tale does at Lv.70. Its 20% Max HP is the part that matters early, because Second Heart pays for every tick of team healing out of her own health bar.
Return From the Underworld
Alternative
Ultimate Charge Efficiency +30%Increases the holder's Ultimate Charge Efficiency by 20%. Upon unleashing their Tactical Assault, their Healing Bonus is increased by 10% for 6s. When the holder provides healing, they grant the target 1 stack of Heartfelt Elegy. Each stack increases ATK by 2% for 36s, stacking up to 6 times.
Why Firtho: The only healing title that pays the target rather than the whole team, stacking Heartfelt Elegy to 12% ATK on whoever she heals. Her Tactical Assault raises her own Healing Bonus first, so the stacks land larger if she opens with it.
Building Firtho with someone? Send them the rotation.
Psyches
Pathologist
Firtho's Charged Skill provides 10% more healing. After she uses a Charged Skill, all characters on the team take 10% less DMG for the duration of the buff.
Fate-Defying Lancet
The buff from Firtho's Charged Skill also increases the Amplitude Coefficient of all characters on the team by 16%.
Shadow of the Heart
After Firtho unleashes a Charged Skill, her Basic Attack DMG is increased by 24% for 6s.
Early Cooperation
After Firtho uses her Tactical Assault, she recovers 20% Silverdrips. For each buff stack her Charged Skill grants, she recovers 2% Silverdrips.
Detective and Doctor
After Firtho uses her Ultimate, she increases the Radiatio DMG of all characters on the team by 15% for 40s.
Shared Days
Firtho's Charged Skill DMG is increased by 15%. For each enemy her Charged Skill hits, the DMG of her next Ultimate is increased by 9%, up to a maximum of 27%.
Firtho Trust and Gifts
The gifts Firtho prefers, what each Trust level costs, and what it pays out.
Firtho prefers Silverium Terrarium, Scientific Horizons: The Compendium and Enamel Pocket Watch.Each one is worth 100 Trust EXP, so 8 of them cover the 780 Trust EXP between Lv.1 and Lv.5. The Gift Shop charges a flat 10,000 Ounce per gift, which puts a maxed Trust level at 80,000 Ounce.
Preferred gifts
Silverium Terrarium
+100 Trust EXP
A small terrarium that houses Silverium beings. It's said one can even glimpse them fading into inactivity, returning to the Argent Strand.
These sold fast upon release, a desirable item for Silverium enthusiasts.
Scientific Horizons: The Compendium
+100 Trust EXP
A hefty essay collection detailing a range of theses that have stirred up debate in modern scientific spheres.
Contains many contentious topics, hence many half-jokingly refer to it as the cutting edge of Silvernian research.
Enamel Pocket Watch
+100 Trust EXP
A watch of outstanding craftsmanship. Another half-century could pass, and its hands would still be accurate to the millisecond.
The owners of such watches tend to engrave their name on the back, the signature to a contract with Father Time himself.
Unlocked by raising Trust
Companionship - Firtho×1
A Special Letter From Firtho×1
Interaction - Physical Exam×1| Trust level | Trust EXP | Running total | Preferred gifts | Rewards |
|---|---|---|---|---|
| Lv. 1 | 100 | 100 | 1 | Ounce×5,000 The Science of All Things: Volume I×3Companionship - Firtho×1 |
| Lv. 2 | 150 | 250 | 3 | Ounce×5,000The Science of All Things: Volume I×3A Special Letter From Firtho×1 |
| Lv. 3 | 220 | 470 | 5 | Ounce×5,000The Science of All Things: Volume I×3 |
| Lv. 4 | 310 | 780 | 8 | Ounce×5,000 Paper Bookmark of Conspiracy×3 |
| Lv. 5 | Max | 780 | 8 |  Standard Shot×1 Reactor Crystal×50Interaction - Physical Exam×1 |
Lv. 5 is the cap, so it carries no further Trust EXP requirement. The running total counts each level's cost as you clear it.
Firtho Voice Lines
Every line Firtho speaks in game, with audio in all four dubs.
Daily
Character Quote
Life has not been kind to me. Death, on the other hand... has been a truer friend.
Scattered Thoughts
I'd rather be a deadly poison than some greenhouse flower.
Inner Feelings
As a child with a heart disorder, I always detested the pity with which people looked at me... I was weak then, but now, I'm strong enough to face the truth. Strong enough to say goodbye.
Greeting
The clinic is closed today. Explaining conditions and treatments to patients is putting a serious toll on my circulatory and nervous systems.
Outside the Detective's Office
I've only come today to monitor your activities and see how many ways you can get yourself injured.
Casual Chat
If you are experiencing a mental block, I do have some psycho-activating agents. In safe doses, of course.
Riding: I
The time a physician spends travelling may be the difference between life and death for the patient.
Riding: II
With transport, house calls are far less annoying.
Riding: Speeding Up
Faster.
Riding: Sudden Stop
(interjection)
Riding: Flying
Straight line, shortest path? Figures you'd say that.
Lucky Find: I
I have little use for this. It's yours.
Lucky Find: II
Remember to disinfect them.
Inspect
Time to observe and diagnose.
Expose
I have the conclusion.
Battle
Battle Start: I
I've seen my fair share of disagreeable patients.
Battle Start: II
Apply restraints on any uncooperative patients.
Tactical Assault: I
I'm taking over.
Tactical Assault: II
Go and take a break.
Entering Battle
I'll handle it.
Skill
Back down, all of you.
Parry
Not so challenging.
Dodge
Vital organs unharmed.
Wounded
No need to worry...
Exhausted
I can dress the wound myself...
Ultimate: I
Commencing emergency surgery.
Ultimate: II
Prepare for surgery.
Execute: I
The anatomical structure is evident.
Execute: II
I know where to make the first incision.
Victory: I
Good. Now comply with my treatment.
Victory: II
Any injuries? I'll take a look.
Other
First Meeting
Dead men don't talk? I beg to differ. I can secure testimonies even from the deceased. Which is why you're here, is it not?
Preparation for Action: I
When it comes to settling people down and shutting them up, I have my ways.
Preparation for Action: II
There's more to me than meets the eye. In fact, I've been trained to handle patient disputes too.
Potential Growth
Hmph, mind your own... I never said I didn't want it.
Potential Break
Dispensing drugs, performing surgeries, chemical analysis, forensics... I'm the only person in this city who meets all your needs, no?
In Rain
The efficacy of drugs may be influenced by weather, so make sure you acquire my advice before use.
Nighttime
It's at night that I speak with the dead. Hurhur. I wonder what the bodies will tell me tonight... hurhurhurhur...
At the Corner Clinic
Work at my clinic is manageable so long as you don't come to me with your problems. That'll be great news for both my patients and me.
Potential Break Costs
Each Potential Break raises Firtho's level cap to the level shown. Taking Firtho through all 6 costs 134,400 Ounce plus Rectified Decay Concentrate, Quick Electrified Core, Fledgling Feather, Juvenile Feather, Hunter Feather and Quilled Feather. Firtho is Radiatio, so the Reactor Attribute material is Rectified Decay Concentrate.
Firtho Stats by Level
Key levels below. Drag the slider at the top of the page for any level from 1 to 80.
| Level | HP | ATK | DEF |
|---|---|---|---|
| Lv. 1 | 816 | 60 | 25 |
| Lv. 20 | 1,917 | 141 | 126 |
| Lv. 30 | 2,652 | 195 | 203 |
| Lv. 40 | 3,386 | 249 | 281 |
| Lv. 50 | 4,120 | 303 | 358 |
| Lv. 60 | 4,855 | 357 | 436 |
| Lv. 70 | 5,589 | 411 | 513 |
| Lv. 80 | 5,997 | 441 | 551 |
Stats, skills, Psyches and costs on this page: last checked . Values can change as the game updates.
Team Synergies
The roster's only healer, with an ATK buff attached
Strengths
- The only direct healing on the roster
- Healing and the team ATK buff come from the same button
- The Passive adds a large team damage reduction on top of the healing
Weaknesses
- No Radiatio carry exists yet, so her attribute buffs usually go unused
- The Skill costs her own HP before it pays out
Best partners
The only other Radiatio unit, so the team Radiatio damage bonus lands on a carry that can use it, and her Psyches add resonance buffs.
Pro Tip: Check the team building guide for how the four slots, attribute sharing, and the Power budget fit together.
Keep Silver Palace Meta free
Every guide, tier list and database here is free, and it stays that way. If something here helped you, $3 a month on Ko-fi or Patreon pays for the hours behind the next one.
Support on Ko-fiFirtho guides and lore
Everything on this site that covers Firtho, from build breakdowns to the lore behind the design.
Radiatio Guardian build and team fit
The 4-star Radiatio Guardian with a saw cleaver and syringes: her durable support role, build direction, and what she is worth to an early team.
The Medical Lancet: Silver Palace title page
A confirmed 4-star Radiatio Guardian from the Corner Clinic, whose Second Heart heals the whole team and stacks attack while it runs.
Firtho Design Breakdown: Silver Palace's Surgeon
Silver Palace's Firtho is a surgeon in disguise: her title page hides surgical tools, an anatomical heart, and medical symbolism. A design breakdown.
Silver Palace Curious Deductions: Multiple Endings
Silver Palace's Curious Deductions mode puts multi-ending cases on the Evidence Board, starting with The Resurrection Enigma. Endings, restarts, rewards.
Silver Palace Metal-Blooded: Werewolves & Harpies
Silver Palace's werewolves and harpies explained: Silverium founts, high-purity exposure, werewolf stabilizers, and the Wolf King's hunting ground.
