The Medicine Stick is a variant of the brush gun. It can hold 8 rounds of .45-70 Gov't, has an item HP of 200, an obstructive rear sight, and is clean in appearance. It also features a unique stock with a symbol similar in appearance to a Native American medicine wheel attached to its side. The Medicine Stick inflicts 78 damage in good condition and has a DPS of 108, which can get higher when factoring in perks.
Due to the gun's tubular magazine, it is reloaded by hand one bullet at a time, allowing the player character to interrupt reloading mid-way. This allows the gun to be fired before reloading is complete.
The Medicine Stick can fire a total of about 995 standard rounds - the equivalent of 125 reloads - from full condition before breaking.
This weapon is the strongest .45-70 Gov't chambered weapon and is the second highest damage per shot ballistic rifle in the game behind the anti-materiel rifle.
The decorative feathers are rigid and do not follow gravity.
Behind the scenes
Medicine sticks are also called "spirit sticks" by some Native American tribes. Spirit sticks are used for rituals relating to the spirit world, and are often decorated with beads and feathers from spirit animals (such as the eagle or the bear). The weapon's name implies that it can take away "bad spirits" and send them back to the spirit world.
Native American tribes during the 19th and early 20th century would frequently decorate Western guns they acquired with feathers, beads, and nails, similar to the Medicine Stick.
The .45-70 used in the Medicine Stick and brush gun was last used in quantity during the Spanish–American War, and was not completely purged from the American inventory until well into the 20th century. Many surplus rifles were given to reservation natives as subsistence hunting rifles and now carry traditional markings. Hence the native iconography of the Medicine Stick.
U.S. President Theodore Roosevelt was also known for carrying a large-bore lever action rifle (in his case a .405 caliber Winchester 1895) that he referred to as his "medicine gun."
When firing from long ranges, it appears that the sights aren't completely aligned, meaning you'll have to aim slightly to the left of an enemy for a direct hit. [verified]
Sometimes, the lever may remain downward after running while reloading. This is purely aesthetic, however; it will return to its original position when you stop moving or holster the weapon. [verified]
While reloading in third-person view, you may not see the usual lever action after reloading. [verified]
If you look at the opposite side of the stock when holstered, the feather will have disappeared. This is most evident when wearing heavy/medium armor such as power armor or NCR Ranger patrol armor. [verified]
As with the regular brush gun, the Medicine Stick may glitch in V.A.T.S. mode, causing the cocking handle to become stuck in the downward position. The player will not fire any rounds, and will stay in the glitched state until killed. This may require a reload of a previous save. [verified]
The reload animation of lever action weapons doesn't have a corresponding jam animation, so the weapon will not jam, even at near-breaking conditions. [verified]
Like all round by round reloading weapons in the game, if the player switches ammo types quick enough, the animation to load a single round is played but the magazine will be fully reloaded. [verified]