@Uuugggg - Well when I last played it was fine, next day I added 3 new mods and changed some mod settings and it was just pure lag and stutter with fps jumping from 5-100 sometimes 5-30 every second.
So I removed those 3 mods and it contined to lag untill I undid those settings 1 by 1 and found which 1 is causing it, this was also just using the same save I had and even tried it on another save.

The Mod Settings option (Doctors will treat patients if no beds are available) is the problem.

So I fixed the problem and can play now but that option just breaks it.

Not sure how to link my Modlist, or do I just have to type out every single one?

Yea, debug logs will have modlist, and any clues for failure

Just load up the game, check the option, see the lag, and then post:

steamapps\common\RimWorld\RimWorldWin_Data\output_log.txt


Now, this can't really be a Smart Medicine problem directly here, since all it does it look for beds, and there's no room for a slowdown there. I've gotta wonder if some other mod is also messing with beds and causing something silly.

Here is my Modlist from that file.

Loading game from file Death Tyranny 1 with mods Core, HugsLib, Children, EdB Prepare Carefully, Expanded Prosthetics and Organ Engineering, Work Tab, ResearchPal, Medical Tab, Fast Spreading Grass, Stack XXL, LT-DoorMat, Allow Tool, [KV] RimFridge - B18, Repair Workbench, RT Fuse, Stack Merger, [KV] Trading Spot - B18, [RF] Fertile Fields [b18], Efficient Light, Double Population, QualityBuilder, Just Ignore Me Passing, AllowDeadMansApparel, More Vanilla Turrets [B18], Quarry, [B18]-LinkableDoors, A Dog Said..., Blueprints, Better Workbench Management, [KV] Refugee Stats - B18, Centralized Climate Control, VGP Garden Tools, VGP Vegetable Garden, VGP Garden Medicine, Hospitality, Facial Stuff 0.18.0, RT's Weapon Pack B18, Avoid Friendly Fire, Animals Logic, Vanilla Animal Overhaul, [XND] Visible Pants, Locks, ED-Laser Drill, ED-EnhancedOptions, [B18] Removable Mt.Rock Roof Patche, CrustyTextiles B18, Misc. Training, Mad Skills, Pick Up And Haul, Smart Medicine, Heat Map, Color Coded Mood Bar, Cut blighted plants, Skilled Stonecutting, Architect Sense, Stuffed Floors, [T] MoreFloors, Billy's Improved Caravan Formation, Billy's Improved Load Transport Pods, Reasonable Components, [KV] Change Dresser - B18, Conduit Deconstruct, Barbed Wire, [sd] advanced powergeneration, Less Rebuff, More Linkables, Area Unlocker, Steel extraction, Various Space Ship Chunk [A18], Omni Core Drill B17, and Quantum Cooling

If your wanting everything in that File I can but it will be very long.

Shrug ~ Post the full thing to pastebin.com, of course if you've searched for 'medicine' and found nothing, all I can say is: don't use that option

Couldn't find anything about 'medicine' but here you go.
https://pastebin.com/kTkZ17Hf

I just added that option same as Kutsuu and having the same real bad lag/stutter. Unchecking the option stops the lag. Im using RuntimeGC and that didnt fix the lag, and I checked with Msi afterburner- no system problems, its def that option.
https://pastebin.com/Sx3eQwNB

I can't actually get Rimworld to load properly with this mod active anymore. My computer gets so hung up on creating a harmony.log file on my desktop that I wind up having to kill the program.

Edit: it will load, if I let my computer do its thing for an extra four minutes of load time (which is normally under a minute). It does okay on subsequent reloads if I leave the .log file in place, but it seems awfully trashy to have to leave a strange text file on my otherwise pristine desktop in order to run a mod.

Edit #the second: Thank you

Yeh, a debug dll got in one of these releases. New one won't have logs

I didn't have such a bug before, but after changing a bit of settings in Smart Medicine, this bug appeared..I think this may be smart medicine. Because i just closed it and now I have not found the error.

(I don't speak English, so I rely on Google Translate)

========

Exception in Verse.AI.ThinkNode_Priority TryIssueJobPackage: System.NullReferenceException: Object reference not set to an instance of an object
at RimWorld.ThinkNode_TraitBehaviors.TryIssueJobPackage (Verse.Pawn pawn, JobIssueParams jobParams) [0x00000] in <filename unknown>:0
at Verse.AI.ThinkNode_Priority.TryIssueJobPackage (Verse.Pawn pawn, JobIssueParams jobParams) [0x00000] in <filename unknown>:0
Verse.Log:Error(String)
Verse.AI.ThinkNode_Priority:TryIssueJobPackage(Pawn, JobIssueParams)
Verse.AI.Pawn_JobTracker:DetermineNextJob_Patch1(Object, ThinkTreeDef&)
Verse.AI.Pawn_JobTracker:TryFindAndStartJob()
Verse.AI.Pawn_JobTracker:EndCurrentJob(JobCondition, Boolean)
Verse.Pawn_HealthTracker:MakeUndowned()
Verse.Pawn_HealthTracker:CheckForStateChange_Patch1(Object, Nullable`1, Hediff)
Verse.Pawn_HealthTracker:Notify_HediffChanged(Hediff)
Verse.Hediff_Injury:Heal(Single)
Verse.Pawn_HealthTracker:HealthTick()
Verse.Pawn:Tick()
Verse.TickList:Tick()
Verse.TickManager:DoSingleTick()
Verse.TickManager:TickManagerUpdate()
Verse.Game:UpdatePlay()
Verse.Root_Play:Update()

Originally posted by Jun:

Verse.AI.Pawn_JobTracker:DetermineNextJob_Patch1(Object, ThinkTreeDef&)

Verse.Pawn_HealthTracker:CheckForStateChange_Patch1(Object, Nullable`1, Hediff)

Well I can say Smart Medicine doesn't touch that part of code, but the _Patch1 means other mods do.

Originally posted by Uuugggg:

Originally posted by Jun:

Verse.AI.Pawn_JobTracker:DetermineNextJob_Patch1(Object, ThinkTreeDef&)

Verse.Pawn_HealthTracker:CheckForStateChange_Patch1(Object, Nullable`1, Hediff)

Well I can say Smart Medicine doesn't touch that part of code, but the _Patch1 means other mods do.

I don't know what caused this bug, but thank you

I was tending one of my colonists, having dropped medicine on the floor so multiple doctors could use it (I was also tending a prisoner). However, since my doctor also had herbal medicine, she tried to use that out of her inventory but somehow the process of doing so meant it took 10 jobs to do so and this cancelled the work. I should note I have Pharmacist installed, but it was set so that she should have been fine using normal instead of herbal medicine.

Here's the error I got:

Brio started 10 jobs in one tick. newJob=WPTendPatient (Job_12246564) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404 jobGiver=RimWorld.JobGiver_Work jobList=(Wait (Job_12246307)) (WPTendPatient (Job_12246546) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246548) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246550) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246552) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246554) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246556) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246558) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246560) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246562) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) (WPTendPatient (Job_12246564) A=Thing_Human2623839 B=Thing_HerbalMedicine4058404) lastJobGiver=RimWorld.JobGiver_Work

WPTendPatient is a mod job, sooo something's conflicting:

Maybe the same problem as here : https://www.reddit.com/r/RimWorld/comments/8i0z3x/started10jobs_in_one_tick_major_laggy_issue_in/

"Animal Expansion Framework to the top of my mod order"

Yea Advanced Animal Frameworks copies redefines a lot of jobs instead of patching the ones Smart Medicines modifies, so no wonder there are problems.

Yeah, I have that framework. I'll report this bug to WalkingProblem.