DF’s system is the way it is because it’s an approximation of how things work in real life. Cataclysm, on the other hand, doesn’t have any plans to be a realistic medical simulator (at the moment) so we can get by with a much less intensive system.[/quote]
Yeah, confirming that “realism” in and of itself isn’t the reason DF’s system works the way it does - but rather narrarative expression (from the things the Toad has says). He wrote things they way he did because they make for more interesting (and brutally descriptive) combat logs, and DF is essentially a log+description generating system with a game tacked on top. An actual body part system was simply the easiest way to achieve this with the large amount of fighting going on the player wasn’t involved in, and it had to be “realistic” enough for the logs to be convincing. DF is also a simulation of course, but he has intentionally made changes that are not like real life - one needs to remember that “realistic” and “like in real life” aren’t actually the same thing after all.
There’s a reason why it is/was so unwieldy in adventure mode - it was never designed as a game system, but as a tool for generating procedural narrative to flesh out combat logs in fortress mode.
Cataclysm is a lot more game than procedural narrative generator, so any major change like this would need a good gameplay reason to go in or at least provide a clear benefit to the player in exchange for the implementation lock-in and investment involved.