Definitely the best update so far. Although, with the health issues, I was referring more to descriptions like "difficulty breathing" or things like that. I wasn't expecting you to add a whole affliction system. While it's not exactly what I had in mind, since there aren't as many new descriptions as I'd like, I certainly see enormous future potential in that affliction system. In my first playthrough, I had a bug with the tanning system. I went to the beach with one of my girls, she got a tan, and it stayed that way for the rest of the game. From what I've read, it should fade over time,. That's all. Definitely a great update, and I have high expectations for the future. You're probably creating the best and most extensive sandbox game for this damn niche fetish so far.
P/D: Oh, by the way, the portrait system is great, I love it and it's definitely my favorite thing about this update so far.