I believe the reference guide may imply that a card of a certain type, when not found, is simply not obtained. In this case, if it is an Illness Condition, then the investigator simply doesn't gain the condition, I believe, and if it is a case where "an investigator may gain an Illness to etc" then he doesn't have that option to do that etc.

However, what about the Epidemic Prelude card in Under The Pyramids which reads

Then each investigator gains 1 ILLNESS Condition and 1 Clue.

There are only 4 Illness cards, so if I have 8 investigators, do only 4 get the Illness, and do only those 4 likewise get Clues for the Prelude because the text implies the Illness and Clue must go hand in hand (I'm not even sure this wording necessarily implies that, although one could imagine wording it as "then each gains an Illness; then each gains a clue" would clarify they don't go hand in hand)?


If condition cards run out, investigators do not gain the condition.

An investigator can gain a card or token only if it is available.

Source: Reference Guide, "Component Limitations" (page 3)

The Epidemic Prelude's "gains 1 Illness Condition and 1 Clue" is an identical situation as "recover 1 Health and 1 Sanity" or "discard 1 Item and 1 Trinket".
These loses/gains aren't dependent on each other, those are just lists.
If you can't do everything from the list you do as much as you can.
Not recovering health doesn't prevent you from recovering sanity.
Not losing a Trinket doesn't prevent you from losing the item.
Not gaining Illness doesn't prevent you from gaining a clue.

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