Before I get into the nitty-gritty, let me just say this:
This is not meant to be a guide and more a reflection on my time and the experiences I’ve had with what this particular settlement location builds. Guides in general are a tough thing with KD:M for me and whilst a little guidance is without a doubt helpful for discovering interesting strategies ever so often, I would encourage you to just give stuff a try and don’t blindly follow the generalized input from the internet or any one person.
Don’t over-optimize – try stuff out! Have fun with it!
Case and point for me: some of my overall favorite weapons in the game are typically labelled as “too expensive” and you “should never build them” from what I have gathered over the last year.
I also may or may not utter guide-like statements at times when going through the items, I would suggest you do not take them as such.
You have been warned!

Here we are, the third and final of the 3 most basic Settlement Locations. All the items you can build here are good. Enough said. That’s it.

In a more in depth attempt at commentary:
The Organ Grinder offers a variety of early support items that generally have decently long staying power throughout any campaign, mostly because they generally offer a mix of Stat increases, Survival gain and survivability.
Because of this the Organ Grinder is equally the least immediately necessary location to build in the very first year, the gateway to “the dream”¹ your average min-max-er can be found salivating over and an absolute necessity as it gives you access to Augury – your only means of triggering Intimacy save for special events or abilities on survivors (unless you are playing PotSun, of course).
Speaking of which:

Augury – 1 endeavor, roll 1D10
Its the premier feature of the Organ Grinder and one of the main ways to gain understanding (1-3) and trigger Intimacy (8+) for many campaigns. (And even if you hit neither, you skill gain +1 survival as a participation price.)
It is not without risk though, as the 1-3 result will cost you a resource from storage, and rewards the +1 understanding only if a resource was lost even.
It should also be mentioned that the survivor that used Augury does not have to participate in the Intimacy story event.

Monster Tooth Necklace – cost: 1 bone and 1 scrap
1 right-red affinity piece
+1STR
And if you have 2 red affinities on your gear you gain another +1STR.
This does require Heat to be made! Speaking as somebody you enjoys the unga-bunga mindset: this good. Even though STR is the most common stat bonus and this is thus the least useful of the stat items build at the Organ Grinder, it should not be overlooked as even just the +1 bonus will ever so often turn a failed attack into a wound. It also combos nicely with a lot of the early weaponry and for that reason alone begs to be taken along.

Monster Grease – cost: 2 organs
1 left-green affinity piece
+1EVA
And for 3 green affinities another +1EVA. Not getting hit is still the king when it comes to defense in KD:M, so reducing the monster’s hit chance by 10 or even 20% is overall very solid and can stack quite quickly.
(Just some quick math: your average SotF-survivor against a White Lion in Tall Grass with an active Monster Grease will only get hit 40% of the time – on 7+.)
It should be noted that this items is soluble, stinky and flammable. With the Frogdog handing out Eproctophilia (D) to sane survivors like its going out of style, stinky can be a quite valuable keyword in modern KD:M.
This item also seems to be especially at home with the leather set.

Luck Charm
1 left-blue and 1 right-blue affinity pieces.
If your gear has 2 blue affinities active this items grants the user +1LCK. Luck is generally considered the most powerful stat a survivor can get and that is likely the reason why this little Behelit-wannabe offers its boons a little less freely than the other two items.
I tend to get this on most of my ranged builds as it finishes the Claw Head Arrow – Luck Charm – Cat Eye Circlet line whilst being activated.

Dried Acanthus – cost: 1 Fresh Acanthus
+2 Survival on Departure
When you would suffer a severe injure you may archive this gear to prevent it.
This has been one of the all-time great survival items in my opinion, and yet another reason that cements lope as the premier Node 2 Quarry in the game right now (as far as I can tell). Biggest downside is that you have to chose to prevent the severe BEFORE rolling, however it can also prevent set severe injuries from story or hunt events.
Whether it is used as a safety net for a VIP on a hunt or just for the extra 2 survival, this is a decent option to bring to almost any fight.
It is a consumable so keep in mind that it will attract hungry lopes.

Fecal Salve – cost: 1 organ
+1 Survival on Departure
Can be activated to make the Survivor using it to not be a threat until their next attack and/or to remove the Priority Target Token from them.
Another stinky piece of gear that probably sees a little more play now that the Frogdog has been released last year (its certainly like this for me), but it also offers another survival gain early on. This is probably the weakest item of the bunch for me, but it has and will have its uses still.

Stone Noses – cost: 1 endeavor
+1 Survival & +1 Insanity on Arrival.
The cost is somewhat steep for the early years but Stone Noses will make up for it in one way or another. The important part about this item is the fact that it triggers on ARRIVAL. Hunts going bad can wreck a settlement for years to come down the line. And, for me at least, arriving at the showdown with 0 survival has been one of the premier reason why I lose to monsters.
To be fair, the noses will get replaces rather sooner than later in your gear grids most likely, but in those early low-survival years they can be a boon for sure.

Barber Surgeon – cost: 3 organs, 1 hide and 1 endeavor
Besides a few powerful (or at least helpful) items you make mainly from the Perfect resources, the Barber Surgeon offers the chance for some light brain surgery, which can decently reliably (30%) cure disorders.
Isn’t the future amazing?!

Overall the Organ Grinder is an important location in any settlement and will be frequently visited throughout any campaign. The only reason why it might not be as important early on is because of the general lack of weapons and armor leading to a more reliable form of survivor-death in your fights. But if you have a surplus of unused organs or acanthus, it should be well worth investing in a Monster Grease or five. Especially if your newest generation of survivors got hooked on that Frogdog-stank.

Typically I build all 3 of the starting settlement locations in Lantern Year 1, if I have the endeavors for them. Otherwise these Tier 1 type buildings should be built as quickly as you can, I think.
From the stat increasing items I will typically have 1 or 2 by the mid-game, depending on the amount of organs we got and how much I needed them to build other stuff.
But for a location that produces mainly items to fill in empty spots in gear grids, there is a lot of competition now, as monsters do seem to get more and more interesting and useful options nowadays. Thus in contrast to the Bone Smith and the Skinnery, each campaign will see a different level of importance for the Organ Grinder‘s items as they seem not nearly as relevant for the first and second Lantern Year compared to the items from the other two locations.

And that’s all 3 basic settlement locations from my point of view. Well, well, well.., I do hope sharing my opinions was at least a little informative, though I know, I know, I’m just about 13 to 15 years late to the party. But instead of wallowing in this irrelevancy, I will just meander onwards. Next up will be the Catarium and perhaps the Stone Circle, maybe the Froskrafter as well. I am debating whether I should finish the Core set first or move up my personal Tier listing instead. In any case, I probably should explain that at some point.
For now, first, there is a White Lion Lvl2 coming up next week.

But, I’m going to leave it at that for the time being.
Kale is calling for me to continue painting (*angry doot*), Lunar Aya needs a few more stars on her dress and I made the mistake to dabble with Stellar Blade again today. 4 hours vanished in an instant. I couldn’t help but notice that Eve has that KD:M body type. Staring respectfully or something like that.

As always, thank you for your time, and if you find a Behelit in a lion’s kidney, if it doesn’t cause a solar eclipse it might just be a weird kidney stone.
Amathul

1. If for some ungodly reason you get the luckiest initial lion fight ever, the supposedly best possible start consists of you building a Barber Surgeon and Scavenger Kit right after the prologue. ↩︎