Campbell
Relaxed Intensity
Hit points (and damage) within 4e are perfectly coherent if you accept the way they are portrayed and discussed within the game itself. If you bring in a set of aesthetics and/or understanding based on previous experience playing and running other editions of the game you can make it feel incoherent for yourself, but that requires smuggling in those expectations a priori. I can get the argument some would make that being inconsistent with the aesthetics that some groups depended on in previous editions might be unacceptable for some, but that is not the same as 4e being incoherent. It's just not cohering to an aesthetic preference some gamers have.
For what it's worth I consider 4e to have the most consistent treatment of hp in D&D land. It's perfectly up front that all hp loss is superficial Diehard stuff. Even in Cleric "healing" is portrayed as more inspiring than knitting of wounds. Personally, I prefer the more Berserk-like aesthetics of Pathfinder Second Edition. That does not speak to relative internal coherency though.
For what it's worth I consider 4e to have the most consistent treatment of hp in D&D land. It's perfectly up front that all hp loss is superficial Diehard stuff. Even in Cleric "healing" is portrayed as more inspiring than knitting of wounds. Personally, I prefer the more Berserk-like aesthetics of Pathfinder Second Edition. That does not speak to relative internal coherency though.