(Thoughts/comments/additions?)
Handbook of Medical Practice
------Introduction and Scope------
- For all medical procedures that involve remedying the negative influence of clear external forces, such as wounds and drugs, on the body. This is in opposition to internal humoral disruptions without as obvious a cause, such as illness and disease. The latter are more properly the care of herbal methods, though other practices can be used, and are beyond the scope of this textbook.
(OOC note: stuff you use treat for, pretty much.)
------I. General Wound Care------
Ia. Corruption of the Humors (infection)
- What is infection from an IC standpoint? In the body the humors are kept properly separated, but when the flesh is pierced, the humors may leak and mingle. Combined with outside influences, this creates a corruption that festers in the flesh and kills it.
- It is best to prevent corruption from setting in whenever possible, as it often kills its victims, but even the best efforts cannot prevent it very reliably.
Ib. Preventing Corruption
- Clean the wound thoroughly, using liquids that burn such as alcohol, vinegar, etc. These liquids combine the purifying forces of water and fire, the two basic cleansing elements of the world.
- Also remove any physically visible debris, as it may seed corruption. This can be done surgically, with careful use of liquid, etc.
Ic. Treating Corruption
- Remove the dead flesh, as it will never heal. It can be cut away, or maggots may be used.
- Continue to wash the wound with burning liquids
- Keep the patient dosed repeatedly with cold and wet liquids such as the proper humoral tea and willowbark tea to restrict the burgeoning of hot/dry humors
- If in utter distress, consider using purgatives to remove the excess of yellow bile
- Last-ditch effort, amputate the body part before the corruption spreads.
Id. Bandaging and Other Wound Care
- Important to keep wounds covered or outside influences can cause corruption
- Most wounds need absorbent material to handle seepage, held in place by firmer material to provide pressure
- Bandages must be changed frequently because the outside corrupting influences seep out, and should be removed when they can.
------II. Blunt Wounds------
IIa. Bruising
- Swelling of blood trapped in one place beneath the skin
- Leeches free trapped blood, allowing the body to make more
- Massaging may also be helpful
IIb. Limb Fractures
- Simple, vs. bone breaks the skin, vs. pulverized bone
- Must always try to reset bone ASAP if possible, bind reset bone together with splinting
- If on big limb, can use stiffened bandages hardened with egg, flour and fat to wrap entire limb
- Fingers/small bones, one month. Arms/medium bones, two months. Legs, three months.
- If not set properly originally, use a fine pointed chisel and a mallet to insure a clean break at the original site, then re-set and re-splint. Dangerous: can kill patient due to causing systemic corruption, and full recovery not guaranteed. However, only possible treatment if bad setting reduces mobility/function and it's not because the bone was simply pulverized.
IIc. Rib Fractures
- Wrap ribs up in tight bandages (no, not done IRL anymore, but y'know)
- Leave wrapped for one month, after which should expect mostly healed
- Avoid strenuous activity during this time, especially heavy breathing/force on chest.
IId. Skull Fractures
- Dangerous, no treatment except fitting skull back together. Put things together, sew back up, essentially. Drain swellings with leeches asap. Trepanation for extreme swelling.
- Death rate very high from head wounds, do not expect survival, especially when skull broken
- For all head wounds, nausea and dilated pupils = signs of brain injury, may leave survivor addled, level of damage impossile to know
IIe. Crushing Wounds
- Clean up blood, have leeches suck out what they can
- Apply cold
- Be wary of corruption caused by dead tissue that may require amputation
- Use maggots to clean out destroyed flesh that can't be easily cleared away via scalpel.
------III. Slashing Wounds------
IIIa. Basic Slashing Wound Treatment
- Clean wound thoroughly if time allows
- Always, always, always careful for blood loss
- Close wound however possible
- Stitches common, leave in for
IIIa. Deep Cuts
- Sew everything together that looks like you can. First priority closing wounds. Cauterize if bleeding is uncontrollable.
IIIc. Severed Body Parts
- Blood loss is immediate threat. Stop bleeding immediately. Cauterize if cannot be stopped quickly. Do not even think about reattaching.
IIId. Puncture Wounds
- Stop bleeding
- Clean wound thoroughly
- Stitch if need be
- If punctured lung: release trapped air in body cavity periodically with needle and pray for the best, little else to be done?
- Bandage with poultice
IIId. Uncontrolled Bleeding
- Yarrow; other herbs we use for this?
- Cauterization if/when needed
------IV. Burn Wounds------
- Cool vinegar/alcohol poured over the burn
- Willowbark tea as a standard drink
- Elder's Elixir, Paynifier's Punch for pain management
- Gently apply burn salve
- Wrap in soft gauze
- Wash in cool liquid once a day, re-wrap
- Probably special humoral diet?
------V. Wounds of Addiction------
Va. Withdrawal Symptoms
- Different severity from drug to drug but similar general effects
- Low severity: sweating, mild fever, bodily aches, nausea
- Medium severity: serious digestive problems (vomiting/diarrhea at length), strong pains, moderate fever
- High severity: dangerous fever, fits (OOC: seizures), uncontrolled tremors, serious bodily pain
Vb. Withdrawal Treatment
- Tincture is a milder, easier to make version of Addict's Respite, uses the ginger to burn out the lingering traces of the drug but floleaf and alcohol to numb the discomfort of the various symptoms. Can be taken internally or applied to numb aches and pains
- Often also paired with symptom-specific treatment (willowbark for fever, gutscalm for digestive, etc.)
- Addict's Respite is preferable because it prevents the symptoms rather than treating them, using similar ingredients but very carefully balanced and concocted. It's extremely hard to make precisely, seek a master herbalist for administration.
- Always counsel a patient to wean their way off drugs slowly, a little at a time, and seek prompt treatment should even minor effects of the sort listed above ensue.
