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[Culise]

Question on building sanitary cisterns for medical use: when people talk about lining it, they just mean putting in smoothed or constructed stone, right?  Does it have to be smoothed or constructed, just one or the other, or can it be left raw stone as long as there aren't any dirt tiles?  I looked in the wiki, but it doesn't give much details in the reservoir about how to keep the water clean.

In my experience, rough walls have worked fine for my cisterns.
KD

Huh, go figure.  Thanks.  At least I got a bunch of practice for my engravers in smoothing out that 25x30x1 cistern.

[MarcAFK]

I think you only need to line any soil walls/floors with constructed stone, but i'm not 100% sure anymore so i always just go the extra mile and seal the wole thing, usually with microcline blocks for added value.

[Sphalerite]

I have yet to see convincing evidence that cisterns need to be lined at all.  I know from my own experiments that contrary to prior claims cisterns do not need to be lined to avoid becoming saltwater - you can have a freshwater cistern with sand walls in a saltwater area, so long as no salt water has ever been in that location.  I suspect that stagnant water works the same.

I do make a point of lining the floor of my cisterns with constructed floors, but that's to prevent plants from growing.  I also sometimes replace the walls with constructed walls, especially if the cistern intersected a vein of cinnabar or pitchblende or something, but that's purely an aesthetic step.

[MarcAFK]

But walls of pitchblende and cinnibar make for the sweetest mineral water!
It's a shame you can't put it into lead barrels and trade it with elves

[Callista]

It's a good thing for doctors to have high self-discipline. You don't want Dr. Urist, M.D. to be On Break when that wave of casualties from the latest forgotten beast fight comes through the doors.

I got lucky in my current fort with a doctor who has high self-discipline and high compassion. I'm up to a population near fifty (I've capped it there) and he's still the only doctor, and doing just fine.

[Niyazov]

These are the perils of socialized medicine. If the dwarves had been responsible and all purchased private insurance policies they would have nothing to worry about. 

[meanjeans]

I'm having this problem too. I have the care for wounded labor enabled for EVERY dwarf (50, not counting the wounded), including 3 doctors who have NO other labors enabled. The doctors are all compassionate. AND THEY JUST SIT AROUND IDLE! It's weird in particular because they were doing just fine before, then they all of a sudden decided to stop. Tons of open buckets, water source available, and they just decided to stop bringing them water. Any hints or suggestions for this case?

My problem with hospitals is that my dwarves absolutely fail in keeping hospitalized dwarves hydrated, despite the hospital having plenty of buckets, a well, and all my docs dedicated soley for fixing up patients as well as tending to their needs (even my important dwarves still have patient care labors enabled). Then again, dwarves generally ignore dwarves who got wounded in battle and prefer to drag corpses and junk back to the fortress and leave the injured to die. So maybe dwarves just give a crap about wounded dwarves, period.

In my experience the "care for patients" labors (labours for 'u' loving cultures) are very low priority.  If you have the pop, dedicate 1or 2 "nurses" who have only those labors enabled  and things will be different.

[i2amroy]

Do your buckets already have water in them? IIRC dwarves will only fill up empty buckets with water for wounded, at which point they just set the bucket that still has water [9] in it and ignore it until somebody eventually takes the water out of it and dumps it on a food stockpile floor somewhere.

[WriterX]

When I had one of my more successful forts I had to keep a team of medical dwarves focused purely on medical duty. I turned off anything that was not related to diagnosis/healing, including item hauling. The Medical Service was still slow, but at least Urist McDoctor did not go outside to gather berries while a soldier was bleeding to death in his hospital.

This is not always a good idea, especially in a small fort, but if you have a high population you might as well reserve some of your dwarves only for this task.

As others mentioned, Soap is a MUST. I went through great lengths to produce soap, and I usually buy any powder caravans bring in. Cloth and Threads are easy to obtain, and they can also often be bought from a caravan.

[caddybear]

I like having my hospitals designed as temples. And burrowing all the medical staff, priests I call them, around it. They have nothing to do other than taking care of the wounded, and they always have to be around the hospital because of the burrow.

[Reudh]

I had a team of two successfully treat three barrages of Forgotten Beast Sickness, one paralysing any uncovered parts of the dwarves involved, and that affected nearly 75% of the population.

One was a rotting sickness, affecting ten recruits and my already crippled militia commander, which they promptly sutured.

The last one was a fever which then caused mild numbness. They easily diagnosed everyone affected, which was ~40% of the population.

Two.

Kosoth Kerlignil and one other dwarf helped good ol' Zalisiden through tough times.

[Xen0n]

Speaking of spreading Sicknesses / diseases:

EDIT: One thing to be aware of is that hospitals can also be a spread vector for contaminant fluids, such as the stuff produced by certain underground beasts that I forget. Those dwarves, regretfully, should not usually be allowed back into your fortress - unless you have a decontaminating chamber available.

What IS the best way to keep you fort decontaminated?  I do the standard "Dwarven Bathtub" just inside each entrance to the fort, as well as the entrance to the hospital, but all it does is put the contaminants into the tub, and now any dwarf who walks through the tub gets infected... kinda pointless without regular use of DFHack's "clean all" command to destroy the contagions. 

I know using waterfalls with grates or running water contraptions and things can get rid of the contaminants, but my framerate is suffering enough as it is.  Have there been any new advancements in decontamination in the last few months I've missed out on?


EDIT: Oh, and one caveat about hospitals.  They are very aggressive in claiming items for the hospital, so it's best to build the coffers inside the zone one at a time.  Also, they will go straight for any adamantine thread, so I usually have a whole wing with food and workshops dedicated to converting raw adamantine > thread > wafers that I can seal off from the rest of the fort, and convert all the adamantine to wafers in one go without giving a chance for the threads to get stolen.

[meanjeans]

Do your buckets already have water in them? IIRC dwarves will only fill up empty buckets with water for wounded, at which point they just set the bucket that still has water [9] in it and ignore it until somebody eventually takes the water out of it and dumps it on a food stockpile floor somewhere.

No, most of them are totally empty. Do they require one of the hauling labors to be turned on, like food or item hauling, or just Feed wounded dwarves?

[Norseman]

When is the antibiotic makers workshop coming?

Actually, DF already has three different kinds of antibiotics (antiseptics, really), and one of them is used already.

• Soap - a surfactant. Damages bacteria by dissolving their membranes, making them more susceptible to death by other causes. Not extremely effective, but it helps.
• Booze - an alcohol. Kills bacteria by denaturing their proteins and dissolving their membranes.
• Honey - a hypertonic solution. Kills bacteria by absorbing most of their water, dehydrating them to death.

Historically, soap and alcohol were used by low-tech societies to clean wounds, even before germ theory. For over 5,000 years, alcohol has been used in low concentrations to make drinking water safe. Honey has been used for over 4,000 years to treat burn patients, whose skin otherwise becomes much more susceptible to infection after a severe burn. Keeping honey on burned skin will prevent bacteria from growing on the wound while the patient recovers. It would also help to keep any large surface wound from getting infected. Note: eating these would not help with infections, except for alcohol, which would help to kill gastrointestinal infections.

[greycat]

What IS the best way to keep you fort decontaminated?  I do the standard "Dwarven Bathtub" just inside each entrance to the fort, as well as the entrance to the hospital, but all it does is put the contaminants into the tub, and now any dwarf who walks through the tub gets infected... kinda pointless

A dwarf that steps into water + contaminant will not emerge from the water with contaminant on his clothing.  I don't know whether a dwarf that goes in barefoot will pick up the syndrome from the transient contact with his skin, but any dwarf with shoes on, at least, should be safe.  As far as I know.

Dwarves with no shoes are in a world of trouble anyway....