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Author Topic: Surgery/Medicine in DF  (Read 26260 times)

Neonivek

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Re: Surgery/Medicine in DF
« Reply #15 on: January 22, 2009, 11:32:24 pm »

Lucilia sericata are Nekrophagic and produce even an antibacterial extract.

You can actually go a few steps further... some maggots can even disolve Viruses (I think so... if I remember correctly)

Your not really going to do better at this time period

Of course however we need to think about how medicine should change remembering two things
1) This is a magical/supernatural setting
and
2) This is a Dramatic/epic/superhuman setting.
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Felblood

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Re: Surgery/Medicine in DF
« Reply #16 on: January 22, 2009, 11:45:35 pm »

So, one dose of maggots can be enough to clean a wound, but using them should effectively consume them, since the player won't want to re-use them anyway, and I doubt your dwarves want to eat a maggot raised on dwarf flesh.

Unless tailors start needing needles, just thread should be enough for stitching cuts. Anesthetic should make this faster/easier/less painful. Does stitching just reduce bleeding and pain, or should it speed healing?

Do fortress dwarves ever remove lodged arrows before death? I've never seen one do it, but it's a big game. Anesthetic, or knives (maybe both) could be used to reduce the pain and damage caused by pulling them out.
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Mel_Vixen

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Re: Surgery/Medicine in DF
« Reply #17 on: January 22, 2009, 11:55:55 pm »

Arrows are another thing. Never ever break the shaft, pull it out or push it through the body this makes things with an very high chance worse if not deadly. Arrows have to be cut out especally if it has an loose tip. After that you have to cauterisize the wound. After that you can stitch it which indeed speeds up woundhealing and prevents infection.

Instead of stitching an wound you can also glue it together.
« Last Edit: January 23, 2009, 12:39:04 am by Heph »
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Neonivek

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Re: Surgery/Medicine in DF
« Reply #18 on: January 23, 2009, 12:05:14 am »

Arrows are another thing. Never ever break the shaft, pull it out or push it throught this makes things with an very high chance worse if not deadly. Arrows have to be cut out especally if it has an loose tip. After that you have to cauterisize the wound. After that you can stitch it which indeed speeds up woundhealing and prevents infection.

Round wounds are highly dangerous. The Epee (It is what most people imagine when someone says "Rapier") for example did a wound JUST large and round enough that the body is uttarly incapable of healing it (or something like that). So anything it struck is doomed. This is one of the reasons why the Epee is considered the most dangerous sword by some respects, that and it requires such little force to actually harm an unarmored target (5 pounds?)

So I can see why a Arrow would be dangerous.

Alright lets get some other kinds of medicine in here... *WARNING!!! I KNOW NEXT TO NOTHING AHEAD!!!*

Pressure points is the art of using points of the body to alter the flow of energy to have a desired effect (Acupuncture also does this). (I need to study this more). Mind you I highly doubt this was used instead of treatment but rather in addition to if the condition was serious.

Also some Japanese doctors employed what was defined to be as "Massages" which have the ability apperantly to clense organs (such as liver or Bowels) of toxins. (This is as far as I know... It probably isn't that kind of massage... more likely he meant he aided the bodies natural ability to process the toxin by rubbing the afflicted area)

So the ability for even Unequipped doctors in Dwarf Fortress to apply treatment to patience could be in the game and could develop into whole new kinds of treatments.

Alright so I know next to nothing... but is it a crime to try to shift the conversation so we can get some non-European medicine in this conversation? Such as using Ants to stich up wounds? Or giving patients treebark to chew on? Or giving them poison so they lose their memory?
« Last Edit: January 23, 2009, 12:12:02 am by Neonivek »
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Felblood

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Re: Surgery/Medicine in DF
« Reply #19 on: January 23, 2009, 12:26:07 am »

Heph, I think you you mixed together a through and a though, up there. You might want to edit for ease of reading.

Alternative medicine is welcome (acupuncture as an alternative to anesthetic?) but it's something I know little about, and a lot of it might should wait for the magic arc. However, I'm mostly concerned with finding at least one solution to all the current problems, and medical uses for current game objects.

Speaking of, what should Golden Salve do? The wiki told me it didn't do anything, so I never even learned how to make it. It's potency and versatility should be based on how hard it is to make, but that's something for someone whose actually worked with it to decide. I suppose there's no time like the present to learn...

I know stitching speeds healing, I just wondered if the system can do that and whether it's a huge priority. So long as there is some way to eventually get my dwarves back, time isn't a huge issue for me, but I'm not everybody and I know others might find it a wallbanger if untreated wounds heal at full speed, but just get infected more.

Should stitching/cauterizing/wound closing end bedrest cycles for yellow wounds, or do we need to wait for them to heal, in addition to closing them? I know guys who had t be physically prevented from digging ditches with broken ribs, but that's far from a good idea, even if it is pretty dwarven.

If treatment alone is enough to end the "Rest" job, that brings a lot of retired dwarves with missing extremities back into action, almost too fast. Maybe have at least some rest required after surgery, maybe not. Perhaps the docs want follow up visits, to check for infection, but dwarves, being dwarves, don't always make those visits. (I still wonder if I should have gone back in, instead of removing those stitches from my face personally, but there's no sense in me paying him to do what I can do with a pair of scissors and a mirror, is there?)

Ooh. Doing your own surgery because you're too bloody cheap, is kinda dwarven. Let 'em do that. Botched surgery should cause excess bleeding and maybe even make wounds worsen, or lead to infection. Leveling up a medic should be pretty lethal, without some system of advance preparation (our doctors have to practice on corpses).
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SirHoneyBadger

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Re: Surgery/Medicine in DF
« Reply #20 on: January 23, 2009, 04:05:06 am »

I'm all for "eastern" medicine, provided you can make a good case for it being "dwarfy". Dwarfs aren't humans, and they certainly aren't European humans, but there's a lot of European tradition bound up into what a dwarf "is", so some consideration/respect should be paid to that.

It's not the end all-be all of the conversation, though. Dwarfs are an Eastern European phenomenon, as well as a Western one, and they *do* have their Asian (and African, and Polynesian, and American, etc etc.) counterparts.

It's really up to Toady and Threetoe to give the final word, though. They're the ones who decide what goes into the game and what doesn't, so if they want shiatsu, we'll get shiatsu  :P

As far as rest requirements after surgery, I'm of the opinion that while surgery *might* reduce rest somewhat (and I'm kindof on the negative side of rest reduction), it probably shouldn't eliminate it.

It could very well be the deciding factor on whether or not your dwarf survives at all (especially if they have red wounds), which-providing the surgery is a success *AND* the patient lives (often mutually exclusive states--Shock is a real bastard, there's lots of things that can complicate a surgery that our dwarfs just aren't going to fully understand, or even be aware of, and sometimes patients just die because they die), it would then allow them to continue their existence, via bedrest and with care, as we currently have it in the game. Not go out dancing, just because they "made their saving throw".

Surgery and healing are kind of almost separate things, in that surgery goes in and fixes specific problems, like a badly broken leg, but it doesn't (arguably) cause the leg to heal any faster, it just helps it heal *better* than it would, if it had never been properly set and cared for by a competent surgeon.

I also think the very real and very deadly risk of infection, aggrivation, and reinjury, should be considered, when thinking about rest.

Until the healing process is completed, no serious wound (yellow or worse) should ever be...less than serious.

And if it's reinjured, even lightly, there could be a chance it might open up the previous wound to it's previous level of injury.

If nothing else, running around with a wound could be a good excuse for the demons to climb in and make you their bitch.

That doesn't mean our dwarfs couldn't engage in some light activity and excercise while they're recuperating. Infact, light activity would probably help them, but their should be serious risks and penalties for sending your dwarfs out to perform hard labour, go without sleep/food, fight battles, attend stressful meetings (perform magic?), or go very far from your fortress, when they're supposed to be recovering.

And if they should be struck by an Artifact mood, there should maybe be a chance that it'll just kill them outright, if they aren't in good health. That's just one of the many hazards of being a dwarf.
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Neonivek

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Re: Surgery/Medicine in DF
« Reply #21 on: January 23, 2009, 07:31:51 am »

Quote
I'm all for "eastern" medicine, provided you can make a good case for it being "dwarfy". Dwarfs aren't humans, and they certainly aren't European humans, but there's a lot of European tradition bound up into what a dwarf "is", so some consideration/respect should be paid to that.

Dwarves are also not the only race in the game...

On that subject... maybe I should look up some Norse and African medicine practices.

Looking up Egyptian: Hmm apperantly Garlic once again surfaces as the trump card.

So I guess my addition is:

Have Garlic, Onions, and Olive Oil play a major part in medicine!

Also I am seeing a pattern of doctors controlling your diet in medicine. (though usually it was just "Don't eat stupid things you moron")
« Last Edit: January 23, 2009, 08:23:32 am by Neonivek »
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Pilsu

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Re: Surgery/Medicine in DF
« Reply #22 on: January 23, 2009, 08:41:30 am »

Whether the, clearly longer lived, purring maggots would be affected like that is up for debate.

Those things are the size of your arm


I don't much care for magical medicine. I mean, what's the point? The entire basis is realism and you throw demons into the mix for no reason? Just because the game has magic doesn't mean every damn little thing has to be magical. If anything the game suffers from it since nothing no longer has to make a fleck of sense

I do like the idea of a Physician noble, unlocked at say, the point you get a sheriff
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Neonivek

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Re: Surgery/Medicine in DF
« Reply #23 on: January 23, 2009, 08:48:31 am »

Quote
Just because the game has magic doesn't mean every damn little thing has to be magical

No it means that there needs to be a magical alternative to almost everything.

Also don't forget that the game was always supposed to be somewhat dramatic as well... So even without magic we could have things like reattaching legs, arms, or heads.

So Magic + Dramatic = Amazing medicine
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Pilsu

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Re: Surgery/Medicine in DF
« Reply #24 on: January 23, 2009, 09:16:11 am »

No it means that there needs to be a magical alternative to almost everything.

I don't see why the world has to be so saturated with magic that it stops being meaningful altogether

Oh, oh, diseases are boring right? Let's make it a magical disease! Nothing changed but it's oh so exciting now! Let's nurse it back to health with magical chicken soup, a magical blanket and magical +socks+! Or maybe rituals that make no sense but people learned of them anyway!

Real life rituals are made up on the spot. If rituals actually had to do anything, we'd be shit out of luck since good luck figuring out you need to hold 3 chicken bones while ballet dancing wearing presicely 2/3rds of a blue sock. Oh, oh, maybe have them study magic by staring at a wall! That's not a cop out or anything!


I think dying horribly after a bear rips off your arm and the wound gets infected is sufficiently exciting in it's own right. Or actually having to face up to the loss of your arm instead of getting a prosthetic that's hundreds of years ahead of our time. Magic trivializes everything, there's no rule saying just because you have fire breathing giant lizards you need to have magic missiles and cure lesser wounds to counter it. That lizard is there to ruin your shit, handing the player a gun makes his existence pointless. Same for physicians vs clerics
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Neonivek

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Re: Surgery/Medicine in DF
« Reply #25 on: January 23, 2009, 09:36:31 am »

Quote
Magic trivializes everything

Lets not get Silly Plisu. The point was that is in a magical and epic world, everything should respect such.

What your suggesting Plisu is making the extrodinary simply mundane while I am suggesting is allowing the extrodinary.

Sure maybe there is such a thing as a magic chicken soup. It of course comes from magic chickens who are bound to be in some sort of dangerous location (afterall, the Golden Apples weren't exactly in the lands of Lollypops and Jello)

Then again an opposing civilisation with access to supernatural healing techniques would be a great adversary indeed.

-Unicorns for example could purify water or eradicate poisons
-Pacts with demons could do pretty much anything

If you read Mythology you also see that Medicine can also be brought to dramatic levels. The best doctors tend to be able to even bring the dead to life. So we have to know that Dwarf Fortress also has to increase the effectiveness of medicine.
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Silverionmox

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Re: Surgery/Medicine in DF
« Reply #26 on: January 23, 2009, 10:19:32 am »

If you need your arm to be put back on, it should be an epic quest in itself even to find someone who *might* be able to do it. Even if you manage to find someone who can and reach him, he might not like you, be of a different clan, work exclusively for someone else, etc. And after you have convinced him you still need to negotiate the price, and maybe provide the necessary resources. Restoring your arm might end up costing you and arm and a leg.

So an adventurer could be able to find almost anything, with enough effort. Making insta-healing available for every peasant in every single fortress would indeed diminish the "dynamic range" of interesting stuff. And that's no fun.
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Rysith

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Re: Surgery/Medicine in DF
« Reply #27 on: January 23, 2009, 10:48:18 am »

Quote
Just because the game has magic doesn't mean every damn little thing has to be magical

No it means that there needs to be a magical alternative to almost everything.

For a counterexample, look to things like the King Arthur legends. Definitely dramatic, definitely involved magic. More often than not, though, magic wasn't the solution. It seems (to me at least) to fit reasonably well into the DF world, too, in terms of flavor.
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Neonivek

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Re: Surgery/Medicine in DF
« Reply #28 on: January 23, 2009, 11:30:00 am »

Anyhow given that Dwarf Fortress is also a Dramatic/Mythological/Epic world as well as a realistic one Ill have to add modifications for things that are clearly impossible/improbable in real life.

Epic (Not Supernatural) Healing techniques.

1) Medicine without equipment: Particularly aiding broken bones without so much as a splint is nearly impossible in real life. Particularly masterful healers in dwarf fortress should be able to close wounds even without stitches. This of course should come at a penalty that makes proper equipment wanted. Mind you this could reflect improvised equipment such as moss and tree bark.
-Real Life: In real life there are interesting things one can do with just your bare hands. Though particularly rare… you can restart people’s hearts by dilating it with your own hand. If you add CPR, Heimlich, and stiff backing and it isn’t so far fetched.

2) Speedy Recovery: A Warrior just came back beaten and bloody. Lucky that your Grand Master Doctor is at hand. He stitches the warrior and like new he is ready to go out and
-This should be reflected by having medicine work by allowing people to ignore injuries to an extent that doctor’s roll does so. Allowing someone to walk on a yellow wound ankle should be easy. Allowing someone who was dying to suddenly go about as if everything was normal should be legendary.

3) Reattachment: More then possible in real life… In this time frame however it was clearly… well… less then possible. It should require very skilled healers with specific equipment to repair this kind of damage.

4) Resuscitation: Basically bringing back people who have recently died. It should require only the greatest of healers and even then it should be rare to actually succeed. It should also depend on how long the person has remained dead for. Your not going to bring back your first king. Some body recently brought back from battle? Sure!

5) Herbology: Plants should be capable of curing almost everything! This is mythology and as anyone who watched Xena knows… For every poison, disease, and even some injuries there is a potion usually by some rare plant that grows in an Island in the south pacific.
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jaked122

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Re: Surgery/Medicine in DF
« Reply #29 on: January 23, 2009, 11:34:06 am »

 the ameaba infection should grow so large that it can consume dwarves whole
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