So kind of want to play a Jack the Ripper style character, a serial killer with a knowledge of anatomy and is a skilled surgeon, but am unable to reconcile the need for a surgeon in a world with clerics and magical healing? I know that just because magic exists it does not mean that surgical techniques are obsolete however it feels like this sort of thing would mostly be the domain of clerics and wizards where as the character I have in mind is a rogue.
I guess it depends on the setting but it seems in most settings healing is mostly done at the temples or by somebody with magical aptitude, seems like the study of surgical practices would mostly be paired with these fields rather than a field one would study on it's own.
So kind of want to play a Jack the Ripper style character, a serial killer with a knowledge of anatomy and is a skilled surgeon, but am unable to reconcile the need for a surgeon in a world with clerics and magical healing? I know that just because magic exists it does not mean that surgical techniques are obsolete however it feels like this sort of thing would mostly be the domain of clerics and wizards where as the character I have in mind is a rogue.
I guess it depends on the setting but it seems in most settings healing is mostly done at the temples or by somebody with magical aptitude, seems like the study of surgical practices would mostly be paired with these fields rather than a field one would study on it's own.
Obviously this is something that can vary greatly from setting to setting, but keep in mind that magic is presented as something relatively rare, and the kind of heights a PC can achieve are rare among casters. Only a small portion of a given temple's population are going to be true clerics, and most of them aren't going to have access to more than Cure Wounds and Lesser Restoration.
Really, it's worth noting that what we think of as "surgery" is a fairly recent practice, because without powerful anesthetics a subject will be writhing in agony as soon as you start cutting into them, which rather impedes the work. That said, it's entirely possible for a setting to have non-magical physicians, and again given that true magical healers are strongly indicated to be pretty scarce compared to the overall population, it really seems more improbable that they wouldn't exist.
So kind of want to play a Jack the Ripper style character, a serial killer with a knowledge of anatomy and is a skilled surgeon, but am unable to reconcile the need for a surgeon in a world with clerics and magical healing? I know that just because magic exists it does not mean that surgical techniques are obsolete however it feels like this sort of thing would mostly be the domain of clerics and wizards where as the character I have in mind is a rogue.
I guess it depends on the setting but it seems in most settings healing is mostly done at the temples or by somebody with magical aptitude, seems like the study of surgical practices would mostly be paired with these fields rather than a field one would study on it's own.
Obviously this is something that can vary greatly from setting to setting, but keep in mind that magic is presented as something relatively rare, and the kind of heights a PC can achieve are rare among casters. Only a small portion of a given temple's population are going to be true clerics, and most of them aren't going to have access to more than Cure Wounds and Lesser Restoration.
Really, it's worth noting that what we think of as "surgery" is a fairly recent practice, because without powerful anesthetics a subject will be writhing in agony as soon as you start cutting into them, which rather impedes the work. That said, it's entirely possible for a setting to have non-magical physicians, and again given that true magical healers are strongly indicated to be pretty scarce compared to the overall population, it really seems more improbable that they wouldn't exist.
I am probably overthinking it but in the forgotten realms it seems like every storefront the party comes across has some sort of magical bauble or gimmick and there is a temple on every corner selling resurrection and healing services for reasonable prices, don't think I have ever played in a game where we have taken the injured party member to the local surgeon to get them patched up, instead all wounds are healed by healing potions or the party's casters and a good nights rest and those injuries and ailments that can't be cured are always taken to one of the many clerics or temples that exist within whatever town we have currently found. Perhaps that is just a flaw of the way the games I have played so far have been run or a preference on the part of the GM though.
I mean, magic is indeed stronger than medieval medicine, but it's also relatively scarce in both people who can use it and how much they can use. Keep in mind PC's are not typical individuals in the setting; you can afford to go to a temple and drop a sack of gold coins to get your problems magically fixed, but the majority of the population doesn't have that kind of cash.
Magical healing is relatively expensive for a commoner at I believe 50gp/spell level. For even a skilled laborer earning 2gp/day, that’s almost an entire month’s worth of income, and for unskilled laborers (aka the average person) who only earns 2sp/day… that represents almost 1 year’s worth of gross income. Even at the discounted rate of 10gp/spell level, that’s still pretty expensive for something like lesser restoration to cure a disease as an example. If a doctor or surgeon can do it for less….
First this is going to depend on the setting itself. the published worlds for 5e, officially, aren't really to types of places where that kind of thinking is going to be easily achieved (in terms of a need for non-magical work great enough to drive a competing economic force into place).
THen you have the time period of Jack -- which is closer to a steampunk style (and one can surmise than in a steampunk world, magic and surgery could compete against each other on the basis of a rivalry and competition) or a Gaslamp style.
D&D is a weird game, lol. The baseline worlds mix bronze Age with Roman Imperial with Germanic and Holy Roman and then mix in Renaissance. Technology is all over the place in so far as levels (FR's only going to be able to pump out the enormous number of items present using a process developed in the 18th century for smelting iron). To argue that surgery couldn't quite fit into a main game world -- even though I did so on one possible basis above -- is such a tough sell because surgery as we know it and surgery as it was known in 1823 and surgery as it was known in 1423 were all still surgery -- and the practices go back to the bronze age with trepanning being only one of several hundred procedures we know they did routinely back then.
So, truly, yes, you could totally have a Jack the ripper who is a surgeon. He wouldn't be a hospital based surgeon that we think of, he would be a Barber, more precisely (and now you can add in the one from Seville is you like). Likely have skills in medicine, apothecary, and healing. All of which are either feats or current skills or backgrounds.
Perhaps, lie Paracelsus, whose contributions to modern medicine are rarely understood by layfolk, he is an Alchemist -- and keep in mind that cocaine was used as an anesthetic long before it was used to feel better and more powerful. Opium went the reverse but meh.
And let us not forget that most of the experemtnationand early surgeries truly were not done with anesthetics -- there is a reason that even after the reforms of John Barry during the English Expansion to military camps and formation that they still kept the surgery tents as far from the troops as possible; nothing kills morale like hearing your buddy who survived getting his arms cut off while fully awake.
There are some few remains of a record of the surgery at the battle of agincourt -- square in the bark times -- where there was more than a little ugly. So...
Magic? Magic? Are farmers using spells to enchant plows to make sure the back forty are taken care of without a horse on the normal? How much does it cost for a typical person to keep their clothes in order (assuming they can only have the one set), eat at least two good meals a day, have a place to sleep and a place to put their stuff? How much for a family of 6, with four under the age of 10 (and at least half will be dead by age 8)?
If a gold piece is a dollar, and a healing potion costs 3, then that makes it about as common and easy to get as a gallon of milk. If a silver piece is, then suddenly that healing potion is a nice night out for one person on the town -- totally extra money, not a thing that they need to survive. if a copper piece is, then ok now we have an economy that make healing potions so unaffordable for the average person that a surgeon, apothecary, alchemist, and "physic" or barber (or Dentist, as Doc Holiday was), becomes absolutely necessary from an economic standpoint.
So, really, the question is "what is the world like?" If it is a published world, then yeah, sure you got this, run with it.
If it is a homebrew world, then it take a bit more, but it still isn't hard to do.
Rollback Post to RevisionRollBack
Only a DM since 1980 (3000+ Sessions) / PhD, MS, MA / Mixed, Bi, Trans, Woman / No longer welcome in the US, apparently
Wyrlde: Adventures in the Seven Cities .-=] Lore Book | Patreon | Wyrlde YT [=-. An original Setting for 5e, a whole solar system of adventure. Ongoing updates, exclusies, more. Not Talking About It / Dubbed The Oracle in the Cult of Mythology Nerds
Not only is magical healing relatively more powerful and costly than mundane healing but the PCs are relatively richer than the common folks so yes they are going to avail themselves of the best healing they can get. Surgeons are basically a late 1800’s development in the medical field. You need an esthetics, painkillers and blood transfusions for most surgeries and most of that was developed after 1860 CE. What you did have were barbers doing cutting and pulling, apothecaries doing herbal medicines and midwives to handle births and related problems. Apothecaries at best were brewing healing potions and creating herbal poultices, teas etc.
Not only is magical healing relatively more powerful and costly than mundane healing but the PCs are relatively richer than the common folks so yes they are going to avail themselves of the best healing they can get. Surgeons are basically a late 1800’s development in the medical field. You need an esthetics, painkillers and blood transfusions for most surgeries and most of that was developed after 1860 CE. What you did have were barbers doing cutting and pulling, apothecaries doing herbal medicines and midwives to handle births and related problems. Apothecaries at best were brewing healing potions and creating herbal poultices, teas etc.
The Roman’s used to perform some surgeries and they used poppy cakes as “anesthesia.” The cesarean section is named after Julius Cesar who was born that way.
oh, it get's better than that: The cesarean section was known at least as far back as 1300 BC, and some older records indicate at least a thousand years prior to that.It seems to have developed independently in both Mesopotamia and China at roughly the same time.
Downside is that most of the time the mother died -- sepsis is a wicked cruel thing.
Rollback Post to RevisionRollBack
Only a DM since 1980 (3000+ Sessions) / PhD, MS, MA / Mixed, Bi, Trans, Woman / No longer welcome in the US, apparently
Wyrlde: Adventures in the Seven Cities .-=] Lore Book | Patreon | Wyrlde YT [=-. An original Setting for 5e, a whole solar system of adventure. Ongoing updates, exclusies, more. Not Talking About It / Dubbed The Oracle in the Cult of Mythology Nerds
Not only is magical healing relatively more powerful and costly than mundane healing but the PCs are relatively richer than the common folks so yes they are going to avail themselves of the best healing they can get. Surgeons are basically a late 1800’s development in the medical field. You need an esthetics, painkillers and blood transfusions for most surgeries and most of that was developed after 1860 CE. What you did have were barbers doing cutting and pulling, apothecaries doing herbal medicines and midwives to handle births and related problems. Apothecaries at best were brewing healing potions and creating herbal poultices, teas etc.
The Roman’s used to perform some surgeries and they used poppy cakes as “anesthesia.” The cesarean section is named after Julius Cesar who was born that way.
Obviously it's not all-or-nothing, but the kind of anesthesia you get from ground herbs and the kind you get from synthetic drugs that have been distilled via modern practices are worlds apart in potency; people have been cutting into patients and sewing them up for centuries, but the kind of fine work that comes to the forefront when we think of "surgery" is a fairly recent milestone. I'd expect a D&D surgeon's work with sharp implements to have more in common with a butcher as opposed to having, well, surgical precision.
So kind of want to play a Jack the Ripper style character, a serial killer with a knowledge of anatomy and is a skilled surgeon, but am unable to reconcile the need for a surgeon in a world with clerics and magical healing? I know that just because magic exists it does not mean that surgical techniques are obsolete however it feels like this sort of thing would mostly be the domain of clerics and wizards where as the character I have in mind is a rogue.
I guess it depends on the setting but it seems in most settings healing is mostly done at the temples or by somebody with magical aptitude, seems like the study of surgical practices would mostly be paired with these fields rather than a field one would study on it's own.
Noah Gordon wrote (IMHO) a great book about how to live as and become a physician in the middle ages. It's aptly named "The Physician". It shows at the difference in European and Arab medicine at the time and what was knowm by what culture. I found it not only entertaining but incredibly interesting. Yes, the protagonist has a knack that is hugely helpful but other than that it is in a no magic setting - but one where people believed in the presence of magic. I think that could give you some inspiration
Not only is magical healing relatively more powerful and costly than mundane healing but the PCs are relatively richer than the common folks so yes they are going to avail themselves of the best healing they can get. Surgeons are basically a late 1800’s development in the medical field. You need an esthetics, painkillers and blood transfusions for most surgeries and most of that was developed after 1860 CE. What you did have were barbers doing cutting and pulling, apothecaries doing herbal medicines and midwives to handle births and related problems. Apothecaries at best were brewing healing potions and creating herbal poultices, teas etc.
The Roman’s used to perform some surgeries and they used poppy cakes as “anesthesia.” The cesarean section is named after Julius Cesar who was born that way.
Obviously it's not all-or-nothing, but the kind of anesthesia you get from ground herbs and the kind you get from synthetic drugs that have been distilled via modern practices are worlds apart in potency; people have been cutting into patients and sewing them up for centuries, but the kind of fine work that comes to the forefront when we think of "surgery" is a fairly recent milestone. I'd expect a D&D surgeon's work with sharp implements to have more in common with a butcher as opposed to having, well, surgical precision.
There are mechanics in 5e regarding triage and in-combat medical care without magic. There is a medicine check involved in stabilizing downed but not yet dead characters.
Medicine as we know it can easily be part of 5e settings. Spells with costs (material or divine effort or whatnot) are often not available to the less affluent, such as those who were targeted by the famous Ripper.
Rollback Post to RevisionRollBack
Human. Male. Possibly. Don't be a divider. My characters' backgrounds are written like instruction manuals rather than stories. My opinion and preferences don't mean you're wrong. I am 99.7603% convinced that the digital dice are messing with me. I roll high when nobody's looking and low when anyone else can see.🎲 “It's a bit early to be thinking about an epitaph. No?” will be my epitaph.
Yes the Roman’s and earlier groups had Caesarian sections, the Native American civilizations had trepanations, everyone had amputations ( with cauterization) and we have had some drugs capable of knocking a person unconscious and or alleviating significant amounts of pain opium, Cocaine, aspirin (willow bark- rich in salicylic acid better known as aspirin)). However the sorts of extended open body activities we think of as surgery called for 3 developments: 1) a means of sterilizing the wound created and the environment of the operation as well as the hands of the surgeon. 2) effective anesthetics to reduce or eliminate the effects of pain induced shock, a means of providing blood safely to the patient to replace the blood lost during the surgery. This last was a 20th century development. A 4th requirement was a means of preventing or removing internal infections resulting after the surgery but before healing was completed. This was also a 20th century development. Were there ancient solutions to some of these problems? Yes, but much of that knowledge was mixed in with a lot of junk knowledge or missing from significant portions of the world. There were doctors, surgeons ( of one sort or another) and related medical professionals pretty much as far back as we have records with some being so renowned they were turned into deities. So there is plenty of room for nonmagical healing technologies in any world - any NPC with the medicine skill should qualify even if that can’t cast a single spell.
Yes the Roman’s and earlier groups had Caesarian sections, the Native American civilizations had trepanations, everyone had amputations ( with cauterization) and we have had some drugs capable of knocking a person unconscious and or alleviating significant amounts of pain opium, Cocaine, aspirin (willow bark- rich in salicylic acid better known as aspirin)). However the sorts of extended open body activities we think of as surgery called for 3 developments: 1) a means of sterilizing the wound created and the environment of the operation as well as the hands of the surgeon. 2) effective anesthetics to reduce or eliminate the effects of pain induced shock, a means of providing blood safely to the patient to replace the blood lost during the surgery. This last was a 20th century development. A 4th requirement was a means of preventing or removing internal infections resulting after the surgery but before healing was completed. This was also a 20th century development. Were there ancient solutions to some of these problems? Yes, but much of that knowledge was mixed in with a lot of junk knowledge or missing from significant portions of the world. There were doctors, surgeons ( of one sort or another) and related medical professionals pretty much as far back as we have records with some being so renowned they were turned into deities. So there is plenty of room for nonmagical healing technologies in any world - any NPC with the medicine skill should qualify even if that can’t cast a single spell.
I think I just have a wider view of what constitutes “surgery” than you do.
there was some understanding of sepsis, anatomy and some cutting to extract arrowheads, reset broken limbs, relieve pressures on the skull/brain, possibly even removal of the appendix or obvious tumors, etc. that occurred in premodern times so I wouldn’t say surgery didn’t exist it just wasn’t as major a part of medicine as it is today.
The word surgery (and therefore how we think about and conceive and use it) has changed considerably over the last 600 years.
Chiruges (hand workers, literally) were what we call Surgeons; the underling linkage places it alongside other hand crafting skills such as basketweaving, pottery work, and even clothmaking (weaving), so it likely grew out of what we also call animal husbandry practices today, and the ultimate roots and usage go as far back as we can look, allowing for varying etymological changes.
Later they were called barbers. Barbers were cheaper than physicians, who were also around, and had access to many of the same tools and were the common person's medical access. Think closer to an NP in modern terms. Or back alley barbers.
This is in part why licensing has been required for barbers for well over a century. They were sorta "light doctors", who in the Uk combined the older knowledge of the Cunning folk with the state of the medical knowledge of the day (and going back into the era of Paracelsus and the Humors theorem that was dominant until germ theory arrived). Midwives are a related segment focused on "women's Issues" and often linked to Mysteries in Ancient Europe, or to the Druid like folks who are surmised to have shifted into the Cunning Folk (and who are distinct from witches).
Barbers also studied nephrology and some other odd stuff we discard today, but then so did physicians of the past, so nt like they can be said to have been the only weird ones.
There is no doubt that modern improvements in many, many areas that often arose during the late 1700's and early 1800's -- often driven by the expansionist tendencies and imperial ambitions of certain European nations. One of the known motivations around Germ Theory was trying to figure out why it was that the exceptionally annoying Barry -- who became commander of all British medical forces -- was so incredibly successful at fighting and overcoming sepsis and other things in field hospitals and why his practices worked to improve the overall health of all the soldiers in the fields. In part it was to knock him down a peg because the man was an annoying cuss -- even Florence Nightingale hated his guts and on finding out his secret after his death wasn't fazed at all.
It should be noted that globally, over half of children were still dying before 8, that communicable disease was the greatest killer of the age, and some of the foundational understandings of what we think of as modern medicine still hadn't reached into the smaller population centers of the world. Darwin was pretty much mocked by anyone who had never had a college education (which was like 95% of the population), and Germ Theory was still hotly debated as late as 1910.
And that was all in 1900. So, really, the leaps and bounds we have made are almost entirely modern inventions of the last 120 years. Prior to that were the three basic groups of healers: Physicians, Barbers, and Midwives, who handles the majority of the care for the wealthy and the poor, respectively, despite assorted names for them in different cultures, going back at least 6,000 years.
more if you go beyond the written record or the bounds of western asia and europe as continental areas..
Also, *this* is what D&D has done to me. Caused me to remember odd little bits and pieces of history. Damn...
Rollback Post to RevisionRollBack
Only a DM since 1980 (3000+ Sessions) / PhD, MS, MA / Mixed, Bi, Trans, Woman / No longer welcome in the US, apparently
Wyrlde: Adventures in the Seven Cities .-=] Lore Book | Patreon | Wyrlde YT [=-. An original Setting for 5e, a whole solar system of adventure. Ongoing updates, exclusies, more. Not Talking About It / Dubbed The Oracle in the Cult of Mythology Nerds
Spell slots are limited, that might not matter to a cleric running a local clinic on the average day, but if there’s a crisis leaving a lot of people injured then they might want to save those slots for the people who really need them to survive.
Also, D&D tends to gloss over actual injuries because they interact weirdly with hitpoints, but a healing spell might not “know” how two pieces of a broken bone are supposed to connect, and could leave you with the bone “healed” at the wrong angles if no previous preparation is done for them.
Rollback Post to RevisionRollBack
To post a comment, please login or register a new account.
So kind of want to play a Jack the Ripper style character, a serial killer with a knowledge of anatomy and is a skilled surgeon, but am unable to reconcile the need for a surgeon in a world with clerics and magical healing? I know that just because magic exists it does not mean that surgical techniques are obsolete however it feels like this sort of thing would mostly be the domain of clerics and wizards where as the character I have in mind is a rogue.
I guess it depends on the setting but it seems in most settings healing is mostly done at the temples or by somebody with magical aptitude, seems like the study of surgical practices would mostly be paired with these fields rather than a field one would study on it's own.
Obviously this is something that can vary greatly from setting to setting, but keep in mind that magic is presented as something relatively rare, and the kind of heights a PC can achieve are rare among casters. Only a small portion of a given temple's population are going to be true clerics, and most of them aren't going to have access to more than Cure Wounds and Lesser Restoration.
Really, it's worth noting that what we think of as "surgery" is a fairly recent practice, because without powerful anesthetics a subject will be writhing in agony as soon as you start cutting into them, which rather impedes the work. That said, it's entirely possible for a setting to have non-magical physicians, and again given that true magical healers are strongly indicated to be pretty scarce compared to the overall population, it really seems more improbable that they wouldn't exist.
I am probably overthinking it but in the forgotten realms it seems like every storefront the party comes across has some sort of magical bauble or gimmick and there is a temple on every corner selling resurrection and healing services for reasonable prices, don't think I have ever played in a game where we have taken the injured party member to the local surgeon to get them patched up, instead all wounds are healed by healing potions or the party's casters and a good nights rest and those injuries and ailments that can't be cured are always taken to one of the many clerics or temples that exist within whatever town we have currently found. Perhaps that is just a flaw of the way the games I have played so far have been run or a preference on the part of the GM though.
I mean, magic is indeed stronger than medieval medicine, but it's also relatively scarce in both people who can use it and how much they can use. Keep in mind PC's are not typical individuals in the setting; you can afford to go to a temple and drop a sack of gold coins to get your problems magically fixed, but the majority of the population doesn't have that kind of cash.
Magical healing is relatively expensive for a commoner at I believe 50gp/spell level. For even a skilled laborer earning 2gp/day, that’s almost an entire month’s worth of income, and for unskilled laborers (aka the average person) who only earns 2sp/day… that represents almost 1 year’s worth of gross income. Even at the discounted rate of 10gp/spell level, that’s still pretty expensive for something like lesser restoration to cure a disease as an example. If a doctor or surgeon can do it for less….
Creating Epic Boons on DDB
DDB Buyers' Guide
Hardcovers, DDB & You
Content Troubleshooting
Okay, so...
First this is going to depend on the setting itself. the published worlds for 5e, officially, aren't really to types of places where that kind of thinking is going to be easily achieved (in terms of a need for non-magical work great enough to drive a competing economic force into place).
THen you have the time period of Jack -- which is closer to a steampunk style (and one can surmise than in a steampunk world, magic and surgery could compete against each other on the basis of a rivalry and competition) or a Gaslamp style.
D&D is a weird game, lol. The baseline worlds mix bronze Age with Roman Imperial with Germanic and Holy Roman and then mix in Renaissance. Technology is all over the place in so far as levels (FR's only going to be able to pump out the enormous number of items present using a process developed in the 18th century for smelting iron). To argue that surgery couldn't quite fit into a main game world -- even though I did so on one possible basis above -- is such a tough sell because surgery as we know it and surgery as it was known in 1823 and surgery as it was known in 1423 were all still surgery -- and the practices go back to the bronze age with trepanning being only one of several hundred procedures we know they did routinely back then.
So, truly, yes, you could totally have a Jack the ripper who is a surgeon. He wouldn't be a hospital based surgeon that we think of, he would be a Barber, more precisely (and now you can add in the one from Seville is you like). Likely have skills in medicine, apothecary, and healing. All of which are either feats or current skills or backgrounds.
Perhaps, lie Paracelsus, whose contributions to modern medicine are rarely understood by layfolk, he is an Alchemist -- and keep in mind that cocaine was used as an anesthetic long before it was used to feel better and more powerful. Opium went the reverse but meh.
And let us not forget that most of the experemtnationand early surgeries truly were not done with anesthetics -- there is a reason that even after the reforms of John Barry during the English Expansion to military camps and formation that they still kept the surgery tents as far from the troops as possible; nothing kills morale like hearing your buddy who survived getting his arms cut off while fully awake.
There are some few remains of a record of the surgery at the battle of agincourt -- square in the bark times -- where there was more than a little ugly. So...
Magic? Magic? Are farmers using spells to enchant plows to make sure the back forty are taken care of without a horse on the normal? How much does it cost for a typical person to keep their clothes in order (assuming they can only have the one set), eat at least two good meals a day, have a place to sleep and a place to put their stuff? How much for a family of 6, with four under the age of 10 (and at least half will be dead by age 8)?
If a gold piece is a dollar, and a healing potion costs 3, then that makes it about as common and easy to get as a gallon of milk. If a silver piece is, then suddenly that healing potion is a nice night out for one person on the town -- totally extra money, not a thing that they need to survive. if a copper piece is, then ok now we have an economy that make healing potions so unaffordable for the average person that a surgeon, apothecary, alchemist, and "physic" or barber (or Dentist, as Doc Holiday was), becomes absolutely necessary from an economic standpoint.
So, really, the question is "what is the world like?" If it is a published world, then yeah, sure you got this, run with it.
If it is a homebrew world, then it take a bit more, but it still isn't hard to do.
Only a DM since 1980 (3000+ Sessions) / PhD, MS, MA / Mixed, Bi, Trans, Woman / No longer welcome in the US, apparently
Wyrlde: Adventures in the Seven Cities
.-=] Lore Book | Patreon | Wyrlde YT [=-.
An original Setting for 5e, a whole solar system of adventure. Ongoing updates, exclusies, more.
Not Talking About It / Dubbed The Oracle in the Cult of Mythology Nerds
Not only is magical healing relatively more powerful and costly than mundane healing but the PCs are relatively richer than the common folks so yes they are going to avail themselves of the best healing they can get. Surgeons are basically a late 1800’s development in the medical field. You need an esthetics, painkillers and blood transfusions for most surgeries and most of that was developed after 1860 CE. What you did have were barbers doing cutting and pulling, apothecaries doing herbal medicines and midwives to handle births and related problems. Apothecaries at best were brewing healing potions and creating herbal poultices, teas etc.
Wisea$$ DM and Player since 1979.
The Roman’s used to perform some surgeries and they used poppy cakes as “anesthesia.” The cesarean section is named after Julius Cesar who was born that way.
Creating Epic Boons on DDB
DDB Buyers' Guide
Hardcovers, DDB & You
Content Troubleshooting
oh, it get's better than that: The cesarean section was known at least as far back as 1300 BC, and some older records indicate at least a thousand years prior to that.It seems to have developed independently in both Mesopotamia and China at roughly the same time.
Downside is that most of the time the mother died -- sepsis is a wicked cruel thing.
Only a DM since 1980 (3000+ Sessions) / PhD, MS, MA / Mixed, Bi, Trans, Woman / No longer welcome in the US, apparently
Wyrlde: Adventures in the Seven Cities
.-=] Lore Book | Patreon | Wyrlde YT [=-.
An original Setting for 5e, a whole solar system of adventure. Ongoing updates, exclusies, more.
Not Talking About It / Dubbed The Oracle in the Cult of Mythology Nerds
Obviously it's not all-or-nothing, but the kind of anesthesia you get from ground herbs and the kind you get from synthetic drugs that have been distilled via modern practices are worlds apart in potency; people have been cutting into patients and sewing them up for centuries, but the kind of fine work that comes to the forefront when we think of "surgery" is a fairly recent milestone. I'd expect a D&D surgeon's work with sharp implements to have more in common with a butcher as opposed to having, well, surgical precision.
Noah Gordon wrote (IMHO) a great book about how to live as and become a physician in the middle ages. It's aptly named "The Physician". It shows at the difference in European and Arab medicine at the time and what was knowm by what culture. I found it not only entertaining but incredibly interesting. Yes, the protagonist has a knack that is hugely helpful but other than that it is in a no magic setting - but one where people believed in the presence of magic. I think that could give you some inspiration
True, but the oldest known surgical amputation happened 31,000 years ago: (https://en.m.wikipedia.org/wiki/History_of_surgery#Origins). Surgery as a practice is a hell of a lot older than the 1800s.
Creating Epic Boons on DDB
DDB Buyers' Guide
Hardcovers, DDB & You
Content Troubleshooting
There are mechanics in 5e regarding triage and in-combat medical care without magic. There is a medicine check involved in stabilizing downed but not yet dead characters.
Medicine as we know it can easily be part of 5e settings. Spells with costs (material or divine effort or whatnot) are often not available to the less affluent, such as those who were targeted by the famous Ripper.
Human. Male. Possibly. Don't be a divider.
My characters' backgrounds are written like instruction manuals rather than stories. My opinion and preferences don't mean you're wrong.
I am 99.7603% convinced that the digital dice are messing with me. I roll high when nobody's looking and low when anyone else can see.🎲
“It's a bit early to be thinking about an epitaph. No?” will be my epitaph.
Yes the Roman’s and earlier groups had Caesarian sections, the Native American civilizations had trepanations, everyone had amputations ( with cauterization) and we have had some drugs capable of knocking a person unconscious and or alleviating significant amounts of pain opium, Cocaine, aspirin (willow bark- rich in salicylic acid better known as aspirin)). However the sorts of extended open body activities we think of as surgery called for 3 developments: 1) a means of sterilizing the wound created and the environment of the operation as well as the hands of the surgeon. 2) effective anesthetics to reduce or eliminate the effects of pain induced shock, a means of providing blood safely to the patient to replace the blood lost during the surgery. This last was a 20th century development. A 4th requirement was a means of preventing or removing internal infections resulting after the surgery but before healing was completed. This was also a 20th century development. Were there ancient solutions to some of these problems? Yes, but much of that knowledge was mixed in with a lot of junk knowledge or missing from significant portions of the world. There were doctors, surgeons ( of one sort or another) and related medical professionals pretty much as far back as we have records with some being so renowned they were turned into deities. So there is plenty of room for nonmagical healing technologies in any world - any NPC with the medicine skill should qualify even if that can’t cast a single spell.
Wisea$$ DM and Player since 1979.
I think I just have a wider view of what constitutes “surgery” than you do.
Creating Epic Boons on DDB
DDB Buyers' Guide
Hardcovers, DDB & You
Content Troubleshooting
Possibly 😁
there was some understanding of sepsis, anatomy and some cutting to extract arrowheads, reset broken limbs, relieve pressures on the skull/brain, possibly even removal of the appendix or obvious tumors, etc. that occurred in premodern times so I wouldn’t say surgery didn’t exist it just wasn’t as major a part of medicine as it is today.
Wisea$$ DM and Player since 1979.
The word surgery (and therefore how we think about and conceive and use it) has changed considerably over the last 600 years.
Chiruges (hand workers, literally) were what we call Surgeons; the underling linkage places it alongside other hand crafting skills such as basketweaving, pottery work, and even clothmaking (weaving), so it likely grew out of what we also call animal husbandry practices today, and the ultimate roots and usage go as far back as we can look, allowing for varying etymological changes.
Later they were called barbers. Barbers were cheaper than physicians, who were also around, and had access to many of the same tools and were the common person's medical access. Think closer to an NP in modern terms. Or back alley barbers.
This is in part why licensing has been required for barbers for well over a century. They were sorta "light doctors", who in the Uk combined the older knowledge of the Cunning folk with the state of the medical knowledge of the day (and going back into the era of Paracelsus and the Humors theorem that was dominant until germ theory arrived). Midwives are a related segment focused on "women's Issues" and often linked to Mysteries in Ancient Europe, or to the Druid like folks who are surmised to have shifted into the Cunning Folk (and who are distinct from witches).
Barbers also studied nephrology and some other odd stuff we discard today, but then so did physicians of the past, so nt like they can be said to have been the only weird ones.
There is no doubt that modern improvements in many, many areas that often arose during the late 1700's and early 1800's -- often driven by the expansionist tendencies and imperial ambitions of certain European nations. One of the known motivations around Germ Theory was trying to figure out why it was that the exceptionally annoying Barry -- who became commander of all British medical forces -- was so incredibly successful at fighting and overcoming sepsis and other things in field hospitals and why his practices worked to improve the overall health of all the soldiers in the fields. In part it was to knock him down a peg because the man was an annoying cuss -- even Florence Nightingale hated his guts and on finding out his secret after his death wasn't fazed at all.
It should be noted that globally, over half of children were still dying before 8, that communicable disease was the greatest killer of the age, and some of the foundational understandings of what we think of as modern medicine still hadn't reached into the smaller population centers of the world. Darwin was pretty much mocked by anyone who had never had a college education (which was like 95% of the population), and Germ Theory was still hotly debated as late as 1910.
And that was all in 1900. So, really, the leaps and bounds we have made are almost entirely modern inventions of the last 120 years. Prior to that were the three basic groups of healers: Physicians, Barbers, and Midwives, who handles the majority of the care for the wealthy and the poor, respectively, despite assorted names for them in different cultures, going back at least 6,000 years.
more if you go beyond the written record or the bounds of western asia and europe as continental areas..
Also, *this* is what D&D has done to me. Caused me to remember odd little bits and pieces of history. Damn...
Only a DM since 1980 (3000+ Sessions) / PhD, MS, MA / Mixed, Bi, Trans, Woman / No longer welcome in the US, apparently
Wyrlde: Adventures in the Seven Cities
.-=] Lore Book | Patreon | Wyrlde YT [=-.
An original Setting for 5e, a whole solar system of adventure. Ongoing updates, exclusies, more.
Not Talking About It / Dubbed The Oracle in the Cult of Mythology Nerds
Spell slots are limited, that might not matter to a cleric running a local clinic on the average day, but if there’s a crisis leaving a lot of people injured then they might want to save those slots for the people who really need them to survive.
Also, D&D tends to gloss over actual injuries because they interact weirdly with hitpoints, but a healing spell might not “know” how two pieces of a broken bone are supposed to connect, and could leave you with the bone “healed” at the wrong angles if no previous preparation is done for them.