[RPG] Medieval Medicine in a Fantasy Setting


In a fantasy game, I'd like to make less use of magic healing – making it something special (magical even 😉 ) – and instead have the characters see doctors/surgeons, often leaving them a little worse for wear.

How can I keep a doctor/surgeon character setting-appropriate?

And how can I deal with characters who want to learn medieval medicine?

Best Answer

Several things to keep in mind about real medieval medicine:

  1. No Sterilization - infection was rampant
  2. very few specialists - mostly wisewomen and barbers. A genuine surgeon was bloody rare. A Medical Doctor was in fact extremely rare, and in many places, a criminal!
  3. Very little of actual systemic issues known.
  4. Lots of herbal remedies merely mask symptoms; a few actually work on problems.
  5. No scientific research of note.
  6. Few effective anesthetics.
  7. Most didn't believe animal studies relevant - veterinary care was often in fact better!

The issue of specialists is important: Romans had surgeons and also healers, and some priests who did healings. Surgeons/Chiurgeons/Chirurgeons basically cauterized wounds and set limbs. Healers treated systemic disorders with herbal and chemical remedies, but generally avoided blood. Priests used potions and prayers, as did some wisewomen.

Post-Roman, the research was all but killed off; prohibitions on human vivisection, dissection, and autopsy, coupled with the loss of many medical texts, resulted in what little knowledge had been accrued being generally lost. Without vivisection and/or dissection and/or autopsy, little was known about the internals, and less about their operation. Further, given the choice between the later, better, Roman book by a noted hardline Christian Era pagan, and the pre-Christian era scholar who was known to have it wrong by the later Romans, typically, the earlier source was the one used.

Without anesthesia, and without sterilization, the risks of infection were immense. Honey-based salves and poultices were used, and known to work, but why wasn't. (Honey is naturally antibiotic.) Leaching of swellings would reduce them, but provided another infection route. Amputation risked contamination with incompatible blood types, as well as infection.

Cauterization was the common mode of cleaning wounds. It was rather effective, but extremely painful and often did damage all its own in addition.

Surgery was oft prohibited inside towns, due to noise and stench.

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