Guide to Healing.

You find yourself a surgeon, physician, acolyte or just some schmuck with a rusty knife and needle. Regardless, all of you are - in a ways - servants of the Goddess of Healing. There are mountains upon mountains upon mountains of ways the people of Rockhill can get themselves sick and injured... it's your job to alleviate their suffering!

While there are plenty of people around Rockhill who can lazily wave their hands and heal someone (in fact, perhaps you're one of them!) there are plenty of reasons why you'd want to go the more mundane route for doctoring. For one, there are plenty of injuries and maladies that miracles cannot cure, nutcracks for instance! Secondly, you don't have to spend a whole lot of time praying and on cooldown, time which could be used stopping your patient from dying! Thirdly, miracles takes a good chunk of fatigue and stamina to cast, meaning a caster can only go so long doing their thing before they need to rest.

So don't count your skills out just yet!

Examining Patients.

The most important skill you'll have as a barber surgeon, physician or Pestran acolyte will be your Diagnose ability.

This will tell you exactly how anemic they, where they're bleeding, how much brute/burn damage they've suffered and what critical injuries they have. However, there are some things that Diagnosis will not tell you, like how much toxic or oxygen damage they've taken.

To use your Diagnosis ability, simply click the scroll at the bottom left of your screen that says "Diagnosis" when you hover over it so that it opens and middle click on the person you want to diagnose. It does have a short cooldown.

If you don't have this ability, you'll have strip the patient of their clothing to see where they're bleeding, and inspect their body parts individually to see what wounds they have.

Medical Items.

Scalpel - The primary cutting tool.
Forceps (x2) - Used for main surgery and manipulation.
Bone Forceps - Used for setting bone, nothing else.
Speculum - Used as a retractor, keeps the chest incision wide open.
Bone saw - Used for cutting bones, or trees, or people in self defense, most durable tool in the set.
Cautery - Used to mend incisions and wounds, needs to be heated up at a torch first, although it will deal around 25 burn damage per wound.
Cloth - Used to bandage a wound to slow bleeding. A needle can't be used through a bandage, but a cautery can.
Needle of Pestra (Only the Court Physician and Priest has this) - Unlimited use Needle, used to close incisions and wounds, deals no damage unlike the cautery.
Iron Needle - Unlike a regular needle made from a thorn and fiber, this needle has 20 uses instead of 5.
Cheele - 10x the blood storage of a normal leech, used to suck the poison out of someone.
Bedroll - Used as a portable bed. Laying a patient on a bed allows them to sleep and increases surgery success rates.
Health Potions (Otherwise known as "Red") - a handy potion that when drank, heals the consumer. Can even heal fractures and other critical injuries. Is a pain to brew and fairly expensive.

Maladies.

Anemia.

Otherwise known as blood-loss. Anemia will be the main killer for the denizens of Rockhill due to the oxygen damage it causes, so everything should be done to prevent and mitigate it. Prioritizing wounds that cause blood loss over ones that don't (i.e. bruises over burns, bleeds over bruises) and sewing/bandaging/cauterizing bleeding wounds is the aim of the game. Once the bleeding is stopped (depending on how severe the anemia is, you may even want to do this while they're bleeding) feed the patient water as it will fill them back up with blood or squeeze a full cheele to make it pump blood into the patient. Also, get your patient to eat some food, as people will regenerate more blood naturally depending on how full they are.

Brute Damage.

Blunt force injuries. Should not be your first priority over other injuries unless there is a hematoma. Really the main concern is the other injuries alongside the brute damage, as in serious cases it's rarely on it's own. You'll see those injuries below. Brute damage can only be tended to using surgery, Red or sleep.

Types of brute damage include:

Bruises.

As said above.

Regular Hematomas.

Twice as painful as a regular bruise.

Massive Hematomas.

More than twice as painful as a regular hematoma. Causes a small amount of bleeding.

Burn Damage.

The absolute last of your concerns. A person could have been fireballed a billion times by the Court Magician and so long as they don't cut their pinky on a shard of glass on their way to the floor; they'll live. In a permanent state between life and death until either you heal them or they enter Necra's embrace, but they'll live. However, they are extremely debilitating and far more painful than bruises and will quickly put someone to the floor from pain. So, if you're able to, you should absolutely treat burns. Burns can only be treated the same ways as bruises.

Oxygen Damage.

Oxygen damage is the metaphorical poison that anemia has slipped into your patient's cups. Oxygen damage WILL KILL and is invisible apart from the affects the patient themself feels, however, generally it's symptoms and causes are pretty obvious. The main cause of oxygen damage is anemia as mentioned above, though there are also other less common sources such as strangling, drowning, missing the lungs/heart and over-dosing. Oxygen damage will heal naturally over time so long as the cause is remedied, though sustained oxygen damage can cause significant brain damage in a subject. Symptoms of oxygen damage include fainting, going unconscious for sustained periods and death.

There is however, a way to treat oxygen damage itself directly; mouth-to-mouth. To initiate it, you must aim for the patients mouth with an empty hand an the touch and weak intents. This won't be enough to save a patient who's bleeding out on the floor alone, but it can keep them alive long enough for someone else to quickly stitch them up.

Toxin Damage.

Toxin damage is the the literal poison that someone has slipped into your patient's cups. Toxin damage shares a lot of the traits of it's counterpart, apart from the fact that it is generally far more obvious, with most of it's causes having symptoms of severe vomiting or brain damage. There are a fair few more ways that toxin damage can be caused to someone, though thankfully the most common are fairly easy to treat. The main treatment for toxin damage is the use of leeches or cheeles and bedrest. Simply squeeze your little sucker into sucking mode and place it on the patients bare skin. Depending on how much and what they've consumed and how fast you get to them, you can avoid the worst of the symptoms all together.

Slashes.

These are the most common bleeding wounds you'll see. While one or two aren't something to pull the cautery out for, they are very common to get from a sustained battle with sharp weapons, so you might be seeing a dozen of these wounds.

Types of slashes include:

Regular Slashes.

Bleeds a very small amount, about half as much as a massive hematoma. Relatively easy to sew up and causes no pain on it's own.

Small Slashes.

Essentially just a half as bad slash. These are superficial wounds.

Gruesome Slashes.

A more gruesome version of the slash. This wounds bleeds more than twice as much as a regular slash and takes a fair bit longer to sew.

Disembowelment.

Your patient has had their stomach sliced open... and their stomach and (on occasion) liver has fallen out. This wound causes an immense amount of bleeding (about twenty times that of a gruesome slash), causes immense pain in the patient and takes a long time to suture. This wound almost always leads to the imminent death of anyone unlucky enough to suffer it.

Incision.

The same as a gruesome slash. However, it will not clot over time, therefore making it worse for blood loss. Try not to let your patients walk away without stitching them up first.

Punctures.

The second most common bleeding wounds you'll see. Specifically caused by stabs, these are essentially mechanically the same as slashes, other than that they take slightly longer to sew up. Therefore they are slightly worse than slashes. You may want to pull out the cautery faster when seeing these.

Types of punctures include:

Regular Punctures.

The same as regular slashes, only that they take slightly longer to sew and heal.

Small Punctures.

The same as small slashes, only that they take slightly longer to sew and heal.

Gaping Punctures.

The same as gruesome slashes, only that they take slightly longer to sew.

Arteries.

Torn arteries should be your absolute priority when treating a patient. You should call anyone around you to help you remove the clothes from the patient to get to their wounds. Don't be afraid to use a cautery to seal the bleeding if you can. Burns are absolutely nothing compared to the severe blood loss torn arteries will cause. Otherwise use a needle, feed them Red or water.

Types of artery tears include:

Torn Arteries.

The "least severe" of the very severe artery wounds. If there's only one tear, you may be able to get away with sewing it shut, multiple and it's time to heat up the cautery. Feed them water and put them to rest once the wound is healed.

Torn Carotids.

Your patient's throat has been severely cut. If you don't do something as soon as you see the wound, your patient will die. This is far worse than even a regular torn artery. Nothing else matters but tending to this wound. The only real advantage you'll have is the wounds location on the head, where there should be very little clothing in the way. If you mange to cauterize the wound in time, you'll need to get a hell of a lot of water into them. Otherwise it's to the Church...

Torn Aortas.

Your patient's heart is severely damaged. This is worse than the carotid as it is far more painful for the injured, still bleeds moderately even when sewn, and is far more difficult to sew or cauterize due to the location. It may be best to spend your time tending to other patients who might be saved.

Unsewn.

Your patient's head or limb has been removed and reattached. The arteries are still unsewn. Most of the time you'll see this in someone who's dead, but there are times where you might reattach limbs to a living patient. This wound is actually FAR worse the actual dismemberment itself, apart from the fact that they are far easier to suture, causing about as much bleeding as a torn carotid or aorta. Under no circumstances should you reattach a limb to someone who is anemic.

Dismemberment.

These are bad news for a patient, and will likely mean death without quick action... that is if they aren't already dead. These cause a fair bit more bleeding than a torn artery, half as much as a torn aorta/carotid, but are hell to sew up. You should cauterize these wounds unless you're unable. Missing heads are loss causes, believe it or not. If the patient is dead or stable, you can reattach the removed limb or head and repair the damage.

Fractures.

Pretty straight forward; your patient has a broken bone! Usually caused heavy blunt force, these are very very debility wounds, causing a whole lotta pain and frustration for your patient... and a whole lot of inconvenience for you with the treatment needed to mend them. Thankfully, they will not kill, so you should mend to any other wounds that will first. Fractures can not be cured through sleep or just tending wounds. You'll need to either go through a lengthy surgery (the length of which depending on the fracture type), use a lot of precious Red... or worse... miracles.

Types of fractures include:

Limb Fractures.

Only seen in limbs. Leg fractures will cause the leg to be disabled, causing immense pain when standing, also stunning and forcing the patient to the floor if they try to walk on it. However, this can be mitigated by using a polearm as a crutch, allowing the patient to walk! Arm fractures will cause the arm to be disabled, causing immense pain that will stun and force the patient to the floor if they try to hold items in it for a long period, also occasionally disabling the use of the hand entirely. These take the shortest amount of time to mend using surgery and Red.

Skull Fractures.

Only seen in the head. The worst of all the fractures. Skull fractures are an absolute pain, taking more than three times as many bone settings as a limb fracture. They are also incredibly debilitating; completely paralyzing the patient (even stopping them from biting!), disfigures them and causes their speech to come out in stutters.

Jaw Fractures.

Only seen in the head. The least debilitating of the fractures, but still very much painful. Causes the patient's speech to come out in an incomprehensible gurgle and stops them from biting. Takes twice as long to tend to as a limb fracture.

Neck Fractures.

Only seen in the head. Essentially a slightly better skull fracture. Completely paralyzes the patient. Takes somewhat longer to mend than a jaw fracture.

Rib Fractures.

Only seen in the chest. Causes the patient to be stunned at random intervals and vomit up blood. This can be a death sentence during battle and a massive pain anywhere else. Takes a little longer to tend than limb fractures.

Pelvis Fractures.

Only seen in the groin. Disables both legs, causing the patient to be unable to walk. Takes the same amount of time to tend as a rib fracture.

Dislocations.

Essentially weak versions of the fractures. Only seen in the limbs or neck. They cause the same effects, but can be healed easily by tending to the wound, sleeping or even naturally over time. Dislocations can be relocated manually however, simply click on the affected body part on the weak and grab intents with a high enough medicine skill.

Poison.

There are many malicious concoctions you may encounter throughout the lands of Rockhill... some far more dangerous than others. Generally the best way to treat poisoning is through the use of leeches to remove the tainted blood, the feeding of water and bed rest.

Types of poisons include:

Berry Poison.

Easily the least dangerous and most common form of poison in Rockhill. Acquired by consuming a poison berry (this includes food and drink products made from poison berries!) or being shot with a poisoned arrow Symptoms include vomiting and feeling unwell. Generally this should be very easy to treat, just squeeze your cheele into sucking mode and place it on the patient's skin until they feel better. If they've consumed a lot, you should get them into bed to heal, feeding them water to replace the blood you're extracting.

Mercury.

Otherwise known as quicksilver. A fair bit more dangerous than berry poison, but also far rarer. Acquired by crushing cinnabar (acquired while mining) in a mortar and pestle. Symptoms include twitching, drooling and moaning. Mercury causes severe brain damage, so it is best to get a cheele on them quickly and put them to rest.

Killer's Ice.

Otherwise known as death. By the time they realize what they've drank, they'll be dead. This poison is INCREDIBLY rare and it's unlikely you'll ever be seeing this around... hopefully, anyways. The symptoms include near-instant death. The best thing you can do for the patient is drag them off to the Church. It metabolizes incredibly slowly compared to other reagents... and if there's any left when they're revived... they'll just die again.

Other Wounds.

Generally rarer wound types that can't be specifically categorized. Most of these are far rarer, though you can definitely expect to see them from time to time.

Types of other wounds include.

Evisceration.

An organ has been completely destroyed! This occurs in the eyes, testicles and ovaries. Eye eviscerations require them to be replaced, tentacular/ovarian evisceration can be tended to using the tend wounds surgery.

Disfigurement.

The patient is so horribly messed up that they are completely unrecognizable, appearing as "Unknown". This can only be fixed using a facial construction surgery.

Surgery.

How to Tend Wounds.

Aim anywhere on the body.
Use a scalpel to make an incision in the patient.
Use a forceps to clamp the patient's bleeders.
Use a needle to tend to the patients wounds; selecting either "Tend Bruises", "Tend Burns", or "Tend Damage".*
Use a forceps to remove embedded objects.
Use a needle to suture the incision.

*The bruises/burns options tend a large amount of their respective damage types. The "damage" option tends a moderate amount of both damage types.

How to Mend Bone fractures.

Notice: the bone repair surgery in its current state is bugged.

Requiring 3+ attempts while the patient is asleep to properly set the bone.

Aim for the body part with the broken bone.
Use a scalpel to make an incision in the patient.
Use a forceps to clamp the patient's bleeders.
Use a speculum to retract the incision.
Use bone forceps >/=3 times successfully.
Use a forceps to remove embedded objects.
Use a needle to suture the incision.
Tell the patient to sleep.

How to Manipulate Organs.

Note: the surgery steps for hard and soft tissue body parts are different.

Hard tissue body parts include the skull (brain) and chest (breasts, lungs, heart and liver).

Soft tissue body parts include the eyes (eyes(You'll need to make another incision to get the forceps and speculum out because of a bug!)), mouth (tongue), groin (appendix, testicles, penis and vagina) and stomach (stomach).

Aim for whichever part of the body part the organ is present.
Use a scalpel to make an incision in the patient.
Use a forceps to clamp the patient's bleeders.
Use a speculum to retract the incision.
If soft tissue, continue to next step. If hard tissue, use a bone saw to cut through the bone.
Use a forceps to manipulate the patients organs, selecting with you would like to remove.
Optionally; replace missing organs by using a healthy and intact one on the patient.
Use a forceps to remove the embedded objects.
Use a needle to suture the incision.

How to Sever External Organs.

Desperate eyes stare up at you, the flicker of torch light reflecting off of their nervous sweat. You bring your worn knife down to their body, sloppily spilling the blood from their body. You carve again and again and again, the screams pushing you further on until you finally pull that lump of meat from that pathetic creature. You bask in the pain you've brought this wretched flesh, for you've earned yourself another piece to your collection to be pickled and jarred. You are no healer. You are a butcher... and you... are magnificent.

Note: Basically a far more damaging, less sophisticated alternative to "Manipulate Organs". Be aware that this will sever an artery on a SUCCESS. You should never use this on someone you intend to actually heal. Also, this can only target external organs. I.e. breasts, penises, wings, etc.

Aim for whichever body part the organ is present.
Use a scalpel to make an incision in the patient.
Use a forceps to clamp the bleeders.
Use a scalpel to remove the external organs.
Optionally; replace a missing organ by using a healthy and intact one of the patient.
Use a needle to suture the severed artery and slashes.
Use a forceps to remove the embedded objects.
Use a needle to suture the incision.

How to Amputate Limbs and Heads.

Aim for the selected limb or head.
Use a scalpel to make an incision in the patient.
Use a forceps to clamp the bleeders.
Use a speculum to retract the incision.
Use a bone saw to amputate the limb.

How to Attach Limbs and Heads.

Aim for the selected limb or head with a replacement in hand.
Use the replacement on the patient to attach it.
Use a needle to suture the limb or head to the patient.
Mend whatever wounds the limb or head has.

How to Reshape Faces.

Aim for the patient's head.
Use a scalpel to make an incision in the patient.
Use a forceps to clamp the bleeders.
Use a speculum to retract the incision.
Use a scalpel to reshape the face.
Type the desired name in the text box and click ok.
Use a forceps to remove the embedded objects.
Use a needle to suture the incision.

Guide to Surgery