Throughout the ages wars, conflicts and everyday life have taken their toll on the sentient races of Caelereth ending the lives of many due to injuries. Healers, clerics, medicinemen, and soldiers on the battlerfield have have sought ways to extend the life of those who have been injured and save their loved ones. Pain, blood-loss, and infection have arisen as the central problems when dealing with the wounded and advancement in these areas have significantly improved mortality rates in medical and surgical treatments.  Historically the Northern Sarvonian tribes have not been very advanced in these areas resulting in high rates of death; however in Southern Sarvonia the tribes are somewhat more advanced (at least in New-Santhala). The Compendium hopes that this documented research will benefit all of Caelereth and many lives will be saved.

Pain Remedies. Anyone who has ever lived has most likely experienced the problem of pain. Pain is an unpleasant feeling one gets usually a result of an injury or disease. Not all races and tribes experience pain in the same way. Studies have been conducting demonstrating that the same pain stimulus illicit different reactions in for example orcs and Brownies. Orcs appear to be the most pain-tolerant race, with dwarves and hobbits a close second. Humans have proved to be one of the least pain tolerant of the sentient races. However even the tribes within the races have various levels of pain tolerance.

From an academic point of view pain is good. Pain causes people to avoid situations and things that bring harm to the body or warn when something is damaged. Nevertheless pain is unpleasant and is most often the reason a person seeks a healer. This chapter of pain remedies studies methods which abate pain from various sources. One should note that pain remedies treat the pain someone experiences, but do not cure the cause of the pain. The use of pain management remedies varies by race and tribe with many healers using multiple procedures.

A fallen hero
View picture in full size Image description. A fallen hero suffering from severe blood-loss. Illustration drawn by Koldar.

Blood-Loss Management. What soldier, knight or warrior has not seen one of his kinsmen sustain a wound and subsequently bleed to death? Blood-loss, along with infection, is one of the major causes of death on the battlefield. In addition almost all surgeries involve blood, and the management of blood-loss is essential in the health of the patient. Many experiments have been performed on captured enemies to test the ability to manage or stop the flow of blood with varying results. As such, over the centuries a variety of methods for controlling the flow of blood have been developed. Many of these methods are being widely used in New-Santhala and in the more advanced military garrisons throughout Southern Sarvonia, with great success. Even some of the more barbaric tribes in Caelereth are beginning to see the value in the methods described. Blood loss is addressed as both internal blood loss and external blood loss.

Internal Bleeding. Internal bleeding may present a dire threat to the health and life of the victim, resulting from an array of causes, be they traumatic or idiopathic. Ranging from an incidental bruise on the cheek to exsanguination and collapse of the sanguine constituent, the site of the bleeding is the key to the threat of the injury. In life-threatening cases, prompt medical attention is needed to extirpate the outflow of blood and help restore the natural flow of sanguine.

Any significant amount of blood loss will produce fatigue, difficulty breathing, and weakening of the heart throbs. Bleeding into certain sites, as in the belly, chest, and limbs, is almost universally heralded by a swelling or lancing sort of pain. In other sites, this bleeding may be completely painless, as in bleeding within the head or gut. In these latter instances, vigilance and high degree of suspicion of internal injury are advised to be made aware of the blood loss.

Injuries to the belly can contain a leak of up to one barrel, that is 30 mugs, of blood, with only the pain of injury and the tumescence of the belly to show any sign of internal blood loss. Bleeding within the muscles of the arms and legs may contain as much as three mugs of blood in each limb. Because of the limited space within the skull, intracranial bleeding is surviveable up to approximately one tot, thereafter giving way to stupor and death. In most cases, even minor intracranial bleeding causes profuse vomiting and lethargy, sometimes accompanied by thrashing spells.

Bleeding in the bowels may be silent or only mildly painful, perceived as either a gnawing or sharp lancing pain, and may persist undetected for up to months. This type of bleeding may result in black, tarry stools, or, if the bleeding is lower down, bright red blood may issue forth into the toilet. Some tumors can cause this type of bleeding, and early diagnosis is the key to treating these aggressive tumors. The lungs and chest can hold a massive quantity of blood, up to one firkin in each lung. However, such congestion can rapidly drown a person in their own blood, described by survivors as "air hunger", and thus this constitutes the most emergent case of internal bleeding. Though no method of detection is universally effective, a simple concensus of healers suggests that probing an inflamed and reddened area with a hollow, wide-aperture stylet is the most direct way to finding the source of the bleeding. In the case of bleeding into the lungs, chest, and belly, this may also be the optimal treatment, siphoning off the excess of sanguine until the balance of constituents returns.

Exsanguination, Bleeding Wounds. Exsanguination means to lose blood such that the sanguine constituent collapses, blood does not course to all parts of the body, and, in the extreme, the victim dies from losing blood. As explained in detail by Sage Aurora Damall in her treatise "On Cuts and their Treatments", the risk of exsanguination is dependent of the gravity of the injury sustained. Most healers will gain expertise in treating these injuries in times of conflict, as field chirurgeons and Dalorins retained by fighting units attend wounded soldiers on the battlefield soon after an injury occurs.

Blood loss most often is not painful; indeed, a wounded person may lapse into stupor, thence into death, without any complaint aside from lethargy and slowing of their thought process. Some signs and symptoms that healers show be vigilant of include nausea, dry mouth and nose, sunken eyes, pallor around the lips and fingertips, absence of production of urine, shallow and weak heart throbs, and rapid breathing. This last effect is likely a result of the phlegm attempting to compensate for the impending collapse of the sanguine constituent, a final effort to recompose the constitution of the ailing individual. In assessing exsanguinating wounds, a healer can never be too careful. All bleeding wounds have at least one escape or outlet for the sanguine; one must gauge both the diameter and the depth of the wound. Take care to look for exit wounds as well, particularly if the victim suffered a deep penetrating wound or received an arrow or other projectile wound. Look for fragments of the projectile inside the wound.

If you see that a hollow organ has been opened by the puncture wound, the victim needs to be attended by a chirurgeon immediately lest catastrophic spillage of bodily constituents occur. It is well established as fact that bile and choler both cause burns if they are spilled outside of their respective cavities, and either will greatly complicate wound healing. Mixing of bodily constituents - such as introducing bile or choler into the blood vessels - is almost universally fatal. Healers are reminded here of the adage, "All bleeding stops," meaning that fast treatment of a seeping wound is critical, before collapse of the sanguine overcomes a victim. If time permits, as judged by the healer attending a victim, then cleansing of a wound with mil'no sap or ormelin prior to surgical closure of a wound may help wounds to heal faster and more neatly. Oil of the totit plant has a similar cleansing effect, though this may be more difficult to obtain than the first two. Stopping blood loss from a wound is more complicated than just putting in a few stitches. Many wounds require aid from herbal preparations, either applied to the wound directly or imbibed to allow the whole body to recover from the loss of blood. Some suggestions to this end are mentioned here:

Infection Cures. Oftentimes on the battlefield a small wound to the leg or the arm if ignored will begin to fester, causing puss and fluid to excrete, and will generally refuse to heal. In many cases the tissue begins to die in and around the wound slowly enveloping the appendage in death. If action is not taken, the wounded warrior usually dies. Some of the less advanced tribes attribute this affect to the supposed evil present in their enemy’s blades. Others believe that Armeros or Queprur is punishing them for waging war without just cause. More advance healers simply recognize that a warblade and the conditions on a battlefield lead to dirty or poisoned wounds. Healers have named this phenomenon “infection” and it must be dealt with by a healer to increase the likelihood of the patient’s survival. For certain, infection is not relegated to the battlefield, in fact infection can invade any wound and, along with blood-loss, is the cause of many deaths all over Caelereth. Infection is still a great mystery to most healers however a few somewhat affective methods have been discovered by various tribes to cure infection:

 Date of last edit 18th Sleeping Dreameress 1670 a.S.

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