• Poor: A poor doctor is never more than a Barber-
Surgeon (or perhaps a Student with delusions of
grandeur) and likely a sloppy one at that. Such doctors
are rarely found in villages because the peasants soon
learn that they are better off seeing the wise woman or
herbalist, but they thrive in cities where folks put less
trust in home remedies. Still, only the destitute and
the desperate come to this butcher and his rusty knives,
and they go with the knowledge that they may end up
worse than they began. The only advantage of the poor
doctor, besides his low prices, is that he tends not to
ask questions about where or how the knife wounds or
powder burns were acquired.
• Common: A common doctor is typically a young
Physician or a well-schooled Barber-Surgeon. He is
schooled in basic herbalism and at least the principles
of surgery, he outfits himself with a clean and mostly
hygienic theatre, and he rarely cuts off limbs without
good reason. The common doctor is treated with an
equal measure of respect and suspicion, and earns
a modest wage. If he is a physician, he maintains a
sizeable collection of powders and tinctures and a few
medical texts; if he is a barber-surgeon he is probably
known for the speed and neatness of his amputations.
• Good: This level of quality includes established, fatbellied
Physicians or world-famous Surgeons who tend
to those townsfolk wealthy enough to afford their rates.
They attended the best schools, have become highly
placed in their guild and in society, and the success
of their practice is as much about whom they cure as
how well they do so. Yet their skills are, in the main,
exemplary, and their devotion is not always lacking:
those who have the coin to spend can be assured of the
latest medicines, the sharpest saws, and the finest leather
strap upon which to bite down.
• Best: Physicians of this quality have gained fame across
at least one of the large cities of the Empire, if not
farther. They may in fact be known in other countries
and called there for their opinions, while in their home
cities they almost certainly tend to the royal and ruling
families. They are likely heads of their guilds, and if
they do not reside in the palaces of the nobility, will
have been so well rewarded by their grateful patients
as to have acquired a stately manor home and entrance
into the best possible society. Few can ever hope to
rise to this rank without either extraordinary medical
talents or extraordinary guile. Those of this quality
are exceptionally skilled, whether it be in medicine or
charlatanry.
The extent of surgical knowledge in the Old World includes
setting broken bones (if the break is clean), staunching the flow
of blood and the spread of infection (if treatment is performed
quickly enough), and stitching skin to hold together what's left
(if the wound is narrow enough). Anything more complicated
is solved by removing the affected area with either a heavy
cleaver or the slower but neater bone saw. A good surgeon is
one who can cut off the damaged areas without destroying the
entire appendage; a great surgeon is one who can do it quickly,
because anaesthetic remains a mystery and because the longer a
wound is exposed, the greater the risk of infection.
types of ailments; whether disease, sickness or insanity, all
conditions are seen to arise from a taint upon, imbalance in
or irritation of some part of the body. Unless the cause of the
problem is obvious and external, the usual diagnosis will be
that the cause is an inflammation of an internal organ. The
organ in question will be determined by examining the Three
Fluids (blood, phlegm, or faeces), taking the pulse, examining
the colour of the patient's skin and eyes, his diet and lifestyle,
his star sign and countless other minutiae.
Gaelenic physicians prefer to treat the symptoms of a fever
rather than the cause, using the idea that "like cures like": hot,
sweating patients will be covered with blankets and locked in
steam rooms to sweat out the fever, cold patients will be placed
in baths of ice; reddened patients bled while pale patients are
given clear liquids. Mechanicals prefer to flush the infection
out to the surface by inducing vomiting or diarrhoea with
powerful drugs, blistering or burning the skin with fired steel
or metal cups, and of course bleeding. Both types believe
the expulsion of unclean fluids—particularly black bile and
pus—is a sign that infection is leaving the body. One of the
newest techniques involves sewing small threads under the
skin or using acid to burn an open sore in order to produce a
full and steady flow of pus out of the patient.
Bleeding is by far the most popular treatment offered by
physicians, however. It is becoming increasingly fashionable
for the wealthier burghers to have "a good bleed" every spring,
to strengthen the constitution. A pint is usually taken, and the
process often leaves the patient light-headed, inspiring many
jokes likening doctors to barmen, "pouring a pint" for paying
customers.
Unsurprisingly, all of these methods take their toll on the
patient, so much so that they are the equivalent of having a
disease. Those vomiting or purging suffer as if they have the
Bloody Flux, while those who have been burned or cupped
will have itchy scars affecting them like the Kruts (but without
the Fellowship penalty). Those being "tapped" for pus or bile
suffer the effects of Scurvy Madness minus the hallucinations,
but thankfully none of these symptoms persist for more than
three days, after which the doctor may make another Heal
Test. If successful, the duration of the original ailment is
reduced by a number of days equal to the degree of success of
the Heal roll. If the disease remains, the treatment will begin
again—if the patient has the funds, of course. By spending
enough money, therefore, a character may exchange the
horrors of Neiglish Rot for a few weeks with the Bloody Flux.