Post by Drache on Jun 13, 2007 20:12:42 GMT -5
Dragonhealing for DragonHealers:
An overview of the injury areas, ailments and basic treatments.
It has been mentioned before that Dragons don't need a lot of Healing and for many instances they are taken care of by their rider, but there are complaints that they do need to see the Dragonhealers about. Dragonhealers deal mainly with injuries but there are some ailments too.
The Dragonhealers principle means of diagnosis is through observation and discussion. A dragonrider Dragonhealer has an invaluable tool in their own dragon to find out where things hurt, but on the whole there are some basic rules.
Infection/Bleeding:
Illness and infection would show up as a slight dulling of the hide, turning to a grey tinge. An internal infection or injuries would feel hot or warm under the hide. Under the sheen of the hide, there can be a rainbow-like effect which is usually the equivalent of a bruise or internal bleeding. A hematoma (bleeding or bruising internally) would appear as a distended ball with a filmy appearance of rainbow colours. Such an ailment would most likely need to be drained.
They would look over an injury site and confirm the type of bleeding which would then determine the treatment. Arterial ichor would be evident from dramatic spurts and a dark green ichor appearance. Venuous ichor would be paler green and pulse slowly. Capillaries tend to ooze rather than bleed dramatically but it all helps to build up a picture of the injury.
A tear across veins or an abrasion can lead to a dramatic amount of ichor in relation to the severity of the injury. These are surprisingly common in mating flights which can be rough, even accidentally. Cuts and lacerations are cleaner but deeper. There can also be puncture wounds with a small entry point, resulting in a high amount of damage and little blood, depending on the depth.
These wounds have a multitude of causes and for minor ones, dragonriders will treat themselves. For minor cuts the best remedy is to clean with redwort and leave to heal uncovered on a dragon. If it is a deep cut that needs to be sutured by a Dragonhealer, numbweed should be used to deaden the pain and possibly another antiseptic, such as redwort, nullifies the effect of numbweed a little. The numbweed will keep the area moist as well and promote healing.
In general, a break in the dragonhide is usually at the source of many problems. Hence the dragonriders preoccupation with oil. One of the things Dragonhealers might have to do is adjust the diet of a habitually patchy dragon to include more fish or make them chew on oilseed cakes. Often a recovering dragon will have a few of these given to them by the dragonhealers but as they are pretty revolting, much like the equivalent of getting a dragon to take a pill, they are difficult to force on them. And it's difficult to force the apprentices to make them as well!
Fractures:
The anatomy of the dragon is such that it is very difficult to break a dragons bones as they are designed to withstand the phenomenal stress of flight in Fall. But it can be done by a crash landing, an impact of any kind at even a moderate speed, perhaps even during a mating flight. A simple fracture is relatively easy to deal with. The bone is realigned and splints placed at 90 degrees to each other and wrapped with bandages. The difference from a human splint essentially being the splints are more like planks and the bandages like thin sheets.
A compound fracture is a little more obvious in that it has an abnormal angle or sometimes the hide is pierced by the bone. The Dragonhealers will treat this in the following way. The injured area will be cleaned with redwort, the bones will be aligned into place. This often requires a team of healers and may need internal splints with sterile wherry gut. The damaged muscles and veins that are affected will need suturing again and the injured area splinted. This will need a LOT of checking, as compound fractures are more prone to infection. Liberal numbweed at least three times a day and a lot of rest is required for the dragon. They do have a tendency to forget to rest as they should. The upside is that they heal very swiftly.
Illnesses:
Dragons rarely get diseases, though it is possible - usually they are particularly healthy. However, if they are prone to any type of illness or ailment it is respiritory based. They can catch the dragon equivalent of a cold, and frankly it's disgusting. A dragon with a cold produces an AMAZING amount of mucus and no one wants to be anywhere near them when they sneeze. They need a lot of water and rest and possibly an herbal tonic from the Dragonhealers. On the whole, dragons are fine with most of the medicines given to humans (except fellis) so an herbal remedy with echinacea, garlic and goldenseal will stimulate the immune system.
Serious respiritory ailments such as pneumonia are usually the result of an injury to the chest region that allows infection to penetrate deeply. It will be pretty obvious that they are not well from their laboured breathing, dull eyes and cold hide. They will need steam inhalation to assist in breathing and to break down the infection as they are kept warm with covers. Often the steam "tents" are filled with a dose of essential oils. Eucalyptus is good, benzoin is also good as it is a good expectorant, antiseptic and also soothes the inflamed membranes.
In general, inhalation is a good means of immediate introduction of a medicine into a dragon's system.
Stomach ailments are possible with dragons, usually if firestone goes down the wrong way. This can cause some damage in the stomach area. It is difficult to diagnose as sometimes poor quality firestone can cause a dragon stomachache, in which case the only cure is to purge the whole lot out by regurgitating it. If a stone has gone into the wrong stomach, it will pass through, but it will irritate the stomach and the intestines before and after it has passed. The usual symptoms are bad stomach pains in the dragon with rapid and almost shocking bloating of the belly area. The best cure is to feed the dragon a meaty broth that is liberally stewed with aloe vera, horsetail grass and slippery elm. These herbs will soothe the stomach lining, coagulate the bleeding and lubricate and coat the intestine so it won't continue irritating. Stomach cramps are often treated either with peppermint essence or a soothing mixure of oils on the belly (lavender, chamomile, etc.)
Threadscores:
Now, minor threadscores on a dragon can be treated by the Dragonhealer first then passed over to the dragon's rider. Barring complications, the process for dragons is simple. The pair might have gone between to catch and kill the thread. A minor score will have cauterized itself and when they reach the ground, the Healer will primarily see a black mark. The first aid is generally to douse the area in the diluted numbweed to make it manageable. The Dragonhealer will then wash out the wound carefully, get rid of ALL the black thread residue and then rinse with redwort, finishing with a thicker coat of numbweed. These surface scores heal best uncovered and within a couple of days, the dragon will be producing fresh hide. Humans heal much more slowly, unfortunately, and the injuries are more complex (See Threadscore article).
Deep threadscores or tangle hits will have to be dealt with immediately by the Dragonhealers.
The protocols are the same as they are with humans; amputation, diagnosis of sleeper threads, radical intervention or otherwise. However, Dragonhealers have a certain amount of latitude that human healers do not. For example, if a tangle filament was eating its way through the wing and spreading out, brutal though it might seem, a concentrated burst of agenothree on the wing membrane, leaving a large hole, is not the same sort of disaster that it would be for a human. For a start, the boron in the dragons musculature and bones is resistant to acid. Even concentrated nitric acid (agenothree) only corrodes it very slowly. This makes the treatment of complex threadscores and injuries much more possible than it is on humans. If the Dragon can be controlled and prevented from going between or panicking, if there is still live thread in the wound, agenothree could be pumped into a burrowing wound to kill the thread.
There would still be corrosion of the tissue but it could be flushed out along with the dead thread and then normal treatment resumed. Dragons regenerate membranes rapidly over time so this is not as drastic a treatment as it first appears. Amputating a wingtip or a claw will also see a new one grow over time. Hide and extremities are very resiliant as long as they don't get infection.
A dragon specific problem associated with threadscore on a dragon is a phenomenon called Rupture veins. The trauma to the area results in a longer term seepage of ichor. This can sometimes need stitching around the outside of the score to seal those vessels before necrosis and infection can settle into the tissue. Numbweed clots the ichor temporarily but the stitching is necessary and it is after the event that it becomes more noticeable.
Stitching and suturing of a wound on the whole will be done by the Dragonhealers. The basic process is to clean the wound with redwort, sterilize the needles and thread then apply a thin amount of numbweed on the wound. Internal sewing sutures use gut thread as it very slowly dissolves, but for external wounds, the dragonhealers use treated tannercraft thread ... somewhat more heavy duty than the stuff used by the human Healers. Membrane area's frequently need heavy cross stitching though fortunately dragonhide grows at a remarkable rate - the trick then is to monitor and get the stitches out in time.
In serious incidents, Dragonhealers may attempt a transfusion of ichor. Fortunately this is nowhere near as complicated as it is for humans. Dragons do not seem to reject anothers ichor, though as a matter of protocol and common sense, the Dragonhealers tend to do colour to colour transfusions as that seems to have the best healing factor. Frequently it is as unscientific as letting the ichor drain into the injured area of the other dragon. The vascular system is such that it is automatically absorbed by cartiledge and the boron based bone structure.
Alternatively, it is done using large demijon's of collected ichor. The healers would need a LOT to pull through one bleeding dragon. The ichor is collected using a sizeable syringe and needlethorn. The glass tube of the syringe is attached to a very large needlethorn via the sealing properties of a basic wax or in the South, a moldable resin mix. The ichor can then be drawn.
Eye damage can take place and it is often down to the competance of the dragonhealer as to the recovery. Damage can take place in Fall or in flights. The cleaning of this wound is paramount, the care and attention to detail is vital. The damaged facet area should be very carefully poulticed then the eyelid is sutured closed and fingers are crossed that the area will regenerate. During this time the dragons diet should be heavily fortified with powdered bone, which is very high in boron. This is a vital part of the dragons optical system and there is the possibility that regeneration might occur if it is present in sufficient quantities.
Wing damage:
Finally, one of the most complicated areas of injury and healing on a dragon is on their wings. Tears and damage to the wing vary in severity - minor injuries heal in a few days but major wing membrane damage can take up to three or four sevendays to heal. The skill of the Dragonhealer lies in making the decision where to stitch. Sometimes there is a tendency to think that stitching the ragged edges together is important to keep as much membrane as possible.
However, this is not strictly the most sensible approach. An experienced Dragonhealer will know that sometimes it is better to cut back to healthy tissue as that which has survived threadscore is likely to be compromised. This can sometimes be a difficult situation for the Dragonhealers as a lot of riders don't take kindly to them making bigger holes in their lifemate's wings.
Membrane can be stitched back over a bone ... bones can be braced, a veritable patchworking can be made of the wing which can result in scar tissue initially that might hamper flight - however, usually within 18 months, scar tissue is absorbed and flexibility regained. Even those grounded with such an injury need not despair of never flying again.
One other major injury that sometimes comes up is a wrenched or dislocated wing or wings. The swelling around the affected joint will be very pronounced and this is a procedure that definitely needs a dragon or two to assist as a human just would not have the strength required to relocate the bone. It should be done as soon as possible as it is the natural reaction of the body to lock muscles around an injured area as tight as possible to naturally splint it. Waiting too long could end up with worse damage in the long run.
As with human dislocations, it is exceptionally painful and usually needs to be pulled _out_ and a little away from the joint before it can be eased back in. The area might then need to be splinted into immobility to protect the torn muscles and ruptured tendons. Usually the sort of herbs and compresses that might be used on a bad sprain, like arnica, lavender, witchazel, or juniper would then be applied to bring the swelling out, along with numbweed.
Hearts:
The last main area that is the source of dragon ailments is that of their hearts. Dragons have a double heart complex and usually these are very solid and reliable. However, it is something that affects very aged dragons. The hearts become less efficient and the dragon shows signs of lethargy, of greying at the extremities as well as tingling. It is possible for a young dragon to experience some symptoms like this if there is a respiratory problem that is interfering with the heart process - always a difficult call to make. If that is the case, heart stimulants are called for, the most effective being quickwort, but if that is not available, foxglove, peppermint and hawthorn can encourage the hearts to work harder. Often this is needed as a sluggish heart means that the bodies defenses are not working properly and it can be a rapid degenerative cycle. The erratic heart beat can be difficult to detect with two heart, but an expert can distinguish it. If it is old age, then it is a case of making the dragon rest, doing light exercise and cutting back on those mating flights otherwise there could be a heart attack and that is it.
But, as most Dragonhealers know, dragons can recover from most things if they survive the initial trauma and their writers evil whims!
www.arolosweyr.co.uk/arolos.php?p=articles/display_article.php&id=159
An overview of the injury areas, ailments and basic treatments.
It has been mentioned before that Dragons don't need a lot of Healing and for many instances they are taken care of by their rider, but there are complaints that they do need to see the Dragonhealers about. Dragonhealers deal mainly with injuries but there are some ailments too.
The Dragonhealers principle means of diagnosis is through observation and discussion. A dragonrider Dragonhealer has an invaluable tool in their own dragon to find out where things hurt, but on the whole there are some basic rules.
Infection/Bleeding:
Illness and infection would show up as a slight dulling of the hide, turning to a grey tinge. An internal infection or injuries would feel hot or warm under the hide. Under the sheen of the hide, there can be a rainbow-like effect which is usually the equivalent of a bruise or internal bleeding. A hematoma (bleeding or bruising internally) would appear as a distended ball with a filmy appearance of rainbow colours. Such an ailment would most likely need to be drained.
They would look over an injury site and confirm the type of bleeding which would then determine the treatment. Arterial ichor would be evident from dramatic spurts and a dark green ichor appearance. Venuous ichor would be paler green and pulse slowly. Capillaries tend to ooze rather than bleed dramatically but it all helps to build up a picture of the injury.
A tear across veins or an abrasion can lead to a dramatic amount of ichor in relation to the severity of the injury. These are surprisingly common in mating flights which can be rough, even accidentally. Cuts and lacerations are cleaner but deeper. There can also be puncture wounds with a small entry point, resulting in a high amount of damage and little blood, depending on the depth.
These wounds have a multitude of causes and for minor ones, dragonriders will treat themselves. For minor cuts the best remedy is to clean with redwort and leave to heal uncovered on a dragon. If it is a deep cut that needs to be sutured by a Dragonhealer, numbweed should be used to deaden the pain and possibly another antiseptic, such as redwort, nullifies the effect of numbweed a little. The numbweed will keep the area moist as well and promote healing.
In general, a break in the dragonhide is usually at the source of many problems. Hence the dragonriders preoccupation with oil. One of the things Dragonhealers might have to do is adjust the diet of a habitually patchy dragon to include more fish or make them chew on oilseed cakes. Often a recovering dragon will have a few of these given to them by the dragonhealers but as they are pretty revolting, much like the equivalent of getting a dragon to take a pill, they are difficult to force on them. And it's difficult to force the apprentices to make them as well!
Fractures:
The anatomy of the dragon is such that it is very difficult to break a dragons bones as they are designed to withstand the phenomenal stress of flight in Fall. But it can be done by a crash landing, an impact of any kind at even a moderate speed, perhaps even during a mating flight. A simple fracture is relatively easy to deal with. The bone is realigned and splints placed at 90 degrees to each other and wrapped with bandages. The difference from a human splint essentially being the splints are more like planks and the bandages like thin sheets.
A compound fracture is a little more obvious in that it has an abnormal angle or sometimes the hide is pierced by the bone. The Dragonhealers will treat this in the following way. The injured area will be cleaned with redwort, the bones will be aligned into place. This often requires a team of healers and may need internal splints with sterile wherry gut. The damaged muscles and veins that are affected will need suturing again and the injured area splinted. This will need a LOT of checking, as compound fractures are more prone to infection. Liberal numbweed at least three times a day and a lot of rest is required for the dragon. They do have a tendency to forget to rest as they should. The upside is that they heal very swiftly.
Illnesses:
Dragons rarely get diseases, though it is possible - usually they are particularly healthy. However, if they are prone to any type of illness or ailment it is respiritory based. They can catch the dragon equivalent of a cold, and frankly it's disgusting. A dragon with a cold produces an AMAZING amount of mucus and no one wants to be anywhere near them when they sneeze. They need a lot of water and rest and possibly an herbal tonic from the Dragonhealers. On the whole, dragons are fine with most of the medicines given to humans (except fellis) so an herbal remedy with echinacea, garlic and goldenseal will stimulate the immune system.
Serious respiritory ailments such as pneumonia are usually the result of an injury to the chest region that allows infection to penetrate deeply. It will be pretty obvious that they are not well from their laboured breathing, dull eyes and cold hide. They will need steam inhalation to assist in breathing and to break down the infection as they are kept warm with covers. Often the steam "tents" are filled with a dose of essential oils. Eucalyptus is good, benzoin is also good as it is a good expectorant, antiseptic and also soothes the inflamed membranes.
In general, inhalation is a good means of immediate introduction of a medicine into a dragon's system.
Stomach ailments are possible with dragons, usually if firestone goes down the wrong way. This can cause some damage in the stomach area. It is difficult to diagnose as sometimes poor quality firestone can cause a dragon stomachache, in which case the only cure is to purge the whole lot out by regurgitating it. If a stone has gone into the wrong stomach, it will pass through, but it will irritate the stomach and the intestines before and after it has passed. The usual symptoms are bad stomach pains in the dragon with rapid and almost shocking bloating of the belly area. The best cure is to feed the dragon a meaty broth that is liberally stewed with aloe vera, horsetail grass and slippery elm. These herbs will soothe the stomach lining, coagulate the bleeding and lubricate and coat the intestine so it won't continue irritating. Stomach cramps are often treated either with peppermint essence or a soothing mixure of oils on the belly (lavender, chamomile, etc.)
Threadscores:
Now, minor threadscores on a dragon can be treated by the Dragonhealer first then passed over to the dragon's rider. Barring complications, the process for dragons is simple. The pair might have gone between to catch and kill the thread. A minor score will have cauterized itself and when they reach the ground, the Healer will primarily see a black mark. The first aid is generally to douse the area in the diluted numbweed to make it manageable. The Dragonhealer will then wash out the wound carefully, get rid of ALL the black thread residue and then rinse with redwort, finishing with a thicker coat of numbweed. These surface scores heal best uncovered and within a couple of days, the dragon will be producing fresh hide. Humans heal much more slowly, unfortunately, and the injuries are more complex (See Threadscore article).
Deep threadscores or tangle hits will have to be dealt with immediately by the Dragonhealers.
The protocols are the same as they are with humans; amputation, diagnosis of sleeper threads, radical intervention or otherwise. However, Dragonhealers have a certain amount of latitude that human healers do not. For example, if a tangle filament was eating its way through the wing and spreading out, brutal though it might seem, a concentrated burst of agenothree on the wing membrane, leaving a large hole, is not the same sort of disaster that it would be for a human. For a start, the boron in the dragons musculature and bones is resistant to acid. Even concentrated nitric acid (agenothree) only corrodes it very slowly. This makes the treatment of complex threadscores and injuries much more possible than it is on humans. If the Dragon can be controlled and prevented from going between or panicking, if there is still live thread in the wound, agenothree could be pumped into a burrowing wound to kill the thread.
There would still be corrosion of the tissue but it could be flushed out along with the dead thread and then normal treatment resumed. Dragons regenerate membranes rapidly over time so this is not as drastic a treatment as it first appears. Amputating a wingtip or a claw will also see a new one grow over time. Hide and extremities are very resiliant as long as they don't get infection.
A dragon specific problem associated with threadscore on a dragon is a phenomenon called Rupture veins. The trauma to the area results in a longer term seepage of ichor. This can sometimes need stitching around the outside of the score to seal those vessels before necrosis and infection can settle into the tissue. Numbweed clots the ichor temporarily but the stitching is necessary and it is after the event that it becomes more noticeable.
Stitching and suturing of a wound on the whole will be done by the Dragonhealers. The basic process is to clean the wound with redwort, sterilize the needles and thread then apply a thin amount of numbweed on the wound. Internal sewing sutures use gut thread as it very slowly dissolves, but for external wounds, the dragonhealers use treated tannercraft thread ... somewhat more heavy duty than the stuff used by the human Healers. Membrane area's frequently need heavy cross stitching though fortunately dragonhide grows at a remarkable rate - the trick then is to monitor and get the stitches out in time.
In serious incidents, Dragonhealers may attempt a transfusion of ichor. Fortunately this is nowhere near as complicated as it is for humans. Dragons do not seem to reject anothers ichor, though as a matter of protocol and common sense, the Dragonhealers tend to do colour to colour transfusions as that seems to have the best healing factor. Frequently it is as unscientific as letting the ichor drain into the injured area of the other dragon. The vascular system is such that it is automatically absorbed by cartiledge and the boron based bone structure.
Alternatively, it is done using large demijon's of collected ichor. The healers would need a LOT to pull through one bleeding dragon. The ichor is collected using a sizeable syringe and needlethorn. The glass tube of the syringe is attached to a very large needlethorn via the sealing properties of a basic wax or in the South, a moldable resin mix. The ichor can then be drawn.
Eye damage can take place and it is often down to the competance of the dragonhealer as to the recovery. Damage can take place in Fall or in flights. The cleaning of this wound is paramount, the care and attention to detail is vital. The damaged facet area should be very carefully poulticed then the eyelid is sutured closed and fingers are crossed that the area will regenerate. During this time the dragons diet should be heavily fortified with powdered bone, which is very high in boron. This is a vital part of the dragons optical system and there is the possibility that regeneration might occur if it is present in sufficient quantities.
Wing damage:
Finally, one of the most complicated areas of injury and healing on a dragon is on their wings. Tears and damage to the wing vary in severity - minor injuries heal in a few days but major wing membrane damage can take up to three or four sevendays to heal. The skill of the Dragonhealer lies in making the decision where to stitch. Sometimes there is a tendency to think that stitching the ragged edges together is important to keep as much membrane as possible.
However, this is not strictly the most sensible approach. An experienced Dragonhealer will know that sometimes it is better to cut back to healthy tissue as that which has survived threadscore is likely to be compromised. This can sometimes be a difficult situation for the Dragonhealers as a lot of riders don't take kindly to them making bigger holes in their lifemate's wings.
Membrane can be stitched back over a bone ... bones can be braced, a veritable patchworking can be made of the wing which can result in scar tissue initially that might hamper flight - however, usually within 18 months, scar tissue is absorbed and flexibility regained. Even those grounded with such an injury need not despair of never flying again.
One other major injury that sometimes comes up is a wrenched or dislocated wing or wings. The swelling around the affected joint will be very pronounced and this is a procedure that definitely needs a dragon or two to assist as a human just would not have the strength required to relocate the bone. It should be done as soon as possible as it is the natural reaction of the body to lock muscles around an injured area as tight as possible to naturally splint it. Waiting too long could end up with worse damage in the long run.
As with human dislocations, it is exceptionally painful and usually needs to be pulled _out_ and a little away from the joint before it can be eased back in. The area might then need to be splinted into immobility to protect the torn muscles and ruptured tendons. Usually the sort of herbs and compresses that might be used on a bad sprain, like arnica, lavender, witchazel, or juniper would then be applied to bring the swelling out, along with numbweed.
Hearts:
The last main area that is the source of dragon ailments is that of their hearts. Dragons have a double heart complex and usually these are very solid and reliable. However, it is something that affects very aged dragons. The hearts become less efficient and the dragon shows signs of lethargy, of greying at the extremities as well as tingling. It is possible for a young dragon to experience some symptoms like this if there is a respiratory problem that is interfering with the heart process - always a difficult call to make. If that is the case, heart stimulants are called for, the most effective being quickwort, but if that is not available, foxglove, peppermint and hawthorn can encourage the hearts to work harder. Often this is needed as a sluggish heart means that the bodies defenses are not working properly and it can be a rapid degenerative cycle. The erratic heart beat can be difficult to detect with two heart, but an expert can distinguish it. If it is old age, then it is a case of making the dragon rest, doing light exercise and cutting back on those mating flights otherwise there could be a heart attack and that is it.
But, as most Dragonhealers know, dragons can recover from most things if they survive the initial trauma and their writers evil whims!
www.arolosweyr.co.uk/arolos.php?p=articles/display_article.php&id=159