Dwale
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Basic Information

The word dwale in old English had a variety of meanings - many of them distinctly sinister and related to deceit and foolishness - but perhaps the most interesting is its use to indicate an early narcotic and anaesthetic drug.

Surviving recipes show a variety of compositions for dwale, but most of them commonly involve ingredients such as pig bile, lettuce juice, bryony, henbane, hemlock and opium1 … unsurprisingly such a concoction was well known as a stupefactant, but one with which is was very easy to kill the patient. How much of that morbidity was due to actual poisoning, and how much to the surgery that the dwale was used to facilitate is not well know2.

Sources

https://link.springer.com/chapter/10.1007/978-1-349-21882-0_3
https://www.bmj.com/content/319/7225/1623

Bibliography
1. full source reference

Game and Story Use

  • In the C. J. Sansom novel Revelation a serial killer uses dwale to facilitate a string of grisly murders.
  • Could be tricky to stat - whatever mechanic you are using to represent the shock of vivisection should be damped to account for the patient being fully anesthetized and unconscious, and the surgeon should have their penalties for working quickly on a screaming, resisting patient reduced but there should probably be a risk of a lethal dose of dwale, and some accounting for the risk of a patient asphyxiating or bleeding out under the knife.
    • If your rules allow for success accumulation try this: first, the patient makes a poison save for the dwale, possibly with a bonus depending on the skill of whoever dosed them. The GM writes the result down in secret. The surgeon then starts working, trying to accumulate enough successes against the target to complete the surgery: amputating a limb should take relatively few, lithotripsy quite a lot, cleaning and suturing a gut wound or removing an internal tumour or imbedded object somewhere in between. Every cycle, the GM accumulates some kind of threat cycle, possibly adding any failures by the surgeon - if the surgeon can meet his objectives and close up before the threat gets to whatever level will prove fatal, the operation is a success. Look at the poison save result to see if the patient comes around from anaesthesia (and maybe give a really good doctor a chance to spot a fail and give some treatment with an outside chance of helping) and then pray the wound doesn't turn septic.
  • For reference, this was traditionally administered orally in wine, which has its own hazards, both to the patient and to anyone prone to finishing up unattended drinks. Presumably, however, it would take pretty strong - or heavily spiced wine to cover up the taste of pig bile. Or pretty bad wine which could mask the flavour in its own horrors.
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