Over the DM's Shoulder

Tuesday, July 22, 2025

Healing by Culture in My Homebrew Setting

In D&D and other tabletop games, healing is a big part of the game. This is for a number of reasons. Primarily, combat happens in tabletop games, and combat means injuries, and injuries necessitate healing. Secondarily, magic is considered a staple of D&D, and an extension of that means that healing magic would exist. And thirdly, since the beginning of D&D, healing has been a major part of the game. But medical care is more than a "Cure Wounds" spell, and I thought it would be interesting and valuable to investigate what healing is like between cultures in my homebrew setting. I know this idea is a little out there in terms of what I write for this site, but trust me--this guide will help to add some great details to healing in the game. So without further ado, let's get started by looking at the cultures in my homebrew setting and how they handle healing and medical care. 



Daltoners

Daltoners follow the teachings of the Dalton Church of Pelor, an extremist belief system involving living sacrifice to keep an angry sun rising every day. Because their version of Pelor does not exist, and because the real Pelor disdains what they believe, they do not grant the Dalton Church of Pelor clerics any healing abilities. This has meant that without direct healing magic, Daltoners have had to learn to deal with serious injuries in other ways. Daltoners have developed a fairly advanced grasp of first aid and other mundane medical care, especially utilizing strong alcohol as a disinfectant and the use of amputation when a limb cannot be salvaged. Missing limbs, usually replaced with wooden prosthetics with decent usability and augmented by canes for those with missing legs as well as rudimentary wheelchairs, are common among Daltoners. 

This is not to say that medical science is advanced among the Daltoners. There is essentially no proactive care for people's health, and the knowledge of using disinfectants is the most advanced medical concept in Daltoner medicine, and it is not understood in terms of cause and effect. Medical experts among the Daltoners tend to be versed in the basics of care, such as tending to illnesses and treating injuries, but more advanced problems, particularly magical ones, are too vexing to approach for Daltoner medical experts. 

For seriously injured Daltoners, there is little that Daltoner medical care can do. Given other cultures' reputations for powerful healing magic and the Daltoner dearth of it, some desperate Daltoners will leave New Dalton and the surrounding lands to seek out healers from other cultures. Because of the negative reputation of Daltoners across Evanoch, not all healers are willing to work on Daltoner patients, and many charge a heavier fee for care than they would other patients. But still, many healers operate on a "do no harm" basis and are willing to treat Daltoner patients regardless of politics.

Faninites

On the island of Fanin, Faninites practice sustaining hunting and gathering, including foraging for alchemical herbs. Traditionally, Faninites are not from a culture that prizes magic highly, and so while there are some spellcasters who are able to heal through magic, most Faninite healing is alchemical in nature. Faninites on Evanoch have taken to the land and learned about Evanine herbs, and a healthy trade with Fanin allows for access to traditional herbs as well. This has made Faninites some of the most talented alchemists in the North of Evanoch, and they have absorbed much of Daltoner first aid treatments to supplement their medical work. Since Faninites generally lead quiet, peaceful lives, injuries tend to be limited to those obtained during physical labor and hunting, and their alchemical means are quite sufficient to care for those needs. 

In Faninite communities, it is considered wise to have at least a few people trained in alchemy and first aid so that the community has reliable healing without having to rely too heavily on just one person; in smaller Faninite communities, it is fairly normal for most people to be trained in healing arts. Larger Faninite settlements might see closer to half of residents familiar with at least basic medical care. In Faninite communities, healers are highly respected, and it is incredibly common for healers from other cultures to employ Faninites as nurses and assistants.

Faninites in Evanoch are generally well-liked by most people, and for a Faninite who is grievously injured beyond what alchemy and first aid can do, it is not uncommon to seek a magical healer. Since assimilating into Evanine culture, some Faninites have taken to using magic, either as Clerics of Ehlonna or Warlocks of the Universe or of Dyzyq, both of which are close to traditional Faninite conceptions of spirituality. But for the most part, as stated above, Faninites tend to need medical care less frequently than other groups due to their simple, peaceful lifestyles. 

Dwarves 

Dwarves live hard lives in an underground city where cave-ins are not unheard of, where physical labor is taxing and constant, and where the way of life centers on worship of a good-aligned god--these ingredients combine to show why dwarven Clerics of Moradin are among the most impressive healers in all of Evanoch. With constant injuries and a deep connection to a god who would offer healing, it is perhaps only natural that dwarves would develop a strong tradition of magical healing. Talented dwarven Clerics who are amenable to leaving Underhar can make excellent money working as a freelance healer across Evanoch. Dwarven Clerics are known for their faith and devotion as well as the power of their healing.

Dwarven Clerics already have a remarkably high reputation among dwarves to begin with--as spiritual leaders, they are experts in a field that dominates public and private life, and Clerics of Moradin in particular often perform public service as part of their vocation. When these factors are combined with the countless lives saved by dwarven Clerics, the place of these healers becomes vital to dwarven society. Even outside of dwarven society, the reputation of dwarven Clerics is marked by respect and dignity.

Because there are so many dwarven Clerics who are so talented, dwarven healing has taken in less ideas from other traditions than it has lent to others. While many dwarven Clerics would have objections to teaching their ways to a person who didn't worship Moradin or another dwarf-approved deity, there are also many dwarven Clerics who have taken on the greater good and spread their skills by mentoring healers of other faiths and cultures; dwarves have a term for these dwarven clerics--orgundarn, or "shooting star"--and for their students--orgunraant, or "new star." 

Orcs 

With little nature to support alchemy, orcish medicine never developed a real consistent use for alchemical healing. However, a long history of war with the elves meant a large amount of serious injuries to contend with all at once. This meant a shift from the peaceful lives orcs enjoyed before contact with the elves towards a more defensive role, and orcs largely worked on preventing injury altogether to conserve the energy of their Clerics, who would be needed on the battlefield. Preventative work included improving the quality of armor (including making armor that was considerably better than the corresponding weapons), using magic to enhance armor, and defensive fighting tactics that allowed orcs to group together to avoid casualties. Injuries and sickness of a more minor nature would be the territory of the curtran, or wise woman, part of whose duties include some basic alchemy and magic for healing purposes. It is worth noting that sick or injured orcs are cared for by the whole community rather than simply turned over to a healer. 

Orcish Clerics tend to specialize in single-cast spells which heal a great amount immediately so that it can be used on the battlefield. This means practicing a great deal in order to access more powerful spells, which also means that these Clerics are free to use their lower level spells on protective magic. Many orcish Clerics have developed a method of casting healing and protective spells focused on the same person at once to turn a vulnerable soldier into an invaluable one. Orcish Clerics are some of the most prized in combat situations, and curtrans are considered respected healers apart from their already notable reputation as pillars of the community.

Orcs gained a great deal from other communities, perhaps most notably the Faninites and halflings, whose alchemical skills advanced orcish alchemy by a great deal. But at the same time, since orcish Clerical and other healing needed to be cast immediately, orcish healers have been able to teach the skills to instantly invoke healing magic, leading to more effective medical care across Evanoch and saving lives of those whose injuries are sudden and severe enough to require medical attention immediately.

Elves

Elven alchemy is quite advanced, using the exotic plants that grow in the mangrove islands where the elven lands lie, and most ailments common to elves can be treated with something made from the natural ecosystem. In terms of more serious healing, elven Clerics and especially Paladins tend to be called upon. This is truly also during times of war, where elven Clerics and Paladins (who receive more combat training and less magic training than other cultures' Clerics and Paladins) are compensated for their relative lack of healing by increasing their numbers; calls to be dedicated as a Cleric or Paladin are given special emphasis during wartimes. 

Elven alchemy, despite its advanced capabilities, has not caught on in the rest of Evanoch given very limited supply of the elven herbs used to create the alchemical products. Most non-elven alchemists regard elven alchemists are either overly specialized or pretentious or both. But amongst elves, reliable medical care for most ailments makes the alchemists quite respected. Elven Clerics and Paladins are known to spend peacetime serving as affordable healers at temples, and they too are regarded highly. Non-elven Clerics and Paladins tend to regard elven Clerics and Paladins as soldiers more than healers, though elven Clerics and Paladins are feared and reservedly respected amongst Daltoners. 

Because elves are capable of living such long lives, it is considered a great tragedy when an elf dies of a preventable cause. To that end, elves tend to maintain very healthy diets; they also often keep an array of alchemical supplements and cures on hand in order to treat things proactively and immediately. Because of this, elven alchemists tend to work in relatively large quantities, hoping to ensure that no one goes without care. Elven Clerics and Paladins sometimes patrol the streets of elven cities both to supplement the local guard and be available for emergency healing. 

Half-Elves

There is no real tradition of alchemy among the half-elves; being most concentrated in the city of Finiel, which is close to both elven and other lands, and on the road, where other lands are all around, most half-elven injuries are treated by people from other groups. It is true that some half-elves practice alchemy, and a fair number of the Paladins in Evanoch are half-elven, but generally speaking, half-elves treat medical issues and injuries as everyday problems which can be resolved rather easily by going to a medical expert. 

Part of half-elven handling of ailments is preventative like their parents, the elves; half-elves often maintain healthy diets and sometimes take herbal supplements for their health. Injury prevention is inspired by their Faninite parents in terms of trying to avoid injury in the first place; but while Faninites lead generally safe lives, being on the road can be dangerous, and surrounding oneself with allies, guards and mercenaries, and a healer can reduce that risk. It is also true that half-elves are known to use diplomacy with aggressors to defuse potentially dangerous situations. 

Because half-elves travel so much, they are actually the vessels through which much of healing science and faith has been spread across Evanoch. Half-elven caravans transporting goods, performers, passengers, and more have invariably included alchemical goods, healers, and medical experts of all sorts, whose methods and ideas have caught on at their destinations. So while half-elves have not added their own healing arts to Evanoch's healing community, they have been responsible for much of the cultural exchange that Evanoch enjoys today.

Gnomes

Gnomish healing is dominated by a scientific approach. Conventional alchemy is enhanced with scientific tools to create the purest and most concentrated cures and healing available to Evanines, marked by different physical forms--rather than pastes, gnomish poultices are powders which must be rehydrated with water, for instance. Gnomish nursing has also become top-of-the-line with advancements in anatomy and understanding of physical health. Gnomish Clerics, on the other hand, are relatively rare, as gnomes are more philosophical than religious, and since medical science is so advanced, there is little need for a large population of magical healers. 

Medical science among the gnomes has blossomed in part due to the medical branch of Vestry's massive university. Experts on biology, anatomy, botany, chemistry, and other sciences have been able to work together as a huge team for over a century to reach current understanding of medical science. Experiments have been run on the alchemical products of every culture to determine maximum possible efficacy, the herbs of each geographical region have been analyzed, and the physical bodies of all groups have been studied to ensure proper care in all circumstances. While gnomish medical science is impressive, gnomish scientists continue their work to perfect medical care. 

Gnomes have been diligent in showing improved methods of alchemical processes to different cultures, specifically using those groups' traditional ingredients and tools, thereby raising the average quality of alchemical work by a considerable amount. Meanwhile, Daltoner first aid and Faninite nursing were drawn on to create care standards, and the alchemical processes of the elves, orcs, and halflings to derive many gnomish standards for alchemical work. There is discussion at Vestry's university to begin studying magical healing after demonstrations by a dwarven Cleric. 

Halflings

Halfling alchemy is the finest in Evanoch, in large part due to the incredible rainforest ecosystem in which halflings live. This is perhaps a great benefit, as life in the rainforests of the halfling lands are very dangerous and filled with poisonous plants and venomous animals. Halfling alchemy, using the many and distinctive herbs in the rainforests, has cures and treatments for all of these as well as preventative cures that are popular with hunters and foragers. Because the are dangerous animals regardless of venom, such as the jaguar, boa constrictor, and cassowary, strong healing potions are especially common, and Clerics of Yondalla often consider it their duty to patrol commonly traveled areas in search of injured people. Clerics of Yondalla are powerful, focusing entirely on heavy healing and resurrection, though they are not quite so dramatically talented as the dwarven and orcish Clerics. 

Like the elves, the halfling alchemist faces a problem when dealing with a non-halfling alchemist in that many staples of halfling alchemy can only be found in halfling rainforests, which are relatively limited and which are dangerous to explore. This problem has largely been solved by halflings cultivating useful herbs in safe places, and halfling community values dictate that these are public resources--so while these herbs are not grown to be sold, there is more than enough of them to go around, and some can be exported to those in need of them elsewhere. Paired by gnomish alchemical science, this has meant a wide availability of high quality medical supplies. 

Many halflings have adopted gnomish advancements to alchemical methods, looking to create the most helpful possible cures and treatments, though some have resisted on the grounds that tradition serves best. Some Clerics of Yondalla, as well as some of Ehlonna, who is another common deity for halflings, have taken to studying with orcish and dwarven Clerics, mostly in terms of their relationships with their deities. Halflings tend to be less directly religious than most other groups, believing the gods are inscrutable, so learning the paternal relationship of Gruumsh and the devotion of Moradin are valuable for halfling Clerics in increasing their power. 



There you have it--a guide to the healing arts and abilities in my homebrew setting. To go behind the scenes for a second, I came up with the idea for this article a long time ago--probably over two years. As it would approach the top of my "to write" list, I would push it back down. It didn't seem like a bad idea, but I didn't really know how I could make healing into an entire article. Finally, these years later, I just committed to it. And I'm really pleased! Every group has something that they've added to collective understanding, every group's contribution feels true to the culture they come from, and every group's strengths help to explain why things like healers and healing potions are so ubiquitous in D&D. And now I can add some real color to situations involving medical needs. Someone gets a bad infection or poison or something, and they make a beeline for a halfling alchemist. You need a trustworthy Cleric at your side in battle, so an orcish or dwarven Cleric is who you hire. You meet a gnomish medical expert, and they start throwing terms around from every culture. These are good details I didn't have before, and just committing to writing this article gave that to me. As always, homebrew is often full of rewards if you're willing to make it happen. 




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