Modern medical sensabilities in a fantasy/historic setting

Before the discovery of germ theory, medicine was pretty gross. Unwashed tools, reused bandages, going from an autopsy to the delivery room, scraping gore from an amputation saw with the heel of a muddy boot.
The first guy to figure out hand washing ('invisible cadaver particles') was drummed out of the medical community.

Here's the question, Veeky Forums, how would explain a fictional pre-modern culture using proper medical sanitation? (This alone like doubles patient survival rates) I'm talking about (from easiest to hardest to handwave)
>washing hand
>bonus points for scrubbing with soap
>boiling or alcohol soaking instruments between use
>alcohol rubs on skin to be cut, then making sure you don't pick your nose during surgery
What kind of rituals or accidental discoveries could lead to even hand washing being widely accepted?
>also inb4 cure wound and disease are ezpz spells

In fantasy it's simple as fuck. A god of medicine that thinks a little further about the "how can I make my worshippers live a little longer and better?". Ingrains this mentality into them and boom.

Combine it with ancient beliefs about bodies and illness
>washing hands removes miasma
>alcohol and boiling drives away bad spirits
>religious cleansing rituals required by gods of health and healing
Things like that

Acceptable, but a little boring and without nuance. If the gods can be so direct why not simply shield their followers from germs?

I'm thinking something more like this
>civilization offers burnt sacrifices
>rend soap from the fat
>this is now sacred soap
>people come to priests to inspect sickness and offer blessings
>immediately before AND after, the priest will pray and do a ceremonial washing with the soap
>gee, the priest doesn't get sick
>midwives start to emulate this, being the first to bring a new life into the world and the first to pray for them
>infant mortality plummets
>doctors, surgeons, and barber's all wash their hands before touching things

But that's just hand washing, maybe tool washing with cold soapy water. And that narrative only works for a bronze age type setting.

>gee it seems that when people drink water they get sick
>but beer, stew, and tea is fine
>after extensive testing and dysentery, it seems it's BOILING that cleanses the water of whatever filth resides within it
>perhaps it will work on the doctors tools as well
>seems plague is spreading less now
>the leeches, however, did not fair as well while being sanitized..

>Boiling beer
Is this an actual part of brewing?

I don't disagree. It's simple tough and it's pretty easy to justify the gods not casting Cure Light Wounds 24/24 because limited powers.

Your idea is more interesting, not gonna dispute that

>bronze age only

Naaaah, can be tought for later periods

The first step in brewing is boiling the water and malted grain mash (known as the wort, typically made with barley).

>after extensive testing
And right there you've gone beyond the mindset of a premodern society.

You have to realize, the scientific method had to be INVENTED. It seems intuitive to us today that if you want to figure something out you do a whole lot of testing by methodical trial and error, but that's only intuitive to us because we've been immersed in it all our lives.

Which isn't to say that premodern societies didn't study or experiment at all; they certainly did practice observation to learn about things, and try things out to see if they'd work. But it didn't rise to the level of "extensive testing" because it simply didn't occur to people that there was much to be gained by that degree of rigor.

>bronze age
I was thinking because of the animal sacrifices. If your fantasy church still incorporates burnt sacrifices, then you're right.

Or it's the not!catholic church then just say some bored monk figures it out, then traded notes with the monks who discover literally all the other scientific things monks figured out in their spare time.

Clerics and healing spells are a pretty good replacement for modern medical knowledge.

Ancient Egypt and China both worked out that washing your tools regularly and regular, almost ritualistic, proper body hygine were directly linked paitent health.
There is a thirteenth century manuscript written by a doctor on delivering babies which called for washing hands in water that had been boiled. Also said that pregnant women should drink nothing but boiled water. Not even alcohol.

Whilst Dr. Ignaz Semmelweis became famous for his dogged approach to hygine and washing of hands and tools in fresh lime solution, he wasn't the first to make the connection, just the most vocal. Also being so very recent, better records were kept.
Also, Semmelweis wasn't universally laughed out. Many doctors across Germany were willing to follow his advice if for no more purpose then it couldn't do any worse and also Vienna General Hospital, where he worked, followed his instructions and when they saw it worked, kept at it and became supporters of him.

Well, in this scenario they probably got at some point that soap is good anyway and use it anyway, without the sacrifices. They might think of it as a ritualistic thing, but it's not a given.

OP here. Learn something new every day. Thanks for proving Veeky Forums really is the only board you ever need.

Wasn't that the joke when vikings would bathe more often then Chinese? Because yeah that was a thing

If you want to know about how ancient medicine worked, check out the Hippocratic Corpus. I think the neatest one is "Airs, Waters, Places" but they're all pretty cool.

There's fascinating things in there. They got about as close as you can get to germ theory without having microscopes.

There's also a neat thing in Thucydides where he noticed acquired immunity existing during the Plague of Athens, but it doesn't seem like doctors picked up on it in his time.

Medicine is handled by priests.
Cleanliness is next to godliness, so their medical practises are typically clean even if they don't directly relate it to germs.

The way it works in my setting (which is extremely low fantasy) is that sometime, somewhere, a surgeon noticed that clean tools and clean hands led to fewer deaths. He experimented with different methods before finding one that worked best.

No one in the setting knows why these work, just that they do. It's still a far cry from modern medicine, but at least your chances of getting an infection from wounds and dying from it are comparatively lower.

You could always prescribe it to religion. Judaism has a bunch of sanitation rules, from handwashing to kosher laws, and it even helped them keep clear of the Black Plague. Soap has also always been a thing, Gauls and Germanic peoples making soap even in Roman times, and Nordic peoples were all about bathing once a week instead of once a month.

I kind of like sticking to real world levels of backwardness.

1. You get to horrify the players as healer stick dirty fingers in wounds to probe them
2. In "Conneticut Yankee" settings it give the players one more thing to add to try to improve the setting.

Depends on how widespread the magic is.

Might be fun to have plagues routinely cured by calling for more priests. Maybe add scary magic resistant diseases.

Imagine if there's just one low level cleric, for like three moderately spaced away hamlets. And he has like, two, maybe three castings of cure minor wound. Suddenly the doctor looks like a more viable option for cuts, colds, and tooth aches. Now for something like being kicked in the head by a mule, or a mangled limb, a doctor would still be useful for stabilizing a patient until the cleric made his rounds.

>>gee, the priest doesn't get sick
This is actually why the egyptians wore that eye-paint thing-
Because the priests of horus did that first and they didnt get sick (I dont remember what sickness it is good for though)

Just worked out that way. For us, it didn't work out that way, it took a while. To make your fantasy world easier, it happened faster.

It's a made-up game of pretend.
I don't need to explain shit.

Eye infections caused by irritation of eyelids by dry air and sand. Superpopular in Egypt for pretty obvious reasons.

I've got a better one: in medieval Europe beer was considered a perfect drink during plagues, since people drinking it were rarely getting sick of cholera. For us the explaination is simple (making beer demands boiling the water, thus making it clean), but they were just knowing the final result.
Galen (you know, THE most influencial guy in European medicine in pre-modern times) noticed that gladiators he's patching up won't get infected if he poured wine over his tools. He didn't know why it worked, but it worked, so a FUCKLOAD of recipes for medicines invented by Galen (they are still used to this day and still effective and not even as alternative medicine - you fucking study this shit when making Pharmacology degree, so go figure how good this guy was, all things considered) against infections and similar ailments are based on wine. Of course he neither knew anything about sanitising things with alcohol nor the effect of ethanol on extraction of chemical compounds from plants, but hey, it worked and worked for real, rather than assumption it should work.

Water and fore were seen in a religious form as symbols of purity and cleansing, so add a religious connotation to the cleaning equipment suvh as instead of a annointment with oil before a ritual the patient is annointed with a spirited alcohol held in high regards for its spiritual and physical purity. Hell priests today wash their hands while saying a blessing with water. And priests in d&d are regular healers so why not