Medical School Handbook

Scorps · Jun 28, 2016

Medical School Handbook

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General Classes:

Advanced Classes/Medical Specialization: (*)

Miscellaneous Links:

Scorps · Jun 28, 2016

Iryō-nin (Medical Ninja)

A medical ninja is a ninja who has learned to make use of Ninjutsu and related skills to provide medical treatment to others. It also encompasses those that, using that knowledge, have enhanced their own combat abilities.

In Naruto Manga, fields like Kinjutsu, Fuuinjutsu and Poison techniques are deeply rooted into Medical Knowledge. Orochimaru is a fair example of how Medical Knowledge can be used to achieve greater power but he isn't the only one.

In Narutobase RPG, the medical ninja is capable of healing others and himself, cure poisonings, enhance his sealing knowledge and skill, develop his regenerative abilities and even learn to use poison techniques in combat.

Medical Ninjutsu is not unlike regular ninjutsu where you use your chakra to achieve effects that you would not be able to otherwise. Most Medical Ninjutsu techniques, however, are deeply rooted into Yang Release and make perfect use of Physical Energy.

Homework:

Students need to write a small text where they explain what chakra is, how it works and how the human body relates to chakra in narutoverse.

Scorps · Jun 28, 2016

Shindan (Diagnosis)

A Medical Ninja needs to start somewhere and that somewhere is detecting the issue with your patient. Shindan or diagnosis is the first step in treatment; understanding the problem. With this skill you use your hands to carefully probe a patient for problems that you might not be able to see. Contact with the patient will initially be needed but with time becomes optional. Despite this, you'll always need a close proximity between your patient and your hands. This technique is preformed by approaching the patient and slowly running both hands over his or her body, using your chakra to examine the body and looking for signs of injury that may not be visible to the naked eye. It can detect any physical alteration to the body (internal or external wounds, lesions, tumors, fractures, diseases, etc) as well as its composition (glucose levels, iron levels, antibodies, etc ) and vital signs (blood pressure, heart rate, temperature, pain levels, breathing, oxygen saturation, etc).

A student of Medical Jutsu will require several minutes to assess all the details but a medical ninja will be able to do so in mere moments. To help less experienced ninjas or to aid in complex cases, direct contact is often used as well as chakra transmiting mediums such as water, wood, etc.

Mental injuries such as psycosis, depression, bipolar disorder, etc can be determined as well. In this case, however, scanning the patients head is necessary. By scanning the various hormones, chemicals as well the electrical currents that make up the inner working of the brain, the medical ninja can detect any inbalance and to what it might be due. He cannot read minds but he can understand if there is a disease or a Genjutsu present.

Additionally, all medical ninjas can use this skill to sense the patients chakra flow. Its by sensing the chakra flow that most of the times injuries and disease are noticed and diagnosed. Ninjas have their physical being greatly intertwined with their chakra, making so that an injury in one will result in changes to the other.

Finally, after gaining mastery over medical jutsu, a medical ninja becomes even able to examine dead bodies, determining cause and time of death.

Let me just explain how Shindan works a bit better, for everyone.

The idea behind it is that you will send your chakra through another body (your hands are the main focus here and its through its tenketsu that you'll release the chakra) and then will it to return to you with the information you need. That means that it doesn't matter whether you will touch the person or not or the location of your initial scan at all; the chakra will find the root of the problem and the manifestation of it. This is the information you require.

You can use chakra transmiting mediums, such as water, to improve you diagnosis and its effectiveness. The easier it is for your chakra to enter the body of the patient and return, the more information you'll be able to attain.

Now, to achieve this you need advanced chakra control and practice. Too much chakra and you risk harming the patient. Too little and you might not get enough information out of it.

What skills, KGs and abilities might help the medical ninja in this procedure?

Any advanced sensory enhacement helps the ninja adquire information in a more detailed manner, faster and without needing so much time. The main examples are:

-Sharingan: the ability to see your chakra flow and is characteristics as well as the ability to gain advanced visual perception in general helps to better identify the issues with the patient.

-Byakugan: perhaps the most useful of all the abilities that can help a medical ninja, the Byakugan allows you to see inside the body, piercing through the flesh and looking at the core issue in detail. Additionally, because you can see the chakra circulatory system completely and in detail, you can gauge the extent of the damage and if it somehow has anything to do with his chakra flow.

-Chakra Sensing: As said above, most injuries and diseases affect the chakra flow. By being able to sense disturbances in the chakra flow of your patients you are able to better understand their nature and extents.

-Enhanced Hearing: This can help you better evaluate biological functions such as breathing, heart function, intestinal function, blood circulation, blood pressure, etc.

-Emotion Sensing: While we talk about injuries of the flesh, the medical ninja also needs to treat injuries of the mind, often associated with Genjutsu. To better do this, sensing the emotions of your targets might help greatly.

Training and Lessons:

-Basic Chakra Control. Teach the students how to focus enough chakra in their hands without doing harm to their patients. Start by making them focus chakra in their core and then move their chakra around their bodies. Make sure they describe everything carefuly and in a detailed manner.

-Injure one student in some specific way and have the other student try to diagnose the extent of the injuries and what they represent. Switch when satisfied.

Scorps · Jun 28, 2016

Teikouryoku (Power of Resistance)

Before one can treat patients, one needs to protect himself. In real life, medical staff use gloves, masks, etc. But for a Medicla Ninja in a battlefield, thats not pratical. A Medical Ninja must always be aware of becoming a victim of whatever their patient is suffering from so he needs resistance to disease. With this skill you, as a Medical Ninja, increase your natural resistance to most natural diseases and toxins as well as most manmade diseases and poisons, allowing you to threat an infected or poisoned patient with a higher safety. It has no effect on diseases or poisons already affecting you though. This skill, as all others, improves as you grow in power and affords greater resistance to a wider range of diseases and poisons and can become something that you don't even need to focus to achieve.

However, there are limits. This skill will essentially provide a boost to your natural resistance to disease, poison, toxins, acids, alkaline substances, etc but will only basically provide a "shield" of sorts around you. This shield can be overcome, like all others, by overpowering it. This essentially means that you cannot use this to defend from enemy offensive techniques in the misdt of battle.

If you decide to and gain Poison Mastery, allowing you to make your own Custom Poison and mastery that branch of medical arts, this skill will allow you to become immune to regular none custom poisons and to your own poison.

How is it performed?

Now, to do this, you need to focus on your chakra at its core. This, when you look at the chakra circulatory system, is the central spiral network of chakra paths thats surrounds your chakra source, normally located in your abdomen. When you focus on it, you need to visualize a growing yellow and warm aura, spreading from your core, outwards towards your skin. Its this focus and this will that will make your chakra passively aggressive towards pathogens and most natural toxins and infectious diseases. This chakra is invisible to the naked eye and doesn't go beyond the users skin. However, doujutsu might see the aura growing and expanding from the medical ninjas core.

Its this a technique?

Teikouryoku is not a technique, has no chakra cost or is otherwise performed in any way remotely similar to a Jutsu. It is a passive skill, much like diagnosis, taught in the medschool, that gets stronger with time; the more you work with it, the better it will protect you against contagious diseases and poisons.

Are there different stages to its effectiveness?

Yes.

Medical Student: can maintain this skill active for a few minutes, enough to treat a single patient but needs effort and to will it to happen. Its impossible to keep active at all times.

Medical Ninja: the skill can be active for as long as he wishes and he doesn't need to dedicate any kind of mental command or focus for it to work.

Poison Master: Not only is the skill the same as the one for regular medical ninjas as it can protect the user from his own Custom Poisons and similar techniques (for example, toxic/poisonous/venomous elements) at all times.

Training:

Attempt to increase your resistance.

Scorps · Jun 28, 2016

Kiyomaru (Cleanse)

As you might imagine, it is not always possible for a medical nin to practice basic hand washing and especially using an antiseptic to disinfect his/her hands. This technique has the effect of instantly removing bacteria, dirt, blood, and other contaminants from the users hands, lower arms, and face. It also insures that any breath that comes from the users body will be free of any bacteria or infectious disease. This technique can also be used to clean the wounds of others in order to prevent infection from bacteria.
Of course in the event that the medical nin is in need to use this technique to prevent infection of an injury that has been inflicted upon him-/herself, it is used as if the shinobi were using it on somebody else.
Now to the actual how to; as I implied above, our complete skin, and most of the mucous membranes are constantly covered with bacteria.. and other microbes. The only thing stopping those microorganisms from causing a disease is the fine balance of them and our physiological protective flora. The best way to describe this better is to give an example: our intestines are covered with millions of microorganisms, and when you get sick (like a cold or something) and you have to take antibiotics for whatever caused the cold, you actually disturb the physiological protective flora of your intestines, and therefore pathological bacteria prevail, and with their tocsins they start damaging the epithelial cells of your intestines thus causing diarrhea [this is for real btw. and I'm sorry for straying away that much lol].
You, with your chakra, can very easily disturb such a tiny energetic system. In order to make your chakra so aggressive you simply visualize how it starts being more agile, warmer and idk.. whatever you think of when you think "destroy >.<". Then you start sending it out from your palms, and while doing so, you simply run your hands over whatever you want to disinfect, be it your arms, face, or the patients wound (requires a different jutsu, since you have got to be careful not to disturb the actual patient’s chakra system). Once the bacteria’s energy system is disturbed, it simply dies because it's membrane starts failing and can no longer keep water inside, and so it dries out.

The method for cleaning yourself:

(Iryō Ninjutsu: Kirei Tomo) Medical Technique: I clean all of me
Type: Supplementary
Rank: C-Rank
Range: Short
Chakra Cost: 15
Damage Points: N/A
Description: The medical shinobi fills his palms with small amounts of extremely aggressive chakra and runs them over the areas of his body he wants to clean of any microorganisms, harmful substances, etc. The chakra will eliminate any inert harmful substance or microorganism present on that area. Normally this technique is done on the hands and lower arms just before having contact with a patient but can be applied to the whole body in specific situations (before performing surgery, if the enemy is highly contagious, etc). After being done, the chakra automatically turns back to his regular, non-harmful and calm one.

For cleaning someone else:

(Iryō Ninjutsu: Kirei Itto) Medical Technique: I clean all of him
Type: Supplementary
Rank: B-Rank
Range: Short
Chakra Cost: 20
Damage Points: N/A
Description: The medical shinobi fills his palms with moderate amounts of semi-aggressive chakra and runs them over any areas of the patient’s body he wants to clean of any microorganisms, controlling the chakra flow constantly so it doesn't becomes too lethal. The area affected is 4 times the area of the users hands. After being done, his chakra automatically turns back to his regular, non-harmful and calm one.

FAQ

Imagine I have access to pathological microorganism... let's say, hypothetically, fungus. How does the rank of these techniques interact with them? Is Med Nin stronger, double stronger, equal? And how would this technique interact in other types of battle applications? What about...lets say I have a mud jutsu, or a dirt jutsu, can I use this technique to coat my hand and body and neutralize it? Is this the same as basic ninjutsu in terms of power? For example, if this was raw ninjutsu, and, thus, weaker to elemental techniques, I'd be able to use it to neutralize a D rank lightning, allowing me to touch electricity, even if momentarily. If it's the same as strong raw ninjutsu, like the hyuuga rotation, then it would be neutral to elemental ninjutsu, so I'd be able to walk through D rank fireballs and the such, like a sort of body armour, as I have my body coated in chakra.

They are equals. Lets use Medical Ninjutsu: Strong Beam as the example.

(Iryo Ninjutsu: Tsuyoi Kōsen) Medical Ninjutsu: Strong Beam
Type: Offensive
Rank: A-Rank
Range: Short-Long
Chakra: 30
Damage: 60
Description: A high level medical technique in which the user gathers medical chakra, akin to the Shosen Jutsu technique, into his index and middle fingers, forming a dense chakra focus point. This chakra quickly changes from a light, translucent green to a heavy, bright red color as the user points his fingers outwards, unleashing a powerful chakra beam. The chakra beam, however, has different properties from normal chakra and, unlike the technique which serves as its basis, has no healing effect, quite the contrary. If it hits an enemy living organism, its aggressive nature injures the targeted tissues, creating an effect similar to a severe burn. The cells burst open as if having been hit by a high temperature, reducing themselves to a mushy pulp as the beam travels through them. If undefended, the beam can easily pierce through an enemy in a fast manner. The travelling speed of the beam is akin to that of a similar ranked lightning technique. The down side of the technique is that, when it collides with an elemental technique, it acts as a simple, concentrate chakra beam, capable of overcoming B-Rank defenses and only being negated by A-Rank ones.

That also accounts for all medical techniques, they are equal in terms of power and, just general everything. However, these techniques, their design is to clean all of him and you. They are mainly just used to kill microorganism/bacteria. They don't really have many battle applications. Sure, one can be inventive and try to find them but its likely that you can do the same in a better way with other techniques.

Can these be used to desinfect instruments and weapons from poisons and toxins?

Yes and no. Simple pathogens and microorganisms, etc. Poisons, no.

Training:

-Make the students clean themselves and their fellow students. Evaluate their descriptions carefully.

Scorps · Jun 28, 2016

Tekishutsu (Extraction)

One of the most common things to happen to a ninja is to get a foreign object lodged somewhere in his or her body. Normally, this poses an issue as these objects tend to be weapons which are normally designed to inflict even more damage when forcefully removed from your flesh. Medical ninjas, however, can use this skill to, in tandem with other skills you'll learn like blood coagulation for example, remove an object lodged in a body without further damaging the tissue around it. So, when a patient's body has a foreign object in it, such as the point of a shuriken, a senbon needle, or an arrow, it is important to remove the object without further harming the patient. Using this technique the Medical Ninja places their hands on either side of the injured area and uses chakra to very carefully manipulate the surrounding tissues in order to remove the object without causing any further damage. Depending on the severity of the wound and nature of the object, it can take anywhere from a few seconds to a few minutes to remove it.

Training:

Remove various foreign objects from your partner (wood splinters, kunais, senbons, etc)

Scorps · Jun 28, 2016

Kuchiyose No Jutsu (Summoning Medical Tools)

A medical ninja, regardless of his skill, will always face situations in which he'll need medical tools to treat patients. Be it to create antidotes or medicine, but to also stitch or bandage wounds, you'll always need to make sure you can access medical tools and supplies to treat patients.

*Hands out a scroll to each of you*

This technique allows a Medical Ninja to summon some of the tools of their trade. It is not practical to carry around syringes, scalpels and other tools but a scroll that can be used to summon these and other similar objects is both practical and convenient.

So as for any good summoning jutsu, you need your blood and a few kanji which you can all find in your scroll. You are expected to carry it with you at all times. It includes:

(Kuchiyose No Jutsu: Eisei Yougu) Summoning technique: Medical tools
Type: Supplementary
Rank: B-Rank
Range: N/A
Chakra cost: 20
Damage: N/A
Description: The medical Ninja will bite his thumb and do the summoning handseals before pressing his palm on the scroll. He will summon any of the medical tools he needs that are listed on the scroll, all or just one, depending on his own needs.
Note: This can only be used by Medical Shinobi.

メス - scalpel, sterilized
ナイフ - knife
アルコール - a bottle of 96% ethanol for disinfection
水 - a bottle of sterilized water
スポイト - syringe, sterile, for one time use only
アドレナリン - adrenaline, to be injected intravasulary, induces faster heartbeat
包帯 - bandage, sterile, 8 meters in length
血液 - a set of everything you need to draw someones blood (Sterile syringe, vacuum system and a test tube.)
温度計 - mercury thermometer, for axillary or rectal use
ベッド - a mobile bed to carry patients
バグ - bug spray, effective against all bugs, lasts for 2 turns (used in cases when your patient is having a reaction to multiple bug stings, and there are still some bugs around it, so you spray-kill them. Kills bugs up to A rank if they've been created/summoned from a jutsu like the Aburame techniques)
テント - a small tent, just enough for two people to lie in
光 - a flashlight
ガスマスク - gas mask with a bottle of oxygen that lasts 5 turns (Not 100% effective against all types of poison/gas. The purpose is to protect the user from breathing in toxic substances, keeping the lungs safe. However, if the poison gets absorbed through the pores of the skin it will still affect you).
流体 - a set to start an intravenous fluid addition line, helpful with dehydration amongst many other conditions
モルタル - mortar and pestle, chemically clean
スプーン - spoon, sterile
パテ - putty knife, metal, sterile
研究所 - a small tent. Into the walls of that house, parts of Nexus' eyes DNA have been inserted, so now it mixes Time And Relative Dimensions In Space , creating an effect of being larger on the inside then it is on the outside. Inside is an advanced ninja laboratory with everything needed to create antidotes and medicines.

Homework:

Pick 3 medical tools and explain how they can be helpful to you as a medical ninja.

Scorps · Jun 28, 2016

Keksuki Gyouko (Blood Coagulation)

This is a fairly simple healing skill that takes a single turn and costs no chakra. The user uses his chakra on a wound to make the blood there coagulate and stop bleeding. This is primarily used as a preliminary treatment option as it does not close wounds. The bleeding from superficial wounds can easily be stopped while we're at it, but deep wounds and "blood leakages" can require several minutes to stop, or can't be stopped at all; meaning simply you can't stop every bleeding, sometimes it takes surgery or so larger scale procedures. All in all, this is ideal for superficial wounds - doesn't requires much work, but stops the bleeding.

Although most of you covered the basis, I cannot correct each of your works individually pointing out what was missing or not so I'll simply make a small concise explanation of what I want you guys to know.

The Coagulation process is one of the most basic but yet complicated processes of the human metabolism (and all animals with blood). In simple terms, its the process through which blood becomes thicker and ultimately solid (cloth) if necessary; its the process through which blood thickness is altered. Taking this basic idea, Blood Coagulation is often dispicted as a stagnant occurrence, triggered only when a trauma occurs and hemostasis is needed.. However, its beyond that idea and is actually an active process constantly changing and balancing the blood's fluidity.

Its a simple idea, although the process itself is complicated. The blood, as a fluid, tends to escape the pathways through which it circulates. These pathways are the blood vessels (arteries and veins). Blood vessels have, inherently a given permeability to enable exchanges between the blood and the cells on the outside of the vessel. The coagulation process serves as a basis for these exchanges to work and is constantly adjusting the blood fluidity in order to keep it flowing in a correct way, containing it in the vessels but maintaining circulation. If the blood is too thin and fluid it will escape the vessels and a passive hemorrhage occurs, disabling the normal exchanging process. If the blood is too thick, it will form cloths, clogging the blood vessel and preventing circulation (trombosis).

This is the process that keeps working 24/7 on adjusting the blood in order for the human body to work and is an automated passive process of our metabolism. Many factors revolve around them and I don't expect you guys to know them all obviously. Vitamin K, Platelets, Fibrogen, Colagen, Water, Ionic Concentrations, Genetic Intrinsic Factors (also named often the coagulation factors), etc all play a part in keeping the passive balance in order. However, this process serves another purpose, which is the main one for our application here in Med School. If blood vessels are ruptured, the blood spills outside of them and a traumatic hemorrhage occurs. Because blood is one of the core participants in the metabolism, the organism can't afford to lose too much of it, so it has to stop the bleeding. This is done through the hemostasis process, a process through which blood is used to produce a cloth of platelets and fribin in the rupture, stopping the bleeding and enabling the repairs to start.

Coagulation works through 2 main factors: The Cell Factor (platelets) and the Protein Factor (Coagulation factor). Basically and resuming it way down since I only want you guys to hav an idea of it, not all the medical details, when a tissue is ruptured and cells are damaged, a special batch of proteins are scattered throughout the wound and surrounding area (they are released as a byproduct of the traumatic destruction of the cells and celular tissue). When the blood comes in contact with these proteins, the platelets and a special protein in the plasm (the "water" base of the blood where all the nutrients and minerals and etc are transported) called fribrogen changes and immediately the primary hemostasis occurs, as a "tampon" of aggregated platelets forms at the rupture, stopping the bleeding. At the same time,the secondary hemostasis ocurrs, through which a complicated chemical and physical reaction ocurrs in the proteins in the plasma, triggering a cascade of reactions that has the byproduct of producing fibrin strands that strengthened the platelet "tampon" and form the definitive cloth. These proteins in the plasma and the cascade reaction of them is the process through which blood becomes thinner or thicker, by the presence of more or less fibrin and its thicker or thinner structure. Fibrin is a thick and gel like protein that combines with water to give plasma its main body (and through more or less "gel", more or less thicker it becomes).

Okay, so, with my explanation and while writing your homework, you all learned (hopefully) what's the basis needed for blood to coagulate. This technique and the procedure around it doesn't makes it do so, and there is nothing you can do to make successful blood coagulation occur, because it is simply too complicated and has too many factors involved. What you can do, however, is help the body while it's trying to do it on its own. This implies that the patients blood has to be able to coagulate on its own already, meaning that all coagulation factors must be present and functioning in his body, he has to have blood, etc. This means that you simply make your patients blood coagulate faster than normal by aiding it with your chakra.

You do so by laying your hand on the wound and infusing it with your chakra, molding, willing your chakra to be of a certain nature that will help the body in the coagulation process; and you do so by simply imagining the chakra how it goes to the blood vessel and starts sticking fibrin and blood platelets together over the damaged area. Pretty simple and doesn't count as a move or requires a technique.

Are there any questions?

Homework:

Explain how blood coagulation works in your own words and how it relates to narutoverse, chakra and a medical ninja's role.

Scorps · Jun 28, 2016

Chishio Tensou no Jutsu (Blood Transfusion Skill)

Loss of blood is a serious condition, and a not very uncommon one in the shinobi battlefield. When a person reaches such a dangerous state, a Medical Ninja can ease their symptoms by using this jutsu. First, the medical nin places a surgically precise cut on the patient and then another cut on the donor. The donor and the recipient must have their respective cuts within six inches of each other; this is typically accomplished by cutting their opposing arms and having them lay beside each other. The Medical Ninja then forms a sphere of chakra between the two cuts drawing out blood from both patients and altering it so that the blood type of the donor matches that of the recipient. It is important to remember that taking more than 1 pint of blood from a donor is extremely dangerous, even with the loss of only 1 pint of blood the donor may suffer from dizziness and fatigue.

The Technique:

(Iryō Ninjutsu: Chishio Tensou no Jutsu) Medical Technique: Blood transfusion Technique
Type: Supplementary
Rank: A-Rank
Range: Short
Chakra Cost: 30 (per turn)
Damage Points: N/A
Description: Once the Medical Ninja has a donor (a willing one or not), he or she makes two small cuts, one on the patient, and one on the donor, placing them side by side so it is easy to put those cuts about 30 cms apart. Then the Nin forms a chakra orb which then transfuses the blood from the donor to the patient. The technique requires high levels of chakra control and can even change the blood type of the donor to match that of the patient.
Note: It transfers 400ml of blood per turn

Homework:

The homework for the class is to write a small description and explanation of blood loss and its effects on humans, namely in narutoverse context. You'll be graded in how you can join real life logic with narutoverse logic.

Scorps · Jun 28, 2016

Ondochousetsu (Temperature Control)

The normal body temperature (which varies between 36°C and 37°C, or 96°F and 98,6°F) is a very important aspect of the body, because when the temperature is other then normal, the organism can't work properly (the more it deviates from the normal values, the more the metabolism gets hindered). Normal temperature is needed for all enzymes to work properly and all proteins to exist in their normal state (non denatured, denaturing is a process where the structure of a protein gets irreversibly destroyed and the protein becomes unusable).

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Homework:

Questions (Answer these after reading the article):

-Which part of the body initiates the increased tempreature, and how does it happen (On the cellular level)?
-Why do we get fevers?
-Why do we feel chills after getting a fever?
-Difference of a Bacterial and Viral induced fever?
-Difference between 'Hypothermia' and 'Hyperthermia'

There are many factors that can disrupt the human bodies temperature; environmental exposition, internal processes (infection, reaction to a poison, etc) or maybe chakra dis-balance. Even extreme physical exertion can destroy enough muscle to trigger an inflamatory rection that will trigger fever. There are various ways to regulate body temperature based on it being high or low, the cause and how far it has risen or dropped. In this skill, you'll learn a few techniques that serve to lower or raise the body temperature. However, this effect is temporary. You'll need to tackle the condition that triggered the change in body temperature and, when that takes time, you'll need to add medicine to help keep the temperature controlled.

Basically, there are two ways this can go: your body temperature will either be too hgih or too low:

Hypothermia occurs mainly due to environmental influences (i.e. when someone isn't dressed appropriately, when someone falls into cold water, gets buried in by snow etc.), internally it can mean damage to the TRC (look below for what that is) or it can also be caused by overuse of the temperature lowering techniques I posted below; and that is why I made that chart, and that is why you have to learn the values .
To counter hypothermia itself you can proceed in 2 ways; one would be using fire chakra (to heat the patients body, not to burn it!! be careful) or to use this tech:

(Iryō Ninjutsu: Rinkai Roppou) Medical Technique: Temperature rise
Type: Supplementary
Rank: B-Rank
Range: Short
Chakra: 20
Damage: N/A
Description: The user will place both of his hands on the patients body, and insert a fair amount of his chakra into the patient. He or she will then will/make the chakra affect the heart (fastening the heart rate), the blood vessels (constricting them rising the blood pressure) and the thyroid gland (inducing faster release of hormones that enhance the metabolism). As result the body temperature will rise to 37°C (or 98,6°F).
Note: user must be a master of Diagnosis

Sub-febrile temperature is, in most cases, just a symptom of a rising infection/upcoming illness. It is important to not lower this temperature because it actually helps the body fight the disease! The rise in temperature is caused by the body in a complicated way, but I will try to simplify it a bit in a few steps:

1. An infection or a strange substance triggers the detection/production of an antigen (as viruses, bacteria, poisons etc.).
2. The antibodies react to the presence of that antigen by attacking it, but first they release mediators. Mediators (histamine for example) are chemical substances that notify the entire organism of the presence of an antigen.
3. Mediators reach the center of thermal regulation (which is located in the hypothalamus) and signal that an antigen was detected.
4. As a result, the TRC (thermoregulation center) rises up the temperature by more or less 0,5°C (that is about 0,9°F) by sending off hormones that tell the pituitary gland to release the TSH hormone which controls the thyroid gland, which in turn releases T3 and T4 hormones which enhance/speed up the overall metabolism of the person, which, in turn, is what is really needed to achieve the rise in temperature. Temperature rises by increasing blood flow, metabolic functions and by burning calories. Shivers, for example, are a way for the body to use the muscles to burn calories through involuntary movements which in turn produces heat.
5. The slight rise in temperatures activates more and more antibodies and enhances their performance as well as further increasing blood glow and circulation which then further increases the response of the organism.

Febrile temperature comes in place when the previously mentioned antigen continues to be produced as a result of a resulting infection, so more and more antibodies get released which in turn release more and more mediators, which then make the TRC go berserk and it totally looses its sense of normal temperature. When this happens, the temperature isn't optimal for enzymes and antibodies in general anymore, and they loose their effectiveness, therefore the effect of sub-febrile temperature is negated, and the state is useless or more often dangerous because at a point the antibody stop working altogether. This is when you need to start lowering the temperature, and you do this by using this technique:

(Iryō Ninjutsu: Rinkai Umou Seppan) Medical Technique: Gentle Temperature Ease
Type: Supplementary
Rank: B-Rank
Range: Short
Chakra: 20
Damage: N/A
Description: In order for this jutsu to take effect, the user must somehow have contact with the earth; be it actual ground or a mere pot filled with earth. The user places his dominant hand on the patients chest, and the other hand on the ground/earth. By activating this technique the user takes excessive temperature from the patient, guides it through his body and releases it into the earth through his other hand. This relieves the temperature of the patient by 0,8°C (or 1,4°F) per use until the patient's temperature is 36ºC.
Note: If unable to guide the chakra into the ground/pot of earth, then the users temperature rises for the mentioned amount

(Iryō Ninjutsu: Rinkai Umou Mattou) Medical Technique: Complete Temperature Ease
Type: Supplementary
Rank: A-Rank
Chakra: 30
Damage: N/A
Range: Short
Description: In order for this jutsu to take effect, the user must somehow have contact with the earth; be it actual ground or a mere pot filled with earth. The user places his dominant hand on the patients chest, and the other hand on the ground/earth. By activating this technique the user takes excessive temperature from the patient, guides it through his body and releases it into the earth through his other hand. This relieves the temperature of the patient by 1,6°C (or ~3°F).
Note: If unable to guide the chakra into the ground/pot of earth, then the users temperature rises for the mentioned amount

Make sure you don't lower the temperature too much (below sub-febrile) because you want that effect it gives, but then again you need to lower it enough to not be dangerous anymore. You'll perfect this with practice .

Very high febrility is when it becomes lethal. The temperature is now higher then the protein structure can stand, and they begin to disintegrate, denature and become useless, this means actually tissue is dying off! And of course, the most effected by this is the brain. At this moment don't think about getting to the optimal temperature, lower it by any means necessary; be it water jutsu (of low rank, you don't want to hurt the patient) or even ice jutsu. Of course you can not use a jutsu and got for the old fashioned way of putting him/her in a bathtub full of ice cubes. Your main goal is to save life here!

This has some cientifical knowledge here but the main aspects to rettain for NB RPG are these:

-All large wounds and trauma will always induce fever due to either the inflamatory reaction to the tissue destuction or the infection caused by large open wounds.

-Toxins, Venoms and Poisons will always rise the body temperature before dropping it abruptly unless its defined in the toxin, venom or poison description as otherwise.

-Blood loss will always lower your body temperature and bring about a state of hypothermia, severe or not.

-Chakra depletion will lower your body temperature.

Scorps · Jun 28, 2016

Kigusuri Souzou (Medicine Creation)

Any medical nin naturally studies the effects of various naturally occurring compounds on the human body and how they can be combined in order to create medicine. In spite of increased knowledge of medical techniques there are times when mixing a medicine is the only solution to a problem. Medicine creation has a variety of uses, such as creating poison antidotes, healing ointments, and disease fighting but is a key aspect of sympton management. Medicines can also be used to treat minor every day ailments such as an upset stomach or cold.

A young nin using this skill has only rudimentary knowledge and often requires a small guide in order to find and create basic medicines. A more experienced ninja will know how to prepare a medicine for any normal injury, poison, or disease.

In the past lessons you have learned how to summon medical tools, and have received kanji for the basic ones. Of the ones you already have through that lesson, you'll need the bottle of sterilized destilied water, the bottle of 96% ethanol (used to desinfect and clean) and the sterile syringe for injecting the medicine if it's to be injected (most aren't!). Here is what you can add to that summon list:

モルタル - mortar and pestle, chemically clean
スプーン - spoon, sterile
パテ - putty knife, metal, sterile

What makes up a medicine then?

All medicine in NB RPG have 2 aspects to it:

-Active Ingredients: these are the ingredients from which you'll borrow a given effect that you need for your medicine. For example, if you want to decrease the amount of pain someone has you can choose poppy seeds. The more active ingredients you add, the more effects you'll cover but the less effective each of them will be.

-Solvent or Medium: this is the medium in which you'll put the active ingredients for delivery to your patient. For example, if you want it to be ingested, you need a medium that can be digested and helps to absorb the active ingredients. There are 3 types of mediums: simple steryle non mineral water (distilled water, normally the norm for injectable IV or IM medicines), oils (any vegetable oil, normally used for skin absorptions or simple mucosa absorption) and other organic mediums (milk, juices, sap, honey, etc, generally used for ingestable medicine), each picked depending on the ingredient, type of delivery, etc.

These are picked based on Chinese and oriental knowledge for medicinal herbs. There is no fixed rule as long as what you describe how and why you added each compound. A herbal list we have will help you but so will google. Since the effects are beneficial either way but not exactly a cure, there is no harm in some freeform as long as its logical and supported somehow.

How can these medicines be applied then?

They can be ingested (and in this case, they can be shyrups or pills), injected (either subcutaneously, intravenously or intramuscularly), inhaled (as either powders or mists/gas) or absorbed through the skin or mucosa (as creams, ointments, etc).

Are they similar to real life medicine in their effects?

Yes, to some extent. We disregard side effects ( too complex to implement) and we add the notion that, like with everything in narutoverse, chakra makes everything faster, stronger and more effective. So an antibiotic medicine that would need to work in RL in 7 to 8 days, can be made to work from one RP day to the next.

What effects can be made into medicine?

The main ones are:

Fever medication (to decrease body temperature and keep it at normal levels)
Pain medication
Anti-inflamatory medication
Antibiotics
Antidotes (these will be covered in a specific class but are medicine none the less and obey the same rules)
Anxiety medication
Sedatives
Anti-psycotics (these, in narutoverse sense, will help deal with the after effects of Genjutsu, like mental stress and pain)
Various Nutrient Concentrated Combinations (stuff like a supplement of Iron and Folic Acid to help deal with blood loss or Vitamin C boosts to help improve your defenses against infections)
Regenerative pills (help to regenerate tissue or heal wounds)
Vital Faillure Medicine (stuff like adrenaline to help with cardiac arrest or diuretics to make your kidneys function)
Chakra Medicine & Chakra Medicine (this is a very specific and advanced type of medicine that will directly influence the takers chakra; one can create medicine to more rapidly regenerate chakra, to improve a given skill or technique or even to empower his own body through the use of chakra)
Empowerment Drugs (these are medicine used to empower your own physical abilities, not through chakra (although they can be combined with those effects for a maxed effect) but through physical organic empowerment like, for example, increasing speed, strength, etc.

But how do we use this in a battle?

You don't. You'll never have time to make a medicine in the middle of a fight and that medicine would never be fast acting enough to be of any help to you during that fight. This skill is solely to use when treating patients in treatment situations, where there is no limit to moves per post but only limits to how much chakra you can spend.

There are, however, medicine you can use in the middle of a fight. These, however, are pre-made and stated in your bio. You'll be able to make a custom medicine for yourself and submit it for approval. If its approved, you can add it to your bio and, like a kunai or some other tool for your fight, it will be there at your disposition in a fight. These custom medicines are made following these principles but are unique to you and are considered to have been made before the fight even starts.

Let's then create a medicine just for example:

I have a patient that has a stomach ache, so I need something that acts calming on the stomach. Also considering the solvent I will need something he can ingest that will help calm his stomach and be absorbed.

After a quick search I find two active ingredients: chamomile and mint. Both have calming effects and both can be digested in the stomach. Both can also be easily infused into any organic liquid so, to help with the calming, I choose goat's milk. Its very rich in all nutrients but, like all milk, its also alkaline in nature, helping to treat stuff like "heart burn".

I put a few fresh leafs of a mint plant in the mortar a long with some dried chamomile leafs, add some milk and crush it all with the pestle until its a uniform paste. I add more milk and stir, creating a thick shyrup. I want it thick to be stronger. I then give it to my patient. After a few minutes, he feels much better.

Let's make an ointment now for demonstrative purposes. Situation: a patient came complaining about a rash that is the result of a poison that was poured over his left arm.
After cleaning the skin of all possible poison residue, I inspect the skin.

Right on touch I notice it's warm, it's red (irritated) and the patient is complaining it hurts on touch. So logically I need something that will cool the arm down, counteract the redness and remove the pain. For that I use mint again (because it has a cooling effect), the roots of a dandelion which both counteracts the red coloring AND the pain because it slightly numbs the skin.

Again I put those in the mortar, add some olive oil and crush it til I'm happy with the result. Oil will protect the skin from harm while also making sure it doesn't dry up. Its also ideal for ointments and, in the case of olive oil, has both reparing and calming properties and is ideal to mix herbs into it. You could use other mediums like water but ideally, in the skin, because it takes longer to absorb, you want a medium that will last in the skin without evaporating. I clean the area with simple water, dry it up carefully and apply the ointment in shallow slow circular movements.

Training:

Create a medicine for a patient with X disease/condition

Scorps · Jun 28, 2016

Jokyo Dokubutsu (Poison Removal)

Okay so this is a tricky one

. To begin with, this technique does not cure a poisoning; it simply extracts a portion of the poison and prevents immediate death by delaying the ongoing poisoning. It mainly allows a medical nin enough time to prepare an antidote for the poison and to slow down the effects of a poison used against the medical nin so as to give them time to escape or prepare an antidote for themselves. A patient will still die from a lethal poisoning even if this technique is used if the poison is not treated. Truth be said this technique is less effective against highly advanced poisons that have very fast acting times.

(Iryō Ninjutsu: Doku Ekiso) Medical Technique: Poison Extraction Jutsu
Type: Supplementary
Rank: B-Rank
Range: Short
Chakra: 20
Damage: N/A
Description: An advanced medical jutsu used when the user cannot make enough antidote to cope with a poison. This is used to extract a great deal of the poison from a body, and then the antidote can be administered. The user will need a medium (his own chakra or a chakra receptive medium compatible with the human body, like water) which he will insert into the patients body, using his chakra to gather the poison directly from the tissues, merging it with the medium to then remove and discard. The technique can only remove a limited amount of poison and will not negate any ongoing effects as it cannot remove poison already being metabolized/in effect. Because of this, the medical ninja will still need to administer an antidote and will need to use the technique twice to remove all of the poison from the patient.
Note: can only be used twice, each use delaying the effects of the poison for 2 turns.

The jutsu works in the way that you insert (either your chakra or another highly absorbable, chakra-reactive medium) into the patients body, where it then looks for the poison in various vital organs, and when it finds it, it binds it to it's own energy and draws it out of the body. If using your own chakra (which you will most of the time) then that chakra cannot go back into your body otherwise you'll poison yourself, you have to discard it, if you're using the previously mentioned medium you have to throw it away. The use of specific chakra receptive mediums helps to mitigate/diminish the risk of self poisoning or injury when dealing with unknown poisons and, more importantly, with corrosive ones.

Removing the poison makes it easier to heal. You remove the "inactive" poison that is circulating the patients body and hasn't yet affected any tissue. By removing that you prevent further injuries and damage into the patient. However, the poison which is already affecting the tissues needs to be dealt with with antidote. If you didn't remove the "inactive", unused one, you'd need to supply antidote for a much longer period of time and would risk losing the patient in the inbetween.

Q&A

First of all, what would constitute a "highly absorbable, chakra-reactive medium"? Would this be some form of medical tool, or other cannon instrument we could use, or would it have to be, for example, a Custom Weapon which absorbs chakra?

The Highly Absorbable chakra-reactive medium can be Water, Wood, etc. It can be anything that reacts with chakra and is compatible with organic medium. Water was what we saw used in the manga by Sakura but you can also simply use your raw chakra. Wood is a possibility as its organic in nature and would be a nice medium for this. In theory, other elements/materials that are compatible with organic living things or that exist inside them can be used.

Is there any particular reason the technique cannot extract all of the poison? And, building on that question, if several med-nin worked together at once, would they be able to extract all of the poison? Or is the fact that we cannot extract it all tied into how poisons affect our bodies?

Poison will cling to the cells and tissues in a way that prevents you from pulling it all out without damaging the patient in one go. You need to take the first portion first, then redo the procedure to remove the remnants that might be left. In essence, you'll only be removing the poison that is "waiting to act" in the body, not the one already acting. Think of it as cleaning spilled oil on a surface. First you pass a cloth that takes the majority of the oil but there is always some left on the surface. You then pass a new cloth once again to clean whatever is left.

Would this work on other toxins aside from poison, such as, for example, venom? Or would this extract solely poison, and leave us unable to extract other deadly toxins?

We will speak about Poison, Toxins and Venoms further on but to answer your question, in terms of our RP, all 3 are cured in the same manner: remove + antidote.

What is considered an advanced poison? Considering that the technique is only B ranked, I'd assume that everything poisonous above B rank is too strong to be extracted, right?

Advanced poisons are all the custom poisons, the specific poisons. Anything not existing in real life/nature/narutoverse nature. Basically, man made poison. Poison form normal Poison Release techniques isn't considered advanced. Sasori's poison is considered advanced poison though severely slow acting.

Scorps · Jun 28, 2016

Kaidokuzai Sōzō (Antidote Creation)

This is actually a simple more specific application of Medicine Creation developed solely to counteract Poisons, Toxins and Venoms.

An antidote is a substance you'll administer to your patient that will counteract the effects and the progression of a poison, toxin or venom. It not only neutralizes poisons, toxins and venoms that are in the body and not in effect yet as it also neutralizes them when they are already acting while also countering the effects their triggered in the patient. Basically,you do the same and follow the same principle as in Medicine Creation as an antidote is, basically, a medicine.

But how do we know what to put into the antidote?

For this you'll need to first use either the poison extraction technique or the poison extraction seal. In the case you use the technique, as you'll be using diagnosis in tandem, you'll be able to know, as you gather the poison and extract it from the body of the patient, its components and mainly its effects. If you use the sealing technique, you just unseal the poison and use diagnosis on the poison to the same effect.

Once you know what the poison is made of and what it can do, you'll be able to determine what herbs and solvents to mix to create an antidote. But here comes the issue: how can you, an NB RPear, know what herbs and what not to mix to counter a custom poison for example? Its not easy and it would become overly complex for the RP to make players do this. Thats why it was decided that creating fixed component of all antidotes, called antiserum* thats made of various herbs, antibodies from various animals and humans, that can counteract any and all non specific or custom poisons, toxins and venoms.

*in reality, antiserum is the component of blood in which passive immunity to diseases is "memorized". Basically, once you're exposed to a disease your body will create antibodies to combat, leading you to cure that disease. Those antibodies don't disappear. Instead, your body creates more and keeps them in the antiserum, circulating in your body for a time when the disease might attack again. If that happens, the antibodies will attack the disease before it infects you and you trully gain immunity to the disease. Vacination works on this principle. And real life antidotes to snake and other poisons, venoms and toxins is often produced and derived from large mammal antiserum (horses, pigs, etc).

Ofc, you'll still need to add specific herbs to counter the effects that poison, toxin or venom creates in the patient but you won't need to worry about finding herbs that are capable of neutralizing the poison. Some toxins, poisons and venoms though, have very specific antidotes, clearly known and defined. When its such a case, you simply use that.

Ok, so how does it actually work? And what technique is that?

So, lets start by stages:

Extract Poison and Analyse it
Determine the effects you need to counter and if the venom/toxin/poison has a known antidote
Gather the antisserum to counter the poison plus all the active ingrdients needed to counter its effects plus a suitable medium for delivery
Mix them all together and create the final medicine, your antidote
Administer it to the patient
Monitor results

Like all medicines, you can choose to administer it in various ways but, normally, intravenously or intramuscular methods are best because they are much faster acting.

But this isn't practical in combat!

Ofc not. Even a very experienced poison master will not be able to counter poisons in combat as you first need access to the poison. However, if you had access to the poison before, you can create an antidote for it and save it on your bio for future uses.

Additionally, you'll always have with you a medical scroll containing all the known herbs you'll need, most mediums/solvents possible and infinite amounts of antiserrum. This way, your own priority is surviving until the end of the fight so you can then produce and administer the antidote for a poison affecting you.

In the long run, however, the best survival possibility is to have someone to treat you if you ever become poisoned.

So, there's really nothing we can do in a fight?

Well, there is a minor technique that might save you long enough to produce the antidote. But its no sure method. This technique is a variation of Power of Resistance but directed at Poisons and Toxins. It works by halting the progression of the poison using chakra, focus and will power. It can't be used until the first effects of the poison are felt though, so you won't be able to fully remain unscaved. Its a self usage technique that cannot be used on others.

Upon feeling the first effects of the poison, you'll focus and use the same method as Power of Resistance to raise your resistance but this time you'll visualize the poison and your own body and focus on having your chakra "hold the poison in place". You cannot expel the poison, neutralize it or cancel it. No. You simply temporarily stop its effects. The first effects you felt, will be there but there won't be a progression of symptons for as long as you can sustain the technique.

But then here comes the various limitations. The technique requires constant chakra input so the effort and drain of chakra is enormous. Additionally, if you're in a fight, you'll consume one of your allocated moves per turn the first time you use the skill. While using this will still allow you to use other techniques at the same time (its treated more as a passive skill), the longer you use it, the longer the cost is and the harder it is to focus and maintain the technique.

(Iryo Ninjutsu: Doku Teikouryoku) Medical Technique: Poison Resistance
Type: Supplementary
Rank: N/A
Range: N/A
Chakra: N/A (40x(Z), with Z = the number of turns while using it)
Damage: N/A
Description: The user will raise his resistance enabling him to stop the progression of a poison, toxin or venom he might have been contaminated with after feeling its first effects. This will not cure the poisoning but rather stop its progression so the user can continue to fight, hopefully winning the fight, to then be able to treat the poisoning. This is a passive skill that only consumes a move when activated, passively draining chakra, focus and stamina from the user as each turn passes.
Note: Poison masters will be able to do this technique with half the chakra cost.

Btw, this technique has no other defensive effect other than stopping the progression of a poisoning once it starts. This poisoning, however, can be of any origin like custom elements or custom poisons but cannot be an infection like from bacteria, fungi or nano-insects.

Materials needed:

Add these to your summoning scroll

抗血清 - antisserum
ハーブ - various medical herbs
溶剤 - various solvents and mediums

All can be used to summon any known medical herb, antisserum and any known solvent and medium. These can also be used for medicine creation if you wish.

Homework and Training

-Research and explain what a Venom, a Poison and a Toxin is

-Practice making antidotes

Scorps · Jun 28, 2016

Hone Chiyu no jutsu (Bone Healer Skill)

When an ally or yourself have broken or fractured a bone, you find yourself in need of fixing it. The ideal way to use this technique is to prepare a concentrated calcium + vitamin D pill with medicine creation to aid the technique but in the absence of the pill (when there is no time to prepare it) it is possible to force the patient's bones to connect together and heal into place without the pill.

Chiyute is, in truth, a variation of the Mystical Palm technique which uses less chakra and is somewhat easier and faster. The technique works by, after setting the bones in place or near it, forcing the osteocytes to grow a fracture callus (harder and stiffer bone growth around a fracture point) to "glue" the bone back together, essentially healing the fracture.

It is important to remember that bones must be properly and often painfully set back in place (or as near in place as possible) before they are repaired. While possible to treat complex fractures, if the bone in question is shattered and pulverized into tiny pieces, the technique will not work and you need to use more advanced methods.

A big limitation of this method is that often in a fracture, there is damage to the surrounding tissues, something this technique does not repair. Ideally, and to make it both faster and more effective, you'll need to use this technique to heal the bone and mystic palm to heal the tissue faster. The end result is spending less chakra and time to treat the same injury as opposed to using only mystic palm.

Finally, the technique is ineffective in spinal fractures. Because the spine has a complex level of nerves and the spinal cord closely linked to it, a fracture to the spine needs to be treated by the most advanced techniques available in a different method.

(Iryō Ninjutsu: Chiyute no Jutsu) Medical Technique: Bone Healer Technique
Type: Medical Ninjutsu
Rank: B-Rank
Range: Short
Chakra: 20
Damage: N/A
Description: When facing a clean and complete bone fracture of a bone and having had manually set the bone in place, the user will focus chakra through his palms and pass them over the fracture, forcing his chakra to influence the osteocytes to start releasing their calcium, which then creates a welded suture between two ends of a broken bone. After that, the stimulated osteocytes lock the calcium back into their structure and the bone is completely healed. Despite not healing any injury to the soft tissues surrounding the fracture, the technique can be very useful when treating simple, clean fractures.

Q&A

"Since it's a variation of Mystic Palm, I assume you're able to perform other techniques and procedures such as blood coagulation whilst healing the bone right?"

You can help the technique to work better using at the same time any skill that doesn't need a technique to be used.

Training:

Treat a fractured bone from your collegue.

Scorps · Jun 28, 2016

Shōsen Jutsu (Mystic Palm)

This technique is established as your core skill for healing injuries and lesions on your patients. It allows you to basically do anything you wish with few limitations when it comes to healing. However, such a versatility comes with a price as otherwise we wouldn't need to learn all the other methods if we could do it all with a simple technique without drawbacks.

(Iryō Ninjutsu: Shōsen Jutsu) Medical Technique: Mystic Palm Technique
Type: Supplementary
Rank: S-Rank
Range: Short
Chakra: N/A (2X the amount of damage healed)
Damage: N/A
Description:
This medical ninjutsu allows the user to speed up the body's natural healing process by focusing mainly Yang chakra onto their hands, forming an aura of greenish healing chakra which he then sends into a wound or afflicted body part. This allows the user to heal a patient without the need for medical equipment or surgery, making it very useful on the battlefield. It can be used to treat both external and internal injuries. It is vital to match the amount of chakra used to the severity of the affliction or injury. This requires a great amount of chakra control. Because of this, only a few highly skilled medical-nin are able to use this technique. The limitation of the technique is that it cannot regrow missing body parts or deal with poisons or toxins, though it can heal its damage. Additionally, perhaps its more severe drawback is the chakra cost, which, as the technique stands as a jack of all trades in terms of medical ninjutsu, is much higher than any other medical technique. For each damage point the user of the technique wishes to heal he needs to spend twice as much chakra. Basically, for X amount of damage the user needs to spend 2X amount of chakra to repair/heal. The user can also use this technique on himself and it can be used with one hand or two and even in two targets at a time or while using another technique with the other hand. The speed of the healing is fast but not instant, specially in internal injuries.

Lets start by how it works. This technique basically infuses vitality (or, in other words, Yang Nature chakra) into your patient. This forcefully makes his tissues and body heal up from any lesion. Highly effective against traumatic damage. You can make the cells divide rapidly and fill in missing tissue in small quantities. You can repair bones, minor peripheral nerves, necrosis, etc. Pretty straight forward.

Not all pink and fluffy though. This technique requires a lot of chakra (for example, to heal the equivalent of an A-Rank technique's damage, you'll need 120 chakra points), concentration/focus and time. Yes, time. Its a very slow technique which means that your patient needs to be somewhat stable to last long enough for you to use it for the time it takes to heal him. It also can't cure poisonings nor mental damage. It can cure the damages left behind by poisons and toxins but it won't remove them or leave them inactive. It can heal up your brains tissue but it won't bring back memories or fix mental damage. It can't also grow missing body parts though, if a remnant of an organ still exists, it can make it regrow.

Its important to know though that, lets say you take a Chidori (A-Rank, 60 damage) to your shoulder. While you'll receive that damage initially and you still have tons of health left, the result is not only 60 damage for you to heal. Each turn/20 minutes that passes, your tissues will get further damaged, your blood loss will lead to further tissue damage and, after the equivalent of 3 or 4 turns, the damage will have multiplied by that same amount.

Basically, when it comes to a medical ninja calculating how much he needs to heal and how much real damage a patient has:

B-Rank techniques and bellow - damage to be healed is in the same amount that the technique does though 30 damage can be as lethal as 90. For example, if you cut someone carotid artery with a C-Rank wind technique, the damage to repair will be 30 but the wound itself can be fatal.
A-Rank techniques and above - the technique does an initial damage that, by the end of 2 turns, has multiplied by 2 for practical medical effects. So, for example, an A-Rank damage, at the end of the 2 turns will have transformed into 120 damage due to pain, blood loss, suffering, etc. The damage continues to multiply, doubling every 2 turns until something is done to stop its progression. That why some injuries that aren't immediately lethal can lead to death. Others, despite doing, imagine, 60 damage, might cause immediate death. The health pool of ninjas in our RP serve only to asses how long they can survive after receiving non-immediate lethal damage. Nothing else and only has a value for medical ninjas, being of no use in battle assessments.

This knowledge is paramount in assessing how much chakra you'll need to spend and makes it essential to stabilize the patient and initiate what we call "primary care" (restoring blood, initiating blood coagulation, giving anesthetics, etc) which will stabilize and prevent the damage from increasing before you actually begin to use Mystic Palm to heal the damage. It also makes it essential to assist the patient as soon as possible as, the longer time passes, the worse the patient will get and, if his health reaches 0, he's beyond salvation.

Also, yes, Mystic Palm can be used on you but, because its unlikely you'll be able to perform correct primary care on yourself, it will take long and cost a lot of chakra.

As a benchmark in terms of time, getting pierced in the shoulder by a Chidori, leaving a gapping hole but avoid major organs, requires, in battle, 4 turns of none stop healing. You spend the 120 chakra points (assuming you start right after the injury) and need to continue performing the technique through those 4 turns, with focus and concentration. Cuts will be easier to heal than a fractured organ. But the worse are combinations of both external damage (like cuts) and internal damage (like fractured organs), similar to the example of the Chidori wound (which is both internal and external damage).

When its done in a healing thread or, after a battle has ended, before you go into a new battle as your final action, you don't have this time issue but you also don't necessarily have turns. So, how does it work? You'll post a single post with the detailed method through which you heal the patient (or yourself if its applicable) and stating time. In medical terms in our RP, 1 turn equals roughly up to 20 minutes or so of medical treatment.

Homework:

Train healing various injuries with all the methods learned so far.

Scorps · Jun 28, 2016

Kin'yō Shippai Soshite Chiryō (Vital Faillure and Treatment)

This would be the equivalent of a Trauma class in a real medical or nursing school. You'd learn all about trauma, injuries, etc and how to deal with patients in those situations. However, this is narutobase RPG and, unlike myself, you don't have medical training. As such, it would be highly confusing, lengthy and overly complex to explain all of this. Instead, we opted for a simplified approach by giving you the knowledge of basic things and how they make the bridge between reality and the RPG.

There are vital functions our bodies need to ensure in order for us to function normally and, well, live. Someone is sick when, due to a plethora of reasons, these functions aren't working as intended. Your job, as a medical ninja, is to assess which ones and fix them. To do so you need at least rudimentary knowledge about the most common vital functions and the most common issues associated with them.

Vital Signs:

These are various parameters that are measured in oder to evaluate how your body is functioning. They are 6

Heart Rate/Pulse - Measured by putting your finger in either the radial artery or the carotid artery and counting how many "pulses" are felt in a minute OR by evaluating the electrical current in the heart. Since the heart beats based on electrical impulses that trigger the muscle reaction to contract the heart, each impulse is equivalent to a heart beat. With diagnosis it can be measured by detecting both the electrical impulses but also the pulses in the arteries. Measured in beats per minute.

Bradicardia = low heart rate. Normally, anything beneath 40 to 30 bpms is bad. The normal is around 60 to 70.
Taquicardia = high heart rate. Normally anything above 150 while not doing exercise is bad.
Arrhythmia = abnormal/irregular heart rate. In a minute, the heart can beat sometimes fast, sometimes slow.
Assytole = no electrical current in the heart muscle.
Fibrillation = short circuit in the heart. Normally, what happens is that theres a lot of electrical activity in the heart but its not producing heart beats. The impulses happen and travel into the muscle but don't trigger a muscle response. There is no pulse but you can feel the electrical currents in the heart.
Blood Pressure - Measured by diagnosis. Its the pressure the blood exerts on the blood vessels. It has 2 values: Systolic (max value, when the heart contracts and sends blood flowing) Diastolic (when the heart is released and not exerting pressure). Measured in mmHG. Its influenced by blood volume, diameter of the blood vessels and osmosis balance.

High blood pressure or hypertension = blood pressure is high and can make weak vessels (like in the brain or eyes) rupture, leading to hemorrhagic strokes. Highly associated with stress, anxiety and nervousness. Pain and general distress might have that effect.
Low blood pressure or hypotension = blood pressure is low and can make it so that blood doesn't heave enough strength to reach all the minor vessels further from the heart. Blood loss leads to hypotension. If the tension is too low, the person will lose conscious.
Temperature - We already talked about this. Measured by a thermometer or diagnosis. Values are either degrees ºC or ºF.
Breathing Frequency - How many ventilations are done in a minute and its characteristics. Breathing can be normal (around 20 to 30 cycles per minute), rapid, slow, superficial (when there is barely movement of the lungs and the ventilation as a result becomes shallow) or difficult (when the lungs have trouble ventilating). You can also have other charateristics like coff (normal sympton of irritation of the lungs/throat), secretions (normal sympton of infection in the lungs), etc.
Pain - Pain is a vital sign, one that can be measured by diagnosis but is generally measured by the patient himself in a scale from 1 to 10, with 10 being the worse pain. If pain is high enough, it can make the person shut down and faint. Different people have different tolerance to pain.
Suffering - A vital sign associated with the emotional distress brought upon the body. Its linked mainly to terminal patients and extreme physical pain.

Other aspects to consider as vital are:

Consciousness - If the person is conscious or not. If he isn't, he might be easily awoken or not. If he isn't, even with painfully stimuli, you call it a coma.
Orientation - if the person, while conscious, has normal grasp of time and space (if he or she knows where and when he or she is). If they don't, its normally considered that the person is confused.
Body Integrity - basic aspect to look at when you asses a patient and a vital portion of a patients health. It basically means to check if the patients body is complete and without external visible injuries or changes. Wounds, abnormal angulation of bones and limbs, growths or edema (swelling), skin color, having all body parts one had, etc etc.
Elimination - this basic means both feces and urine excretion. These need to happen normally in a frequent basis.

These are the main aspects you'll look for in a patient to assess if something is wrong with him in narutobase RPG. This is very very very basic and somewhat dumbdown so you can look up some aspect in the web to use in battles or for creating customs.

Main Problems, Conditions and Diseases in Narutobase RPG:

Skin and Soft Tissue Trauma - simple to understand. It pertains to bruises, hematomas, cuts, stabs, etc. Basically, any wound on the body, both internal and external. You need to heal the wounds and treat their consequences (blood loss, pain, infection).
Blood Loss - Loss of blood and all that comes with it. You'll need to help the body restore the blood, prevent more from escaping or replenish the blood.
Infections - bacterial and viral infections, normally after your wounds getting infected. You need to fix the cause and treat the bacteria/virus. Don't forget the fever.
Bone Fractures - heal the surrounding tissue and whatever lead to the fracture, treat the pain, set the bone and heal the bone. Normally, it goes toe and toe with wounds and other injuries, internal or external.
Poisonings - stabilize the patient, remove the poison, identify it, produce the antidote, administer it.
Chakra Flow Disturbances - detect the origin, negate it and restore normal chakra flow.
Mental Trauma - if trauma isfrom a technique, release it or end it and if not, just move on to the next step which is to administer medicine to calm the patients mind and keep him sedated until the mind heals itself with time.
Severed Limbs & Body Parts - same principle as with normal wounds but with more focus on containing blood loss before attempting to re-attach or heal the injuries.
Heart & Breathing Faillure - detect the issue, keep blood flowing with CPR, fix the issue, keep blood flowing with CPR, use Thunder Hands to restart heart.
Allergic Reactions - detect the cause, remove it, administer adrenaline, monitor reaction and vital signs.
Extreme Fatigue - administer medicine in order to more rapidly restore the patient to normalcy levels of stamina.

Scorps · Jun 28, 2016

Sansokyoukyuu (Oxygen Supply)

While it is possible for anyone to do CPR without chakra, this technique is an improvement. By holding your hands over a patients chest you are able to use chakra to contract the myocardium (heart muscle) which causes the heart to start pumping blood as well as the diaphragm and the intercostal muscle so the rib case starts compressing and de-compressing the lungs. This technique is not effective if for some reason the air passage is blocked. It does not provide oxygen or blood, only forces air in and out of the lungs and makes the heart continue to beat by forcefully making the muscles to move. A high ranked mednin is able to perform this technique on two patients at once if the need should arise. Off course, the patient must be on cardiac arrest (or in a severe risk of such) and unconscious as it would otherwise not be needed to use this technique. Essentially, this will keep blood circulating and air coming in and out of the patients lungs in an attempt to minimize damage from the lack of circulation. It does the same as compressing a patients chest and doing mouth to mouth breathing (traditional CPR) but using your chakra and doing it move effectively, essentially avoiding the tiredness and fatigue that comes from doing the compressions/ventilations manually. This, however, is only a temporary solution. In between usages, the medical ninja still needs to try and tackle the original issue that lead the heart to stop. Because its not the same as the patients own heart beat and respiration, the technqiue can only be effective for a small time window before brain and tissue damage start to happen.

For every 15 heart compressions, normally 1 each .5 seconds, the medical ninja must produce 2 ventilations.

(Iryō Ninjutsu: Omoi-Gozou Anma) Medical Technique: Chakra CPR
Type: Supplementary
Rank: B-Rank
Range: Short
Chakra Cost: 20 per turn
Damage Points: N/A
Description: The user puts his palms on top of the patients chests and uses his chakra to keep the heart pumping and the muscles that normally expand the lungs in order to suck in air contracting - therefore artificially keeping the patient alive until his heart and lungs start working on their own again. Each use allows 15 heart compressions and 2 ventilations.
Note: This can be done on 2 patients simultaneously if the situation calls for it doubling the chakra cost.
Note: Can only be sustained for 6 turns.

In a battle thread, what you'll do is use this technique together with passive diagnosis and then, each turn, along this technique, you'll use others to treat the underlining issue in between the pauses.

Task: Post here your questions regarding Chakra CPR, and save the patients.

Volunteers are picked and then shocked until dead. The students must keep the blood and air flowing in the patients lungs through the use of this technique.

Q&A

I thought this technique only sustained life, artificially, it could not actually prompt the patients body to restart. If there is an heart attack or an asphyxiation, after unclogging everything, can we use this.technique to always save our patient and restart his breathing and heart beat on his own? When will it not work? When do we know to give up? Or when do we know that the patient is brething or beating on his own?

The jutsu keeps the patients body alive artificially while you actively try to find the issue that stopped his heart and fix it. It, in itself, will not allow the heart to restart. In the case its a chemical issue, you'll need to tackle that (you'll learn how in other classes) or if its some sort of electrical issue in the hearts system, use a technique to fix it.

You have to use logical reasoning when determining what damage can be healed. How long have the patient's heart and lungs been stopped? The heart pumps blood through the body, nourishing and replenishing organs with oxygen. The lungs provide that oxygen. So how long can someone live without those working? The answer is around 5 minutes in reality but for RP, 6 turns. If his heart has been stopped for longer than that, then the patient is dead. He's breathing on his own when your chakra seemingly has no effect on the patient. At that point, the patient is sustaining himself.

Hekirekite no Jutsu (Thunder Hands Technique)

This method is basically a ninjutsu in which the user focuses the chakra in his hands so that they can create an electric shock able to give a sufficient amount of electricity to make the heart start beating again in the event it has stopped (not saying that this is the only usage, I'm just making a comparison).

The technique:

(Iryō Raikō Ninjutsu: Ikazuchi Te) Lightning Medical Technique: Medical Thunder Hands
Type: Attack / Supplementary
Rank: B-Rank
Range: Short
Chakra Cost: 20
Damage Points: 40
Description: A technique used to reset the hearts electrical frequency and pace or to induce it. In other words, this technique is the medical ninjas version of a defibrilator. The medical ninja will charge up electricity on both his hands and press them on the patient. The left hand must be directly on top of the heart and the right hand on the side, beneath the armpit of the patient. As the electricity is discharged, the electric pace of the heart is either normalized or restarted. The technique can be used in healthy targets as a way to induce abnormal electric paces and if done repeatedly can even cancel it completely. While the technique is effective, it has to be used in between the use of chakra CPR to have some chance of success and even so, only 1 every 3 uses will be successful depending on the targets conditions.

This can be used on the heart, as a shorter but less efficient (tho sometimes necessary) version of the Oxygen supply method. To use this technique on the heart which has stopped beating, you place one hand on the patient's upper right chest, just below the shoulder and the other hand on the left side of the patients chest, several inches below the arm and to the left of the chest. It is important that the patient be dry as possible when this technique is used and that no other person is touching.

This will be used in conjunction with the body points disturbance technique also, and you can use it as an attack (yay right?) only make sure you're actually touching the opponent with only your hands, otherwise you'll get electrocuted too.

Questions?

Q&A

"I actually do have a question, maybe somewhat irrelevant to this technique but essentially it's the same principle. In the last few manga editions we've seen Sakura pump Naruto's heart with her bare hands. I believe that this is more or less a weaker method of that? Btw. this seems like basic defibrillation. I also wonder (since it can be used as an attack) if it can be used on other internal organs to cause harm to the opponent?"

Its nothing like that.

Your heart works (like all muscles) on electrical input commands. This means that it contracts and beats according to an electrical pulse that originates in a small nodule of the heart. That electricity is what keeps the heart beating. When the heart beats, blood flows into the artheries as a ripple (a spike in pressure) which you can feel in certain more superficial artheries as what we call a pulse (in your wrist, behind your thumb on the palm side or in your neck, next to the traquea are the most common places to feel your pulse). The beating of the heart produces a blood pressure. Blood pressure has 2 values: the high one (when your heart beats) called systolic blood preassure (when the heart contracts in the systolic phase) and the low one (in that small time your heart is relaxed) called diastolic (as it happens in the diastolic phase). Its measured in mmHG (mercury millimeters) and is one of our basic vital signs. If its too high it can stress the heart and cause hemorraghic strokes and heart attacks, if its too low, it causes lack of oxygenation to the organs and brain with similar results. Normal values are between 100/60 mmHG to 120/80 mmHG. This is what is the result of your heart beating and having enough blood. If you don't have enough blood, the pressure is low and the heart can't beat properly.

But the heart beats as a result of electrical current through its muscle body. Now, electricity travels in mediums as we well know. Muscle and nerves are a medium. It also, in biological context, is dependent on salt and ion based balance which enables that electrical current to work and be generated. Now, I won't dwell on details of RL electrocardiac aspects but you can essentially have 3 situations of abnormality:

No electrical current, which is otherwise called asystole, or flatline. There is no electrical current to make the heart beat. This can happen due to many situations such as lack of energy (if the person becomes too weakened or lacks nutrients, there is no ATP and energy to produce electrical discharges basically), damaged nodule, poisons, etc. Many things can cause this. Even an overload of excessive electrical energy (like an external shock) or even muscle death or destruction.
Disfunctional electrical current and the main, most known one is Fibrillation. In this case the nodule is fired up and releases electrical inputs but instead of doing their job, they simply go haywire and don't make the heart beat. There is a spike, meaning there is the electrical beat but there is no muscle function in response. Basically, you have a spike in the EC monitor but you don't have a pulse. This can be from diseases, shocks, poisons or toxins, etc. The variety is enormous.
Out of Control Pace is the last type. In this case what happens is a change in the frequency of the electrical current pulses. This can cause bradicardia (low frequency), taquicardia (high frequency) or extrasystoles (there is an electrical pulse here and there that doesn't produce a muscle reaction, thus a beating). Many things from anxiety, to blood cloths, to diseases, toxins, poisons, drugs, etc can cause any of these. The Taquicardia, mixed with Extrasystoles normally is in the early stages of a fibrilation episode for example.

Now, having electrical current doesn't always equal a beating or a periferal pulse. Now, departing from RL and to make this simpler, in Nverse, what happens is that you might have a patient with chakra (physical energy) trying to make its heart beat but to no sucess because its heart is simply not responding for some reason. The electrical energy is disfunctional. So, in this case, you need to set it straight and reset it. what do you do? You use this technique to shock the patients heart, making it restart. Its the Nverse counterpart of the Defibrilhator you all see in TV and Movies, the thing they use with two paddles before saying "CLEARRRRRRR!!!!!! ZAP! Charge to 300 joules!!!!! CLEARRRRRR!!!!!!". It won't always work on the first try and you need to make sure that you are performing chakra CPR in between the shocks to make sure blood is flowing and oxygen is being supplied. Basically, anytime you have a patient who has no pulse, use this technique in between the chakra CPR to make his heart restart. Remember though that blood level, chakra level, injuries, etc all play a part and most of the times, the injuries might be too advanced to allow this.

What Sakura did was, because she had little chakra, what we call "manual compressions". Its when instead of doing the compressions in the chest to keep blood floowing, you do them manually in the heart. Cardiac Massage. She used chakra scalpel, opened his thorax, inserted her hand and squeezed his heart manually, making sure his blood is being pumped to his body. Its very very limited in the effect and difficult to achieve but can work to keep a person alive a few minutes. What she did was the manual and internal version of Chakra CPR.

Curiosity: when people flatline in the movies and tv, they shock them with a defibrilator...yet people were not fibrilating...they were assystole. In RL, you give medicine and compresse their hearts until the electrical current restarts. The shocking isn't used in Assystole. But in Nverse, lets always assume it is. Lol

PS- This is a very simplified explanation as its a very complex thing. I hope you guys understand. If you want to know more, use wikia to know like the "user friendly" level of details and if you want we can develop it a bit more.

Scorps · Jun 28, 2016

Karada Tensū Jōran (Important Body Points Disturbance) & Chakra Jōran (Chakra Disturbance)

Any medical ninja knows that one of the key aspects of healing a patient is to ensure his body is in balance. Though, in narutoverse, this goes into close proximity with ones chakra. As such, any disturbance to one, disturbs the other.

Our body has important key points to ensure this balance. These points are associated with important nerves in our body which are, by extension, closely associated with our chakra system. By disrupting nerves you can achieve a multitude of effects, from the practical "numbness" and "paralization" of a given area to loss of conscience to disturbances to your heart rate to loss of conscience.

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Only Medical Ninjas receive training in this area in hand to hand combat. Knowing the weak spots in the body as well as what happens when you attack them is essential in both treating ninjas and defending yourself. There are various weak points and we won't list them as most of them are common knowledge (eyes, groin, heart, throat, etc etc) but some, specially those that require anatomical knowledge and pressure point knowledge as well as the effects that trigger from them are your upper hand in a fight. Some are in that image, others, like the occipital ridge or the vagus nerve will require you to do some homework.

There is currently only a few techniques that take use of this knowledge:

The Ranshinsho is a ninjutsu technique where the ninja turns their chakra into an electrical pulse which is transmitted into an enemy's body by striking the base of their neck. The electrical impulse travels up their brain stem and disrupts the flow of electricity in the nervous system. The brain cannot work like this, thus all communication between the brain and body are confused, causing a person to move their arm when they should be moving their leg, and generally debilitating them. Only an unusually skilled ninja would be able to overcome such a handicap.

Finally a combat jutsu, eh? lol. It's important to point out that this isn't Juuken in any aspect. Juuken uses chakra to disrupt chakra lines, Ranshihsho is a lightning based jutsu which makes the nerves go wild; and it can only be used in the way that is described above, variations aren't possible.

(Iryo Ninjutsu: Ranshinshou) Medical Technique: Chaotic Mental Collision
Type:Supplementary
Rank:A-Rank
Range:Short
Chakra Cost:30
Damage Points: N/A
Description:
Manipulating the chakra in their hand, the user can create an electric field to disrupt the target's nervous system. Because the brain and body communicate using electrical impulses, the user can use the field to disrupt the target's ability to move. The result is the commands to move one body part being relayed to another, making it near impossible for the opponent to move unless they have high skill and understanding of the body or with time. This effect can be achieved by making contact with the enemy, preferably near or directly on his spine (neck, lower back, etc). Contact with a single limb or body part will affect only its symmetric counterpart. The effects last for 10 turns unless countered but are short live in high level taijutsu users (Jyuken users, EIG users), which have an unparalleled awareness of their body movement, quickly adjusting themselves to their new nervous arrangement and in medical ninjas, who possess a high level of awareness of their own bodily functions, achieving the same effect by pure control and adaptability.

Another use of this knowledge is to achieve local anesthesia or numbness through a simpler application of the same concept:

(Iryō Raikō Ninjutsu: Shinkeikei Konran no Jutsu) Lightning Medical Technique: Skill of Nervous System Confusion
Rank: B-Rank
Type: Supplementary
Range: Short
Chakra cost: 20
Damage: N/A
Description: The user charges electrical chakra into his index finger and hits the opponent. Doing so temporarily neutralizes all feeling to the targeted area for a limited amount of time, essentially anesthetizing it (by overloading and numbing the nerves with the electrical discharge), allowing the medical ninja to perform minor surgery or sutures without the patient having to endure the pain or being able to move his body part. This type of local anesthesia is very effective on the limbs and superficial tissues and, depending on which nerve cluster/pressure point/body area its applied to, can even leave a whole limb anesthetized. In battle, this skill can be used with free form taijutsu to great effect, though, due to the rapid contact, will produce a shorter effect.
Note: Lasts 5 turns for medical uses but only one turn if used offensively

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But this knowledge doesn't stop here. As one learns medical ninjutsu, one gains knowledge of the chakra, chakra system and tenketsu throughout the body. While one can't, without the Byakugan, seen these minute details, a medical ninja is knowledgeable enough to, through the use of Diagnosis, know the location of each person's tenketsu as well as his chakra lines when performing said skill. While closing a tenketsu requires jyuuken mastery, opening one requires either that or medical mastery. Through a medical technique, you can re-open closed tenketsu and chakra lines. A medical ninja also becomes able to feel and evaluate the Eight Inner Gates of a patient, if they were opened or not before, if they are healthy or not and if they, if opened, will burst and kill the user or not. They can't, however, manipulate from the outside, these gates to neither forcefully open or close them. They can't, either, heal damaged Inner Gates.

While this knowledge is essential for diagnosing the problems, it can be extremely important when restoring missed body parts, doing surgery or treating the result of various techniques, like the aforementioned Jyuuken but also the result of opening the Eight Inner Gates, etc etc.

Finally, some battle skills and techniques resort to damaging a tarks chakra system either by damaging the chakra pathways or by disturbing ones chakra flow. Genjutsu is a good example of this. Because patients like these exist, Medical Ninjas needed to learn how to treat them and as such developed techniques to help in this task.

There are a few things that can't be done though, like healing the Eight Inner Gates. But there are many more that can. For example, restoring chakra, calming the chakra flow and restoring it to normal, opening up closed tenketsu, rebuilding missing chakra lines and finally, purging mallicious chakra or energy from a patients body.

All of this is done through these techniques that revolve around chakra, chakra pathways and chakra flow:

(Iryo Ninjutsu: Kūgeki no Tenketsu) Medical Technique: Open Tenketsu
Type: Supplementary
Rank: A-Rank
Range: Short
Chakra: 30
Damage: N/A
Description: The medical ninja, once having diagnosed the patient as having a Tenketsu traumatically closed, will press one of his palms on the vicinity of the Tenketsu affected and use his own chakra to open it. While one can open several Tenketsu with one use, if the patient has more than half of his Tenketsu closed, the technique will need to be used again. The final core tenketsu (#361) cannot be opened if closed.
Note: Can only be used by medical ninjas

(Iryo Ninjutsu: Modosu Heikō) Medical Technique: Restore Balance
Type: Supplementary
Rank: S-Rank
Range: Short
Chakra: 40
Damage: N/A
Description: When facing a patient with a chakra disturbance or an abnormal chakra flow, the medical ninja will place his hand on the patients chest and use his chakra to calm and retore the normal flow of chakra of the patient. This technique can essentially dispel chakra abnormalities and allow for healing techniques to work better. The result is leaving the patients chakra in a calm and healthy flow. Additionally, as a side effect, this technique leaves the patient complete calm and relaxed, without pain or stiffness. It can also be used to dispel Genjutsu the patient might be under the influence of, including Doujutsu Genjutsu and pure Yin Release techniques. The medical ninja, however, cannot use this on himself.
Note: Can only be used by medical ninjas.

(Iryo Fuuinjutsu: Setsuzoku no Chakra) Medical Sealing Technique: Chakra Link
Type: Supplementary
Rank: S-Rank
Range: Short
Chakra: 40 (-100 per turn for the user, +100 per turn for the patient)
Damage: N/A
Description: An otherwise simple technique in concept, it stands as a very complex technique. The medical ninja, when facing a patient with depleted or near depleted chakra, will link his own chakra flow with that of the patient, sharing some of his chakra with the patient. Because not all ninjas have the ability of chakra transfer, medical ninjas developed a sealing technique to allow this. The user will take 2 small paper tags with a seal inscribed containing one the kanji for "Donor" and the other the kanji for "Recipient". He will place the respective tags in their place on the chest (one on him or a donor, and the other on the person that needs the chakra) and do the Horse+Hare+Tiger handseal, triggering the technique. The seal on the paper tag will expand and spread across the targets body. The donor seal and the recipient seal are connected to each other and as such make it possible to link both chakra networks. Immediately, the chakra will start to flow from the one with more chakra to the one with less chakra. Without medical knowledge and mastery, one wouldn't be able to link both chakra networks without hurting both targets but without chakra transfer abilities of their own, a medical ninja needs the seal to mediate the transfer. Once the transfer is under way, it can be cancelled by doing the same handseals in an inverse order or let it take it course as the seal has a safeguard to prevent death. The seal will only serve to, at most, equalize both targets chakra levels, never allowing the donor to drop below the recipient. For example, if the donor has 1002 points of chakra and the recipient has 2 points, the technique will end when both are left with 502 points of chakra. A drawback of the technique is that both participants need to have their chakras calm and undisturbed. If one is under the effect of a genjutsu it will pass to the other and if one has natural energy mixed with his chakra and the other is incapable of dealing with it, he will petrify. A big vantage of the technique is that while one needs the ritual to trigger it, once it starts, both parties no longer need to be near eachother, allowing the medical ninja to treat other patients while donating his chakra or even go to another battlefield to help in another front. Additionally, the seal is refined enough to filter Natural Energy and other harmful energies that might be coursing inside the donors or recipients chakra system, allowing the use to cause no harm to either side due to those factors.
Note: Can only be used by medical ninjas with sealing mastery.

(Iryo Ninjutsu: Saiken no Keiro) Medical Technique: Rebuilding Chakra Pathways
Type: Supplementary
Rank: S-Rank
Range: Short
Chakra: 100
Damage: N/A
Description: A simple technique designed solely to help rebuild and regenerate lost or destroyed chakra pathways. In essence, its a more advanced and highly specific form of Mystical Palm in which the user will focus large amounts of chakra (orange in color) on his palms and, through it, helps rebuild chakra pathways on a patient. This technique, despite being Medical in nature, actually has a very strong Yang component. The user needs to visualize the chakra pathway and will it to regenerate back to its former form. The technique is very hard to use, requires lots of concentration and focus, consumes a lot of chakra and takes a lot of time. To rebuild the chakra pathways in an area like the patients hand, the user will take 3 or 4 turns of continous use. This technique cannot rebuild Eight Inner Gates nor destroyed Tenketsu.
Note: Can only be used by medical ninjas.

(Iryo Fuuinjutsu: Chakra Kiyomeru) Medical Sealing Technique: Chakra Purge
Type: Supplementary
Rank: S-Rank
Range: Short
Chakra: 70
Damage: N/A
Description: A sealing technique designed to purge mallicious or harmful chakra from a patient. The user will place a small paper tag with the kanji "Purge" on the patients chest and do the confrontation handseal with his other hand. The tag will activate, spreading a circular sealing formula on the chest of the patient. The seal will then draw onto itself all the harmful and external chakra that might be present in the users path way. This can work to revert incomplete jinchuriki transformations, curse mark transformations, sage mode, etc. As long as there's an external chakra or energy that isn't the patients native one coursing through him, this seal will draw it in and purge it from the patient. Once the seal does its job, the tag becomes pitch black and crumbles into ash.
Note: can only be used by medical ninjas with sealing mastery.

Training:

Use each of the techniques and methods in various situations.

Scorps · Jun 28, 2016

Shinreitejutsu (Psychic Surgery)

This skill is used to perform major surgical procedures. Unlike normal RL surgery this skill does not require instruments. The Medical Shinobi literally inserts their bare hands into the patient, by using an advanced version of the process used in the Extraction method you learned earlier in your training. To do this, you will place a hand on the body/skin of your patient and use your chakra to gently separate the cells and make an opening for you to enter the body, without actually making an incision in the flesh and damaging any tissue or severing blood vessels. This involves you making a controlled break in the the cytoskeletal (more on that in a second) structure of the skin and then triggering the cells around this break to migrate away from that spot, creating a controlled "orifice" in the patient while otherwise leaving them unharmed. You will need this opening to be able to use a technique which will heal the damaged tissue, since it is required to keep your palms just above the tissue that needs repairing. It will also give you the chance to move tissue around with your hands; like you would need to do if you're dealing with a complex bone fracture which can't be fixed with the Bone healing method simply because there are a lot of fragments.

(Iryō Ninjutsu: Soshiki Bunri) Medical Technique: Tissue Separation
Type: Supplementary
Rank: B-Rank
Range: Short
Chakra Cost: 20 per turn
Damage Points: N/A
Description: The user places a palm on the patients body, pouring their chakra into the tissue, gently moving it apart to create an opening to allow him to perform surgery on the patients internal organs without creating an incision. In fact, the technique separates tissue in a non traumatic way, avoiding damage and relinquishing the need to heal the tissue afterwards. The opening closes virtually instantly after the chakra input is stopped. However, even if it doesn't do damage, the usage of the technique causes tremendous pain to the patient so the use of anaesthetics before the procedure is highly recommendable.
Note: User must have their hand on the patient for a full turn before this takes affect and must maintain constant physical contact and chakra supply to maintain it. However, the technique can be done in tandem with others such as chakra scapel or mystical palm.

The difficulty of this procedure depends greatly on the exact kind of operation being performed. It is even possible to remove an organ with this procedure in the event that it has been too severely damaged to repair. Note that in the process of using this technique, you don't damage the patient as you are instead manipulation the nerves, blood vessels etc; so that they move out of your way. This technique, though, because it doesn't actually do damage, to make incisions or remove tissue, you'll need to use at the same time, chakra scape and mystic palm, cutting and healing. This technique doesn't allow you to remove or cut tissue and thus has a limit.

As most people do tend to ask; Yes, you can use this to simply reach into your opponent and pull out their heart, however you would have to keep your hand on them for one full turn before you are able to even touch their heart so in combat, this is not effective.

Most surgery requires hours of exhausting work by the Medical Shinobi and only when there is no other choice should such a procedure be attempted in the field. To repair any damage done to the internal organs of the patient, you must use your chakra to reinforce the cytoskeleton of the tissue, re-knitting the flesh to its original state.

The cytoskeleton is essentially made up of proteins that lie in the membranes of each cell and protrude long chain molecules into the space between cells, allowing them to communicate, transfer materials through certain processes and the part you need, allowing cells to bind to each other, forming tissues. Using your chakra, you will stimulate the cell membranes, moving them closer to each other and then stimulating the cytoskeleton to rebind the cells back into the original, intact tissue.

This is essentially a far more complex version of the bone healer skill you learned previously but still a weaker version to Mystic Palm.

(Iryō Ninjutsu: Seru Soutei) Medical Technique: Cell Binding
Type: Supplementary
Rank: A-Rank
Range: Short
Chakra Cost: 30
Damage Points: N/A
Description: The user will focus chakra through one of his hands, forcefully making separated tissue (cuts, severed body parts, etc) to bind together. First, the user wills his chakra to physically bind the tissue together, only to then force the cells to bind together as they were before the trauma. By manipulating the Inter-cellular proteins on the surface of the cells to re-knit the tissue cytoskeleton. The technique can only bind cells and tissue together if there hasn't been any tissue loss. However, it can be used to even reattach cut limbs or body parts, assuming these were cut clean.
Note: For this technique to have effect, an actual separation between cells that were once together must be present. This technique will not work on uninjured tissue.

Now just to clarify on how the technique works; you are manually performing a process the body performs naturally. Cellular tissue in the early stages of development, such as during fetal growth or in the development of new blood vessels, migrates and binds to cells similar to it, therefore with this technique, it is important to realise that cells perform this as part of their natural functions and therefore you merely "encourage" this using your chakra to stimulate the cells movement and cytoskeletal binding, rather than using your chakra to force them together.

You are able to use this healing method on yourself as long as you can see, sense and know exactly what you're doing. However the issue is, if you require surgery (and this is a method for extended and deep surgery), you normally aren't in a good enough shape to perform one on yourself; thus meaning performing it on yourself might not be possible. It is, however, an excellent method for removing foreign objects or stopping internal bleedings, as examples. Just don't forget to take an anesthetic first.

If you were to try to use (Iryō Ninjutsu: Seru Soutei) Medical Technique: Cell Binding to attempt to rejoin a body cut cleanly in two, there would be some issues. For one, you can't have tissue loss nor can you have tissue movement. Your internal organs would move out of the position they were when it was cut and prevent you from "welding" it back together perfectly.
That is not to say you can't rejoin parts of a body using this technique; it can be done for Arms, legs, and similar but not for parts where once cut and detached, they change and end up not mirroring each other.

Homework:

Perform minor surgery on your partner.

Scorps · Jun 28, 2016

Iryō Ninjutsu (Medical Techniques)

Apart from all the various skills and techniques you learned above, Medical Arts contain various more techniques that are either healing in nature or can be combat applications of medical ninjutsu. You'll learn all of those you can use from the medical just list here.

Medical School Handbook

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