Wary of all strangers, the elusive Amalthean Dragons cloak themselves in mist to avoid detection. The water sources they live near are astonishingly clear and pure, and have been found to contain medicinal properties. These dragons are known for their ability to cure any disease, wound, or poison, as well as the purification of any water they come across. A blessing from an Amalthean Dragon is said to increase longevity, though they are very selective of who they will heal. An Amalthean’s horn grows from the same wood as a White Dragon’s staff and is highly sought after for its ability to channel and store potent life magic.

Dragons are highly-intelligent reptilian creatures that—from a human perspective, at least—appear to live forever. Many different varieties of dragon exist, each with their own unique qualities, habitats, and behavior. Adolescence in dragons is usually marked by the growth of a hatchling’s wings, although not all breeds of dragons grow wings and some breeds have other traits that indicate the beginning of maturation. In Galsreim, dragons and humans coexist peacefully.

While in medical school, Doctor Rivermane was working part-time in the administration office when a daydream got rejected because she was not creation-aligned. Rivermane went into medical practice after getting her licence and largely forgot about the incident until, one day, an astrapixeno wyrmling she was treating for a sprained back said, "When I grow up, I wanna be a doctor, too!" His mother told him he couldn't because he was destruction-aligned. Rivermane decided she had to do something. That day, she quit her private practice in order to found a serious medical university, where anyone could enrol regardless of elemental affinity. She eventually built a campus in Nworset, where equality is writ in law, with additional support from Viral Corona and Fellanthropist. She sent fliers out to advertise, including to the xeno family and the daydream whose rejection led to Rivermane's decision to found the Open Medical University. That daydream ended up in the first graduating class.