Amputation (sage ability)

Amputation is an authority-status sage ability available through the study of medicine. The skill allows the character the potential to safely remove a part of the body, as a means of controlling the spread of disease or necrosis moving outward from an affected limb, such as malignancy or gangrene. It may also be necessary to separate a creature from a limb if the creature is trapped and cannot otherwise be freed. It is possible that this may result in the subject's death.

When performed by any person without sufficient medical knowledge, the chances of a creature surviving the loss of a limb is extremely low. To determine if a creature survives an amputation, the creature will need to roll on the amputation shock survival chart. If survival occurs, the creature will have to recover from a severe injury.

Amputation Shock Table

Constitution	category of amputation (d100 roll)
	incidental	minor	major	radical	drastic
3	45%	35%	19%	2%	0.1%
4	51%	40%	22%	3%	0.1%
5	57%	45%	26%	4%	0.2%
6	63%	50%	30%	6%	0.2%
7	68%	55%	34%	8%	0.3%
8	73%	60%	38%	11%	0.4%
9	78%	65%	43%	14%	0.5%
10	83%	70%	48%	17%	0.7%
11	88%	75%	53%	21%	0.8%
12	93%	80%	58%	25%	1.0%
13	98%	85%	63%	30%	1.2%
14	100%	88%	67%	35%	1.4%
15	100%	91%	71%	40%	5%
16	100%	95%	76%	46%	9%
17	100%	97%	80%	51%	14%
18	100%	99%	83%	57%	20%
19	100%	99%	85%	61%	27%
20	100%	99%	87%	66%	34%
21	100%	99%	89%	71%	43%
22	100%	99%	91%	77%	52%
23	100%	99%	93%	82%	62%
24	100%	99%	95%	88%	74%
25	100%	99%	97%	93%	86%

Seriousness

The seriousness of an amputation depends on the limb that is severed. For the purpose of this system, amputations have been broken down into five categories, from the least invasive to the most extreme, from the least likely to result in death to the most likely:

• Incidental: fingers and toes, ears, nose and teeth.
• Minor: partial hand or foot, tongue or eyes.
• Major: wrist or ankle, through the forearm, at the elbow, below the knee, at the knee.
• Radical: above the elbow, at the shoulder, above the knee, at the hip, removing the genitals or the breasts.
• Drastic: cutting through the torso or decapitation (remembering that many creatures have more than one head).

Success or failure of the procedure cannot always be determined in a period of minutes. There are therefore two stages in determining the survival of the patient. The first is the chance of surviving the initial surgery, as a percentage shown on the amputation shock table. Attempts to amputate are divided into "unskilled" and "skilled."

Unskilled Attempts

Even if the would-be surgeon does not possess the sage ability, he or she may yet attempt the amputation. A percentage die is rolled according to the seriousness of the amputation and the patient's constitution. The chance of success by an unskilled "surgeon" is -6% per experience level of the character below 18th.

If this roll fails, the patient has died; without any skill, and even taking every possible measure with or without the use of magic, the unskilled surgeon will not be able to save the patient short of using a heal spell. Even a [[Regeneration (spell)|regeneration spell) will not suffice, as the shock experienced will be too great (though if the patient were naturally able to regenerate, that would be another matter). The patient will bleed out or die from shock, no matter what cure spells or procedures are attempted.

Success indicates that the amputation has been managed and the patient has not died; however, there remains the chance of a post-operative infection.

Skilled Attempts

If the surgeon possesses the sage ability, in addition to the roll indicated on the amputation shock table, the surgeon will also roll a second percentile die against their knowledge points in medicine. If either roll succeeds, there will remain a chance of saving the patient.

However, if the patient survives the operation because of the amputating surgeon's roll, while failing according to the shock table, then the patient must remain in bed throughout their entire recovery, and they must be attended by a medical physician everyday of that recovery, who is equal in knowledge to the actual die that the surgeon rolled during the amputation, to ensure the survival of the patient.

For example, while performing the amputation, Bertrand, who has 46 knowledge points in medicine, rolled a 27 on the die, preserving the patient's life. Through the patient's recovery, he or she must be attended by someone with at least 27 knowledge. It need not be Bertrand, but if no one else is available, then Bertrand will have to attend. No day can be missed, or else the belayed post-operative infection being managed will run free through the body and possibly kill the patient.

Recovery Time

Following an operation, the patient will need to remain indoors in order to avoid an post-operative infection. If the character was saved by the surgeon and not according to the amputation shock table, then they must spend the first two-thirds of their recovery in round-the-clock bedrest; thereafter, they may move about for 2-4 hours per day (each day is rolled), so long as they perform no work of any kind, even writing, at this time. When their hours of the day expire, the patient will feel exhausted and will want to return to bed to rest.

Time before survival is certain
incidental	minor	major	radical	drastic
2-5 days	6-15 days	2-5 weeks	3-12 weeks	2-5 months

Alternatively, if the character did succeed upon the shock table, then they need spend only the first third of their recovery in round-the-clock bedrest. They may spend the second third of their time moving about for 3-6 hours a day, and the last third of their recovery with 3-12 hours to move about. Also, during the last third of their recovery, they may perform light duties that do not involve lifting or moving about steadily. They may read, write, tutor individual students, study their spells or practice cantrips, but may not cast spells.

Post-operative Infections

Roll	Result
equal or less	no effect
1 above	character must make a malady check
2-4 above	character has contracted a severe affliction affecting the blood (1-3), joints (4-11), skeleton (12) or skin (13-20)
5-7 above	character has gangrene; roll 1-4 points of necrotic damage
8 or more above	character has contracted a terminal affliction affecting the blood (1-3) or skeleton (4-8)

Each day of recovery, the character must make a constitution check. The time of recovery is divided into quarters; during the first quarter, adjust the character's constitution down by 2 points. During the second quarter, treat as normal. In the third quarter, increase the character's constitution by 1 point; and in the last quarter, increase it by 2 points.

For example, a character has a nose removed, an incidental amputation, and rolls 3 days before their recovery is certain. Day One is 1 of 3, or 33% of the total time, so the first quarter is ignored and the amputee's constitution, 14, is treated as normal. On Day Two, the amputee's constitution is treated as 15; and on Day Three, it is treated as 16.

Should a malady check indicating a fall or twisted ankle, or similar malady, occur when the patient is bedridden round-the-clock, assume that the accident has resulted from the delirious character falling out of bed or attempting to sleep walk, or having a bowl of hot soup dropped upon them, or some such similar unpleasantness.

Naturally, diseases and necrotic damage has the potential for treatment, recovery and management through sage abilities and spellcasting.

Amputation as Injury

In addition to the lost of a limb or body part, and the danger of infection, the trauma of amputation also causes a loss of hit points and the creation of an injury. The total amount of damage for each depends upon the patient's maximum hit points and the seriousness of operation.

Damage Table

Form of Damage	% of patient's maximum hit points
	incidental	minor	major	radical	drastic
initial damage	50%	75%	90%	100%	105%
% of damage that is injury	10%	25%	50%	75%	100%

Using the damage table, Callandra's maximum hit points are 36 at the time of the amputation; at present, she has 19 hit points. She needs to have her hand removed, which is a cut through the wrist, considered a "major" amputation. She survives the shock, but as a result of the operation, according to the table shown, she suffers hit point damage equal to 90% of her maximum. Fractions are ignored, so this equals 32 damage; once the operation was accomplished, Callandra would be reduced to -13 hit points, which would make her dead. Additionally, the operation would also cause her to be wounded for 2 points of damage per round. While the spell death's door would revive her, it would be more practical to raise her initial health before the operation at least 6 or 7 points, to be certain of being able to withstand the damage involved and so that there was time to bind her wounds before she bled out.

Additionally, the damage table also indicates that Callandra would suffer 50% of her maximum, or 18, points of injury. These points heal ten times more slowly than ordinary damage, ensuring that Callandra will require rest to heal as well as to ensure she does not receive an infection.

See Medicine