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.

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. 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.

category of amputation (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
2-3 above	character has contracted a severe affliction affecting the blood (1-3), joints (4-11), skeletal (12) or skin (13-20)

WORKING.

Infections

Regardless of who performs the amputation, all patients must make a constitution check against acquiring a disease of some kind. This is a random roll, determining the area of infection, nature and degree of the ailment; the amount of time necessary to survive this disease is then added to total recovery time for both disease and amputation survival. If a disease is contracted and the patient failed their initial amputation shock roll, they will need the care of a physician, with the necessary knowledge, for the combined recovery time. And, of course, there is always a chance that the disease might end in death.

Injuries

Naturally, the amputation is in itself an injury, meaning that hit points are lost and the amount of time to heal is greatly increased.  For the amount of damage suffered, consult this table:

	damage resulting from amputation (by category)
	incidental	minor	major	radical	drastic
initial damage	50%	75%	90%	100%	105%
% of damage that is injury	10%	25%	50%	75%	100%

Returning to Bertrand, imagine that he has a maximum total of 36 hit points at the time of the amputation (always use the character's full health as the guideline when determining the amount of damage). We'll remember that Bertrand had his hand removed at the wrist. Because the amputation was major, he suffers a total of 32 damage from the removal of his hand. Of this, 18 of this damage will be injury damage, meaning that he will need to regain a total of 196 hit points before he is at full (180 from the injury and the additional 16 ordinary damage he suffered). This damage can be healed by any form of spell, magic item, or rest to which the character has access.

Note that where 105% of total hit points is indicated, this will mean that the character is reduced to negative hit points (Bertrand would take his full 36 hit points plus 1.8 more - rounded down to 1 additional hit point, putting him at -1 total).

If the number of hit points caused by the amputation is sufficient to kill the patient, then no amount of medical care can help the patient survive the procedure. Somehow, the patient's hit points must be raised sufficiently to allow the patient to survive the amputation.

See Medicine