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,

WORKING.

For example, a character with a 15 constitution, Bertrand, has a hand removed at the wrist by a physician with 46 points of medical knowledge. With a 71% chance of surviving outright, Bertrand rolls a 74. The DM then rolls a d100, with the result of 37 - meaning that Bertrand will survive, as long as he continues to receive care from a physician with at least 37 points of knowledge. At this point, we consult the Survival Time table to see how long Bertrand's life remains in jeopardy:

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

Bertrand's amputation was major, so he will need 2-5 weeks of recovery. If it proves that no physician of sufficient knowledge can look after him, he will die at the end of the period rolled - it is simply a matter of course that his body fails in some manner to adjust to the damage done. On the other hand, if he gets sufficient care, he will absolutely survive once the time period has passed.

Note that if the original roll of d100 resulted in a number that an amateur (or even less than an amateur) had enough knowledge points to look after Bertrand, he would not actually need an authority physician to ensure his good health.

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