Amputation (sage ability)

A procedure in which a part of the body is removed, possibly resulting in death. Amputation is sometimes used to control 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.

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 (see below). If survival occurs, the creature will also suffer a severe injury.

Shock

The amount of shock a creature suffers from an amputation depends upon 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).

It must be noted that the success or failure of the procedure is not always one that can be determined in a matter of minutes. For that reason, there are two stages in determining the survival of the patient. The first is where the chance of surviving the initial surgery is checked on the amputation shock table below:

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%

This indicates the patient's chance to survive the procedure. Note that these numbers are unchanged even if the amputation is performed by an ordinary person - so long as every possible measure (with or without the use of magic) is made to reduce the bleeding and care for the patient's welfare. If the roll is made under the percentile shown, the patient has not died on the table and is very likely to survive (see post-surgery infection, below).

If the patient has failed the amputation shock roll, however, and the operation was performed by an unskilled surgeon, then the patient will be dead in just a few minutes. Note that nothing can be done to save the patient short of a heal spell. Because the amputation was bungled by a physician with less than an authority medical knowledge, the patient will bleed out or die from shock no matter what other cure spells or procedures are employed.

However, if the amputation was performed by a character with a medical knowledge of at least 30 points (amputation is a medical sage ability for authorities), then there is still a chance of saving the patient. If this is the case, the patient is assumed not to die immediately, unless the amount of knowledge needed is greater than the medical skill of the physician. To determine this, the DM rolls a d100 in secret. If this number is greater than the number of knowledge points possessed by the physician, the patient will still die - but they will linger for a time before death occurs.

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.

Injury

Naturally, the amputation is in itself an injury, meaning that hit points are lost and the amount of time to heal is greatly increase.  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