Book excerpt: This book opens with a unique historical review of natural amputations due to congenital absence, disease, frostbite, animal trauma, and to punishment and ritual. The advent of surgical amputation and its difficulties form a major part of the book, summarising the evolution of the control of haemorrhage and infection, pain relief, techniques, instrumentation, complications, prostheses, results and case histories. Alternative procedures, increasingly important in the last two centuries, are also debated.