The removal of a patient’s limb was the most radical procedure performed by early modern surgeons. It occurred only when a part of the body was considered lost to the “cold fire” (der kalte Brand)—a final, irreversible putrefaction. The harrowing experience held life-altering consequences for patients and their families. By drawing on surgical treatises, correspondences, field manuals, and examination books, this article uncovers a process of negotiation that took place during diagnosis and prognosis in cases of the cold fire. Medical reasoning entered a volatile social space in order to determine the best course of action. The opinions of medical colleagues, patients, family members, friends, and even pastors were crucial to the formation of a shared consensus necessary to undertake a procedure. Amputation was a collective endeavor guided as much by communal concerns as by medical ones.