Blood: The modern practice of blood transfusion is little more than a century old, having been introduced during the First World War and dependent on an understanding of blood groups, sterility, storage and separation of bloods components. However, the historical journey to do this safely began in ancient times. The ancient Greeks from 300 BCE until the time of Galen believed that the arteries carried air from the lungs to the rest of the body, this theory was disproved by Galen who still thought that blood was generated by the liver and circulated in the vessels until consumed while being constantly replenished by the liver. The Arab physicians developed an understanding of the circulation which was later re-discovered by William Harvey. The Chapter then proceeds to cover the management of war wounds including the work of Ambroise Paré, John Hunter and Dominque Larrey. There was little further progress through wars of the 19th century - the American Civil, Franco-Prussian or Sino-Japanese Russian wars. The First World War saw major advances in performing major surgery close to the front line, as well as the managment of femoral fractures, greatly reducing mortality. Considerable improvements in the timing and management were achieved for laparotomy, thoracotomy and neurosurgery, accompanied by more efficient resuscitation and management of shock. In the 1980’s the development of the advanced trauma life support (ATLS) courses and over definitive trauma managment courses in addition to establishing systems of trauma care and clinical governance have continued to ensure better outcomes even from significant injuries and multi-system trauma. The chapter closes with a section on the history of amputation.