The first version appears in the Asylum, and they look like mental patients with their arms and legs chopped off, ending in bloody stumps. Some of the ones in the Asylum can, interestingly, hang on the ceiling. Pulling them off with the Painkiller WILL hurt you if their corpse hits you. These enemies, overall, are hardly a threat.
The second version looks similar to the first, but instead of wearing a patient suit, they wear brown, ragged clothes and are marked with strange symbols. These appear in the Town, and the first batch you encounter are actually harmless. (The rest in the town WILL attack, however.)
Amputees make a return in Painkiller: Hell & Damnation, starting in the industrial section of the Opera House levels and appearing out of furnaces. They are largely unchanged from their earlier appearances, but have a notable visual difference with cuts and markings in elaborate patterns across their faces and chests.
- Given their hideous, malformed look, they might represent hospital patients who were mutilated beyond repair in hospitals, either by accidents or maliciousness.
- The town variant might represent victims of satanic cults or the Inquisition.