This chapter discusses the experience and methods of one mid-seventeenth-century London surgeon, Joseph Binns. It explains the subject which has hitherto attracted little attention from historians of medicine – the day-to-day practice of surgery. Binns was a typical seventeenth-century English surgeon. Binns's thirty years of practice spanned a particularly violent and dangerous period of English history, including the years of the Civil War. Binns's casebook mentions approximately 671 patients. This number is necessarily approximate because some case-notes are incomplete, some illegible, and some duplicates. Out of the total, only 616 are detailed enough to make any sort of analysis possible. Binns's practice demonstrates not the familiar historical axiom about conflict between medicine and surgery, but the shared theoretical assumptions according to which both were practised. The symptoms Binns treated will be discussed within three major groups: conditions resulting from recent injuries, long-standing disorders requiring repair work, and the collections of symptoms produced by venereal disease.