Chapter 144

"Is there a problem?" Professor Feiernan stepped closer as the examination stalled.

Kraft did not respond immediately; instead, he extended his percussion range further downward, comparing it with his memory. Yet except for the spot directly below the inferior angle of the scapula, all other percussion sites produced sounds nearly identical to the earlier findings.

This made no sense at all. If slight positional differences due to respiration were to blame, fine—but two percussion results from the exact same location being utterly contradictory meant either his memory or his common sense had been insulted.

"I cannot understand—this sound differs from the one I heard before."

"What does this mean?" As the interior minister, Wilbott showed far more anxiety than the duke himself. Whether due to confidence in his own body or indifference, the patient merely uttered, "Oh?"

Kraft realized he should explain the purpose and principles of the examination to his colleagues and the patient, lest a gap in information lead them to believe, "This isn't a big deal."

"Like judging whether there are hidden doors or secret chambers behind a wall by the echo of tapping, different substances produce entirely distinct sounds when struck with the proper technique."

"Generally speaking, as a loose, lightweight organ, the lungs should return a clear sound when percussed—but not so clear as to seem nearly empty. Properly, it sounds like this." He tapped lightly on the duke's healthy lung area, demonstrating a pleasant, clear resonance.

"But pulmonary consumption is a terrible disease—it gradually erodes the lungs, forming large lesions that decay, dissolve, and are expelled, leaving behind cavities—'secret chambers behind the wall.' When percussed, these produce a hollow, drumlike or jarlike sound."

【Honestly, recently I've been using HuanYuanApp to read and keep up with updates—easy to switch sources, multiple voice options, available on Android and iOS.】

He selected another detected cavity and struck it, producing the sound of pathology.

Finally, he pointed to the area beneath the right inferior angle of the scapula. "And this spot was the same during the first examination—a cavity with an internal diameter of at least the length of a phalanx, certainly not small."

"But now it isn't."

A dull, solid, dense sound rang beneath his percussing finger. Compared to the previous two, it was like a wall packed with sand and gravel—muffling vibrations into a muffled, low reply. "I call this a dull sound."

"You mean… something has filled this cavity?" As a scholar with strong comprehension, Feiernan quickly grasped the implication from the terminology—but instead of clarity, he sank into a deeper, almost inexpressible confusion. "In just the time since the last episode?"

Kraft gave a slow, firm nod. He could not believe it either—but the objective result was undeniable.

Wilbott, having taken the teapot from a servant, carefully poured the duke a second cup of warm tea to soothe his throat. He had understood Professor Feiernan's summary and interjected: "Could it be phlegm or something similar filling it?"

"Liquid shouldn't produce this sound." Compared to Professor Feiernan, it was precisely because Kraft understood disease more deeply that this change struck him as stranger, more inexplicable.

Though the classic adage "Patients don't get sick according to textbooks" had been proven countless times, this development still exceeded all understanding.

Then again, there was another saying, heard later: "Even the hardest problems have their answers in the books." The old compilers always managed to slip unexpected details into the most obscure corners.

He scoured those texts for details related to tuberculosis—pneumothorax, empyema, hemorrhage, airway narrowing, atelectasis, pulmonary aspergillosis, cor pulmonale—each term accompanied by paragraphs, pages of text. Perhaps one of them held the answer to this "impossible event."

Many forced explanations were possible. For instance, perhaps a liquid had been introduced into the cavity during movement, and its unusual position made the sound peculiar; or the lesion had accidentally formed a valve-like narrowing in the airway, opposite to tension pneumothorax, resulting in an extremely unusual atelectasis.

In the end, all possibilities boiled down to one question: Do you believe this nonsense?

There was also a far simpler, more brutal explanation—but he did not wish to propose it without clear evidence.

Moreover, no matter what he speculated, he could not verify his hypothesis without imaging results.

That same agonizing, visual-loss-like torment crept back into his mind. Kraft felt a craving spreading through his neural folds like a subarachnoid hemorrhage of spiderweb filaments, a stimulation as intense as pain, urging him onward.

His mind offered a suggestion—and he found it hard to refuse.

"Will this affect my treatment?" Yet someone still cared about his treatment plan. The old duke wrapped himself in a fur coat—not a precious breed, likely from some beast hunted near the nearby mountains.

He curled his fingers against his chest, clearly unmoved. "A hole the length of a finger joint? Not that wide. I still have plenty of lung left. If nothing else is wrong, let's begin preparing for treatment soon."

"…"

Silence. Silence was today's Westmin.

Not only Kraft, but even Professor Feiernan fell into a stunned silence. Fortunately, Feiernan had likely faced such demands before; he was not completely thrown off course.

"Your Grace, this is a dangerous course of action. No one knows what unexpected consequences an 'active' lesion might cause during treatment." He emphasized the word "active" with deliberate pause, knowing this term should not be taken literally here—it felt even more repugnant, as if acknowledging something capable of motion could exist within the lungs.

"I think Knight Kraft's therapy makes sense. Perhaps we could just crush this lesion altogether?" The earlier warnings about risks had failed to frighten the patient; instead, they had sparked overly bold ideas.

Feiernan had no recourse. As the duke's longtime attending physician, he knew the man's nature all too well. He could only give Kraft a look: "It's your suggestion—you handle it."

The original goal had been to find a new approach to the duke's nearly unsolvable condition. That goal had been achieved—but not in the way anyone had imagined.

"I agree with Professor Feiernan—we need more careful deliberation." Kraft did not believe he could change the duke's mind on the spot, but he could buy time—and there was more to say.

"Preparing the equipment for artificial pneumothorax takes time, and the patient must also adjust his physical condition beforehand. During this period, I wish to trace the detailed medical history—such as who the duke interacted with, what foods he consumed, or where he traveled before the new symptoms appeared."

Of course, there was also one special examination.

"Wilbott will fulfill your requests—you may specify the tools and medicines needed." The duke showed no interest even in lifting a hand for this expenditure. "But the menu and visitor list… never mind, it doesn't matter much."

【For the sake of funding and curiosity】

After careful consideration, Kraft decided to employ a single mental sense—this truly was a situation beyond all comprehension.

Just for an instant—like an alcoholic briefly inhaling near a bottle's mouth, savoring the ghost of liquor—he eased the suppression of his mental instinct. It would relieve the restraint, solve an unusually peculiar case, and secure the next phase of treatment. Three benefits in one.

He convinced himself. Or perhaps he wasn't sure if it was himself who convinced him—but the barrier before his mental sense did lift, just for an instant.

His consciousness greedily absorbed the incoming information, like parched earth meeting rain. The lung, riddled with holes, projected into his mind in three-dimensional, transparent clarity.

He focused his attention on the shallow layer beneath the right inferior angle of the scapula, locking onto the mystery wrapped in confusion, curiosity, and a touch of fear—there was a strange, illicit pleasure in peeking at the answer.

The first percussion had been correct—it was indeed a tubercular cavity, its size matching his estimate, internal diameter slightly longer than his middle phalanx. The spatial perception in his mental vision was exceptionally precise.

Calling it a "cavity" now seemed inappropriate. A roughly spherical mass filled the interior, slightly smaller than the cavity's diameter, leaving behind a narrow, crescent-shaped gap—enabling him to distinguish surfaces not fully adhered to the wall.

It was a bizarre, velvety, hairy surface, radiating a vigorous, flourishing vitality utterly incongruous with this increasingly failing respiratory organ.