Chapter 286

"I need a reason—a reason I must be here." Kraft ran his fingers through his wet hair and sat down in a spot he found for himself.

He shouldn't have gone out in this weather—at least, he thought he shouldn't have.

About two hours ago, he was still in his overcrowded clinic, seeing his thirty-fourth patient of the morning, counting down to lunchtime.

These days, there's no such thing as appointment registration. The clinic had tried limiting patient numbers through similar methods, but they quickly realized that unlinked quotas just handed money to middlemen.

So now the situation was this: predicting tomorrow's patient count was harder than predicting the weather. At least weather could actually be predicted; Kraft had no idea whether his lunch would come in the afternoon or evening.

The clinic's current patients were no longer limited to tuberculosis—they now had to screen for digitalis suitability as well, which was far more difficult.

Compared to tuberculosis, whose symptoms were obvious, even many doctors had no understanding whatsoever of the concept of "heart failure."

Even blood circulation hadn't yet gained absolute dominance in academic circles; according to the four humors theory, blood gushed like a spring from the liver, flowed to every corner of the body, some absorbed and consumed, the rest evaporating through the pores—known as the "dispersion theory."

According to this theory, edema occurred when red fluid arrived at its destination but couldn't be fully consumed or dispersed, becoming trapped and swelling up.

So how was it traditionally treated? Simple: if there was too much, drain some off. Thus, the treatment path returned to the familiar bloodletting—indeed, it could be observed that some patients showed improvement after bloodletting.

Don't ask how the person is doing—just ask whether the edema has lessened.

Theory applied to practice, practice validating theory—a closed loop.

Before allowing Dai Wei to prescribe, Kraft needed to correct his already minimal anatomical knowledge once more, reshaping it from his own perspective.

As is well known, blood travels through the body starting from the left ventricle, returning to the right ventricle after systemic circulation, then passing through the lungs back to the left ventricle.

Now, due to various reasons that could take a month to explain, either the right or left ventricle's pumping function has failed—it can no longer push out sufficient blood, like a river with enormous flow suddenly narrowing.

Water upstream flows too slowly; water behind it piles up, the level rising, pressure increasing, until eventually causing flooding or breach.

In left heart failure, blood is blocked in the lungs, manifesting as coughing up blood-tinged frothy sputum and difficulty breathing; in right heart failure, blood is blocked in the venous system.

The venous system involves far more structures.

All unpaired abdominal organs—including the stomach and intestines—drain into the portal vein, pass through the liver, then exit via the hepatic vein into the inferior vena cava to return to the heart.

Liver congestion causes hepatomegaly and tenderness; gastrointestinal congestion causes bloating and nausea; limb venous congestion causes edema—all these symptoms, scattered across the body, stem from the same cause.

Returning now to the four humors theory, one finds that though its principles are entirely wrong, it somehow stumbled upon part of the truth: blood really is relatively excessive.

And bloodletting, aside from the most absurd extremes, mostly draws venous blood, thereby reducing venous volume and relieving pressure to some extent.

What Kraft needed to do was redirect Dai Wei's thinking toward his own framework, so he could understand why these combined symptoms pointed to heart failure—not some other random mess.

The bad news: Dai Wei was deeply indoctrinated by the four humors theory and needed time to adapt; the good news: he had virtually no anatomical training, so it was easy to deceive him—he quickly accepted this far more concrete explanation.

He didn't need to know about ion pump inhibition or reflexive vagal excitation slowing heart rate; he only needed to understand that digitalis was a cardiac stimulant that, under normal conditions, enhanced myocardial contraction and slowed the heartbeat.

But clinical application was far more complex than a few sentences; Dai Wei needed more time to gradually learn drug contraindications, which involved cardiac auscultation—a whole other set of things that made one's hairline recede.

Only in actual practice did Kraft realize how extremely difficult it was to fabricate a usage guide without referencing physiology—and even harder to make others accept, understand, and execute it properly.

Just a few days after catching his breath, the professor suddenly realized he had piled up clinical work, drug experiments, and teaching duties—all tasks waiting, time vanishing like spent money, always insufficient.

Even his plan to "target the samples" had been indefinitely postponed.

So when Vading invited him to drop by Green's place for tea, Kraft politely expressed incomprehension—how had they come knocking already, when he hadn't even started?

The Inquisition's invitation was hard to refuse; considering their current and future prolonged state of hypersensitivity, Kraft ultimately decided to spare his precious afternoon to meet them and find out what unwarranted interpretations they'd formed about his work.

But once seated across from the priest, he realized the matter wasn't so simple.

Green looked utterly drained—not like someone who'd merely been forced to take a few days off; his mental state resembled that of someone who'd just crawled out of the Tem River.

Regarding the new drug, after examining the sample, he readily accepted Kraft's explanation, appearing to exhale a sigh of relief, then fell into silence.

The two sat listening to the rain outside for a while, until finally Green spoke:

"You don't look well either. Have you had any unusual dreams recently?"

"No. I've been up half the night writing the drug guide you insisted I explain." Every second wasted outside reminded Kraft how long his to-do list was; a quiet urgency never left him.

But from Green's tone, he'd encountered something unusual—otherwise, why would a priest seek out a doctor to discuss dreams? It was like asking a blind man about the road.

Oh, wait—apparently, in this era, doctors did include dream interpretation in their practice.

"What did you dream about?" For caution's sake, better to ask more.

"Hard to describe." Green propped his head on one hand and tossed a log into the fire, as if trying to dispel the dampness in the room—but on a rain-soaked day, that heat barely dried the ground beneath their feet.

"Tell me anyway—go by instinct."

"Here… no, a place very much like here." He noticed Kraft sit up straighter, his attitude shifting from mild impatience to faint interest.

"And then?"

"Wetness, tapping, vibration." Green struggled to gather the scattered fragments of the dream, but the elements that had left a deep impression were now incoherent—like peering through a keyhole at memory, seeing only the most obvious patches of color.

"Tapping, vibration, outside was strangely dark, but… there was light."

"White light?"

"Yes. White light." Green nodded, prompted. "You know about it?"

【I know it too well!】

Kraft obtained the information he wanted—rarely did a consultation come so easily: "Correct. After exposure to those things, experiencing such symptoms is entirely reasonable."

"My advice: find a place that's very high, very hard to climb, and offers a view of the sky—live there for a month. Your church's bell tower would be perfect."

"If you wake up somewhere that feels similar to sleep but not quite the same, and you confirm you're temporarily safe—immediately, I mean immediately—look at the moon. If all goes well, you'll wake up."

"Of course, in practice, you may need a doctor present to guide you—conveniently, I need more cases." The professor extended his hand confidently. "Here's to another successful collaboration."

The priest hesitantly shook the hand, but wasn't reassured by his confidence: "But… there doesn't seem to be a moon there."

"Hmm?"

"It's raining there. A heavy rain."