“Really! You're quite sure!” said the Grand Duke rather mockingly. “That is one satisfaction. But will you be so kind as to tell me what there can be a question of, then.”
“With pleasure, Royal Highness. The cause of the malformation is entirely a mechanical one. It has been caused through a mechanical constriction during the development of the embryo. We call such malformations constriction-formations, yes.”
The Grand Duke listened with anxious disgust; he obviously feared the effect of each succeeding word on his sensitiveness. He kept his brows knit and his mouth open: the two furrows running down to his beard seemed deeper than ever. He said: “Constriction-formations, … but how in the world … I am quite sure every precaution must have been taken …”
“Constriction-formations,” answered Dr. Sammet, “can occur in various ways. But we can say with comparative certainty that in our case … in this case it is the amnion which is to blame.”
“I beg your pardon…. The amnion?”
“That is one of the fœtal membranes, Royal Highness. Yes. And in certain circumstances the removal of this membrane from the embryo may be retarded and proceed so slowly that threads and cords are left stretching from one to the other … amniotic threads as we call them, yes. These threads may be dangerous, for they can bind and knot themselves round the whole of a child's limb; they can entirely intercept, for instance, the life-ducts of a hand and even amputate it. Yes.”
“Great heavens … amputate it. So we must be thankful that it has not come to an amputation of the hand?”
“That might have happened. Yes. But all that has happened is an unfastening, resulting in an atrophy.”
“And that could not be discovered, foreseen, prevented?”
“No, Royal Highness. Absolutely not. It is quite certain that no blame whatever attaches to anybody. Such constrictions do their work in secret. We are powerless against them. Yes.”