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of ‘art’ which still stands before the threshold of what we call ‘science,’ it is obviousthat the art of healing occupies an exceptional and problematic position. For here thereis no ‘work’ produced by art, and no ‘artificial’ product. Here we cannot speak of amaterial which is already given in the last analysis by nature, and from which somethingnew emerges by being brought into an artfully conceived form. On the contrary,it belongs to the essence of the art of healing that its ability to produce is an ability tore-produce and re-establish something. This signifies a special modification of what ‘art’means, and one which is unique to the knowledge and practice of the physician. 30We should acknowledge that health is certainly a rather special thing to produce,compared to, say, shoes, loaves of bread, or buildings. Indeed, according to Aristotle --as well as to Plato, Hippocrates and other ancient philosophers -- health is not somethingthat the doctor can bring about by himself, but something that can only be brought aboutby the doctor helping nature heal itself. Health is a self-restoring balance, and what thedoctor does is to provide the means by which a state of equilibrium can re-establish itselfby its own powers.Gadamer’s aim is to investigate the ancient philosophy of medicine in order to findguidance for contemporary medical practice. This is not (only) a nostalgic appeal for apremodern, “humane” medicine, which was not dominated and controlled by technoscience,but rather a strategy that rests, on Gadamer’s insistence, upon the importance ofGreek philosophy for our contemporary thinking and our contemporary way of life. Weneed to address and make explicit this influence in order to elucidate the structure andgoals of contemporary medical practice, just as we need to do so in order to elucidate thestructure and goals of the Geisteswissenschaften. The reason for this is indeed that modernmedical practice is not applied medical science only, but a hermeneutic activity, whichenvelops the theories and technologies of science. 31The second way chosen by Gadamer, in The Enigma of Health, for addressing medicalpractice philosophically, is the way of phenomenology. Phenomena central to clinicalpractice, such as death, life, body and soul, anxiety, freedom and health, are analyzed byGadamer for the most part in accordance with the phenomenological framework developedby Heidegger in Sein und Zeit. We have already confirmed the importance of Heidegger’sphilosophy for Gadamer in Truth and Method, and the same holds good for The Enigmaof Health. Since the phenomenological hermeneutics of Heidegger and Gadamer is itselffirmly rooted in Aristotelian patterns of thought, the marriage between the historical, philologicalapproach and the phenomenological attitude in The Enigma of Health should comeas no surprise at all. What might be more surprising is that Gadamer relies on the patternof understanding developed in Truth and Method to such a small extent, when analyzingthe dialogue essential to medical practice. He focuses, instead, upon the phenomenon thatis central to the goal of clinical practice: health. Since this goal is what distinguishesmedicine from other hermeneutic activities (which have other goals), it seems in many30Gadamer, The Enigma of Health, 32. “‘Techne’ ist jenes Wissen, das ein bestimmtes, seiner selbstsicheres Können im Zusammenhang eines Herstellens ausmacht. Es ist von vornherein auf Herstellenkönnenbezogen und aus diesem Bezug erwachsen. [...] Innerhalb eines solchen Begriffs von “Kunst”, dervor der Schwelle zu dem steht, was wir “Wissenschaft” nennen, nimmt nun offenbar die Heilkunst eineexzeptionelle und problematische Stellung ein. Hier gibt es kein Werk, das durch Kunst hergestellt undkünstlich ist. Hier kann man nicht von einem Material reden, das zuletzt in der Natur vorgegeben ist undaus dem etwas Neues wird, indem es in eine kunstvoll ersonnene Form gebracht wird. Zum Wesen derHeilkunst gehört vielmehr, dass ihr Herstellenkönnen ein Wiederherstellenkönnen ist. Dadurch kommt indas Wissen und Tun des Arztes eine nur ihm eigene Modifikation dessen, was hier “Kunst” heisst.”Gadamer, Über die Verborgenheit der Gesundheit, 51-52.31Svenaeus, The Hermeneutics of Medicine and the Phenomenology of Health, part 3.180
ways a promising way to go. It is also an original way to approach questions of medicalethics, which are seldom related in any substantive way to a theory of health.Central to Gadamer’s analysis of the concept of health is the thought that health is notsimply synonymous with the absence of any disease (i.e., of pathological states or processesaffecting the biological organism). Health has a phenomenological structure initself, as a certain way of being-in-the-world:So what genuine possibilities stand before us when we are considering the question ofhealth? Without doubt it is part of our nature as living beings that our conscious selfawarenessremains largely in the background so that our enjoyment of good health isconstantly concealed from us. Yet despite its hidden character health none the lessmanifests itself in a general feeling of well-being. It shows itself above all where sucha feeling of well-being means we are open to new things, ready to embark on newenterprises and, forgetful of ourselves, scarcely notice the demands and strains whichare put on us. This is what health is. ... We need only reflect that it is quite meaningfulto ask someone ‘Do you feel ill?’ but that it would border on the absurd to asksomeone ‘Do you feel healthy?’ Health is not a condition that one introspectively feelsin oneself. Rather, it is a condition of being involved, of being in the world, of beingtogether with one’s fellow human beings, of active and rewarding engagement in one’severyday tasks. 32In many ways the phenomenon of illness seems to be far more concrete and easy toget hold of than the phenomenon of health. When we are ill, life is often dominated byfeelings of meaninglessness, helplessness, pain, nausea, fear, dizziness, or disability.Health, in contrast, effaces itself in an enigmatic way (the dual meaning of the GermanVerborgenheit). It seems to be the absence of every feeling of being ill, the state or processwhich we are in when everything is running smoothly, flowing in its usual way andwithout hindrance.The conceptual background for Gadamer’s analysis of health is here undoubtedlyHeidegger’s phenomenology of everyday human existence found in Division 1 of Sein undZeit, although Heidegger himself never addresses health and sickness there. Anotherimportant source of inspiration for Gadamer’s analysis is ancient health theory. Theoriesof health in antiquity were built around various conceptions of balance and harmony, themost famous and influential of which was the Hippocratic doctrine of balance between thefour bodily fluids -- blood, phlegm, yellow and black bile. 33 In classical Greece, thisbalance between fluids or other elements (such as air, water, fire and earth) in the humanbody was thought to mirror the order of the entire world. Man was seen as a microcosmos,built according to the same principles as the order of all things -- as the order ofthe kosmos.32Gadamer, The Enigma of Health, 112-113. “Welche Möglichkeiten haben wir dann eigentlich,wenn es sich um Gesundheit handelt? Es liegt ganz unzweifelhaft in der Lebendigkeit unserer Natur, dassdie Bewusstheit sich von sich selbst zurückhält, so dass Gesundheit sich verbirgt. Trotz aller Verborgenheitkommt sie aber in einer Art Wohlgefühl zutage, und mehr noch darin, dass wir vor lauter Wohlgefühlunternehmungsfreudig, erkenntnisoffen und selbstvergessen sind und selbst Strapazen und Anstrengungenkaum spüren – das ist Gesundheit. […] Mann mache es sich nur bewusst, dass es zwar sinnvoll ist zufragen: “Fühlen Sie sich krank?” Aber es wäre fast lächerlich, wenn einer einen fragte: “Fühlen Sie sichgesund?” Gesundheit ist eben überhaupt nicht ein Sich-Fühlen, sondern ist Da-Sein, In-der-Welt-Sein, Mitden-Menschen-Sein,von den eigenen Aufgaben des Lebens tätig oder freudig erfüllt sein.” Gadamer, Überdie Verborgenheit der Gesundheit, 143-144.33Oswei Temkin, The Double Face of Janus (Baltimore: Johns Hopkins University Press, 1977).181
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various forms of idealist philosoph
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self-givenness (Selbstgegebenheit)
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It must be admitted in this regard
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down and all the way back.” 51 Fo
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Heidegger characterized his own pro
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Heidegger’s transcendental-existe
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perceived world” (PP, 25), Merlea
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in the unreflected, in “perceptio
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Nor would Merleau-Ponty have had an
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a way that we do not all crash into
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“I think” but in “the dialogu
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in existence a “super-abundance o
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crucial “other” in our becoming
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to its being grounded in terms of b
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(“History is this quasi-‘thing
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manner (statistical or regression a
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and they are such, precisely becaus
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interpreted the world, and that the
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is not rationalist or idealist in t
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title Herbert Spiegelberg gave to h
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II.TOWARD A TELOS OF SIGNIFYING COM
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published in Being and Having. 12 T
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inside me which makes me able to re
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or is not existence something that
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ReflectionPhilosophical thought is
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attempt at unification, the reflect
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thereof. And an ethical aspect: tha
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According to Ricoeur, “It is here
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the most meaningful contemporary sw
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ival hermeneutics that we perceive
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more pronounced recoil whereby the
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these structures throughout the who
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By seeking a deeper unity of Dasein
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folds a pre-given set of possibilit
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of experience is correlated to a pa
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explanations of causal events in th
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accept one argument over another. A
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a subtle dialectic between argument
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or warrant an assertion. Such fulfi
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the assertive vehemence of the hist
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positions of the subject. For memor
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attestation slips a plurality, most
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What confidence in the word of othe
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From where, perhaps, the place of t
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Sans le correctif du commandement d
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life), Rembrandt proposes an interp
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only as a place made for oneself as
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III.THE HERMENEUTIC PHENOMENOLOGY O
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consolidated by terming it an “un
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If our analysis is correct, the “
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The esthesiology of the senses of t
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in certain cases, together with the
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what the touched hand recognizes wh
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heart; a presence where a lived tak
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conceives it, not on the basis of n
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Merleau-Ponty, a form, a relation o
Page 132 and 133: out in “Eye and Mind.” So, let
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Page 154 and 155: 4. THE SUBJECTIVE BODY AND THE IDEA
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Page 158 and 159: The Oversight of Life’s OneselfTh
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Page 172 and 173: According to views held by Gadamer
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Page 189: IV.PHENOMENOLOGICAL MOMENTS IN THE
Page 192 and 193: Therefore, I would like to concentr
Page 194 and 195: classical Greek tradition of thinki
Page 196 and 197: This uneasiness in human beings, wh
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Page 206 and 207: II.A Liberation, With a Meeting in
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Page 214 and 215: Der christlich-jüdische Gott ist d
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Page 221: V.THE ARCHEOLOGY OF HERMENEUTIC PHE
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transcendental reason, 46 pure rati
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and properties of sensible phenomen
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In clear distantiation from his own
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2. HISTORY AS THE OTHER -- NOTES ON
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precisely the accomplishment of phe
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ought as such into the present, it
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educed state. As soon as the reflec
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explicitly in the Vienna lecture, w
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the task and the very environment o
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stood “from itself.” As a resul
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makes possible the further interpre
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of Being -- already grown into Bein
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the Husserlian idea of phenomenolog
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into the openness of Being, it diff
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We now need to quote a second, well
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“knowledge about the world.” In
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Husserl’s ConversionsTheological
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And this proved, probably, to be a
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Husserl’s Reflective Phenomenolog
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to beings of the same nature. But t
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worldlessness of Husserl’s intent
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According to Aristotle, intellectio
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6. RIGOR AND ORIGINARITY: THE TRANS
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The latter, the nonessential princi
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that, for Husserl, every act is ind
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not forget what Husserl meant by a-
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things, we shall comprehend by intu
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something,’ is not merely there (
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epoché in Husserl become a hermene
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When Heidegger characterizes world-
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