医术的本质:亚里士多德与现象学传统

On the Essence of Medical Skills:Aristotélēs and Phenomenology Tradition

从亚里士多德以及深受其影响的海德格尔、伽达默尔代表的现象学传统来看,关于医术活动之本质的寻常认识问题重重。对亚里士多德来说,医术的对象是作为自然物的身体,但由于医术本身作为技艺属于创制科学,具有很大的不确定性,并且必须无条件地服从于健康这一根本目的。在海德格尔那里,作为技艺的医术和作为自然的身体在人的康复活动中具有某种交织性,但是前者永远无法代替后者,医术对于在根本上具有运动尤其是自我遮蔽之倾向的自然性身体,只能发挥一种配合与支持的功能。伽达默尔在综合性继承亚里士多德与海德格尔思想的基础上,不仅继续强调医术相对于自然性身体的服务性、参与性地位,强调医术远不止于对医学知识的简单运用,而且要求在实践理性的反思框架中来运用医术,即医术属于一种自我理解和相互理解的人类生存经验。总之,按照亚里士多德和现象学传统,人类身体的健康虽然关乎医术,但是首先关乎自然、关乎人之整体性存在,乃至我们自身与他人之间的实践性交往。

From the perspective of Aristotelian philosophy and phenomenological tradition of Heidegger and Gadamer, deeply influenced by Aristotle, some common understanding about the nature of medical activities is quite problematic. For Aristotle, although the object of medical art is the body as natural thing, medical activity itself as an art, which belongs to productive science, has much uncertainty, and must be submitted to its fundamental aim unconditionally which called health. In Heidegger, medical art as a craft and body as a natural thing have some kind of interweaving in the rehabilitation activities, but the former could never replace the latter, and it should only play the function of cooperating and sustaining to natural body which essentially has the tendency of movement, especially of self-concealment. Comprehensively inheriting Aristotle's and Heidegger's thought, Gadamer did not only continue to stress the service role of medical art applied to natural body, but also required to use the art of medicine in the framework of reflecting practical reason, which means that, medical art belongs to a kind of human experience of self-understanding and mutual understanding. All in all, according to Aristotle and phenomenological tradition, although the health of human body is related to medical art, it is first bound up with nature, the integrity of a human being, and the practical communication between human beings.