) (ibid., 415b); “the soul is the first grade of actuality [
] of a natural body having life potentially in it” (ibid., 412b). The mind and soul, therefore, are simultaneously body and extracorporeality, whereas the body is soul and mind, or rather a reality that surpasses both. Both body and soul, then, are manifestations of an existing entity that points to itself and beyond itself at one and the same time.9 (The aim of 
—a compound of 
(full) and 
(to be in a certain condition) — is in itself; whereas 
is an organ, an instrument, so its goal is outside itself — it relates to something.) Only man is such an existing entity. Man is identical with himself and yet has a meaning beyond himself; he is simultaneously creature and creator (naturally, not in the sense that his body is creature and his soul creator); he is master of himself, but is also at the mercy of existence; he has very little command over that which can serve as the main proof of his existence: his life; and he is the one who has a human body and soul. In that sense, the definitive difference between human and animal bodies is not anatomical but existential. (One has in mind, for example, the upright stance, which is not primarily an anatomical but an existential property of man.) Man’s eyesight is dimmer than that of a bird, yet he sees more; he runs slower than a cheetah, and yet he can call a greater territory his own. The secret of the human body is precisely that it lives in a human — that is, an intellectual — manner, and for that reason one can speak of it only as an existential and functional unit. If the body is examined and regarded purely as an anatomically definable set of morphological units, then it is not man that one is examining but a hunk of flesh (a pathologist, who analyzes humans after their death, is examining a body differing only anatomically from an animal’s body); if only the soul is interpreted, on the other hand, then man is replaced by an angel, and thereby he is lifted out of the world to which he owes his existence as man.10
Medicine of bygone times was always clear about the inseparability (and indistinguishability) of body and soul; it appears that a radical turning point was reached only when Descartes sharply separated the provinces of res cogitans and res extensa. In antiquity, the Hippocratic, empirical way of looking at things started from the symptoms of the body to draw conclusions about the condition of the soul (both the Greek word 
and the Latin spiritus conjure up the bodily process of inspiration) and hence about a failure of the cosmos as a whole: the Empedoclean philosophical and medical view of things descended from an examination of the general laws of existence to an empirical understanding of diseases (catharsis related to both body and soul—
, “Purifications,” the title that Empedocles gave to his medical work, signals that physical nature and the intellectual world have identical dimensions). The difference between body and soul was thus negligible in comparison with the unity of the cosmos as a whole. This led to the notion of the microcosm, which became crucial for medical science: to be healthy meant to live in harmony (
) with the cosmos, and therefore the nature of disease could not be unraveled solely on a physical basis. Although the notion of a microcosm, which is also of decisive significance for today’s psychosomatically oriented medicine, reflected the effort to unify an original duality (only after there was a rift between human and natural law—
and 
—did it become possible to pose the problem conceptually; it was in the Hellenistic period that the previously uniform view of being was conceptually reconstructed), the metaphor pointed not only to a heroic skepticism concerning the ultimate insolubility of human existence, but also to the possibility of gaining a true understanding of disease. Reviving the antique notion, Paracelsus wrote that man is a small world with everything in him that the world at large contains, healthy and unhealthy alike (Lepenies, Melancholie und Gesellschaft, 172); and writing about melancholia, Robert Burton asserted: man is the most excellent and noble creature in the world because he is a “Microcosmus, a little world, a model of the world, sovereign lord of the earth, viceroy of the world” (Burton, Anatomy, partition 1, sec. 1, member 1, subsec. 1, 130); Thomas Browne, likewise a physician, one of the most melancholic minds of all time, laid down: “The world that I regard is my self; it is the Microcosm of my own frame that I cast mine eye on; for the other, I use it but like my Globe, and turn it round sometimes for my recreation” (Religio Medici, pt. 2, sec. 11). The Romantics tried to heal the Cartesian rift of body and soul (which would later be profoundly suitable for the bourgeois mentality),11 and Romantic psychology, after laying a relatively brief theoretical groundwork, assumed the most intimate kinship between mood and body as a matter of common knowledge (Franz von Baader, Carl Gustav Carus). The conviction slowly grew that man did not get sick because he had a body or a soul, but because he had a body and a soul, or in other words, because he was born a man.
According to the radical school of psychosomatically minded medical science, it is not just specific diseases that are psychosomatic, every illness is psychosomatic in origin: there is no illness that could not be set in a wider context and investigated as a manifestation of the patient’s anamnesis. The role of psychological (or, more correctly, anamnestic) causes is obvious in gastrointestinal disorders (gastric and duodenal ulcers, inappetence, vomiting, etc.), asthma, high blood pressure, angina pectoris, hypo- and hyperthyroidism, diabetes mellitus, migraine, various dermatological diseases and menstrual disturbances, but extensive research is under way with respect to the psychosomatic origin of all physical alterations, including cancer. (Galen noticed that melancholic women developed breast cancer a good deal more frequently than sanguineous ones, and in recent times American researchers have reached the conclusion, based on a comprehensive sample, that certain types of cancer — lymphomas, leukemia, uterine cancer — are preceded by severe depression stemming from an insoluble situation in life: as a component of stress, depression promotes hormonal changes in the immune system, and cancer is related to, among other things, precisely such disturbances of immune reactions.) The possibility of disintegration is inherent in the organism (without this there could be no life), and according to the psychosomatic approach, the environment and the life condition of the individual are able to induce, speed up, or slow down this inevitable destruction: letting go of oneself psychologically leads to losing all lines of defense, including the defensive role of the body. As a result, the person in question can shortly come under attack by a serious organic disease. (This may account for the “prophetic” capabilities of many physicians: they can foretell imminent death in the case of certain diseases when no major organic changes are demonstrable; the patient is ready to accept death, which indeed, wasting no time, arrives in some previously unsuspected form.) Physical symptoms and vital complaints accompanied by melancholia (a sensation of pressure in the chest and the hypochondrium — so-called globus melancholicus) can likewise be traced back to a change in the relationship of the individual to the world: not only the mind, temperament, and mood, but the body as well plays a part in interpreting existence. One cannot be understood from objectively dismantled elements of one’s body or one’s soul, but only from the position one occupies in the world and in one’s environment. One’s view of life and physical state cannot be picked out causally except from one’s situation, and one’s organism cannot be described as a morphological but only as a functional unit. Neurologists (Gustav Ricker, Victor von Weizsäcker) showed that many neurological phenomena were incomprehensible on the basis of the morphological “objectivism” of the Cartesian concept of the body, and it was possible to explain them only if the researcher, instead of regarding the nervous system as a closed, object-like unit, accepted that objectivity contains cognitive subjectivity from the outset, and that biological acts are not independent, autonomous events taking place in space and time, but interactions in the course of which space and time are created and the functioning of the nervous system becomes humanized. At the bottom of this recognition lay a radically new picture of human beings (although that picture was not at all as alien to more ancient cultures as to our own): human illnesses can be interpreted only as part of a context that in principle assumes a general openness. (Just as you ought not to attempt to cure the eyes without the head, or the head without the body, so you ought not attempt to cure the body without the soul, writes Plato in Charmides [see 156b — c].) The cause (etiology) and course of development (pathogenesis) of a disease are not congruent: in the case of numerous diseases, we know why they came into being without knowing what the cause is. All kinds of things are known about allergies, for example, but one cannot say why X became ill at ten years of age, Y at the age of twenty, and Z not at all. Nosocentric medicine is usually able to supply explanations for cases in which man is the same as an animal (animal experiments), but it barely concerns itself with etiology. As was remarked by Arthur Jores, a German gastroenterologist who became one of the founders of psychosomatic medicine, in an age of technical civilization, the causes of most diseases are still as unknown as in the era of magic; only the spirits have vanished, and their place has been taken by impersonal (yet still unknown) forces. The nosological approach, since it starts out from the duality of body and soul (in other words, it overlooks all other factors in its practice), implicitly suggests that although we all possess unique, diverse minds, our bodies are nevertheless uniform. Up to a certain point, all bodies are indeed similar; yet individuality is not a function of the mind alone: paradoxically, in police records people are distinguished on the basis not of their minds but of their bodies (fingerprints, descriptions) — that is, the body as an existential-functional unit, the vehicle of the endon, is the incarnation of individuality. It is not just the soul but also bodies that are different for everybody, and as existential-functional units, two bodies, like two souls, are merely reminiscent of, but not identical to, each other. If this is the case, the diagnosis and the examination of a patient naturally call for much greater prudence (and more money) than is currently used: it is necessary to establish what tangible disease a specific body is suffering from. Making the disease tangible means elucidating it in every respect, which entails no longer generalizing it. If no two humans are identical, then neither can be diseases; they can, at most, only resemble each other. A precondition of the apprehension of a disease is a functional-existential interpretation of the human body: in the end, what has come about is a disturbance of the unique life history of an irreplaceable person. His illness is not my illness, but exclusively his, so it is his personal life that has to recover. In connection with brain physiology, Erwin Straus, a representative of the Daseinsanalysis school of psychiatry, wrote: