If we conceive of man exclusively as a unit of body and soul, that leads not only to a dynamic reinterpretation of systems, but also to our seeing illness differently from nosologically oriented medical science, incomprehensibly optimistic as it still is (at least in its methods) in spite of its innumerable failures. A human body is a body by having a goal as an organism, seeking to fulfill something, and it carries within itself the unreachable horizon, which distinguishes man from all other existing entities. “The discernment,” wrote Thure von Uexküll, a representative of psychosomatically oriented medicine, “that, in the case of corporeality, one is dealing not with an inflexible, invariable structure but with a mobile, provisional structure that is coordinated differently from one situation to another, in point of fact, confronts us with the task of the creation of a new anatomy. In that, the organs would no longer be described on the basis of purely morphological criteria but as a group of accomplishments that regroups itself again and again and possesses various presumed goals” (Uexküll, “Möglichkeiten und Grenzen psychosomatischer Betrachtung,” 380). (Some of the body’s organ systems, such as the hematologic, endocrinological, and immunological, do not form morphological units by their very nature, and can be characterized only functionally, in the more profound sense of the word.) The place of the earlier clinical diagnosis would be taken over by a structural analysis of body and soul. The doctrine based on functional units would not only render the concept of disease dynamic (and, in the last analysis, unclassifiable), but would also show the link between illness and health in a new light: illness, as the neurologist F. W. Kroll set forth, is rooted in healthy organisms: “In this sense one can speak of a
syndrome, certainly as a foreground, as being the centre of a clinical picture, and one must distinguish the background, which is rooted in the reactions of a healthy, premorbid state of the given individual, and is not limited to the nervous system but much rather lies in every tissue and organ, and that is determined by all sorts of factors, both temporal and spatial, inner and outer world. We have thereby arrived not at a nervous illness but at the structural form of the nervous patient” (quoted in Leopold Szondi, Experimental Diagnostics of Drives, 451; emphasis in the original). The dynamic approach in medicine reaches the same point as philosophical anthropology: a disease affects only an individual patient, or to be more precise, the person’s being induces the disease. An illness is always an illness of the self, similar to life and death, which means that an illness (even a simple toothache) is not merely a corporeal state but also an existential trauma. Sick persons see the world differently from others, and from the way they themselves do in their healthy state. In sickness the relationship between the individual and the world changes in the same way as the unity of the patient’s body and soul, which is a reminder that an illness is not just a physical change, an unbending state in the patient’s life, but a focal point in a system of relationships. Hippocrates distinguished illness, patient, and physician; in other words, the same phenomenon could be approached from three angles. Needless to say, the three viewpoints are not congruent; patients will always interpret their condition differently than their physicians (physicians may consider people who feel sick, healthy; and healthy, sick), and the concept to which their statements refer obviously does not mean the same for both parties.