[Significance of time and language in view of the process of medical diagnostic processes. Philosophical methodologic preliminaries].

The understanding of the patient is a prerequisite to philosophical and methodological thinking about the process of medical diagnosis-making. In regard to the philosophical discussion about the recently development of scientific knowledge, the comprehension of the medical object and the conceptions of health and illness has been modified. The human state of illness as a "Zeitgestalt" of intra- and intersubjective disturbances of communication is joined with the individuality and complexity of the subjective experiences of the patient. The modified conceptions of health and illness can help to overcome the division between subject and object, a consequence of Cartesian rationalistic thought. In this way new connections within medical thinking and a new comprehension of medical diagnosis appear. The medical diagnosis-making is simultaneously a process of knowledge to the physician and an instruction for his therapeutical action. The special significance of the medical diagnosis at all is the irreversibility and the temporal openness of the therapeutical action. Medical diagnosis is a form of communication leading to the action of the diagnosis-making physician and therefore a inseparable part of the physician-patient relation. The adequate valuation of the multi-dimensionality of the individual pathogenesis (physic, psychic, social) is possible only within this relation. The prediction of critical states presupposes the knowledge of the individual pathogenesis. Of course, such predictions are not completely quantifiable.