Rationalité et opérationalité du savoir médical. Histoire et épistémologie de la cardiologie/éléments de philosophie cardio-chirurgicale.

Abstract

This article atttempts to define the theoretical reference patterns and the philosophical motivations involved by the notions of cardiovascular diseases, from 1728, date of Giovanni Maria Lancisi (1654-1720) De Motu Cordis et Aneurysmatibus, in which cardiology is scientifically recognised, to the present. It examines the role played by conceptual operators such as causal explanation and deduction relative to the rectification of notions and diagnosis of cardiovascular diseases in Lancisi's works. This analysis leading to the explanation and criticism of the ideal characteristic of the notion of causality in general and particularly in Jean-Bertrand Senac's (1693-1770) cardiological related work, unequivocally extracts the opposition of identification procedures of both the seat and nature of cardiological and arterial pathologies, conceived by the physicians during the Enlightment, to the investigational strategies of diagnosis and therapeutic methods perfected by modern medecine and surgery. Success of both of these emerged themselves through the coordination of the act (the cardiological surgical techniques) and the vision (the invasive and non-invasive exploratory methods) whom testifies the evolution of modern day video-surgery. This synergy of the application of rationality, always derived from a <<vision>> of reality, and of the operationality of medical knowledge, requires more than ever the associated action of the scientific and philosophical thoughts as Claude Bernard demonstrated the usefullness in his Introduction a l'etude de la medecine experimentale.