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Philosophie Antique, 12 | 2012, « Autour De La Perception » [En Ligne], Mis En Ligne Le 01 Novembre 2018, Consulté Le 24 Octobre 2020 Philosophie antique Problèmes, Renaissances, Usages 12 | 2012 Autour de la perception Édition électronique URL : http://journals.openedition.org/philosant/928 DOI : 10.4000/philosant.928 ISSN : 2648-2789 Éditeur Éditions Vrin Édition imprimée Date de publication : 1 novembre 2012 ISBN : 978-2-7574-0400-3 ISSN : 1634-4561 Référence électronique Philosophie antique, 12 | 2012, « Autour de la perception » [En ligne], mis en ligne le 01 novembre 2018, consulté le 24 octobre 2020. URL : http://journals.openedition.org/philosant/928 ; DOI : https://doi.org/ 10.4000/philosant.928 Ce document a été généré automatiquement le 24 octobre 2020. La revue Philosophie antique est mise à disposition selon les termes de la Licence Creative Commons Attribution - Pas d'Utilisation Commerciale - Pas de Modification 4.0 International. 1 Par quelles capacités ou quels mécanismes appréhendons-nous les objets qui nous entourent et généralement le monde ? À cette question, la première qui se pose à qui s'interroge sur la connaissance humaine, n’ont pas manqué de s’intéresser les anciens. À l’heure des sciences cognitives, la question semble échapper à la philosophie, fût-elle phénoménologique, et relever de la psychologie, de la neurologie, voire de la physique ou de la géométrie puisqu’elle fait intervenir les lois de l’optique. L’intérêt de ce numéro est donc, non seulement de nous informer sur les théories de la perception qui avaient cours et entre lesquelles se partageaient les anciens, mais de montrer que, dès l’antiquité, la philosophie était loin d’avoir le monopole de l’analyse de la perception. En réalité, sur ce terrain comme sur d’autres, la philosophie s’est trouvée dès l’origine en concurrence avec d’autres approches et d’autres méthodes, en l’occurrence avec la médecine. Cette situation perdurera tout au long de l’antiquité, comme c’est encore le cas aujourd’hui, et l’on verra que jusque chez un auteur comme Héron d’Alexandrie, volontiers tenu, parce que méconnu, pour étranger à toute philosophie, la question de la vitesse de la lumière mobilise un concept de causalité qui engage en réalité toute une cosmologie et fait de la physique une philosophie autant que l’inverse. Philosophie antique, 12 | 2012 2 SOMMAIRE L’économie des sensations dans la clinique hippocratique Laurent Ayache Les polémiques sur la perception entre stoïciens et académiciens Jean-Baptiste Gourinat L’absence de préconception du temps chez Épicure Lecture de la Lettre à Hérodote, 72‑73 Marianne Gœury La théorie de la vision chez Galien : la colonne qui saute et autres énigmes Heinrich Von Staden Modernité de la catoptrique de Héron d’Alexandrie Alain Boutot Varia Is there an answer to Socrates’ puzzle? Individuality, universality, and the self in Plato’s Phaedrus Voula Tsouna Les trois amours platoniciens ou la philosophie à hauteur d’homme Anca Vasiliu Sextus Empiricus et l’ombre longue d’Aristote Emidio Spinelli Comptes rendus Jaume PÓRTULAS & Sergi GRAU, Saviesa grega arcaica Livio Rossetti Enrique HÜLSZ PICCONE, Nuevos ensayos sobre Heráclito : Actas del Segundo Symposium Heracliteum Guido Calenda Gabriel DANZIG, Apologizing for Socrates. How Plato and Xenophon created our Socrates Louis-André Dorion Livio ROSSETTI, Le dialogue socratique Agnese Gaile‑Irbe Suzanne HUSSON, La République de Diogène. Une cité en quête de la nature Louis-André Dorion Emmanuel BERMON, Valéry LAURAND, Jean TERREL (éd.), Politique d’Aristote : famille, régimes, éducation Refik Güremen Mary‑Anne ZAGDOUN, L’Esthétique d’Aristote Anne‑Lise Worms Philosophie antique, 12 | 2012 3 Marie‑Odile GOULET CAZÉ (éd.), Études sur la théorie stoïcienne de l’action Christelle Veillard Mauro BONAZZI, Carlos LÉVY, Carlos STEEL (éd.), A Platonic Pythagoras: Platonism and Pythagoreanism in the Imperial Age Constantin Macris Archives internationales d’histoire des sciences, 1-2 : Pline l’Ancien à la Renaissance Pierre Caye Bulletin Bibliographique Philosophie antique, 12 | 2012 4 L’économie des sensations dans la clinique hippocratique Laurent Ayache 1 Aucun texte de la Collection hippocratique, pas même le court traité De la vision, ne présente, pour elle-même, une théorie physiologique de la sensation. Les passages qui concernent sensation ou perception sont insérés dans des développements qui relèvent de trois registres : un registre anatomique, notamment à l’occasion de la description des vaisseaux qui passent par les organes sensoriels ; un registre pathologique, les troubles de la sensation (surdité, cécité, nyctalopie, etc.) apparaissant souvent comme des accidents au cours des maladies ; enfin, un registre méthodologique, la sensation du malade et les perceptions du médecin étant présentées comme des guides pour le jugement médical dans le pronostic et la conduite de la thérapeutique. 2 Cette étude se concentrera sur la question particulière de l’usage des perceptions dans l’activité clinique du médecin, c’est‑à‑dire sur le registre méthodologique. Je chercherai à dégager les modalités du recours aux sensations dans l’élaboration du jugement médical. Ce faisant, j’userai indifféremment des termes « sensation » et « perception », en les comprenant dans toute l’étendue du sens que les textes hippocratiques imposent, sans m’enfermer dans une définition préalable de l’αἴσθησις. Mon étude se concentrera sur quelques traités qui possèdent une certaine homogénéité, essentiellement, les traités chirurgicaux et le Pronostic. 3 Le recours à la sensation lors de l’examen clinique apparaît sous deux formes différentes : tantôt le médecin s’informe des sensations du malade, tantôt il recourt à ses propres perceptions. Il convient donc d’étudier ces deux usages. Le recours à la sensation du patient 4 Les traités chirurgicaux font régulièrement référence à la sensation du blessé pour régler l’activité thérapeutique du médecin. Ainsi, le traité Des fractures expose la technique du bandage d’un membre cassé. L’interrogation du patient sur ce qu’il ressent sert en premier lieu à ajuster le bandage à sa conformation individuelle : Philosophie antique, 12 | 2012 5 Voici les signes d’un beau traitement et d’un bandage correct (ὀρθῶς) : si vous demandez au blessé s’il est comprimé, et s’il dit qu’il est comprimé, mais modérément (ἡσύχως), et s’il dit : « surtout à l’endroit de la fracture (μάλιστα […] κατὰ τὸ κάτηγμα) » (c. 5 : Kühlewein, II, 53 = III, 432 L.)1. 5 Par la suite, la force de la compression est adaptée, lors de chaque nouveau pansement, à l’évolution de la blessure. Le médecin est alors attentif à l’expression précise de l’évolution des sensations du blessé : Interrogé, le blessé répondra qu’il est serré un peu plus qu’auparavant (ὀλίγῳ μᾶλλον […] ἢ τὸ πρότερον), surtout sur la fracture (μάλιστα […] κατὰ τὸ κάτηγμα), et sur le reste proportionnellement (κατὰ λόγον) (ibid. : Kühlewein II, 54-56 = III, 436 L.). 6 L’interrogation du blessé et l’écoute attentive de ses réponses sert également à corriger l’application du bandage pour approcher la compression optimale : Voici les signes de la juste mesure (σημεῖα δὲ τάδε τῆς μετριότητος) : si le jour du pansement et la nuit suivante il se sent serré, non pas moins, mais davantage (μὴ ἐπὶ ἧσσον πεπιέχθαι, ἀλλ᾽ ἐπὶ μᾶλλον), et si le lendemain il survient à la main un peu de tuméfaction molle ; tel est le signe d’une juste mesure de la compression (μετριότητος γὰρ σημεῖον τῆς πιέξιος). Vers la fin du second jour il doit se sentir moins serré (ἐπὶ ἧσσον), et le troisième vous devez trouver l’appareil relâché. Si quelqu’un des caractères ici énumérés est en défaut, il faut savoir que le bandage est plus lâche que la mesure (χαλαρωτέρη ἐστὶν ἡ ἐπίδεσις τοῦ μετρίου) ; si quelqu’un de ces caractères est en excès, il faut savoir qu’il a été serré au-delà de la mesure (μᾶλλον […] τοῦ μετρίου), prenant ces points comme des indications (τούτοισι σημαινόμενος) pour, dans la réapplication du bandage, davantage lâcher ou serrer (ibid. : Kühlewein II, 53 = III, 432 L.). 7 L’évolution de la sensation du patient concourt ainsi à conduire le médecin vers le point exact de la juste mesure (τὸ μέτριον, ἡ μετριότης) de la thérapeutique. Le jugement du médecin épouse l’évolution de la sensation du blessé et ajuste l’action en conséquence. Il n’applique pas uniformément une règle universelle, mais se conforme à une méthode de rectification régulièrement renouvelée dont le guide principal est la sensation du patient. 8 Le recours à la sensibilité du patient dépasse parfois ce rôle d’adaptation des principes conceptuels à la diversité des cas et de leur évolution. Au début de ce même traité Des fractures, l’auteur opère une véritable substitution d’une idée par la sensation du patient. Dans ce passage, l’idée produite par la théorie sert seulement de lieu commun, amorçant une démarche dont l’aboutissement est purement sensible. 9 Ce traité s’ouvre en effet sur la question de l’attitude dans laquelle il faut immobiliser un bras luxé ou fracturé. La réponse théorique est qu’il faut placer le bras dans sa conformation naturelle, κατὰ φύσιν. La théorie apporte même une détermination de cette conformation : l’attitude naturelle comprend l’idée de rectitude (ἰθυωρίη) : Le médecin doit, pour les luxations et les fractures, faire, autant qu’il est possible, les extensions dans l’attitude la plus rectiligne : c’est la conformation la plus juste (ἐχρῆν τὸν ἰητρὸν τῶν ἐκπτωσίων τε καὶ κατηγμάτων ὡς ἰθύτατα ποιεῖσθαι τὰς κατατάσιας· αὕτη γὰρ ἡ δικαιωτάτη φύσις). (c. 1 : Kühlewein II, 46 = III, 412 L.). 10 Et pourtant, la recherche de cette position naturelle par le raisonnement est condamnée
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