This dissertation contributes to the growing literature concerning the appropriateness and potential for hermeneutics in medicine. I claim that hermeneutics is fundamental to the conception of 'knowing' required in clinical praxis. Certainly, the physician utilizes theoretical knowledge gleaned from scientific studies and randomized clinical trials in the clinical encounter, but in a practical way using inherited paradigms, pragmatic problem solving, probabilities, interpretation, and empathetic communication for the well-being of particular patients. In fact, hermeneutics is a necessary element for a reflection on clinical praxis that is both descriptive of what actually happens in the clinic, and prescriptive of how to improve clinical praxis. Among those arguing that clinical diagnosis and judgment are a hermeneutical, and not merely an empirical process, scholars have been divided between the dialogical hermeneutics of Hans-Georg Gadamer and the textual hermeneutics of Paul Ricoeur. Although Gadamer's insight into the process of understanding and interpretation as a dialogue with the other is profoundly helpful, I argue that Ricoeur's philosophical hermeneutics is an appropriate and fruitful approach to follow, precisely because it integrates an objectifying moment of explanation into the discursive activity of understanding. Ricoeur builds explanation into his hermeneutical arc, based not on external needs or interests, but on an analysis of language as the medium of understanding and interpretation. Language, especially in its objective form as a text, displays a distantiation of meaning from event yielding what Ricoeur calls "semantic autonomy." Semantic autonomy justifies the application of explanatory methods to texts as a necessary moment of testing and verification within the whole of the hermeneutical process. Furthermore, the emphasis on the textual nature of the clinical encounter is in fact a strength when viewed through the lens of Paul Ricoeur's philosophical hermeneutic, because it places the experience and narrative of the patient on equal footing with the objective analysis of lab reports and instrumental readings.