Transdisciplinary Enactive Realism: Towards an Ontology of the Leib and Epistemic Translation in the Sociosanitary Ecosystem

Background: The historical fracture between biomedical positivism and social constructivism has perpetuated an epistemic schizophrenia, reducing the human body either to a molecular machine (Körper) or to a discursive epiphenomenon, thus obscuring the structural roots of illness. This study establishes a rigorous metatheoretical framework to overcome this fragmentation. Methods: We employ a dialectical-transdisciplinary epistemological matrix—integrating Peircean abduction and negative dialectics as vectors of conceptual translation—to map the intersection between natural/medical sciences and social theories without falling into reductionisms. Results: The analysis demonstrates that health and illness constitute stratified complex wholes where structural violence and biological somatization (such as allostatic load) co-determine one another. Likewise, it deconstructs the technocratic neutrality of the medical model, proving that clinical practice must reintegrate the lived body (Leib). Conclusions: We propose an innovative paradigm—Transdisciplinary Enactive Realism—that bridges empirical evidence and hermeneutic meaning, providing a holistic, critical, and humanized foundation for contemporary sociosanitary ecosystems.