In this paper I present a novel understanding of diagnostic hypothesis that draws ideas from Walter Benjamin's work on translation. My framework originates from previous literature that aligns diagnostic hypothesis with Peircean 'abduction.' I argue that the abductive step, rather than being an inference to the best explanation, is a strategic conjecture that is simultaneously interrogative and interpretive. While Peirce places the burden of interpretation solely on semiotic analysis, I develop a form of dialectical abduction that draws on Benjamin's distinction between semiotic and mimetic faculties of language. I further argue that while all abduction functions through language interpretation, diagnostic abduction works not simply as interpretation but is more accurately described as the translation of patient narrative and clinician investigation into the language of clinical medicine. I then analyze diagnostic translation within the dialectical framework for translation described by Benjamin, and use this model to develop suggestions for a methodology of clinical abduction.