Physical and Spiritual Health in 'Causae Et Curae'

The Mistress and the Handmaid: Physical and Spiritual Health in Hildegard of
Bingen’s Causae et curae

Jacqueline Mahoney
MA ARTS (Research)
A thesis submitted for the degree of Master of Arts by Research at

Monash University in 2017
1
Copyright notice
© Jacqueline Mahoney (2017).
I certify that I have made all reasonable efforts to secure copyright permissions for
third-party content included in this thesis and have not knowingly added copyright
content to my work without the owner's permission.
2
Abstract
Causae et curae, a medico-religious text of Hildegard of Bingen (1098-1179), is a

valuable work which reveals the personal passions of a figure more commonly associated with
the fields of prophecy and morality. As such, this thesis explores how perceptions of spiritual
and natural health within Causae et curae firmly situate the text at the core of Hildegard’s
entire body of work, thus revealing facets of her writing and context previously overlooked
by historians and biographers. This thesis focuses on how Hildegard interpreted spiritual
concepts and biblical narrative to rationalise her understanding of the human body and its
processes, and how she argued for the importance of the human body as a vehicle for the
healing and salvation (salus) of humanity. The goal of this thesis is to situate Causae et curae
within Hildegard’s body of work as the text by which she expressed her most personal
passions and interests, and which she used as the cornerstone for concepts embellished in
her more famous texts. It also strongly argues in favour of firmly identifying these texts as
authored by Hildegard, a subject of contention for the past century. By revealing how many
of the unique concepts portrayed in Scivias and Book of Divine Works reappear in Causae et
curae and Hildegard’s letters I aim to assist in settling this discussion.
3
Declaration
All Students should reproduce this section in their thesis verbatim
This thesis contains no material which has been accepted for the award of any other degree
or diploma at any university or equivalent institution and that, to the best of my knowledge
and belief, this thesis contains no material previously published or written by another
person, except where due reference is made in the text of the thesis.
Signature:
Print Name: JACQUELINE MAHONEY
Date: 26/06/17
4
The Mistress and the Handmaid:
Spiritual and Physical Health in Hildegard of Bingen’s Causae et curae
Jacqueline Mahoney
5
With thanks to my parents, and to Kay, Garrett and Annie, for their unending support. Also
with thanks to my supervisors Megan Cassidy-Welch and Constant Mews for their constant
enthusiasm and hard work.
6
CONTENTS
ABBREVIATIONS 8
TIMELINE 9
INTRODUCTION 10
CHAPTER ONE: EDUCATION AND THE BURGEONING HEALER 20
The Monastic Garden 21

Sowing the Seeds in Scivias 26
The Public Image of Hildegard 32
CHAPTER TWO: HILDEGARD AND THE HUMAN FORM 36
Body and Soul 37

The Cosmic Body 42
Livor, Flegmata, and Adam’s Fall 46
Conclusion 50
CHAPTER THREE: THE PROCESS OF HEALING 53
Hildegard the Healer 54

Physica and the Healing of the World 64
Conclusion 68
CONCLUSION 71
BIBLIOGRAPHY 76
7
ABBREVIATIONS
CC Hildegard of Bingen, Causae et Curae

CCCM Corpus Christianorum Continuatio Mediaevalis
Consolation Boethius, De Consolatione Philosophiae
LDO Hildegard, Liber Divinorum Operum
LVM Hildegard, Liber Vitae Meritorum
VH Vita Hildegardis
VJ Vita domnae Juttae inclusae
8
TIMELINE
1098 Hildegard of Bingen is born
1106 Hildegard is entrusted to Disibodenberg
1112 Hildegard and Jutta of Sponheim are enclosed at Disibodenberg
1136 Jutta dies; Hildegard is elected magistra
1141-51 Hildegard and her assistant Volmar write Scivias
(1147-48) The Council of Trier takes place; the Scivias is allegedly discussed and
approved by Pope Eugenius III
(1149-50) Hildegard begins work on Physica
1150 Hildegard establishes a convent at the site of Rupertsberg
1151-58 Hildegard finishes work on Physica and also creates Causae et curae
1160 Hildegard writes Liber vitae meritorum; begins work on Liber divinorum
operum
1165-70 Hildegard establishes a convent at the sites of Eibingen
1179 Hildegard dies
9
INTRODUCTION
Causae et curae, a medico-religious text of Hildegard of Bingen (1098-1179), is a valuable

work which reveals the personal passions of a figure more commonly associated with the
fields of prophecy and morality. As such, this thesis explores how perceptions of spiritual and
natural health within Causae et curae firmly situate the text at the core of Hildegard’s entire
body of work, thus revealing facets of her writing and context previously overlooked by
historians and biographers. By investigating how Hildegard interpreted the relationship
between the metaphysical and the physical, I also hope to expand studies of Hildegard’s
medical works, which so far have been largely neglected by modern historians. This thesis
focuses on how Hildegard interpreted spiritual concepts and biblical narrative to rationalise
her understanding of the human body and its processes, and how she argued for the
importance of the human body as a vehicle for the healing and salvation (salus) of humanity.
Of interest is a distinction Hildegard makes in Scivias that the flesh (caro) is the
handmaid (ancilla) of the soul, its mistress.1 This concept had been used before by other
theologians, but Hildegard adopted and adapted it to suit a particularly feminised
understanding of the human body and its relation to the natural world. I explore this
distinction with relation to how Hildegard also perceived the physical form and its worth in
relation to the soul. Although much has been written on this topic, Hildegard’s ideals do not
necessarily coincide with her patristic forebears. Indeed, she finds several ways to subtly
protest certain biblical concepts in favour of a more feminine, naturalised worldview.
I also discuss the role played by immorality, sin, and evil within Hildegard’s medico-
religious works in impacting on health and biological functions. Specifically, I examine how
Hildegard understood sin to be related to the physical body with regards to correlation and
causation, and whether this was simply due to circumstance or biological imperative.
Examples used include the comparison of epileptics to victims of demonic possession, and
Hildegard’s treatment of both as equally legitimate medical conditions. While Hildegard was
clearly aware of current medical teachings, she differed markedly from traditional Christian
theorists about the physical body and its frailties in relation to the fallibility of the soul.
Finally, I focus on Hildegard’s ultimate aims with regards to health and healing acts,
namely the restoration of viriditas to the world. For Hildegard, viriditas reflected the original
purity of the world at the time of Creation, the greenness of the Garden of Genesis. The world
of her time was imbalanced and soured by immorality, sin, and sickness. Hildegard saw the
natural world as having the properties to heal, and humankind as having the skill to do so.
Thus, those with the ability to heal had the imperative to do so, to restore spiritual viriditas
to humankind and subsequently, to the world in its entirety. Ultimately it is this goal which
drives Hildegard’s medico-religious texts on both a spiritual and personal level, as her own
pervasive illnesses strongly inspired her dedication to the healing arts.
I will offer a concentrated critical examination of Causae et curae. This will be
contextualised using contemporary natural science of Hildegard’s time, and prevailing biblical
1
Scivias, 1:4.25, ed. Führkötter, CCCM 45, 83; Hart and Bishop 123. “Anima autem est magistra, caro uero
ancilla.”
10
belief. I also explore the origins of Hildegard’s medical theories in her earlier body of work,
particularly her principal texts, Scivias and Book of Divine Works, as well as aspects of her
medical pharmacopeia Physica, to explore Hildegard’s close and prevailing interest in the
workings of the human body and mind. The goal of this thesis is to situate Causae et curae
within Hildegard’s body of work as the text by which she expressed her most personal
passions and interests, and which she used as the cornerstone for concepts embellished in
her more famous texts. It also strongly argues in favour of firmly identifying these texts as
authored by Hildegard, a subject of contention for the past century. By revealing how many
of the unique concepts portrayed in Scivias and Book of Divine Works reappear in Causae et
curae and Hildegard’s letters I aim to assist in settling this discussion.
THE GENESIS OF CAUSAE ET CURAE

Hildegard of Bingen, born in 1098 as the last of ten children to a prominent family in the Rhine
region, recalls that she was entrusted to the monastery of Disibodenberg at the age of eight,
and placed under the care of Jutta, daughter of the Count of Sponheim.2 According to the
annals of Disibodenberg, she and Jutta were both fully enclosed at Disibodenberg on 1
November 1112 when she was in her fifteenth year. When Jutta died in her forty-third year
in December 1136, Hildegard was elected magistra in her stead, and tasked with managing
and caring for the female recluses of Disibodenberg.3 Between 1141 and 1150, Hildegard
worked with her assistant Volmar in producing her first major composition, Scivias, “Know
the Ways”, presenting her understanding of the messages of the bible wherein she focused
on the need for moral reform.4 By 1150, however, perhaps before she had fully completed
Scivias (and either shortly before or shortly after she moved with her nuns to the site of
Rupertsberg) Hildegard turned her attention to writing about the human body and the
entirety of creation. In the opening of her Book of Life’s Merits she refers to a vision which
revealed to her “the subtleties of created things.”5 This vision led her to produce the works
Causae et curae, which was concerned with the human person, and Physica, which discussed
the rest of creation. Causae et curae is divided into sixteen parts, titled respectively: The
Creation of the World; Elements and Humours; Adam; Embryology; Human Sexuality;
Complexion and Aptitude; Sleep and Dreams/Waking; Disorders and Diseases; Menstruation,
Conception and Pregnancy; Regimen of Health; Bloodletting; Bathing; Nutritional Disorders,
Digestive System Disorders, and Disorders of the Skin/Fevers; Treatment; Diagnostic and
Prognostic Signs and Lunar Prognostication. The text serves as a practical reference for bodily
diseases, dietary habits, and women’s health.
This work is preserved in a single thirteenth-century manuscript as the Beate Hildegardis
Cause et cure, kept at the Kongelige Bibliotek in Copenhagen since 1859.6 From this
manuscript came Paul Kaiser’s critical edition, which is still sometimes referred to today.7
Kaiser’s edition also popularised the title Causae et curae instead of the earlier Liber
compositae medicinae. In the 1950s the Eibingen nuns Marianna Schrader and Adelgundis
Führkötter reignited interest in Hildegard’s medical works when they released a slew of
2
VH, 1:1. Silvas, 139.
3
VH, 1:2. Silvas, 140.
4
VH, 1:3. Silvas, 141.
5
LVM, 1.1. CCCM 90. Carlevaris, 8.
6
Ed. Beverly Kienzle, Debra Stoudt & George Ferzoco, A Companion to Hildegard of Bingen (Boston: Brill,
2013), 254.
7
Hildegard of Bingen, Causae et Curae, ed. Paul Kaiser (Teubner, 1903).
11
modern translations of her body of work, aiming to settle ongoing debate about the true
authorship of the texts.8 Around this time Heinrich Schipperges and later Manfred Pawlik
were also using Kaiser’s work for their translations into German.9 Patrick Madigan and John
Kulas’ Holistic Healing10 is an indirect English translation of Kaiser’s text, as they worked
primarily from Pawlik’s German translation. In an effort to patch the gaps in Kaiser’s text and
facilitate ease of reading through a more concise and comprehensible structure. Margret
Berger’s English translation (1999) is based on both the Copenhagen manuscript and Kaiser’s
edition.11 A new critical edition of Causae et curae, also based on the Copenhagen manuscript,
was published in 2003 by Laurence Moulinier.12
Several manuscripts from the fourteenth and fifteenth century contain fragments of
Physica, a thematic sibling of Causae et curae.13 Additionally, there are five supposedly
complete manuscripts of this text. These include a manuscript (now in Florence) from the
early fourteenth century, which not only provides descriptions of medicinal recipes, but also
several methods of application.14 The Wolfenbüttel codex from the thirteenth century is not
nearly as complete as that of the Florence manuscript, as it omits descriptions of treatments
given in the latter. However, Melitta Weiss-Amer argues that the simplified language and lack
of paraphrasing used in the Wolfenbüttel codex indicates a later effort by some to reconstruct
Physica as a contemporary medical text.15 Moreover, Weiss-Amer arguessegments of the
fifteenth-century medical text, The Cookbook of Master Eberhard, are in fact copied directly
from the original Physica. She has dedicated several years to the extraction and
deconstruction of these segments in an effort to expand studies of Hildegard’s medical
works.16 The Brussels manuscript, a fourteenth-century text, is considered to be the least
faithful to the original Physica, as it incorporates individual additions and personal edits added
over the years.17 The earliest complete printed edition was produced in 1533 by Johannes
Schott, who titled it Physica, in what is still known today as the Strasburg edition.18 It is still
unknown, however, what source or sources he relied upon for his translation. Schott’s edition
was subsequently reprinted by several others, including one in 1544. One of these, known as
the Paris codex, was owned by sixteenth-century physician Nicolas Guglerus, and is believed
to be again highly edited and paraphrased, perhaps for easier reference.
8
Charles Singer, among others, had published an article in 1917 famously denouncing the Copenhagen
manuscript, as well as the Physica manuscripts.
9
Kienzle, Stoudt & Ferzoco, 254.
10 Hildegard of Bingen, Holistic Healing, ed. John S. Kulas & Patrick Madigan (Minnesota: Liturgical Press,
1994).
11 Hildegard of Bingen, On Natural Philosophy and Medicine (Selections from Cause et Cure), trans. Margret
Berger (Cambridge: D.S. Brewer, 1999).

12
Hildegard of Bingen, Cause et Cure, ed. Laurence Moulinier (Berlin: Akademie Verlag, 2003). This is the
edition I use throughout this thesis.
13
Margret Berger (1999), Preface, ix.
14
Melitta Weiss-Amer, “A Re-evaluation of Saint Hildegard’s Physica in Light of the Latest Manuscript Finds,” in
Manuscript Sources of Medieval Medicine: A Book of Essay (Abingdon: Taylor & Francis, 1995), 59-60.
15
Weiss-Amer, “A Re-evaluation,” 61.
16
Germany: Melitta Weiss-Amer, “Die ‘Physica’ Hildegards von Bingen als Quelle für das ‘Kochbuch Meister
Eberhards,’” Sudhoffs Archiv, No. 76 (1992), 87-96.
17
Weiss-Amer, “A Re-evaluation,” 64.
18
Full title: Physica S Hildegardis Elementorum, fluminum aliquot Germaniae, metallorum leguminum fractuum
et herbarum: arborum et arbustorum: piscium denique volatilium et animantium terrae naturas et operationes
IIII libris mirabili experientia posteritati tradens.
12
Although the Physica survives in more fragments and reconstructions than Causae et
curae, these vary widely in quality and content, and thus do not necessarily serve the purpose
of this thesis as well its counterpart. Modern translations of Physica are largely based on these
incomplete manuscripts. In 1882, J.-P. Migne reprinted the Strasbourg edition within vol. 197
of the Patrologia Latina under the title Sanctae Hildegardis Abbatissae Opera Omnia.19 It was
on this text that Priscilla Throop based her 1998 English translation of Physica, as did Bruce
Hozeski in his translation of Physica in relation to plants.20 In 2008 Irmgard Müller and
Christian Schulze also published an edition of Physica, with each page bearing a comparison
text to the Patrologia Latina edition for ease of reference.21 In 2010 Hildebrandt-Gloning
released an edition of the text, and a more recent critical edition of Physica by Reiner
Hildebrandt and Thomas Gloning was published in 2014.22
HISTORIOGRAPHY
This thesis builds on the work of a number of scholars who have explored the relationship
between the natural and the spiritual in Hildegard’s works. These studies grew markedly in
the 1980s with the surge of scholarship fascinated with eminent women of history together
with holistic medicine. The translations of Marianna Schrader and Adelgundis Führkötter in
the 1950s helped historians delve into Hildegard’s visionary and prophetic works, thus
reigniting interest in Hildegard’s particularly broad body of work and the implications it may
have for historians of the Church and for women’s history more generally.
Monica H. Green, known for her studies on Trota of Salerno (a female healer and
occasional lecturer who lived sometime in the early twelfth century) and women’s health in
medieval times, writes prolifically on medieval medicine and the phenomenon of ‘women
physicians’.23 Green recently published an English translation of the Trotula,24 a medieval
compendium on women’s health, and an earlier article “In Search of an ‘Authentic’ Women’s
Medicine: The Strange Fates of Trota of Salerno and Hildegard of Bingen,”25 is a good example
of scholarly writing in the 1980s and 1990s. These works were primarily concerned with
unearthing overlooked or understudied women within history and correctly recognising and
describing their accomplishments, which otherwise may have been attributed to male
influence or disregarded altogether. As such, it is biographically valuable, but does not
critically examine Hildegard’s ideas of the body and soul as this thesis intends to do.
19 France: Jacques-Paul Migne, S. Hildegardis Abbatissae Opera omnia, PL 197 (1855; Paris: Migne, 1882),
1255D-1256A.
20
Hildegard of Bingen, Physica, trans. Priscilla Throop (Rochester: Healing Arts Press, 1998); Hildegard’s
Healing Plants: From her Medieval Classic Physica, trans. Bruce W. Hozeski (Boston, MA: Beacon; Enfield;
Airlift, 2001).
21
Hildegard of Bingen, Physica, Edition der Florentiner Handschrift (Cod. Laur. Ashb. 1323, ca. 1300) im
Vergleich mit der Textkonstitution der Patrologia Latina (Migne), ed. Irmgard Müller and Christian Schulze
(Leinen: Georg Olms, 2008).
22
Hildegard of Bingen, Physica: Liber Subtilitatum diversarum naturarum creaturarum: Textkritische Ausgabe,
ed. Reiner Hildebrandt und Thomas Gloning, 3 vols. (Berlin: De Gruyter, 2010-2014).
23
See: Monica H. Green, Making Women’s Medicine Masculine: The Rise of Male Authority in Pre-Modern
Gynaecology, (Oxford University Press, 2008). See also: Women’s Healthcare in the Medieval West: Texts and
Contents, (London: Ashgate, 2000).
24
Monica H. Green, The Trotula: An English Translation of the Medieval Compendium of Women’s Medicine
(University of Pennsylvania Press, 2010).
25
Monica H. Green, “In Search of an ‘Authentic’ Women’s Medicine: The Strange Fates of Trota of Salerno and
Hildegard of Bingen,” Dynamis, 19 (1999), 25-54.
13
Additionally, Green’s work regarding Trota, the woman most often compared to Hildegard
with regards to women’s medical history, is useful for establishing context for Hildegard’s
unique concepts in this thesis.
Sabina Flanagan authored the leading biography Hildegard of Bingen: A Visionary Life in
1989, an icon in biographical studies of Hildegard.26 Flanagan also edited Secrets of God:
Writings of Hildegard of Bingen,27 which contains a critical overview of Hildegard’s literature
as well as several excerpts from her writing, and articles on Hildegard’s unique perception of
social conventions and spiritual philosophy.28 In A Visionary Life Flanagan acknowledges the
issues surrounding Hildegard’s medical works; in particular their structure, manuscript
tradition, and marked difference in tone and language as compared to the rest of Hildegard’s
body of work.29 She determines that the best approach would be to dissect existing medical
theories from the Causae et curae and Physica (i.e. from Galen, Aristotle, etc.), and determine
if what remains is a result of Hildegard’s own making.30 Regarding Causae et curae, Flanagan
argues that “Hildegard’s idea of physiology is predicated upon her cosmology.”31 Flanagan is
referring to the unique relationship Hildegard interprets between the four elements (air,
water, earth, fire), qualities (cold, wet, hot, dry), and the humours (blood, yellow bile, black
bile, phlegm), with the human body. Galenic theory was commonly referred to during
Hildegard’s time, and is highly relevant to this thesis topic. However, it only skirts the edges
of Hildegard’s rationalisation of illness, which Flanagan herself acknowledges is not
necessarily traditional, yet she does not expand further.32
In 1988 Barbara Newman produced Sister of Wisdom: St Hildegard’s Theology of the
Feminine33 and her collection of essays Voice of the Living Light: Hildegard of Bingen and her
World.34 She has also published several articles on Hildegard’s visionary and prophetic
works.35 Her article “Hildegard of Bingen and the ‘Birth of Purgatory’” investigates Purgatory,
or the state of suffering, as described in Hildegard’s visionary and prophetic works, expressing
particular curiosity in Hildegard’s fascination and relationship with pain.36 Newman cites the
Liber vitae meritorum as Hildegard’s major work on the topic, describing it as “part
psychomania, part otherworld vision, and part penitential.”37 Hildegard, Newman argues,
believed that the introduction of sin into the world poisoned not only humanity, but the
elements of the world itself. And so, Causae et curae is an example of Hildegard arguing in
favour of a mutual balance of ‘goodness’ between nature and humanity, in order to expunge
26
Sabina Flanagan, Hildegard of Bingen, 1098-1179: A Visionary Life (London: Routledge, 1989).
27
Sabina Flanagan, Secrets of God: Writings of Hildegard of Bingen (Michigan: Shambhala, 1996).
28
See: Sabina Flanagan, “For God Distinguishes the People of Earth as in Heaven: Hildegard of Bingen’s Social
Ideas”, Journal of Religious History, Vol. 22, No. 1 (1998), 14-34.
29
Flanagan, “Visionary Life,” 77.
30
Ibid, 78.
31
Ibid, 92.
32
Ibid, 94.
33
Barbara Newman, Sister of Wisdom: St Hildegard’s Theology of the Feminine (California: University of
California Press, 1998).
34
Barbara Newman, Voice of the Living Light: Hildegard of Bingen and Her World (California: University of
California Press, 1998).
35
See: Barbara Newman, “Hildegard of Bingen: Visions and Validation,” Church History, Vol. 54, No. 2 (1985),
163-175.
36
Barbara Newman, “Hildegard of Bingen and the ‘Birth of Purgatory’,” Mystics Quarterly, Vol. 19, No. 3
(1993), 90-97.
37
Newman, “Birth of Purgatory,” 91.
14
this poison.38 This is of interest to explorations of Hildegard’s relationship with bodily pains
and illnesses.
In 2013, Debra Stoudt, George Ferzoco and Beverly Kienzle edited a compendium titled A
Companion to Hildegard of Bingen. Stoudt’s contribution is of great use for this thesis. Her
chapter, “The Medical, the Magical, and the Miraculous in the Healing Arts of Hildegard of
Bingen,” discusses the complex interweaving of the spiritual and the physical within
Hildegard’s physiological texts, and indeed within medieval society as a whole.39 Her
explanation of the transition from a more cohesive physical/spiritual healing into the
university and church sequestered circles of Seelenarzt (spiritual healer) and Leibarzt (bodily
healer) during the twelfth century supplies excellent context for the integration of physical
and spiritual healing which Hildegard championed.40 It is a necessary precursor to
comprehensive discussions of Hildegard’s unique medical interpretations.
Constant Mews’ body of work on Hildegard includes several titles on the political nature
of her time, such as “Hildegard, Visions, and Religious Reform”41 and “From Scivias to the
Liber Divinorum Operum: Hildegard’s Apocalyptic Imagination and the Call to Reform”42, in
which Mews explores Hildegard’s relationship with the highly charged political state in which
she lived. He contributed to Newman’s collection of essays in 1998 with his piece “Religious
Thinker: ‘A Frail Human Being’ on Fiery Life”43 wherein he discussed Hildegard’s fascinating
perceptions of the human body, and by extension, the impact her ongoing illnesses had on
that perception, stating “Hildegard’s concern is with the inner unity of the soul and the body.
The relationship of the soul to the body is like that of sap to a tree, the intellect being the
viridity of its branches and leaves.”44 Mews co-edited and contributed to an anthology in 1995
titled Hildegard of Bingen and Gendered Theology in Judaeo-Christian Tradition with the
article “Hildegard of Bingen: Gender, Nature, and Visionary Experience,” in which he
examines Hildegard’s relation to Place and the natural world, discussing the means by which
Hildegard validated and supported her claims to prophetic authority. 45 Recently he
contributed to an Australian-based anthology on Hildegard’s effect on modern studies with
the article “Redefining Gender and Identity within Monastic Life”, wherein he examines the
close relationship between Hildegard and her scribe and confidant, Volmar. 46
38
Newman, “Birth of Purgatory,” 93.
39
Debra Stoudt, “The Medical, the Magical, and the Miraculous in the Healing Arts of Hildegard of Bingen,”
from A Companion to Hildegard of Bingen (Leiden: Brill, 2013).
40
Stoudt, “The Medical, the Magical,” 251.
41
Constant Mews, “Hildegard, Visions, and Religious Reform” in Im angesicht gottes suche der mensch sich
selbst: Hildegard von Bingen 1098-1179 (Berlin: Akademie Verlag, 2001), 325-352.
42
Constant Mews, “From Scivias to the Liber Divinorum Operum: Hildegard’s Apocalyptic Imagination and the
Call to Reform,” Journal of Religious History, Vol. 24, No. 1 (2000), 44-56.
43
Constant Mews, “Religious Thinker: ‘A Frail Human Being’ on Fiery Life,” from Barbara Newman, Voice of the
Living Light: Hildegard of Bingen and Her World (California: University of California Press, 1998), 52-70.
44
Mews, “Religious Thinker,” 59.
45
Ed. Julie S. Barton and Constant J. Mews, Hildegard of Bingen and Gendered Theology in Judaeo-Christian
Tradition (Victoria: Monash University, 1995).
46
Ed. Katharine Massam and Fotini Toso, The Greening of Hope: Hildegard for Australia, (Victoria: Morning Star
Publishing, 2016) See also: Constant J. Mews, “Male-Female Spiritual Partnership in the twelfth century: the
witness of Abelard and Heloise, Volmar and Hildegard,” Hildegards von Bingen Menschenbild und
Kirchenverstandnis heute, ed. Rainer Berndt and Maura Zatonyi, Erudiri Sapientia 12 (Münster: Aschendorff,
2015), 167-186.
15
The work of Victoria Sweet is particularly relevant to this thesis. Her book Rooted in the
Earth, Rooted in the Sky: Hildegard of Bingen and Premodern Medicine47 and article
“Hildegard of Bingen and the Greening of Medieval Medicine,”48 both critically examine
Hildegard’s medical works for her unique tropes regarding the natural sciences and the
human body. Sweet expresses just why the Causae et curae is of such significance to
Hildegard’s body of work, arguing that “Accepting Causes and Cures as Hildegard’s own work
will require that we finally do change our idea of Hildegard, from a miracle into a wonder.”49
Sweet’s comment illuminates why the medical text stands so markedly apart from Hildegard’s
other works. It also contributes to the idea that Hildegard has been situated somewhat
restrictively within the studies of visionary and prophetic figures in history. Sweet goes on to
examine Hildegard’s writing on the physical relationship between the body, or spiritual vessel,
and the earth. In particular, she examines the properties of medieval plants and medieval
medical simples, as well as Hildegard’s dietary observations. Conversely, this thesis is more
concerned with Hildegard’s method of consolidating biblical theory with her innate interest
in the natural sciences. However, Sweet’s body of work remains a highly useful influence on
this study. Sweet is also largely responsible for the argument that Hildegard served as
pigmentarius (essentially a nurse or nurse’s assistant, responsible for preparing and
administering poultices and potions) during her time at Disibodenberg, with which this thesis
helps support.
Melitta Weiss-Amer focused on Hildegard’s medical works in the 1990s, primarily
concerned with searching for surviving original manuscripts or extracts from them, as in “Die
‘Physica’ Hildegards von Bingen als Quelle für das, Kochbuch Meister Eberhards,”50 wherein
she argues that the fifteenth-century medicinal text The Cookbook of Master Eberhard is
compiled of various pieces of the original Physica manuscript, jumbled together. Weiss-Amer
later published an article discussing the German context of the Paris manuscript.51 Her
interest in Hildegard clearly stems from her larger body of work, which focuses primarily on
food and dietary habits in the medieval world, something Hildegard was noted for in the
scholarly work of the 1980s regarding alternative medicine. However, Weiss-Amer does not
investigate in detail Hildegard’s unique methods of merging biblical dogma with the natural
sciences, and is more concerned with the vital task of preserving and expanding the
manuscript history of the texts.
Laurence Moulinier has also deepened our understanding of Hildegard’s writing through
her monograph on Causae et curae and Physica and their relationship to the 1533 Strasburg
edition.52 Like Weiss-Amer, Moulinier has striven to uncover more of Hildegard’s original
manuscripts, as evident in her study “Deux fragments inédits de Hildegarde de Bingen copiés
47
Victoria Sweet, Rooted in the Earth, Rooted in the Sky: Hildegard of Bingen and Premodern Medicine
(London: Routledge, 2006).
48
Victoria Sweet, “Hildegard of Bingen and the Greening of Medieval Medicine,” Bulletin of the History of
Medicine, Vol. 73, No. 1 (1999), 381-403.
49
Sweet, “Rooted in the Earth,” 33.
50
Melitta Weiss-Amer, “Die ,Physica’ Hildegards von Bingen als Quelle für das ,Kochbuch Meister Eberhards,”
Sudhoffs Archiv, Vol. 76, No. 1 (1992), 87-96.
51
Melitta Weiss-Amer, “Der deutsche Anhang zu Hildegard von Bingens, Liber simplicis medicinae in Codex
6952 der Bibliotheque Nationale in Paris (fol. 232v-238v)”, Sudhoffs Archiv, Vol. 79, No. 2 (1995), 173-192.
52
Laurence Moulinier, Le manuscrit perdu à Strasbourg: enquête sur l’oeuvre scientifique de Hildegarde (Paris:
Presses universitaires de Vincennes, 1995).
16
par Gerhard von Hohenkirchen (1448)”.53 Moulinier’s interest is focused on the value of
Hildegard’s work in the history of medicine, and although it touches on Hildegard’s personal
perceptions of spiritual and illness, it does not discuss it to the extent that this thesis intends
to.
The overall historiography regarding Hildegard to this point has, in summary, been
particularly focused on either her spiritual writing, or on her identity as a literate woman with
authority in the twelfth century. The ongoing debate regarding the legitimacy of texts
attributed to Hildegard has waned somewhat since the contributions of Charles Singer, but
not abated, as evident by the work of Moulinier and Weiss-Amer. What discussion there has
been on her medico-religious works has either focused heavily on the complications of the
texts, or otherwise emphasises the benefits of natural-medicine in both medieval and modern
times. The work of Victoria Sweet and Monica Green are an exception to this, and benefit this
thesis greatly with their careful examinations of the role of Hildegard’s medical works in her
life and in her greater body of work. I aim to bolster these cornerstone works with a close
examination of Causae et curae, and in turn encourage other historians to approach
Hildegard’s medico-religious work with greater courage in the future.
A BRIEF SUMMARY OF GREEK THEORY

Much of Hildegard’s medical knowledge draws on traditional medieval syntheses of
Hippocratic and Galenic physiology. This thesis makes frequent mention of such theories, and
so a brief summary will be supplied for the sake of comprehensive reading. Hippocratic and
Galenic theory, largely summarised as the “Greek tradition”, had its roots in the work of pre-
Socratic philosophers such as Thales of Miletus (624-548 BCE) and Anaximander (611-547
BCE).54 These theories closely examined the workings of the human body by
compartmentalising its functions with relation to the quantities and qualities it contained.
These quantities, coined by Hippocrates (460-371 BCE) and Galen (129-200 CE) as humours,
were separated into four: blood, black bile, yellow bile, and phlegm. The qualities, or
temperaments, were also four: sanguine, choleric, melancholic, and phlegmatic. The inner
workings of the human body and its functions were all some way or another reliant on a
balance of these elements. Subsequently, an excess or lack of these elements would in turn
cause changes to a person’s health, mood, or even personality. Hippocrates summarises the
correlation and causation of this relationship when he writes
We are also to consider what are the effects of intemperance in food or drink; of too
much or too little sleep; or of the passions, as of gaming; of great fatigue, whether of
body or mind, and if or not of an accustomed character. The changes which take place
are to be investigated, together with their causes and effects. Thus, as to what are the
effects of mental labour, in deep research, thought, seeing, converse; or from sorrow,
anger, avarice, and all that can exert an influence on the mind and body, through
vision or hearing. The noise of a grindstone sets the teeth on edge; the sight of a
precipice near to which we pass, makes the legs tremble; as do our hands, when
anything is suddenly snatched from them that we wish to retain; the unexpected sight
53
Laurence Moulinier, “Deux fragments inédits de Hildegarde de Bingen copiés par Gerhard von Hohenkirchen
(1448),” Sudhoffs Archiv, Vol. 83, No. 2 (1999), 224-238.
54
John Aberth, An Environmental History of the Middle Ages (London: Taylor and Francis, 2012), 11.
17
of a snake induces paleness. Fear, modesty, pain, pleasure, anger, &c., all produce
some change in some part of the body, as sweat, palpitation, and similar effects.55
Lifestyle practices such as sexual intercourse, diet, or exercise could impact the balance of the
humours, whereas the quantities were generally seen to be more fixed in nature, a biological
happenstance that makes up a person’s personality. During Hildegard’s lifetime, there was a
strong resurgence of the Greek tradition, with the reintroduction of translated Greek texts
being brought from the East with an influx of Byzantine and Islamic scholars and physiologists.
Theories of humours and qualities were therefore a cornerstone of medical education, even
for women, and Hildegard’s medico-religious texts are suffused with Greek ideas of biological
balance. In Causae et curae she writes that “In the way that the elements, as has been said
before, hold the world together so they are also are the fastening of the human body.”56 What
is of interest to this thesis is how Hildegard rationalises these physiological theories with
biblical narrative.
CHAPTER OUTLINE
This thesis uses the editions of Kaiser, based on the Copenhagen manuscript, supplemented
with the Berger translation. On occasion, I use my own translations. For discussion of
Hildegard’s other works, including Scivias and Physica, I consolidate the original Latin with the
English translators (as noted). On information regarding Hildegard herself, the Vita, written
by the monks Theodoric and Gottfried, will be examined,57 as well as the Life of Jutta,58
although to a lesser extent.
Additionally, this thesis will support, but not focus on the authenticity of Causae et curae
and, by extension, Physica, particularly with regards to their connection with Hildegard’s body
of work. This thesis is based on the understanding that these texts are in fact Hildegard’s own
creation, if somewhat removed from their original nature due to time and editorial
interference. Similarly, current debates concerning the verisimilitude of biographical texts
such as the Vita and Life of Jutta are not of relevance to this thesis.
This thesis is separated into three chapters. The first, Education and the Burgeoning
Healer, examines the nature of Hildegard’s education in the healing practice. It explores
possible sources of information and inspiration, discussing the role healing played in the
Church and the construct of Benedictine monasteries. It argues that evidence for Hildegard’s
education in the herbal gardens lies within her texts and the symbolism she uses therein. This
chapter also discusses the role healing played in the construction of Hildegard’s public image,
and the roots of her medico-religious ideas as they appeared in her primary work, Scivias.
Chapter Two discusses Hildegard’s unique understanding of the physical human body,
supported by a close examination of Causae et curae. Hildegard’s ideas surrounding the body,
the soul, and the relationship between humanity and health is supplemented by the theories
of her predecessors, including Augustine and the Greek philosophers. In this chapter Causae
et curae is dissected as containing ideas unique to Hildegard’s writing, and to her time,
55
Hippocrates, On the Humours, 4: Of the Uneasiness of the Mind and Body, trans. John Redman Coxe, 104.
56
CC, 2:4. “Nunc autem, ut supra dictum est, quemadmodum elementa mundum simulcontinent, sic etiam
elementa compago corporis hominis sunt…” Kaiser, 49; Berger, 36.
57
Monks Gottfried and Theodoric, The Life of the Holy Hildegard, ed. Mary Palmquist & John Kulas (Minnesota:
The Liturgical Press, 1995).
58
Anna Silvas, Jutta and Hildegard: The Biographical Sources (Pennsylvania: Penn State Press, 1999).
18
including the elevated level of importance Hildegard plays on the balance of the body in
relation to the balance of the world, and how she understands the process of healing itself.
Finally, Chapter Three looks at Hildegard herself and the role of healing in her life and
works. This includes several primary accounts of Hildegard practicing healing acts, supported
by her Vita and letters. Whereas Chapter Two discusses Hildegard’s understanding of healing,
Chapter Three discusses how she puts these concepts into practice. There is some discussion
of her supplementary medical work Physica, a disjointed pharmacopeia that resembles more
a practical guide to healing than Causae et curae, which places greater emphasis on the
philosophy of healing itself. Additionally, Chapter Three returns to Hildegard’s overarching
ethos – that to heal the human body was to heal the world entirely – and how it operates as
the cornerstone of her entire body of work, and indeed her entire life’s philosophy.
19
CHAPTER ONE
EDUCATION AND THE BURGEONING HEALER
How did Hildegard learn medicine? The Benedictine order was known for its emphasis on
education and literacy, generating large numbers of male authors. It also produced some
remarkably literate women, like Heloise (d.1164), Elisabeth of Schönau (1129-1165) and
Gertrude the Great (1256-1302).1 Of course, this is not to say female religious had as much
access to education as their fellow monks. Even dual monasteries, where men and women
lived bordering one another (but not together) favoured monks with regards to instruction
and supplies.2 And yet, the increase in number of these arrangements also facilitated a
greater exchange of information and education – to a degree.3 This chapter will argue that
Hildegard’s early exposure to and education in the healing arts, as well as her later access to
traditional and contemporary healing practices, formed the groundwork for her interests in
health and healing and acted as the cornerstone for her medico-religious texts. Ultimately,
Hildegard’s example would help the development of female-authored monastic literature,
after centuries of overwhelming dominance by male authors within Benedictine
monasticism.4
Whether this trend towards male-authored literature was encouraged by Church
authorities or simply a happenstance of time and opportunity is a matter of interpretation.
Certainly, the intensity and manner by which female religious communities focused on
education differs on a case by case basis. The Hortus deliciarum, a twelfth-century text on
morals and behaviour, compiled at the Augustinian convent of Hohenburg, strongly
encouraged self-improvement in its community of canonesses by way of education. Compiled
by a woman, Herrad of Landsberg (1130- 1195, also known as Herrad von Hohenbourg), this
text encompassed traditions both Christian and pagan, poetry, and art.5 And yet; despite
Hildegard’s broad knowledge of contemporary texts and theories of her time, she herself was
known to criticise the field of established education from which she and her sisters were more
formally excluded.6 What we witness, then, in the volume of texts left to us by Hildegard or
1
John D. Cotts, Europe’s Long Twelfth Century (Palgrave Macmillan, 2013), 122; 156. It is not certain if Elisabeth
could read or write Latin, as she dictated her works in German to a scribe who in turn translated them. She also
corresponded (in Latin) with Hildegard a number of times, and she is included with Hildegard in what scholars
see as a trend of Frauenmystik within the twelfth century.
2
Cotts, “Europe’s Long Twelfth Century,” 132.
3
Caroline Muessig, “Learning and Mentoring in the Twelfth-Century: Hildegard of Bingen and Herrad of
Landsberg,” from Ed. George Ferzoco and Caroline Muessig, Medieval Monastic Education (London:
Bloomsbury Publishing, 2001), 89.
4
Andrew Weeks, German Mysticism: From Hildegard of Bingen to Ludwig Wittgenstein (New York: State
University of New York Press, 1993), 44-45.
5
Muessig, “Learning and Mentoring,” 97 see also Fiona J. Griffiths, The Garden of Delights: Reform and
Renaissance for Women in the Twelfth Century (Philadelphia: University of Pennsylvania Press, 2007).
6
Gillian T. W. Ahlgren, “Visions and Rhetorical Strategy: Hildegard of Bingen,” from Ed. Karen Cherewatuk,
Dear Sister: Medieval Women and the Epistolary Genre (Pennsylvania: University of Pennsylvania Press, 1993),
49.
20
transcribed for her, is the effort of a woman who was largely self-taught, or otherwise
instructed by her personal mentor, Jutta of Sponheim, an equally well-respected recluse and
yet also restricted in education by virtue of her gender. Any other mentors or formal
instructors in matters of medicine and theology are unknown. It is also likely that Hildegard
took advantage of the undoubtedly extensive library of Disibodenberg. Later, when she was
more comfortably situated in the site of Rupertsberg, Hildegard would use her newfound
freedom to investigate and discuss subjects of education heretofore denied to her. As for
matters of medicine, as it is known to us today, much of Hildegard’s experience appears to be
firsthand. In any case, in her own texts Hildegard refers to her audience as homo, not vir (man)
or mulier (woman), but as a human only. In this way, among other, more subtle methods,
Hildegard is acknowledging that her audience will include women, as well as men.7
T HE M ONASTIC G ARDEN
In the early ninth century, a copy was made of a schematic for the ideal Benedictine
monastery. This is known as the Plan of St Gall and still exists today in the Abbey Library of St
Gall in St Gallen, Switzerland. Of interest is the attention paid to the health facilities of the
monastery, with ample space dedicated not only to medical practice but private quarters and
meeting rooms for the physician himself (Fig. 1.) The latter included places for the physician
to eat and sleep in private (mansio medici ipsius) as well as a pharmacy for storing poultices
and potions (armarium pigmentorum). This pharmacy would be stocked using herbs from the
monastery’s medicinal garden, the contents of which the original Plan of St Gall labelled.
These included lilies, roses, pepperwort, costmary, rosemary, and sage, all plants to which
Hildegard refers in her healing texts.8
Fig. 1. Plan of St Gall (The Physicians’ Quarters)9
7
Constant Mews, “Re-defining Gender and Identity within Monastic Life,” from Ed. Katherine Massam and
Fotini Toso, The Greening of Hope: Hildegard for Australia (Victoria: Morning Star Publishing, 2016), 46.
8
Faith Wallis ed., Medieval Medicine: A Reader (Toronto: University of Toronto Press, 2010), 97.
9
St Gallen, Stiftsbibliothek, Cod. Sang. 1092 accessed at http://www.stgallplan.org/recto.html25/07/16.
21
As a self-contained monastery with its own baking house, kitchens, pantries, and lodgings,
Disibodenberg also contained an extensive garden.10 Here monks grew their own vegetables
for meals and medicinal herbs. However, when Hildegard joined the monastery, the female-
adjacent abbey was several times smaller than the main construct. Although records are
unclear, it is likely that as a young girl Hildegard shared a series of small cells with her mentor,
Jutta of Sponheim (1091-1136), as well as a small group of other women. There was perhaps
a small garden or courtyard area, which was separated from the main monastery by a large
wall near the men’s church.11 In the Vita of Hildegard this condition of enclosure was
described as being “buried with Christ and with him to rise to immortality.”12 Certainly, the
ultimate ideal of Benedictine rule with regards to women recluses was to ensure they were
wholly enclosed, with little to no contact with the outside world or the men to whom they
lived adjacent.13 Although food products were delivered to the women from the monastery
kitchens, it is also probable that they shared a small communal garden from which they grew
edible plants and herbs.
As Hildegard grew older and the female wing of Disibodenberg grew in size and
number, a need for easily accessible consumable food – and medicine - would have become
more apparent. Moreover, the Benedictine rule placed a heavy emphasis on labour. For
female recluse this would had involved traditionally feminine duties such as weaving, but
would also have included light gardening and the gathering of herbs.14 Therefore, in her
youth, Hildegard would have been involved in the identification and use of medicinal plants,
and is in fact noted to be primarily employed as a nurse for her peers.15 Victoria Sweet
theorises that Hildegard might have been trained in a more official practice by the male healer
responsible for the monks of Disibodenberg.16 In a letter to Gunther, a bishop of Speyer,
Hildegard even creates an extensive analogy using the herb gardens of the monastery, writing
Hear, O man: a certain man had a very fertile plot of land, which he ploughed and
planted very densely, and it brought forth an abundant harvest. Then the man decided
to make that plot into an herb garden, so that aromatic plants would grow there to
heal wounds and scars. Thus that land was made better than it was before.17
The familiarity with which Hildegard writes speaks volumes about the commonality and even
centralisation of herbal gardening within everyday monastery life. This was not restricted to
religious communities. Plants and knowledge of herbology were vital components of
medieval life for almost every member of society, used not only in medicine but also food and
drink, textiles and paints. A decent knowledge and identification of different plants was a
necessity in most cases, and even Hildegard’s initial reclusiveness would not have exempted
10
Frances Beer, Women and Mystical Experience in the Middle Ages (Woodbridge: The Boydell Press, 1992),
17.
11
Fiona Maddocks, Hildegard of Bingen (Faber and Faber, 2001), 35.
12
VH, 1:1. Silvas, 139.
13
Kevin Madigan, Medieval Christianity: A New History (New Haven: Yale University Press: 2015), 149.
14
Beer, “Women and Mystical Experience,” 18.
15
Ibid.
16
Victoria Sweet, Rooted in the Earth, Rooted in the Sky: Hildegard of Bingen and Premodern Medicine (London
& New York: Routledge, 2006), 11.
17
Hildegard, Ep. 41r to Gunther, Bishop of Speyer (1153-54), ed. Van Acker; trans. Baird and Ehrmann, 1, 113.
Emphasis my own.
22
her from this type of education.18 Moreover, her emphasis on their use in healing wounds
and scars is also significant, as they reflect her past duties as healer for the women of
Disibodenberg. However, Gunther’s letter is dated to several years after Hildegard’s move to
the site of Rupertsberg, when her fame became widespread and her cohort several times
larger than the small quarters of the Disibodenberg nunnery could comfortably house.19
The situation at Rupertsberg was markedly different. There was no male hermitage to
compete with for supplies and space – or rely on for food – and aside from occasional
deliveries the women were entirely dependent on themselves to grow and cultivate their own
vegetables, and to prepare medicines. Today the ruins of Rupertsberg only hint at some walls
and the occasional building, but it is understood that the Benedictine convent, once fully
constructed, owned enormous tracts of land. These contained multiple lodgings, chapels,
kitchens, pantries, a cemetery, stables, workshops, and of course – gardens.20 The infirmary,
a necessary staple, would have been outfitted with beds for the invalid, tubs for bathing,
medicinal cabinets, and a number of medical devices for the practices of grinding, mixing, and
pasting poultices. A chapel would either be included in the infirmary or situated close by for
ease of mind of the patients and convenience for unsuccessful treatments.21 The upper
Rhineland, where Rupertsberg was located, contained especially fertile earth. Of the plants
Hildegard mentions in Physica and Causae et curae, most could be found in any monastery
garden, and the rest growing in the wild surrounding fields or forests.22 For example
Hildegard’s Lingua ignota, an invented language comprising around 1100 terms, includes new
titles for plants including lavender, garlic, hyssop, and wormwood.23 More commonly,
however, she would rely on her native German to identify and prescribe various plants. Up to
forty plants in Causae et curae are identified this way, as are several illnesses.24
This implies that Hildegard was instructed in the general lay remedies of the era which
had developed over the years with the plants at hand. These folk remedies demanded a sense
of respect for the plants and herbs utilised, as the correct dosage could be immensely useful
to an ailing person, and the incorrect, immediately fatal. Therefore, herbalists and physicians
employing these remedies “encouraged treating them [the herbs] with a dignity not shared
by oats, wheat, or trees – that is not shared by the mundane plants on which medieval
agrarian societies actually depended for protein and nutrients, for building and clothing
materials.”25 This distinction between ‘vital’ and ‘non-vital’ herbs is clearly apparent in Physica
and Causae et curae as well as in Hildegard’s other works. When Hildegard prescribes a potion
or poultice with the use of herbs, she does so with explicit instructions and carefully defined
dosages. She, like a physician, offers the pros and cons to these dosages, warns against
18
Jerry Stannard, “Medieval Herbalism and Post-Medieval Folk Medicine,” Pharmacy in History, Vol. 55, No.
2/3 (2013), 48.
19
VH, 1:5. Silvas, 143. There were several other motivations for the move to Rupertsberg, including Hildegard’s
desire to break away from the restrictive control of the monks at Disibodenberg. These are not of importance
to the subject of this thesis. For further reading see the in-depth biographical work of Sabina Flanagan and
Fiona Maddocks, among others.
20
Maddocks, “Hildegard of Bingen,” 98.
21
Florence Eliza Glaze, “Medical Writer” from Voice of the Living Light: Hildegard of Bingen and Her World
(Berkeley, Los Angeles, London: University of California Press, 1998), 126-7.
22
Marijane Osborn, “Anglo-Saxon Ethnobotany: Women’s Reproductive Medicine in Leechbook III,” from
Health and Healing From the Medieval Garden (Woodbridge: The Boydell Press, 2008), 146.
23
24
25
Peter Dendle, “Plants in the Early Medieval Cosmos,” from Health and Healing From the Medieval Garden
(Woodbridge: The Boydell Press, 2008), 52.
23
overdoses, and offers alternatives on a patient-by-patient basis. These signs all indicate a
period of intense study, as well as first-hand experience with herbal medical treatment.
Therefore, the idea of Hildegard being trained in lay remedies, if not in an official medical
practice (perhaps even by her mentor Jutta), is not impossible.
In Hildegard’s Vita, the monks Theodoric and Gottfried claim “Except for simple
instruction in the psalms, she (Hildegard) received no other schooling, either in reading or in
music.”26 Hildegard’s attributes her prolific writing instead to divine intervention, which she
describes in the opening to Scivias:
O fragile human, ashes of ashes, and filth of filth! Say and write what you see and hear.
But since you are timid in speaking, and simple in expounding, and untaught in writing,
speak and write these things not by a human mouth, and not by the understanding of
human invention, and not by the requirements of human composition, but as you see
and hear them on high in the heavenly places in the wonders of God.27
Hildegard constantly professes her illiteracy, lack of education, and general ignorance, to such
an extent that it reflects adherence to the level of humility expected by the Church, rather
than complete truthfulness. For example, the Vita’s claim that Hildegard received no training
in music seems highly doubtful, given that the Vita also claims Jutta’s tutelage included
training Hildegard in “learning and singing the sacred songs of David.”28 That Hildegard went
on to compose a great number of musical pieces is testament to this contradiction. The monk
Volmar (d.1173), who guided her in Disibodenberg before joining her entourage in the move
to Rupertsberg, certainly acted as Hildegard’s scribe and editor up until his death. And yet,
Hildegard’s literacy was sufficient enough to discuss a broad number of topics within her
letters, and Causae et curae is filled with contemporary theories on health and biology. It is
highly unlikely the latter was included in her formal education, as it would have been for the
monks as part of the Seven Liberal Arts (the trivium: grammar, dialectic/logic, rhetoric, and
the quadrivium: arithmetic, geometry, astronomy and music), standard for anyone entering
the Church or government.29 Therefore it can be inferred that Hildegard absorbed
information on a number of topics outside of Jutta’s tutelage from the library at
Disibodenberg, at least in her early years, and then at her own leisure later in her career when
she had greater access to the outside world.
The specific sources to which Hildegard had access are currently unknown. There is no
comprehensive listing of the titles in Disibodenberg’s extensive library, and Hildegard never
supplies any names. However, German monasteries – male and female – were centres of
education far longer than their European counterparts in the medieval period.30 We can
reasonably assume the Disibodenberg library would have contained the works of eminent
26
VH, 1:1. Silvas, 139.
27
Scivias, Declaration, Führkötter, 3. Hart & Bishop. “O homo fragilis, et cinis cineris et putredo putredinis, dic
et scribe quae vides et audis. Sed quia timida es ad loquendum, et simplex ad exponendum, et indocta ad
scribendum ea, dic et scribe ea non secundum os hominis, nec secundum intellectum humanae adinventionis,
nec secundum voluntatem humanae compositionis, sed secundum id quod ea in coelestibus desuper in
mirabilibus Dei vides et audis…”
28
VH, 1:1. Silvas, 139.
29
30
Barbara Newman, “Liminalities: Literate Women in the Long Twelfth Century,” from European
Transformations: The Long Twelfth Century, ed. Thomas Noble and John Engen (Indiana: University of Notre
Dame Press, 2012), 379.
24
figures within the Church – those of Augustine (354-430), Gregory (538-594), and Anselm
(1034-1109), for example. It is not unreasonable that Hildegard would have encountered the
more widespread medical references of her time during her studies, certainly Isidore of Seville
(560-636) and possibly, Pliny (23-79), pseudo-Apuleius (4th C), Galen (129-210), Soranus (1st
C) and others.31 Several historians, including Margret Berger and Eliza Glaze, have compared
Hildegard’s words and the writings of contemporary theologians, arguing that Hildegard’s
reproduction of their concepts is certifiable proof of her extensive reading. Laurence
Moulinier argues that Hildegard had at least rudimentary knowledge of the works of Pliny,
Isidore, Ovid (43BCE–18CE), Macer (d. 66BCE), Strabo (64BCE-24CE), Palladius (4th C) and
Quintus Serenus (d.212).32 Among others, Hildegard was also allegedly able to quote
Boethius’ (480-524) sixth-century text Consolation of Philosophy by heart,33 and notably paid
particular attention to the second-century text The Shepherd of Hermas, incorporating its
feminisation of spiritual imagery into much of her work.34 She also incorporated much of
Constantine the African’s (d.1098-99) Pantegni in Causae et curae when she discusses the
male and female reproductive systems, borrowing select terminology from Constantine’s
examination of the hernia.35
Many monastic libraries contained popular medical treatises, as well as recipe books
and pharmacopeia.36 It was also common for monasteries to exchange or share texts, so it is
likely Hildegard would have encountered new material semi-regularly.37 The complications
within this large-scale exchange of knowledge arose largely from issues of language. The full
extent of the Greek medical tradition was re-introduced to the West by migrating Eastern
scholars, and then translated into Latin (Constantine the African was known for his
translations). Thus, the texts lost much of their original nuance.38 Therefore Hildegard, like
other aspiring scholars of the time, built her knowledge of medicinal practices up with
treatises that were at best verbose, and at worst incomprehensible. Debra Stoudt argues that
the influx of travellers to Disibodenberg and (more likely) Rupertsberg would have exposed
Hildegard not only to current news and politics, but to these Latin-translated medical tracts
as well. For example, Bishop Siward of Uppsala (d.1159) stayed at Disibodenberg for some
time in 1138. When he died, he left behind a library which included extensive texts on the
identification of different plants and minerals, as well as six separate medical texts including
Isidore of Seville’s Etymologies.39 His son would go on to become one of Hildegard’s closest
and most regular visitors.
And yet, Hildegard’s medico-religious works are not just a reproduction of the tracts
that came before her. True, she adopts the Galenic-Hippocratic theory of the humours and
elements. This thesis will argue her understanding of the world and its natural order is built
31
32
Laurence Moulinier, “Ein Präzedenzfall der Kompendium-Literatur. Die Quellen der natur- und
heilkundlichen Schriften Hildegards von Bingen,” in Prophetin durch die Zeiten, ed. Edeltraud Forster (Freiburg
im Breisgau: Herder, 1997), 435.
33
34
Constant Mews, “Gender, Nature & Visionary Experience,” in, Hildegard of Bingen and Gendered Theology in
Judaeo-Christian Tradition, ed. Julie Barton and Constant Mews (Clayton: Monash University Press, 1995), 70.
35
Eliza Glaze, “Medical Writer,” 140.
36
37
38
39
Heinrich Schipperges, Hildegard of Bingen: Healing and the Nature of the Cosmos (Princeton: Markus Wiener
Publishers, 1997), 10.
25
largely out of the physiological tradition combined with Platonic traditions, mediated through
writers like Boethius. But as Florence Eliza Glaze states, “What she [Hildegard] writes about
disease and healing is fundamentally in agreement with contemporary medical literature, but
in no case does she take information from any one source and reproduce it unchanged.”40
Indeed, Hildegard takes current medical concepts and reworks them in Causae et curae and
Physica into something ultimately genuine in its distinctiveness. These works represent a real
effort on Hildegard’s part to produce something not only new to medical and spiritual theory
of the time, but also a text that most perfectly represents Hildegard’s unusual worldview –
one riddled with theatrical visions, political intrigue, chronic illness, and power struggles on
both the intimate and largescale.
S OWING THE SEEDS IN S CIVIAS

The introduction to Hildegard’s Liber vitae meritorum, written in 1160, is vitally useful for
situating Causae et curae within a clear timeline. In it Hildegard declares
The following happened in the ninth year after a true vision had shown me, a simple
person, the true visions which I had previously laboured over for ten years. This was
the first year after that vision had shown me the subtleties of the different natures of
created things with reactions and warnings for greater and lesser people. It had also
shown me the symphony of the harmony of heavenly revelations, and an unknown
language with letters with certain other explanations. I had been physically sick and
weighed down with a lot of work for nine years after the true vision had shown me
these things so that I might explain them. When I was sixty years old, I saw another
strong and wonderful vision which I laboured over for five years.41
This introduction is fascinating for several reasons. Firstly, it provides valuable

autobiographical testimony. Secondly, the true visions over which Hildegard had laboured
for ten years were Scivias, which she describes in that work as begun when she was in her
forty-third year (therefore 1141). Hildegard reveals that nine years into that process of
writing, she fell ill, and in doing so received a further vision about the natures of created things
(as well as the Harmony and The Unknown Language). This strongly implies that she began
work on her medical texts before finishing Scivias, and not after. However, Hildegard only
provides one title for her medical texts. Either the texts originated as one, as Moulinier argues,
or Physica was created before her move to Rupertsberg, and Causae et curae after she was
settled in her new location. This is understandable, if she was in the midst of creating a larger,
more pressing text, and coming into her own growing influence over the region and her peers.
40
41
LVM, 1.1. CCCM 90. Carlevaris, 8. “ET FACTVM EST in nono anno postquam uera uisio ueras uisiones, in
quibus per decennium insudaueram, mihi simplici homini manifestauerat; qui promus annus fuit, postquam
eadem uisio subtilitates diuersarum naturarum creaturarum, ac response et admonitions tam minorum quam
maiorum plurimarum personarum, et symphoniam harmonie celestium reuelationium, ignotam que linguam et
litteras cum quibusdam aliis expositionibus, in quibus post predictas uisiones multa infirmitate multo que
labore corporis grauata per octo annos duraueram, mihi ad explanandum ostenderat; cum sexaginta annorum
essem, fortem et mirabilem uisionem uidi, in qua etiam per quinquennium laboraui.” Emphasis is not my own,
Hildegard is referring directly to the titles of the scripts in question.
26
The Physica certainly resembles more the idle jottings of a preoccupied mind than an
intellectually unified composition like Causae et curae.
There is a third point of interest regarding Hildegard’s medical texts, and this specific
window of time. The Council of Trier took place sometime between November 1147 to April
1148, during which the subject of Scivias was allegedly raised with, and approved by, Pope
Eugenius III.42 This was the catalyst of Hildegard’s life, which legitimised and encouraged her
ever-growing body of work. If Hildegard, as she writes, experienced another vision nine years
after her initial inspiration for Scivias, this would have been sometime between 1149 and
1150. In other words, this would have happened soon after Scivias was approved, but before
it was finally completed. With Scivias nearly finished but suffering from, as she says, multa
infirmitate, the papal approval of Hildegard’s work would have given her a surge of
confidence. This could even have been to the extent that she put aside her larger work to
begin writing down an issue of personal importance to her: that is, a treatise on health. This
chapter will examine how aspects of these interests were already appearing in Scivias.
Therefore, although Physica is not visibly inspired by the larger work, it conceptually comes
from the same place; a deep-rooted fascination with the workings of the human body and
soul. It would also act as the reference point from which Hildegard would then go on to write
Causae et curae, years later after the tumultuous move to Rupertsberg, now comfortably
settled within a realm of her own control and authority. If Scivias was the narrative by which
Hildegard achieved legitimate authority, then Causae et curae explored the characters in that
narrative, that is to say, humankind itself.
Scivias, or Scito vias Domini, was Hildegard’s first major composition, a labour of love
completed over ten years from 1141 to 1151.43 It consists of three books, The Creator and
Creation, The Redeemer and Redemption, and The History of Salvation Symbolised by a
Building. Each chapter contains several prophetic visions. Even today, Scivias remains
Hildegard’s most celebrated work. However, despite its nature as a work of prophecy, there
are moments Hildegard’s personal interest in health and healing reveals itself. In Book One,
Vision Four, Hildegard debates the nature of the soul and how it can be swayed by forces of
evil or good. She briefly departs from the subjects of cosmology and ineffability to give advice,
clearly influenced by Galenic principles, on the nature of pregnancy and childbirth: “…for that
strong semen,” Hildegard writes, “which is usefully and well-matured and tempered,
produces energetic people […] And one part is thin, and from it weak cheeses are curdled; for
this semen, imperfectly matured and tempered in a weak season, produces weak people, who
are for the most part foolish, languid, and useless…”44 This description is not far removed
from contemporary medical philosophy of Hildegard’s time, which followed Galenic and
Hippocratic principles and were therefore primarily concerned with the four bodily humours
(blood, yellow bile, black bile, phlegm), qualities (cold, wet, hot, dry), and the elements (air,
water, earth, fire). Hildegard revisits these ideas in more detail in Causae et curae wherein
she relates ‘the poison of semen’ to Adam’s Fall.45
However, the above example also demonstrates how Hildegard’s – sometimes graphic
– views regarding procreation are starkly different from that of her Church predecessors.
42
Justin A. Stover, “Hildegard, the Schools, and their Critics,” from A Companion to Hildegard of Bingen, ed.
Beverley M. Kienzle et al (Leiden & Boston: Brill, 2014), 116.
43
“Know the Ways of the Lord.”
44
Scivias, 1:4.13. Mother Columba Hart and Jane Bishop, Hildegard of Bingen: Scivias, (Connecticut: Paulist
Press, 1990).
45
CC, 3:2. Kaiser, 86; Berger, 39.
27
Moreover, it reveals a broader understanding of how Hildegard viewed the dichotomy (or
lack thereof) of the body and the flesh. Popular spiritual belief dictated that the human body
was a vessel and its flesh ruled by instinct – that is, instinct towards copulation. The perfect
vessel therefore is one which rises above the instinct of the flesh.46 Although Christianity did
not condemn the lay community for intercourse with the intent of procreation (between a
married couple, specifically), there was a longstanding belief that their vessels were
irreparably ‘damaged’ by this. Lay people who partook of intercourse without the intent of
procreation, on the other hand, were certainly condemned by the spiritual community for
wastefulness and immorality. Augustine of Hippo (354-430 CE) summarises this distinction
neatly in a treatise on marriage, declaring that:
Marriages have this good also, that carnal or youthful incontinence, although it be
faulty, is brought unto honest use in the begetting of children, in order that out of the
evil of lust the marriage union may bring to pass some good.47
This carnal incontinence was commonly blamed as the cause for illness in such people. There
were exceptions to this. Some medieval Christians, for example, did not trust in the distinction
between moral and immoral intercourse, believing instead that any form of intercourse was
a mortal sin.48 What Hildegard writes about the diverse natures of semen in Scivias (and in
greater detail in Causae et curae) seems to suggest a move away from these beliefs.49 Instead,
she seems to be affirming that although immorality and wastefulness do impact physical
health, parentage may simply be the cause. That is, Hildegard acknowledges that people are
biologically different. This may not be a controversial belief for those studying the sciences,
but for an abbess it is highly unusual. And yet, later in Scivias Hildegard defers to spiritual
tradition when explaining how immoral unions cause deformity in infants.50 As Scivias was
Hildegard’s first text, when she was more interested in establishing a foothold by way of a
more general prophetic text, she only begins to hint towards her unique views regarding
health and biology. Certainly, many of her ideas did not differ from spiritual tradition.
However, this example shows us that Hildegard clearly put great thought into the workings of
the human body many years before her medical texts came into existence.
Perhaps the most significant example of Hildegard’s perception of spiritual and natural
health is God’s proclamation in Book One, Vision Three, of Scivias: “I am the great Physician
of all diseases and act like a doctor who sees a sick man who longs to be cured.”51 The image
of Christ as healer (Christus medicus) was a popular motif in the medieval Church, and
famously invoked by Augustine on several occasions. In one case, he dubs Christ medicus et
salvator noster, “the physician of our salvation.”52 Later, Thomas Aquinas (1225-1274 CE),
46
Ruth Mazo Karras, Sexuality in Medieval Europe: Doing Unto Others (London: Taylor and Francis, 2012), 34.
47
Augustine, Of the Good of Marriage, trans. C.L. Cornish in Nicene and Post-Nicene Fathers: First Series, Vol. 3
(Buffalo: Christian Literature Publishing Co., 1887).
48
Shaji George Koohuthara, The Concept of Sexual Pleasure in the Catholic Moral Tradition (Rome: Gregorian
Biblical Bookshop, 2007), 196.
49
See “Diversity in Conception,” CC 5.2.
50
Scivias, 1:4.15, ED. Führkötter. CCCM 45, 77; Hart and Bishop 15.
51
Scivias, 1:3.30, ED, Führkötter, CCCM 45. r, 58; Hart and Bishop 104. “Ego enim sum magnus medicus
omnium languorum: faciens velut medicus qui languidum videt, qui medelam ardenter desiderat.”
52
Augustine, Commentary on the Psalms (http://www.mlat.uzh.ch/MLS/index.php?lang=0accessed 24/05/16).
28
calls Christ spiritualis medicus, or, “the physician of souls.”53 This motif naturally gave impetus
to a vital role within the medieval church. That is, apart from prayer and instruction, the duty
of the clergy was to heal and nurture the flock in the model of Christus medicus.54 The remains
of martyrs and saints were particularly famous for their healing properties. Faithful Christians
took part in pilgrimages to shrines where these holy relics – which included bone fragments,
crucifixes, or hair – were put on display.55 Pilgrims gave donations in the hope of attaining
spiritual protection or healing an illness, sometimes travelling across countries and continents
in excruciating agony, even occasionally carried.56 Before the rise of established universities
towards the end of the twelfth century, medical care and rudimentary hospitals were almost
entirely run by members of the clergy.57 The Church was the largest source of medical aid to
the people, and advances in medical sciences were, at least initially, attributed to divine
influence. Hildegard’s dialogue was certainly in line with the ethos of her community.
Hildegard’s use of medicus in Scivias is significant in one other instance. This is in Book
Three, Vision Thirteen. In this vision, Hildegard describes a dialogue between the Virtues, a
desperate soul, and the Devil, in what is essentially an early version of her Ordo Virtutum. The
Devil is attempting to take the wandering soul for his own, while the virtues defend her right
to enter Heaven. The soul laments her sin of pride, at which point Humility enters the
dialogue, stating
HUMILITY (to the soul): O unhappy daughter, I will embrace you; for the great
Physician for your sake suffered deep and bitter wounds.58
This magnus medicus is, of course, Christ. It is one of Hildegard’s most recurrent titles for
Christ in her writing and in her epistles. In this case, it is interesting that Hildegard directly
links Christ’s role as a healer to the injuries he suffered before and during his crucifixion, his
“deep and bitter wounds.” The medieval community up to the twelfth century certainly drew
strong associations between the infirm and Christ, seeing Christ’s response to pain and
suffering as a model by which the ill and invalid should follow.59 This connection was
emphasised to the extent that suffering people were seen to be closest to God, and some
circles saw disease and illness as enviable states of being. Why then does Hildegard associate
this state with the role of the medicus? Jole Agrimi and Chiara Crisciani have shed some light
on this association, arguing that:
The role of the invalid was one of assisting in redemption. The invalid at the same time
was himself a penitent and offered an opportunity to perform penitence, to
53
Thomas Aquinas, Summa Theologiae, 3:68.4. from Fathers of the English Dominican Province, Summa
Theologiae: Part Three (Authentic Media Limited, 2012).
54
Darrel W. Amundsen, Medicine, Society, and Faith in the Ancient and Medieval Worlds (Baltimore: John
Hopkins University Press, 1996), 183.
55
Kevin Madigan, Medieval Christianity: A New History, (New Haven: Yale University Press: 2015), 327.
56
Madigan, “Medieval Christianity,” 329, 331.
57
Amundsen, “Medicine, Society, and Faith,” 177.
58
Scivias, 3:13.9, Führkötter, CCCM 45+++., 627; Hart and Bishop 531. “O misera filia, volo te amplecti, quia
magnus medicus dura et amara vulnera propter te passus est.”
59
Jole Agrimi and Chiara Crisciani, “Charity and Aid in Medieval Christian Civilisation,” from Western Medical
Thought from Antiquity to the Middle Ages (Cambridge: Harvard University Press, 1998), 176.
29
accomplish acts of charity that heal others. From this point of view, the true
‘physicians’ were the sick, the deformed, the diseased beggars who cried for alms.60
This theory proposes that Christ’s role as healer to the masses as well as his suffering during
crucifixion meant he embodied the true model of what it meant to be a medicus. That is, not
only did he perform miracle cures before his sacrifice, but Christ’s sacrifice itself brought
salvation to humanity, cleansing the people of their sins and, therefore, their ‘sickness.’ 61
Consequently, Hildegard’s preference for referring to Christ as magnus medicus indicates that
she shares this association between illness and spiritual fallibility. “Thus,” writes Gerhart
Ladner, “she sees repentance and penitence as a process in which the physiological and
spiritual causes and effects are inextricably mingled.”62 In the dialogue above, Humility states
that it will assist because Christ suffered greatly for the wandering soul. Of course, in a
simplistic sense, this reflects common Christian tropes of mercy and charity. However, if we
consider the argument of Agrimi and Crisciani, there is an extra layer behind Hildegard’s
words. That is, because Christ suffered, there was an impetus for him to ease the suffering of
others. By association, that impetus was shared by all physicians. It is not unreasonable to
believe that Hildegard, whom suffered from debilitating illnesses, believed herself to share
that impetus as well.
Medieval theology traditionally viewed illness as a consequence of sin. Hildegard
agrees with this, and additionally defines it as a trial from God. Through her medical and
spiritual concerns, she acts as a guide through that trial. However, rather than restricting her
prescriptions to standard rotations of repentance, prayer and forgiveness, she instead echoes
the Benedictine ethos in promoting ora et labora. Namely, pray and act.63 In Book One, Vision
Four of Scivias, she portrays this model through a metaphor in which the immoral or impure
human should do more than just beseech God to receive forgiveness and entrance into
Heaven. Instead, Hildegard demands, “So let the faithful person recognise his pain and seek
a physician before he falls dead.”64 She directly targets those who claim to want the cleansing
that comes from forgiveness, but do not wish to acknowledge their sins to do so, stating:
But he who neglects repentance for his sins, saying it is hard for him to chastise his
body, will be wretched, for he does not want to look at himself, or seek a physician,
or have his wounds healed, but hides the dreadful wound in himself and covers over
death with false appearances to conceal it.65
In this case Hildegard’s urging to seek a physician is a clear metaphor for the penitent to turn
to God, or perhaps more physically the Church itself. What is of interest within Scivias is
Hildegard’s constant use of the physical to describe the spiritual. Her work is awash with
60
Agrimi and Crisciani, “Charity and Aid,” 175.
61
Agrimi and Crisciani, “Charity and Aid,” 175.
62
Gerhart B. Ladner, “Terms and Ideas of Renewal,” in Renaissance and Renewal in the Twelfth Century,ed.
Robert Benson, Giles Constable and Carol Lanham (Toronto: University of Toronto Press, 1999), 17.
63
Foreword, Holistic Healing: Hildegard of Bingen (Minnesota: Liturgical Press, 1994), xiv.
64
Scivias, 1:4.30, CCCM 45. Führkötter, 89. Hart and Bishop 128. “Sed si vulnera acceperis, medicum quaere ne
moriaris.”
65
Scivias, 1:4.30. CCCM 45. Führkötter, 91. Hart and Bishop 128. “Qui autem poenitentiam peccatorum suorum
neglexerit, quoniam corpus suum castigare sibi difficile esse dicit, miser est quia non vult in se ipsum respicere,
nec ullum medicum quaerere, nec vulnera sua sanari, sed pessimum livorem in se celat et mortem in
simulationem tegit ne videri possit.”
30
metaphors of the state of the body and its treatment, betraying an obvious preference
towards the natural sciences. Rather than seeing the physical form as simply a vessel for the
soul to inhabit, Hildegard instead envisions a relationship built on mutual accord. Put most
poetically, she decides that “the soul is the mistress, and the flesh the handmaid.”66 The image
of the flesh as a handmaid had been used sparingly elsewhere before (although never by
Augustine), as in Basil of Caesarea’s (329-379) Admonitio ad filium spiritualem, ninth-century
prelate Grimlaicus’ Regula solitariorum,67 and a sermon of Chromatius of Aquileia (d.407) in
the fourth century, as well as Paulinus II of Aquileia’s (750-802) Liber Exhortationis, among
others.68 However, in Scivias Hildegard lays claim to the idea, and reshapes it with her own
understanding of the relationship between soul and flesh as like that between a mistress or
teaching and her servant. She even evokes it in a letter to one Abbot Helenger, writing, “And
who is this man? Why, he is the one who keeps his body under control like his handmaiden,
and cherishes his soul like the lady he loves and serves.”69 The soul commands the flesh to its
will, as a mistress commands the handmaid. However, the body may still act against that will,
and by doing so and engaging in evil deeds becomes “as bitter for the soul as poison is for the
body.”70 In this example, Hildegard is referring to the flesh, caro, rather than the body itself
as a single entity – Anima autem est magistra, caro ergo ancilla. In this manner, she is not
describing the physical form itself, but what it is made up of. That is to say, everything
excluding the soul itself that completes a human being, such as senses and emotions.
To put it even more succinctly, the Vita quotes Hildegard as stating, “Although human
beings by nature are composed of body and soul, they are nonetheless a single structure.”71
Hildegard is clarifying the body as a single entity, whilst simultaneously dividing it. This is a
challenge of the existing Augustinian theory that the soul is somewhat displaced from the
body. Whether this challenge is direct or indirect is arguable, there was certainly a tradition
behind challenging Augustinian theory during Hildegard’s time, but no confirmation as to
whether or not Hildegard read his works (in Causae et curae there is no mention of Original
Sin at any point, which may add significant weight to this discussion). Moreover, the image of
the flesh as a maidservant does not appear in Augustine’s works. When Hildegard goes on to
describe the body as the universe in miniature – that is, a microcosm of God’s macrocosm,
Brianna Marron summarises, “Hildegard assigns to the soul an interesting nature in which she
pulls it down towards the physical but also elevates it towards God.”72 It is this unique
distinction that characterises Hildegard’s medical and metaphysical musings, and that it
66
Scivias, 1:4.25. CCCM 45. Führkötter, 83. Hart and Bishop 123. “Anima autem est magistra, caro euro
ancilla.”
67
Rules for Solitaries. A tract on the concept of hermits composed in the early 900s.
68
Chromatius of Aquileia, Sermon 24, ed. J. Lemarié, CCSL 9A (Turnhout: Brepols, 1974), 108il, Admonitio ad
filium spiritualem, PL 103, 694C; Grimlaicus, Regula solitariorum, PL 103, 635B; Paulinus, Exhortatio sive De
salutaribus documentis, pl 90, 232B); Basil, Admonitio ad filium spiritualem, PL 103, 694C.
69
Hildegard, Ep. 76r to Abbot Helenger (1170), ed. Van Acker; trans. Baird and Ehrmann, 1, 164-165, “In
spirituali uisione que a Deo est, hec uerba audiui: Valde necessarium est homini qui animam suam in desideriis
ipsius inuenire uult, ut mala opera carnis perdat et beatam scientiam habeat quomodo uiuat, ita etiam quod
anima eius sit domina caro ancilla, secundum quod psalmista dicit: Beatus homo quem tu erudieris, Domine, et
de lege tua docueris eum. Et quis est homo iste? Scilicet ille qui corpus suum habet sicut ancillam et animam
suam sicut dilectissimam dominam.”
70
Scivias, 1:4.25, ed. Führkötter, CCCM 45, 83; Hart and Bishop, 123. “Sed cum homo malum opus sciente
anima operator, hoc tam amarum animae est velut venenum corpori, cum illud corpus scienter accipit.”
71
VH, 2:14. Silvas, 174-77.
72
Brianna Marron, “A Space of Convergence: Hildegard of Bingen’s Multivalent Understanding of the Body,”
Magistra, Vol. 20, No. 2 (2014), 38-57; 55.
31
appears so early in her body of work – indeed, in her first text Scivias – is particularly
significant. Her understanding of the physical form and all it contains is complexly portrayed
in Scivias. She at once adheres to and staunchly contradicts existing theory, reshaping and
repainting it to depict a far more interwoven idea of the interaction between the spiritual and
the physical. Although Scivias was her flagship text for her spiritual proclamations, it is also
here that we see the construction of Hildegard’s medico-religious texts in action. Her
discussion of what the body actually is leads directly to the detailed deconstructions we find
in Causae et curae, where Hildegard strips back biblical theory to its skeleton and examines it
for how it fits into her understanding of the metaphysical world both around and within her.
T HE P UBLIC I MAGE OF H ILDEGARD

The Vita Sanctae Hildegardis, written and compiled by the monks Gottfried and Theodoric
after her death in 1179, dedicates a chapter to the holy miracles of Hildegard, titled De
miraculis. Included herein are accounts of Hildegard’s healing of tumours, deafness,
hemorrhages, pregnancy pains, blindness, possession, and even depression (The Healing of
Emotionally Sick Women). The Vita goes as far as to claim that “the gift of healing shined so
brightly in the holy virgin that hardly any sick person came to her who did not go away
completely healed.”73 Of course, much of this can be assumed as hagiographical
embellishment, as Hildegard’s ‘treatment’ often extends only as far as a spiritual blessing.
However, there are some hints towards a broader physiological practice. In The Healing of a
Swabian of a Tumour, Hildegard’s treatment is said to have included keeping “him (the victim)
with her for a few days,” and overseeing his recovery personally, as well as the par-for-course
blessing.74 Other remedies employed by Hildegard in the Vita include her dispensing holy
water to victims of throat-based illnesses (Healing of a Throat Ailment; Healing of a Young
Girl Who Could No Longer Speak; Healing of a Deathly Ill Man) and bread blessed with
Hildegard’s tears for fits of immoral desires (Healing from a Passion through Blessed Bread).75
Multiple accounts also depict victims of severe pregnancy pain laying strands of Hildegard’s
hair against their bare skin for relief.76
The account of Sigewiza, a mad noblewoman, is discussed in detail using several
letters to and from Abbot Gedolphus of Brauweiler.77 One such letter describes how the
demon inhabiting Sigewiza declared it would only relinquish its victim “through the advice
and help of an old woman in the area of the Upper Rhine.” Hildegard at this point was in her
sixties. To make matters even more specific, the demon mockingly titled this woman
Schrumpelgardis, “Shrivelled up Hildegard.” Hildegard’s skills in prophecy and healing were
at this point so renowned that she was quickly recognised and contacted for further advice.78
Indeed, in the chapter of miracles within Hildegard’s Vita, Hildegard’s reputation as a healer
of ills and woes is so pronounced that she is contacted by people both rich and poor, from all
over Europe, not just within the clergy itself but also the lay community and even occasionally
73
VH, 3:1. Klaes, 38; Silvas, 184. “Igitur curationum tam potens gratia in Virgine enituit beata, ut nullus fere
aegrotus ad eam accesserit, quin continuo sanitatem receperit.”
74
VH, 3:4. Klaes, 39; Silvas, 185. “Denique per aliquot dies charitative eum secum detinuit, et manibus suis
languidum contrectans et benedicens, per gratiam Dei pristinae incolumitati restituit.”
75
VH, 3:6; 3:7; 3:8; 3:9. Silvas, 186-7.
76
VH, 3:11; 3:12. Silvas, 187-8.
77
Hildegard, Ep. 68 and 68r to Abbot Gedolphus (1169), ed. Van Acker; trans. Baird and Ehrmann.
78
Fiona Maddocks, Hildegard of Bingen: The Woman of Her Age (London: Headline Book Publishing, 2013), 223
Discussed further below.
32
nobility. However, a majority of Hildegard’s recorded treatments are seemingly restricted to
a powerful incantation, either spoken by Hildegard personally or otherwise sent out by way
of letter.
And yet, Hildegard’s biographical comments within the Vita and parts of her body of
work reveal that she is less concerned with her healing of others than she is with her own
suffering. The epilogue of Liber Divinorum Operum stands as particularly telling of this
preoccupation, as Hildegard states “From the very day of her birth this woman (Hildegard)
has lived with painful illnesses, as if caught in a net, so that she is constantly tormented by
pain in her veins, marrow, and flesh.”79 Similarly, Causae et curae and Physica do not include
primary accounts of using the treatments described therein on other people. It is evident,
therefore, that Hildegard’s identity as a healer was not wholly self-constructed. Further
evidence for this line of argument lies within the overabundance of healing incantations in
the De miraculis of the Vita. These incantations described by Gottfried and Theodoric are
curious, given that, from what we have already argued in this thesis, Hildegard herself was
particularly conscious of the need for physical methods of healing. Of course, Hildegard’s role
as a spiritual leader and her own belief would support her use of spiritual blessings as
methods of healing. However, her body of work undeniably weighs on the side of poultices,
potions, exercise, and diet. That the Vita is instead overwhelmingly concerned with the use
of incantations is therefore a matter in need of further discussion. Of the seventeen acts of
healing included in this chapter, twelve explicitly describe the use of a powerful healing
incantation, sometimes in conjunction with an ingestible substance. Therefore, we can
assume that these accounts are largely the construction of the Vita’s authors, or otherwise
re-told in a manner which emphasises the holy nature of Hildegard’s healing acts.
The presence of miraculous healing in saintly vitae is not unusual, indeed it is even
expected. However, the emphasis placed by the authors on Hildegard’s healing prowess in
the introductory chapter (as quoted above) and the extensive examples listed suggest that
for Gottfried and Theodoric, at least, healing and illness were pivotal to Hildegard’s public
image. Causae et curae and Physica therefore gave theoretical formulation to these concerns.
Hildegard’s reputation was certainly built on her visionary prowess, but it was her healing acts
that endeared her to the public, as evident by the many pleas for assistance from the ill or
injured in surviving letters. Cylor Spaulding and Melissa D. Dodd argue that Hildegard was
certainly conscious of the role healing played in her public relations with the common people.
They use the case of Sigewiza as an example, citing how Hildegard made a public
announcement to the lay community at the Festival of Maria wherein she promised Sigewiza’s
cure within forty days.80 Hildegard, argue Spaulding and Dodd, was acutely aware of how her
physical presence alone could bolster her already illustrious reputation. Within her lifetime,
she undertook four tours of the Rhineland, visited several abbeys and monasteries, and even
attended the court of Emperor Frederick Barbarossa (1122-1190).81 The expectations of
female recluses were that they remained safely within the walls of their communities, never
to travel and especially not to preach to the public. And yet Hildegard renounced these rules
with little to no consequence, even preaching to the community within the illustrious
79
LDO, Epilogue: 38. CCCM 92. Derolez and Dronke, 462. “A die enim nativitatis suae in doloribus infirmitatum,
quasi reti illaqueata est, ita ut in omnibus venis, medullis et carnibus suis, continuis doloribus vexetur…”
80 Cylor Spaulding and Melissa D. Dodd, “The Public Relations and Artful Devotion of Hildegard Von Bingen,” in
Pathways to Public Relations: Histories of Practice and Profession, ed. Burton St John III et al. (London:
Routledge, 2014), 48.
81
Spaulding and Dodd, “Public Relations,” 48.
33
cathedral of Trier.82 Granted, the subject of much of Hildegard’s public addresses were
concerned largely with the moral and metaphysical. And yet, the example of Hildegard’s
proclamation at the Festival of Maria reveals to us that Hildegard considered her healing acts
just as important to her image as her prophetic abilities.
That Hildegard saw devotion to healing and concern for the ill as a vital component of
her image is unsurprising, as her mentor and childhood companion, Jutta of Sponheim, was
also lauded for her healing acts. The cells at Disibodenberg were small, and far out of the way
of the general public, but Jutta was known to welcome travellers who came to her for healing.
The Vita domnae Juttae inclusae makes a note of stating “Through her consoling words, many
were restored from all kinds of wretched conditions.”83 In fact, Disibodenberg was not
designed for the type of traffic attracted by its spectacular female recluse, Jutta, who received
a great many guests through her reputation as a healer of ills. When Hildegard came to rival,
and then surpass her mentor in this, she was fully aware of the abbey’s restriction, and so the
move to Rupertsberg was not just a matter of establishing independence from the oppressive
control of the Disibodenberg monks, but also a way of securing a location closer and more
accessible to the public. The Rupertsberg abbey was situated atop a hill close to the local
thoroughfare, an identifiable landmark from miles around and within eyesight of multiple
surrounding towns.84 Unlike the cells at Disibodenberg, which were ideally closed to the
public, the Rupertsberg abbey was officially open to visitors, and would eventually come to
be fully equipped with infirmaries and gardens bursting with medicinal herbs.85 In essence,
with the move to Rupertsberg Hildegard had created a site of public office in which she could
receive, and treat, the ill and infirm.
So why, therefore, does Hildegard not make more reference to her healing acts in her
body of work, and her biographical commentary scattered throughout her Vita? There are
several possible factors to consider. Firstly, it might be argued that Hildegard was
unconcerned with establishing healing as a matter of her public image, as it was already being
constructed for her by the members of the clergy and the laity who spread word of her deeds.
Secondly, Hildegard may have been wary of espousing her own skills in healing just as she was
with her visionary talents, to better protect herself from accusations of heresy. And thirdly,
there would have been some risk involved in the celebration of healing acts, as the example
of Sybil from Lausanne further below illustrates. The possibility of failing to heal a victim of
illness or disability would have wounded Hildegard’s reputation, and moreover cast doubt on
her other abilities. That Hildegard follows her medico-religious texts with the Book of Life’s
Merits, wherein she celebrates the triumph of morals and values over all else, certainly
indicates a perceived dissatisfaction with such dealings with the laity.
And yet, despite Hildegard’s apparent aversion to discussing her own healing acts, we
can glean some information about what kind of healer she was. Causae et curae and Physica
are written in such a way that they reveal an author with great knowledge of a range of
potions, poultices and tonics. For each remedy, Hildegard offers the pros and cons (juvamenta
et nocumenta), gives a strict description of the amount to be administered, and leaves no
82 Maddocks, “Women of Her Age,” 215.

83
VJ, 4, Silvas (1998).
84 Maddocks, “Women of Her Age,” 101.
85
Sabina Flanagan, Hildegard of Bingen: A Visionary Life (New York: Routledge, 1989), 6-7. The matter of
guests at Rupertsberg was an occasional subject of concern for Hildegard, as the early years were spent
desperately trying to build a liveable community within the ruins of the abbey while managing the increasing
influx of pilgrims and visitors to the site.
34
room for guesswork.86 Potentially poisonous materials are to be handled with extreme care,
and Hildegard often admits that most cases of illnesses are to be treated on a patient by
patient basis. Ultimately, however, Hildegard determines that these remedies and practices
are only as effective as the patient allows them to be, citing their agreeable nature and
willingness to make changes to daily habits, diet and exercise. Predominantly, Hildegard is
concerned with hygiene, swearing by the importance of cleanliness from skin, to teeth, to
hair, as the first step towards good health.87 The image Causae et curae and Physica paint for
us, therefore, is of a naturalist physician of broad firsthand experience in treating ills, who
places great importance on tried-and-true physical therapies and sees the healing of others
as a vital component of Christian charity, if not a vital component of the Church’s public
image. This misericordia, or spirit of compassion, stands as the cornerstone of Hildegard’s
public image, and indeed her approach to healing as a whole.88
86
Heinrich Schipperges, Hildegard of Bingen: Healing and the Nature of the Cosmos (Princeton: Markus Wiener
Publishers, 1997), 72.
87
Schipperges, “Healing and the Nature of the Cosmos,” 84
88
Schipperges, “Healing and the Nature of the Cosmos,” 73
35
CHAPTER TWO
HILDEGARD AND THE HUMAN PERSON
“The human being exists as created from the four elements, two of which are spiritual
and two carnal.”1
In this quote from an early chapter of Causae et curae Hildegard quickly defines her
understanding of the human body. Fire and wind are defined as spiritual, being present in the
human’s brain and marrow at the time of creation when humanity was formed from clay and
burning with a red heat. Earth and water are carnal, as man was physically made from earth
and water is within the blood and moisture of the body. Summarily, Hildegard argues that
because God made man from clay, and that blood runs like water, they are inherently carnal,
but wind (which infuses the body with the ‘breath of life’) and fire are intangible, and
therefore “celestial.”2 Thus, “Spirits consist of fire and air; the human being consists of water
and clay.”3 These four elements, Hildegard decides, must exist in perfect unity with one
another to ensure the health of a human being and their soul, and the health of the world in
its entirety. This theory of essential balance stands as the cornerstone for Hildegard’s medico-
religious works, and indeed, her theoretical writing as a whole.
This chapter will discuss the interconnectivity of physical and spiritual health within
Causae et curae, with emphasis on how Hildegard rationalises the human body and its
physicality with spiritual belief. A close reading of the text will examine Hildegard’s perception
of the human body and the ailments which affect it, in particular, the role Adam’s Fall played
in the formation of the human condition as Hildegard understood it; Hildegard’s merging of
Greek humoral theory with Christian belief; Hildegard’s approach and understanding of
mental illness (as it is known in modern times) as a bodily defect first, and a spiritual defect
second; and Hildegard’s theories of cosmology as they relate to the worth and value of the
human body. It the last of these points which is the most apparent in Hildegard’s medico-
religious texts, as it stands as a particularly interesting aspect of her perception of the human
condition. Hildegard praises and elevates the physical body in a way that is unusual for her
time, when ascetic practices and self-flagellation were readily accepted, if not necessarily the
norm, and the human body was seen as the lesser half of what makes up the ‘human being’
(the other, and more important half being the soul). In fact, Hildegard’s own mentor, Jutta of
Sponheim, so closely followed the ascetic practice of self-punishment that it is readily
apparent why Hildegard developed this contrasting view. That is to say, witnessing the effects
of starvation and flagellation on Jutta’s body would have certainly impacted Hildegard’s
personal views on the worth of the human body. That Jutta ultimately died at the age of thirty-
three is testament to the severity of this self-punishment.4
1
CC, 4:1, The Infusion of the Soul, “Homo namque ex quatuor elementis creatus constat, quorum duo spiritalia,
duo carnalia sunt, ignis soilicet et ser spiritalia, aqua vero et terra carnalia.” Kaiser, 64. Berger, 43.
2
CC, 2.2, That There are Only Four Elements. Kaiser, 89. Berger, 35.
3
CC, 2.2, Souls and Spirits. Kaiser, 41-42. Berger, 35.
4
VJ, 4:0.
36
Hildegard communicates this sense of value through her depiction of bodily processes,
such as pregnancy, digestion, breath and even thought. Moreover, her specific and repeated
use of certain terms for human beings indicates that she contributed some thought to this
elevation. For example, her preferred use of the Latin homo to refer to herself and other
women within her texts, as well as men, infers a subtle rebellion against the more patristic
ideals of her community, which viewed the female form as both spiritually and physically
other. Homo, which translates to ‘human’ or ‘person’, is more general than the specific vir
(man) and mulier (woman). In the past, translators have seen suffice to translate vir as the
generalised ‘man’ i.e. ‘mankind’; but modern translators (such as Jane Bishop and Anna Silvas)
shy away from this in favour of interpreting vir as gender-specific to the male sex. Therefore,
it is telling that in her works Hildegard recounts that God and his angels refer to her as homo,
and not mulier, inferring that Hildegard herself perceived people via the human condition
first, and gender second. It is with this in mind that we move onto the first, and most central
aspect of Hildegard’s medico-religious works.
B ODY AND S OUL

Hildegard’s artworks are consumed by the cosmological and metaphysical. When featured,
the human body is surrounded by multiple planes of sense, thought, sound, and even
existence. Visions coming to Hildegard are portrayed as flames from heaven, pouring out from
the sky and into her eye sockets. Her image of the universe as she sees it, containing God, the
cosmos, and humanity, is an egg-like structure (Fig. 2), with the ‘flames’ of the cosmos
surrounding the physical plane.
Fig. 2, Scivias 1.3 God, Cosmos, and Humanity5
In Causae et curae, and indeed, in many of Hildegard’s works, the human body is described in
much the same manner. “And God made the elements of the world,” Hildegard writes, “They
5
Hildegard of Bingen, Scivias, 1:3; Führkötter, 40-41.
37
are within the human, and the human concerns himself with them.”6 As mentioned in Chapter
One, Hildegard’s concept of the physical body creates two major distinctions. One is that of
the “Mistress and the Handmaid”, magistra et ancilla, that is, the soul is a mistress who orders
the flesh about, while the flesh is the handmaid who obeys the orders of her mistress whilst
occasionally acting independently of her. The second concept is that of microcosm versus
macrocosm, wherein the human body is simply a smaller container of the cosmic system that
surrounds it. “For the firmament is like the head of a human being. Sun, moon and stars are
like the eyes. The air is like hearing. The winds are like smell. Dew is like taste, and the sides
of the earth are like arms and like touch.”7 These two concepts seem remarkably dissimilar,
when they simply betray Hildegard’s incredibly complex perception of spiritual and physical
interconnectivity.
During Hildegard’s time, interpretations of the role of both corpus (body) and caro
(flesh) were many and complex. Corpus was understood to be a physical entity only, exempt
from spiritual substance, whereas caro was established by St. Paul as meaning the
accumulation of the senses outside of the spirit. That is to say, the mortal frailties of the
human person – “For if you live according to the Flesh, you will die, but if by the Spirit you put
to death the deeds of the body, you will live.” (Romans 813) Modern thought easily blurs the
two subjects, but the medieval distinction between flesh and body comes down to an idea of
senses. These senses include breath, thought, sound, movement, and so on. Just as Hildegard
states Animam, corpus et sensus; in his vita hominis exercetur. “Soul, body and feelings; in
these the life of man is carried out.”8 Senses are what suffuse a body with life in addition to
the soul, thus making up the entirety which is God’s creation of humankind. It is with this idea
that medieval Christianity viewed the corpus and its caro differently before and after death.
If the senses of the body are necessary to consist of a human in accordance with the soul and
the vessel it inhabits, then medieval philosophers struggled to define what was left when a
person died, and all these senses also abruptly ceased. These senses, which are different to
the soul but vital to the operation of humanity, “suggest a participation in divinity as a
condition of life.”9 This idea carried a greater consequence of thought when applied to
rigorous debate surrounding Christ and his resurrection.
These debates, specifically those regarding Christ’s resurrection, but also regarding
the role of his body as the consecrated host, would persist for centuries.10 In particular,
medieval theologians questioned whether the nature of Christ’s body (corpus) changed
before and after resurrection. They also discussed how Christ’s body was transformed
through the words of consecration. It is important to note that consecration is the consuming
of Christ’s body, not his flesh, thus subtly reflecting the emphasis Church fathers placed on
the value of the corpus (the vessel by which Christ carried his absolution) from the caro (the
weaknesses of humanity to which Christ was subject). Consequently, iconography often
depicted the soul as a separate entity to the body, particularly in art depicting the crucifixion
and subsequent resurrection of Christ. Often the soul appeared as a small humanoid figure
6
CC, 1:1, The Elements and the Firmament, “Et elementa mundi deus fecit, et ipsa in homine sunt, et homo cum
illis operator.” Kaiser, 3; Berger, 24.
7
CC, 1:1, The Harmonies of the Firmament, “Nam firmamentum est velut caput hominis, sol, luna et setllae ut
oculi, aer ut auditus, venti velut ordoratus, ros ut gustus, latera mundi ut brachia et ut tactus.” Kaiser, 10-11.
Berger, 30.
8
Scivias, 1.4:18. CCCM 45. Führkötter, 79; Hart and Bishop 120.
9
Karmen MacKendrick, “Eternal Flesh: The Resurrection of the Body,” Discourse, Vol. 27, No. 1 (2005), 67.
10
Peter Biller, “Medieval Theological Concern with the Body,” from Medieval Theology and the Natural Body
(York: Medieval Press, 1997), 5.
38
bearing a pair of wings.11 Its childlike stature infers a sense of returning humanity to its most
blameless – that is, its moment of creation.12 From these debates stemmed natural questions
about the human body itself, its role on the physical plane, and its relationship to the spiritual
world. What is the body constructed of? Are female and male bodies developed differently?
What comes first, the soul, or the body it inhabits? Early Church sentiment saw this division
between the body and soul within the book of Genesis.
A now-famous letter attributed to Gregory the Great claims that Eve embodied the
flesh when she willingly accepted the forbidden fruit and Adam the soul when he ultimately
relented to it.13 Curiously, Hildegard counters this argument by stating that Adam and Eve are
both of the same flesh, subtly rejecting blame for the Fall being squarely placed with Eve
whilst simultaneously protesting the disparagement of the flesh.14 Indeed, Caroline Walker-
Bynum even argues that Hildegard’s high esteem of the flesh was paramount to her
feminisation of biblical theory. Although Hildegard states Eve and Adam were of the same
flesh, it was Mary herself who was the ‘container’ for the flesh which was then to become the
flesh of Christ. Thus, Christ’s flesh was innately female.15 Debates such as these were not
limited to the Church, and infiltrated facets of art, literature, and poetry, most significantly
within a twelfth-century poem known as the Dialogus inter corpus et animam,16 wherein the
body and soul of a dead man argue over who is more to blame for the miseries of life, thus
leading the body to proclaim, “The world and the devil have made a pact and have leagued
with them wretched flesh; now if the energy of the soul ceases to hold the flesh in check, both
in truth fall into the slough of sin!”17 The longevity of this intense debate speaks volumes
about how central it was to Christian understanding of the self.
And yet despite this overwhelming criticism of the weaknesses of the flesh, self-
flagellation and starvation were tempered in the twelfth century by the growing ethos of the
Christian community that all life was precious and worthy of living.18 Bernard of Clairvaux
argued, “The spiritual creature which we are has a body which is necessary to it, and without
which it cannot reach that knowledge which is the only way to the knowledge the blessed
have.”19 He agreed that the perfect embodiment of humanity is spiritual, but advised not to
disregard or wound the physical body out of single-mindedness, as “only through the body
does the way, the ascent to the life of blessedness, lie open to us.”20 Indeed, the twelfth
century was witness to a particular preference for concepts of rebirth and renewal, most
11
Moshe Barasch, “The Departing Soul: The Long Life of a Medieval Creation,” Artibus et Historiae, Vol. 26, No.
52 (2005), 16.
12
Barasch, “The Departing Soul,” 18.
13
Gregory the Great, Registrum Epistolarum, Book XI, Letter 64, ed. Phillip Schaff, Nicene and Post-Nicene
Fathers, Second Serie (Buffalo, New York: Christian Literature Publishing Co., 1898).
14
Scivias, 1:2.11, CCCM 45. Führkötter, 20. “Quapropter ut Adam et Eua caro una exstiterunt, sic et nun uir et
mulier caro una in coniunctione caritatis ad multiplicandum genus humanum efficiuntur.”
15 Caroline Walker-Bynum, Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women
(Berkeley, Los Angeles: The University of California Press, 1987), 265.

16
“Dialogue Between the Body and Soul”.
17
Clark Sutherland Northup, “Dialogus Inter Corpus et Animam: A Fragment and Translation,” PMLA, Vol. 16,
No. 4 (1901), 518.
18 Darrel W. Amundsen, Medicine, Society, and Faith in the Ancient and Medieval Worlds (The John Hopkins
University Press: London, 1996), 75.

19
Bernard of Clairvaux, Sermon 5 (ed. Gillian Rosemary Evans, Bernard of Clairvaux: Selected Works, New
Jersey: Paulist Press, 1987)
20
Ibid.
39
commonly communicated through metaphors regarding the natural world.21 These
arguments grew largely out of the work of Augustine, Gregory, and Jerome, although were
certainly supplemented by the contributions the like of Peter Lombard’s Sentences, wherein
he questioned the adage of ‘you are what you eat’ by interpreting the renewal of the physical
body after resurrection as a matter of nutrition. That is to say – is the physical body God
resurrects the same physical body that the human person maintained all those years on the
mortal plane, via diet, hygiene, and so on?22 If not, is it instead the image of the soul itself
that is resurrected, reflecting the moral nature of the human being, rather than the physical?
Peter Lombard appears to decide that the resurrected form is a combination of both of these
things.23 Overwhelmingly discussions of the body were complicated by differing opinions as
to what constituted as a matter, or a substance, and which of these two will be the
resurrected item, the veritas humanae naturae.24 As such, if the body was – as many believed
– an item of matter, and the soul a substance, then the necessary maintenance of the body’s
flesh (caro) certainly complicates the resurrection narrative. Certainly, as Caroline Walker-
Bynum argues, the body was at the very least an instrument of salvation, if not necessarily
the matter to be saved.25 And thus the subject of innate hierarchy of the spiritual over the
physical permeated these debates, and would do for several centuries to come.
Augustine clearly struggled with the distinction between soul and body. In his
Retractions, he writes:
…touching the origin of souls in individual men, I had confessed that I knew not
whether they are propagated from the primeval soul of the first man, and from that
by parental descent, or whether they are severally assigned to each person without
propagation, as the first was to Adam; but that I was, at the same time, quite sure that
the soul was not body, but spirit.26
Augustine places a greater emphasis on the role of the soul over the flesh, questioning
if human beings existed in a celestial sense before the consummation of man and woman, or
if the soul as the Church understands it (an intangible, higher creation) existed only after the
creation of the embryo. Platonism dictated that the soul is the clear superior of the two facets
as it represents God’s creation in its most pure immutable form. And yet, if the soul only
comes into creation once the physical construct is there to receive it, this complicates this
sense of innate hierarchy.27 Hildegard’s assertion that the soul is to the flesh as the mistress
is to her loyal handmaid certainly indicates that she too, despite championing for the value of
the human body, believes – at least superficially - in this innate superiority.
And yet, within Causae et curae Hildegard argues that the soul is only introduced in
the process of creating life after the creation of a physical construct the embryo. “Then, as
God wills and as he decreed it to happen,” Hildegard writes, “the breath of life comes and,
without the mother knowing it, touches that form like a strong, warm wind, like a wind
21
Caroline Walker-Bynum, The Resurrection of the Body in Western Christianity, 200-1336 (Columbia:
Columbia University Press, 1995), 120.
22
Walker-Bynum, “Resurrection of the Body,” 124.
23
24
25
Caroline Walker-Bynum, “Why All the Fuss about the Body?” Critical Inquiry, Vol. 22, No. 1 (1995), 15.
26
Augustine, Retractions, Book II, Chapter 56, ed. Phillip Schaff, Nicene and Post-Nicene Fathers, First Series,
Vol. 5, (Buffalo, New York: Christian Literature Publishing, 1887).
27
G. R. Evans, Philosophy and Theology in the Middle Ages (London: Routledge, 1993), 91.
40
blowing against a wall with its roar.”28 Then, the now-human form is infused with knowledge,
and its predisposed strengths or weaknesses, according to its parentage. This process as
Hildegard understands it is very curious, as it infers that a physical construct must always exist
before the individual soul of that construct comes to inhabit it. This is much like Aristotelian
theory, wherein the soul is only the representation of a potential for life, rather than a
certainty.29 This concept of ‘substance dualism’, that is, that the body and soul together make
the entirety of what is human, was a subject of much debate within medieval Christian
theology.30 In this way Hildegard appears to be taking a definitive stand on an issue of much
consternation for medieval theologians. Later, in her Liber Divinorum Operum, she revisits
this subject when she writes:
The soul causes our limbs to germinate the same way that moisture causes the Earth
to germinate, because the soul is infused throughout the human organism, just as
moisture is infused throughout the Earth. And just as the Earth causes both useful and
useless things to grow, human beings have within themselves a longing for higher
things as well as a fondness for sin.31
The image Hildegard paints here, of the body being nourished with spiritual viriditas, “for the
soul is the green life-force of the flesh”, further supports her belief that the flesh predates the
soul.32 This is not meant to infer that she believes that there is a particular hierarchy of the
body over the soul, but instead that the body is not – like many of her peers believe – a
wasteful substance, whose only function is to act as a container for the soul until it re-joins
God and his angels in heaven. Instead, Hildegard views it much in the same way as she views
plants – a natural thing, suffused with the viriditas of its sap (or soul), and with the potential
for doing good or ill. It requires constant maintenance, yes, but Hildegard interprets this with
the Benedictine ethos of ora et labora as her groundwork, seeing the maintenance of the
human form as a matter as spiritual as it is physical, for “Indeed, the soul sustains the flesh,
just as the flesh sustains the soul. For, after all, every deed is accomplished by the soul and
the flesh.”33
There is one final interpretation of the medieval soul needing to be discussed. Some
female mystics of the medieval period painted the image of the soul as a bride, with Christ
the bridegroom waiting for his beloved in the afterlife.34 Hildegard does not associate herself
personally with this romantic image, instead choosing to adopt the role of caretaker and
28
CC, 4:1, The Infusion of the Soul. Kaiser, 61.; Berger, 45. “Deinde sicut deus vult et sicut fleri disposuit, venit
spiraculum vitae et formam illam matre nesciente tangit ut vehemens calidus ventus, velut ventus, qui in
parietem cum sono flat, ac se infundit et infligit in omnes compages membrorum formae illius.”
29
Evans, “Philosophy and Theology,” 90.
30
Godehard Brüntrup, “Soul, Body, and Survival: The Renaissance of Christian Materialism,” Revista
Portuguesa de Filosofia, Vol. 65, No. 1, (2009), 318.
31
LDO, 1:4.21, ed. Derolez and Dronke, CCCM 92, 153. The Head as the Firmament of the Body, “…et hoc modo
membra hominis quemadmodum humiditas terram germinare facit, quia per totum corpus hominis, sicut
humiditas per totam terram diffusa est. Et ut terra utilia et inutilia germinat, ita et homo suspirium sursum, et
gustum peccati in se habet.”
32
LDO, 1:4.21, ed. Derolez and Dronke, CCCM 92,x, 152. The Head as the Firmament of the Body, “Anima
quoque viriditas carnis est.”
33
LDO, 1:4.24, ed. Derolez and Dronke, CCCM 92,x, 157. On the Effect of the Soul and the Body, “Anima quippe
carnem adjuvat, et caro animam, quia per animam et per carnem unumquodque opus perficitur.”
34
Frances Beer, Women and Mystical Experience in the Middle Ages (Woodbridge: The Boydell Press, 1992),
52.
41
guide.35 Indeed, she prefers to compare herself with male biblical figures (such as Joseph, Job,
and Jeremiah), drawing comparisons between the trials and tribulations she suffered with the
saintly epics of the Bible.36 However, the propensity for embellished garments and glittering
tiaras within Hildegard’s community suggests she did not hold her followers to the same
standard.37 Indeed, Hildegard received a vitriolic letter from magistra Tenxwind (or
Tengswich) of Andernach for this very practice.38 “They say on feast days,” Tenxwind writes,
“your virgins stand in the church with unbound hair when singing the psalms and that as part
of their dress they wear white, silk veils, so long that they touch the floor.”39 Hildegard’s
approval of grandiose adornment in both her artistic imagery and for the ceremonial
communion within her nunneries reflects a deep personal approval of the symbolic ‘Bride of
Christ’. This belief manifests in particular in one of her letters, wherein Hildegard argues
against the ban placed on the women at Rupertsberg from singing the Divine Office,
something she believed brought heaven unto earth.40 She believed the noble maidens of
Rupertsberg had an intrinsic role in suffusing the world with spiritual viriditas.41 This concept
reappeared with great significance in the work of Mechthild of Magdeburg (d.1282-1294), a
Beguine whose attacks on immorality within the clergy saw her accused of heresy around
1270. Her text The Flowing Light of Godhead echoes the traditions of German romantic poetry
as she paints the soul as the fervent bridge of Christ, beset with an almost sensual rapture. 42
Yet another Beguine by the name of Hadewijch of Antwerp (d.1260) moves away from this
concept to champion the soul as an embattled knight, an image much more in line with
Hildegard’s interpretation of her personal role.43 This feminisation of the soul – and the soul
of female mystics, in particular – is a readily apparent sentiment within Hildegard’s perception
of the body/soul dichotomy.
T HE C OSMIC B ODY
The Rule of St Benedict does not argue one way or the other with regards to abstaining from
food. It of course recommends all things in moderation, but as far as restrictions go states
only that “Except the sick who are very weak, let all abstain entirely from eating the flesh of
four-footed animals.”44 Therefore, within the Benedictine Order at least, fasting seemed to
be a matter of independent prerogative. The Rule of St Benedict even goes to lengths to
describe the medical facilities necessary in the construction of a church, indicating an overall
35
36
Barbara Newman, “Hildegard and Her Hagiographers,” from ed. Catherine M Mooney, Gendered Voices:
Medieval Saints and Their Interpreters (Pennsylvania: University of Pennsylvania Press, 2016), 24.
37
38
Sara Ritchey, Holy Matter: Changing Perceptions of the Material World in Late Medieval Christianity (Ithaca,
New York: Cornell University Press, 2014), 55.
39
Mistress Tenxwind to Hildegard (1148-50), ed. Joseph Baird and Radd Ehrman, The Letters of Hildegard of
Bingen, Volume 1, (Oxford, New York: Oxford University Press, 1994).
40
Caroline Muessig, “Learning and Mentoring in the Twelfth-Century: Hildegard of Bingen and Herrad of
Landsberg,” in, Medieval Monastic Education, ed. George Ferzoco and Caroline Muessig (London: Bloomsbury
Publishing, 2001), 93.
41
Ritchey, “Holy Matter,” 56.
42 Kevin Madigan, Medieval Christianity: A New History (New Haven & London: Yale University Press, 2015),
422-423.
43
Madigan, “Medieval Christianity,” 424.
44
Saint Benedictine’s Rule for Monasteries – 39. On the Measure of Food (trans. Leonard J. Doyle, Minnesota:
Saint John’s Abbey, 1941-2001).
42
ethos in support of living “conducive to health and not intolerant of bodily illness.” 45 Yet early
Church leaders had a tendency to praise self-denial of the flesh as a deserved punishment for
the human condition, and extreme asceticism was a practice which in some circles reflected
a genuine rejection of the needs of the body as inherently evil, including the Gnostics and
Manicheans.46 Hildegard’s own mentor Jutta allegedly drove herself to starvation on multiple
incidents, as well as inflicting “relentless torments and wounds upon her body.”47 An early
twelfth-century theological text argued that because Christ did not have to die, and moreover
did not have to eat, he was superior to Adam.48 And yet, Hildegard herself never practiced
asceticism, nor denied her body food or drink when it was within her ability to do so.49 In fact,
in Causae et curae Hildegard repeatedly recommends a healthy balanced diet in order to ward
off maladies, including even depression.50 Given that Hildegard lived in very close quarters
with Jutta for the formative years of her life, she would have been witness to the effects of
extreme asceticism on Jutta’s body.51 It is likely witnessing this had a significant impact on
Hildegard’s perception of nutrition. As it stands, Hildegard staunchly disapproves of self-
inflicted starvation, declaring:
When some persons abstain excessively from food so that they do not afford their
body its rightful and appropriate restoration through food, and when, in addition,
some of them are fickle and imprudent and others preoccupied with immense and
serious sufferings, then it sometimes happens that tempests, as it were, originate in
their bodies because the elements in them are moved in an adverse way.52
Diet and nutrition, therefore, are central to Hildegard’s medical works. Anything that cannot
be solved with a poultice or potion may certainly be solved with an adjustment to a patient’s
diet. For the body, Hildegard argues, is like the earth. It needs nourishment so that it can grow
and develop and, once developed, stay strong.53 Of course, all things must be in moderation,
but “if, however, [the earth] was touched by only a little moisture or none at all, it does not
empower the earth to be fruitful.”54
45
Florence Eliza Glaze, “Medical Writer” from Voice of the Living Light: Hildegard of Bingen and Her World
(Berkeley, Los Angeles, London: University of California Press, 1998), 126.
46
Darrel W. Amundsen, Medicine, Society, and Faith in the Ancient and Medieval Worlds (Baltimore; Maryland:
The John Hopkins University Press, 1996), 83.
47
Life of Jutta: IIII, (from Anna Silvas, Jutta and Hildegard: The Biographical Sources, Pennsylvania: Penn State
Press, 1999).
48
49
With the exception that her numerous infirmities caused her to be bedridden at times during which she took
little food or drink.
50
CC, 10:1, Intemperateness in Summer and the Diversity of Foods. Kaiser, 117-18; Berger, 87. “But, when a
person suffers from great sadness he ought to eat a significant amount of food that agrees with him, so that he
becomes invigorated anew from food, since sadness weighs on him.”
51
Julie Hotchin, “Enclosure and Containment: Jutta and Hildegard at the Abbey of St. Disibod,” Magistra, Vol.
2, No. 2 (1996), 121.
52
CC, 13:1, Indiscriminate Abstinence. Abscesses. Kaiser, 135; Berger, 100. “Cum vero quidam homines supra
modum in cibis abstinentes sunt, ita quod instam et congruentem refectionem ciborum corpori suo non
tribuunt, et cum etiam alii instabiles et leves in moribus suit sunt et alii multis et magnis languoribus occupati,
tunc aliquando contingit, quod velut tempestates in corporibus illorum oriuntur, cum elementa, quae in eis
sunt, in contrarium modum vertuntur.”
53
CC, 13:1, Diet.
54
CC, 13:1, Diet. Kaiser, 165; Berger, 105. “Si terra nimiam humiditatem habuerit, inde laesionem incurrit; si
autem modica vel nulla humiditate tacta duerit, ei ad prosperitatem non valebit.”
43
As Hildegard promotes the restoration of viriditas to the earth, its plants, and its
animals, so too must viriditas be restored in the human body.55 But whereas the earth can be
restored through water, sunlight, and the contribution of animals, viriditas is largely restored
to the human body through food.56 It is interesting that Hildegard equates the body to the
earth in a community which generally viewed the flesh as inherently ‘lesser’, as it required
constant maintenance. Instead, Hildegard abjectly disagrees with this, and practices such as
self-emaciation are considered anathema to her medical ethos. However, what Hildegard
regards as essential nourishment is not just restricted to the food which people eat. She
believes nourishment extends to all matters of restoration of the body, including sleep,
prayer, light, fluids, and exercise. Therefore, anything that is a depletion of this nourishment
– drunkenness, sloth, immorality, poor diet – are all believed to be equally sinful. Essentially,
to degrade the body was to degrade the soul that inhabits it, and thus, the world entirely.
Hildegard’s assertion that the body is like the earth contains an additional layer of
meaning, especially with regards to gendered spirituality, evident throughout her works.
Although she agrees with traditionally patriarchal concepts of the Church (for example that
Adam’s Fall was the fault of Eve most prominently, and Adam to a lesser extent) nonetheless
Hildegard’s perception of spirituality is shaped by an unusual number of feminine images.
Indeed, some of her assertions may have been a gentle rebuke against certain popular
theories that woman was to the man as the body was to the mind.57 That is to say she is an
important, but base, lesser form. Hildegard’s rejection of these tropes is evident within
Causae et curae as she praises the role of women throughout each stage of their bodily life,
from menarche to their role in conception and, most importantly, childbirth. “For as ether
contains all the stars,” Hildegard writes, “so she [Eve], pure and uncorrupted, carried
humankind within herself when she was told: ‘Be Fruitful and Multiply.’”58 Regardless of her
personal commitment to chastity, Hildegard frequently praises mothers and the role of
motherhood, even at times explicitly equating childbirth with the moment of Creation. In her
hymns, for example, she describes images such as that of Lady Wisdom, a driving force of
creation and love, who enfolds the world with her protection and motherly affection.59 Much
of this celebration of the feminine is born out of Hildegard’s perception of Mary. She
interprets Mary’s role in the birth of Christ as bestowing him with his intrinsic humanity. Not
the humanity of her patristic forefathers, which debases the body and is intrinsically tied with
immorality and the weaknesses of the flesh, but the humanity which allowed Christ to pardon
all humankind upon his crucifixion. As Eve bore humankind, so too did Mary bear Christ, who
would allow humankind to begin again. Consequently, Hildegard views the female body as
vital to the healing of the world, and the rebirth of the original blameless humanity. In
essence, a cosmic body.
This cosmic body that Hildegard speaks of has been a subject of much scholarly
interest. It has its origins in Plato’s Timaeus, which argues that humans both embody, and
55
Allison Elledge, “You Are What You Eat: Hildegard of Bingen’s Viriditas,” Conference Paper Delivered to Mid-
Atlantic Popular and American Culture Association, October (2010), 3.
56
Elledge, “You Are What You Eat,” 5.
57
Caroline Walker-Bynum, Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women
(Berkeley, Los Angeles: The University of California Press, 1987), 262.
58
CC, 9:2, Eve. Kaiser, 104. Berger, 81. “…quia ut aether stellas integras in se continent, sic ipsa integra et
incorrupta sins dolore genus humanum in se habebat, cum ei dictum est: crescite et multiplicamini.”
59
Nancy Fierro, Hildegard of Bingen and Her Vision of the Feminine (Maryland: Rowman & Littlefield, 1994),
27.
44
dwell within, the cosmos.60 “So to think of the human body,” writes Andrew Louth, “(as a
whole informed by reason, not as a mere piece of matter: that would be simply a corpse) is
to think of something that is an analogy of the cosmos, a key to understanding the cosmos
itself.”61 Hildegard’s artwork of the cosmos itself is in the shape of an egg (Fig. 2), which, aside
from explicit connotations of pregnancy and motherhood, contains traditionally feminine
symbols such as curves, circles, and ovals.62 Andrew Weeks argues that this sense of
feminisation came about from the chaotic period in which Hildegard lived, which she decried
as the weaknesses of tempus muliebre, a ‘womanish time’.63 And yet, Weeks insists, it is this
same feminisation which Hildegard sees as being necessary to correcting the world around
her. Issues of ‘Cathar’ heretics, immorality within the Church, political tensions between the
German kingdom and the Papal state – all could be assuaged with the intuition and maternal
instinct of women.64 This conflicting perception of women’s bodies as being battlefields of
both inherent weakness and celestial inspiration is a common and well documented feature
of the works of medieval female mystics.65 Within Hildegard’s texts this contradiction is
embodied by the character of Synagogue, a monolithic womanish figure who holds the
prophets within her womb and Moses within her breast, yet also represents the sins of the
Jews before the arrival of Christ.66
For medieval theologians and philosophers, the human body embodied everything
there was to realise about existence.67 Despite concepts of inherent guilt and the pains
associated with maintaining the physical body, this idea of centrism remained. What is of
interest is how Hildegard adapts and feminises these concepts within her works to elevate
the human body beyond its previous role in medieval and Christian philosophy, so that it was
no longer caught between its physical and cosmic status, but was representative of cosmology
as a whole. Therefore, maintenance of the body – which requires a balancing of its humours,
qualities, and elements – is reflective of maintaining the balances of the world itself. Thus, at
least to Hildegard, it is vitally important and a subject of serious concentration within her
works. In the words of Brianna Marron, “The body in Hildegard’s medical writing was a
container that was filled to the brim with the imprint of God.”68 To inflict unhealthy lifestyle
choices such as poor diet, immoral intercourse, alcoholism, or unhygienic behaviours on such
a creation was anathema to Hildegard, and it this central belief which appears most
frequently within her medico-religious works.
60
Andrew Louth, “The Body in Western Catholic Christianity,” from Religion and the Body, (Cambridge:
Cambridge University Press, 2000), 111.
61
Louth, “The Body,” 112.
62
Fierro, “Vision of the Feminine,” 25.
63 Andrew Weeks, German Mysticism: From Hildegard of Bingen to Ludwig Wittgenstein: A Literary and
Intellectual History (State University of New York Press: New York, 1993), 46-47.
64
Weeks, “German Mysticism,” 47.
65
Dyan Elliot, “The Physiology of Rapture and Female Spirituality,” from Medieval Theology and the Natural
Body, ed. Peter Biller (York: York Medieval Press, 1997), 157.
66
67
Brianna Marron, “A Space of Convergence: Hildegard of Bingen’s Multivalent Understanding of the Body,”
Magistra, Vol. 20, No. 2, (2014), 48.
68
Marron, “A Space of Convergence,” 50.
45
L IVOR , F LEGMATA , AND A DAM ’ S F ALL
In Causae et curae Hildegard proposes a theory that is quite unique within the spiritual
community of her time, claiming that the origins of Black Bile – or flegma as she calls it – are
intertwined with Adam’s Fall. She writes
But when the human transgressed God’s command he was transformed both in body
and mind. For the pureness of his blood was turned into something different so that
he emits the foam of semen instead of pureness. Had the human stayed in Paradise,
he would have remained in an immutable and perfect state. But after his transgression
he was turned into something different and bitter.69
Ideas surrounding the true nature of Adam’s (and therefore humankind’s) transformation
following the Fall were not uncommon during Hildegard’s time. Many theologians argued the
specifics of the transition from life in the Garden to life on Earth. Hildegard’s version of the
events of Genesis describe how Adam was given the chance to avoid the forbidden fruit by a
spirit who offered him a flower suffused with viriditas instead, but failed to do so. Thus, the
viriditas of the Holy Spirit was drained from him, and Adam became “a parched, desiccated
creature, dried out through sin.”70 Augustine famously declared that the consequences of
what he called ‘Original Sin’ were transmuted to humans through birth, standing by this
concept of natura vitiata even after the reception of baptism.71 Within this treatise Augustine
attempts to justify the relation between sexual practice and sexual desire, that is to say, “the
categorical split between the physical and the mental, body and soul, and emotions and
rationality: ideals on the one hand and physical reality on the other.”72 However, whereas
Augustine attempts to justify that diversity with relation to moral and immoral procreation,
Hildegard instead examines it with relation to the condition of men and women, respectively.
Whether this is an intentional split from Augustinian theory is unclear. Hildegard’s fascination
with the biological and her desire to rationalise the spiritual results in a particularly unique
perspective of a vital component of medieval Christian theory. It is in this way that Hildegard
gives shape to the livor (bruise, or wound) of Augustinian theory, and rationalises the nature
of the human body as it was in her time: fragile, diverse, and easily susceptible to illness.
Pier Franco Beatrice divides natura vitiata into two forms: that of the sinless natura
of man at birth, and that of the physical construct of the body itself, which is “… mortal and
subject to ignorance and to the flesh.”73 More tellingly, he describes how the body of pre-Fall
Adam was pure and ‘blameless’, but was now tainted and in need of a physician. 74 Yet the
rhetoric surrounding Adam and Eve’s fall from grace does not usually follow with the
anatomic detail Hildegard describes, particularly surrounding certain ‘medical’ ramifications.
69
CC, 3:1, Adam’s Fall. Kaiser, 88; Berger, 39. “…sed cum homo praeceptum dei transgressus est, mutates est
etiam corpore quam mente. Nam puritas sanguinis eius in alium modum versa est, ita quod pro puritate spumam
seminis eicit. Si enim homo in paradiso mansisset, in immutabili et perfecto statu perstitisset. Sed haec omnia
post transgressionem in alium et amarum modum versa sunt.”
70
Joy A. Schroeder, “A Fiery Heat: Images of the Holy Spirit in the Writings of Hildegard of Bingen,” Mystics
Quarterly, Vol. 30, No. ¾ (2004), 83.
71
Roughly, ‘fallen [by] nature.’
72
Anne Stensvold, A History of Pregnancy in Christianity (London: Routledge, 2015), 34.
73
Pier Franco Beatrice, The Transmission of Sin: Augustine and the Pre-Augustine Sources (New York: Oxford
University Press, 2013), 38.
74
Beatrice, “Transmission of Sin,” 39.
46
Indeed, it appears that Hildegard’s understanding of the debased nature of humanity after
the Fall was similar to that of a debilitating illness, one that required constant attention and
treatment. Rather than allowing spiritual belief to dictate why humankind suffers various
ailments, she instead chooses to patiently lay out her entire process of thought regarding the
structure of the human body. And thus, she begins Causae et curae, quite sensibly, with the
events of the Book of Genesis.
Hildegard does not mark Adam’s susceptibility to illness as simply due to divine
influence, but instead describes how the nature of his body was changed; specifically, the
introduction of various and sinister flegmata to the human condition.75 This anatomical shift
caused a permanent livor to Adam’s body, one that is not necessarily physical, but perhaps
spiritual in nature. Thus, her qualifier that Adam was transformed in body and mind, corpore
quam mente. This is an important distinction. Although Hildegard uses livor frequently
throughout Causae et curae, a term typically used for physical wounds, the way in which she
employs it infers that the livor is in fact the ongoing punishment for Adam’s Fall – that is, the
loss of immortality which came with life in the Garden. Like Augustine, Peter Abelard (1079-
1142) argues that this punishment is passed from human to human through the act of
procreation and the event of birth.76 He argues that it follows the livor – the inherent
weakness of humanity, as Abelard describes in his Ethics – is passed too.77 It is a passive
wound, which affects all of humankind indiscriminately. The flegmata Hildegard describes, on
the other hand, are entirely physical, and more Galenic in concept. Yet the two are intrinsically
linked. She emphasises this connection by explaining:
With the taste for evil the blood of Adam’s children was changed into the poison of
semen from which the humans’ offspring are propagated. Therefore their flesh is
ulcerous and perforated. Those ulcers and perforations cause some kind of storm and
a vaporous moisture in human beings. From this develop and coagulate flegmata that
affect the human body with various infirmities.78
Generally speaking, Hildegard agrees with the concept of inherent guilt being passed through
conception. However, she makes a point to note in detail how exactly this is done. Most
significantly, she claims that women’s bodies in general contain more livor and ‘noxious
humours’ than men due to Eve’s guilt, and these are generally shed during menstruation.79
This seems to indicate that she finds the woman slightly more responsible for transferring the
punishment for Adam’s Fall through to her child. Marcia Kathleen Chamberlain argues that
this belief does not reflect the contextual misogyny of medieval theology, but instead reflects
the elevated level of importance Hildegard places on the female body, as the excess
menstrual foam in turn travels upwards through the body to become breast milk - “a blessing
75
Hildegard’s use of flegmata to describe malicious forces within the body varies from passage to passage;
sometimes generally with regards to negative humors, sometimes more specifically used to describe black bile.
76
Paul C. Kemeny, “Peter Abelard: An Examination of His Doctrine on Original Sin,” Journal of Religious History,
Vol. 16, No. 4 (1991), 376.
77
Kemeny, “Peter Abelard,” 377.
78
CC, 3:2, Infirmities. Kaiser, 36; Berger, 39. “Nam de gustu mali versus est sanguis filiorum Adae in venenum
seminis, de quo filii hominum procreantur. Et idea caro eorum, ulcerata et perforata est. Quae ulcera et
foramina quandam tempestatem et humectatem fumi in hominibus faciunt, de quo flegmata oriuntur et
coagulantur, quae diversas infirmitates corporibus hominum inferunt.”
79
“All the blood vessels of woman would have remained integral and healthy had Eve stayed in Paradise for
the fullness of time.” Causae et curae, 9:2: On Eve’s Corruption. Kaiser, 103; Berger, 80.
47
in disguise.”80 Augustine, conversely, argues that children are biological copies of their father,
and as Adam was the first of fathers, all of humankind (and men, in particular) contain the
same inherent punishment.81 Despite addressing humankind as ‘Adam’s children’, Hildegard’s
theory instead focuses largely on the female womb, and the role pregnancy and childbirth
play in the formation of the injurious human condition.
Hildegard argues that women who lose their virginity have even more livor in their
blood than before, and that their menstruation becomes heavier.82 When the child is ready
to be born, “the vessel in which the child is enclosed is torn, and then comes the eternal
power that took Eve from Adam’s side, and is present and turns upside down all the corners
of the woman’s body.”83 This vis aeternitatis is a curious turn of phrase. Does Hildegard mean
the power of God, infiltrating and encouraging the woman’s body to give birth, the same force
which literally took Eve from the ribs of Adam’s side? This seems probable, given that
Hildegard also created a sequence with the title O vis aeternitatis which contains the lyrics,
“and then your very Word / was clothing within that form of flesh / from Adam born.”84
Therefore, this energy could be both negative and positive. Negative because it brings
punishment in the form of childbirth pains, but also positive because it assists the woman in
bringing forth life. Hildegard then adds that the child itself feels this vis aeternitatis and
rejoices. But this reception to “the knowledge to learn and to comprehend everything to the
fullest when stimulated by wish and desire” is both a blessing and a curse, Hildegard warns,
because “the Devil, seeing this, blows onto the human’s knowledge with perversity and
cunning so that the human learns quickly whatever evil he desired to learn.” 85
Knowledge for its own sake is something in which Hildegard repeatedly and
enthusiastically rejoices, and yet, it is this same knowledge which brought about the expulsion
of Adam and Eve from the Garden. Therefore, this energy which resides, dormant, in the
female body to bring about childbirth, and encourages the child itself to gain consciousness
and receive its soul, may yet be an aspect of Augustine’s livor of the human condition: the
ability both to have knowledge, and to use that knowledge for sinful means. By contrast,
Hildegard rationalises how this livor came about by following the biological history of the
human body (that is, the human condition before and after Adam’s Fall) by determining how
men specifically were biologically predisposed to contain negative flegmata, and pass that
flegmata on to their children. It is just one of the many subtle ways Hildegard protests
longstanding patriarchal narratives regarding sex and gender within the Church, as she
continues to elevate the role of the female body in creation and the healing of the world in
her other literary works. These sorts of contradictions are common within Hildegard’s texts.
It is likely that she knew she had to adhere to certain expectations, whilst still desiring to
80
Marcia Kathleen Chamberlain, “Hildegard of Bingen’s Causes and Cures: A Radical Feminist Response to the
Doctor-Cook Binary,” from Hildegard of Bingen: A Book of Essays (New York and London: Garland Publishing,
Inc., 1998), 64.
81
Stensvold, “A History of Pregnancy,” 32.
82
CC, 9:2, Why Menstruation. Kaiser, 108. Berger, 80.
83
CC, 4:1, The Birth. Kaiser, 66. Berger, 49. “Sed cum iam partus instat, vas, in quod infants clausus est,
scinditur, et vis aeternitatis, quae Evam de latere Adae educit, mox veniens adest atque omnes angulos
habitaculi corporis mulieris de locis suis evertit.”
84
“…et ipsum Verbum tuum induit carnem in formation illa que educta est de Adam.”
85
CC, 4:1, Knowledge. Kaiser, 67; Berger, 49. “Sed cum homo se ad malum aliquod et malam artem vertit et
illud discere cupit, tunc diabolus hoc videns scientiam eius perversitate et versutia sua afflat, ut malum hoc,
quod discere cupit, cito discat, quia etiam homo scientiam boni vel mali habet.”
48
communicate her own personal ideals. Thus, Hildegard’s comments on the body and gender
are occasionally hidden alongside adherence to existing biblical narrative.
Because of this, Causae et curae discusses menstruation on two, curiously contrasting
fronts. Hildegard argues that a woman’s menstruation is the result of Adam’s Fall, and that
the nature of an individual woman’s menstruation depends entirely upon her sexual
proclivity. Hildegard makes no personal judgements with regards to sexual women, and
indeed offers several methods for treating both the absence of menstruation and the
abundance of it, as well as ways for treating menstruation flow and pain. These include
applying a cold compress about the inner thigh with warmed celery; taking a tonic mix of wine
and betony (common hedgenettle); avoiding “hard or bitter” foods which might complicate
digestion; as well as general therapeutic massage to the legs, stomach, and arms.86 Many of
these methods aim at soothing the inordinate warmth of menstruation pain, as with the cold
compress, or contributing a more healthy warmth, as with the celery.87 It is likely that
Hildegard’s pragmatic attitude towards dealing with such issues comes not only from her
personal experience as a woman, but as her experience growing up in (and fostering her own)
all-female communities. Much like Physica and Causae et curae themselves, Hildegard’s
approach to and strategies for menstruation seem borne out of genuine necessity. It is
interesting to contrast Hildegard’s rationalisation of menstruation with that set forth in the
Trotula, a late twelfth-century text composed of three separate tracts of women’s health from
the Salerno school of medicine. Within this, menstruation occurs simply because “Nature
established a certain purgation especially for women, that is, the menses, to temper their
poverty of heat.”88 This argument follows on from the Galenic belief that women were
particularly cool and airy, in comparison to the warm dryness of men. There is no spiritual
theology attached to this section, and indeed, the Trotula only reiterates that menstruation
occurs fully naturally, because “Nature, if burdened by certain humours, either in men or in
women, always tries to expel or set aside its yoke and reduce its labour.” 89 Inasmuch as
Hildegard agrees that menstruation is a natural biological function that must be dealt with
pragmatically, she goes to a greater length in order to explain its origins, and indeed
rationalise it, with relation to her own spirituality.
Hildegard acknowledges that Adam’s body was changed after the Fall, but in a
different way than Eve’s. “In Adam’s transgression,” she writes, “both the great love that he
felt when Eve proceeded from him and the sweetness of the sleep which he then slept were
turned into a contrary mode of sweetness.”90 It is this contrary nature which causes men to
lust violently, rather than sweetly, as Adam did for Eve. Therefore, women were changed far
more physically, whereas men were altered in a greater sense more spiritually with their
emotions, thoughts, and instincts. The exception to this is, of course, the nature of Adam’s
semen, which Hildegard writes was adversely changed into a type of ‘foamy’ poison. And yet,
as with women and their menstruation, Hildegard offers several remedies for sexually active
men who are experiencing troubles. For infertility she recommends covering the liver of a
86
CC, 14:1, The Menstrual Flow. Kaiser, 185-88. Berger, 113.
87
Warmth in this context refers to the Galenic theory regarding the elements and qualities of the human body.
88
Trotula, Book on the Conditions of Women, 3, trans. Monica Green, The Trotula: A Medieval Compendium of
Women’s Medicine (Philadelphia: University of Pennsylvania Press, 2001).
89
Ibid.
90
CC, 5:4, The Creation of Adam and the Formation of Eve. Kaiser, 136. Berger, 53. “Magna autem dilectio,
quae in Adam erat, cum Eva de ipso exivit, et dulcedo soporis illius, qua tunc dormivit, in transgressione eius in
contrarium modum dulcedinis vera est.”
49
sexually mature goat with hasenzeppun (catkins), ertpeffer (water pepper) and wina
(bindweed), before removing the herbs and eating the liver with some raw pork fat.91 For
incontinence she suggests a potion mix of rue, wormwood, sugar, honey, and wine, warmed
over a stove, which will cause “the noxious livor that remained in him [to] leave together with
urine and feces.”92 Hildegard also differentiates between virile and sanguine men, and the
type of children they propagate. On the matter of melancholic persons Hildegard states quite
firmly that “It [livor] produces black bile that first originated from Adam’s semen through the
breath of the serpent, since Adam heeded its counsel in taking food.”93 Hildegard’s unique
interpretation of the natura vitiata appears frequently within her medical works, clearly
defining her stance on a matter of much consternation within medieval theology and
philosophy.
C ONCLUSION
A close examination of Hildegard’s theories on the role of the human body in the nature of
humanity itself reveals theories distinctly at odds with that of her contemporaries. Unlike
philosophers such as Augustine and Abelard, Hildegard does not seek to rationalise or
comprehensively justify the natural hierarchy of the soul over the body, however minor.
Instead, she resolutely argues for the value in the human body in all aspects of humanity’s
existence. She exemplifies this through various metaphors, most significantly comparing the
relationship between soul and the flesh (or the senses) as that between mistress and
maidservant (magistra et ancilla). Hildegard interprets the value of soul and the flesh or
senses in their relation to one another, arguing that although the soul exists on a higher plane
of being – as the ‘Mistress’ – the senses are a necessary part of human existence, with the
duties of suffusing, and being suffused by, cosmic viriditas. As such, she does not see the
physical form as a lesser state of being, but instead views it as the centre of the cosmos,
through which the soul interacts with all of God’s creation. Moreover, although Hildegard
recognises the soul as the purest form of God’s creation, she seems personally invested in the
workings of the human form, passionately explaining the process of Adam’s Fall and how it
shaped humanity physical, emotionally, and spirituality for the rest of time.
Most significantly, Hildegard states that Adam and Eve share a common flesh. This
seemingly innocuous clarification is in fact highly important as it counters the narrative set
down by the Church regarding the relationship between the sexes and the blame for Adam’s
Fall. Many of Hildegard’s predecessors asserted that as Eve was made of Adam, her flesh was
innately weaker, and more susceptible to influence and sin. Hildegard rejects this and insists
that although Eve contributed to Adam’s Fall, he was also partially responsible, and so Eve’s
flesh was only as weak as Adam’s, and equally as holy. Therefore Mary, Hildegard argues,
being descendent of Eve, created Christ with a body made of Eve’s flesh. By placing such
importance on the role of the female body with relation to Christ, Hildegard rejects some
patristic narratives that women represented the flesh inasmuch as they were physical
creatures prone to base instincts of the flesh, whereas men represented the spirit in that they
91
CC, 14:1, Male Infertility. Kaiser, 182. Berger, 110.
92
CC, 14:1, Incontinence. Kaiser, 192-3. Berger, 114. “Et sic noxious livor, qui in eo remansit, cum urina et
digestione egreditur.”
93
CC, 3:3, Melancholic Persons. Kaiser, 38. Berger, 39. “Unde in his crescit flegma, quod nec humidum nec
spissum est, sed tepidum, et quod est ut livor, qui tenax est, et qui se ut gummi in longum protrabit, et qui
parat melancoliam, quae in primo ortu de simine Adae orta est de flatu serpentis, quoniam Adam consilium
illius in cibo perfecit.”
50
were rational and superior in mind and temperament.94 Without Mary, Hildegard argues,
there would be no Christ, and in fact no ‘humanity’ at all. It was Mary who bestowed Christ
with his humanity, just as Eve was bestowed life from Adam’s flesh. To dismiss the one would
mean to dismiss the other. Hildegard distances herself from interpreting the flesh and body
as innately sinful, and instead elevates them to a holy level.
Her investment in the human body is strengthened in her medico-religious writing by
her incorporation of various feminine images, such as Lady Wisdom and Synagogue.
Hildegard’s fascination with the human body extends to the female body, particularly when
she argues that the results of Adam’s Fall are most apparent in the womb of Eve and that the
duty of restoring the cosmic imbalance caused by the Fall resided with all women. Hildegard
takes the contemporary discourse of her time surrounding the female body and its faults and
reinterprets them to argue the case of female responsibility, and therefore, power in restoring
the faults of their bodies and of the world around them. Hildegard’s body of work, and indeed,
her medico-religious works, are a natural result of this sense of innate responsibility. Causae
et curae and Physica are a method by which Hildegard could aid her immediate community,
and indeed, supply the world around her with viriditas. Through the healing of others
Hildegard saw her actions inadvertently as a response to Adam’s Fall, and as an expression of
spiritual and physical authority.
Moreover, Hildegard’s medical works acted as an argument in favour for the
importance of maintaining the human body. She claimed that achieving perfect balance for
the body benefited the world around it and helped ‘restore’ the damaged nature of humanity.
She describes this process in Causae et curae when she states:
In the way that the elements, as has been said before, hold the world together so they
also are the fastening of the human body. Their perfusion and operating in human
beings is apportioned in such a way that they are held together. This is similar to the
way the elements perfuse the world and affect it. Fire, air, water, and earth are
present in human beings, who consist of them. […] The world prospers when the
elements fulfil their tasks well and in an orderly manner, so that warmth, dew and rain
apportion and descend separately and moderately at the proper time to provide earth
and fruits with proper weather and to bring much fruitfulness and health. For if they
sudden fell onto the earth simultaneously and not at the proper time, the world would
break asunder and its fruitfulness and health would perish.95
94
Caroline Walker-Bynum, “Holy Feast,” 262.
95
CC, 2:4. Kaiser, 48; Berger, 36. That the Human Being Consists of the Elements, Berger, 26, Kaiser, 50 “Nunc
autem, ut supra dictum est, quemadmodum elementa mundum simulcontinent, sic etiam elementa compago
corporis hominis sunt, atque effusion et official eorum ita se dividunt per hominem, ut insimul contineatur,
velut etiam per mundum effuse sunt et operantur. Ignis enim, aer, aqua et terra in homine sunt, et ex his
constat. Nam ex igne habet calorem, ex aere halitum, ex aqua sanguinem et ex terra carnem, ita quod etiam de
igne habet visum, de aerea auditum, de aqua motionem atque de terra incessum. Et ut mundus in prosperitate
est, cum elementa bene et ordinate official sua exercent, ita quod calor, ros et pluvial singillatim et moderate in
tempore suo se dividunt ac descendunt ad termperiem terrae et fructuum et multum fructum et sanitatem
afferunt; quoniam, si simul et repente ac non in tempore suo super terram caderent, terra discinderetur ac
fructus eius et sanitas interiret: sic etiam, cum elementa ordinate in homine operantur, eum conservant et
sanum reddunt; sed cum in eo discordant, eum infirmum faciunt et occident. Nam coagulationes humorum a
calore, humiditate, sanguine et a carne in hominem descendentes et in eo existentes, si cum tranquillitate et
iusto temperament in illo operantur, sanitatem habent; si autem eum simul indiscrete tangent et super eum in
superfluitate cadunt, illum debilem faciunt et occident. Calor enim ac humidiates <et> sanguis et caro propter
transgressionem Adae in contraria flegmata in homine mutate sunt.”
51
Hildegard’s understanding of the perfect maintenance of the body is fused with that of the
maintenance and order of the earth. Therefore, to debase the body was to debase the world
itself. Her frequent imagery of the natural world and its plants, fruits and earth also reflect
the nature of her upbringing in the convent, like tending the small garden and attending to
the poultices and potions of the convent infirmary. For Hildegard, the natural world was the
source of healing and the arbiter of balance. Hildegard’s understanding of the role of the
human body so complexly intertwined the physical and spiritual planes that ongoing debates
about the relationship between body and soul were too dichotomous as to fully encapsulate
her unique (and sometimes incomprehensible) worldview.
52
CHAPTER THREE
THE PROCESS OF HEALING
It is easy to imagine Hildegard in the role of healer, based on the depth and passion of her
healing works alone. This natural extension from theory to practice was not necessarily
common for her time. There were multiple potential dangers to putting her interest in health
into practice – her reputation, her position, and her own health, to name a few. Moreover,
this image of Hildegard at the bedside of labouring commonfolk, tending their brows and
feeding them potions is likely highly exaggerated. Not that Hildegard thought poorly of the
physical practice of healing. Indeed, her works largely praise healing as not only necessary but
also a holy act in of itself. It is far more likely that Hildegard’s position, authority, and social
standing kept her away from the infirmary tending to the local commonfolk who came to
Rupertsberg for aid, except perhaps for the most unique cases. Hildegard certainly took on
patients of her own, as the following chapter will show. Even then, she often expresses
reluctance and even frustration at being called on repeatedly to heal and advise. Her letter
responses range from being extensive and detailed to short and curt. And yet, as this chapter
will argue, at the heart of Hildegard’s work like a very real and strong appreciation for the
healing works.
Indeed, the examination of Hildegard’s education, her outside influences, and her
literary works reveals to us a woman predominantly concerned with the healing and
restoration of the human form. For Hildegard, this process is not necessarily focused on the
healing of the individual, but is a natural process which restores the balance of the person,
the community, and the world as a whole. Hildegard’s approach to healing appears to
explicitly reject the traditional dualist conceptions involving the body and the spirit (and by
extension, their various infirmities), inasmuch that her medico-religious works infer that to
heal the human being is to heal the entire world. Hildegard views the human body much as
she views plants – as a living, breathing organism, through which either ill or good could be
achieved. Just as biblical scripture argues that the fall of Adam diminished the human
condition, Hildegard believes that this diminished human condition can be restored by
achieving good by following the tenets of the Church and living a morally upstanding life. To
heal the human body of its ills and pains, or to heal others of their ills and pains, only further
restores the body – and thus the world - of this vital viriditas.
Therefore, Hildegard’s medico-religious works are separated into two distinct themes:
causation and treatment. A greater portion of Causae et curae is dedicated to the explanation
and rationalisation of particular illnesses and their warning signs, whilst the remaining part,
and her subsidiary text Physica, lists methods for managing these illnesses. This exemplifies
the overall intent behind Hildegard’s medico-religious texts, a comprehensive medical
reference for use by her community at Rupertsberg. Consequently, this chapter is concerned
with Hildegard’s approach to, and understanding of, healing. This includes several case
studies of Hildegard’s personal acts of healing, as well as a close examination of Physica and
53
its understanding of healing materials. I also examine what Hildegard means, or rather
desires, with regards to salvation, being her ultimate goal. This is the ultimate balance of the
physical and spiritual planes, with the human body and the world itself as the medium for this
balance.
I have already discussed in Chapter One the manner of Hildegard’s education – both
practical and theoretical – with regards to holistic healing, and the influences she would have
been subject to in both the cloisters of Disibodenberg and Rupertsberg. In Chapter Two I
examined how she interpreted, justified and categorised that education within Causae et
curae, manipulating biblical narrative and contemporary theological debates to rationalise
her fascination with the natural world and the human body. I now turn to how Hildegard put
this into practice. To do so I examine several case studies of moments in Hildegard’s life
wherein she acted as physician, healer, and miracle-worker, largely using her epistolary works
and, to a lesser extent, the Vita of Monks Gottfried and Theodoric. To substantiate these case
studies, I draw from Hildegard’s medical manual Causae et curae and, additionally, Physica to
construct a broad view of Hildegard’s holistic practice and theory. Finally, I examine
Hildegard’s ultimate goals for her medico-religious works, and what she wants her audience
to take from it. Thus, this chapter cements the argument of this thesis – that Hildegard’s
medico-religious musings crystallise her understanding of humanity, the world, and the
cosmos, and that they warrant greater attention and critical examination than they currently
enjoy.
H ILDEGARD THE H EALER

In a letter to an unknown priest Hildegard writes,
Those who have an excess of blood are suddenly struck with horror and readily give
way to anger, and so they often cry out and shriek insanely, because of the attack of
devilish machinations.1
Causae et curae contains multiple references to the Devil and evil spirits. In Physica, Hildegard
even recommends certain herbs and rituals one might use to protect themselves and their
households from such creatures. The aroma of lavender wards off malign spirits, the presence
of ferns signifies a place free of evil, ingesting whale flesh drives out inhabiting spirits, carrying
the bark of the cypress tree drives away the devil, and so on. Evil spirits are just as real and
malicious to Hildegard as the flegmata of the human body, and she approaches them with
the same or similar methods by which she would approach a migraine, or a stomach ache,
that is, with medical treatment. “If someone’s brain is chilled so that he turns mad,” Hildegard
advises, “take laurel berries and pulverise them. Then take wheat flour, combine it with the
laurel powder and mix it with blessed-thistle water. After the patient’s head has been shaved,
spread this paste over his entire head and hold it in place with a felt cap until the inside of the
head is warmed and the patient falls asleep. […] Repeat this often and the patient will regain
his senses.”2
1
Hildegard, Ep. 287 to an unknown priest (1173-79), ed. Van Acker; trans. Baird and Ehrmann, 3, 83.
2
CC, 14:1, Madness. Kaiser, 166; Berger, 106. “Si alicui cerebrum infrigidatum est, ita quod inde amens
efficitur, accipe baccas lauri et eas in pulverem redige et tunc accipe farina similae et pulverem istum baccarum
ei commisce et sic cum aqua cnith et crinibus capitis illius abrasis deich istum super totum caput illius pone et
desuper cum pilleo de viltro facto constringe, quatinus caput eius interius incalescat, et ut ita obdormiat; et
54
Like many authorities of her time, Hildegard ultimately describes an ongoing state of
madness as a spiritual defect, rather than a physical illness. And yet, she specifically warns
against blaming demons solely for the afflicted person’s behaviour. Instead, Hildegard argues
an imbalance of humours or a previous affliction is the cause for a person’s insanity, and the
possession by demons the result, “because driving someone insane is part of their function.”3
She exacerbates this process painstakingly within Causae et curae, at one point stating that
certain people are predisposed to bouts of madness and insanity, but it is only once they
become mad that the Devil “sees this and frightens them with the breath of his suggestion.”4
This is an important distinction. Although not uncommon, it is rarely seen with such clarity,
as the motives and ideals within the Western medieval era regarding the relationship
between the physical and the supernatural were regularly blurred with metaphor and intent.
Darrel W. Amundsen attempts to define this process of understanding by separating the
medieval Catholic approach into three parts: firstly, that sin was the cause of illness inasmuch
as there cannot be suffering without material evil; secondly, that individual wickedness is
cause for individual illness; and thirdly, sickness as a result of a specific sin.5 Hildegard’s
method tends to agree with each of these approaches, but determines that treatment first
and foremost must be physical, which in turn becomes spiritual.
Sometime in the late 1160s Hildegard was called upon by Abbot Gedolphus of
Brauweiler to consult the case of a noblewoman who had become mad.6 The woman was
called Sigewiza (or Sigewize), and she had been beset by an evil spirit for seven years.
However, varying accounts of Sigewiza’s case also attribute her illness to a collection of bad
or evil bodily humours, a dark oppression of sensibilities, as well as demonic influence.7
Initially claiming sickness would not allow her to travel, Hildegard advised a second exorcism
take place in which Sigewiza should be lightly beaten with rods across her body, to drive the
inhabiting evil out. Although this was first reported to be effective, eventually the spirit
returned, and Sigewiza was brought to Rupertsberg.
Hildegard’s new approach, which she claimed would cure Sigewiza within forty days,
was twofold. Firstly, she enfolded the noblewoman into her community at Rupertsberg,
where she was to partake in the same daily rituals of ora et labora as Hildegard’s community.8
This included a strict diet, exercise, and prayer.9 Secondly, after these forty days were
completed, Hildegard performed a final exorcism.10 Sigewiza’s treatment might have
calorem cerebro confert. Sed cum deich iste exsiccatur, iterum alium eodem modo para et capiti illius
superpone, et sic saepe fac, et ille sensus suos recipiet.”
3
CC, 8:1, Insanity. Kaiser, 169; Berger, 70.
4
CC, 13:1, Rage. Madness and Epilepsy. Kaiser, 156; Berger, 101. “Et cum isti aliquando in iram moventur et
quibusdam saecularibus angustiis aggravantur, hoc diabolus videns etiam flatu suggestionis suae eos terret…”
5 Amundsen, Darrel W., Medicine, Society, and Faith in the Ancient and Medieval Worlds (The John Hopkins
University Press: London, 1996), 187-188.

6 Maddocks, Fiona, Hildegard of Bingen: The Woman of Her Age (Headline Book Publishing: London, 2013),
223.
7
Suzanne M. Phillips and Monique D. Boivin, “Medieval Holism: Hildegard of Bingen on Mental Disorder,”
Philosophy, Psychiatry, and Psychology, Vol. 14, No. 4 (2007), 360.
8
“But God rained down the dew of his sweetness upon us, and without shrinking back or trembling and
without any help from strong men, we found a place for her in the living quarters of the sisters.” VH, 3:22.
Silvas, 203-5.
9
Phillips and Boivin, “Medieval Holism,” 360.
10
Cylor Spaulding and Melissa D. Dodd, “The Public Relations and Artful Devotion of Hildegard Von Bingen,” in
Pathways to Public Relations: Histories of Practice and Profession, ed. Burton St John III et al, (London:
Routledge, 2014), 48.
55
resembled the methods in Causae et curae for the dispelling of demonic influence and evil
apparitions. Herein, Hildegard commands a victim to construct a belt of elk hide and deerskin,
fastened with steel pins in precise locations. As the victim applies each pin they are to recite
specific phrases in praise of God for their own protection. For “No matter how strong a person
might be, steel is some addition to one’s powers. There exists a certain strength in elk, and
the deer is a pure animal. Therefore, diabolical spirits disdain these animals and shun them.”11
To cure a victim of demonic possession would have given Hildegard –at this point already a
famous and well-respected figure – enhanced prestige. The claim that following this exorcism
Hildegard herself took to bed for exactly forty days more may be a matter of hagiographical
embellishment for the sake of her saintly image.12 Nevertheless, the treatment and
subsequent exorcism of the noblewoman Sigewiza was deemed a success.
Hildegard’s treatment of Sigewiza is a subject of contention. Suzanne M. Phillips and
Monique D. Boivin argued that the case of Sigewiza perfectly exemplifies the synthesis of the
spiritual and physical within Hildegard’s medicine. They argue that several aspects of
Hildegard’s approach were uniquely representative of her understanding of illness, and
particularly that of mental illness (or possession). For example, her bringing the victim into
the community of Rupertsberg for treatment and observation, and her modification of
Sigewiza’s daily ritual and dietary habits stand out as significant given that, Phillips and Boivin
argue, no mention of either aspect within Sigewiza’s life was made when Abbot Gedolphus
first contacted Hildegard. Therefore, it can be construed that matters of habitat, diet, and
exercise were deemed irrelevant by the abbot and others who had treated Sigewiza
previously.13 Hildegard agreed that the woman was beset by an evil influence. However, she
was focused on correcting these lifestyle aspects for at least some period before attempting
another exorcism. Her understanding of correlation and causation is especially apparent in
this circumstance. That is to say, to Hildegard unbalanced humours and unhealthy habits
(such as overeating, immoral sexual acts, or alcoholism) were the wound, and demonic
influence but an infection of that wound. Phillips and Boivin agree with this assessment,
arguing that “Hildegard discussed multimodal treatment not as an efficient way to locate the
one treatment strategy that would work, but as a package that is more efficacious in its
entirety than any one element would be alone.”14
Jerome Kroll disagrees. He paints a conflicting portrait of a reluctant Hildegard taking
in Sigewiza out of a sense of community and Benedictine duty, rather than saintly charity. As
for Hildegard and her long hours spent with the woman in conversation, and in conversation
with the demon inhabiting her; Kroll argues that this is simply a reflection of curiosity, rather
than an explicit method of treatment.15 This argument against what he sees as a trend of
‘presentism’ does not seem to address the context by which Phillips and Boivin base their
claims, and with which this thesis agrees. Hildegard’s (by this point) long and involved
consideration of physical and spiritual health, and her references to thus within both her
spiritual and physiological texts. That the case of Sigewiza contains tenets of hagiography is
11
CC, 14:1, Against Apparitions. Kaiser, 195; Berger, 115. “Nam calibs est firmamentum et ornamentum
aliarum rerum et est quasi quaedam adiunctio ad vires hominis, quemadmodum homo fortis est. Sed in helun
quaedam fortitudo est, et capreola mundum animal est, et ideo diabolici spiritus ista dedignantur et ea
abhorrent.”
12
Spaulding and Dodd, “Public Relations,” 48-49.
13
14
15
Jerome Kroll, “Medieval Holism and ‘Presentism’ - or: Did Sigewiza Have Health Insurance?”, Philosophy,
Psychiatry, and Psychology, Vol. 14, No.4 (2007), 371.
56
undeniable, but to disregard it altogether as an example of Hildegard’s application of
practices she had spent the better part of her life espousing is also uncharitable. Phillips and
Boivin’s response summarises Hildegard’s approach quite neatly when they argue,
“Everything interacts with spiritual concerns, to be sure, but everything also interacts with
the biological, and with the interpersonal, and with the astrological.” 16 It is this
interconnectedness that is the vital point of interest within Hildegard’s treatment of Sigewiza,
and indeed, within this thesis.
Hildegard tends to disregard epilepsy as being caused by demonic influence. She
differentiates between two types of epilepsy: that caused by intense rage and subsequently
demonic influence, and that caused by a certain predisposed moral or physical weakness.
Specifically, she claims that during epileptic fits the body and the soul (once previously
intertwined) split apart. In this way, the “the body faints, falls down and remains in this state
of unconsciousness until the soul, having resumed its powers, surges again.”17 She repeats
this concept a second time, writing on the matter of epilepsy that “…the body from which the
soul’s powers have been withdrawn, so to speak, falls to the ground and remains there as if
dead until the soul has regained its powers.”18 This is a curious interpretation of the spasms
and fits endured by victims of certain disorders – Hildegard, previously determining that the
soul and body are irrevocably intertwined, now declares that there are instances in which
they may be divorced without fatal consequences.
Prior to the Pseudo-Hippocratic treatise De morbo sacro, epilepsy and similar physical
disorders were generally attributed to divine influence; a ‘sacred disease’.19 Early canon law
dictated that epilepsy, and mental illnesses in general, were classified as irregularities; that is,
owing in some form or another to demonic influence.20 De morbo sacro, on the other hand,
staunchly argued that most cases of “possession” were in fact physical disorders, rather than
spiritual, declaring:
But this disease seems to me to be no more divine than others; but it has its nature
such as other diseases have, and a cause whence it originates, and its nature and cause
are divine only just as much as all others are, and it is curable no less than the others,
unless when, from of time, it is confirmed, and has become stronger than the
remedies applied. 21
De morbo sacro does not entirely disavow demonic influence in cases of epilepsy, but instead
argues against the idea that the illness itself was divinely attributed. Indeed, critical
16
Suzanne M. Phillips and Monique D. Boivin, “Hildegard and Holism,” Philosophy, Psychiatry and Psychology,
Vol. 14, No. 4 (2007), 378.
17
CC, 13:1, Rage. Madness and Epilepsy. Kaiser, 156. Berger, 101. “…unde anima, quae in ipsis est, fatigata
succumbit et se subtrahit, ac sic corpus deficiendo cadit atque ita in defectum iacet, usque dum anima iterum
resumptis viribus exsurgit.”
18
CC, 13:1, Epilepsy. Kaiser, 156; Berger, 102. “Sed alii sunt alterius generis eiusdem morbi, ita quod
inconstantes et leves in moribus suis sunt et impatientes, quorum anima, dum in ipsis supra modum his
moribus fatigatur, se multotiens subtrahit et succumbit, et ita corpus velut viribus animae substractis in terram
cadit ac sic quasi mortuum iacet, usque dum iterum anima vires suas recipit.”
19
Jacques Jouanna, “The Birth of Western Medical Art,” from Western Medical Thought from Antiquity to the
Middle Ages, ed. Mirko D. Grmek (Cambridge, Massachusetts: Harvard University Press, 1998), 39.
20
Simon Kemp and Kevin Williams, “Demonic Possession and Mental Disorder in Medieval and Early Modern
Europe,” Physiological Medicine, No. 17 (1987), 23.
21
Pseudo-Hippocrates, De Morbo Sacro. trans. Charles Darwin Adams, The Genuine Works of Hippocrates
(Dover, New York: 1868).
57
evaluations of the text draw the conclusion that the author themselves are staunchly
religious, wary of the immoralities of humanity and highly critical of self-professed
‘magicians.’22 And yet they argue that all diseases are equally divine inasmuch as they are all
fundamentally part of the human condition, therefore, no one illness is more divine than the
next.23
Quite soon after the circulation of this treatise and the popularisation of Hippocratic
medicine a more physiological approach appeared in the texts of physicians and clergymen
alike, in which the humours and elements were examined, and natural therapies
recommended.24 Isidore of Seville in his Etymologiae defines epilepsy as arising “whenever
black bile happens to develop in excess and is turned in its course to the brain.” 25 And yet,
many theologians still defined epilepsy and madness as being demonic in nature.26 During
Hildegard’s time, this difference became a matter of prognostics. Physicians of note
recommended ways of differentiating between epilepsy (caducus) from demonic possession
(demoniacus). Constantine the African (d. circa 1089-99), a North African monk who
translated and studied the Arabic medical tradition, considered demons and humoral
imbalance equally viable causes for epileptic fits. He devised a test of sorts wherein a
physician might speak gently in the victim’s ear, commanding the demon to move out of the
body. If the victim was best by demons, he would immediately fall down as if dead for at least
an hour. If, however, he did not immediately fall down, this would prove him to be an
epileptic.27 As for Hildegard, in Causae et curae she paints an image of the human body as a
house with the soul at its centre, writing:
Thus the soul too sits in the heart as in a house and lets thoughts in and out through
a door and looks at them as through windows. It sends their forces to the brain in
order for it to discern and investigate them there, as burning fire sends its smoke up
a chimney. […] But when bad and fetid humours are stimulated in a person, they send
a noxious vapour to the brain.28
Within this we can clearly see the influence of this Greek physiological tradition on Hildegard’s
thought process, although Hildegard places a greater emphasis on the role of the soul in
maintaining the body. Subsequently in Causae et curae flegmata alone is not the direct cause
of such fits. Instead, it promotes a noxious vapour to travel throughout the body and to the
brain, where many – including Hildegard - believed the soul resided.29 For the Greeks the brain
22
J. Van der Eijk, “The ‘Theology’ of the Hippocratic Treatise On the Sacred Condition,” Apeiron: A Journal for
Ancient Philosophy and Science, Vol. 23, No. 2 (1990), 89.
23
Van der Eijk, “Theology of the Hippocratic Treatise,” 95.
24
Jouanna, “Birth of Western Medical Art,” 39.
25
Isidore of Seville, Etymologiae, 4:7.5 from trans. William D. Sharpe, Isidore of Seville: The Medical Writings,
Transactions of the American Philosophical Society, new series 54, pt. 2 (Philadelphia: American Philosophical
Society, 1964).
26
Kemp and Williams, “Demonic Possession,” 24.
27
Aristidis Diamantis, Kalliopi Sidiropoulou and Emmanouil Magiorkinis, “Epilepsy During the Middle Ages, the
Renaissance, and the Enlightenment,” Journal of Neurology, Vol. 257, No. 5 (2010), 691-8, 693.
28
CC, 8:1, The House of the Soul. Kaiser, 95-6; Berger, 74. “Sic et anima in corde velut in domo sedens
cogitationes velut per ianuam eius emittit et immittit et eas quasi per fenestras considerat ac vires earum velut
accenso igne ad cerebrum velut ad fumarium transducit, ut eas ibi discernendo discutiat. […] Cum autem
quidam mali et foetidi humores in homine suscitantur, quendam noxium fumum ad cerebrum emittunt.”
29
Marron, Brianna, “A Space of Convergence: Hildegard of Bingen’s Multivalent Understanding of the Body,”
Magistra, Vol. 20, No. 2 (2014), 45.
58
was the seat of human rationality, reasoning, and logic, what they understood to make up the
unique construct that is the soul itself.30 Consequently in the case of madness or epilepsy the
soul loses its powers and, like a puppet with its strings cut, the body falls to the ground as if
dead. Even within earlier Greek theory, when Hippocrates was loudly decrying the
involvement of supernatural forces in epileptics, these fits were seen to involve such a force
as to completely drive the soul out of the body.31
Hildegard displays great sympathy for the unfortunate victims of epilepsy. “Such
people,” she writes, “have an engaging expression and a gentle attitude. When they fall to
the ground, thrown down by this illness, they sometimes let out a sound that seems rather
mournful and natural and they froth a lot at the mouth.”32 However, Hildegard insists, they
are easily treated. It is here that surviving texts of Causae et curae move on to other matters,
but Hildegard’s subsidiary text Physica fills in the spaces, listing several remedies for the
treatment of epilepsy. These include: dousing peony seed in the blood of a swallow, and then
covering it with fine whole-wheat flour, to be placed in the mouth of the victim;33 taking a
herb known to Hildegard as meygelana and placing it under the tongue of the victim during a
fit;34 and taking an emerald and placing it in the victims mouth, followed by reciting praise to
God after they regain consciousness.35 It is of significant interest that a majority of Hildegard’s
treatments involve placing an object in the mouth of the victim, given the very real possibility
of the victim choking. This may have been related to the fear that epilepsy was a contagious
disease, which some argued was spread by the evil vapours of the victim’s mouth.36
Notably, Hildegard advises several of these methods for both victims of epilepsy and
demonic possession. Chyrsoprase, for example, a type of gemstone, should be worn on the
affected person’s body at all times, as for an epileptic “the airy spirits around him will be
unable to prepare their mockery, and the one suffering will expel the foam from his mouth.”37
As for expelling evil, Hildegard warns that the gem is not much use against ‘bitter demons’,
whom prevent victims from speaking or laughing, but is effective in torturing them to the
point of making them weak against subsequent exorcisms.38 Within the Vita, among other
acts of miracle, Hildegard is said to have cured an epileptic man with a powerful healing
incantation.39
There is one other account within the Vita that describes Hildegard’s healing process
in detail. It recounts the tale of a woman known as Sibyl from the city of Lausanne, who
contacted Hildegard for assistance in healing her haemorrhage. This account is supported by
surviving letters, and we have in detail Hildegard’s instructions. She advises Sibyl:
30
R. J. Hankinson, “Magic, Religion and Science: Divine and Human in the Hippocratic Corpus,” Apeiron: A
Journal for Ancient Philosophy and Science,” Vol. 31, No. 1 (1998), 1-34, 10.
31
Mirko D. Grmek, “The Concept of Disease,” in Western Medical Thought from Antiquity to the Middle Ages,
ed. Mirko D. Grmek (Cambridge, Massachusetts: Harvard University Press, 1998), 250.
32
CC, 13:1. Kaiser, 156; Berger, 102. Epilepsy “Isti autem blandam faciem et lenes gestus habent, et dum a
morbo isto deiecti in terram cadunt, interdum aliquam vocem, sed tamen lugubrem et naturalem, emittunt et
multam spumam de ore eiciunt, sed tamen facile curari possunt.”
33
Physica, 1:127, ed. Hildebrandt-Gloning, 126; Throop, 66.
34
Physica, 1:159, ed. Hildebrandt-Gloning, 140. Throop, 76.
35
Physica, 4:1, ed. Hildebrandt-Gloning, 231. Throop, 138.
36
Diamantis, et al, “Epilepsy During the Middle Ages,” 692.
37
Physica, 4:13, ed. Hildebrandt-Gloning, 246; Throop, 148. “Homo quoque qui caducum morbum habet,
crisopassum apud se semper habeat, et nocturna pestis, scilicet caducus morbus, eum minus laedet, quia aerei
spiritus circa eum irrisionem hanc interim parare non poterunt, quin ex ore suo spumam dolens eiciat.”
38
Phyisca, 4:13, ed. Hildebrandt-Gloning, 246; Throop, 148.
39
VH, 3:19. Silvas, 192.
59
O Sibyl, I say these things to you in the light of true visions. You are a daughter of the
woods caught up in a whirlwind of disease. But God keeps watch over you, lest your
soul be lost. Therefore, trust in God. Also, place these words on your breast and on
your navel in the name of the One Who disposes all things with justice: “In the blood
of Adam, death was born; in the blood of Christ, death was enchained. By that blood
of Christ, I command you, blood, to cease your flow.”40
The Vita states that Sibyl was then cured. However, a letter from Hildegard contradicts this,
and implies Sibyl contacted her for further advice. Here she adopts an admonishing tone, and
chides the woman for not being more discreet about her illness.41 This is unsurprising, as
Hildegard was a vocal advocate for prudentia – discretion – which she crowned the mother
of all virtues.42 It is here that she then makes a most curious argument. She claims that Sibyl’s
suffering is due to the sins of her parents, for “God sometimes extends His scourges to the
third and fourth generation.”43 She then advises Sibyl to trust in God and follow her
instructions so that she might be cured, but adds that Sibyl’s daughter may yet still suffer the
same curse.
This account reflects a key concept within Hildegard’s medico-religious works - that
people are ultimately biologically different, and that these biological differences depend
largely on the humoral and elemental makeup of their parentage. The fixation on parentage
is a natural extension of her understanding of class and society. When Tenxwind of Andernach
openly criticised Hildegard’s practice of accepting only the highborn into her convent,
Hildegard sharply retorted “Who would gather all his livestock indiscriminately into one barn
– the cattle, the asses, the sheep, the kids?”44 Within Causae et curae Hildegard interweaves
this concept with judgements of a spiritual nature. Certain men, she claims, who are virile and
intelligent, coursing with ‘burning’ blood, and who have an obsession with intercourse with
women, propagate children with harsh dispositions – “like a misshapen piece of wood charred
by fire as compared to a beautiful figure made from beautiful wood.”45 Sanguine men, who
have gentle temperaments, and are able to live in concordant harmony with their wives and
families, propagate children with immense self-control, who are generally cheerful and not
easily swayed by envy or bitterness.46 Melancholic men, whom Hildegard describes as having
‘fatty’ brains, have uncontrollable sexual urges, and their loins have three modes: fiery, windy,
40 Hildegard, Ep. 338 to Sibylla, A Married Woman of Lausanne (1153), ed. Van Acker; trans. Baird and
Ehrmann, 3, 132, “Deus uigilat super te, ut non detur anima tua in dispersionem. Ideo confide in Deum. Hec
autem uerba circa pectus et circa umbilicum tuum pone in nomine illius, qui omnia recte dispensat: 'In sanguine
Ade orta est mors, in sanguine Christi mors retenta est. In eodem sanguine Christi impero tibi, o sanguis, ut
fluxum tuum contineas'.”
41
Perhaps Hildegard disapproved of Sibyl complaining that her initial ‘cure’ had failed.
42 Heinrich Schipperges, Hildegard of Bingen: Healing and the Nature of the Cosmos (Princeton: Markus
Wiener Publishers, 1997), 93.

43
Hildegard, Ep. 339 To Sibylla, A Married Woman of Lausanne (1153-55), ed. Van Acker; trans. Baird and
Ehrmann, 3, 133-134.
44
Hildegard, Ep. 52r to the Congregation of Nuns (1148-1150), ed. Van Acker, trans. Baird and Ehrmann, 1,
128.
45
CC, 6:1. Kaiser, 71; Berger, 58. More on Adam’s Banishment, “Homines autem, qui de his nascuntur,
multotiens acerbos mores habent et incontinentes in libidine sunt et tam perversi in moribus suis ad humanos
mores sunt, velut informis forma est, quae ex informi et igne fere combusto lingo formatur, ad similitudinem
pulchrae formae, quae de pulchra lingo fit…”
46
CC, 6:1, Sanguine Men. Kaiser, 72; Berger, 59.
60
and consumed by black bile. Around women they “are without restraint like asses.”47 And
when they do attempt to practice self-restraint, quickly turn mad. Their children, Hildegard
argues, are filled with a diabolical nature, as they were conceived without love. Finally,
phlegmatic men, who have large eyes and ‘dead looking’ skin, are often dim-witted and slow,
and therefore not necessarily immoral in nature. But because of their weak temperament,
they are rendered ultimately infertile, and “do not have the plough’s skill to tear up the soil.”48
Hildegard’s assessment of what she titles the complexion and aptitude of different
types of parents relies heavily on placing the onus on the father for the complexional outcome
of the child. This was, in her mind, both a biological and spiritual process, in that both the
physiological makeup of the father and his moral (or immoral) acts results in the type of child
he will propagate. Hildegard understands that his moral acts as a human are a direct
consequence of his humoral and elemental makeup, and so in some ways the makeup of the
child would become a matter of inevitability.
In the Greek tradition, there was some disagreement regarding what exactly was
involved in the process of procreation, and the amount of importance placed on the male and
female involved. Aristotle believed that the soul was conveyed to the child only through the
father’s seed, the female body being but a physical receptor for the creation of life. 49 As the
soul was conveyed through the father, this meant that the mother contributed “matter”, that
is, the physical entity of the child, hence the presence and use of menstrual blood (which was
transformed in the mother’s body to become breastmilk).50 Galen, on the other hand, made
pointed reference to the existence of ovaries, arguing that they mirrored the male testes and
therefore had an equally important role in creating children.51 However, it should be noted
that Galen interpreted the inverted nature of the female reproductive system as more proof
for his theory that women were, as a creature, ‘unfinished.’52 Giles of Rome, a thirteenth-
century philosopher, wrote a treatise on health in which he laid out and critiqued the
arguments for either side of the discussion. He summarily determined that the father cannot
contribute the soul alone to the formation of the child, but also ‘matter.’ Consequently, the
mother cannot just contribute ‘matter’, but also some aspect of the soul.53
As for the nature of the child itself, sons were generally expected to result from a
surplus of heat and virility in the early stages of pregnancy, and daughters a result of a
combination of factors including insufficient heat, the father’s age or effeminacy, or the
mother drinking an excessive amount of cold water.54 Some medieval authorities even
expressed concerns that the child could be adversely subjected to the imbalance of humours
within the mother’s womb itself, such as the excess of heat caused by menses.55 However,
47
CC, 6:1, Melancholic Men. Kaiser, 73; Berger, 60. “…Sed amari et avari et insipientes sunt et superflui in
libidine ac sine moderatione cum mulieribus velut asini…”
48
CC, 6:1, Phlegmatic Men. Kaiser, 75; Berger, 61. “Sed perfectionem aratri non habent, ut terram scandant,
quia deminis ita coniungi non possunt, quemadmodum fertiles viri, sed steriles sunt.”
49
Kim E. Power, “Body and Gender in the Fathers of the Church,” in Hildegard of Bingen and Gendered
Theology in Judeo-Christian Tradition, ed Julie S. Barton & Constant Mews (Clayton: Monash University, 1995),
44.
50
William F. MacLehose, “A Tender Age”: Cultural Anxieties over the Child in the Twelfth and Thirteenth
Centuries (New York: Columbia University Press, 2007), Para. 77.
51
Sophia M. Connell, “Aristotle and Galen on Sex Difference and Reproduction: A New Approach to an Ancient
Rivalry,” Studies of Historical Philosophy Society, Vol. 31, No. 3 (2000), 405-427, 418.
52
Connell, “Aristotle and Galen,” 418.
53
Connell, “Aristotle and Galen,” 418.
54
Power, “Body and Gender,” 43.
55
MacLehose, para.44.
61
Hildegard’s advice on the propagation and nature of children quite clearly states her position
on the matter: “Flegmata and humours grow in the human being, depending on the nature
of his semen. For, depending on whether spring wheat, winter wheat or barely is sown, they
bring forth their grains according to their nature.”56 The semen mentioned is, of course, the
father’s. Hildegard believes that women do not secrete semen, but instead a cold foam, as
their blood is too weak and thin to transform into the ‘poisonous’ result of Adam’s Fall.57 As
for matters of morality, Hildegard warns the young and immature against procreating without
thought to the consequences, as their children will suffer from severe physical disabilities. 58
Indeed, Hildegard pursues this topic even further by addressing men in particular, warning
them to be aware of their time of sexual maturity, that they should observe proper matters
of conduct, and that they should not approach, nor lay a hand on a woman “before he has
grown a beard.”59 It is possible that Hildegard was drawing on this concept in particular when
she accused Sybil’s parents of ‘past sins’.
In Causae et curae Hildegard also discusses the four qualities (choleric, sanguine,
melancholic and phlegmatic) with relation to women. However, unlike the section on male
temperaments, there is no discussion regarding what kind of children these women
propagate. Instead, Hildegard is concerned with the plumpness of these women, the colour
of their eyes, the thickness of their bones, the thinness of their skin, or the nature of their
blood in matters of menstruation. On childbearing, Hildegard only makes judgements on the
amount of children each type of woman is likely to bear, and says nothing on the nature of
the children themselves.60 Yet later in the text, Hildegard does imply that although the morals
and physiology of the father determines that of the child, the level of affection in the mother
for the father may determine the gender of said child.61 The seemingly single exception to
this rule involves obese women, who are suffused with inordinate warmth. In cases such as
this, Hildegard claims, the warmth of such women will conquer the power of the father’s
semen, and the child will resemble her more closely. The child’s physiology and nature is
otherwise unmentioned. One last subject of interest within Causae et curae is an incomplete
section on cosmography and lunar progression. Included herein Hildegard judges the qualities
of a person by the season and time in which they were conceived. For example, those
conceived on a rainy day experience an innate attraction to bodies of water, which Hildegard
warns lends them to drown more easily than other people. People who are conceived on an
especially sunny day are more attracted to heat, and therefore are more likely to burn
themselves, and so on, and so forth.62 Other than some curious examples of gender
differences in the child, and the qualities attributed to them by the cycle of the moon, there
is no mention of the qualities of the parents.
It is significant that Hildegard chooses to focus on the role of the father’s elemental
makeup in forging the nature of a child, despite her championing for mothers and
56
CC, 4:1, Reproduction. Kaiser, 5; Berger, 48. “Tunc etiam flegmata et humores in eo crescent, secundum quod
natura seminis eius fuit, quoniam secundum quod triticum aut siligo aut ordeum seminatur, secundum hoc
etiam et grana naturaliter proferunt.”
57
CC, 4:1, Conception. Kaiser, 88; Berger, 43.
58
CC, 5:1, The Time for Procreation. Kaiser, 30; Berger, 50.
59
CC, 5:1, The Time for Procreation. Kaiser, 30; Berger, 50. “…Vir ad feminam non accedat, cum illa puella est,
sed iuvencula, quod tunc matura est, nec ipse feminam tangat ante barbam, sed cum barbam habuerit,
quoniam tunc maturus est ad fecunditatem prolis.”
60
CC, 6:2, Sanguine Women; Phlegmatic Women; Choleric Women; Melancholic Women.
61
CC, 5:2, Diversity in Conception.
62
CC, 16:1, Lunar Prognostication.
62
motherhood in much of her extensive body of work. And yet, as it appears in Causae et curae,
her argument remains largely interested in the immorality or sins of the father in creating
children of a diabolic nature, or children who are susceptible to a particular condition (such
as haemorrhages). Thus, Hildegard moves away from such medieval misogynist traditions
such as the ‘fallen woman’ trope, instead seeing the initiative for sin and illness as coming
from a largely masculine source, such as the father, or in her spiritual texts, the Devil himself.63
Her instructions to Sybil of Lausanne reflect this nature of genetic causation, as inferred in the
holy rites she commands Sybil to repeat: “In the blood of Adam, death was born; in the blood
of Christ, death was enchained.” Hildegard thus determines that it was Adam’s blood – the
blood of man - which was adversely affected following Adam’s Fall, and Christ’s blood (and
subsequent sacrifice) which allowed the human condition to be healed.
Hildegard’s subtle manipulation of longstanding tenets is masterful to the extent that,
as Joan Cadden appraises, “She affronts neither theology nor philosophy nor morality.” 64 Her
intrinsic belief – that is, that men bestow seed and women receive it – may fall in line with
Aristotelian biology, but not purposefully, and indeed, soon diverges from the Greek tenets
as Hildegard weighs the value of both man and woman in the process of procreation.65 And
if, by Hildegard’s estimation, the morals and physiology of the father are the greater
determinant of the nature of the child (be it good or evil), this is only because Hildegard agrees
with the Church narrative that men are, physiologically and morally, the dominant sex. Thus,
Hildegard defends herself – intentionally or not – from accusations of heresy. Persecution was
a very real threat to Hildegard during her life, as once again potential heretics caused the
Church increasing anxiety towards the end of the eleventh century. The enthusiastic
movement towards religious reform in the eleventh and twelfth centuries led to an influx of
new religious orders, thus complicating the narrative set down by the Catholic Church. 66
Many public figures faced intense scrutiny for espousing concepts aside from the norm.
Moreover, there was some resistance to the growing number of female mystics, based on the
edict of St Paul that women should not teach or have authority (Timothy 2:12). Although
Hildegard set the precedent for female writing mystics in her lifetime, many women were
persecuted for daring to put their spiritual musings into literature. Sixty years after
Hildegard’s death Marguerite Porete (1248-1310) would be burned at the stake in Paris for
circulating her spiritual works. Indeed, although Hildegard had powerful connections and an
impressive lineage of her own, there was no certainty she would avoid persecution should
her spiritual works ever cross the wrong boundary. Indeed, even her actions as a healer could
be used against her, as the Church fathers believed that Satan and his demons were able to
heal, so that they might seduce the innocent.67 That Hildegard managed to perfect this
balance of adherence to biblical tradition whilst simultaneously espousing her own –
sometimes radical – views, is testament to her understanding and control of her public image.
63
Constant Mews, “Hildegard of Bingen: Gender, Nature, and Visionary Experience,” in Barton & Mews (1995),
72.
64
Joan Cadden, “It Takes All Kinds: Sexuality and Gender Differences in Hildegard of Bingen’s Book of
Compound Medicine,” Traditio, Vol. 40, (1984), 149-174, 152.
65
Cadden, “It Takes All Kinds,” 155.
66
John D. Cotts, Europe’s Long Twelfth Century (Palgrave Macmillan: London, 2013), 108.
67
Amundsen, 7.
63
P HYSICA AND THE H EALING OF THE W ORLD
Above all else, Hildegard’s body of work is fascinated with the natural world. Whether
religious, moral, or medical, her texts use the natural world as a mirror by which Hildegard
can inspect humanity itself. This preoccupation with the earth and its resources certainly
stemmed from her upbringing in Disibodenberg, and her role in the maintenance and
application of the nuns’ herbal gardens. It is in Physica that we see the results of her complex
education at its most apparent, as Hildegard laboriously details the many and varied items of
the natural world in each level of the natural ecosystem, and the many ways they could be
used to treat the ill and infirm. Moreover, in Physica we witness – in explicit detail -
Hildegard’s unique application of spiritual theory to even the most mundane of healing arts.
For Hildegard, in fact, saw the healing of a human being as tantamount to the healing of the
world.
With earth was the human being created. All the elements served mankind and,
sensing that man was alive, they busied themselves in aiding his life in every way. And
man in turn occupied himself with them. The earth gave its vital energy, according to
each person’s race, nature, habits, and environment. Through the beneficial herbs,
the earth brings forth the range of mankind’s spiritual powers and distinguishes
between them; through the harmful herbs, it manifests harmful and diabolic
behaviours.68
And so, Hildegard introduces book one of her Subtilitates diversarum naturarum creaturum,
known otherwise as her Book of Medicinal Simples, and generally today as the work Physica.69
This is open to debate, as we have as of yet no confirmation whether Causae et curae and
Physica were intended as separate texts, or as a single item, as Moulinier argues. As it is, the
text is comprised of nine chapters, discussing respectively the medicinal uses of various
plants, elements, trees, stones, fish, birds, animals, reptiles, and metals. The structure of the
text is erratic in nature. Some entries contain extensive descriptions, judging not only the
medicinal uses of the item but also the complexities of their origins, their elemental makeup,
and detailed instructions for their application. Conversely, some entries contain only one or
two sentences. For example, Hildegard’s entry on salewida – “Goat Willow”, simply instructs
the reader to defer to her section on the willow tree, and her section on folbaum dismisses
the tree as being useless in all regards.70 Indeed, Physica certainly resembles an ongoing
reference, compiled either by Hildegard alone or with the contribution of the nuns at
Rupertsberg for aiding in the identification and application of medicinal simples.
Overwhelmingly, however, one trope remains a constant. This is the role and usefulness of all
earthly creation in the healing of mankind, which, in turn, contributes to the healing of the
cosmic world. Physica is the true example of Hildegard’s pressing desire for the rightful
balance of cosmic viriditas.
68
Physica, 1: Introduction, Plants. Hildebrandt-Gloning, 49; Throop, 9 “In creatione hominis de terra alia terra
sumpta est, quae homo est, et omnia elementa ei serviebant, quia eum vivere sentiebant, et obviam omnibus
conversationibus ejus cum illo operabantur, et ipse cum illis. Et terra dabat viriditatem suam, secundum genus
et naturam et mores et omnem circumitionem hominis. Terra enim cum utilibus herbis ostendit circumitionem
spiritalium morum hominis, eos discernendo; sed inutilibus herbis demonstrat inutiles et diabolicos mores ejus.”
69
“The Subtle Differences in the Nature of Created Things.”
70
Physica, 3:27, 3:28. Hildebrandt-Gloning, 211; Throop, 21.
64
Hildegard’s understanding of the harmony of the world is drawn extensively from the
Psalms, which champion the unification and balance of the world through music, words, and
symbolism.71 Hildegard also draws from Christian tradition in seeing within nature the
solution to humanities ills, whether physical or metaphysical. This tradition in turn was a
result from a close conglomeration of “pagan” and monotheistic concepts, which by the time
of Hildegard were so closely fused in dominant Christian rhetoric that they were essentially
inseparable.72 Obvious connotations can be drawn from Genesis, for example, and the
popularity of the natural world in the imagery and hagiography of saints and martyrs. In
Causae et curae and Physica this ethos manifests in Hildegard’s healing methods at every
level, through the balance of diet, exercise, sleep, and thoughts. “Healing and health are
words which relate to wholeness,” writes Pozzi Escot, “a wholeness that is innately connected
with total balance.”73 In Scivias Hildegard was already lauding the merits of restoring cosmic
balance to the universe via the relationship between the body and the soul. Causae et curae
and Physica are therefore how to do so. Admittedly, Hildegard understands this true “perfect”
balance of health, this summum bonum, cannot be achieved completely in earthly life.74
However, Hildegard is of the belief that the more someone struggles to obtain this balance,
the more they will be rewarded spiritually and physically. And so, Physica is her attempt at
compiling a concise list of the various materials of the natural world, and how they can either
nurture, or weaken, this supreme goal of true harmony.
At the same time, Hildegard was directly inspired by the works of the Graeco-Roman
world, many of which had become cornerstones of education in the twelfth century. The
Roman philosopher Boethius (480-524 AD) in De consolatione philosophiae (a text that, as
aforementioned, Hildegard was allegedly able to quote by heart) sees this harmony of the
world on a cosmological level, arguing that the world and nature itself is ruled by a fixed
cosmic order ordained by God.75 Boethius was in turn influenced by the work of Nicomachus
of Gerasa (d.120 CE), a mathematician whose work on musical harmony appears at times in
the Consolation and Boethius’s other works, as well in aspects of Hildegard’s musical works.76
In essence, Boethius’ overwhelming philosophy was that any matter of inequality or
disharmony was ‘ugly’, deriving from the true perfect form of unity known as the ‘mother’
who controls the limits of this disharmony with reason and knowledge. 77 Hildegard’s theory
determines that any natural order that once existed in the world was disturbed by the fall of
Adam. It is probable that, given Hildegard’s known appreciation for Boethius’ work, this
perfect cosmic harmony she wishes to restore to the world strongly resembles the one
Boethius painted in his Consolation when he was imprisoned awaiting execution.78 A maternal
image of cosmic and spiritual unity, where all sins and vices are balanced and measured,
accordingly. This theory is reinforced by Hildegard’s words in the Liber Divinorum Operum, “I,
71
Pozzi Escot, “Hildegard von Bingen: Universal Proportion,” Mystics Quarterly, vol. 19, no. 1 (1993), 34-39, 35.
72
Steven A. Epstein, The Medieval Discovery of Nature (Cambridge: Cambridge University Press, 2012), 12.
73
Escot, “Universal Proportion,” 35.
74
Ruth M. Walker-Moskop, “Health and Cosmic Continuity: Hildegard of Bingen’s Unique Concerns,” Mystics
Quarterly, Vol. 11, No. 1 (1985), 19-25, 19.
75
Boethius, De consolatione philosophiae, ed. H. F. Stewart and E. K. Rand, (London: William Heinemann,
1926), 286-287. See also Beer, “Women and Mystical Experience,” 17.
76
Andrew Hicks, Composing the World: Harmony in the Medieval Platonic Cosmos (UK: Oxford University
Press, 2017), 34.
77
Hicks, “Composing the World,” 34.
78
Noel Harold Kaylor Jr., “Introduction: The Times, Life, and Work of Boethius,” from A Companion to Boethius
in the Middle Ages (Leiden, Netherlands: Brill, 2012), 38.
65
the highest and fiery power, have kindled every spark of life, and I emit nothing that is deadly.
I decide on all reality. With my lofty wings I fly above the globe: With wisdom I have rightly
put the universe in order.”79 This appears to be a direct reflection of Boethius’ Consolation,
This world could never have taken shape as a single system out of parts so diverse and
opposite were it not that there is One who joins together these so diverse things. And
when it had once come together, the very diversity of natures would have dissevered
it and torn it asunder in universal discord were there not One who keeps together
what He has joined.80
This idea of cosmic and natural harmony continued to occupy the focus of many debates
within and between medieval universities following the twelfth century.81 Texts such as Pliny
the Elder’s Natural History, Seneca’s Natural Questions, and Isidore of Seville’s Etymologies
were the groundwork for these discussions, as educated elite sought to conflate theological
discourse with the rapidly maturing natural sciences.82 Twelfth-century natural philosopher
Adelard of Bath (1080-1152) asks in his Natural Questions why “some plants are called warm,
when all are more earthy than fiery?” and how “the hot plant taking that which is hot; the
cold that which is cold; the dry what is dry; and the moist what is moist.”83 The similarities
one can draw between Adelard’s work and Hildegard’s description of natural medicinal
simples in Physica are undeniable. In the opening chapter of Physica, Hildegard even
addresses these discussions when she writes “Every plant is either hot or cold, and grows
thus, since the heat of the herbs signifies the spirit, and the cold, the body.” 84
Overwhelmingly, however, these questions surrounded an ethos of Apuleius’ De Mundo –
mundus est ornate ordinatio, “The world is an ordered collection.”85 Hildegard’s Physica, by
compartmentalising and defining the natures and uses of all natural things, is working with
this in mind.
Not only did Hildegard echo contemporary debates about the relationship between
man and nature, but she saw it as her personal responsibility to ‘restore’ this relationship to
its first, purest form. Just as the image of Christus medicus gave impetus to the Christian duty
of care towards the community, Hildegard saw the restoration of this relationship as her
personal, primary duty. Indeed, to her it was the primary duty of the Church. Given that she
lived in a time of great civil, political and religious upset – the ongoing crisis of the papal
79
LDO 1:1.2. CCCM 92. Derolez and Dronke, 47-48. “Ego summa et ignea vis, quae omnes viventes scintillas
accendi, et nulla mortalia efflavi, sed illa dijudico ut sunt, circumeuntem circulum cum superioribus pennis meis,
id est cum sapientia circumvolans, recte ipsum ordinavi.”
80
Boethius, Consolation, 3:12, True Happiness and False, “Mundus hic ex tam diversis contrariisque partibus in
unam formam minime convenisset, nisi unus esset qui tam diversa conjungeret; conjuncta vero naturarum ipsa
diversitas, invicem discors, dissociaret atque divelleret; nisi unus esset qui quod nexuit, contineret. Non tam
vero (10) certus naturae ordo procederet, nec tam dispositos motus, locis, temporibus, efficientia, spatiis,
qualitatibus explicaret, nisi unus esset qui has mutationum varietates manens ipse disponeret. Hoc quidquid
est, quo condita manent atque agitantur, usitato cunctis vocabulo Deum nomino.”
81
Edith Dudley Sylla, “Creation and Nature”, from Ed. A. S. McGrade, The Cambridge Companion to Medieval
Philosophy (Cambridge: Cambridge University Press, 2006), 171.
82
Sylla, “Creation and Nature,” 175.
83
Adelard of Bath, Natural Questions, trans. Berachya Hanakdan, Humphrey (Milford: Oxford University Press,
1920).
84
Physica, 1:1, Plants. Hildebrandt-Gloning, 50; Throop, 9. “Omnis autem herba aut calida aut frigida est, et sic
crescit, quia calor herbarum animam significat et frigus corpus.”
85
Apileius Madaurensis, De Mundo, 1:1.
66
schism, the political upset of the German nobility – it is unsurprising that Hildegard, bolstered
by her position as the ‘voice of God’, felt personally responsible for restoring the cosmic
balance of her world.86 Her apocryphal narrative even goes so far as to specifically describe
not just how the sinners will be purged, but how the world will be cleansed of the ‘filth’ of
Adam’s Fall, restoring the elements and the world itself of its disharmony.87 In the meantime,
Hildegard was doing what she could to heal the damage. Indeed, it is this ultimate sense of
supreme purpose that inspires Hildegard’s medico-religious texts, and is the driving force
behind her career.
This goal is not always clearly expressed in the description of each item, but it is
nonetheless Hildegard’s ultimate aspiration. Often, she refers to the search for harmony by
determining the ‘value’ of each item. This reflects a deeply ingrained concept of the
usefulness of plants and herbs. Plants rarely only had one use. They were crushed and used
for seasoning, dried and hung in kitchens for off-seasons, grown in floral abundance in
‘pleasure’ gardens, used to flavour, to dye, for use in paints, for textiles, for ceremonies, and
so on.88 When Hildegard describes the many facets of each medicinal simple, she is then
adapting this sense of value to suit her spiritual worldview. For example, her description of
the usefulness of cherry trees includes:
The cherry tree is more hot than cold, and it is much like a joke, since it shows forth
happiness but is harmful. Its sap and leaves are not much use in medicine, since there
is a weakness in it. Its fruit is moderately warm and is neither very useful nor very
harmful. Eating it does not harm a healthy person, but it creates pain if a sick person,
or one with bad humours in him, eats much of it.89
In this example, Hildegard expresses various understandings of the natural world and its
relationship with humanity. She judges the tree first by its elemental makeup, and then by its
‘spirit’, that is to say, what kind of nature it has the power to imbue. Then, she lists its
medicinal uses. Although Hildegard maintains it cannot be very useful in medicine, she
nevertheless goes on to list several ways it might be applied. These include: eating the kernel
raw to treat belly pains, using the tree gum with rye bread to act as a band across sore eyes,
and dissolving the gum over fire to then place in the ears to treat ear pains and deafness. Like
many of the items listed in Hildegard’s Physica, the cherry tree is divided by its pros and cons
– how it can support the human condition and how it can damage it. The effect it has depends
entirely on the humoral, elemental, emotional and spiritual makeup of the patient in
question. Thus, Hildegard returns once more to her core medicinal text, Causae et curae,
wherein she espouses that each person is – as a rule – biologically different. Therefore, it
follows that there is no single way that one might obtain pure cosmic balance, but each
86 Beer, Frances, Women and Mystical Experience in the Middle Ages (The Boydell Press: Woodbridge, 1992),
20.
87
Barbara Newman, “Hildegard of Bingen and the ‘Birth of Purgatory’”, Mystics Quarterly, Vol. 19, No. 3
(1993), 93.
88
Stannard, Jerry, “Medieval Herbalism and Post-Medieval Folk Medicine,” Pharmacy in History, Vol. 55, No.
2/3 (2013), 48.
89
Physica, 3:6, Cherry Tree. Hildebrandt-Gloning, 192-3; Throop, 111 “Cerasus plus calida quam frigida est, et
ad plenum et similitudinem joci habet, qui laetitiam ostendit, et qui etiam nocivus est. Et succus ejus ac folia
non multum ad utilitatem medicinae valent, quia debilitatem in se habet. Et fructus ejus temperate calidus
existit, nec multum utilis est, nec multum nocivus, et sanum hominem in comestione non laedit, infirmum
autem et qui malos humores in se habet aliquantum dolere facit si multum de eo comederit.”.
67
person as an individual must manage their own physical and spiritual needs in order to seek
this level of perfect harmony.90
How does Hildegard expect we do this? By following what she has set out in Physica,
a list of all the materials the natural world has to offer, and how they might affect certain
types of people. It is significant that in Physica we find a text almost entirely devoid of
traditional ‘sacred’ writing tropes.91 There are no extended platitudes regarding Hildegard’s
unworthiness, or the method by which her inspiration came to her. Items are categorised by
their usefulness, and nothing more. This is not to say she disregards her spiritual background
entirely. Hildegard clearly regards all natural materials on earth as gifts from God to be used
accordingly. However, her primary goal in much of her body of work is in restoring cosmic
balance. And to Hildegard, the onus of this restoration is on humankind, and indeed, the
human body itself. As writes Ruth Walker-Moskop, “Her emphasis on health indicates a belief
in the importance of humanity.”92 In Scivias, we see Hildegard championing the need for true
cosmic harmony, in Causae et curae the effect cosmic disharmony might have on the human
body and soul, and in Physica the ways in which humankind might restore this harmony once
again.
C ONCLUSION
It is important to acknowledge Hildegard’s relationship with healing outside of her texts. This
is not only to better illustrate the true breadth of her public image, lifestyle, and personality,
but is also vital in identifying Causae et curae and Physica as central to her body of work.
Additionally, it helps alleviate the doubt regarding the true authorship of these works. I have
already illustrated how concepts within Hildegard’s medico-religious texts appear also in her
prophetic and moralistic works. By painting a fuller image of the role health and healing
played in her life and in her actions, this relationship is clearer. Many of the theories and
imagery that Hildegard employs in Causae et curae are distinctly at odds with traditional
biblical theory, revealing that the author was both well-read, and sure enough in their position
that they could write on such topics confidently without fear of persecution. There were of
course limitations to this. I illustrate how healing was central to Hildegard’s day-to-day
practices with regards to her letters, yet Hildegard herself was not constrained to the bedside
of ailing patients in the Rupertsberg infirmary (as she may have been in her youth at
Disibodenberg). Indeed, the examples I have provided in this chapter reveal an image of a
figure perpetually frustrated, if not irritated by, frequent requests for healing or the
dispensing of holy balms. How then does this connect to Hildegard’s assertion that the healing
of others is central to the healing of the world? One must account for class in this instance,
as Hildegard was of such a status that she may have considered infirmary work below her
status, at least later in life. Her own illnesses occupied much of her time as well, and were
perhaps the main inspiration for her interest in the healing arts. Regardless, it is evident from
her texts and from her letters that healing, both physical and spiritual, was tantamount to
Hildegard’s understanding of humanity and the world.
It is also within these texts that we witness Hildegard’s approach to treatments in a
more personal manner. In her letters responding to requests for clarification, Hildegard
reveals in detail her interpretation of the various ills and infirmities that humanity suffers in
90
Walker-Moskop, “Health and Cosmic Continuity,” 23.
91
92
68
a more succinct language than that of her official works. These interpretations are usually
markedly unique in matter, and provide us with insight into how she merged biblical and
holistic theory to rationalise some of society’s more pressing concerns regarding the human
form and its frailties. Examples provided regarding epileptics and mentally ill patients are
deconstructed alongside diagnoses of demonic possession and evil influence, and Hildegard’s
approach to all these cases are generally the same - a measured response, followed by strict
treatment and observation. These treatments include an equal measure of potions, poultices,
and palms, as well as prayers and exorcisms. To Hildegard, one treatment was just as
legitimate as the other, it was all just a matter of prognosis. Herein too we witness a curious
decision on Hildegard’s part, and that is a significant lack of judgement to those whose injuries
or maladies are self-inflicted, either through action or moral offense – indeed, many
treatments are the same for illnesses whether self-inflicted or not. In some cases, Hildegard
even excuses a person’s immorality or ill behaviour as simply an unavoidable reflection of
their parentage. That is to say, those with predetermined weaknesses according to their
balance of humours, elements, and senses are of course likely to succumb to these
weaknesses. This is part of being human, Hildegard argues. Thus, she espouses in both her
medical and prophetic works, it is the prerogative of the Church and of humanity itself that
those with the ability to heal must do so, regardless of the patient. It is in this way that a
person fully encapsulates the meaning and example of the Christus medicus.
However, there are some arguments Hildegard makes with regards to maladies and
biology that warrant acknowledgement, and indeed, further investigation. Her attention to
the pains of menarche, menstruation, and childbirth are understandable given she is not only
a woman herself, but shared close quarters with a great number of other women throughout
her life. However, her careful lack of criticism for childbearing women who experience (in her
opinion) extreme menstruation pains due to their sexual activity is notable given the history
of disapproval – overt or not – from the Church regarding procreation, particularly women’s
procreation. Indeed, when it comes to childbirth, Hildegard goes so far to infer that any
predetermined weaknesses of a person must be inherited from the immoralities or
weaknesses of the father, as women simply receive the seed of man, and do not bestow their
own. Thus, just as she argued that Adam and Eve were of one flesh and so Eve’s humanity
was just as holy as Adam’s purity, here too Hildegard masterfully reinterprets biblical theory
to alleviate – if not remove – the responsibility for sin from the shoulders of women.
Hildegard’s marked interest in childbearing and by extension the creation of life is
important, as at the centre of her work lies a deep-seated fascination with the role of the
natural world in reforming humanity. By examining Physica I reveal how Hildegard considered
even the smallest plants to the largest stones for their value with regards to the healing of
mankind and, therefore, the healing of the world. Causae et curae therefore is her explanation
as to the ‘why’ and ‘what’ of humankind’s maladies, and Physica the ‘how’ to heal them. If
Causae et curae represents a lifetime of interest into health and healing, then Physica
represents Hildegard’s lifelong study into how the natural world bears the key to healing
humanity itself. In her introduction to the chapter on Stones she describes how the
importance of the natural world was purposeful, claiming:
God had decorated the first angel as if with precious stones. Lucifer, upon seeing them
shine in the mirror of Divinity, took knowledge from there and recognised that God
wishes to do many wondrous things. His mind was exalted with pride, since the beauty
of the stones which covered him shone in God. He thought that he could do deeds
69
both equal to and greater than God’s. And so his splendour was extinguished. But, just
as God restored Adam to a better part, He sent neither the beauty nor the powers of
those precious stones to perdition, but willed that they would be held in honour and
blessing on earth and used for medicine.93
It is evident here that Hildegard believes each facet of the natural world (including humanity)
has the key, or several keys, to reform humanity and restore the world back to its pure, most
holy form as it was in Creation. These were all planted purposefully by God, likely after the
Fall and not before, so that humankind could help instrument their own salvation. Although
Hildegard acknowledges this may not be achieved in a single lifetime, she also argues that any
effort to heal oneself (both physically and spiritually), or another person will redeem oneself
in the eyes of God. Physica is her ongoing catalogue, as evident by its list form, of which items
of the natural world will benefit this endeavour, and which will harm it. When we take this
into account, it is understandable that much of Hildegard’s public image, at least with regards
to lay people, was built around her role as a healer. Indeed, the majority of incoming mail that
has survived are requests for healing, or at least healing items. Lay people beg for strands of
Hildegard’s hair, of holy water blessed by her, and in many cases Hildegard consented.
To say that Hildegard’s interest in healing is born out of a desire for humanity’s
salvation is a broad statement unless one investigates what salvation means to her. As such
this chapter examines how salvation, to Hildegard, means a desire for a restoration to the
original world of Creation. That is, a world of pure balance. Indeed, Hildegard believed that
the Garden of Genesis was never destroyed or lost, but instead is waiting with doors firmly
barred for the return of blameless humanity. For Hildegard, her current world was out of
balance, overridden by immorality and evil influence. This perception was likely influenced by
the climactic environment of her time, suffused with political chaos and uncertainty. What is
of strict importance is that Hildegard does not simply encourage the usual platitudes to
restore balance – prayer and religious service, for example – but also encourages interaction
with the physical world and employing modern medical remedies. This open merging of
biblical and medical theory is what makes Hildegard’s medico-religious works so distinctive,
and so important in relation to the rest of her body of work.
93
Physica, 4:1. Hildebrandt-Gloning, 229; Throop, 138. "Nam Deus primum angelum quasi pretiosis lapidibus
decoraverat, quos idem Lucifer in speculo Divinitatis splendere videns, et inde scientiam accepit, et in eis
cognovit quod Deus multa mirabilia facere voluit tunc mens eius elevata est, quia decor lapidum qui in ipso erat
in Deo fulgebat, putans quod ipse aequalia et plura Deo posset, et ideo splendor eius extinctus est. Sed sicut
Deus Adam in meliorem partem recuperavit, sic Deus nec decorem nec virtutem pretiosorum lapidum istorum
perire dimisit, sed voluit ut in terra essent in honore et benedictione, et ad medicinam.”
70
CONCLUSION
There is no doubt that concern for healing and health lies at the centre of Hildegard’s creative
output. Causae et curae and, by extension, Physica, are exceptional examples of the most
personal concerns of a figure who is today seemingly fixed in the studies of prophecy, art and
medieval naturopathy.
Unfortunately, studies of Hildegard’s medico-religious texts have been beleaguered
by issues of quality, authenticity, authorship and legitimacy. Causae et curae and Physica have
been acknowledged at best as curious examples of Western medieval treatments with little
context and, at worst, as a conglomeration of items from various untrustworthy sources, none
of which were likely Hildegard herself. Several historians over the past century have famously
questioned their authenticity, leading to decades of scrupulous scepticism that only in the
past twenty or so years has abated. This thesis has sought to argue against this injustice by
drawing from Hildegard’s non-medical body of work several examples in which Hildegard’s
personal and pervasive concerns regarding health and healing are apparent.
Hildegard’s fascination with the natural order of the universe as being ordained by the
natural order of Earth’s creatures and their internal fixtures is central to her understanding of
the importance of healing. This reflects her sense of the classical image of the human person
as a microcosm of the macrocosm. Herein Hildegard conflates the internal processes of
humanity as being equal or elevated to the processes of the universe. Thus, she raises
humanity to a level of holy importance. That is to say, all that humanity entails, including their
flesh and bodies and the maintenance needed for them. This comes from Hildegard’s main
goal of Causae et curae, and all her healing acts, and that is to argue in favour of the
importance of the body beyond being a vessel for the soul to inhabit. Rather, Hildegard
argues, the body is important on its own merit in that it is the method by which humans
restore balance to the world and to their own souls (by caring for and restoring balance to
the physical form). This is her “Mistress and Handmaid” concept, which she adopted from
earlier texts and reshaped in a particularly feminine manner. Hildegard infers that the female
body is especially significant in restoring spiritual balance to the world because it is women
who bear life, as Mary bore Jesus, whereas men are primarily responsible for imparting
spiritual and physical fallibilities to their descendants. Even matters of menstruation and
childbirth, usually overlooked or frowned upon by patristic authors, are to Hildegard holy acts
which only embellish the importance of the female body. Thus, Hildegard’s idea of the cosmic
body, a body in which the universe is represented and flush with spiritual viriditas due to a
cosmic, spiritual, and bodily attuned balance is distinctly feminine in nature. I argue that
concepts such as the above, which are not only apparent in Hildegard’s medico-religious work
but also in her more celebrated spiritual texts, warrant greater acknowledgement for the
significance they have on studies of Hildegard’s life and works.
In Chapter One, Education and the Burgeoning Healer, I argued that the quality and
nature of Hildegard’s education, however informal, would have certainly provided context for
the creation of medicinal texts which would have been of significant use in both the cells of
Disibodenberg and the greater, sprawling community of Rupertsberg. Although at the time
their influence did not reach beyond these areas, in later decades her words were certainly
71
reprinted, revised, and generally viewed as helpful hand guides, certainly within Germany
itself. Hildegard’s experience in the natural environment both within and surrounding her
separate locations, encompassing wild forests, meadows and herbal gardens, is clearly
evident in her invented lingua ignota, her pharmacopeia Physica, and the many naturalist
remedies recommended in Causae et curae. Moreover, I provide examples in Hildegard’s
texts wherein she employs the herbal gardens of monasteries as analogies for moral
improvement, a particularly Hildegard-esque motif. This chapter shows that although there
is a clear basis in the Western medieval world for viewing plants and herbs as tantamount to
various facets of society, Hildegard’s elevation of flora to the status of holy constructions is
unique to her work.
Chapter One also argues that Hildegard’s broad diversity of reading – despite all claims
to the contrary in her biographical texts – infused her works with a great variety of traditional
and contemporary theories, which Hildegard reshaped and manipulated into unique
perceptions of spirituality and physicality. Although there is no specific listing for the titles
that passed through Hildegard’s hands during her life, there is ample existing historiography
which provide us with an image of what the libraries of Disibodenberg and Rupertsberg may
have contained. These theories are supported by Hildegard’s adaption of familiar texts into
her own works – such as the works of Pliny, Isidore of Seville, and most notably Boethius. I
have provided some of these examples and how they are adapted in Hildegard’s theories to
support the argument that Hildegard’s biographical comments regarding her literary
knowledge were vastly exaggerated. This was most likely to preserve a sense of modesty
expected of her gender and position.
This chapter also shows where the roots of Hildegard’s medico-spiritual works begin
in earnest in her first major work Scivias. I argue, based on evidence from her Liber vitae
meritorum, that Causae et curae and/or Physica (depending on the nature of the original text)
was started either shortly before or shortly after Scivias was completed. This is highly
significant as Scivias was the text by which Hildegard was brought to public attention, and
more importantly, papal attention. That she saw fit to pause or put aside this work to focus
on a subsidiary text regarding the human form, its ailments and how to treat them, is truly
indicative of the importance Hildegard placed on them. I draw attention to Hildegard’s
preference for evoking the imagery of Christus medicus, and with equating spiritual purity and
cleansing with the healing touch of a physician. I explain that although Hildegard is drawing
on existing tradition, the way in which she adapts it to focus on the physical form and its
ailments betrays her preference for the physical sciences. In summary, this chapter argues
that Hildegard’s background, education, upbringing and exposure to the practice of healing
generously supports my argument that Hildegard’s medico-physical works were not a passing
interest, but rather vital components of her literary collection.
Finally, Chapter One discusses the public image of Hildegard as a healer. Although
today she is remembered largely for her spiritual texts and prophetic artworks, during her
lifetime she was more significantly known for her healing acts and prowess. This is argued
using the account of the mad noblewoman Sigewiza, who was healed by Hildegard after the
demon inhabiting her called for the powerful healer Schrumpelgardis – thus signifying
Hildegard’s notoriety in the region primarily as a saintly healer. I support this by citing the
presence of an entire chapter in Hildegard’s Vita dedicated to her healing acts, some in
extensive detail with supporting letters attached. However, I also examine how unconcerned
Hildegard appears to be with this attachment to her public image – indeed, she appears more
concerned with her own ill health. As such, I argue that Hildegard’s passion for health and
72
healing did not extend to the purposeful building of a profile as a healer, but that his profile
was built largely for her from the words and deeds of others. This is not to say that Hildegard
was unaware of the association, but that she was aware – as I argue – of the complications
the association may cause for a woman in her position. The presence in the saintly vita of
Hildegard’s healing acts – so extensive, in fact, that an entire chapter was committed to listing
only a select few – and the presence of healing advice in her letters only supports the
argument that health and healing were prominent tropes in the construction of Hildegard’s
public image, if not more significant than her claims to prophetic ability, than at least equal
to. That examples exist of Hildegard speaking openly not only on matters of prophecy and
spiritual morality, but on the importance of vitality, nutrition and exercise speaks volumes
about the responsibility Hildegard assumed in the healing of her community, and the world
around her. The anecdote of Hildegard preaching publicly about the cure of Sigewiza, the
noble madwoman who was sent to her for aid after the demon inside her called for Hildegard
(however mockingly) also indicates a prevalent rhetoric within society at the time that
Hildegard, perhaps above all else, was known as a great and powerful healer.
In Chapter Two, Hildegard and the Human Person, I examine Causae et curae in close
detail. By drawing out some of Hildegard’s more unique concepts and dissecting them of their
existing theories as well as Hildegard’s embellishments, I highlight the true significance of
Causae et curae not only to Hildegard’s body of work but to medico-religious titles of her
time. Of interest is Hildegard’s perception of the physical and the spiritual, and how one
impacts the other by way of the human body. For Hildegard, the human body is not a base
aspect of humanity but in fact a vital transit of spiritual viriditas. This chapter argues that such
a distinction is paramount to Hildegard’s understanding of humanity not only within her
medico-religious works but in her body of work, and thus warrants greater discussion and
acknowledgement in modern historiography.
Chapter Two begins by examining how Hildegard understands the distinction – and
relationship – between body and soul, specifically. Hildegard’s thoughts are influenced by all
manner of outside sources, not only that of the Church fathers but of the Greek tradition and
even further Eastern influences. I support this section with an example of Hildegard’s artwork
wherein she portrays her understanding of the structure that supports God, cosmos and
humanity. In this section, I argue that Hildegard takes existing biblical tradition and feminizes
it in a way that is strategically inoffensive to her audience, whilst simultaneously arguing for
a more preferential relationship between the body and soul. Moreover, I provide reasons as
to why Hildegard developed this opinion, largely related to her experience with the results
extreme asceticism and self-flagellation had on her mentor Jutta. Of interest is the claim
Hildegard makes in relation to the process of conception and when the soul inhabits the
physical form. This is significant as she staunchly disagrees with existing tradition. That Causae
et curae is often disregarded as a sideline text when it contains some of Hildegard’s more
controversial comments is thus unacceptable.
Building on this, Chapter Two then goes on to discuss how Hildegard rationalised her
understanding of the body in relation to biblical theory of the creation of men and women,
respectively. It examines how she reinterpreted existing tradition to portray a feminized
cosmos, with the impetus of spiritual reform on the female body itself. This subject has been
raised before in other works examining Hildegard as a female author, and her imagery of the
world, but is also vitally important in the discussion of the relationship between the physical
and the spiritual. I have argued that Hildegard elevated the human body to the level of
transitory vessel for spiritual viriditas, I now establish how she – sometimes subtly, sometimes
73
overtly – argued that this vessel was explicitly feminine in nature and form. That this imagery
is clearly reflected in her artworks supports the argument for Causae et curae belonging to
Hildegard’s body of work, and not a conglomerate text sourced from unknown authors (as
some have argued).
The most significant topic raised in this chapter is a concept of Hildegard’s I have not
found replicated in any other work before Causae et curae. This is the idea that Adam’s Fall
not only created maladies of the body, but the formation of black bile (a Greek conception)
itself. Moreover, that it was largely the impetus of the father who hands this inherent malady
down to his children, and not the mother (whom as previously argued, is the impetus for
curing the maladies of the world). This theory of course has its exceptions, which Hildegard
allows for, but is a startlingly unapologetic stance on an issue of much consternation for
medieval authors during Hildegard’s time, and for many centuries after. I argue that Hildegard
again portrays the level of importance placed on the female form as she takes great care to
describe the amount of inherent malady – or livor – in a woman before and after losing her
virginity, or during menstruation and childbirth. It is of great significance that during this
discussion Hildegard does not attribute blame for the livor on the woman, or adhere to biblical
tradition in describing menstruation as a punishment for Adam’s Fall. Instead I show how
Hildegard approached menstruation and menarche pragmatically, openly, and without
judgement. Ultimately in this way Causae et curae shifts much of the responsibility for Adam’s
Fall which was popularly given to Eve, instead towards Adam himself. Hildegard pays lip
service to the tradition that Eve sinned first, but then through her medico-spiritual work goes
on to discuss in more detailed, subtle ways why this is not necessarily the case. This section
highlights the clear distinction between what Hildegard understood she was expected to say,
and what she really felt. As such, the parallels between Hildegard’s spiritual-prophetic works
and Causae et curae are readily apparent.
After illustrating Hildegard’s background, theory and education in the first and second
chapters, Chapter Three (The Process of Healing) discusses how she put this into practice. In
this chapter, I argue that although Hildegard could be interpreted as a proactive and
enthusiastic healer, the reality was likely far different. Although Causae et curae and Physica
are evident of a real personal passion for health and healing, I argue here that this did not
necessarily transfer across to Hildegard’s actions – at least not in full. To do this I examine
surviving anecdotes regarding Hildegard’s personal acts of healing towards others, and the
methods recommended in the practical sections of her medico-spiritual tracts. Case studies
used includes the more famous account of the madwoman Sigewiza, and the lesser known
but still revealing letter exchange between Hildegard and the woman Sybil. Through these
cases studies I explore Hildegard’s methods of healing both remote (with blessed items) and
intimate (through personal care and attention). In this way, I support my argument that health
and healing were central to Hildegard’s personal interests and public image.
This chapter also explores Hildegard’s developed understanding of how certain
illnesses of the body are related to the spiritual state of a human being. Epilepsy and madness,
for example, had the possibility of being attributed to demonic influence. Hildegard goes
further with this by arguing (with support from her writing on hereditary diseases in Causae
et curae) that certain people are predisposed to certain conditions due to their spiritual state.
That is to say, morally inept people, or those born from morally inept people, are more likely
(but not exclusively) to fall ill. This is not an unusual claim for the time, but Hildegard takes it
further in Causae et curae by explaining in physiological detail why this is the case. Specifically,
she describes how certain moral failings can impact the chemical balances of the body, that
74
is, the balance of humours and elements within the human frame. Therefore, unlike other
writers of her time, Hildegard does not simply strike off diseases as a work of God, but goes
to great lengths to describe how this occurs inside the body itself in a physical, almost
scientific way. This level of enthusiasm and thought is clearly indicative of a further level of
interest beyond the superficial, and one that should not be easily dismissed.
Finally, in Chapter Three I turn to Hildegard’s subsidiary medico-spiritual text Physica,
a pharmacopeia of sorts which details in list form the various uses (or lack of uses) of different
animals, minerals, plants, trees, and fish, to name a few. Specifically, I argue that in Physica
we see the answer to the questions Hildegard raises in Causae et curae and even Scivias, to
some extent. In these texts, Hildegard describes a world damaged, but not permanently, with
the potential to restore and restore the creatures within it enough spiritual viriditas to raise
humanity out of perdition. Even if, Hildegard argues, this is done by the simple act of healing
others. Thus, where Causae et curae is the guidebook for maladies and how they impact the
spirit, Physica is the manual as to how to treat the maladies themselves. We witness Hildegard
applying the spiritual to even the most mundane of healing acts. No small act of mercy is
without benefit to the soul. Ultimately, in this chapter I show that Hildegard’s ideas of spiritual
and cosmic unity in Scivias and her other works are firmly intertwined with the instructions
she provides in her medico-religious work. To heal the world, Hildegard argues, we must first
heal one another.
By drawing on Hildegard’s body of work, including her spiritual, prophetic, and
moralistic texts, this thesis ultimately argues that instead of disregarding Causae et curae and
Physica as the idle jottings of an uncertain author, we should be examining them for what
they truly are – a unique and at times shockingly bold observation of the human form and its
mechanics, bolstered by spiritual interpretation and biblical authority, that could only be the
work of one author. In fact, the unambiguous merging of spiritual belief and medicinal
practice in these texts can only be attributed to Hildegard, as we can witness the roots of
these ideas – specifically regarding the relationship between humanity, God, and the natural
world - in Hildegard’s earlier, more ‘general’ texts. Imagery such as that of viriditas, a cosmic
“greenness” which suffuses the earth and all creatures inhabiting it, may be considered par
for course of medieval cosmic imagery, if not for Hildegard’s staunch assertion that the
maintenance of the human body and its health is tantamount to its creation. As such, I have
argued for the case of Causae et curae and by extension Physica to be firmly situated within
Hildegard’s body of work as items of impact, with significant importance to both studies of
her life and studies of medical philosophy of the twelfth century.
75
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The Mistress and the Handmaid: Physical and Spiritual Health in Hildegard of

Bingen’s Causae et curae

A thesis submitted for the degree of Master of Arts by Research at

© Jacqueline Mahoney (2017).

Causae et curae, a medico-religious text of Hildegard of Bingen (1098-1179), is a

All Students should reproduce this section in their thesis verbatim

Print Name: JACQUELINE MAHONEY

CHAPTER ONE: EDUCATION AND THE BURGEONING HEALER 20

The Monastic Garden 21

CHAPTER TWO: HILDEGARD AND THE HUMAN FORM 36

Body and Soul 37

CHAPTER THREE: THE PROCESS OF HEALING 53

Hildegard the Healer 54

CC Hildegard of Bingen, Causae et Curae

1098 Hildegard of Bingen is born

1106 Hildegard is entrusted to Disibodenberg

1112 Hildegard and Jutta of Sponheim are enclosed at Disibodenberg

1136 Jutta dies; Hildegard is elected magistra

1141-51 Hildegard and her assistant Volmar write Scivias

(1149-50) Hildegard begins work on Physica

1150 Hildegard establishes a convent at the site of Rupertsberg

1165-70 Hildegard establishes a convent at the sites of Eibingen

1179 Hildegard dies

Causae et curae, a medico-religious text of Hildegard of Bingen (1098-1179), is a valuable

THE GENESIS OF CAUSAE ET CURAE

Berger (Cambridge: D.S. Brewer, 1999).

A BRIEF SUMMARY OF GREEK THEORY

EDUCATION AND THE BURGEONING HEALER

Fig. 1. Plan of St Gall (The Physicians’ Quarters)9

S OWING THE SEEDS IN S CIVIAS

This introduction is fascinating for several reasons. Firstly, it provides valuable

T HE P UBLIC I MAGE OF H ILDEGARD

82 Maddocks, “Women of Her Age,” 215.

HILDEGARD AND THE HUMAN PERSON

B ODY AND S OUL

Fig. 2, Scivias 1.3 God, Cosmos, and Humanity5

(Berkeley, Los Angeles: The University of California Press, 1987), 265.

University Press: London, 1996), 75.

THE PROCESS OF HEALING

H ILDEGARD THE H EALER

University Press: London, 1996), 187-188.

Wiener Publishers, 1997), 93.

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