Humors and conditions

The first German woman physician, the mother of German botany, a pioneer of ecological thought, an advocate of “creation spirituality”: these modern titles for Hildegard of Bingen contain a kernel of truth and contribute to her reputation as a polymath. They also suggest a secular path in life parallel to her vocation as a Benedictine nun, but this does not reflect what we know about Hildegard: she was a religious woman through and through. Even so, her knowledge of and appreciation for the natural world as well as her concern for the sick and her personal suffering were essential to her worldview and her life’s work. 

MONASTIC MEDICINE

It is not surprising that Hildegard was familiar with time-honored medical concepts, basic diagnostics and treatments, and recipes for various cures. Before universities became the seat of medical study and training in Europe in the thirteenth century, medieval monastic communities played this role. Monks and nuns created medical manuscripts from learned classical and contemporaneous sources as well as folk medicine traditions; they recorded the information and preserved it in their libraries. In their gardens they grew not only fruits and vegetables but also herbs and plants with recognized healing properties. In a time before hospitals became widespread in Europe, the sick and injured sought treatment in religious communities (see CH #101).

Hildegard had no formal medical study or training. She would have gained knowledge of the healing arts from her mentor and teacher Jutta of Sponheim, the monks and their library, or visitors to the monastery. Before the Benedictine nun founded her own religious community at Rupertsberg, she may have gained practical experience gathering ingredients and preparing medicines or serving as an infirmarian. As her reputation as a holy seer grew, individuals traveled to the monastery for her advice, blessing, and healing. Her Vita records the miraculous cures she performed and notes that almost every sick person who came to her recovered.

Hildegard’s medical reputation today is based on two works, the Physica and Causae et curae, or Causes and Cures (composition dates of both manuscripts are unknown). Though these works have long been attributed to the saint, recently scholars have questioned their authorship. Much of their content is nonreligious, and the writing differs in style from her genuine works. Relatively few manuscripts of each survive, and none were written during Hildegard’s lifetime. Neither work was included in the Riesencodex, the giant manuscript compiled shortly after the saint’s death that provides a nearly complete collection of her writings.

On the other hand, two of Hildegard’s visionary works allude to her writing about the natural world and give us good reason to believe she authored the Physica and Causae et curae. In the prologue to the Liber vitae meritorum, she states that in the previous year, a vision had shown her “the simplicity of the various natural creatures,” and the Liber divinorum operum describes how she “revealed certain natural powers of various things.” In the 1150s, before writing the Liber vitae meritorum, Hildegard probably began to record and organize what she had learned about the physical world and the function of and care for the human body. The result, which is known as the Book of Subtleties of the Diverse Nature of Creatures, was originally a single medical-scientific work; copyists had divided it into two by the 1220s. 

HUMORS AND HEALING

Each of the nine books of the Physica deals with categories in the natural world: plants, elements, trees, stones, fish, birds, animals, reptiles, and metals. Hildegard does not describe objects physically but rather in terms of their characteristics, especially their hot, cold, moist, or dry qualities. These relate to the four humors of classical medicine that in turn were thought to affect people’s physical and mental health. A “hot” remedy or treatment is recommended for a “cold” illness to balance the humors. 

The first book explains what medical condition a plant cures and how the healer should prepare the remedies. It describes flowers and herbs that grew in the nuns’ gardens as well as exotic ones such as frankincense and myrrh. Similar passages exist about vegetables and common cooking ingredients such as salt, milk, and eggs. 

The other books also provide a mixture of common knowledge, traditional folk wisdom, and learning from sources that remain unnamed. Few remedies involve fish, birds, animals, and reptiles since most of these creatures are of little medicinal use. The book on the elements discusses only air, earth, and water, although fire appears frequently elsewhere in the Physica. 

Hildegard mentions by name the Nahe and Glan Rivers, local waterways that had special significance for her. The Disibodenberg monastery stood above the spot where the Nahe and Glan flow together, and Hildegard had her monastery at Rupertsberg built where the Glan empties into the Rhine. The Nahe valley is a scenic, verdant region; the river begins in mountains with volcanic soil that still produces minerals and gemstones today. Hildegard appreciated the beauty of her surroundings and recognized the value of the nearby natural resources. They likely inspired her to write about the splendor, practical use, and curative powers of the natural world.

The first book of Causae et curae describes how God created the world in the manner God wished. It explains the existence and meaning of objects in the cosmos such as stars, planets, and elements as well as natural phenomena like winds, thunder, and dew. Humankind takes center stage in the second book, which repeatedly discusses procreation and the related topics of semen, conception, menstruation, and childbirth. Many passages mention the humors and conditions caused by their imbalance along with descriptions of individual physical, psychological, and diet-related ailments. 

The author answers questions about the natural world such as what phase of the moon is most favorable for conceiving a child, why humans have two kidneys, and what happens when people dream. She also occasionally shares views on theological issues, such as how Adam was created and why Eve sinned first. In addition Books 2 through 4 contain cures and remedies. The author seldom mentions the quantity of individual ingredients but provides directions for preparation and occasionally an explanation of why healing occurs. The fifth book contains practical information for healers, including identification of signs of life and death, and details on the visual inspection of urine, a common method for identifying illness. Finally, the last book predicts the personalities of men and women based on the day of the month they were conceived.

MAGIC OR MIRACLES?

Both the Physica and Causae et curae reflect commonly accepted beliefs and theories about the natural world and medicine based on the writings of classical scholars such as Dioscorides (40–90) and Galen (c. 130–c. 216). But some of the ideas are unique, especially concerning the humors and conception. Recommended cures include herbal remedies, bloodletting, the use of gemstones, and the recitation of incantations—a mixture of the natural and the supernatural. The books often include a caveat that the treatment will be effective only if it is God’s will.

Several of Hildegard’s letters and the Vita relate how Hildegard cured illnesses of the body and the mind. According to these accounts, she offered medical advice and healed fever, tumors, epilepsy, and even lovesickness through the laying on of hands or blessing with the sign of the cross. If the afflicted person could not travel to Rupertsberg, Hildegard blessed water or bread and had it sent to the person, who then consumed it and recovered. Sometimes the saint’s prayers on the sick person’s behalf sufficed, and sometimes she resorted to other measures. For example Hildegard sent Sybil, who suffered from a hemorrhage, a letter with these words and instructions: 

In the name of him who disposes all things rightly, place these words next to your heart and your navel: “In the blood of Adam, death arose, in the blood of Christ, death was extinguished. Through the same blood of Christ I order you, O blood, to check your flow!”

 Pagan societies used incantations for healing purposes, and Christianity also recognized the power of words to heal. Religious and lay healers recited prayers or parts of the liturgy to cure in addition to or in lieu of other remedies. For example a demon-possessed woman, Sigewize, required a special cure. Hildegard provided the woman’s local priests with the text for an exorcism. When their attempt proved unsuccessful, they sent Sigewize to Hildegard, who was able to expel the demon. Hildegard never addressed the evil power, and her words and actions did not violate the expectations of the church, so her treatments with incantations and exorcism were considered miraculous rather than magical.

Hildegard herself suffered serious illnesses on many occasions throughout her life. She became sick when she refused to write down the visions God had granted her, and she fell deathly ill when Abbot Kuno refused to permit her to leave Disibodenberg and establish her own community (see pp. 12–15). In both cases she felt God afflicted her because of disobedience or stubbornness; once she or others obeyed God’s will, she regained her health. Hildegard’s theology frequently depicts illness as punishment for sin. The saint never employed remedies for any of her own illnesses but accepted her condition and waited for God’s healing.

HOLISTIC HILDEGARD

Despite recent skepticism regarding their origin, the medical-scientific perspectives of the Physica and Causae et curae complement the theology in Hildegard’s visionary works, giving credence to the long-standing tradition of her authorship. While the former writings deal with the healing of the physical body and the mind, the latter address spiritual wholeness and the soul’s well-being, which the body’s condition affects. Hildegard’s final visionary work, the Liber divinorum operum, synthesizes the physical and theological worlds, expanding her vision by discussing the elements, humors, illnesses, and other topics found in her medical-scientific works.

Hildegard’s worldview emphasizes the reciprocal relationship between Creator and creation. God is life and made all things for the good of humankind. The creation story in the Physica focuses on the importance of humanity: 

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.

In the Liber divinorum operum, God as Creator speaks: 

I flame above the beauty of the fields, and I shine in the waters, and I burn in the sun, the moon, and the stars. With the airy wind I quicken all things with some invisible life that sustains them all. 

Hildegard’s later visions see God embracing the universe as supreme judge and ruler, the macrocosm, with humankind situated at the center, the microcosm (see pp. 25–29). She reminds readers that God created the natural world for the benefit of humankind and admonishes them to care for this gift from God.

The physical greenness of plants and trees has a sacred counterpart in Hildegard’s concept of viriditas. God infuses life into all creation through this “greening power” or “greening force,” which provides not only for physical existence but for spiritual energy and health. Viriditas epitomizes the relationship between the natural and spiritual worlds, between God as Creator and the created world.

The depth and breadth of Hildegard’s medical-scientific knowledge was extraordinary, especially for a woman in the time and the place she lived. She wrote about traditional beliefs and practices, interpreting them according to her own understanding and incorporating her own ideas, some of which evolved over her lifetime. Most remarkable was her ability to make the natural world an essential part of her visionary experiences and to demonstrate the wonder of God’s creation.  CH