Causae et Curae

In 1151, Hildegard completed her first visionary work, Scivias (“Know the Ways”). Around the same time, she started work on her practical guides to nature and healing, originally called “Liber subtilitatum diversarum naturarum creaturarum” (the “Book of the Subtleties of the Diverse Nature of Creatures”). This tome was later broken into two volumes now known as  “Causae et Curae” and “Physica”.

Hildegard’s Causae et Curae

Both Causae et Curae and Physica deal with the qualities of nature and man. They include parts physiology, pathology, sexuality, and theology. Causae et Curae emphasized the specific causes of disease along with their corresponding natural treatments while Physica focused on natural science and medicine as a whole.

The Dubious Authorship of Causae et Curae

Researchers today remain puzzled by Hildegard of Bingen’s writings on natural healing because they were the first of their kind to appear during that time. Equally as intriguing was the manner in which they were written. Hildegard’s typical practice – as was appropriate for her station, was to exclusively use Latin in such texts. Her writings, however, included both German and Latin phrases.

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Woodcut of Hildegard von Bingen

These inconsistencies have fueled some uncertainty about whether to attribute Causae et Curae to Hildegard alone (if even at all) or to multiple authors that may have altered or contributed to the texts.  Most modern scholars, however, support Hildegard’s authorship. In light of the emphasis on themes central to Hildegard’s philosophy involving man’s creation in nature as a primary healing force, scholars support the theory that Hildegard did indeed author Causae et Curae. Her distinctive philosophical position would not easily lend to multiple or surrogate voices. But given that the oldest manuscripts date back to the 13th century, it is also a fair assumption that they were likely edited or revised from the original.

By the 13th Century, the original piece, “Liber subtilitatum diversarum naturarum creaturarum” (the “Book of the Subtleties of the Diverse Nature of Creatures”) had been divided into two works, Causae et Curae and Physica. 

Origins of Causae et Curae

The origins of Causae et Curae are further complicated by the fact that only one traditional manuscript remains from the 13th century, stored at the Royal Library in Copenhagen. The only other surviving document is a text fragment from the same period, which is preserved at the Berlin State Library.


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Image from manuscript by Hildegard of Bingen

Evidence supporting Hildegard’s authorship includes records dating from her canonization process in 1233, wherein she is credited, albeit under another title “Liber compositae medicinae” with writing Causae et Curae. The revised title found in canonization records apparently never stuck.

The Compelling Origins of Physica

In contrast to Causae et Curae, Hildegard’s second naturopathic work, Physica survives in several traditional manuscripts. However, like with Causae et Curae, no original manuscripts of Physica exist, with a clearly identified author. The oldest known version of Physica remains in the German town of Wolfenbüttel, with the title “Liber subtilitatum de diversis creaturis” (the “Book of Subtleties among Diverse Creatures”).

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Image from first print of Physica, 1533

In 1983, a monk from Trier, in southwest Germany discovered a 13th century manuscript entitled “Physica Hildegardis. Liber subtilitatum diversarum naturarum creaturarum“.

Through further examination into the authenticity of these works, readers begin to appreciate the dynamic nature of Hildegard medicine. It is clear that Hildegard medicine derived from aggregating the knowledge that had preceded her, but it is also likely that her work continued to evolve further after her death through fragmentation and compilation by others.

The content of these records follows the unique visions and philosophies present throughout the body of Hildegard of Bingen writings. In addition, the focus on distinctive health conditions similarly validates Hildegard’s influence. Specifically, Hildegard would not shirk from taboo subjects like sexuality and the female reproductive system.

Speculation will most likely persist over Hildegard’s authorship of “Causae et Curae” and “Physica“. The close relationship between these writings and her visionary work, however, along with the credit she had received during her early canonization process all suggest, at a minimum, the core themes derive from Hildegard.

6 Books of Causae et Curae

Causae et Curae consists of six books combined in a single volume. Much like the framing of ancient mythology into three component parts, including departure, journey, homecoming, Causae et Curae follows the triad of creation, the fall of man, and salvation on judgment day.

As in Joseph Campbell’s understanding of myth, Margret Berger proposes this triad parallels the human triad of birth, the journey of life (including the perils of sin and disease), and death.


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Excerpt from Causae et Curae

Book One: Chapters 1-55

The first book deals with the order of the world. It describes creation, the structure, components, and formation of the universe. The book includes descriptions of celestial phenomena, including lunar and solar cycles. In addition, we learn about the planet, its elements, different types of water, and the various regions of the earth.


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Humans are miniature versions of the cosmos

Theological and anthropological issues appear from Hildegard’s perspective. We learn through Hildegard’s worldview that humans possess the same components as the universe and are thus miniature versions of the cosmos. This section also briefly explores Lucifer’s fall from Glory.

Book Two: Chapters 56-352

Book two, the longest section of the volume, addresses the origins and treatment of diseases. The first reference comes from the Book of Genesis and the original sin committed by Adam and Eve by consuming the fruit of the tree of knowledge, resulting in the fall of man. The book then explores the differences between man and woman in the context of creation.

Here Hildegard examines the different temperaments of man, including the effects of varying elements. The book takes us through the human body and soul, tying all of it to the causes and consequences of biblical flood. Through her descriptions of bodily juices the book identifies individual illnesses and their treatment methods.

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The description of our human condition logically starts with embryology, the birthing process, and child development. The book continues by focusing on women’s health conditions, including the menstrual cycle and its relationship to the lunar cycle.

Book two delves into a complete description of the human body, from top to bottom. Starting with the head and eyes, the book examines our digestive system, the urinary system, and common conditions such as gout and fever. Book two focuses on the most relevant conditions of that time and evaluates therapeutic measures, including nutrition, blood-letting, cupping, and cauterization.

This book concludes with an evaluation of the physiology of pleasure and emotions, where Hildegard’s emphasis relies on discipline.

Book Three: Chapters 353-391

The third book deals with natural remedies, addressing the universe of health conditions throughout the body. These formulas address the body from head to toe, starting with the head, eyes, teeth, and moving along to the digestive system, kidney and bladder, along with the functioning of male and female sex organs. As was probably common at that time, there is a focus on gout, wounds, and ulcers.

Book Four: Chapters 392 to 460

As in book three, the fourth book also describes remedies, this time expanding on formulas for the treatment of less common conditions like poisonings, cramps, jaundice, edema and inflammation, epilepsy, and internal parasites. This section also explores the treatment of health conditions in animals.

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Remedies were introduced in Chapter 3

Book Five: Chapters 461-492

In the fifth book, Hildegard focuses on symptoms and prognoses. Starting with the eyes, this section considers face color, voice, awareness, the pulse, urine, bowel movements and other bodily functions and effects.

Book Six: Chapters 493-530

The sixth and final book presents the influence of the moon on the human organism, describing how it affects our character and constitution throughout our lives, from the date of conception until death.

Hildegard’s Causae et Curae goes beyond identifying the symptoms and treatment of disease. The book delves into the overall human condition, beginning with creation of man and the universe in the image of God, and how the responsibilities and frailties of man integrate him into the universal order of the cosmos.

The more you know, the more you know you don’t know

The 12th century was a period of significant change. People’s daily life started to improve through advancements in agriculture and the subsequent urbanization, which assembled people from all walks of life.

Intellectually, this was the age of reason. Like the disparate people who occupied cities, ideas coalesced from far-reaching cultures like Byzantium and the Arab Empire. These new ideas were enthusiastically received through new channels opened by trade and commerce.

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Europe in the 12th century

Faith was no longer the only answer for life’s mysteries. Ancient writings emerged on the subjects of philosophy, mathematics, and medicine. For the first time, these works were received with broad approval from the emerging scholars, rather than immediate dismissal as heresy. The surroundings were no longer taken at face value, but rather questioned thoroughly to understand the meaning of all things.

Hildegard’s place in this change

Hildegard of Bingen is no exception. Through her natural science works, Physica and Causae et Curae, Hildegard reflects the spirit of the times. She embodies this spirit through her tireless observations and attempts to rationalize the relationship among human beings with the divine and natural worlds. Her examination spans broadly, from subjects as expansive as the universe, to the various genera of fish that occupy the waters near Bingen (in Physica).

Even the title of the once aggregated work, “Liber subtilitatum diversarum naturarum creaturarum” (the “Book of the Subtleties of the Diverse Nature of Creatures”) informs Hildegard’s perspective. The title speaks to her rational observations of the world surrounding her.

Reconciling the Past with a Brave New World

Even as it relates to taboo subjects such as human passions and sexuality, Hildegard takes the same rational approach to describing basic processes in the human body. Hildegard’s observations go beyond the human form, she also delves into natural phenomena, attempting to find rational, physical causes for occurrences, such as rain, dew, or lunar eclipses.

Hildegard’s work also reflects the upheavals her time. Both Causae et Curae and Physica present the conflict between old and new that had been brewing in the 12th century. Hildegard attempts to aggregate past thinking with intellectual developments by uniting theological underpinnings with emerging natural history. Her intrepid curiosity and openness to challenging subjects underscores her impact.

Validity of Hildegard Medicine

Regarding Hildegard’s medical texts, the question arises whether her theories and treatments were in harmony with existing healing practices known at that time.  Along the same lines, the question arises as to where and how Hildegard acquired all of her knowledge.

Assuming western medicine had its origins in ancient Greece, and expanded in the Arab world, Hildegard of Bingen medicine represented an aggregation of those practices. Her time was marked by ideas travelling along merchant routes from the Far East to Western Europe. Though she lived during the final phase of monastic medicine, her practices and techniques embodied what had been learned over centuries of practice.

Humoral Medicine Found in Causae et Curae

The basis of treatment described in Causae et Curae is humoral pathology or the four juices doctrine.  This was an approach first explored by the ancient master of medicine, Galen. Hildegard adopted the concept of four juices, integrating man with the four elements (air, fire, wind, earth) of his natural environment.

Likewise, influence from the Arabic Materia Medica finds its way into Causae et Curae with information related to the medicinal treasures traditionally found in nature, along with generally recognized dietary practices and surgical procedures.

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Blackberry, Dioscurides, early 6th century

The Greening Power of Viriditas

In addition, to aggregating the known medical practices up to that time, Hildegard introduces new concepts based on her own visions and philosophies. Hildegard reevaluated the primary elements involved in the human condition and also discovered a whole new remedy that remains overlooked in large part by medical systems, Viriditas.

Hildegard emphasized the greening force of Viriditas, symbolizing the fertile life-giving force of the universe. This is the gift from God that allows us to serve as the gardener of our own bodies.

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