HILDEGARD OF BINGEN - A TEMPORAL-LOBE EPILEPTIC, AN INGENIOUS WOMAN, OR BOTH?

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9l(363):6.16.853
Acta
Fac med
Pturn 1997;l?(l)$1'35
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AMIR
MUZUR
I
IURAJ
SEPCIC
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Neumcierrce
Sectot,
lnternational
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fm Adranced Studies
(585,+f
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Triesle, lta ly
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Ftcpihl CfiEicdCentrc
Riicfta,
Croaia
MEDTCAT FIYPOTHESIS
Keywords:
hlrtor;,
of r,rrcdicine,
mediwal;
epllepsy, cornplex partia
l.
AccSd:199G28-IA
ff we search for mental
dis€ases in the
persons
frorn
the pa*tt
it is not b€cause we are trying to dis-
cledit
them,
Rather
than reviging
our opinion on
thefi, we are
interested
in revising
our assumptions
ofi the diseases. ln these cases, it is impossible
to
prove
anything.llowever, it is
of great
importance
to pldvoke
discussidns leading
towards
a better un.
derstanding of our culture.
t tr{ildeU?fd
o{ Bingen
(Betmersheim
near Alzey,
Cermany,
1098
- ftupertrberg nunnery,
1t
79) is the
HILDEGARD
OI BINGEN.
A TEMPORAL-LOBE
EP|LEPT|C,
AN INGENIOUS
WOMAN,
OR
BOTH?
SUMMARY ln order to throw some new light upon the work and per-
sonality
of Hildegard
of Bingen
(1098-1
1 79), the famous medievat
vi-
sionary and philosopher, this article interpretes her writings from a par-
ticular point of view, examining the possibility that Hildegard sufferd
from the temporal-lobe
epilepsy.
The hypthesis was creatd on the ba-
sis of a symptom an4lysis,
using modern neuropsychiatric approachu
but considering historical specificities, as well. The syinptoms consid-
ered are of interictal
character
(changes
in sexual behavior, increared
re-
ligiosity, heightened
experience
of emotions, viscosity
of personality,
hy-
pergraphia,
and, the most important, hallucipations.
Are these characler-
istics
sufficient for considering somebody a temporal-lobe epileptic?
How many minds were
characterized by these
osymptoms"
and still rcv-
olutionized the course of the history?
Can the case of Hildegard
fu com-
pared to the background
of St. Paul's and Mohammed's
theological-et&t-
cal systems?
These
and other questions
of importance for both our medi-
cal and cultural concepts are discussed in this
paper suggesting
the pos-
sibility of a modern
analytical approach
to historicaldocuments.
most
famous
female
med i
eval
visionary, wel
l-known
already
to her
contemporaries. The rich written ma-
terials, originating from
her dictations, allow us
to
revisit
the
world
of her visions
and to examine
it
critically.
Already Hildegard's
noble
parents
rnust hqve
noticed very
soon that something had
to be
wrong
with
the
girl:she
was
constantly ill,
sufforing from
all kinds
of aches, always weak
end exhausted.
Hoping
that a pious
surrounding
could curc the
(ohh( 3t

A. Muzur,
l. Septid:
HILDECARD
OF BINCEN
- A TEMPORAL-LOBE EPILEPTIC, AN INCENIOUS WOMAN,
OR BOTH?
child, they delivered the girl to a convent.
Hildegard's sufferings, none the less, did not
cease
at all.
Hildegard
was
a strange combination of a wea-
kish,
by
pains
always tormented body, and
a mind
full of energy and
action. At the age of thirty-eight,
she
was directing the nunnery of Disibodenberg.
Several vears
later she
founded
another one at
Rupertsberg. She
traveled all
over
the Rhine
basin,
the Main region,
Schwaben, and Lotharingia,
preaching
with
ardor against the Catharrs and cor-
rupted clergy. She
wrote more than ten
books on
various
topics,
and
established an
unusual
corre-
spondence network
with the most
prominent
of her
contemporaries-emperors,
kings,
popes,
cardinals,
but
with many
common
people,
as
well.
In the time
which was more male
than any other,
giving
birth to
first crusades, and monastic and knightly orders, to
be
a woman
was already difficult enough, and to
express
publicly
her own thoughts
and
become a
moral authority was
almost
impossible for
a
woman.
There have already been
offered different theories
explaining Hildegard's singularity. Several authors
proposed
migraine
and scintillating scotoma''' as
the source of Hildegard's sufferings. Hildegard was
well acquainted
with migraineous
symptoms
(...nunc
in dextra
parte
capitis
nunc in sinistra.),3
and certain similarities between classic
(ophthalmic)
migraine and Hildegard's
case do really exist
(fe-
male
predominance;
scintillating
scotoma as the ex-
planation
of
visions;
alternations of
euphoria
and
depression;
etc.) However, it is
not typical
for mi-
graineous
patients
to present
interictal
mood and
behavior
alternations.
Could
have
the talents and
courage of Hildegard
originated from the state
known
to us
as
temporal-lobe
epilepsy?
According to Kaplan & Sadock, the major tem-
poral
-
lobe-epi lepsy
(=complex
partial
ep
i lepsy)
per-
sonality alterations are changes
in
sexual behavior
(far
more commonly, hyposexuality'); increased reli-
giosity
("heightened
interest in global
and
philo-
sophical concerns"); heightened experience of emo-
tions,s
viscosity
of personality
(conversation
is
"slow,
serious,
ponderous,
pedantic,
overly
replete
with non-essential
details, and often
circumstan-
tial");
hypergraphia
(some
authors
consider
this
symptom
as
"virtually
pathognomonic
for
complex
partial
epilepsy"), and,
finally,
"the
most character-
istic
symptoms of the
psychoses"-hallucinations.'
For
our discussion, the interesting elements of
the
temporal-lobe-epilepsy diagnosis
are that these
symptoms
are
of an interictal characte16, and that
one of the
risk factors is
female
gender
(unfortunate-
ly, we
do not have data
about
Hildegard's
possible
left-handedness, which would
add new risk factors).
Knowing nothing
more
than
general
monastic-
32
life
rules,
we can only
guess
about Hildegard's
sex-
ual
biography. Her relationship with her secretary
Volmar
is not strictly defined. From her writings,
nevertheless,
hyposexuality
can be
traced.
Among
the six
hygienic
regimes
the
man
should
pay
atten-
tion to, there is no mention of sexuality.'
Hildegard's miniature
tractates against
polygamy
(Cur
ante
incarnationem
Domini quidam
plures
ux-
ores haberunt);t against incest
(Quod
consanguinei
in conigio non copulentur)8;
in favor
of a reproduc-
tive sexual
intercourse,
only at the age
when the
man
in forti aetate
est,
ita quod venae ullius sanguine
plenae
sunt,
tunc
fertilis in semine suo est,8
and when the woman
iam fluxum sanguinis sui
partitur;"
Hildegard's
accusations of those
who practice
inter-
course during
pregnancy
for being baby-murders
(Qui in coitu praegnantis
se polluunt homicidae
sunt.);8 her theorizings
on eunuchs
(Sunt
enim eu-
nuchi
qui de matris utero
sic nati
sunt, et sunt eu-
nuchi
qui facti
sunt ab
hominibus,
et sunt eunuchi,
qui se ipsos castraverunt propter regnum
caelorum.)8 and the moral aspects
of night
pollu-
tions
(Although
the
point
is
again shifted towards
"(in)purity: " Si dormienti
homini
commotio seminis
in somnio subrepserit,
nolo ut ita in ardente calore
illo ad sacramentum officii altaris
mei accedat.\8-all
these
"excursions"
into the
world
of sexuality are
characterized by a scientifically cold, objective ap-
proach,
always with
a higher moral aim. Therefore,
an
explicit
propagation
of
virginity as the most ap-
preciated
quality'is
not
surprising
at
all.
An increased religious feeling,
combined
with
"philosophical
interests," another
feature
of the tem-
poral-lobe
epileptics
is not difficult to be
proved
in
the case of Hildegard,
constructing
an
entire
theo-
logical
system based
upon direct divine revelations:
Et iterum audivi vocem de caelo mihi dicentem:
"Clama
ergo et scribe sic!"8
(which
cannot miss reminding of
Jaynes'
"divine
voices",
originating
from
the
right hemisphere.')
The
revelations are
presented
in the first
person,
as if
Cod himself
would
be
giving
the directions.
An es-
pecially
accentuated
preoccupation
of Hildegard is
represented
by the discrimination of Cood
vs.
Evil,
stressing
precisely
the distinguishing bonum
and
malum as the major role of the
intellectus
(which
makes,
together
with voluntas, the anima).8
Hildegard
is more known for her visions,
which
she claimed to have
experienced
for
the first time at
about three
yearsr0
(some
other sources
mention
5
years").
Nevertheless,
for
a long
time she did not
collect enough courage to confide
it to anybody
(Pre
timorem autem,
quem
ad homines habebam,
quomodo viderem, nulli dicere audiebam.\" Ihe
Acta Fac med Flum 1997:22i.11:31-35

A. Muzur,
l. Sepdid:
HILDEGARD OF BINCEN
- A TEMPOML-LOBE EPILEPTIC,
AN INCENIOUS WOMAN, OR BOTH?
termination
of this "critical"
phase/
hence, when
Hildegard
was about forty, was stirred
up by inten-
sive
painful
torments:
When
I was neglecting these
ways which Cod
taught me of, because of being
afraid of people,
pains
of my body
augmented and
did not cease."
So Hildegard
discovered a kind of self-psy-
chotherapy:
when
she started
to note
the
visions,
the aches
were ceasing.to"t
lt is,
of course,
a ques-
tion
what
was
considered
as
"pains"
by
Hildegard?
Although she
mentions
"bodily"
disturbances
sever-
al times
(in his doloribus adhuc
laborarem; ot: cor-
pus
meum tantis
doloribus conterebafur,'etc.'2)
these
pains
were
atributed
by some authors to the
"trou-
bles
psychosomatiques,"
without entering deeper
discussions.'3
There
are some
indications that those
symptoms actually
reflected mood
variations:
I am often
seized by great
uneasiness
(Magna
egritudo iterum invasit me.\12
One should
remember
that
depressive mood,
anxiety, and sorrow, alternating
with maniacally
heightened frame of mind,
perfectly
fits
into tempo-
ral-lobe-epilepsy symptoms.'o
The
state
in which
Hildegard
was
experiencing
visions would
be cer-
tainly significant
for
our
discussion, but is not easily
determinable.
While some authors emphasize the
seeing
"in
the deepness of Hildegard's soul, but
pre-
serving the external sight,"'s
Hildegard herself writes
that she experienced a
vision
"[...]
so that all my viscera are
concussed and
my
corporeal sensuality
[sensitivity?1
is
extinct"
(ita
quod
omnia uiscera mea consussa sunt et sensuali-
tas
corporis mei ectincta est)12
(The
description
can
remind us
of the
"insub-
stantiality"
feeling,
mentioned by Williams.")
Hildegard's
contemporary Richard of St. Victor
dis-
tinguished four
types of
visions:
two spiritual and
two
physical
defining Hildegard's ones
as coming
"through
the eyes of the hearth". lt is not
clear
if
Richard of St. Victor's definition or simply nonmedi-
cal approaches
paved
the
way
for the
generally
ac-
cepted statement of non-ecstatic
nature of
Hildegard's visions
(cf
. "
die einzige
nichtekstatishe
Visioniirin
des
Hochmittelalters.,""
or Hildegard's
"ekstaseloses
Schauen.,"tt
etc.).
According
to a defi-
nition,
ecstasy
means nothing
but
"feeling of intense
rapture,"'
and the feeling
of "concussed
viscera"
could be interpreted
exactly
in
that sense.
Hildegard's visions
are very
often composed
of
simple
elements-flame, flash,
spark, shine, lapis,
lux,
splendor, lacus, ignis,
murus lapideus
as a leit-
motiv,
etc.:
Afterwards, I saw as if a large multitude
of living
torches,
having
great
brightness and receiving
fiery
flash,
would
be
in
this
way
illuminated
by
the
most
serene
splendor. And look!
There
emerges a lake
of
Acta Fac med Flum
1997;22(11:31-35
a huge
size
and depth, having a mouth like mouth
of a
waterwell, and sending off
fiery
smoke
with
a
lot of stench.
(Deinde vidi velut maximam multitudinem
viventium
lampadarum multam claritatem
haben-
tium, quae igneum fulgorem accipientes
ita serenis-
simum splendorem
adeptae sunt. Et ecce lacus mul-
tae
latitudinis et profunditatis
aparuit, os velut os
putei habens et igneum fumum cum multo foetore
emitfens.)'
Since, based on
these simple
elements, a very
complex
cosmological
and
philosophical
system
has been built
up
("conceptualization
and circum-
stantiality
warm and appropriate
in affect"
is
exactly
the
main differential-diagnostic
moment
between
temporal-lobe
epilepsy
and
schizophrenian),
the
question
"What
is
the
ratio
between
rational and
ir-
rational
portions
in Hildegard's
work?" seems to be
more
than
justified.
The
complicated "superstruc-
ture" of some
visions could be a subsequent
rational
imputation
as well as the explications of the
basic
visions.
(The figurative manner of expressing
thoughts
was well known
in
the
12th-century
philo-
sophical culture.'5)This
blending of irrational hallu-
cinatory elements
and rational amendments could
explain also the apperance
of contradictory theo-
ries, like,
for instance,
those of creation: the one
was
dicitated
by visions
and
(Neo)
platonic
"super-
naturalness", the other by Empedokleian and
H ippocratic
four-principles
doctrine.'s
Hypergraph ia as a temporal-lobe-ep
i lepsy char-
acteristic can be easily atributed to Hildegard.
Except the enormous correspondence
with hun-
dreds
of persons,
and three books of visions
(Schivias;
Liber vitae meritorum; Liber divinorum
operum), the
Bingenian nun ventured on declaring
herself
in
the
matters
of botany,
zoology, and
mine-
rafogy
(Physica),
medicine
(Causae
et curae);
upon
composing
a musical drama
(Ordo
virtutum); lyrics;
psalm
exegesis
(Expositio
Evangeliorum); and ha-
giographies
(St.
Rupert and St. Disibod). To this, two
books on her
private
secrete language
(Lingua
igno-
ta and Lifterae ignotae) should be added.
CONCLUSION
Heightened
emotional experiencing, exchang-
ing
of ecstatic and depressive,
uneasy mood, libido
deprivation or hyposexuality,
propagation
of strict
moral rules
and
preaching
against those
who are
vi-
olating them, circumstantiality
in
descriptions, ten-
dency
towards repeating,
obstinacy,
interpretation
of
many
events as symbolic or divine signs, hyper-
graphia,
deep
religiosity
and mysticism, metaphysi-
cal and moral
speculations, cosmological theories,
declarations
of helplessness
(paupercula
mulier in-
,
-
t\
-l
=l
,l
-l
;
I
\
\
33

A. MUZUT,
J.
SCPtiC:
HILDECARD
OF BINGEN A TEMPORAL-LOBE
EPILEPTIC, AN INCENIOUS WOMAN,
OR BOTH?
docta),
sedateness
and lack of humor
- are
these
characteristics
sufficient for
considering
somebody
a
temporal-lobe
epileptic?
How many
minds were
characterized
by these
"symptoms" and
still revolu-
tionized
the course
of the history?
Can the
case of
Hildegard
be compared to the
background
of the St.
Paul's
" and Mohammed's
theological-ethical
sys-
tems? In that
case,
we have
to confess that
the tem-
poral-lobe
epileptics can lead
our civilization
more
rapidly and more
strongly
than the non-epileptics.
In
that case,
we also have
to confess
that,
after thou-
sands of years
of human-thought
history, we still do
not
know
which
mental
diseases
have
to be called
"diseases"
at all, and which
ones should
be consid-
ered only
as
"differences".
One cannot
doubt in Hildegard's
intelligence:
according
to a study with a large number
of epilep-
tics, only
the
most intelligent
ones
were
able
to pro-
vide
an adequate description
of their experiences.'o
We should
not,
therefore,
draw a wrong
conclusion
that each
temporal-lobe
epilepsy results
in inge-
niousness.
According
to the
laws
of hysterical
imita-
tions or some favoring
circumastances
(Hildegard
certainly
"taught"
her
time to listen
at
the
woman's
voice),
a series of female
visionaries,
similar to
Hildegard,
appeared in
the Middle Ages
and after,
from
Elisabeth
of Schonau
" to Friedricke
Hauffe of
Wi.irttemberg
(19th
c. The
biography
of the latter
one
fascinantingly
resembles
that one of Hildegard:
visions
already as a
child,
physical
illness
becoming
more
and
more
severe, revelations
about
personal
and
general
matters received
from
disincarnate
spir-
its,
symbolic
representations
of spiritual
conditions,
periodical
use of an unknown
language,
prescrip-
tions of medications,
etc.)r2
Nevertheless,
none
of
those
"seeresses" ever
reached
the reputaton
of
Hildegard of Bingen;
the
reputation
which
would
be
maybe
even
greater
if we would
understand more
of
her
concepts.
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and evolution of dynamic
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New York: Basic Books, lnc., Publishers, 1970:79-81 .
Acta Fac med
Flum
1997;22(11:31-35

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