Chapter VIII: Anatomy and Physiology

Hildegard’s ideas on these subjects are set out in the fourth vision of the _Liber Divinorum Operum_, which is devoted to a description of man’s body according to the macrocosmic scheme. This setting makes her account by no means easy to read, while it increases the difficulty of tracing the origin of her views.

The list of works containing anatomical descriptions available to a German writer in the early Middle Ages is not long. Avicenna was hardly yet accessible, and only such scraps of Galen as appear in Constantine and the Salernitans. The available works may be enumerated thus:

(_a_) The short _Anatomia porci_ of Copho of Salerno, dating from
about 1085.[95]

(_b_) An anonymous Salernitan anatomy,[96] written about 1100 and
largely based on Copho and Constantine.

(_c_) The _Liber de humana natura_ of Constantine the African,
written probably between 1070 and 1085 at Monte Cassino.[97]

(_d_) Constantine’s _De communibus medico cognitu necessariis locis_,
written about the same time as the above.[98] This work is in
four books, of which the second, third, and fourth are devoted
to anatomy and physiology.

(_e_) Here may be placed also Constantine’s translation of the
_Viaticum_ of Isaac Judeus. Both these latter works of
Constantine are long and technical, and designed for the use of
the trained physician.

In addition to these there was in the Middle Ages a definite anatomic tradition, which expressed itself constantly in:

(_f_) A series of five anatomical diagrams representing respectively
the arteries, veins, bones, nerves, and muscles[99] (see Plate
XXXIII, opposite page 92 of the present volume). These diagrams
were copied in the most servile fashion for centuries, and
something very like them has remained in use to this day in
Tibet.[100] The versions, whether in Persia or England, in
Germany or Italy, were remarkably uniform.

(_g_) In several MSS. there has been found attached to these
remarkable diagrams a short text describing the five systems,
arteries, veins, nerves, bones, and muscles. This text,
however, purporting to be from Galen, has little relation to
the figures, which it does not really explain, and it should
therefore be regarded as a separate work.[101]

Plate XIX. BIRTH. THE ARRIVAL AND TRIALS OF THE SOUL]

Plate XX. DEATH. THE DEPARTURE AND FATE OF THE SOUL]

Of these seven sources it appears to us that (_c_) and (_f_)--the short _De humana natura_ of Constantine, and the five-figure series--are those on which Hildegard drew. The absence of Arabisms and the scarcity of technical anatomical terms in her writings, her failure to distinguish between veins and arteries, the absence of anything of the nature of myology or osteology, together with the neglect of the spinal marrow as an important organ, make it very unlikely that she consulted Constantine’s longer works or the Salernitan authorities or the text of the five-figure series. Her anatomical descriptions resemble those of Constantine’s shorter work, on the other hand, in the description of the three vesicles of the brain and their relations to the faculties of the mind, in the treatment of the five senses, in the view of the influence of the planets on the child and the emphasis laid on epilepsy, as well as in the absence of any distinction between arteries and veins, and in the loose doctrines of the humours and of the causes of deformities and monstrosities. In some of these respects also her account of the human body presents points of resemblance to the _De hominis membris ac partibus_ of Hugh of St. Victor,[102] with whom, however, her contact appears to be less close than with Constantine.

We may infer that Hildegard had consulted anatomical diagrams and was accustomed to this method of representing the organs from a passage descriptive of the microcosm, in which she says that ‘in the mouth of the figure in whose body was the disk, I saw a light brighter than the light of day, in the form of threads, some circular, some in other geometrical forms, and some shaped like human members belonging to the figure, which was clearly portrayed on the disk upright and accurately limned’.[103] These ‘circles and geometrical figures’ fairly describe the highly diagrammatic manner in which the five-figure series represents the internal organs, and several points suggest that she does indeed refer to this series. Her description of the abdominal muscles (_umbilicus_) ‘covering the viscera like a cap’, her general descriptions of the vessels (_venae_) and the muscles, and especially her account of the vessels of the leg and of the intimate relations of the main _venae_ to the organ of hearing, fits in perfectly with the form of these remarkable diagrams (Plate XVIII).

We here render some of the most important of her general anatomical descriptions:

‘The humours may pass to the liver, where wisdom is tested, having
been already tempered in the brain by the strength of the spirit,
and having absorbed its moisture so that now it is plump, strong,
and healthy.

‘In the right of man is the liver and its great heat, so that the
right is swift to act and to work;[104] but towards the left are
heart and lung, which fortify the body for its task and receive
their heat from the liver as from a furnace. But the vessels of
the liver, affected by the agitation of the humours, trouble the
venules of the ear of man and sometimes confound the organ of
hearing....

‘I saw also that sometimes the humours seek the navel, which covers
the viscera as a cap, and holds them in, lest they be dissipated,
and maintains their course and preserves the heat both of them
and of the veins.... But sometimes the humours seek the loins
(_lumbos_),[105] which mock, deceive, and endanger the virile
powers and which are held in place by nerves and other vessels; in
which, nevertheless, reason nourishes so that man may know what to
do and what to avoid....

‘And the same humours go to the vessels of the reins and of other
members, and pass in their turn to the vessels of the spleen, and
then to the lungs and to the heart; and they meet the viscera
on the left where they are warmed by the lungs, but the liver
warms the right-hand side of the body. And the vessels of the
brain, heart, lung, liver, and other parts carry strength to the
reins, whose vessels descend to the legs, strengthening them; and
returning along with the leg vessels, they unite with the virile
organ or with the womb as the case may be.

‘And as the stomach absorbs food, or as iron is sharpened on a
stone, so do they bring the reproductive power to those parts.

Plate XXI. THE FALL OF THE ANGELS]

‘Again, the muscles of the arms, legs, and thighs contain vessels
full of humours; and just as the belly has within it viscera
containing nourishment, so the muscles of arms, legs, and thighs
have both vessels and the [contained] humours which preserve man’s
strength.... But when a man runs or walks quickly, the nerves about
the knees and the venules in the knees become distended. And since
they are united with the vessels of the legs, which are numerous
and intercommunicate in a net-like manner, they conduct the fatigue
to the vessels of the liver, and thus they reach the vessels of the
brain, and so send the fatigue throughout the body. But the vessels
from the reins pass rather to the left leg than to the right,
because the right leg gets its strength more from the heat of the
liver. And the vessels of the right leg ascend as far as the renal
and kindred vessels, and these latter vessels unite with those of
the kidney. And the liver warms the reins which lie in the fatness
derived from the humours....

‘The humours in man are distributed in just measure. But when they
affect the veins of the liver, his humidity is decreased and also
the humidity of the chest is attenuated; so that thus dried, he
falls into disease of such a nature that the phlegm is dry and
toxic and ascends to the brain. There it produces headache and pain
in the eyes and wasting of the marrow, and thus if the moon is in
default he may develop the falling evil [epilepsy].

‘The humidity also which is in the umbilicus is dispersed by the
same humours, and turned into dryness and hardness, so that the
flesh becomes ulcerated and scabby as though he were leprous,
if indeed he do not actually become so. And the vessels of his
testicles, being adversely affected by these humours, similarly
disturb the other vessels, so that the proper humidity is dried up
within them; and thus, the humours being withdrawn, impetigos may
arise ... and the marrow of the bones and the vessels of the flesh
are dried up, and so the man becomes chronically ill, dragging out
his days in languor.

‘But sometimes the humours affect breast and liver ... so that
various foolish thoughts arise ... and they ascend to the brain
and infect it and again descend to the stomach and generate fevers
there, so that the man is long sick. Yet again they vex the minor
vessels of the ear with superfluity of phlegm; or with the same
phlegm they infect the vessels of the lung, so that he coughs and
can scarce breathe; and the phlegm may pass thence into the vessels
of the heart and give him pain there, or the pain may pass into the
side, exciting pleurisy; under such circumstances also, the moon
being in defect, the man may lapse into the falling sickness.’[106]
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Sometimes Hildegard’s anatomical ideas can be paralleled among her contemporaries. Thus the following passage on the relationship of the planets to the brain is well illustrated by a diagram of Herrade de Landsberg.

]

‘From the summit of the vessel of the brain to the extremity of the
forehead seven equal spaces can be distinguished. Here the seven
planets are designated, the uppermost planet in the highest part,
the moon in front, the sun in the middle and the other planets
distributed among the other spaces’ (Fig. 9).

Plate XXII. THE DAYS OF CREATION AND THE FALL OF MAN]