"Causes and Treatments of Diseases" – that's the German translation of Causae et Curae, the main natural science work by Benedictine abbess Hildegard of Bingen. If you want to understand the core of Hildegard's teachings—her ideas about people, illness, and well-being—you need to know this book. It's the key to everything else: her herbal recipes, her nutrition teachings, her temperament theories, her view of body and soul.
This article takes you through the origins, structure, and content of Causae et Curae, explains its adventurous journey through history, and shows what this 12th-century work still has to say today.
What you'll learn in this article
| Topic | Content |
|---|---|
| Name & Title | What Causae et Curae means—and what other names the work has |
| Origins | When and how the work was created; its relation to the Physica |
| Transmission | Why it was almost lost—and how it was saved |
| The 6 Books | Structure and content in detail |
| Hildegard's Teachings | Four elements, four humors, temperaments—the worldview |
| Physica vs. Causae et Curae | How the two main works differ |
| Modern Significance | What remains—and what should be viewed critically |
Name, Title, and Alternative Names
Causae et Curae is Latin and literally means "Causes and Remedies"—basically, "Causes and Treatments of Diseases." That's exactly the title of the leading modern German translation by Prof. Ortrun Riha (Beuroner Kunstverlag, 2011/2012): "Origins and Treatments of Diseases".
The work is also known by two other names in historical records: Liber compositae medicinae (Book of Composite Medicine)—that's what the canonization protocol of 1233 calls it, the first historical document that explicitly attributes the work to Hildegard. And originally, together with the Physica, it formed a single work called Liber subtilitatum diversarum naturarum creaturarum—"The Book of the Secrets of the Various Natures of Creatures."
Origins: When did Hildegard write Causae et Curae?
Hildegard's natural science works were created between about 1150 and 1160—while she was abbess at Rupertsberg near Bingen. They were the result of decades of observation: Hildegard welcomed people who came to her, studied traditions, and recorded her findings—dictated to her secretary Volmar.
Important to know: Causae et Curae is not a visionary work. It's not like her writings such as Scivias, where Hildegard wrote down divine revelations. Historians see it as everyday natural and experiential knowledge of the Middle Ages—a personal compilation of knowledge by an exceptionally observant woman of the 12th century, shaped by the monastic tradition of her time, ancient humoral theory, and her own perspective.
Originally, Causae et Curae and the Physica were one big work. The split into two separate books happened early in the 13th century—so, when many people who knew Hildegard personally were still alive. The exact reason isn't clear. Maybe the split matched their different practical uses: the Physica as a reference for herbs and recipes, Causae et Curae as a theoretical foundation.
The adventurous history of transmission: Almost lost, rediscovered in the 19th century
This is one of the most fascinating stories in medieval cultural history: Causae et Curae survives today thanks to just one manuscript.
While the Physica was still fairly widespread in the Middle Ages (five versions are known, the first print appeared in 1533 in Strasbourg), Causae et Curae was mostly forgotten after Hildegard's death. It's missing from the Rupertsberg Giant Codex—the complete edition of Hildegard's works, created during her lifetime or shortly after. No medieval library catalog listed the work, and no monastery made copies.
What survived: An almost complete copy from the 13th century, which somehow ended up in Denmark and is now in the Royal Library of Copenhagen. It's supplemented by the so-called "Berlin Fragment" (Staatsbibliothek Preußischer Kulturbesitz, Ms. lat. qu. 674), which fills a gap in the section on the elements at the end of the first book.
It wasn't until the mid-19th century that botanist Carl Jessen rediscovered the Copenhagen codex. Jean-Baptiste Pitra and Paul Kaiser published excerpts; Kaiser published the first complete edition of the Latin text in 1903 (Teubner, Leipzig). The first full German translation appeared in 1933 by Hugo Schulz. The current standard critical edition is by Laurence Moulinier (Akademie Verlag Berlin, 2003), and the modern standard translation is by Ortrun Riha (Beuroner Kunstverlag, 2011)—published by the Abbey of St. Hildegard Eibingen.
"Causae et curae is now the best-known and most widely read work of Hildegard of Bingen."
– From the foreword of the Abbey of St. Hildegard Eibingen in Ortrun Riha's edition (Beuroner Kunstverlag)
Structure: The six books of Causae et Curae
According to the standard edition by Ortrun Riha, the work contains 492 sections in six books:
| Book | Title (per Riha) | Sections | Main Content |
|---|---|---|---|
| Book I | The Order of the World | 1–55 | Cosmology, creation story, four elements, the place of humans in the cosmos, four humors, temperament theory |
| Book II | Origins and Treatments of Diseases | 56–352 | Systematic description by body region from head to toe |
| Book III | Recipes | 353–393 | Specific preparation instructions; herbs, spices and |
With 297 sections in the second book alone, the actual theory of illness is the heart of the work—and also the most practical part.
The Worldview of Causae et Curae: Macrocosm and Microcosm
Why does a book about illnesses start with the story of creation and the order of the universe? For a modern reader, that seems odd. For Hildegard, it was completely logical—and that's exactly the key to her way of thinking.
Hildegard's worldview is built on a single core idea: Humans are a reflection of the cosmos—a microcosm within the macrocosm. Just as the world is made up of four elements (fire, air, water, earth), humans are made up of four corresponding bodily fluids. Well-being is the harmonious balance of these fluids; illness happens when one fluid dominates.
Hildegard puts it like this—roughly quoted from the first book of Causae et Curae:
“Just as [the world] is made up of four elements, so [humans] are made up of four fluids (temperaments), and in a specific mixed ratio.”
This way of thinking wasn't invented by Hildegard—it comes from ancient teachings, especially Galen and Hippocrates, passed down through Arabic and early medieval writings. Hildegard's achievement was to fill this traditional system with her own observations, connect it with her mysticism, and translate it into the language of the 12th century.
The Four Elements and Their Assignments
| Element | Quality | Assignment according to Hildegard | Bodily Fluid / Phlegma Type |
|---|---|---|---|
| Fire | warm, dry | Warmth, vision | dry phlegma (siccum) |
| Air | warm, moist | Breath, hearing | moist phlegma (humidum) |
| Water | cold, moist | Blood, mobility | foamy phlegma (spumaticum) |
| Earth | cold, dry | Tissue, bones, upright posture | lukewarm phlegma (tepidum) |
The Doctrine of Temperaments: Hildegard's Unique Development
This is where Hildegard's intellectual independence really stands out. The ancient tradition recognized four temperaments (sanguine, choleric, melancholic, phlegmatic). In Causae et Curae, Hildegard describes 14 character types—separately for men and women—and connects them with specific tendencies.
Each type, according to Hildegard, has a characteristic disposition for certain behaviors and also certain virtues or vices. This is an early link between character and physical constitution. If you know yourself—your type, your fluids, your tendencies—you can live more consciously. This approach is still the truly fascinating part of Hildegard's teachings today.
The Second Book: The Systematic Description
With 297 sections, the second book is the core of Causae et Curae. Hildegard systematically works her way through the human body—from top to bottom. What she describes is one of the most comprehensive systems found in a medieval work.
Not included: surgical procedures for broken bones or injuries. That wasn't Hildegard's field—and not part of the monastic tradition of her time either.
Recipes, Prognoses, Moon: Books III to VI
Books III and IV, with a total of 108 recipe sections, are what practical Hildegard herbalism still uses most directly today. Here you'll find concrete instructions for herbal preparations, tinctures, ointments, and teas—many of them identical or related to recipes also found in the Physica.
Book V (Prognoses) contains rules for assessing the course of an illness—a kind of checklist of clinical signs. Book VI (Moon) covers the influence of the moon's cycle—a concept that was universally widespread in medieval tradition.
Physica vs. Causae et Curae: How Do the Two Main Works Differ?
| Physica | Causae et Curae | |
|---|---|---|
| Main Focus | Natural history: plants, animals, stones, metals—with uses | Teachings: origins of illness, theory of illness, recipes |
| Structure | 9 books, encyclopedic by natural kingdoms | 6 books, from cosmology to practice |
| Transmission | 5 manuscripts + fragments; first print 1533 | 1 main manuscript (Copenhagen) + 1 fragment |
| Character | Reference work, herbal manual | Theoretical foundational work |
| Relevance Today | Basis for concrete Hildegard recipes (herbs, spices, stones) | Basis for understanding Hildegard's view of humanity |
Simply put: If you want to know what Hildegard wrote about a particular plant, read the Physica. If you want to understand why Hildegard thought the way she did, read Causae et Curae.
Authenticity and Authorship: What the Research Says
You can't have an honest introduction without this question: Are Causae et Curae really entirely by Hildegard herself? Medieval studies give a nuanced answer.
Since the original manuscripts haven't survived and all existing texts are copies from the 13th century or later, most researchers today say: The works are essentially by Hildegard, but may have been edited, added to, or changed by scribes.
Backed up by external sources: The writings are mentioned in Hildegard's Vita, which was written shortly after her death, and appear in the canonization documents from 1233—under the
Alternative title Liber compositae medicinae.What Causae et Curae means today – and where you should be critical
The translator Ortrun Riha pointed out a tension that shapes how people deal with Hildegard’s work: between the historical text on one hand and modern interpretations on the other. Popular ideas about Hildegard’s teachings being instantly applicable often ignore the complex origins of the texts, their compiled nature, and the challenges of how they’ve been passed down.
That doesn’t mean Causae et Curae isn’t valuable today. On the contrary – it contains insights that go way beyond its own era:
Holistic thinking: Hildegard’s connection between character, mood, and physical constitution in her teachings on temperaments is a fascinating forerunner of modern holistic approaches. Her core idea – that body and soul are inseparable – is timeless.
Holism as a method: Hildegard doesn’t just treat individual symptoms, but looks at the person in the context of their whole life. Diet, sleep, movement, mood, season, constitution type – all of this plays a role in her descriptions.
Herbal knowledge with substance: Many of the plants mentioned in Books III and IV – wormwood, galangal, pellitory, fennel, thyme – are still being studied in modern botanical and phytopharmaceutical research. The herbal tradition Hildegard drew from had gathered knowledge over centuries that’s still fascinating today. You can find more about individual herbs in our overview of herbs according to Hildegard of Bingen.
Where you should be critical: Hildegard’s anatomy and physiology are based on medieval knowledge. Her descriptions of bodily fluids and organs aren’t modern science. If you read Causae et Curae, you’re reading medieval knowledge – with all its insights and all its limitations.
Where you can read Causae et Curae: Editions and translations
| Edition | Language | Special feature |
|---|---|---|
| Ortrun Riha (trans.), Beuroner Kunstverlag, 4th ed. | German | Authoritative standard translation; published by the Abbey of St. Hildegard Eibingen |
| Laurence Moulinier, Akademie Verlag Berlin, 2003 | Latin (critical edition) | Scholarly standard edition |
| Paul Kaiser, Teubner Leipzig, 1903 | Latin | First complete edition; historically significant |
| Hugo Schulz, Munich, 1933 | German | First complete German translation |
Causae et Curae and Hildegard’s teachings today
Much of what’s practiced today as Hildegard’s teachings – the doctrine of temperaments, spice blends, fasting cures, herbal recipes – has its theoretical roots in Causae et Curae. The Physica provides the raw materials; Causae et Curae provides the system of thought behind it.
You’ll find more about practical preparations from Hildegard’s writings in our articles on Hildegard of Bingen’s teachings, on nutrition according to Hildegard, and on our herbs and spices inspired by Hildegard’s teachings. Also check out our full range.
Summary
| Question | Answer |
|---|---|
| What does the title mean? | “Causes and Remedies” – German: “Origin and Treatment of Diseases” |
| When was the work written? | About 1150–1160 |
| How has it been preserved? | One manuscript (Copenhagen, 13th century) + Berlin fragment |
| How many books? | 6 books, 492 sections |
| What’s the central theme? | Human as microcosm; illness as imbalance of the four bodily fluids |
| Which translation? | Ortrun Riha, Beuroner Kunstverlag |
