Anorexia mirabilis


Anorexia mirabilis, also known as holy anorexia or inedia prodigiosa or colloquially as fasting girls, is an eating disorder, similar to that of anorexia nervosa, that was common, but not restricted to the Middle Ages in Europe, largely affecting Catholic nuns and religious women. Self-starvation was common among religious women, as a way to imitate the suffering of Jesus in his torments during the Passion, as women were largely restricted to causing themselves voluntary pain by fasting, whereas holy men experienced suffering through physical punishment, voluntary poverty, and celibacy.

Overview

Etymology

Anorexia mirabilis comes from the latin meaning "miraculously inspired loss of appetite", whereas inedia prodigiosa means "great starvation".

Description

Anorexia mirabilis is primarily characterized by the refusal to eat, resulting in starvation, malnutrition, and oftentimes, death, but differs from anorexia nervosa in that the disease is associated with religion as opposed to personal aesthetics, although this behavior was usually not approved by religious authorities as a holy one. Though anorexia mirabilis is, by definition, connected to religion, particularly Catholicism, sufferers have been known to defy the orders of their religious superior to cease fasting and their refusal to eat sometimes preceded their involvement in religious activities. Additionally, sufferers engaged in worrisome and bizarre behaviors designed to cause them pain, so that they might be reminded of Jesus Christ's suffering, and desired to appear unattractive in hopes of avoiding marriage and sexual contact.
The self-starvation practice of anorexia mirabilis was a behavior only adopted by women, particularly in the Middle Age, as a way to imitate the suffering of Jesus in his torments during the Passion, as women preferred to experience this voluntary pain by fasting, whereas holy men experienced suffering through physical punishment. For this reason, they were often colloquially called "fasting girls", as there were no "fasting boys". This colloquial naming became the most common one in the Victorian era, with anorexia mirabilis being the term used only in medical circles.
Documentation exists regarding about two thirds of the holy women officially regarded by the Roman Catholic Church as saints, blesseds, venerables, or servants of God and who lived after 1200 AD showing that more than half of these displayed clear signs of anorexia, with extensive and highly reliable documentation being available for about two dozen of these.

History

The earliest reported sufferer of anorexia mirabilis is St. Wilgefortis, a legendary princess who reportedly lived sometime between the 8th century and 10th century in Galicia, who starved herself and took a vow of chastity to avoid an arranged marriage. She asked for God to make her ugly and she subsequently grew excessive facial and body hair, which is a common symptom of malnutrition in women. Her suitor rejected her based on her appearance and so, as punishment for sabotaging the union, her father, the king of Portugal, had her crucified. For her suffering, she was venerated in the Catholic Church.
Though the disease was most prominent during the Middle Ages, modern cases do exist. Notably, in 2014, medical researchers published an article about the case of an unidentified woman in her sixties, born in Chicago, Illinois, who'd suffered from anorexia mirabilis. The woman entered a convent at the age of 13 and began to restrict her eating in hopes of achieving sainthood.

Notable cases

Anorexia mirabilis has in many ways, both similarities to and clear distinctions from the more modern, well-known "anorexia nervosa".
In anorexia nervosa, people usually starve themselves to attain a level of thinness, as the disease is associated with body image distortion. In contrast, anorexia mirabilis was frequently coupled with other ascetic practices, such as lifelong virginity, flagellant behavior, the donning of hairshirts, sleeping on beds of thorns, and other assorted penitential practices. It was largely a practice of Catholic women, who were often known as "miraculous maids".
The anorexia nervosa of the 20th century has historical correlates in the religiously inspired cases of anorexia mirabilis in female saints, such as Catherine of Siena in whom fasting denoted female holiness or humility and underscored purity. The investigation of anorexia nervosa in the 20th century has focused on the psychological, physiological, and various other factors.
For Caroline Walker Bynum, anorexia mirabilis, rather than misdiagnosed anorexia, was a legitimate form of self-expression with motives set in contrast to the modern disease paradigm. She considers cases such as that of Julian of Norwich and other Christian anchorites, as using fasting as a legitimate means for communing with Christ.
Joan Jacobs Brumberg suggests that anorexia mirabilis no longer exists not because the motives of those who starve themselves have changed, but because the paradigms for coding these behaviors have shifted. If a young woman were to make the decision to self-starve as a means to communicate with Christ, healthcare professionals would code her as anorexia nervosa regardless of her motives.
Whether or not there is historical continuity between anorexia mirabilis and anorexia nervosa is a subject of debate with both medieval historiographers and the psychiatric community. Some have argued that there is historical continuity between the two conditions, while others maintain that anorexia mirabilis should be comprehended as a distinct medieval form of female religious piety within the historical context of such societies.

Historical instances

Anorexia mirabilis was frequently accompanied by behaviors most medical professionals today would find worrisome and dangerous. Angela of Foligno was known to eat the scabs of the poor and Catherine of Siena was known to drain the pus from sick individuals into a cup to drink.
Many women notoriously refused all food except for the holy Eucharist, signifying not only their devotion to God and Jesus, but also demonstrating, to them, the separation of body and spirit. That the body could exist for extended periods without nourishment gave people of the time a clear picture of how much stronger, and therefore how much more important, the spirit was. It mattered not in popular opinion that the reported periods of female fasting were impossibly long and simply added to the allure of this very specifically female achievement.
Both Angela of Foligno and Catherine of Siena were reportedly anorexia mirabilis sufferers. They both refused food, but drank the pus from the sores of the sick. Angela of Foligno is reported to have said it was as "sweet as the Eucharist", and also to have eaten the scabs and lice from those same patients, though precious little else.
In the time of Catherine of Siena, celibacy and fasting were held in high regard. Ritualistic fasting was both a means to avoid gluttony, and to atone for past sins. Catherine initially fasted as a teenager to protest an arranged marriage to her late sister Bonaventura's husband. Bonaventura herself had taught this technique to Catherine, refusing to eat until her husband showed better manners. Fasting then was a means of exercising some control, taking power back for the individual and as such it is similar to one of the underlying factors in anorexia nervosa today. Thus, women could gain more freedom and respect remaining virgins than they would becoming wives. Catherine managed to pursue her interests in theology and papal politics, opportunities less likely available to a wife and mother.
She purportedly lived for long intervals on practically no food save the Eucharist, leading to an untimely death at thirty-three years from starvation and emaciation.
Any additional food she was forced to eat she would expel through vomiting induced by pushing a twig or small branch down her throat.
Marie of Oignies reportedly lived as a hermit, wore only white, cut off pieces of her body to expunge her desire, and both she and Beatrice of Nazareth claimed that not only did the smell of meat make them vomit, but also that the slightest whiff of food would cause their throats to close up entirely.
A gang of would-be rapists got as far as removing the clothing of Columba of Rieti, but they retreated as she had mutilated her breasts and hips so thoroughly with spiked whipping chains that they were unable or unwilling to continue. Columba did eventually starve herself to death.

Perceived benefits

Many of these women felt that they possessed at least some measure of spiritual enlightenment from their asceticism. They variously said they felt "inebriation" with the sacramental wine, "hunger" for God, and conversely, that they sat at the "delicious banquet of God".
Margaret of Cortona believed she had extended communications with God himself. Columba of Rieti believed her spirit "toured the holy land" in visions, and virtually every one of these women was apparently possessed of some level of psychic prowess. These women's exercises in self-denial and suffering did yield them a measure of fame and notoriety. They were said to alternately be able to make a feast out of crumbs, exude oil from their fingertips, heal with their saliva, fill barrels with drink out of thin air, lactate even though virginal and malnourished, and perform other miracles of note.
The practice of anorexia mirabilis faded out during the Renaissance, when it began to be seen by the Church as heretical, socially dangerous, or possibly even Satanically inspired. It managed to survive in practice until nearly the 20th century, when it was overtaken by its more popularly known counterpart, anorexia nervosa.
Contemporary accounts of anorexia mirabilis do exist, most notably that of a fundamentalist Christian girl in Colombia, as reported by medical anthropologist Carlos Alberto Uribe.