Sacks quotes this description in his book "Migraine," after having minutely detailed the various forms of the "aura," visual hallucinations experienced by people with classical migraines: brilliant flashes of light or geometric patterns sweeping across the visual field. The close correspondence of Hildegard's visions to the characteristic figures of the migraine aura leads Sacks to conclude that the visions were "indisputably migrainous."
In contrast to "Hildegard's allegorical interpretation," he offers his own "literal interpretation ... that she experienced a shower of phosphenes [radiant lights or sparks] in transit across the visual field, their passage being succeeded by a negative scotoma [absence of vision]." He remarks further on how "a physiological event, banal, hateful, or meaningless to the vast majority of people, can become, in a privileged consciousness, the substrate of a supreme ecstatic inspiration." For him, the migraine is fundamentally a physiological event with no intrinsic meaning; the inspiration Hildegard drew from it was a function of her genius.
But to medieval people pain was as much an attribute of the body as pleasure, and equally meaningful. Thus for Hildegard, the fact that these visual manifestations may have been accompanied by pain was not their primary meaning; rather, they were a gift of grace from God. The use of her physiology as a medium of transmission would not detract in the slightest from their significance; nor would she feel, as we do, that the first imperative was to get rid of them.
In examining women's relationship to pain, then, it is important to cast our imagination beyond the limits of the categories imposed by our culture and to look at pain as a plastic phenomenon that flows into varying configurations depending on place, time and circumstance. For even in this post-Descartes age, pain acquires meaning beyond physiology.
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