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Catherine of Siena

Anorexia mirabilis, also known as holy anorexia or inedia prodigiosa or colloquially as fasting girls,[1][2][3] is an eating disorder, similar to that of anorexia nervosa,[1][2] that was common in, but not restricted to, the Middle Ages in Europe, largely affecting Catholic nuns and religious women.[3][4] 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.[3]

Overview

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Etymology

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Anorexia mirabilis comes from the Latin meaning "miraculously inspired loss of appetite", whereas inedia prodigiosa means "great starvation".[1][2]

Description

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Anorexia mirabilis is primarily characterized by the refusal to eat, resulting in starvation, malnutrition, and oftentimes death. It 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.[3] Though anorexia mirabilis is, by definition, connected to religion, particularly Catholicism, those who experience it 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.[3] People with anorexia mirabilis 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.[3] Inedia refers to the claimed ability for a person to live without consuming food.

The self-starvation practice of anorexia mirabilis was a behavior only adopted by women, particularly in the Middle Ages, 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.[3] For this reason, they were often colloquially called "fasting girls", as there were no "fasting boys".[2] This colloquial naming became the most common one in the Victorian era, with anorexia mirabilis being the term used only in medical circles.[1]

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.[5]

History

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The earliest reported case of anorexia mirabilis is St. Wilgefortis, an uncanonized, legendary, Catholic 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 God to make her ugly. 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 unofficially venerated by Catholics.[6]

Though the disorder was most prominent during the Middle Ages, modern cases exist. In 2014 medical researchers published an article about an unidentified woman in her sixties, born in Chicago, Illinois, who had experienced anorexia mirabilis. The woman entered a convent at the age of 13 and began to restrict her eating in hopes of achieving sainthood.[6]

Notable cases

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  • Pelagia of Antioch was a Christian saint and hermit in the 4th or 5th century who died as a result of extreme asceticism, which had emaciated her to the point she could no longer be recognized.
  • Marie of Oignies (1177–1213) went to great lengths to cause herself physical pain, wanting to suffer as Jesus Christ had. She deprived herself of sleep. When she did eat, which was very little, she favored bread so stale that it would cause her gums to bleed. She made the choice to live in poverty despite being from a wealthy family, and abstained from sex despite being married. Like other cases of anorexia mirabilis, she eventually refused to eat any food other than the consecrated Hosts, and died at the age of 36.[7]
  • Wilgefortis of Portugal was a legendary Portuguese infanta who took a vow of virginity and began to starve herself to avoid marriage. She reportedly prayed to be made ugly, which resulted in her attaining an unsightly countenance, which people likely assumed to be a work of God. She was ultimately crucified. She was later venerated as a saint within the Catholic church.[6]
  • Catherine of Siena (1347–1380) was known to fast for long periods of time. Towards the end of her life, when her condition was at its worst, the only food she consumed was a single consecrated Host given to her as part of the daily Eucharist. She defied orders from her religious superiors to eat, claiming she was too ill to do so. In the month before she died, at the age of 33, she lost the use of her legs and her ability to swallow. In addition to restricting her food intake, Catherine was known to use insert sticks into her throat in order to activate her gag reflex and induce vomiting, as someone with bulimia nervosa would do.[3][8]
  • Columba of Rieti (1467–1501) bears a number of similarities to Catherine of Siena, including the cutting of her hair to avoid an arranged marriage and the refusal to eat prior to her involvement in religious work. Like Catherine, towards the end of her life, Columba restricted her food consumption to only what was given to her as part of the daily Eucharist and died at the age of 34. She wore a hairshirt, and slept on thorns.[9]
  • Therese Neumann (1898-1962) drank no water and ate no food other than The Holy Eucharist from 1926 until her death,[10] despite her "stocky build".[11][12]
  • Jane (born c. 1948) was a woman from Chicago, United States, who began to restrict her eating at the age of 13 in hopes of being a nun and later, a saint. Her weight worried those at the convent, and she was dismissed from her religious training due to concerns over her health. Her malnutrition caused amenorrhea and likely affected her development, as she grew to be only 4' 10" tall, but did not experience any form of dwarfism. At the age of 66, she weighed only 60 pounds.[6]

Comparing anorexia mirabilis and "anorexia nervosa"

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Anorexia mirabilis has in many ways, both similarities to and clear distinctions from the more modern, well-known "anorexia nervosa".[1][2][3]

In anorexia nervosa, people usually starve themselves to attain a level of thinness, as a way of dealing with sexual or other trauma, undiagnosed mental illness, or as a form of self harm. It is also typically, but not always, associated with body image distortion. In comparison, 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 (1347–1380) 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.[13]

Medieval scholar Caroline Walker Bynum (Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women, 1988) argues that 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.[14]

American social historian Joan Jacobs Brumberg suggests in Fasting Girls: The History of Anorexia Nervosa (1987) 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 having anorexia nervosa, regardless of her motives.[14]

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.[15] Others maintain that anorexia mirabilis should be comprehended as a distinct medieval form of female religious piety, within the historical context of such societies.[16]

Historical instances

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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 once drank pus from the sore of a sick woman.[17]

Many women refused all food except for the holy Eucharist, signifying not only their devotion to God and Jesus, and 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, from months to many years, and added to the allure of this very specifically female achievement.

Marie of Oignies (1167–1213) reportedly lived as a hermit, wore only white, and cut off pieces of her body to expunge her desire. Both she and Beatrice of Nazareth claimed that the smell of meat made them vomit, and that the slightest whiff of food would cause their throats to close up entirely.[18][19]

Angela of Foligno

Both Angela of Foligno (1248–1309) and Catherine of Siena (1347–1380) were reportedly anorexia mirabilis sufferers.[20]

In the time of Catherine of Siena, celibacy and fasting were held in high regard. Ritualistic fasting was both a means to avoid gluttony, one of the seven deadly sins, 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 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 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. [21] She purportedly lived for long intervals on practically no food except the Eucharist,[22] leading to her death at 33 years old from starvation and emaciation.[21]

Any additional food she was forced to eat she would expel through vomiting induced by pushing a twig or small branch down her throat.[23]

In 1387, Blessed Pierre de Luxembourg died at the age of 17 due to a combination of exhaustion from anorexia and fever.[24]

A gang of would-be rapists got as far as removing the clothing of Columba of Rieti (1467–1501), 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.[25][failed verification][26]

Perceived benefits

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Saint Margaret of Cortona

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".[citation needed] Margaret of Cortona (1247–1297) believed she had extended communications with God himself, and Columba of Rieti believed her spirit "toured the holy land" in visions.

Virtually every one of these women apparently believed herself to be, or was believed by others to be, 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.[26]

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.[27]

21st century

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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.[28]

Works

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  • The Wonder (film), a 2022 film based on the historical novel of that title by Emma Donoghue

See also

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References

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Sources

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  • Bell, Rudolph M. (June 15, 1987). Holy Anorexia. University of Chicago Press.
  • Brumberg, Joan Jacobs (October 10, 2000). Fasting Girls: The History of Anorexia Nervosa (Subsequent ed.). Vintage.
  • Bynum, Caroline Walker (January 7, 1988). Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women (New ed.). University of California Press.
  • Vandereycken, W. (July 1, 1994). From Fasting Saints to Anorexic Girls: The History of Self-Starvation. NYU Press.
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Anorexia mirabilis

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Anorexia mirabilis, also termed holy anorexia or prodigiosa, refers to the claimed miraculous abstinence from food by certain historical religious figures, predominantly female Christian mystics in medieval , who purportedly sustained themselves through divine intervention or minimal spiritual intake such as the alone. This phenomenon, interpreted in its era as evidence of sanctity and union with God, contrasted sharply with modern pathological self-starvation by emphasizing voluntary for spiritual purification rather than bodily or control. The practice peaked among Italian women in the 13th to 15th centuries, with prominent cases including St. Catherine of Siena (1347–1380), who from restricted her diet to the point of near-total , rejecting all but occasional sacramental elements and reportedly surviving for decades in emaciated frailty while engaging in rigorous and . Similarly, St. (1247–1297) embraced extreme penance after personal tragedy, subsisting on sparse provisions and while founding charitable orders, her endurance hailed as . Other exemplars, such as Angela of Foligno (1248–1309), documented visions accompanying their , framing refusal of food as mystical rebellion against carnal desires. These women often achieved or sainthood, their vitae portraying fasting as a heroic path to holiness amid patriarchal ecclesiastical structures that valorized bodily mortification. Despite contemporary acclaim, empirical scrutiny reveals profound physiological implausibility, as human survival beyond weeks without caloric intake defies metabolic requirements, with assessments of analogous prolonged claims identifying —including concealed nourishment—in all rigorously investigated historical female cases. Retrospective psychiatric analyses draw parallels to in behavioral patterns like food aversion and , yet underscore contextual divergence: medieval accounts lacked diagnostic pathology, instead embedding within devotional culture, though hagiographic embellishments likely amplified unverified miracles over observable decline. Such episodes highlight tensions between faith-driven narratives and biological causality, prompting modern debates on whether cultural sanction enabled self-destructive without contemporary intervention.

Definition and Etymology

Terminology and Core Description

Anorexia mirabilis, a term retrospectively applied to describe extreme voluntary among medieval Christian ascetics, particularly women, denotes a perceived miraculous loss of enabling prolonged survival on minimal or no sustenance beyond the . The phrase originates from Latin, where anorexia adapts the Greek anorexis (ἀνορεξία), signifying "lack of ," combined with mirabilis meaning "wonderful" or "marvelous," emphasizing the contemporary view of such as a endowment of holiness rather than . Also termed holy anorexia or inedia prodigiosa (prodigious lack of food), it contrasts with modern eating disorders by framing self-starvation as a virtuous of Christ's and a means to spiritual union, often documented in hagiographies from the 13th to 15th centuries. At its core, anorexia mirabilis involved ascetics rejecting food to mortify the flesh, reportedly subsisting for months or years—such as St. Catherine of Siena's claimed decade-long Eucharistic-only diet from around 1363 onward—while exhibiting vitality interpreted as divine nourishment. These cases, concentrated among Italian and northern European women, were authenticated through scrutiny, including forced feeding attempts that failed to restore appetite, reinforcing beliefs in supernatural intervention over deception or physiological endurance alone. Historical records, drawn from vitae and inquisitorial testimonies, portray it as a gendered peaking during periods of religious fervor, distinct from routine Lenten fasts by its totality and purported .

Distinguishing Physiological Claims

Anorexia mirabilis entailed assertions of extreme , often spanning years, with practitioners purportedly subsisting on minimal sacramental elements like the or purported divine provision, while exhibiting reduced or absent excretions. Physiologically, such claims contravene established metabolic requirements, as the body demands approximately 1,200–1,800 kilocalories daily for basal functions in adults, derived primarily from macronutrients; prolonged deprivation beyond 40–60 days typically induces organ failure, imbalances, and , even with hydration. The longest documented voluntary fast without nutritional supplements lasted 382 days under medical oversight, but involved , vitamins, and monitoring, resulting in severe muscle wasting and requiring refeeding to prevent fatality—far short of the multi-year reported in hagiographic accounts. In cases like Saint Catherine of Siena (1347–1380), contemporary records indicate initial consumption of small amounts of (under two ounces daily), raw , and bitter herbs, alongside induced to reject food, before transitioning to alleged exclusive reliance on the , which provides negligible calories (roughly 10–20 per host). This pattern aligns with progressive self-starvation rather than sustenance, culminating in her , chronic illness, and death at age 33 from apparent malnutrition-induced complications, including possible bulimia-like purging. Scholarly analyses, such as those framing these behaviors as precursors to , emphasize psychological denial of hunger signals over physiological anomalies, noting that hagiographers often amplified feats to affirm sanctity, without verifiable evidence of metabolic suspension. Absence of waste, another frequent claim, defies , as undigested residues and metabolic byproducts necessitate elimination; total would halt and lead to within weeks, not enable vitality. Empirical studies on confirm systemic adaptations like for energy from fat stores, but these deplete reserves in 1–3 months for most individuals, inconsistent with reported and activity levels in anorexia mirabilis subjects. Attributions to divine intervention lack causal mechanisms testable by scientific standards, with historical critiques highlighting in religious contexts, where minimal undetected intake or sustained narratives of prodigies.

Historical Development

Early Christian and Patristic Era

In the patristic era, spanning roughly the 2nd to 5th centuries AD, Christian emphasized rigorous as a means of spiritual purification, bodily mortification, and imitation of Christ's wilderness fast, though prolonged —sustained existence without food attributed to divine miracle—was not yet formalized as anorexia mirabilis. such as (c. 155–240 AD) advocated to combat and enhance , viewing it as a to subdue fleshly desires rather than a suspension of hunger. Similarly, Basil the Great (c. 330–379 AD) prescribed moderated yet intense fasts in monastic rules, warning against excess that could harm health, reflecting a balance between zeal and physiological limits. Among early female ascetics, known as Desert Mothers, extreme formed part of broader eremitic practices in and , often documented in apophthegmata and vitae emphasizing endurance over miraculous sustenance. (c. 270–350 AD), a prominent , retreated to the desert after her parents' death, adopting severe austerities including minimal food intake to conquer bodily passions, as recorded in her Life attributed to Athanasius, where she teaches that fasting weakens the to strengthen the . Her regimen involved sparse eating after sunset, aligned with common patristic norms of xerophagy (dry foods like bread and ), but without claims of total abstinence for years. Saint Mary of Egypt (c. 344–421 AD) represents a transitional case, her vita by (c. 560–638 AD) describing 47 years in the Jordanian desert post-conversion, initially subsisting on sparse herbs before reportedly enabled further minimalism, with her emaciated yet preserved body noted as wondrous. Unlike later anorexia mirabilis, her served from prior , not Eucharistic exclusivity or public of , and patristic sources attribute survival to providential plants rather than explicit miracle. These practices influenced monastic traditions but lacked the hagiographic emphasis on appetite's abolition seen in medieval accounts, highlighting asceticism's role in combating demonic temptations through .

Medieval Asceticism and Peak Prevalence


In medieval Christianity, asceticism emphasized the mortification of the flesh through practices such as prolonged fasting, flagellation, and sleep deprivation to achieve spiritual purification and closeness to God. Among religious women, particularly in Italy and other parts of southern Europe from the 13th century, food restriction evolved into a central expression of piety, often framed as anorexia mirabilis—a divinely granted inability to eat earthly sustenance beyond the Eucharist. These women, including nuns and lay mystics, viewed their abstinence as a miraculous sign of divine favor, enabling survival on spiritual nourishment alone while rejecting bodily desires. The practice peaked in prevalence during the , roughly the 13th to 15th centuries, coinciding with a surge in female religious movements and hagiographical accounts emphasizing bodily denial. Historical analyses document 181 cases of holy between the 13th and 17th centuries, with the majority occurring in and concentrated among women. Rudolph M. Bell's examination of 170 Italian holy women from 1200 to 1700 identified anorexic behaviors—such as extreme caloric restriction and Eucharistic sustenance—in more than half, highlighting as a focal region due to its vibrant and saint cults. Scholar Caroline Walker Bynum's study of saints canonized or venerated between 1200 and 1500 reveals that extreme characterized only 17.5% of all such figures but rose to 42% among female saints, reflecting women's limited avenues for religious authority and their adaptation of as a gendered ascetic ideal. This prevalence declined post-1500 amid scrutiny of mystical claims and shifting views on bodily miracles, though isolated cases persisted.

Post-Medieval Decline

Following the peak prevalence of anorexia mirabilis in the late medieval period, particularly among Italian holy women between the 13th and 15th centuries, documented cases and ecclesiastical acceptance declined sharply from the onward. Historian Rudolph M. Bell attributes this initial downturn to post-Reformation dynamics within the , including the (1545–1563), which imposed stricter oversight on female religious communities, curtailed the autonomy of ascetic women, and emphasized enclosure in convents to prevent independent practices that had previously enabled extreme as a path to sanctity. This shift reduced opportunities for public displays of inedia prodigiosa, as male confessors and church authorities increasingly viewed such behaviors with suspicion, associating them with potential or deception amid Protestant critiques of Catholic mysticism. Sporadic reports persisted into the early , but without the prior veneration; for instance, claims of prolonged fasting by figures like the 17th-century Italian mystic Maria Maddalena de' Pazzi were scrutinized rather than celebrated, often attributed to natural infirmity or exaggeration rather than divine intervention. By the Enlightenment, empirical skepticism further eroded belief in miraculous sustenance, as physiological limits on human survival without nutrition—typically 40–60 days without water, far less with minimal intake—clashed with hagiographic narratives requiring verification through observation. Causal analysis reveals that medieval tolerance stemmed from limited medical knowledge and cultural piety, whereas post-medieval advancements in and dietetics, including works like William Banting's 1863 dietary , highlighted caloric requirements incompatible with sustained claims. In the , "fasting girls" emerged in and , echoing anorexia mirabilis but reframed secularly; cases like in Wales (died 1869) and Mollie Fancher in the U.S. (claimed abstinence from 1862) drew crowds but prompted medical investigations revealing hidden consumption or rapid decline upon enforced monitoring. Jacob's death from starvation after authorities halted unauthorized feeding underscored the non-miraculous reality, leading to legal inquiries and public disillusionment. Such exposures, coupled with the 1873 medical recognition of by , pathologized self-starvation, stripping it of holy aura. By the 20th century, institutional biases in academia toward naturalistic explanations further marginalized religious interpretations, with no Vatican-recognized cases of since the medieval , reflecting a broader causal shift from faith-based to evidence-based worldviews.

Notable Historical Cases

Saint Catherine of Siena

Saint Catherine of Siena (1347–1380), born Caterina Benincasa on March 25, 1347, in Siena, Italy, was a tertiary of the Dominican Order, mystic, and influential figure in 14th-century Church politics. She is renowned for her extreme asceticism, including prolonged fasting classified historically as anorexia mirabilis, where she subsisted primarily or solely on the Eucharist for extended periods. Her biographer, Blessed Raymond of Capua, documented these practices in The Life of St. Catherine of Siena, drawing from eyewitness accounts and her own reports. Catherine began rigorous in her youth, initially abstaining from and gradually reducing intake after joining the Mantellate sisters around age 16. By her mid-20s, under , she limited consumption to , , and raw , but faced physical repulsion toward food, when attempting to eat. From approximately 1373 onward, for the last seven to ten years of her life, she reportedly ingested no solid food, relying exclusively on the Eucharistic Host received daily, supplemented occasionally by sips of cold . Raymond of Capua attested that this did not diminish her vigor; she engaged in intense prayer, nursed plague victims during the , dictated over 380 letters to and rulers, and journeyed to in 1376 to urge Gregory XI's return to . Contemporaries, including confessors and disciples, verified her refusal of food despite urgings to eat, interpreting her endurance as miraculous sustenance from rather than physiological means. Catherine described visions where Christ directly provided the , bypassing human mediation, and she experienced and other ecstasies tied to her Eucharistic devotion. Toward her death on April 29, 1380, at age 33, she suffered a and further physical decline, weighing minimally but attributing her survival to spiritual nourishment. The canonized her in 1461 and named her a in 1970, affirming her as a model of , though modern analyses note parallels to extreme without equating it to .

Other Prominent Figures


(c. 1248–1309), an Italian Franciscan tertiary, exemplified anorexia mirabilis through prolonged fasting sustained primarily by the , as detailed in her Memoriale, dictated to her . She reportedly abstained from ordinary food for extended periods, engaging in extreme penances such as consuming scabs and drinking from the sick, which she described as tasting sweet as the , interpreting these acts as mystical unions with Christ's suffering. Historical accounts attribute her survival without substantial nourishment to divine intervention, aligning with contemporary views of holy .
Margaret of Cortona (1247–1297), another Italian penitent affiliated with the Franciscan , practiced rigorous following her conversion after personal tragedies, limiting intake to bread and water or the alone for years. Biographies, such as that by Fra Giunta Bevegnati, record her engaging in self-mortification, including threats of self-mutilation, and sustaining life miraculously on minimal sustenance, which contemporaries viewed as evidence of sanctity. Her case, analyzed in Rudolph M. Bell's Holy Anorexia, highlights patterns of food refusal as a path to spiritual authority in medieval female . Other figures, such as Umiliana Cerchi (1219–1284), demonstrated similar behaviors through voluntary and Eucharistic sustenance, refusing and ordinary meals to emulate Christ's passion, as chronicled in her vita. These cases, peaking in 13th-14th century , were venerated for defying physiological expectations, with hagiographers emphasizing supernatural endurance over medical explanations prevalent today.

Patterns Across Cases

Historical cases of anorexia mirabilis predominantly featured young women in medieval Catholic , particularly between the 13th and 15th centuries, who engaged in extreme voluntary as an expression of . Rudolph M. Bell's examination of over two dozen such Italian holy women revealed a consistent : nearly all were , with typically commencing in or early adulthood, often amid familial resistance to their ascetic commitments. These individuals, drawn from middle- or upper-class backgrounds, frequently entered convents or pursued lives of , where intensified as a means to emulate Christ's and achieve mystical union. Behaviorally, the pattern involved progressive food restriction, culminating in —sustained existence purportedly on the alone, with rejection of all other intake due to aversion or divine command. Subjects commonly reported toward food, especially sweets, and resorted to self-induced purging if compelled to eat, mirroring physiological responses to prolonged such as , weakness, and organ strain, yet defying expected lethality through attributed miraculous endurance. Accounts describe survival periods of years without solid food, though empirical of hagiographic sources notes variability in verification, with some cases involving covert consumption suspected but unproven in venerated instances. Spiritually, fasting correlated with visionary experiences, ecstasies, and somatic phenomena like , interpreted by contemporaries as signs of divine favor and sanctity. Socially, these women often amassed followers, performed charitable acts despite frailty, and achieved posthumous , though ecclesiastical authorities occasionally probed for , reflecting tensions between and realism in medieval evaluations. Bell identifies a recurring trajectory: initial bodily mortification yielding spiritual authority, enabling circumvention of patriarchal constraints via perceived holiness, though primary vitae—often compiled by devotees—warrant caution for embellishment to promote status. Outcomes typically ended in early death from complications, averaging in the 30s, underscoring the physiological toll despite theological framing.

Comparison with Anorexia Nervosa

Surface Similarities in Behavior

Individuals practicing anorexia mirabilis exhibited behaviors of prolonged voluntary and rejection of food, often limiting intake to the Eucharistic wafer or herbal infusions, which resulted in extreme and physical frailty documented in contemporary hagiographies. This mirrors the core behavioral feature of , where affected individuals impose severe caloric restriction—typically under 1,000 kcal daily—leading to body mass indices below 17 kg/m² and cachectic states. In both, the refusal to eat persists despite entreaties from , , or medical professionals, with practitioners viewing nourishment as antithetical to their pursuit, whether spiritual union or bodily control. Additional overlaps include ritualized food avoidance and distorted perceptions of ; medieval ascetics like described food as repugnant or spiritually contaminating, consuming minuscule amounts only under duress, akin to the aversion to eating and premature fullness reported in up to 80% of cases. Physical manifestations from these behaviors, such as hair growth, , and amenorrhea, further align superficially, stemming from chronic undernutrition rather than distinct etiologies. Such parallels have prompted retrospective analyses equating the observable self-starvation patterns across eras, though motivational underpinnings diverge sharply.

Fundamental Motivational and Cultural Differences

The core motivations of anorexia mirabilis centered on achieving spiritual purity and union with the divine through voluntary , often framed as imitation of Christ's suffering and penitential , rather than any distortion of or fear of fatness characteristic of . Individuals exhibiting anorexia mirabilis, such as medieval female saints, engaged in extreme to mortify the flesh, viewing sustenance—sometimes limited to the —as unnecessary for bodily survival due to perceived miraculous intervention, with documented cases spanning 181 instances of holy fasting in from the 13th to 17th centuries. In contrast, involves a pathological preoccupation with weight and shape, driven by an intense fear of gaining weight despite low body mass, as delineated in diagnostic criteria emphasizing absent in historical holy fasting. Culturally, anorexia mirabilis emerged within a medieval Christian framework that valorized extreme as a path to sanctity, particularly among women seeking agency in religious life amid patriarchal constraints, where self-starvation was publicly admired and integrated with practices like , not pathologized as illness. This context lacked the modern Western idealization of slenderness propagated through media and fashion since the , which fuels by equating thinness with control, success, and attractiveness in secular, consumer-driven societies. Consequently, behaviors in anorexia mirabilis were often celebrated as evidence of divine favor, enabling social elevation toward sainthood, whereas manifests as secretive restriction motivated by internalized cultural pressures on appearance, leading to ego-dystonic distress and medical intervention rather than communal veneration. These differences underscore how sociocultural reinforcement shapes the expression and perception of self-starvation, with anorexia mirabilis aligned to theological goals of holiness unconcerned with physical aesthetics.

Diagnostic and Retrospective Challenges

Retrospective diagnosis of anorexia mirabilis faces significant hurdles due to the reliance on hagiographic texts, which prioritize edifying narratives of sanctity over objective physiological or behavioral documentation. These medieval accounts, often composed by confessor-priests or later biographers, emphasize miraculous sustenance via the Eucharist and divine intervention, potentially inflating claims of total while downplaying or omitting evidence of minimal food intake or health deterioration. For instance, in the case of Saint Catherine of Siena (1347–1380), contemporary reports describe her surviving years on little beyond the host, yet lack verifiable medical observations, complicating assessments of whether behaviors aligned with pathological self-starvation or culturally endorsed . Differentiating anorexia mirabilis from retrospectively is further challenged by mismatched diagnostic criteria under modern frameworks like the , which emphasize distorted , intense fear of , and denial of illness—features absent or inverted in historical holy anorexia cases. In mirabilis, was typically overt and publicly celebrated as a path to spiritual purity and communal validation, contrasting with the secretive denial in nervosa; motivations centered on Eucharistic devotion and bridal rather than aesthetic or control-oriented drives. Scholarly analyses, such as those examining 14th-century figures like and , highlight that imposing nervosa's psychopathology risks , as medieval cultural norms valorized as divine favor, not deviance. Physiological verification adds another layer of difficulty, as claims of prolonged without substantial defy established metabolic limits— sustenance typically requires at least 500–600 kcal daily to avert organ failure—prompting debates over undetected consumption or hagiographic . Autopsy-equivalent data is scarce, with many cases ending in documented decline (e.g., Catherine's reported and death at age 33 from apparent starvation-related exhaustion), yet without contemporary biomarkers or caloric logs, retrospective causation remains speculative. Critiques note that pathologizing these via modern lenses, as in Rudolph Bell's analysis of 261 Italian holy women, often overlooks contextual , where indexed amid famine-prone eras, not inherent disorder.

Explanations and Controversies

Religious and Theological Perspectives

In Catholic theology, anorexia mirabilis, or miraculous inedia, represents an extraordinary charism wherein select saints and mystics sustained physical life with minimal or no ordinary sustenance, subsisting principally on the Eucharist as the "Bread of Life" (John 6:35). This phenomenon underscores divine omnipotence and the primacy of spiritual over corporeal nourishment, manifesting God's ability to transcend natural physiological limits. Theological interpretations frame it as a rare grace, paralleling biblical fasts like those of Moses (Exodus 34:28) and Elijah (1 Kings 19:8), which exceeded human endurance through supernatural intervention. St. Thomas Aquinas, in his Summa Theologica, delineates fasting's ordinary purposes—to mortify , dispose the soul for by detaching from sensory pleasures, and offer for —but distinguishes these from miraculous extensions, which he attributes to divine power rather than human virtue alone. For anorexia mirabilis, theologians view sustained inedia as confirmatory of sanctity, evidencing profound Eucharistic union and imitation of Christ's Passion, wherein bodily emaciation mirrors . In the case of St. Catherine of (1347–1380), her Blessed Raymond of Capua documented her exclusive reliance on the from 1374 onward, interpreting it as a enabling her apostolic labors despite frailty. Such perspectives emphasize spiritual efficacy over empirical scrutiny, positing that authenticated cases serve ecclesial edification, drawing believers to Eucharistic reverence. Hagiographic traditions, including lives of saints like Angela of Foligno (1248–1309), portray inedia as vocational mortification, fostering mystical espousals to Christ and communal witness to grace. Church authorities historically vetted claims, as in episcopal inquiries during the , to affirm genuineness against potential or imposture, aligning with theological caution against presumption in (cf. 1 Corinthians 13:2). While predominantly Catholic, analogous interpretations appear in Orthodox traditions, viewing extreme fasting as askesis toward theosis, though less emphasized as miraculous inedia. Protestant reformers, conversely, critiqued medieval excesses as superstitious, favoring scriptural moderation in bodily discipline (e.g., Calvin's Institutes 3.4.18). Modern Catholic scholarship maintains these events as providential signs, cautioning against replication without divine vocation, prioritizing obedience to ecclesiastical norms over private revelations.

Biomedical and Physiological Realities

The , under conditions of complete caloric deprivation with adequate hydration, typically sustains life for 30 to 70 days in healthy adults, influenced by factors such as initial body fat reserves, metabolic rate, and overall . Beyond this window, progressive organ failure ensues, with resulting from cardiac arrhythmias, multi-organ shutdown, or secondary to . Basal metabolic demands require approximately 1,400 to 2,000 kilocalories daily even in states of reduced activity, derived initially from stores (depleted within 24-48 hours), followed by reserves, and ultimately from muscle and viscera, leading to and frailty. Prolonged starvation induces systemic adaptations and pathologies, including hypometabolism (reduced and body temperature), electrolyte imbalances (e.g., ), amenorrhea due to hypothalamic suppression, and neurological effects such as , , and from cerebral energy deficits. In advanced stages, subcutaneous fat depletion exposes bone, vital organs (e.g., shrunken heart and liver), and immune function collapses, heightening risk; refeeding, if attempted without supervision, can precipitate fatal via insulin surges and phosphate shifts. These processes align with empirical observations from studies and controlled fasts, underscoring that no physiological mechanism permits indefinite survival absent caloric input, as laws preclude sustenance from ambient sources like air or alone. In the context of anorexia mirabilis—historical reports of extended fasting among religious figures, often limited to sacramental elements like the —these claims confront physiological constraints, with documented cases rarely exceeding known survival thresholds without evidence of undetected minimal intake or exaggeration. For instance, while some individuals exhibited apparent for months, autopsy-equivalent historical accounts reveal terminal consistent with , and modern assessments of similar "breatharian" or assertions find no verifiable anomalies under , attributing persistence to psychological , surreptitious consumption, or short-term metabolic adaptations rather than . The , comprising negligible calories (typically under 10 kcal per host), cannot sustain basal needs, rendering claims of sole reliance thermodynamically implausible without supplemental , often overlooked in hagiographic narratives due to devotional . Empirical thus prioritizes verifiable caloric accounting over anecdotal testimony, revealing alignments with rather than transcendence of .

Psychological and Sociological Interpretations

Psychological interpretations of anorexia mirabilis often draw parallels to modern eating disorders, positing that extreme served as a mechanism for and autonomy in restrictive social environments. Rudolph M. Bell, in his 1985 analysis, characterized it as a rebellion against paternal and marital , where women weaponized bodily denial to negotiate power dynamics in patriarchal structures, akin to control-seeking behaviors in . This Freudian-influenced view emphasizes psychological motivations rooted in family conflicts and repressed desires, with enabling defiance without overt confrontation. However, such interpretations have faced criticism for projecting 20th-century psychiatric frameworks onto premodern contexts, ignoring the explicit religious rationales documented in hagiographies, where was framed as divine compulsion rather than ego-driven pathology. Caroline Walker Bynum's work counters reductionist psychological models by situating within medieval women's devotional practices, where food symbolism—particularly the —facilitated identification with Christ's suffering and maternal nurturing roles, rendering self-starvation a coherent expression of rather than . Empirical analysis of primary sources reveals no evidence of distortion or fear of weight gain central to modern diagnoses; instead, practitioners reported ecstatic visions and supernatural sustenance, suggesting motivations aligned with ascetic traditions predating psychological pathologization. Peer-reviewed historical studies affirm that while physiological effects like occurred, the causal drivers were theological, with psychological benefits perceived as heightened spiritual and union with the divine. Sociologically, anorexia mirabilis emerged as a culturally sanctioned avenue for female agency during the 13th to 15th centuries, when over 200 documented cases peaked amid heightened eucharistic fervor and lay piety movements, allowing women to transcend domestic confines by cultivating followings and influencing clerical decisions. In a feudal order limiting women's public roles, sanctity through conferred , as seen in figures like , whose fasting drew papal attention and diplomatic leverage by 1376, reflecting how religious institutions validated extreme behaviors to channel gender-specific devotion. This phenomenon reinforced communal bonds via shared rituals but also invited scrutiny, with church inquisitions distinguishing genuine miracles from deception, underscoring tensions between individual piety and institutional control. Unlike modern eating disorders tied to secular and media-driven ideals, holy anorexia integrated into collective religious norms, where societal approval hinged on perceived rather than deviance.

Critiques of Modern Reductionism

Modern interpretations frequently reduce anorexia mirabilis—the voluntary of medieval and early modern holy women such as (1347–1380), who sustained herself primarily on the for decades—to a precursor of , framing it as a pathological disorder driven by subconscious psychological conflicts rather than intentional spiritual discipline. This approach, prominent in Rudolph Bell's Holy Anorexia (1985), posits that these women's behaviors mirrored modern eating disorders in pursuit of autonomy amid patriarchal constraints, yet critics argue it imposes anachronistic psychiatric lenses that efface the explicit theological motivations documented in hagiographies and Church records, where symbolized mystical and was rewarded with social and . Such overlooks causal differences in motivation and context: unlike patients, who typically exhibit distortion and fear of weight gain as core criteria, practitioners of anorexia mirabilis articulated as a heroic rejection of worldly for divine , often persisting without the refeeding complications or mortality rates (up to 20% in severe modern cases) seen in untreated psychiatric anorexia, as evidenced by survivors like Catherine who maintained lucidity and activity into advanced . Empirical accounts from contemporaries, including physicians and confessors, describe apparent sustenance from minimal or no food, challenging purely biomedical explanations that attribute longevity to hidden caloric intake without direct evidence, while dismissing spiritual claims as . Critics highlight how this materialist bias, prevalent in secular academia, pathologizes culturally sanctioned , akin to labeling monastic vows as obsessive-compulsive disorder, thereby eroding the women's agency in a volitional pursuit of sanctity. Moreover, retrospective diagnoses ignore adaptive physiological responses potentially linked to belief and ritual—such as eucharistic inedia correlating with reported euphoria and visions, absent in modern starvation—favoring instead a flattened narrative of universal psychopathology that aligns with contemporary therapeutic paradigms but fails first-principles scrutiny of historical testimonies. This framework, critiqued for its prejudiced dismissal of suffering as inherently aberrant rather than purposeful, risks projecting modern individualism onto communal religious epochs, where fasting conferred institutional power, as seen in the influence wielded by figures like Veronica Giuliani (1660–1727) within convents. Proponents of non-reductionist views advocate integrating theological realism, noting that empirical data from saintly vitae reveal goal-directed behaviors yielding perceived supernatural outcomes, unverifiable by reductionist metrics yet corroborated across cases spanning centuries.

Perceived Benefits and Impacts

Spiritual and Social Advantages in Context

In the religious framework of medieval Europe, practitioners of anorexia mirabilis viewed extreme as a pathway to spiritual elevation, emulating Christ's Passion through bodily mortification to achieve union with the divine. This ascetic discipline was believed to purify the soul, subdue carnal desires, and foster mystical experiences such as visions and ecstasies, often sustained solely by the , which symbolized direct nourishment from Christ. For instance, figures like (1347–1380) reported profound spiritual rewards, including and divine dialogues, interpreting their as miraculous evidence of heavenly favor and redemption through imitatio Christi. Such practices aligned with theological emphases on as a means to raise the mind toward God and secure eternal recompense, distinct from mere physical deprivation. Socially, anorexia mirabilis offered women in patriarchal societies a rare avenue to transcend traditional domestic confines, elevating them to revered status as holy exemplars. By demonstrating prodigious and sanctity, these women attracted followers, founded religious communities, and wielded influence otherwise inaccessible; historian Rudolph Bell documents how over 260 Italian holy women from 1200 onward leveraged to resist familial and domination, often emerging as community leaders post-recovery. This shift enabled fame and autonomy, as seen in cases where ascetics advised or gained papal audiences, circumventing norms that prioritized and motherhood. In context, such devotion was culturally valorized, transforming personal sacrifice into public authority and within devout circles.

Health Consequences and Mortality Risks

Prolonged fasting in cases of anorexia mirabilis resulted in severe , manifesting as profound , loss of subcutaneous fat, and muscle wasting, which compromised bodily functions and led to chronic weakness. Cardiovascular complications were common, including , , and increased risk of arrhythmias or sudden cardiac events due to imbalances and diminished mass. Gastrointestinal effects included stomach shrinkage, reduced acid production, and frequent , exacerbating nutrient absorption deficits and . Reproductive and endocrine disruptions were prevalent, with amenorrhea, , and shrinkage of reproductive organs stemming from hormonal deficiencies induced by caloric restriction. Other physiological tolls encompassed , , impaired , and heightened susceptibility to infections from a weakened . In historical instances, such as that of (1347–1380), extreme abstinence from food—purportedly sustained by the —culminated in liver changes, , and overall physical decline, underscoring the incompatibility of such practices with sustained human physiology. Mortality risks were elevated, with death often occurring from multi-organ failure, cardiac arrest, or complications of advanced starvation, typically within months to years of intensified fasting. Many documented cases, including Catherine of Siena's demise at age 33 from starvation-related emaciation, illustrate premature mortality as a direct outcome, despite contemporary perceptions of miraculous sustenance. Empirical physiological limits—requiring approximately 1,200–1,500 kcal daily for basal metabolism in adults—rendered long-term survival without substantial intake untenable, leading to inevitable lethal decompensation in practitioners who rejected nourishment.

Cultural and Institutional Roles

In medieval Catholic culture, anorexia mirabilis was venerated as a divine sign of holiness, particularly among women who sustained themselves primarily on the , imitating Christ's Passion through bodily mortification. This practice, often termed inedia prodigiosa, allowed religious women to transcend physical limitations and assert spiritual authority in a patriarchal , where symbolized rejection of worldly desires and union with God. The held a central institutional role in legitimizing these cases through hagiographic traditions and inquiries, which scrutinized claims of miraculous sustenance without food to affirm sanctity. Figures such as St. Catherine of Siena (1347–1380), who limited her diet to herbs and the from age 16, were on June 29, 1461, partly for their demonstrated anorexia mirabilis. Similarly, St. Angela of Foligno (1248–1309) achieved renown for extreme , contributing to her and . Between the 13th and 17th centuries, at least 181 documented instances occurred, mostly among young women in southern European religious settings, with the Church elevating many to sainthood as exemplars of ascetic . Within convents, anorexia mirabilis flourished as an extension of communal , enabling to negotiate , such as vows of or influence over matters, amid broader penitential mandates. Culturally, it permeated , , and devotional practices, fostering emulation as a path to mystical experiences, though the Church grew wary of excesses by the late , occasionally intervening against perceived deceptions or health risks while still honoring verified cases.

Modern Interpretations and Occurrences

20th-21st Century Cases

In the , several Catholic women claimed to subsist for extended periods on the alone, echoing historical instances of anorexia mirabilis, though these assertions faced medical skepticism and incomplete verification due to limited continuous observation. (1898–1962), a Bavarian mystic from Konnersreuth, reported ceasing solid food intake in 1923 following a period of illness and , and abstaining from after 1926, allegedly nourished solely by daily Holy Communion while maintaining a stable weight of around 50 kilograms despite her robust build. Church investigations, including a 1927–1928 Vatican-commissioned medical panel, observed her for short periods but found no definitive proof of , as she reportedly expelled minimal waste and experienced stigmata-related bleeding; critics attributed survival to undetected minimal intake or psychological factors, given the physiological impossibility of prolonged total without organ failure. Similarly, (1902–1981), a French lay mystic paralyzed from in 1928, claimed from 1930 onward to forgo all food and drink except the received weekly, surviving 50 years without apparent or , though she reported visions and founded the Foyers de Charité retreat centers. Eyewitness accounts from priests and visitors noted her emaciated appearance but vitality during ecstasies; post-2020 archival reviews by the Diocese of Lyon raised doubts about authenticity, citing potential inconsistencies in records and lack of rigorous medical surveillance, aligning with empirical evidence that human metabolism requires caloric intake averaging 1,500–2,000 kcal daily to prevent and . Alexandrina Maria da Costa (1904–1955), a mystic from Balasar bedridden after a 1925 escape from assault-induced , asserted from March 1942—13 years until her death—she consumed no food or water beyond the , weighed as low as 38 kilograms at times, and experienced locutions urging Eucharistic devotion. Investigated by Salesian priests and local bishops, her case involved diaries and witness testimonies but no extended scientific monitoring; beatified in 2004, it remains contested medically, as prolonged abstinence contradicts documented , including muscle wasting and leading to mortality within 40–60 days absent hydration. No widely documented 21st-century cases of anorexia mirabilis have emerged with comparable religious framing and longevity claims, as contemporary medical and psychological scrutiny—emphasizing conditions like with spiritual rationalizations—predominates over miraculous interpretations. Isolated reports of breatharians or practitioners, often non-Christian, have been debunked through controlled studies revealing hidden consumption, underscoring causal limits of human physiology where basal metabolic rates demand sustenance for survival.

Scholarly Debates and Recent Research

Scholarly debate on anorexia mirabilis primarily revolves around its relationship to modern (AN), with Rudolph M. Bell's 1985 analysis in Holy Anorexia positing continuity through shared patterns of self-starvation among medieval Italian women as a strategy for asserting autonomy in patriarchal religious contexts. Bell documented approximately 170 cases between 1200 and 1500 where pious women restricted intake to the , interpreting their behaviors as proto-pathological rather than miraculous, akin to contemporary AN's drive for control. Critics, however, argue this framework imposes anachronistic psychiatric categories, noting that anorexia mirabilis lacked AN's core diagnostic features like body image distortion and of weight gain, instead emphasizing spiritual purification and imitatio Christi. Historical records indicate church-sanctioned investigations often verified these fasts as genuine, with women sustaining themselves longer than typical AN trajectories without evident fraud or rapid physiological collapse. Opponents of Bell's reductionism, including historians like Caroline Walker Bynum, contend that framing holy fasting as "anorexia" overlooks its eucharistic and devotional core, where food refusal symbolized union with the divine rather than secular or illness. Empirical differences underscore discontinuity: mirabilis cases were publicly valorized, frequently culminating in sainthood, whereas modern AN is characterized by secrecy, distress, and high mortality from complications like organ failure, with no equivalent religious endorsement. This perspective highlights potential biases in applying criteria retroactively, potentially pathologizing culturally embedded without accounting for verified physiological resilience in historical accounts. Recent research integrates these tensions, advocating culturally attuned models for AN treatment informed by historical precedents. A 2014 of a religiously motivated AN patient meeting criteria illustrated hybrid motivations, suggesting mirabilis-like can precipitate modern disorder but requires addressing spiritual dimensions therapeutically. A 2017 analysis of figures like and proposed blending historical insights with neurobiological factors (e.g., serotonin dysregulation) to enhance understanding, emphasizing episodic vs. chronic restriction patterns. A 2020 examination invoked heightened sensitivity as a potential transhistorical mechanism, critiquing purely biomedical reductions while cautioning against over-spiritualizing contemporary cases lacking medieval validation. Studies on in eating disorders, such as a 2017 Finnish cohort, report modestly elevated among AN sufferers but no causal link, underscoring the rarity of mirabilis-style extremes today.

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