Reformed theologian John Riggs has argued that the [[School of Antioch]] in the [[Eastern Roman Empire]], along with [[Hilary of Poitiers]] and [[Ambrose]] in the [[Western Roman Empire]], taught a realist, metabolic, or somatic view, where the elements of the Eucharist were believed to be changed into [[Christ's body and blood]].{{sfn|Riggs|2015|pp=12–13}} Riggs maintains that the influential fourth-century Western theologian [[Augustine of Hippo]], on the other hand, held that Christ is really present in the elements of the Eucharist, but not in a bodily manner, because his body remains in [[Heaven in Christianity|heaven]].{{sfn|Riggs|2015|p=15}} [[Thomas Cranmer]] argued similarly that Augustine held to spiritual presence of the Eucharist.<ref>{{Cite book |last=Allen |first=Amanda Wrenn |url=https://books.google.com/books?id=S_NiDwAAQBAJ&dq=Augustine+spiritual+real+presence&pg=PA144 |title=The Eucharistic Debate in Tudor England: Thomas Cranmer, Stephen Gardiner, and the English Reformation |date=2018-08-15 |publisher=Rowman & Littlefield |isbn=978-1-4985-5976-8 |language=en}}</ref> Anglican theologian Brian Douglas maintains that "Augustine is clear, nonetheless, in his use of realism and argues that the presence of Christ in the Eucharist is real such that the bread and wine and their offering participate in a real way in the eternal and heavenly Forms of Christ's body and blood."{{sfn|Douglas|2011|p=23}}
Another influentalinfluential theologian that has been argued to have held a pneumatic view of real presence is [[Tertullian]].<ref>{{Cite book |url=https://books.google.com/books?id=cjIsAQAAMAAJ&dq=Tertullian+spiritual+presence+Eucharist&pg=PA136 |title=Bibliotheca Sacra and Theological Review |date=1844 |publisher=Allen, Morrill, and Wardwell |language=en}}</ref><ref>{{Cite book |url=https://books.google.com/books?id=mbBPAAAAMAAJ&dq=Tertullian+spiritually+present+Eucharist&pg=PA525 |title=The British Magazine and Monthly Register of Religious and Ecclesiastical Information, Parochial History, and Documents Respecting the State of the Poor, Progress of Education, Etc |date=1833 |publisher=J. Petheram |language=en}}</ref><ref>{{Cite book |last=Kaye |first=John |url=https://books.google.com/books?id=SZcZKlLb53AC&dq=Tertullian+spiritually+present+Eucharist&pg=PA154 |title=Works of John Kaye, Bishop of Lincoln: Miscellaneous works with memoir of the author |date=1888 |publisher=Rivingtons |language=en}}</ref>
In the medieval age some theologians taught the pneumatic view of real presence,. theThe view was commonly held in medieval England, as can be seen in the writings of [[Ælfric of Eynsham|Aelfric of Eynsham]]. Pneumatic presence was also advocated by [[Berengar of Tours]] in the 11th century, whose views caused a controversy in the medieval Church.<ref>{{Cite web |title=Philip Schaff: History of the Christian Church, Volume IV: Mediaeval Christianity. A.D. 590-1073 - Christian Classics Ethereal Library |url=https://ccel.org/ccel/schaff/hcc4/hcc4.i.xi.xxiv.html |access-date=2022-03-07 |website=ccel.org}}</ref> [[Thomas R. Schreiner|Thomas Schreiner]] additionally argued that [[Ratramnus]] believed in a spiritual presence in the Eucharist.<ref>{{Cite book |last1=Schreiner |first1=Thomas R. |url=https://books.google.com/books?id=OSm5AwAAQBAJ&dq=Ratramnus+spiritual+real+presence&pg=PA141 |title=The Lord's Supper |last2=Crawford |first2=Matthew R. |date=2011-01-01 |publisher=B&H Publishing Group |isbn=978-1-4336-7338-2 |language=en}}</ref>