Before the Germanic peoples developed a cultural hegemony in the Middle Ages, Arab doctors paved the way for Western medicine with the development of Islam. The most remarkable examples from that period mixed Greek and Arab traditions to form a new whole. The Persian philosopher and physician Ibn S'lna, also known as Avicenna (980-1037), recommended physical activity in his book 'Kitabasch schifa' (the book of healing). He developed special exercises for recovery after fever, weakness, dropsy, neurological foot injuries, kidney disease, etc. Although his advice received little attention in his day, he influenced Western medicine in the following centuries. According to him, maintaining health consisted of prescribing exercises, diet and sleep. Exercising included three parts: the muscle massage before exercising, the exercise itself and a cold bath afterwards. He also explained the extreme importance of physical exercises:
"At the moment we focus our attention on regular exercise both in number and in time, we will find that there is no longer a need for drugs that are normally needed to cure diseases, this applies if the rest of the treatment is suitable and appropriate.
The value of the exercise includes the following:
1. It strengthens the organs and makes them suitable for their function
2. It results in better food absorption and nutrition improves by increasing the congenital heat,
3. It purifies the pores of the skin,
4. It removes depleted substances via the lungs
5. It strengthens the physique.
6. Vigorous practice stimulates the muscles and the nervous system."
Avicenna appointed fifty different types of pulse. The opening passage of his epic 'Canon' was as follows:
"Medicine is the science in which the order of the human body is known so that everything that is superfluous is removed or cured, with the aim of preserving or regaining health when it is absent."
The knowledge of the pulse gave an important picture of the inner workings of the human body. According to Avicenna, even the changes in water and food quality could lead to a disharmony of body fluids. First, he showed that the blood enters the heart and is then pumped throughout the body. Although the Greeks, the Jews and the Christians labeled the blood as the soul of the body, he said:
"Blood is the means of transport of food and waste."
At the time students from all over of Europe went to Salerno where the study of anatomy was emphasized as an essential basis for surgical practice. From Salerno came Roger of Parma (1140-1195) who wrote a book in Western Medical Literature at the end of the 12th century. In it is found much of the Greek material with little trace of Arabian influence. From Salerno, surgery moved up the Italian peninsula to the newly created University of Bologna in 1113. Bologna still ranks as a foremost center or orthopedic surgery. In Bologna effective and simple braces were devised, such as spinal supports and splints for fractured femurs.
The Syrian doctor Ibn Al Nafis (1213-1288) claimed that the heart muscle was fed by the arteries that ran through it and not by the blood in the heart chambers, like Galen (129-216). He described his findings in the book 'Sharh Al Tashrih', four hundred years before the publication of the 'De Motu Cordis' by William Harvey (1578-1657). Ibn al-Nafis was the first to describe the pulmonary, capillary and coronary circulation, which makes him the father of circular physiology but also the greatest physiologist of the Middle Ages. He stated that the left and right ventricles were separated and together with the heart and lungs formed the pulmonary circulation (small blood circulation). He described that blood runs through the pulmonary artery from the right ventricle to the lungs. In the lungs, the blood was split into two, thin blood filtered through the pores of the pulmonary artery, and thick blood remained as food in the lungs. The thin blood mixed with air from the trachea and entered the vein-like arteries (pulmonary veins) through the wall. The thin air-mixed blood reached the left ventricle, the center where vital spirit was formed. The spirit moved from the left ventricle to the aorta and through the rest of the arteries to the tissues. So he suggested that the blood moved through the lung walls of the arteries to the veins.
During construction works in the Middle Ages, the treadmill worker had to lift stones to the top of the building. It was a dangerous job, therefore only blind people were hired.
Unfortunately, the importance of physical exercise decreased during the Dark Ages. The progress of Medicine was meager in that period and the religious rigor prevented any research into human anatomy and physiology. As a result, the empirical theory of the four body juices declared by Hippocrates (460-370 BC) and Galen (131-201) continued to exist until the Renaissance. Christianity condemned "improper" body care, which was therefore no longer used and the monks / doctors found spells more suitable than massage and gymnastics, which therefor went into oblivion. Hygiene was abandoned, the baths and the thermal baths were destroyed and the body care was considered useless luxury. The manual and the mechanical therapy came into the hands of charlatans.
Yet Arnaldo de Villanova (1238-1311), Pietro de Abano (1257-1315) and Giovanni di Michele Savonarola (1385-1468) referred to the concepts of Avicenna (980-1037).
Arnaldo de Villanova (1235-1313) was a Spanish alchemist, astrologer and doctor. After many years of study in Montpellier and a stay at the court of Aragon, he moved to Paris where he built a solid reputation, but he incurred the enmity of ecclesiastics and was forced to flee to Sicily, where he got asylum. In 1313 the sick Pope Clement V (1264-1314) invited him, but he died during the trip to Avignon. He translated many medical works from Arabic, including those from Avicenna (980-1037), Qusta ibn Luqa (820-912) and Galen (131-201). He discovered carbon monoxide and pure alcohol.
Pietro de Abano (1257-1315) was an Italian physician, philosopher and astrologer who studied Medicine and Philosophy at the University of Padua. After a stay in Constantinople and Paris, he taught Medicine and Natural Philosophy in Padua from 1306 and onwards. Because he was very rationalistic about the miraculous and supernatural (he declared, among other things, the death of Christ as a trance), he was condemned as a heretic. He died, however, before the inquisition made the definitive verdict, nevertheless his corpse was dug up and burned.
Giovanni di Michele Savonarola (1385-1468) was an Italian humanist, writer and scientist and one of the most renowned doctors of his time. From 1419 to 1437 he taught at the University of Padua, but later settled in Ferrare where he became a personal physician to marquis Nicolas III d'Este (1383-1441). Savonarola published a lot of works, his most important was 'Pratica Maior. Pratica de egritudinibus a capite usque ad pedes'. He followed the footsteps of Pietro de Abano (1257-1315) and studied the Baths of Abano, after which he published 'De balneis et thermis naturalibus Italiæ' in which he dealt with the thermalism that had been practiced in the region of Padua since the Roman era.
It was only thanks to the renewed interest in the authors of earlier times that Medicine underwent a revival during Humanism and that ideas, discoveries and teachings of the old times were further developed.