Avicenna - The Canon of Medicine - Physical Exercise: The Key To Health

Physical Exercise: The Key To Health

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The Canon of Medicine: Volume 1 of 5; Part 4 of 5: The Preservation of Health

Of Ibn Sina's Canon of Medicine which is written in 5 volumes, only the first volume has appeared in the English Language. In the first volume, Ibn Sina divides medicine into two parts as he explains it throughout the first book: the theoretical and the practical. The theoretical part consists of, but is not limited to, such things as: the causes of health and disease, the temperaments, the humours, anatomy, general physiology, the breath, psychology, discussion of causes of diseases and symptoms, the causes of illness, the classification of diseases, the pulse, the urine etc.

As he himself says in the book on pg 353 "In the first part of this book it was stated that medicine comprises two parts, one theoretical, and one practical, though both are really speculative science." (Avicenna 1999, p. 353)

Theoretical and Practical Medicine

Ibn Sina goes on to say that you do not get any benefit from just knowing how your body works, but rather the true benefit of medicine itself is in its practical aspect, since medicine is for the preservation of health.

"That which is speculative named theory relates to the formation of opinions and the showing of the evidence upon which they are based, without reference to the mode of acting upon them. Thus this part deals with the temperaments, the humors, the drives, and with the forms, the symptoms, and the causes of disease. That which is specially named practical relates to the mode of acting upon this knowledge, and the prescription of a regimen." (Avicenna 1999, p. 353)

The Benefits of Exercise

Once the purpose of medicine has been set forth, then from pages 377-455, Ibn Sina divides the way of achieving health as:

"Since the regimen of maintaining health consists essentially in the regulation of: (1) exercise (2) food and (3) sleep, we may begin our discourse with the subject of exercise". (Avicenna 1999, p. 377)

Exercise itself is divided into three main parts: The Massage (which is equivalent to massaging your muscles before you start to exercise); The Exercise itself; and lastly the Cold Bath.

Giving one of the greatest benefits of the regimen of exercise, and then explaining the extremely important and necessary need for physical exercise; Ibn Sina states:

"Once we direct the attention towards regulating exercise as to amount and time, we shall find there is no need for such medicines as are ordinarily required for remedying diseases dependent on matters, or diseases of temperament consequent upon such. This is true provided the rest of the regimen is appropriate and proper." (Avicenna 1999, p. 377) The value of exercise includes the following (1) it hardens the organs and renders them fit for their functions (2) it results in a better absorption of food, aids assimilation, and, by increasing the innate heat, improves nutrition (3) it clears the pores of the skin (4) it removes effete substances through the lungs (5) it strengthens the physique. Vigorous exercise invigorates the muscular and nervous system." (Avicenna 1999, p. 379)

In what manner does Ibn Sina uses the word temperament? In saying that exercise cures diseases of temperamant

Ibn Sina divides temperament into that which is harmonious and that which is non-uniform. Ibn Sina says on pg 276-277

"In addition to the signs of the normal temperament already given, there are: Mental faculties including: vigor of imagination, intellectual power, and memory." (Avicenna 1999, p. 276) "In brief, there is non-uniformity of temperament among the members; or, perchance, the principal members depart from equability and come to be of contrary temperament, one deviating towards one, another to its contrary. If the components of the body are out of proportion, it is unfortunate both for talent and reasoning power." (Avicenna 1999, p. 277)

The Purpose of Exercise and the Dangers of its negligence

Continuing on the proof to why exercise should be so beneficial Ibn Sina says "We know that this must be so when we reflect how in regard to nutriment, our health depends on the nutriment being appropriate for us and regulated in quantity and quality. For not one of the aliments which are capable of nourishing the body is converted into actual nutriment in its entirety. In every case digestion leaves something untouched, and nature takes care to have that evacuated. Nevertheless, the evacuation which nature accomplishes is not a complete one. Hence at the end of each digestion there is some superfluity left over. Should this be a frequent occurrence, repetition would lead to further aggregation until something measurable has accumulated. As a result, harmful effete substances would form and injure various parts of the body. When they undergo decomposition, putrefactive diseases arise . Should they be strong in quality, they will give rise to intemperament; and if they should increase in quantity, they would set up the symptoms of plethora which have already been described. Flowing to some member, they will result in an inflammatory mass, and their vapors will destroy the temperament of the substantial basis of the breath. That is the reason why we must be careful to evacuate these substances. Their evacuation is usually not completely accomplished without the aid of toxic medicines, for these break up the nature of the effate substances. This can be achieved only by toxic agents, although the drinking of them is to a certain extent deleterious to our nature. As Hippocrates says: "Medicine purges and ages." More than this the discharge of superfluous humor entails the loss of a large part of the natural humidities and of the breath, which is the substance of life. All this is at the expense of the strength of the principal and the auxiliary members, and therefore they are weakened thereby. These and other things account for the difficulties incident to plethora, whether they remain behind in the body or are evacuated by it." (Avicenna 1999, pp. 377–8)

Just before this Ibn Sina explained how accumulation of food in our body, can cause diseases, and one way to rid us of this is strong medicines. However, as he explains; this is not the ideal way, and certainly not the long-term. Thus, to make his point very clear, and show the extreme necessity of daily exercise for health, Ibn Sina states:

"Now exercise is that agent which most surely prevents the accumulation of these matters, and prevents plethora. The other forms of regiment assist it. It is this exercise which renews and revives the innate heat, and imparts the necessary lightness to the body, for it causes the subtle heat to be increased and daily disperses whatever effete substances have accumulated; the movements of the body help them to expel them conveying them to those parts of the body whence they can readily leave it. Hence the effete matters are not allowed to collect day after day and besides this, as we have just said, exercise causes the innate heat to flourish and keeps the joints and ligaments firm, so as to be always ready for service, and also free from injury. It renders the members able to receive nutriment, in being free from accumulated effate matters. Hence it renders the members light and the humidities attenuated, and it dilates the pores of the skin. To forsake exercise would often incur the risk of "hectic", because the instinctive drives of the members are impaired, inasmuch as the deprivation of movement prevents the access to them of the innate breath. And this last is the real instrument of life for every one of the members." (Avicenna 1999, pp. 378–9)

Massage

Before you begin to exercise it is important that you massage your muscles; as Ibn Sina says on page 385:

"Massage as a preparatory to athletics. The massage begins gently, and then becomes more vigorous as the time approaches for the exercise." (Avicenna 1999, p. 385)

Exercises

The exercises themselves are divided into 'strenuous, mild, vigorous and brisk'. On pages 379-381; Ibn Sina states the types of exercises under each type:

"Strenuous exercises include: wrestling contests, boxing, quick marching, running, jumping over an object higher than one foot, throwing the javelin, fencing, horsemanship, swimming. Mild exercises include: fishing, sailing, being carried on camels, swinging to and fro. Vigorous exercises include: those performed by soldiers in camp, in military sports; field running, long jumping, high jumping, polo, stone throwing, lifting heavy stones or weights, various forms of wrestling. Brisk exercises include: involves interchanging places with a partner as swiftly as possible, each jumping to and fro, either in time or irregularly." (Avicenna 1999, pp. 379–81)

There are certain important things to note once you start exercising, one is the amount, the other consistency; Ibn Sina states about the amount:

"(1) the color - as long as the skin goes on becoming florid, the exercise may be continued. After it ceases to do so, the exercise must be discontinued." (Avicenna 1999, p. 384)

On being consistent with exercise Ibn Sina states (on the importance of having a regimen):

"At the conclusion of the first day's exercise, you will know the degree of exercise allowable and when you know the amount of nourishment the person can bear, do not make any change in either on the second day. Arrange that the measure of aliment, and the amount of exercise shall not exceed that limit ascertained on the first day." (Avicenna 1999, p. 385)

On the side note those who think themselves to be elderly, and thus think of shunning exercise, Ibn Sina write a complete chapter titled "Concerning the Elderly" in the Qanun, and states the same regimen for them, as he does for others. He states on page 433

"For if, towards the end of life, the body is still equable, it will be right to allow attempered exercises. If one part of the body should not be in a first-rate condition, then that part should not be exercised until the others have been exercised..... On the other hand, if the ailment were in the feet, then the exercise should employ the upper limbs: for instance, rowing, throwing weights, lifting weights." (Avicenna 1999, p. 433)

Bathing in Cold Water

Once you have finished exercising; it is often that the person will feel tired and fatigued; to combat this problem Ibn Sina says on page 388:

"The beneficial Effects of Baths: The benefits are (1) induction of sleep (2) dilation of pores (3) cleansing of skin (4) dispersal of the undesirable waste matters (5) maturation of abscesses (6) drawing of nutriment towards the surface of the body (7) assistance to the physiological dispersion and excretion of poisonous matters (8) prevention of diarrhea and (9) removal of fatigue effects." (Avicenna 1999, p. 388)

Most importantly you should remember:

"A person should not go into the bath immediately after exercise. He should rest properly first." (Avicenna 1999, p. 387)

There are two more things that are important to mention on this subject:

"Injurious effects include the fact that the heart is weakened if the person stays too long in the bath" (Avicenna 1999, p. 388) "Cold Bathing should not be done after exercise except in the case of the very robust. Even then the rules which we have given should be followed. To use cold baths in the ways we have named drives the natural heat suddenly into the interior parts, and then invigorates the strength so that the person should leave the bath twice as strong as when he entered." (Avicenna 1999, p. 390)

Diet

Once Ibn Sina has laid the foundation of exercise being central to health, he names many exercises as running, swimming, weight lifting, polo, fencing, boxing, wrestling, long jumping, high jumping, etc. He also gives a diet to go along with the exercise:

"The meal should include: (1) meat especially kid of goats; veal, and year-old lambs (2) wheat, which is cleaned of extraneous matter and gathered during a healthy harvest without ever being exposed to injurious influences (3) sweets (fruits) of appropriate temperament." (Avicenna 1999, p. 390)

Lastly, the third thing mentioned is sleep; to make sure that you do not sleep during the days, and do not stay awake during the nights. From the above reading, it is clear that Ibn Sina gave advice in his book which is still the same advice medical doctors give to their patients. Daily Physical Exercise; and to defeat diseases such as type 2 diabetes, high blood pressure, the prescription of a diet which contains high amounts of Whole Grains and little to no amounts of Refined Carbohydrates.