During the Middle Ages, medicine, as a science, practically ceased to exist. In the Christian era hospitals and asylums for the sick were established, but it cannot be said that the clinical material thus gathered was utilized to much good. Leper hospitals in great numbers were established throughout Europe and England, necessitated by the spread of that disease by pilgrims and crusaders returning from the East.
To their preservation in various monastic libraries we owe the possession of most of the literary remains of ancient Greek, Latin, and Arabian medicine, but no additions were made during many centuries to the knowledge of anatomy, physiology, or other fundamental branches of medicine. The monks who wrote on medical subjects were either mere copyists who transcribed ancient manuscripts which were contained in monastic libraries, or compiled formularies of therapeutic measures.
The "Schola Medica Salernitana" was a Medieval medical school, the first and most important of its kind, believed to be the first medical school in the western world. It was founded in the 9th century (Antonio Mazza dates the foundation of the school in 802) and was originally based in the dispensary of a monastery. The "School" was based on the synthesis of the Greek-Latin tradition supplemented by notions from Arab and Jewish cultures. The approach was based on the practice and culture of prevention rather than cure, thus opening the way for the empirical method in medicine. The Salerno school was a fruitful bridge between the ancient medical tradition, Arab medicine and Western Latin medicine. Salerno owned a hospital attached to a Benedictine convent before the year 1000; according to the well-known founding myth of the Schola Salerni, a group of lay doctors also developed: one Greek, Pontus, one Latin, Salernus, one Arab, Adela and one Jew, Helinus. The legendary figure, however, had something true in indicating the convergence of the greatest Mediterranean traditions of ancient medicine, namely Hippocratic and Galenic, Roman and Latin, and finally the medieval renewal carried out by Arabs and Jews always in the Arab context. The novelty of the secular medical school was to emphasize clinical realism, therapeutic simplicity and the value of experience
The Salernitan Medical School was Italy's solution to the ills of the time, a beacon in the so-called "dark" Middle Ages: Founded between the 9th and 10th centuries, it was the first medical institution in Europe. It combined Greek-Latin, Arab, and Jewish knowledge, promoting empirical and preventive medicine. Its health rules (Regimen Sanitatis Salernitanum) advised on diet, mental balance, and hygiene: "Mens laeta, requies, moderata diaeta". The Mulieres Salernitanae, such as Trotula de Ruggiero, were pioneers in the field of gynecology and surgery. Salerno is not just a city buried under centuries of history: it is a city that cared for Europe when the world seemed to be dying.
It achieved its greatest celebrity between the 10th and 13th centuries, from the last decades of Lombard power, during which its fame began to spread more than locally, to the fall of the Hohenstaufen. The city of Salerno was already very famous for its healthy climate and its doctors, and the fame of the medical school had reached northern Europe.
The arrival in Salerno of Constantine Africanus in 1077 marked the beginning of Salerno's classic period. Through the encouragement of Alfano I, Archbishop of Salerno and translations of Constantine Africanus, Salerno gained the title of "Town of Hippocrates" (Hippocratica Civitas or Hippocratica Urbs). People from all over the world flocked to the "Schola Salerni", both the sick, in the hope of recovering, and students, to learn the art of medicine.
Arabic medical treatises, both those that were translations of Greek texts and those that were originally written in Arabic, had accumulated in the library of Montecassino, where they were translated into Latin; thus the received lore of Hippocrates, Galen and Dioscorides was supplemented and invigorated by Arabic medical practice, known from contacts with Sicily and North Africa. As a result, the medical practitioners of Salerno, both men and women, were unrivaled in the medieval Western Mediterranean for practical concerns.
The elements of nature are at the origin of the treatments to which the Schola was addressed: it has built its glorious tradition starting from the landscape as an overall space of its particular history that originates in the ancient Mediterranean world. To eighteen "simple" ones, in fact, he entrusted the treatment of every disease: mallow, mint, sage, rue, onion, mustard, violet, nettle, hyssop, cherofolio, enula bell, pulegio, nasturtium, celandine, willow, crocus, leek, black pepper. These are the eighteen therapeutic herbs to which "suffering" humanity turned, accompanied, however, by the awareness recited by the aphorism of sage, the saving plant par excellence, the panacea, the plant that together with garlic, saffron, cinnamon, made up a talisman-amulet that had the virtue of maintaining good health and protecting from evil influences.
Although an important role is attributed to several men of this school, who were recognized as wise and learned doctors, modern historiography has also reevaluated and extolled the praiseworthy role of women. Contrary to the common beliefs and expectations of a woman's “place” at the time, these women were fully titled physicians. Attention was also paid to the health and welfare of children.
The most famous work of the Salernitan School was the "Regimen Sanitatis Saleritanum", a Latin poem of rational, dietetic, and hygienic precepts, many of them still valid today. The school also produced a physician's reference book, with advice on how to treat a patient, a sort of code of conduct to help the physician to respect the patient and his or her relatives. The first science-based surgery appeared on the scene of the discredited medieval practice in Salerno, thanks to Roger of Salerno and his fellows. He wrote a book on surgery, called "Rogerina" or "Post Mundi Fabricam", in which surgery from head to toe is described, with surprising originality.
Still in the habit of the Salerno School, around the year 1100 alcohol began to be used in its two forms: aqua ardensa 60 ° and aqua vitae at 90 °, as solvents for the preparation of remedies. The plurality of uses is also denoted in the terminologies used for the new substances: first essence, quintessence, soul of wine, flagrant, permanent or eternal water, subtle spirit, mercury light.
The most famous was the formula synthesized by the doctor and alchemist Arnaldo di Villanova, who in 1260, through repeated distillations and condensations, synthesized the ardentem water or the Water of Immortality. to whom miraculous powers were attributed as it is written in his work 'Tractatus de vino'. Therefore the name of acquavitae, still in use today, is also to be attributed to Villanova. Obviously, the preparation could only be sold by mortgages and could cure, according to the sellers, almost everything.
Famous members of 14th century were Abella of Salerno, physician and medical writer associated with the Salerno School of Medicine, recognized for her contributions to bile studies and women’s health, and Mercuriade, italian physician, surgeon, and medical author, remembered as one of the few female physicians of the Middle Ages.