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In many Hindu serials especially Mahabharata we see female nurses assisting a male doctor my question is do these nurses who exist historically/religiously in scriptures get paid? Some argue women cannot get a job that has a salary as per Shastra, but this is untrue since well I won't say it, but here is the source: [Source] So, to reiterate my question is were nurses present in ancient India and did the role include females who worked for a salary?

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  • Hospitals didn't exist in India before British rule. And the concept of nursing as a profession didn't emerge globally before the Crimean War. Hence it's absurd to ask whether nurses existed in ancient India.
    – অনু
    Commented Mar 12 at 12:22
  • There are certain anecdotes about Buddhist nuns performing roles similar to modern-day nurses but such activities are no different from that conducted by the Christian nuns in hospices run by the MoC, so they can't be technically considered as nursing.
    – অনু
    Commented Mar 12 at 12:26
  • @অনু hospitals didn't I mean during war time and we know medical practitioners did exist correct?
    – Haridasa
    Commented Mar 12 at 13:45
  • Yes doctors did exist, but not nurses. Besides, you should know that here we don't Wikipedia as a authority, let alone serials.
    – অনু
    Commented Mar 12 at 15:55
  • @অনু I know I am just making sure you understood the question correctly.
    – Haridasa
    Commented Mar 12 at 18:50

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In order to talk about 'nurses' in the framework of cikitsāśāstras and Indian civilization, some basics regarding cikitsā and its practice as mentioned in śāstras, need to be detailed.

bhiṣag dravyamupasthātā rogī pādacatuṣṭayam /
guṇavatkāraṇaṁ jñeyaṁ vikāravyupaśāntaye //
~ Carakasaṁhitā sūtrasthāna (9.3)

Bhiṣaj (vaidya), dravya, upasthātā (paricāraka), & rogī, constitute the four fundamental pādas of cikitsā, these four upon being guṇayukta lead to the alleviation of rogas.

Here, upasthātṛ is a paricāraka, who is like an assistant, helper or attendant of the vaidya, as specified by Cakrapāṇidatta in his commentary (comm.) Āyurvedadīpikā. The next two quoted ślokas specify the diff. b/w vaidya & paricāraka, by stating their guṇas.

śrute paryavadātatvam bahuśo dṛṣṭakarmatā /
dākṣyaṁ śaucamiti jñeyaṁ vaidye guṇacatuṣṭayam // (9.6)

upacārajñatā dākṣyamanurāgaśca bhartari //
śaucaṁ ceti catuṣkoʼyaṃ guṇaḥ paricare jane // (9.8)

~ Carakasaṁhitā sūtrasthāna

The four guṇas of a vaidya are- pūrṇarūpa jñāna of cikitsāśāstras (śrute-paryavadātatvam), extensive practical experience in cikitsākarma (bahuśo-drṣṭakarmatā), dākṣyam, & śaucam. - (9.6) The four guṇas of a paricāraka are- upacārajñatā, dākṣyam, loyalty/devotion to the doctor (anurāga ca bhartari), & śaucam.- (9.8)

In his comm. Āyurvedadīpikā, Cakrapāṇidatta adds that upacārajñatā means being jñāta on how to prepare yūṣa (soup), rasa (juice), etc., do patients' (rogin) massage, make them sleep, do their sevā, etc. (upacārajñatā yūṣarasādikaraṇasaṁvāhanasvāpanādijñatā). So, the requirements of theoretical expertise of śāstras and practical experience are not made of the paricāraka of vaidya, the paricāraka literally meaning one who does paricara i.e. follows after, and so, paricāraka's first allegiance is to the vaidya s/he is working under, instead of the patient. Apart from dākṣyam & śaucam, a paricāraka must be upacārakuśala, knowing exactly what is involved in tending and attending to a patient. Caraka saṁhitā sūtrasthāna (15.7) further specifies that they (paricārakas) should be able prepare pulses or soups, cook rice, give baths (snāpaka) & massages (saṁvāhaka), lift patients (utthāpaka), help them lie down again (saṁveśaka), grind necessary auṣadhis (auṣadhapeṣakaṁsca). All such paricārakas should have the requisite guṇas of of śīla, śauca, anurāga, dākṣya, and respectful behavior (prādakṣiṇya). They should be upacārakuśala, trained in all necessary karmas (sarvakarmasu paryavadātān), and not averse to any required karmas (sarvakarmasvapratikūlān), and so on.

Suśrutasaṁhitā sūtrasthāna (34.24) states that a paricāraka should have the following guṇas- friendly/tender (snigdhaḥ), non-reproaching (ajugupsu), balavāna, dedicated in the caring for the patient (yukto vyādhitarakṣana), obedient to the vaidya's orders (vaidyavākyakṛd), and tireless (aśrāntah). [snigdho'jugupsurbalavān yukto vyādhitarakṣaṇo / vaidyavākyakṛdaśrantaḥ pādaḥ paricaraḥ smṛtaḥ].

There is no norm in Āyurveda unlike modern west that the paricārakas should be specifically female in all cases (i.e. for all patients). Since, most of the directives in cikitsāśāstras refer to the patient in masculine form, the paricāraka too is assumed to be a man. But we can safely assume, that the gender of the paricāraka may most likely depend on the gender of the patient. Usually, where a female patient is specified in śāstras, the paricara (of vaidya) is always female. Thus, a midwife is assumed to be a woman. Suśruta saṁhitā śārīrasthāna (10.8) explains that there should be four female paricārakas (catasraḥ striyaḥ) at the bedside (of the garbhiṇī), who are mature (pariṇatavayasaḥ), not easily upset (aśaṅkanīyaḥ), skilled at giving birth (prajananakuśalaḥ) and whose nails are cut short (kartitanakhaḥ). [tataḥ kṛtopadhāne mṛduni vistīrṇe śayane sthitāmābhugnasakthīmuttānāmaśaṅkanīyāścatasraḥ striyaḥ pariṇatavayasaḥ prajananakuśalāḥ kartitanakhāḥ paricareyuriti].

The dhātrī (wet nurse) is of necessity female. Carakasaṁhitā śārīrasthāna (8.52) & Suśrutasaṁhitā śārīrasthāna (10.25) describe her in some detail. Caraka states in śārīrasthāna (8.52) that a dhātrī should be - belonging to the same varṇa as that of baby (samānavarṇa), yuvatī (yauvanasthāṁ), viśvāsapātra, rogarahita, without any hīna or more aṅgas, without durvyasanas (addiction/vices), not kurūpa, without nindita svabhāva/veśa, belonging to the baby's deśa, not kṣudra, not one who does kṣudrakarma, from uttamakula, having affectionate disposition towards children, having a living male child, having profuse lactation, not careless, not sleeping when the baby has done excrements, not patita by dharma or ācaraṇa, kuśala in baby's sevā, śuddha, having dveṣa of aśuddhatā, and endowed with excellent breasts & milk. (nibhṛtāmanāturāmavyaṅgāmavyasanāmavirūpāmajugupsitāṃ deśa jātīyām akṣudrām akṣudrakarmiṇīṁ kule jātāṁ vatsalāmarogāṁ jīvadvatsāṃ puṃvatsāṁ dogdhrīmapramattām anuccāraśāyinīmanantyāvasāyinīṃ kuśalopacārāṁ śucimaśucidveṣiṇīṁ stanastanyasampadupetāmiti). The next ślokas (8.53-57) detail the properties of excellent breasts and characteristics, complications, etc. of breast milk.

In śārirasthāna (8.58), Caraka states dhātrīkarma- when a dhātrī with madhura & śuddha breast milk is found, then before breastfeeding, she should take a snāna, apply candana paste on stanamanḍalas, wear a clean white dress, and put one of these auṣadhis (upon herself) - aindrī, brāhmī, śatavīryā, sahasravīryā, amoghā, avyathā, śivā, ariṣṭā, vāṭyapuṣpī, and viśvaksenakāntā. Then taking the baby, she should sit facing the east and make him suckle the right breast first. (dhātrī tu yadā svādubahulaśuddhadugdhā syāttadāsnātānuliptā śuklavastraṁ paridhāyaindrīṃ brāhmīṃ śatavīryāṁ sahasravīryāmamoghāmavyathāṃ śivāmariṣṭāṁ vāṭyapuṣpīṁ viṣvaksenakāntāṁ vā bibhratyoṣadhiṁ kumāraṁ prāṅmukhaṁ prathamaṁ dakṣiṇaṁ stanaṁ pāyayet //). Suśruta in śārirasthāna (10.25) adds that while breastfeeding, the baby's face should be towards east while the dhātrī's face should be towards north. (tithau śiraḥsnātamahatavāsasamudaṅmukhaṃ śiśumupaveśya dhātrīṁ prāṅmukhīṁ copaveśya dakṣiṇaṃ stanaṃ dhautamīṣatparisrutamabhimantrya mantreṇānena pāyayet)

As per Kauṭilya's Arthaśāstra (10.3.47), on battlefields and in army camps, women play an auxiliary role and are mentioned with vaidyās (and their paricaras who carry instruments, etc.), being at the rear of army. This is stated as follows-

cikitsakāḥ śastrayantrāgadasnehavastrahastāḥ striyaścānnapānarakṣiṇyaḥ puruṣāṇāmuddharṣaṇīyāḥ pṛṣṭhatastiṣṭheyuḥ //

Cikitsakas (vaidyas) carrying śastras (surgical instruments), yantras (medical apparatus), agadas (medicines & auṣadhis) , sneha (medicinal oils), vastras (bandages), and women in charge of food & drink with the duty of emboldening the men, should be stationed at the rear (of the army).

Kauṭilya's Arthaśāstra (3.13.30) further states -

kāruśilpikuśīlavacikitsakavāgjīvanaparicārakādirāśākārikavargastu yathānyastadvidhaḥ kuryāt / yathā vā kuśalāḥ kalpayeyuḥ tathā vetanaṁ labhet /

The group of those who work in hope (or renumeration) such as kāru (artisans), śilpi (craftsman), kuśīlava (performers), cikitsakas, vāgjīvanas (bards), paricārakas, and others should receive a renumeration (vetana) as others of that type do or as experts may determine.

So, as per Kauṭilya's Arthaśāstra (3.13.30), cikitsakas and paricārakas (including female ones such as dhātrīs) came in the category of āśākārikas, i.e. those who work in the expectation of renumeration/reward, rather than a wage. Jain (1947:179) states the following -

If a vaidya was brought to the home of a patient, he was provided with a hot bath and other comforts. He has to be fed on old rice and was provided with costly utensils. After the examination the vaidya was to be given his proper fees.

There were state vaidyas as well. It's said that once a vaidya did not treat the queen of a certain king properly and so he was put to death. Another physician was addicted to gambling and he didn't attend to his work. His śāstra on cikitsā was stolen by robbers and his surgical instruments rusted. When this was brought to the notice of the king, he stopped his salary.

Therefore, there shouldn't be any doubt that many vaidyas received payment for their services, and so the paricaras would most likely attain payment too, either from the vaidya or from the patient directly. A third source of payment for the vaidya & paricaras might be grants from external sources (other than patient).

There's a late 11th century inscription on the wall of the temple at the town of Tirmukkūḍal, not far from Kandhi, covers 540 sq.ft., and is 55 ft. long. The Tirmukkūḍal inscription records grants given by Vīrarājendra (i.e. Cola king Rājakeśarivarman) for the support of a Saṁskṛta viśvavidyālaya, vidyārthīs, hostel, and an āturaśālā (kinda-hospital/clinic). The inscription provides detailed information on Vīrāśōḷan "house for the sick" (āturaśālā). The clinic was provided with 15 beds. The vaidya's name was Savarṇan Kōdaṇḍarāman Aśvatthāma-Bhaṭṭan of Ālappākkam, who was a recipient of land grants to support his medical prescribing. He was paid annually 90 kalams of paddy and 8 kāśus, as well as a grant of land, for prescribing medicines to the patients lying in the clinic, for the dāsas attached to the institution and for the adhyāpakas & vidyārthīs of the vidyālaya. In addition to the vaidya, the inscription mentions the following staff (Wujastyk 2022: 21-22)-

  • one surgeon who received 30 kalams of paddy
  • two persons for fetching medicinal hebs who were paid 60 kalams of paddy and 2 kāśu; these staff also supplied firewood and prepared medicines;
  • two paricaras, who received 30 kalams of paddy and 1 kāśu, and attended patients and administered medicines
  • a barber who received 15 kalams of paddy
  • there were also cleaners

So, in this case, not only the vaidya but even paricaras of this kinda-clinic attached to the vidyālaya, are being funded by the royalty.

In Mahāsāṅghika Lokottaravāda Bhikṣuṇī Vinaya (pāccatika-dharma 82), there's an account regarding a Bauddha bhikṣuṇī named Candakamātā, who was a vaidyikā.

The Lord was staying at Kauśāmbī. A bhikṣuṇī, Candakamātā, was accepted in the inner household of the king. She was skilful with root, leaf and fruit medicines. With the relatives of the king, ministers, merchants, and [other] excellent families, she established a (basti) for women. She cured fainting fits, offered medical treatments such as black ointment, [other] ointments, emetics, purgatives, sweat-treatments, nasal treatments, and bloodletting. Before she left, she received soft food and hard food. Then the bhikṣuṇīs found out, "This is not a bhikṣuṇī" they said, "This is a vaidyikā." The bhikṣuṇīs informed Mahāprajāpati about the situation. The Lord said, "Summon Candakamātā." She was summoned. The Lord said, "Is it true, Candakamātā, that you make a living by cikitsā-vidyā ?" "Yes, Lord." "This is badly done, Candakamātā. It is not suitable to make your living by cikitsāvidyā." And the lord [ordained]..."Whichever bhikṣuṇī makes a living by cikitsā-vidyā commits a fault requiring expiation."

(Langenberg 2014: 161-162)

As we see, Candakamātā had opened a kinda-clinic where she treated women patients. Although she did not accept direct payment (as that's against Vinaya), she received food from the women she treated. Her fellow bhikṣuṇīs found her cikitsākarma as not aligning with bhikṣuṇīdharma and accused her of acting like a vaidyikā, instead of a bhikṣuṇī. And then, Buddha ordained that bhikṣuṇīs couldn't make their living by means of cikitsāvidyā, or they would commit a fault requiring expiation. But clearly, in this Vinaya story, it's not mentioned that Candakamātā provoked any criticism of laypeople, as her lay patrons welcomed her medical expertise and flocked to her for cures for variety of ailments.

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  • Very cool, and informative answer, I am wondering what other jobs females did I know this and prostitution is one, but the latter is evil and against chastity I believe.
    – Haridasa
    Commented Mar 12 at 20:46
  • @Haridasa Well, even veśyās had a certain respect in pre-Izlamic Indian society, the Indians were not affected by Victorian prudishness then. They aren't seen as 'evil' in Indian tradition.
    – Bingming
    Commented Mar 12 at 20:48
  • I am very curious on this regard I am no liberal, but the complexity of society is beautiful
    – Haridasa
    Commented Mar 12 at 21:31

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