history of nursing history of nursing the word "nurse" originally came from the latin word "nutrire", meaning to suckle, referring to a wet-nurse; only in the late 16th century did it attain its modern meaning of a person who cares for the infirm. from the earliest times most cultures produced a stream of nurses dedicated to service on religious principles. both christendom and the muslim world generated a stream of dedicated nurses from their earliest days. in europe before the foundation of modern nursing, catholic nuns and the military often provided nursing-like services. it took until the 19th century for nursing to become a secular profession. ancient history the early history of nurses suffers from a lack of source material, but nursing in general has long been an extension of the wet-nurse function of women. buddhist indian ruler (268 bc to 232 bc) ashoka erected a series of pillars, which included an edict ordering hospitals to be built along the routes of travelers, and that they be "well provided with instruments and medicine, consisting of mineral and vegetable drugs, with roots and fruits"; "whenever there is no provision of drugs, medical roots, and herbs, they are to be supplied, and skilful physicians appointed at the expense of the state to administer them." the system of public hospitals continued until the fall of buddhism in india ca. ad 750. about 100 bc the charaka samhita was written in india, stating that good medical practice requires a patient, physician, nurse, and medicines, with the nurse required to be knowledgeable, skilled at preparing formulations and dosage, sympathetic towards everyone, and clean. the first known christian nurse, phoebe, is mentioned in romans 16:1. during the early years of the christian church (ca. ad 50), st. paul sent a deaconess named phoebe to rome as the first visiting nurse. from its earliest days, following the edicts of jesus, christianity encouraged its devotees to tend the sick. priests were often also physicians. according to the historian geoffrey blainey, while pagan religions seldom offered help to the infirm, the early christians were willing to nurse the sick and take food to them, notably during the smallpox epidemic of ad 165-180 and the measles outbreak of around ad 250; "in nursing the sick and dying, regardless of religion, the christians won friends and sympathisers". following the first council of nicaea in ad 325, christianity became the official religion of the roman empire, leading to an expansion of the provision of care. among the earliest were those built ca. 370 by st. basil the great, bishop of caesarea mazaca in cappadocia in asia minor (modern-day turkey), by saint fabiola in rome ca. 390, and by the physician-priest saint sampson (d. 530) in constantinople, called the basiliad, st. basil's hospital resembled a city, and included housing for doctors and nurses and separate buildings for various classes of patients. there was a separate section for lepers. eventually construction of a hospital in every cathedral town was begun. christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals after the end of the persecution of the early church. ancient church leaders like st. benedict of nursia (480-547) emphasized medicine as an aid to the provision of hospitality. 12th century roman catholic orders like the dominicans and carmelites have long lived in religious communities that work for the care of the sick. some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by christian mercy and byzantine innovation. byzantine hospital staff included the chief physician (archiatroi), professional nurses (hypourgoi) and orderlies (hyperetai). by the twelfth century, constantinople had two well-organized hospitals, staffed by doctors who were both male and female. facilities included systematic treatment procedures and specialized wards for various diseases. in the early 7th century, rufaidah bint sa’ad (also known as rufaida al-aslamia) became what is now described as the first muslim nurse. a contemporary of muhammad, she hailed from the bani aslam tribe in medina and learned her medical skills from her father, a traditional healer. after she had led a group of women to treat injured fighters on the battlefield, muhammad gave her permission to set up a tent near the medina mosque to provide treatment and care for the ill and the needy. medieval europe medieval hospitals in europe followed a similar pattern to the byzantine. they were religious communities, with care provided by monks and nuns. (an old french term for hospital is hôtel-dieu, "hostel of god.") some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. some hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor, or for pilgrims: not all cared for the sick. the first spanish hospital, founded by the catholic visigoth bishop masona in ad 580 at mérida, was a xenodochium designed as an inn for travellers (mostly pilgrims to the shrine of eulalia of mérida) as well as a hospital for citizens and local farmers. the hospital's endowment consisted of farms to feed its patients and guests. from the account given by paul the deacon we learn that this hospital was supplied with physicians and nurses, whose mission included the care the sick wherever they were found, "slave or free, christian or jew." during the late 700s and early 800s, emperor charlemagne decreed that those hospitals which had been well conducted before his time and had fallen into decay should be restored in accordance with the needs of the time. he further ordered that a hospital should be attached to each cathedral and monastery. during the tenth century the monasteries became a dominant factor in hospital work. the famous benedictine abbey of cluny, founded in 910, set the example which was widely imitated throughout france and germany. besides its infirmary for the religious, each monastery had a hospital in which externs were cared for. these were in charge of the eleemosynarius, whose duties, carefully prescribed by the rule, included every sort of service that the visitor or patient could require. as the eleemosynarius was obliged to seek out the sick and needy in the neighborhood, each monastery became a center for the relief of suffering. among the monasteries notable in this respect were those of the benedictines at corbie in picardy, hirschau, braunweiler, deutz, ilsenburg, liesborn, pram, and fulda; those of the cistercians at arnsberg, baumgarten, eberbach, himmenrode, herrnalb, volkenrode, and walkenried. no less efficient was the work done by the diocesan clergy in accordance with the disciplinary enactments of the councils of aachen (817, 836), which prescribed that a hospital should be maintained in connection with each collegiate church. the canons were obliged to contribute towards the support of the hospital, and one of their number had charge of the inmates. as these hospitals were located in cities, more numerous demands were made upon them than upon those attached to the monasteries. in this movement the bishop naturally took the lead, hence the hospitals founded by heribert (d. 1021) in cologne, godard (d. 1038) in hildesheim, conrad (d. 975) in constance, and ulrich (d. 973) in augsburg. but similar provision was made by the other churches; thus at trier the hospitals of st. maximin, st. matthew, st. simeon, and st. james took their names from the churches to which they were attached. during the period 1207–1577 no less than 155 hospitals were founded in germany. the ospedale maggiore, traditionally named ca' granda (i.e. big house), in milan, northern italy, was constructed to house one of the first community hospitals, the largest such undertaking of the fifteenth century. commissioned by francesco sforza in 1456 and designed by antonio filarete it is among the first examples of renaissance architecture in lombardy. the normans brought their hospital system along when they conquered england in 1066. by merging with traditional land-tenure and customs, the new charitable houses became popular and were distinct from both english monasteries and french hospitals. they dispensed alms and some medicine, and were generously endowed by the nobility and gentry who counted on them for spiritual rewards after death. according to geoffrey blainey, the catholic church in europe provided many of the services of a welfare state: "it conducted hospitals for the old and orphanages for the young; hospices for the sick of all ages; places for the lepers; and hostels or inns where pilgrims could buy a cheap bed and meal". it supplied food to the population during famine and distributed food to the poor. this welfare system the church funded through collecting taxes on a large scale and possessing large farmlands and estates. roles for women catholic women played large roles in health and healing in medieval and early modern europe. a life as a nun was a prestigious role; wealthy families provided dowries for their daughters, and these funded the convents, while the nuns provided free nursing care for the poor. meanwhile, in catholic lands such as france, rich families continued to fund convents and monasteries, and enrolled their daughters as nuns who provided free health services to the poor. nursing was a religious role for the nurse, and there was little call for science. middle east the eastern orthodox church had established many hospitals in the middle east, but following the rise of islam from the 7th century, arabic medicine developed in this region, where a number of important advances were made and an islamic tradition of nursing begun. arab ideas were later influential in europe. the famous knights hospitaller arose as a group of individuals associated with an amalfitan hospital in jerusalem, which was built to provide care for poor, sick or injured christian pilgrims to the holy land. following the capture of the city by crusaders, the order became a military as well as infirmarian order. roman catholic orders such as the franciscans stressed tending the sick, especially during the devastating plagues. early modern europe the subject of saint sebastian tended by saint irene, here by jan van bijlert, c. 1620s, became popular in art in the early 17th century, connected with fears of plague and the encouragement of nursing catholic europe