For political reasons, Ninisina also acquired some traits originally belonging to Inanna when the kings of Isin lost control over the cult center of the latter goddess, Uruk.

[4] While "nin" is often translated as a feminine noble title, it was grammatically neutral and can be found in the names of male deities as well, for example Ningirsu, Ninazu and Ningublaga, in which case it instead means "lord.

"[5] Multiple variants of the second element of Ninisina's name are attested, leading to spellings such as dNin-ezen(ki) or dNin-IN (logographic) in addition to phonetic ones such as dNin-i3-si-na, but it is agreed that in all cases it refers to the city of Isin.

[27] However, Julia M. Asher-Greve notes that caution is necessary when evaluating the origin of such epithets, as they did not necessarily refer to motherhood in the biological sense, but rather to a given deity's authority and high position in the pantheon, similar as the analogous masculine ones.

[55] According to Irene Sibbing-Plantholt the marriage was most likely theologically motivated by the need to provide Ninisina with a spouse representing an ideologically significant city, rather than by shared primary function between her and Pabilsag, who was not a healing deity.

[57] Sporadically an association between Ninisina and Ninurta is also attested, but there is no strong indication in known sources that they were regarded as a couple in their respective cult centers, Isin and Nippur.

[58] Damu, Gunura[59] and Šumaḫ were regarded as Ninisina's children[60] Dietz Otto Edzard[2] and Klaus Wagensommer refer to Pabilsag as their father,[60] but Irene Sibbing-Plantholt notes that no text directly labels him this way.

[61] She also proposes that Damu only acquired his own character as a healing deity due to his new status as Ninisina's son, and that originally his primary role was that of a dying god comparable to Dumuzi and Ningishzida.

[13] Šumaḫ, whose name means "the one with the mighty hand," also functioned as his mother's sukkal (divine vizier) and according to the god list An = Anum as one of the five udug (in this context: protective spirits) of the temple Egalmaḫ.

[64] A further member of her court was Ninarali whose name, "lady of Arali," contains a poetic term for the underworld, which according to Barbara Böck might reflect Ninisina's own association with this sphere.

[74] While the healing goddesses of the Mesopotamian pantheon - Ninisina, Nintinugga (associated with Nippur),[75] Ninkarrak (worshiped especially in Terqa[76] and Sippar[77] ), Gula (possibly originally from Umma),[78] Meme and Bau[79] - were initially separate deities,[80] they were at times either partially conflated or treated as equivalents of each other.

[82] The fact that Ninisina, Gula and Ninkarrak occur separately in the Weidner god list is considered evidence in favor of assuming they were not conflated at the time of its composition.

[83] In modern scholarship, Mesopotamian medicine goddesses are sometimes treated as fully interchangeable, with the theonym Gula used to refer to them collectively, but as noted by Irene Sibbing-Plantholt, this approach "does not do justice to the idiosyncratic, diverse characters" of the individual deities.

[83] Ninisina is entirely absent from known texts from Umma,[63] and had no cult in this city, though in an inscription from the Ur III period the local governor Lu-Utu calls himself a son of this goddess.

[13] Barbara Böck argues that Ninisina was fully absorbed by Gula in the centuries following the reign of Ishbi-Erra,[93] but according to Irene Sibbing-Plantholt the association between them is only attested in Isin after Hammurabi's conquest of the city,[58] and Christina Tsouparopoulou states that it is not certain if they were viewed as identical in the Old Babylonian period.

[102] However, in early sources, such as inscriptions of Uru'inimgina, she is not yet a healing deity, but rather a "lifegiving, motherly figure," and it is possible she only acquired the former role due to syncretism with Ninisina.

[54] The lasting result of this process was an exchange of attributes between the two goddesses involved,[110] with Ninisina acquiring a warlike aspect and Inanna being occasionally associated with healing.

[69] Julia M. Asher-Greve argues the association between Ninisina and the rod-and-ring symbol attested in Isin was another aspect of it, and points out a possibly related passage occurs in a hymn[11] which describes how her various roles were bestowed upon her by Enlil and Ninlil.

[53] The earliest attestations of Ninisina come from the Early Dynastic period, and include oath formulas from Isin, an entry in the god list from Fara,[6] and a passage from the Zame Hymns.

[138] Sîn-kāšid built a temple of Ninisina in Uruk, and in the inscription commemorating this event refers to her as "the incantation priestess of the numerous people, chief physician of black-headed" and as his lady.

"[146] Since it also invokes many other deities (Anu, Enlil, Ninlil, Ninurta, Nuska, Enki, Ninḫursag, Nanna, Utu, Ishkur, Nergal, Inanna and Ninšenšena), Odette Boivin suggests that it reflected the "newly achieved supra-regional extent" of his kingdom.

[148] Julia M. Asher Greve states that temples of both Ninisina and Ninkarrak existed in Sippar,[149] but Irene Sibbing-Plantholt in a more recent publication concludes that she was not worshiped in this city.

[152] While the aforementioned king referred to the Egalmaḫ as a temple of Gula,[153] later rulers consistently treated Ninisina as the goddess of Isin during building projects undertaken there.

[60] According to Wilfred G. Lambert, multiple traditions regarding Enlil's parentage are known, and his father could variously be Anu, Lugaldukuga or possibly the primordial deity Enmesharra.

[157] The rest of the text briefly describes a visit of the goddess in Nippur, gifts she presents to the city's master Enlil, and the declaration of a good destiny for her.

[162] It is followed by a lacuna of 10 lines, and when the text resumes, Ninisina and Pabilsag enter the Egalmaḫ, sit on a dais and listen to the music performed by Ninḫinuna.

[164] A šir-gida (literally "long song"[40]) composition dedicated to Ninisina states that she invented the šuba stones, perhaps to be identified as carnelian, for Inanna.

[168] Three hymns dedicated to Ninisina on behalf of specific monarchs are known, Ishbi-Erra D, Iddin-Dagan D and Lipit-Ishtar E; their titles used in scholarship follow the ETCSL naming system.

[173] For example, in the Lament for Sumer and Ur, she is one of the mourning deities because "Isin was split by onrushing water;" the section dedicated to her is placed after that focused on Lugal-Marada and his wife Imzuanna, and before the one which describes the fate of Ninlil.

[176] Dina Katz, following earlier studies, notes that in contrast with other dying gods, Damu was seemingly imagined not as a young man, but as a baby, with one text apparently describing him as a "newborn child who was not yet washed," which might indicate traditions pertaining to him were inspired by high infant mortality rates in ancient Mesopotamia.