Museum of Health Care Blog

The following blog post was written by 2014 Collections Technician Katrin MacPhee.*

While handling an artifact from the Museum’s collection, a familiar sight piqued my curiosity. Stamped onto a pin awarded by the Canadian Medical Association was a snake coiled around a staff. I had seen the same symbol on the badges of emergency health service workers, emblazoned on ambulances, and on pharmaceutical logos. I wondered, what were the origins this symbol? Why was it significant to medical organizations? Through what process had so many health professionals adopted it as a representation of their work?

The symbol, called the Rod (or Staff) of Asklepios (in Greek) or Asclepius (the popularized version of the Latin name) represents the Greco-Roman god of healing. According to a fairly recent exploration of the symbol within the Annals of Internal Medicine, Asclepius was a revered figure within Greco-Roman medical traditions between 1200 B.C.E. until 500 C.E, and was upheld as the ideal physician. Appearing in The Illiad (circa 9^th to 10^th century BCE) as a mortal but heroic healer, by the 8^th century BCE he was deified and worshipped as the son of Apollo, whose healing powers he was believed to have improved. Scholars have traced the actual historical figure of Ascelpius and his family to the region of Thessaly in Greece.[2] By the 6^th century B.C.E., hundreds of temple complexes, called Asklepions, existed throughout the Greco-Roman world.[3] Some of the most extensive of these facilities had centres for medical practices, and in time Asclepius became perceived as the patron of physicians, especially those who treated the vulnerable and the poor.[4]

Although several origin myths of the Rod symbol exist, the one generally accepted as the most popular tells the tale of Asclepius examining a man recently struck dead by one of Zeus’ lightening bolts. Startled by an approaching snake, the healer killed the snake with his staff. A second snake quickly appeared and placed some herbs into the dead snake’s mouth, thereby restoring it to life. Asclepius, so the legend goes, quickly followed the snake’s example and revived the man from the dead. As a tribute to the snake, he then adopted the symbol of the snake coiled around the rod as his own emblem.[5]

As a recent analysis of the symbol’s enduring popularity notes, it is rather bizarre that the snake has withstood lengthy centuries as a healing symbol. On a cultural level, within Christian societies snakes are often associated with the Fall of Man and various vices.[6] And yet, according to historian and doctor Touraj Nayernouri, despite their apparently unsavory connotations, “in the history of medicine, few (symbols) have survived the vicissitudes of time and the changing fashions, except the image of the serpent.” [7] Authors of an exploration of the symbols of the snake and the healing staff within Egyptian, Greek, and Judeo-Christian traditions argue the snake in particular has been perceived alternatively as a symbol of rejuvenation, of luck, of the earth’s fertility, and of sin, death, resurrection, and therapy, making it overall a rather appropriate symbol for modern practitioners.[8]

The longevity of the symbol is particularly remarkable in light of its widespread and prolonged suppression throughout much of Europe. The Rod of Asclepius, alongside many other symbols of Greco-Roman Gods and Goddesses, was banned by the Catholic Church throughout much of the early Christian era and the Middle Ages. As uroscopy, the examination of urine for signs of disease, rose to prominence as a pre-eminent healing practice, the urine flask became the most recognizable symbol of medicine during the Middle Ages. However, during and after the Protestant Reformation, Catholic patron saints of medicine lost favour and ancient healing symbols regained popularity in many Northern European areas. The symbol re-emerged, alongside other classical themes, in Renaissance artwork.[9]

By the beginning of the 17^th century, the Rod of Asclepius was widely adopted as a symbol of the medical profession in many regions of Europe.[10] As Jan Schouten, a historian of the art of the Rod of Asclepius has argued, by the 18^th century the symbol’s link to ancient Gods and pagan healing practices had largely been obscured as it was embraced by a wide array of medical practitioners.[11] That practice continues as today many organizations use the rod as part of their logos.

Interestingly, I was almost as accustomed to seeing two snakes intertwined around a staff beneath unfolded wings used as a medical symbol, as I was with the singular snake of the Rod of Asclepius. Had I been mistaking the two symbols? Why would some medical groups wear the sign with two snakes instead of one, or vice versa? Once I began reading a little about medical symbology I realized myself and others could be forgiven for the confusion. The dual snake symbol, called the Caduceus, is the current emblem of many prominent medical organizations, and it is particularly popular within the United States. According to a survey conducted in 1993 of 242 medical logos, over 38% percent of American medical associations and over 63% of American hospitals use the Caduceus as their symbol.[12]  This seems especially strange in light of the fact that many organizations use both the Caduceus and the Rod of Asclepius. For instance, within the army, the Caduceus is the sign of the U.S. Army Medical Corps, but the U.S. Army Medical Department uses the Rod of Asclepius.[13]

The Caduceus’ place of pride on medical badges, crests, and logos has never been without its vocal detractors. The caduceus is the sign of Hermes (as he is known in Greek mythology, or Mercury, as he is known in Roman mythology). Hermes was the messenger of the Gods, a patron of travelers, the conductor of the dead to the world of the afterlife, the conveyor of dreams, and the protector of merchants, commerce, and thieves. Hermes’ staff was also associated with peacemaking and negotiating, during the Imperial Roman era the Caduceus was an olive branch wrapped with white linen and was used to designate noncombatants on a battlefield. Given these associations, some historians and medical professionals have argued that the Caduceus is an inappropriate symbol for medical professions. In particular, Hermes’ role as a conductor of the dead has been claimed as unfitting for a profession dedicated to healing.[14] The occasional dissenting voice has sought to redeem the symbol’s relevance to medicine due to the use of the Caduceus as a sign of honour within the Royal College of Physicians in London in the 1500s, and its popularity with alchemists the Middle Ages and Oculists in Roman times (both fields connected to healing practices). However, even amongst those who point to the Caduceus’ tangential relevance to the history of medicine maintain that its popularity is doubtless due to an error.[15]

Indeed, as historians Wilcox and Whitman argue, the adoption of the Caduceus by the medical community was a mistake rooted in the similarity of the image to the symbol of the Rod of Asclepius. The Caduceus was featured prominently on texts printed by the prolific medical text publisher John Churchill of London in the 19^th century. Churchill also printed the Rod of Asclepius on his books, so it was likely that he deliberately selected the Caduceus as the sign of his printing business, and was not attempting to promote it as a symbol for the medical profession as a whole. The proliferation of the Caduceus on these respected medical texts has been cited as the probable reason why the symbol became popularized within the early 20^th century.[16]

Historian Touraj Nayernouri argued assistant surgeon Captain Frederick Reynolds of the U.S. Army Medical Corps was the originator of the confusion. Evidently Captain Reynolds insisted that the symbol was commonly used by many European army medical corps (wrongly, as most used Christian imagery or the Rod of Asclepius) and that it would therefore be appropriate as a collar insignia for his organization.[17] Although Reynolds’ request was at first denied by Surgeon General G.W. Steinberg, it was approved by his successor, Surgeon General W.H. Forwood. Reynolds’ confusion is evident in that he referred to his proposed design as the Rod of Asclepius in his correspondence with both men. The error did not go unnoticed for long, By 1917 the librarian to the Surgeon General publicly bemoaned the use of the inappropriate symbol. [18]

In 1924 a debate broke out in the pages of The Military Surgeon over whether or not the symbol was appropriate for the U.S. Army Medical Corps. While some writers argued the profession should universally correct their error and adopt the Rod of Asclepius, one writer countered that the symbol was appropriate. In Encyclopedia of United States Army Insignia and Uniforms William Emerson stated the symbol was not adopted by the Medical Corps for its medical connotations, but for the Caduceus’ ancient use in designating neutrality amongst noncombatants, and was therefore chosen wisely and deliberately.[19] Regardless of this debate, the Caduceus was adopted by the Navy Hospital Corps and many other organizations in the early 20^th century including, briefly, the American Medical Association.[20] Its continuing popularity with medical associations, and, even more so, commercial medical organizations, has been attributed to the prioritization of easily recognizable logos over iconographically correct ones.[21]

At the least, heated discussion surrounding the symbols of medical associations draws attention to the interwoven histories of mythology and medicine. Most modern medical organizations are secular institutions firmly rooted in ideas of scientific rationality, but it certainly is interesting to view the occupation’s symbols within the continuum of their past. In an age when many medical professionals would likely avoid a public association with a pre-modern symbol of spirituality, it is rather neat that such symbols persist right under our noses, on our ambulances, hospitals, and medical uniforms.

*We acknowledge the financial support of the Government of Canada (Youth Employment Strategy) through the Department of Canadian Heritage for the Young Canada Works Program.

Bibliography

Antoniou , Stavros A., Antoniou, George A., Learney , Robert , Granderath, Frank A. and Athanasios I. Antoniou. “The Rod and the Serpent: History’s Ultimate Healing Symbol.” World Journal of Surgery 35, 1 (January 2011): 217-21.

Emerson, William K. Encyclopedia of United States Army Insignia and Uniforms. Norman: University of Oklahoma Press, 1996.

Engle, Bernice.”The Use of Mercury’s Caduceus as a Medical Emblem.” The Classical Journal 25, 3 (December 1929): 204-8.

Friedlander, Walter J. The Golden Wand of Medicine. New York: Greenwood Press,

Hart, G. D. “The Earliest Medical Use of the Caduceus.” Canadian Medical Association Journal 107, 11 (December 1972): 1107-1110.

Nayernouri, Touraj “Asclepius, Caduceus, and Simurgh as Medical Symbols Part 1,”

Archives of Iranian Medicine 13, 1 (January 2010): 61-8.

Schouten, Jan. The Rod and the Serpent of Asklepios: Symbol of Modern Medicine. New York: Elsevier Pub. Co., 1967.

Mineka, S. and M. Cook. “Social learning and the Acquisition of Snake Fear in Monkeys.” In: Social Learning: Psychosocial and Biological Perspectives, edited by T. Zentall and B Galef, 51-73. Hillsdale, NJ: Erlbaum, 1988.
Sacks, Alexandra C., and Robert Michels, “Caduceus and Asclepius: History of an Error.” The American Journal of Psychiatry 169, 5 (May 2012): 464.

Wilcox, Robert A. and Emma M. Whitman. “The Symbol of Modern Medicine: Why One Snake is More than Two.” Annals of Internal Medicine 138, 8 (15 April 2003): 673-8.

[1] Touraj Nayernouri, “Asclepius, Caduceus, and Simurgh as Medical Symbols Part 1,” Archives of Iranian Medicine 13, 1 (January 2010): 62.

[2] Touraj Nayernouri, “Asclepius, Caduceus, and Simurgh as Medical Symbols Part 1,” Archives of Iranian Medicine 13, 1 (January 2010): 62.

[3] Robert A. Wilcox and Emma M. Whitman, “The Symbol of Modern Medicine: Why One Snake is More than Two,” Annals of Internal Medicine 138, 8 (15 April 2003): 674.

[4] Alexandra C Sacks and Robert Michels, “Caduceus and Asclepius: History of an Error,” The American Journal of Psychiatry 169, 5 (May 2012): 464.

[5] Wilcox and Whitman, “Why One Snake is More than Two,” 673.

[6] Stavros A. Antoniou ,George A. Antoniou, Robert Learney , Frank A. Granderath and Athanasios I. Antoniou, “The Rod and the Serpent: History’s Ultimate Healing Symbol,” World Journal of Surgery 35, 1 (January 2011): 217-9.

[7] Touraj Nayernouri, “Asclepius, Caduceus, and Simurgh as Medical Symbols Part 1,” 61.

[8] Stavros A. Antoniou ,George A. Antoniou, Robert Learney , Frank A. Granderath and Athanasios I. Antoniou, “The Rod and the Serpent: History’s Ultimate Healing Symbol,” 221.

[9] Jan Schouten, The Rod and the Serpent of Asklepios: Symbol of Modern Medicine (New York: Elsevier Pub. Co., 1967): 62-85.

[10] Wilcox and Whitman, “Why One Snake is More than Two,” 675.

[11] Jan Schouten, The Rod and the Serpent of Asklepios: Symbol of Modern Medicine, 116.

[12] Walter J. Friedlander, The Golden Wand of Medicine (New York: Greenwood Press, 1992): 9-22.

[13] Wilcox and Whitman, “Why One Snake is More than Two,” 675.

[14] Wilcox and Whitman, “Why One Snake is More than Two,” 676.

[15] G. D. Hart, “The Earliest Medical Use of the Caduceus,” Canadian Medical Association Journal 107, 11 (December 1972): 1110.

[16] Wilcox and Whitman, “Why One Snake is More than Two,” 676

[17] Touraj Nayernouri, “Asclepius, Caduceus, and Simurgh as Medical Symbols Part 1,” 66.

[18] Wilcox and Whitman, “Why One Snake is More than Two,” 675.

[19] William K. Emerson, Encyclopedia of United States Army Insignia and Uniforms (Norman: University of Oklahoma Press, 1996): 181-2.

[20] Bernice Engle, “The Use of Mercury’s Caduceus as a Medical Emblem,” The Classical Journal 25, 3 (December 1929): 207.

[21] Friedlander, The Golden Wand of Medicine, 150-170.