A picture is worth 1,000 words, and the world today is full of symbols. Emojis share paragraphs of information. Logos inform us about what a company represents or does. Shapes and colors share messages of safety or caution on the road. Symbols are everywhere and understanding them brings deeper understanding to the world around us. Medicine is a field of precision, and that is precisely why it is so strange that such confusion exists as to which symbol should represent it.
The Caduceus is a staff with two serpents winding upwards topped by a pair of wings. It is used on clinic logos, ambulances, tattoos, awards, diplomas, everywhere. The Caduceus is frequently recognized as the symbol of medicine. However, this is a misunderstanding. It is an affront and an insult.
The Caduceus has nothing to do with medicine. It is an ancient symbol of Greek deity Hermes, the god of commerce, luck, travel and thieves. Hermes was given the staff by Apollo, as a gift of reconciliation after a long feud between the two gods. Apollo is a god of healing, his name is invoked in the original Hippocratic Oath, yet the staff he gives to Hermes doesn’t have any more connection to the healing arts than that. When Hermes first received the staff, it was unadorned beyond the pair of wings on top, a symbol of Hermes and his speed. One day Hermes happened upon two serpents fighting and thrust the rod between them to stop their struggle. Both snakes stopped fighting and curled around the rod, thus making it a symbol of peace. Roman heralds would carry a Caduceus before them to sue for peace as they carried messages.
How did this Greek symbol of commerce, travel, thieves and peace become associated with medicine? It happened as a result of ignorance and misunderstanding. The caduceus appeared on the uniforms of the United States Army Hospital Stewards around 1850. In 1871, the Surgeon General adopted the caduceus for the Marine Hospital Service which became the U.S. Public Health service in 1912. At the turn of the 20th century, the U.S. military widely adopted the caduceus as a symbol for their medical officers.
Controversy exists about whether or not these choices were due to ignorance about the symbolism of the caduceus or for other reasons. William Emerson, in his Encyclopedia of United States Army Insignia and Uniforms, had this to say about Colonel John R. Vann Hoff, the man largely responsible for the military use of the caduceus: “Hoff was far too scholarly and intelligent a man to commit the blunder of ‘confusing’ the caduceus with the serpent staff of Aesculapius. The sign of Mercury was deliberately adopted, as I have heard him state, because it was the emblem of the merchant and hence the emblem of the noncombatant. In junctures when it was necessary for a vessel to proclaim its nature, it was customary for a merchant vessel to indicate its noncombatant status by flying a flag which bore the emblem of Mercury, the God of the Merchant.”
Unfortunately, the field of medicine seems to have forgotten the true meaning behind these ancient symbols. Since the military adopted the symbol, it has largely become accepted as the symbol for medicine in the United States. One finds it on company logos, prescription pads, ambulance windows, medical professionals’ tattoos and more. A study on the prevalence of the caduceus found that it is used by 76% of commercial health care organizations. Too often a symbol of commerce is used to represent medicine. But if the caduceus isn’t a symbol of medicine, then what is?
The Rod Of Asclepius
A staff with a single serpent is the true symbol of medicine. There are multiple theories about its origin. The most likely theory concerns an ancient Greek healer Asclepius, whose name is also mentioned in the original Hippocratic Oath. Asclepius was the son of Apollo and demi-god of medicine. He is often depicted carrying a staff with one snake winding around it. The story of the snake has many variations, but the basic premise is that Asclepius learned about healing herbs from a snake and thus used serpents as a symbol of healing. Asclepius was a kind man who gave medical attention to all, regardless of station. His healing prowess was so great that Zeus became worried that man’s mortality would soon rival his own immortality and killed Asclepius with a thunderbolt. Asclepius’ staff has long been used as the true symbol to represent medicine.
Another theory for the “single rod and a snake” symbol comes from the Old Testament. The Children of Israel were being set upon by “fiery serpents.” Many were perishing from the venomous bites inflicted by these snakes. Moses was told to make a serpent out of brass and fix it to a pole. He raised this brazen serpent, and anyone who would come look upon it was healed from the serpents’ venom. A single snake affixed to a pole became a strong symbol of healing.
The weakest theory for a single rod and a serpent as a symbol of medicine is Dracunculus medinensis, the Guinea worm. One archaic method to treat this worm is to wait till it protrudes from the skin and to wrap a section of it around a small stick. Slowly the body of the worm is removed as one continues to wind it around the stick. This theory is a stretch since one could argue any archaic method of medical treatment could have become medicine’s symbol. Why not leeches, or a trepanning drill? Why a worm found in subtropical and tropical regions? More likely the symbol originates from Asclepius and was strengthened by the Judeo-Christian influence of Moses’ brazen serpent.
What is to be done?
The Caduceus is everywhere, but should medicine stop using it? If it has pervaded culture enough to be on high-profile sculptures, on a building dedicated to healthcare and facing a hospital, has it evolved to become a symbol for medicine? I don’t think so. A century of error should not erase millennia of symbolism.
While many physicians and hospitals would prefer not to switch out placards, signs and logos, our collective ignorance on the proper symbol for medicine shouldn’t change their meaning. It is unlikely that the medical world will en masse throw out the caduceus and universally adopt the Rod of Asclepius. Doing so would certainly be more proper, because shouldn’t medicine be represented with a symbol of healing and help instead of commerce and thievery? Stuart L. Tyson said it well back in 1932 when he wrote: “As god of the high-road and the market-place Hermes was perhaps above all else the patron of commerce and the fat purse: as a corollary, he was the special protector of the traveling salesman. As spokesman for the gods, he not only brought peace on earth (occasionally even the peace of death), but his silver-tongued eloquence could always make the worse appear the better cause. From this latter point of view, would not his symbol be suitable for certain Congressmen, all medical quacks, book agents and purveyors of vacuum cleaners, rather than for the straight-thinking, straight-speaking therapeutist? As conductor of the dead to their subterranean abode, his emblem would seem more appropriate on a hearse than on a physician’s car.”
It may seem like a small thing to argue about the correct interpretation of symbols that are thousands of years old, but it matters. As previously stated, medicine is a field of precision, and it is incongruous that so many of us use the incorrect symbol to represent ourselves. Surely we don’t want to proclaim ourselves and our healing arts with a symbol of thievery and currency. At that point, we might as well just use a dollar sign. Instead, we should seek to be represented by Asclepius’ Rod, the symbol of the founder of medicine. An innovative, compassionate and skilled physician. It is unlikely that we will change our symbol use overnight, but hopefully with time we can correct this pervasive error of representation. So next time you design your clinic’s logo remember: one snake, no wings. That is medicine.
Image credit: Rod of Asclepius (CC BY 2.0) by Mark Morgan Trinidad B