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Snakes and staffs

Two different symbols combining snakes and staffs have been used to represent the medical profession. Laxmi Vilas Ghimire looks at the history of these symbols and asks which is better

If you ask which symbol represents medicine and doctors, some people might say a white coat, others might say a stethoscope, but some may say that it is a snake entwining a staff. However, two different symbols that feature snakes and staffs are used to represent medicine. One is the aesculapian symbol, which has a snake rolled around the staff of Aesculapius. The other has two snakes entwined around the caduceus (staff) of Hermes with a pair of wings on the top called, unsurprisingly, the Caduceus of Hermes. But why are these used to represent the medical profession, and which one is a more accurate representative?

Aesculapius and his medical sign

Aesculapius is known as the Greek god of medicine and had a complicated start to life. He was the son of Apollo and the nymph Coronis. Although Apollo loved Coronis and impregnated her, Coronis fell in love with someone else and wanted to marry him. To avoid Apollo's humiliation, Artemis, the sister of Apollo, killed Coronis. But her unborn child was delivered from her dead body and named Aesculapius. Apollo entrusted the child's education to the centaur, Chiron, who taught Aesculapius the art of healing.

Later Aesculapius became skilled in surgery and in the use of medicinal plants, which could even restore the dead to life. But Aesculapius's ending was not much nicer than his mother's. Infuriated with what Aesculapius was doing, Hades, ruler of the dead, complained to Zeus. Zeus felt that immortality of the gods was threatened and killed Aesculapius with a thunderbolt. Aesculapius had three daughters Meditrina, Hygeia, and Panacea, who became the symbols of medicine, hygiene, and healing.

Between 1200 BC and AD 500, Aesculapius was the major focus of Greco-Roman medical tradition.¹ He was deified and worshipped, and his traditions of care spread throughout most of the Roman Empire. Aesculapius was also described in Homer's writings as a mortal physician, who performed heroic acts of healing on the battlefield. Hippocrates, the father of medicine proudly claimed descent from Aesculapius.

But what did the snake and the staff have to do with medicine? A popular tale in Greek mythology is that while Aesculapius was examining a man, Glaukes, who Zeus had struck with a thunderbolt, a snake came crawling into the room. Aesculapius killed the snake with his staff. Another snake crawled into the room and placed herbs in the mouth of the dead serpent and restored it to life. Aesculapius then used the same herb to revive Glaukes.

Caduceus of Hermes

According to Greek mythology, Hermes, the messenger of the gods (the Roman equivalent is Mercury), was the son of Maia and Zeus. One tale says that Hermes threw his staff between two fighting snakes and stopped their battle, at which point they entwined themselves around the wand. Confusingly, some medical organisations have adopted this symbol.

Hermes is regarded as the deity of wealth and commerce, areas that are famous for dishonesty, however. Hermes was also a reputed crafty and promiscuous trickster. It was due to this that he was honoured as the patron of thieves. Moreover, his duty was to lead the souls of the dead to the underworld, which perhaps contrasts to the deeds done by healers or helpers. However, one tale about Hermes links him up to Aesculapius. According to Greek myth, when Artemis killed Coronis, Hermes worked as obstetrician to deliver Aesculapius from her womb.

The real one

Although it seems like Aesculapius should be the real symbol of medicine, the Caduceus of Hermes is still sometimes used to represent the profession. A few reasons have been postulated for this. In the 19th century, a medical publishing house used the symbol of caduceus as their insignia because they thought it symbolised their role as a messenger and a businessman. Another stems from the United States; the US Army Medical Corps adopted the caduceus as their collar badge in 1902 and it soon caught on.²

The staff of Aesculapius represents strength and solidity, and also refers to unwavering ethics of doctors. The snake symbolises the power to create life. It also represents the snake's unique ability to shed old skin and become young and healthy again. Doctors in some countries still take the Hippocratic oath: "I swear by Apollo physician and Aesculapius and Hygeia and Panacea and all the gods and goddesses, making them my witness…"³ This probably shows that the aesculapian staff is the correct symbol of medicine and not the Caduceus of Hermes after all.

Laxmi Vilas Ghimire, fifth year medical student, Institute of Medicine, Maharajgunk Campus, Kathmandu, Nepal
Email: Vilas_laxmi@iom.edu.np


studentBMJ 2005;13:221-264 June ISSN 0966-6494

1. Wilcox RA, Whitham EM. The symbol of modern medicine: why one snake is more than two. Ann Intern Med< 2003;138:673-7.
2. Friedlander WJ. The golden wand of medicine: a history of the caduceus symbol in medicine. New York: Greenwood, 1992.
3. Von Staden H. "In a pure and holy way": personal and professional conduct in the Hippocratic oath? J Hist Med Allied Sci 1996;51:404-37.

       

           

	EDUCATION Snakes and staffs       Laxmi Vilas Ghimire (June 2005)
	Robert O'Connor (June 07, 2005)       Final year resident, Memorial University Newfoundland, St. Johns, Newfoundland, Canada robert@medicalmnemonics.com
	Thanks for your very interesting and informative article. To better battle others at the pub, one should be aware of the urban legend that another suggested partial origin is from the ancient (and still useful) medical technique of removing netatodes such as "Dracunculus medinensis". Nematodes are long, worm shaped parasites that can infect humans and can be difficult to remove unless properly extracted. The technique involves capturing the end of the nematode through the skin, then slowing winding the nematode around the stick. A small amount of the nematode is wound around at regular intervals until the entire nematode is withdrawn intact. The nematode (which has a snakelike shape) is thus wound around the stick leading to the medical cure of this difficult disease. The symbol of snake around a stick for medicine is therefore solidified. A short description is here (as well as elsewhere in the literature) http://www.emedicine.com/ped/topic616.htm