What’s in a Symbol

What is the origin of these symbols for the practice of medicine?  Why is one favored over the other by some medical organizations (e.g. the American Medical Association)?  Should the symbol of medical practice be the one-snake staff of Asclepius or the two-snake staff of Hermes?

Staff of Asciepius
Staff of Asclepius   


                            Staff of Hermes (Caduceus)
Staff of Hermes (Caduceus)


Let’s start with who they were …

Asclep and HermesMercury (Hermes) & merchant (left) approach disapproving Asclepius (Physician) and the naked Graces (Meditrine, Hygeia and Panacea) [Engraved from an original in the then Museum Pio Clemens in Rome Galerie Mythologique, Recueil de Monuments by Aubin Louis Millin, Paris 1811.]

Asclepius was a Greek hero who later become the Greek god of medicine and healing. The son of Apollo and Coronis, Asclepius had five daughters, Aceso, Iaso, Panacea, Aglaea and Hygieia. He was worshipped throughout the Greek isles. The main symbol of Asclepius is a physician’s staff with a snake wrapped around it; this is how he was depicted in the art of healing, and his symbol still survives to this day as the sign of the modern medical profession.

Hermes, the herald of the Olympian gods, is the son of Zeus and the nymph Maia, daughter of Atlas and one of the Pleiades.  Hermes is the god of shepherds, land travel, merchants, weights and measures, oratory, literature, athletics and thieves, and known for his cunning and shrewdness.  Most importantly, he is the messenger of the gods. Besides that he was also a minor patron of poetry. He too was worshiped throughout Greece.

Why is there confusion over which staff should represent medicine?

In the seventh century, the caduceus came to be associated with a precursor of medicine, based on the Hermetic astrological principles of using the planets and stars to heal the sick.  As a symbol for medicine, the caduceus is often used interchangeably with the Rod of Asclepius (single snake, no wings), although learned opinion prefers the Rod of Asclepius, reserving the caduceus for representing commerce.

Originally the caduceus was a rod or olive branch ending in two shoots and decorated with garlands or ribbons.  Later the garlands were interpreted as two snakes entwined in opposite directions with their heads facing; and a pair of wings, in token of Hermes’ speed, was attached to the staff above the snakes.

The two snake caduceus became popular in America, perhaps because of its symmetry, but the majority of non-commercial and altruistic organizations use the Staff or rod of Asclepius rather than Hermes’ staff to symbolize the humanistic qualities of their organization.

Organizations using the single snake to represent their mission:

American Medical Association American Veterinary Medical Association British Medical Association
Southern Association for the History of Medicine and Science Canadian Medical Association Medical Council of New Zealand
Florida Medical Association Alachua County Fire Rescue Florida Medical Association Alliance
Royal Army Medical Corps World Health Organization New Zealand Medical Association
Star of Life

Further discussion can be found at the following web sites:
http://www.britannica.com/eb/article-9018504/caduceus http://en.wikipedia.org/wiki/Caduceus

The debate over the appropriate symbol is quite extensively documented in medical literature as well.  The abstract reproduced below is only one of many responses (520) to a PubMed search that document the controversy over which symbol is appropriate.  In general, physicians support the meaning and history behind the use of Asclepius’ staff.

“The symbol of modern medicine: why one snake is more than two”
Ann Intern Med. 2003 Apr 15;138(8):673-7.
Wilcox RA, Whitham EM.
Department of Medical Biochemistry, Flinders Medical Centre, Bedford Park, South Australia, 5042, Australia.

Today, two serpent motifs are commonly used to symbolize the practice and profession of medicine. Internationally, the most popular symbol of medicine is the single serpent-entwined staff of Asklepios (Latin, Aesculapius), the ancient Greco-Roman god of medicine. However, in the United States, the staff of Asklepios (the Asklepian) and a double serpent-entwined staff with surmounting wings (the caduceus) are both popular medical symbols. The latter symbol is often designated as the “medical caduceus” and is equated with the ancient caduceus, the double serpent-entwined staff of the Greco-Roman god Hermes (Latin, Mercury). Many physicians would be surprised to learn that the medical caduceus has a quite modern origin: Its design is derived not from the ancient caduceus of Hermes but from the printer’s mark of a popular 19th-century medical publisher. Furthermore, this modern caduceus became a popular medical symbol only after its adoption by the U.S. Army Medical Corps at the beginning of the 20th century. This paper describes the ancient origin of the Asklepian and how a misunderstanding of ancient mythology and iconography seems to have led to the inappropriate popularization of the modern caduceus as a medical symbol.  PubMed

And what about the UF College of Medicine?

The well known alligator and staff, designed by Jeremy Melker, M.D. (UF Class of 1999), is an adaptation of the staff of Asclepius, and is used as an unofficial symbol of our medical school by our medical education community.