aduceus Cthe staff of Asclepius or Hermes Eric Vanderhooft, M.D. The author (AΩA, University of Utah, 1988) is clinical assistant professor in the Department of Orthopedics at the University of Utah, and in private practice at the Salt Lake Orthopedic Clinic. He is also the clinical director of the University Orthopedic Rotation and Family Practice Residency Orthopedic Rotation at HCA St. Mark’s Hospital. he staff entwined by a serpent or serpents is ac- cepted as a common symbol of the medical pro- fession and health care industry. Unfortunately, twoT distinct images exist. The staff with a single snake be- longed to Asclepius, father of western medicine. The staff with two entwined snakes belonged to Hermes, the prince of thieves, and is more commonly seen. A review of 527 professional medical academies, asso- ciations, colleges, and societies revealed that 23 organiza- tions use the staff in their symbolism. The staff of Asclepius outnumbered that of Hermes nearly three-fold, 92 versus 3 organizations respectively. Introduction Hippocrates has come to be considered the father of Western medicine, and, in the United States, a modification of the Hippocratic Oath continues to be recited by graduat- ing medical students. It should therefore be no surprise that Roman statue of Asclepius. © Mimmo Jodice/CORBIS. The Pharos/Autumn 2004 our symbol for medicine, the caduceus, similarly is derived from Greek traditions. Greek healers such as Hippocrates be- lieved they were descended from Asclepius, the mythic phy- sician, and came to be known as Asklepiadai or Asclepiads, “sons of Asclepius.”1p6 Represented variously by the snake, cock, dog, and goat,1p28–32, 2, 3p258 the staff entwined by a single snake is the most recognized symbol of Asclepius. The staff of Asclepius was part of the crest of the U.S. Surgeon General’s office in the early nineteenth century, but it was replaced in 87 by the caduceus, the staff of Hermes, per- haps partly because of an aesthetic preference for the latter’s symmetry.4 Today both symbols are used by various medical organizations and are referred to as the caduceus. Mark P.O. Morford and Robert J. Lenardon state in Classical Mythology: In Latin the herald’s staff was known as the caduceum, derived from the Greek word keryx or herald, and his staff the kerykeion. Hermes, as divine messenger, was invariably depicted with the caduceus, which was represented as a staff with white ribbons or intertwined snakes. The white ribbons may have indicated the inviolability of his office. The image of intertwined snakes may have been drawn from the near eastern use of copulating snakes as a symbol of fertility, for Hermes was a fertility god. The staff of Hermes became con- fused with the staff of Asclepius because some stories about Asclepius involved snakes and the reptile has the ability to slough its old skin and seemingly be “reborn,” and so had Apollo felt sorrow for his unborn son and snatched the child associations with healing.5 Asclepius from his mother’s corpse, saving him from death. Apollo then handed Asclepius to the Centaur Chiron who While the modern practitioner associates fertility with the became his tutor and mentor.6 practice of medicine (through both childbirth and impotency), for the ancient Greeks, pregnancy was part of the natural order Son of Cronus (a Titan, also the father of Zeus), Chiron and not treated as a medical condition. Carl Kerényi writes, was a wise physician whose pupils included Hercules, Achilles, “Women in labor were excluded from the sacred precinct and Jason, as well as Asclepius.7p38–39 After receiving an incur- [Asclepieion, or sanitarium], for pregnancy is not an ailment able wound, Chiron gave his immortality to Prometheus and that calls for cure.”1p31 Thus, although Hermes and his staff died. Zeus turned Chiron into the constellation Sagittarius. have no relationship to the healing arts, his caduceus appears Through Chiron, Asclepius acquired the knowledge of sur- to have become more prominent than the staff of Asclepius in gery, the art of healing, and the use of drugs, love potions, representing the profession. and incantations. Ultimately, Asclepius was able to restore the dead to life through a magic potion made from the blood of Asclepius the Gorgon, a gift from Athena.* Leadbetter notes, In Greek mythology, Asclepius (meaning “cut up” or “turn round and round”—also Aesculapius, Aesclepius, or Asklepios) was a famous physician and son of Apollo, the sun god (as well * Ironically, it was Athena who created the Gorgons, three sisters turned into hideous immortal beasts. The youngest of the three maid- as a god of prophecy, music, poetry, and healing, representing ens, Medusa, aroused the anger of the goddess by courting Poseidon reason and intellect). Asclepius’s mother Coronis, a princess in a temple consecrated to Athena. As punishment, Medusa was of Thessaly, died when he was an infant, or, according to one transformed into a hideous creature with scales, bulging red eyes, myth related by Ron Leadbetter, was murdered. brazen wings and hands, and hissing snakes for hair. Anyone looking upon her face was immediately turned into stone. Her sisters, Stheno and Euryale, protested this punishment and were similarly changed. Coronis was unfaithful to Apollo, and Artemis, Apollo’s Using winged shoes and a sword provided by Hermes, the Greek hero twin sister, killed her for her unfaithfulness. Coronis was Perseus was able to decapitate Medusa by gazing at her reflection in a placed upon a funeral pyre. As her body started to burn, bronze shield provided by Athena.7pp81, 132 The Pharos/Autumn 2004 23 Caduceus, the staff of Asclepius or Hermes Legend tells that the blood of the Gorgon has a different Healing was a miracle brought about through the nightly di- effect depending from which side the blood was taken. If vine dreams of the sick, interpreted by the physicians. taken from the right side of the Gorgon, it has a miraculous There were many centers and schools of medicine, with tem- effect and is said to be able to bring the dead back to life, but ples built to Asclepius from Trikkis in Thessaly to the island of taken from the left side it is a deadly poison.6 Cos. Hippocrates plied his trade on the island of Cos. Following a plague from 295 to 293 B.C., the worship of Asclepius spread to Rome. In adopting the cult of Asclepius, the Romans changed This power of resurrection ultimately resulted in his name to the Latin Aesculapius. Kerényi tells us, “It was only Asclepius’s own death. Hades became alarmed at a mere in the days of Roman emperors, when healing lost its meaning mortal helping men evade death and complained to Zeus. In a as a divine event and Epidauros had become more of a climatic differing account, Asclepius offended Zeus by receiving pay- resort . that halls for expectant mothers and the dying were ment to bring Hippolytus back to life. The goddess Artemis built outside the sanctuary.”1p31 implored Asclepius to resurrect Hippolytus, a favorite of hers. Asclepius had five daughters: Aceso, Iaso, Aglaea, Hygeia, In the eyes of Zeus, Asclepius’s action upset the natural order and Panacea. Hygeia (“Health”) and Panacea (“Cure-all”) were of the universe,3p251 and “with one swift action, the great Zeus both healers and their names are now embedded in medical sent down a thunderbolt killing both men.”6 jargon. Although angry at Asclepius’s hubris in raising the dead, Asclepius is recognized as an “excellent physician” in Zeus still recognized the good Asclepius had brought to man- Homer’s Iliad, through his sons, the heroes Machaon and kind, and placed Asclepius among the stars, transforming him Podalirius.8p95 But in this reference he is not divine, merely into the constellation Ophiuchus (the serpent-bearer). another warrior king. The cult of Asclepius became very popular during the 300s B.C. Cult centers (known as an Asclepieion) were used Hermes by priests to cure the sick. Invalids also came to the shrines Like Apollo, Hermes (Mercury to the Romans) was one of of Asclepius to find healing. The process of healing was the twelve Olympians. He delivered messages for the gods and known as incubation. Physicians did not administer medicine. was also the god of travelers, roads, orators, commerce, and Nonpoisonous snakes were left in the dormitory where the thieves. The antics that led to his possession of the caduceus sick slept overnight on bare ground. During the night, patients are recounted in Homer’s Hymn to Hermes.5, 9 were supposedly visited by the god in a dream. Priests inter- preted the dreams and recommended remedies, or gave advice According to legend, Hermes was born in a cave on on how the patients could be cured with massage, or perhaps Mount Cyllene in Arcadia. Zeus had impregnated Maia at visits to the baths and gymnasiums. The snake endures to this the dead of night while all other gods slept. When dawn day as a symbol of the modern medical profession. broke amazingly he was born. Maia wrapped him in swad- Asclepius was worshipped throughout the Greek world, dling bands, then resting herself, fell fast asleep. Hermes, but his most famous sanctuary was located in Epidaurus in however, squirmed free and ran off to Thessaly. This is the northeastern Peloponnese. Kerényi tells us that, while where Apollo, his brother, grazed his cattle. Hermes stole a recognizing Asclepius’s Thessalian heritage, the Epidaurian number of the herd and drove them back to Greece. He hid Pausanias gives a different account of his birth. them in a small grotto near to the city of Pylos and covered their tracks.