THE CADUCEUS AND ITS SYMBOLISM By ROBERT WILSON, jr., m. d. CHARLESTON, S. C. HE association of the Caduceus the U. S. Public Health Service, and in 1902 with Hermes, or Mercury, the by the United States Army as a designation messenger of the gods, and the of medical officers. The Royal Army Medi­ Tpatron of trade, seems to give cal Corps use the staff with the single no intimation of its right to become the serpent which is the form now appearing on accepted symbol of the medical profession. the button of the American Medical This right, indeed, has been called into Association. question and the staff of Aesculapius with a The most ancient illustration of the single serpent twined around it, is regarded Caduceus which is known is upon the as the correct emblem. The symbolism of libation vase dedicated by Gudea, King of the serpent, however, is the same in both, Lagash, to the god Ningishzida. This figure but the winged Caduceus probably embodies does not show the wings which usually an interesting combination of two primitive appear upon the Caduceus of Greek and cults which were associated with the earliest Roman mythology. This interesting vase conceptions of the healing art. was unearthed upon the site of Lagash According to Garrison,1 the Caduceus was and Frothingham thinks it indicates the first used as a medical emblem in the Assyrio-Babylonian origin of the Caduceus sixteenth century when Johann Froeben, which ultimately found its way from Accad publisher of medical books, employed it as a and Sumer into the later Greek and Roman title page device; and a little later Sir civilizations. The date of this vase he places Wm. Butts, physician to Henry vm, used at 3,500 b. c. which corresponds to the it on his crest. What suggested its use in beginning of the dynastic period in Egypt. these instances instead of the Staff of Other chronologies, however, place the Aesculapius is not clear. accession of Gudea nearly a thousand years About the middle of the nineteenth later, or about 2,450 b. c. which is about the century the medical publishing house of beginning of the ninth Egyptian dynasty. J. S. Churchill, of London, employed the But already in predynastic Egypt the sym­ Caduceus, and in 1856 it was used on the bol of the two serpents appears upon the chevrons of hospital stewards in the United monuments, although not in the identical States Army. Later it was adopted by form as upon the Lagash vase. The question of the origin of civilization came a symbol of the phallus, the venerated is still under discussion, but the weight of emblem of life and regenerative power. The evidence indicates that the civilization of particular variety of serpent which seems Egypt antedated that of the Mesapotamian to have possessed special significance was states and was the source from which the the cobra di capello; and it is clearly this latter derived much of their culture. We serpent which is figured on so many Egypt­ must therefore revert to the history of the ian monuments. The sacred uraeus was older culture and the symbolism in which doubtless the cobra and not, as Max its conceptions found expression in order Muller5 suggests, the asp. to reach an understanding of the real mean­ It is a curious and interesting fact that ing of the winged Caduceus and of its serpent worship and sun worship are found association with the healing art. This leads invariably and universally associated. The us to a consideration of two very early worship of the sun was probably of earlier forms of worship in which the struggling origin. Primitive man soon traced the faith of man took form, serpent worship connection between sunshine and the bless­ and sun worship. ings of life and health, and so set up the The serpent cult originated very early in source of this beneficent influence as the Egypt, the proto-Egyptians,2 according to main object of his worship. In his effort to Elliott Smith, being serpent worshippers. personify in some familiar form this mighty Its origin is obscure and need not be and powerful being who every day moved discussed in this connection. What interests across the heavens dispensing light and us here is its early association with the warmth, health and life, the early Egyptians idea of health. Wake3 says: “sought to describe it as a hawk which flew daily across the sky. Therefore, the One of the leading ideas connected with the most popular forms of the solar deity, Re serpent was, as we have seen, its power over and Horus, have the form of a hawk or of a rain, but another equally influential was its hawk-headed man,6” and at the beginning connection with health. That the idea of health of the dynastic period the worship of was intimately associated with the serpent Horus was general throughout Egypt. is shown by the crown form of the asp, or sacred Thermuthes, having been given particularly to Instead of being represented always by the Isis, a goddess of life and healing. complete figure of a hawk, Horus is often symbolized merely by two outstretched The idea of this association persisted for wings, or by a winged disc. This winged many centuries and became widespread, disc was carried from Egypt to Assyria and appearing for example in Gaelic and Ger­ Babylonia where it became a common and man folk-lore as a belief that “the white familiar emblem. In the predynastic period serpent when boiled has the faculty of before the northern and southern kingdoms conferring medicinal wisdom.” In the book became united, serpent worship flourished of Genesis the serpent personifies the evil especially in Lower Egypt and the capital one and typifies subtlety and cunning; Buto with its protecting serpent-goddess but in Exodus, Moses sets up a brazen was the center of the cult, but in both serpent-image as a healing agent and it kingdoms “the hawk-god Horus was wor­ seems to have occupied a place in the shipped as the distinctive deity of both worship of the Israelites down to the kings.” When the two kingdoms became time of Hezekiah.4 united under Menes about 3,400 b. c., the Whether serpent worship originated in symbols of the two cults began to appear phallicism or whether the latter developed side by side, and later the king who was the at some later time is difficult to determine, sun-god’s representative upon earth adopted but at any rate the serpent very early be­ the sacred uraeus of the north, which he wore upon his forehead. Elliott Smith7 is of phallic character of Hermes was forgotten. the opinion that this union of sun and The function of Hermes as messenger later serpent worship was the beginning of an seemed to dominate his other functions, association which later spread over the and the emblem which he bore at first world. He says: because he was a god of healing, or a The fact that the dominion of the sun-god Re phallic deity, became the kerykeion, or (or Horus) was attained in the northern capital, herald’s staff. The winged cap and winged which was also the seat of serpent worship, sandals also are generally supposed to have led to the association of sun and serpent. From been worn because he was the messenger of this purely fortuitous blending of the sun’s the gods, but it is quite probable that these disc with the uraeus, often combined, espe­ as well as the wings of the Caduceus were cially in later times, with the wings of the Horus- originally the emblem of the sun-god Horus. Hawk, a symbolism came into being which was A faint memory of the Horus origin of the destined to spread until it encircled the world wings of the Caduceus perhaps lingers in the from Ireland to America. myth which narrates that Hermes received The staff of Aesculapius with its single the emblem in exchange for the lyre from serpent had doubtless a similar Egyptian Apollo, who was a sun-god; and it may be origin. The Aesculapian cult may be traced of some significance, too, that the hawk was to Egyptian sources and the knotted staff one of the animals sacred to Apollo. with its serpent of later times was probably Whether the Caduceus in its present form derived from the sacred uas staff. An inter­ originated as an Egyptian or as an Assyrian esting relief from the tomb of Amenemhet device, the symbolism which it represents i, shows the hawk-headed god Horus pre­ dates back to predynastic Egypt. It bears a senting the crux ansata, the symbol of life, silent witness to the union of two ancient to the royal hawk which surmounts the kingdoms which marks the beginning of Horus name of Amenemhet, behind which history, and to the fusion of two primitive is a uas staff with a serpent twined around cults whose emblems indicated to man the it, a symbolic representation of the author divine source of life and health, while the and giver of life and health conferring use of these ancient emblems to symbolize upon his earthly representative these divine the medicine of today brings us into touch powers. across the space of more than fifty centuries The emblems peculiarly indicative of with the crude primitive beginnings of the healing would naturally be associated with healing art and man’s earliest striving after the special divinity presiding over health, truth.