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Home , Caduceus, Coronis (mythology), Serpent (symbolism)

Medical : Rod of ?

By

Maria Crescenzi

Andrew Nichols, Advisor

A thesis submitted is partial fulfillment

of the requirements for the

Degree of Bachelor of Arts with Honors

in Classical Studies

University of Florida

Gainesville, Florida

21 April 2015 Crescenzi 2

Medical Emblems: Rod of Asclepius or Caduceus?

Abstract

Historical and mythological evidence depicts the as an appropriate symbol in the healthcare . Two ancient emblems depicting entwined with a staff have been associated with the medical field. ’ Caduceus has been mistakenly associated with , while the rod of Asclepius correctly represents the symbol of medicine based on tradition and mythological context. The association between the Caduceus and medicine seems to stem from conformity rather than from tradition, which is the result of modern society

(particularly the ) following a trend rather than paying attention to historical context. This paper will explore the history of the confusion between the rod of Asclepius and the Caduceus through mythology, history, and modern popular culture.

Introduction

Birth of Asclepius

Asclepius, the god of medicine, was the son of and a mortal woman named

Coronis. Before Asclepius’ , Apollo discovered Coronis’ infidelity with a mortal man and warranted her death by his sister . Artemis burned Coronis on a funeral pyre at Apollo’s request, but because Apollo felt guilty for killing his unborn child, he managed to cut Asclepius from the womb of the burning Coronis. This legendary birth is interesting to note because as the god of medicine he marks one of the earliest indications for Cesarean section (commonly known as C-section). The baby Asclepius was entrusted to , a with exceptional medicinal skills who became Asclepius’ mentor while he was growing up (Hart 232).

From Minor Deity to God of Medicine Crescenzi 3

Asclepius was only a minor deity who was learning the art of medicine through Chiron.

He served the role of a Greek physician and offered “health and freedom from disease” (Hart

232) to mankind through the priests and physicians associated with his temple. He went from town to town healing people from pain and disease with his remedies. Asclepius’ capacity for healing continued to increase until eventually he was capable of raising the dead. Asclepius took the opportunity to revive those who have died, which frustrated because he claimed that

Asclepius was “depopulating his domain” (Hart 233). Considering his brother’s complaint, also worried that Asclepius was disrupting the natural of the universe by bringing the dead back to life. Consequently, Zeus struck Asclepius with a bolt of lightning as punishment for interfering with . After Asclepius’ death, Zeus deified him and he became the god of medicine (Hart 233).

The Rise and Fall of the Asclepian Cult

Because of Asclepius’ increased power and appeal, before the third century A.D. his religious cult was the predominant religion in the ancient world (Hart 233). The Asclepian cult was popular throughout Greece and surrounding Mediterranean countries and people would travel to his temples called Asclepieions to seek cures for sickness and disease. Although

Asclepian cult was the most important aspect of the ritual, of cock or lamb were frequent occurrences, similar to the animal sacrifices in the worship of any god in antiquity (Hart

233).

In the third century A.D. the rise of Christianity resulted in the fall of the Asclepian cult.

Hart discusses Christianity’s rejection of Asclepius more than any other pagan deity and attributes this to the fact that Jesus was also a healer in the Christian tradition (234). Christianity also condemned the Asclepian cult because Asclepius excluded the dying and pregnant, while Crescenzi 4

Jesus offered sanctuary to all. Even though both are healers, Christianity criticized Asclepian religion, which is mirrored in today’s western culture with allopathic and osteopathic physicians.

People from different academic or philosophic backgrounds have a tendency to compare and criticize other methods for similar outcomes. Although the rise of Christianity caused the decline of Asclepian religion, “he is still among us even if the humors have been replaced by hormones and the temples by hospitals” (Hart 236). Asclepian religion declined during the early Christian era, but the pagan god resurfaced and is still considered the god of medicine and a symbol of healing today.

The Rod of Asclepius

Several describing the origin of Asclepius’ staff and how Asclepius chose his symbol exist. However, in the most popular story of origin, Asclepius is examining Glaukos, a man whom Zeus killed with a . A slithered into the room and Asclepius responded by killing it with his staff. He was surprised and inspired when a second serpent appeared to revive the snake by putting herbs into its mouth that he decided to adopt the snake entwined around his staff as his symbol for healing and rejuvenation (Wilcox 673).

Although the rod of Asclepius was a very popular symbol and motif, the Catholic Church suppressed the worship of pagan gods and any Greco-Roman symbols associated with anything other than Jesus Christ. From the sixth century until the Renaissance, the urine flask took the place of the rod of Asclepius as the prominent symbol for medicine. However, Catholic icons and saints began to lose favor, which encouraged the rediscovery of symbols from antiquity

(Wilcox 674). Countries in northern Europe became fond of these ancient symbols even though they did not view Asclepius and the other pagan gods as deities under their own religion. People accepted these symbols into their society for what they represent and not for where they came Crescenzi 5 from. The Asclepian, a term used to describe the rod of Asclepius, was again renounced the symbol of medicine, and the of Asclepius is now connected to the origins of medical science and the healing arts.

Birth of Hermes

Hermes, the of the Olympian gods, was the son of Zeus and a named .

Zeus impregnated Maia in the middle of the night, like so many others, and by dawn, Hermes was born in a cave in Arcadia (Wilcox 675). Hermes was an unethical child who ran off to

Thessaly not long after he was born. There, he encountered Apollo’s and stole several to take back to a cave near the city of Pylos. Hermes sacrificed two of the cattle and a tortoise, which he used to make a musical instrument known as the . He used cords from the cattle to string the tortoise shell, thus inventing the lyre. Apollo, Hermes’ brother, was infuriated when he found out what happened so he immediately went to Maia to explain the situation to her. She did not believe Apollo because baby Hermes was bundled up and could not have gone all the way to

Thessaly and back with cattle. Zeus intervened because he saw Hermes’ deceitful act and ordered Hermes to return the cattle to Apollo. Hermes took the opportunity to play his lyre, which enchanted Apollo, causing him to offer Hermes the cattle in exchange for his lyre. Later,

Apollo mastered the art of the lyre and thus became one of his symbols (Wilcox 675).

Deceitful Hermes

Hermes was clever and inventive, and he continued to use these tactics to his advantage.

After creating the lyre, he was accredited as the inventor of the -pipes and the flute. While

Hermes was watching over his new cattle, he made a shepherd’s pipe (pan-pipes) out of reeds, and this caught Apollo’s attention. Apollo, with his new appreciation for music, also desired this Crescenzi 6 musical instrument so he exchanged his golden used to herd the cattle for Hermes’ pipe

(Wilcox 676). This golden wand became Hermes’ herald staff.

Hermes is the messenger of the gods, which means it is his duty to guide the departed souls to the underworld. He is also considered a god of travel who is a patron of roads.

Originally, Hermes was a phallic god, which was associated with fertility and good fortune.

Despite the various representations of Hermes, he is also loosely associated with peace and medicine because of his remote connections with .

Caduceus

The Caduceus symbol was created when Hermes separated two fighting serpents with his new staff from Apollo. The serpents entwined themselves around the staff, which formed the

Caduceus symbol for friendship and peace. The wings typically portrayed today on the Caduceus symbol were not originally in the design. Hermes’ wings did not appear on the until about 250 B.C. (Wilcox 676). Hermes was an ingenious deceiver, who was also the patron of thieves, merchants, and travelers, as well as the god of luck, games, and commerce (Wilcox

676). These aspects of Hermes’ character contradict the values of a physician and the medical field in general, which marks Hermes’ Caduceus as an inappropriate symbol of medicine (Sacks

464). The only significant association regarding the art of medicine is in reference to Hermes’ role as patron of the alchemists. Antoniou discusses the interpretation of the Caduceus as a medical emblem, which references alchemy as the “precursor to and pharmacology,” meaning that “it is speculated that the symbol of the patron of the alchemists thereby became an allegorical emblem of medicine” (Antoniou 220). In regards to medicine, the only aspect to

Hermes and his staff that could make an appropriate symbol would be in palliative care.

Palliative physicians and specialists help ease patients’ remaining days and help guide them to Crescenzi 7 peace in death. Because Hermes guides the dead to the underworld, this could be an appropriate representation of the Caduceus in the medical community.

Serpents in Mythology

Historical and mythological evidence shows the significance of serpents throughout the ancient world. The snake’s association with the Greek god of medicine, Asclepius, and the Greek god, Hermes, has been previously reviewed. However, the snake’s symbolic background can be traced back to the worship of gods of the earth’s blossom in and also the earth related deities in the archaic period of antiquity (Antoniou 217). The origin of the snake symbol can be traced to Minoan Crete and the ancient people of Thessaly. The perpetual power of the earth’s self-renewal and rejuvenation in depictions of the earth’s blossom is mirrored in the representations of the snake, and “its ability to perpetually rejuvenate by shedding its skin made it an underworld symbol of renewal of the vital powers of life” (Antoniou 218).

The serpent induces a variety of emotions on opposite sides of the spectrum, including fear and idolization. The snake, and the dualism it provokes, encouraged the creation of several myths, in which the snake represents rejuvenation, wisdom, sin, and death (Antoniou 217). The distinctions between the that snakes preserve are significant because it indicates differences in cultures and belief systems. For example, in ancient mythology, serpents are typically portrayed with good, healing qualities that reflect the medical field. However, in the

Old Testament of Christian and Jewish traditions, the snake represents evil and temptation, which are clearly inappropriate qualities for a medical related symbol. This may be an additional explanation for Christianity’s discrimination against the Asclepian cult that was previously discussed. Because Asclepius is associated with serpents and the Christian tradition believes that snakes represent the devil, the Christians attempted to destroy the Asclepian cult. Later, the New Crescenzi 8

Testament adopted the notion that snakes represent healing and therapeutic progress, which is portrayed in stories about Jesus Christ assuming the role of the snake to cure mankind’s illnesses

(Antoniou 219).

Integration of Asclepian and Caduceus in Medical Field

Asclepian as a Medical Emblem

The rod of Asclepius combines the god of medicine with the healing symbol of serpents.

In the ancient world, Asclepius was relied on for patient care and was supplicated by the poor and weak during times of illness (Wilcox 673). Many physicians in the Greco-Roman world prided themselves claiming that they were descendants of Asclepius. Hippocrates, one of the men that claimed to be a descendent of Asclepius, was called the Asclepiade by Apollo, meaning the family of Asclepius. The term Asclepiade was later used more loosely to Asclepius’ followers (Wilcox 673). The Hippocratic Oath is one of the oldest binding documents in history and a modern version is still used today. The opening lines of the classical version, “I swear by

Apollo Physician and Asclepius and and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant…” (Trans Edelstein) clearly depict the importance of Asclepius and his father and daughters to the people of the ancient world. The Hippocratic Oath (classical and modern versions) then outlines the respectable principles that a physician promises to live by.

Asclepius and his emblem were commonly depicted on statues, coins, art, physicians’ rings, and his temples (also: hospitals) because of his roots in medicine. Asclepius and his staff were often depicted together in the ancient world, but they could also be recognized separately.

To the ancients, the emblem was significant in two ways: for the principles it represents and inspires, and also for appreciation for the god of medicine himself. The rise of Christianity (from Crescenzi 9 early Christian era to Middle Ages) effected the development of the Asclepian cult as the

Catholic Church gained more power throughout the ancient world because the Catholic Church strived to suppress all worship of pagan deities, but especially of Asclepius. However, later

Asclepius and his emblem regained popularity, but no longer as a divinity among the Christians, but rather the symbol of medicine. By the beginning of the 17th century, many western medical schools and hospitals incorporated Asclepius and the Asclepian into their artistic designs, such as statues and representations of the medical field. Just as in antiquity, the Asclepian was used in a medical context and began appearing on things like medical medals and calling cards. The

Asclepian, having survived the Dark Ages and the early Christian era, is still a popular medical emblem today with a significant span of over two millennia (Wilcox 676).

Caduceus as a Medical Emblem

Scholars and physicians interested in the history of medicine have been studying the use of the Caduceus as a medical emblem and although there is little evidence revealing uses from antiquity, there is evidence regarding the establishment of western medicine and the United

States Army. Fielding H. Garrison, Lieutenant Colonel of the United States Army defended his use of the caduceus and argued the relevance of the medical emblem in at least the army (Engle

204). It seems that the first appearance of the caduceus as a medical emblem was with Johann

Froben (1460-1527), a Swiss medical printer, who incorporated an earlier version of the caduceus (featuring doves instead of wings) with a Greek inscription: “Be ye therefore wise as serpents and harmless as doves” (Trans Engle 204). The physician to Henry VIII, Sir William

Butts was the first known case of a medical professional using the caduceus as a medical symbol

(Engle 204). After Butts’ death in 1554, John Caius, “author of a famous tract on sweating sickness, presented a visit to Gonville and Caius College, Cambridge, a cushion, a silver Crescenzi 10 caduceus, a book, and a , emblems which were carried before him in procession upon his next visit to the college in 1558” (Engle 205). In his Annals, Caius speaks of this silver caduceus referenced above, which is still in existence today (Engle 205).

Centuries later, there is more evidence regarding the use of the caduceus as a medical emblem. Many scholars attribute the outbreak in popularity of the caduceus as a medical symbol to J.S.M. Churchill, a medical publisher, who used the caduceus printer’s mark on the titles of many medical and scientific books starting in 1844 (Engle 205). However, Churchill also included the representation of the Asclepian throughout his texts, which suggests this use of the

Caduceus as only his printer’s mark rather than the symbol of medicine. By the late 19th century, many United States publishing companies adopted Churchill’s printer’s mark of the Caduceus as the prominent symbol of medicine represented throughout their medical texts (Wilcox 675). In

1856, hospital stewards in the U.S. Army carried the caduceus on their uniforms, which later transferred to the uniforms of the U.S. Army medical officers in 1902 (Engle 205). Engle also mentions the 1901 French periodical of military medicine called Le Caducee (205).

Although the American Medical Association adopted the Asclepian rod as the official medical emblem in 1912, Colonel Garrison (previously mentioned) argued for the relevance of the Caduceus in the U.S. Army. Engle discusses Colonel Garrison’s wishes to separate the administrative and military functions of the medical department of the U.S. Army (represented by the Caduceus), and the purely medical functions indicated on the Medical Corps

(represented by the Asclepian staff) (206). It is difficult to distinguish whether Colonel Garrison actually believed that the U.S. Army should carry both staffs on their medical uniforms, or that he misunderstood the classical mythological iconography and used evidence of other misunderstandings to justify his reasoning. Crescenzi 11

Medical Emblems

Purpose of Symbols in Medicine

Medical emblems provide a visual representation of the principles associated with the medical field. The symbols are used to characterize the qualities that medical professionals are expected to have and serve as a reminder of these expectations during stressful times. The medical emblems also increase awareness and propaganda opportunities because a symbol is more easily recognizable than verbose descriptions. In a way, these emblems unite the physicians and professionals in the field, which creates a sense of unity and teamwork that is important for functionality in the medical field. Throughout history, ancient medical emblems, such as the rod of Asclepius and loosely the Caduceus, have helped shape the image of medicine and the medical field in general by symbolizing the healing qualities of the medical community.

Iconography: Snakes and Mistakes in Mythology

The snake has served a significant amount of time as a medical emblem and the healing powers associated with serpents can be traced back to ancient Egypt and the archaic period of ancient Greece around 800-500 B.C. (Antoniou 217). The snake represents polar opposites – redemption and sin, rejuvenation and death. This duality expresses life and death and the unpredictable factors in the medical field: “even if a therapy is applied, the outcome often remains uncertain” (Antoniou 221). Because of the snake’s associations with healing, it makes sense that emblems involving snakes also symbolize properties of healing and therefore are associated with medicine. However, the intention behind the snakes in ancient symbols can differ, such as the Asclepian and the Caduceus.

The Asclepian is inevitably associated with medicine because Asclepius is the god of medicine and his staff is an emblem symbolizing the qualities that he represents. The knotted Crescenzi 12 staff entwined with a single serpent signifies the struggles that a physician experiences throughout his career in the field. The Caduceus is a winged staff with two serpents entwined around it. Some myths say that Hermes separated two fighting snakes with his staff, which indicates stopping war peacefully. Also, a historian traces the wings on the Caduceus to the sun god Apollo. Engle says that this historian thinks that Hermes’ interaction with Apollo is displayed in the Caduceus because the wings represent a hawk, which is a sacred animal of

Apollo (206). The debate about this is that the wings on the Caduceus are best explained by

Hermes’ wings as the messenger god.

Conclusion: History of an Error

Symbols are effective because of their associations and traditions, which makes the

Asclepian, and not the Caduceus of Hermes, an appropriate symbol for medicine. Once one understands Hermes’ role as a pagan deity, it is easier to understand why the Caduceus is an inappropriate symbol for medicine. Hermes is a deceiver whose attributes contradict most of those associated with physicians and the medical community. He is the guide to the underworld and the patron of roads, thieves, merchants, and commerce. Hermes’ relations to medicine are very slim and do not play as significant a role as his other relations. He is considered a patron of alchemy, which is associated with chemistry and pharmacology. One could argue that because

Hermes is the guide to the underworld, the Caduceus could represent palliative care in the medical field. However, these associations with the art of medicine are vague and are not prominent in mythological stories about Hermes.

There are several cases in history where the Caduceus represented the symbol for medicine, but we do not have enough evidence to conclude if these cases had real cause for their interpretations or if they confused the rod of Asclepius and the Caduceus along with the many Crescenzi 13 people today. The evidence that seems most linked to the increase in the misuse of the Caduceus is the European publishing house, specifically Churchill, who used the Caduceus as a printer’s mark and thus influenced the United States publishing houses to inappropriately adopt the

Caduceus symbol as the symbol for medicine. Also, the popularity of the Caduceus could be attributed to the simplicity of the nomenclature, rather than the verbose “rod of Asclepius”, “staff of Asclepius”, or “serpent and staff of Asclepius.” Another point that adds to the confusion is the confusion between the Greek and forms of the name Asclepius (Asklepios, Aesculapius).

The concise term “Asclepian” (or “Asklepian”), describing the single serpent-entwined emblem, was introduced in order to help increase the recognition and correct use of the ancient medical symbol. Also, this term will hopefully help to avoid incorrectly calling the “rod of Asclepius” the

“caduceus of Asclepius.” The simplified nomenclature will hopefully catch on and help to provide clarity to the differences between the two ancient emblems. Some scholars that argue for the Caduceus as a medical symbol make the argument that since this symbol has survived for over a century, it should not still be considered a mistake. However, by accepting this emblem as a symbol for medicine, we are misusing the ancient sources and misinterpreting the ancient mythology. Therefore, the confusion becomes that of conformity rather than tradition.

Crescenzi 14

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(1965): 232.

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