MEDICAL SYMBOLS:
FACTS, ERRORS AND CONFUSION
Gaby Frank, MD, FACP
Associate Chief of Hospital Medicine
Denver Health & Hospital Authority
Assistant Professor of Medicine
University of Colorado, School of Medicine
WHEN DID HERMES DEFEAT
ASCLEPIUS?
Moreover, with the help of which
army?
OBJECTIVES
• To review differences between Hermes and Asclepius
• To review the definition of caduceus
• To review the historical use of the caduceus in Medicine
• To review the use of the caduceus by the US army
• To review current medicine state in regards to caduceus use
• To discuss appropriateness of Rod of Asclepius vs. Caduceus
as a symbol of Medicine
Hermes- Greek
Mercury- Roman
• God of Commerce and Merchants
• Messenger of the Gods
• Magic wand between 2 snakes.
• Multiple Hermes
Pre- Homeric Hermes
• God of the Boundary-stone
• God of roads and paths
• God of the “agora” or
marketplace
• God of oratory
• God of a fertility cult
• Psycho-pomp
• God of luck
Archaic Hermes
• 700-500 BC. Homeric Hymns
• Could “put people to sleep”
• Messenger of the Gods
• God of athletic contests
• A trickster, a thief and a liar
• Apollo gave him the caduceus
Peter Paul Rubens. “Mercury and Argus”, saving Io from Hera.
Traditional Hermes
• Becomes Hermes-Mercury
• God of gymnasiums and athletes
• Birth of at least 9 infants
• Hermes “transplanted” Zeus
muscles
• Many attributes
• Invented speech!
Hermes-Thoth
• Greco-Egyptian. 5th century BC.
• Gods ran to Egypt in fear of Typhon
• Scribe, heart and tongue of Ra.
• Great ethics
• Invented enemas, revived Horus
• Creator of ALL arts and science.
• Wisest of all gods.
Thoth
Traditional Hermes
• Wise, clever wise
• Wise, knowledgeable wise
• Inventive: crafts and objects
• Inventive: arts and science
• Liar, Trickster
• Grave judge of right and truth
• Death: psycho-pomp
• Death: officiated souls judgment
• Messenger of the Gods
• Scribe of the Gods
• Sexually promiscuous
• Source of laws
• Caduceus
• Ibis
Hermes Trismegistus
• Three-times Great
• 2nd-1st century B.C.
• Pseudo-Hermes trismegistus
• Written by roman philosophers,
• Between 3rd – 4th century
• Alchemy created by Hermes 3
Asclepius- Greek
Aesculapius - Roman
• Demi-God of Medicine?
• The “ blameless physician”?
• A Hero? Together with his sons
• God of Medicine?
ASCLEPIUS DEIFICATION
• Mycenaean inscriptions 1500 BC
• Homer circa 900 BC, NO GOD but a HERO
• Hesiod 700 BC DEMI-GOD
• Pindar 520-442 BC DEMI GOD
• Progressive deification 500 BC-100 AD
• Hellenistic Greece 420 BC. GOD
• Pausianas 140 AD Roman.
ASCLEPIUS BIRTH AND DEATH
As told by HESIOD. 700 BC
As told by PINDAR. 520-440BC
• Son of a GOD, and a mortal
• Apollo and Coronis were lovers.
• Apollo’s jealousy killed Coronis.
• Rightful Apollo killed Coronis
• Asclepius born by C-section
• Asclepius accepted gold
• Zeus killed Asclepius.
• Post –Homeric Greece
• Asclepius was destroyed because of
• Asclepius was destroyed because he
his benevolence to mankind
was greedy
WHAT’S IN THE NAME?
• Askles: a tyrant of Epidaurus
• Epios: Greek for gentleness,
kindness, calmness
• “kindness to all those suffering”.
• “ To cut open” “ The mole-Hero”.
• Etymology :pre-Greek
Sebastiano Riccica, 1720. “Dream with
Asclepius”. Academy Gallery, Venice, Italy
ASCLEPIUS’ FAMILY
•
Father: Apollo
• Mother: Coronis
• Wife: Epione, “epios”
• Machaon: “Surgery”
• Podalirius: “ Internal Medicine”
• Hygeia: goddess of health.
Asclepius and his family meet the sick. Unknown author.
National Museum of Art. Athens.
• Panacea: “ soothing simples” or remedies
HERMES AND ASCLEPIUS’ FAMILY
• Daughters: Hygieia, Panacea, Meditrina,
Aceso, Iaso, Aglaea
• Sons: Machaon, Podalirius, Telesphoros,
• Killed by Zeus with a Thunderbolt
• Post-mortem God
•
Constellation Ophiuchus
JOHN WILLIAM WATERHOUSE. “ A SICK
CHILD BROUGHT INTO THE TEMPLE OF
ASCLEPIUS. 1877
SANCTUARY OF ASCLEPIUS,
ALBANIA. BUILT III BC
ASCLEPIADS
Asclepius
• Lover of all people
Asclepiads- Physicians
• Hippocrates > the Asclepiad (Plato’s)
• Accessible to supplicants
> the leader of the
Asclepiads ( Aristotle’s)
• Man-God
• Killed for his compassion to the
condemned
• Dared to care for the outcast, regardless
of the consequences
• Medicine: responsibility to care for
the sick, even if placed the physician
at danger. Despite social status,
financial gain or personal risk
• Altruistic art
HERMES AND AESCULAPIUS RELATIONSHIP
• Hermes was Aesculapius
Uncle
• Saved him from his death
(some say)
• Hermes thought to have
married Hygeia (among
many others)
Hermes, a merchant, Aesculapius, Meditrine, Hygeia, Panacea. Engraved
from an original in the then Museum Pio Clemens in Rome Galerie
Mythologique, Recueil de Monuments by Aubin Louis Millin, Paris 1811
ONE MORE COMPARISON HAD BEEN MADE….
Christianity
Paganism
DEFINITION OF CADUCEUS
• Caduceus: Latin word
• From Greek word kerykeion
• Herald’s wand
• Non- Medical dictionaries: still Herald’s wand
• ..” figure whose basic structure consists of
two serpents encircling a wand or rod ”
THE CADUCEUS IN MEDICINE
Caduceus of Royal
College of Physicians
of Edinburgh
Butt’s caduceus
Caius’ emblem
Harvey’s
caduceus
Caduceus of the Royal
College of Physicians,
London. Caius
SIXTEENTH AND SEVENTEENTH CENTURY
Similar coat of arms as 2 other
Padua’s law students (1602)
Sir William Butts
Prudent in judgment
John Caius
President of the Royal College of
Medicine 1555-1571. “Authority
should be exercised with gentleness
and mercy”. Snakes> prudence.
Replica given to ACP in 1954.
William Harvey
CADUCEUS AS A PRINTER’S MARK
Multiple American printer’s marks derived
from Churchill’s.
Medicine, Literis. Unbreakable bond unites
Johann Froben’s
printer’s mark. 1516.
medical and nonmedical books
John Churchill’s printer's
mark. 1837. Medical books
CADUCEUS IN MILITARY
• Sign for PEACE
• Peloponnesian War 431-404 B.C
• Caduceator: non-combatant w/ message of peace.
• Peace in Munster 1648
• peace of Nystadt 1721
• Ambassadors 18 th century: coat of arms.
ROD OF ASCLEPIUS- MILITARY MEDICAL CORPS
France
German WWI medical
uniform
South Africa
UK
Australia
Army Reserve
Indian
MEDICAL DEPARTMENT OF US ARMY COAT OF
ARMS- 12/10/1817-12/02/1818
• Never had an official sanction
• 20 stars, 13 strips (before Illinois
became the 21st state)
• Stamped on an 1882 book
“ Antiseptic Surgery”
US NAVY SURGEON’S UNIFORM
1826-1832
• Staff of Aesculapius
embroidered on the collar
• “ of disproportionate size
and probably the ugliest
device ever worn”- Roddis,
L.H. A short history of
nautical medicine. 1941.
US MILITARY- HOSPITAL STEWARD- CIVIL WAR
1851-1887
US Army’s General Order no.
31. 06/12/1851, 10/31/1851
US ARMY MEDICAL OFFICER DISTINCTION
1840
MS- Medical Staff
1872
MD- Medical Department
1891
Shield. 13 stars + 13 strips.
Rod of Asclepius
HOSPITAL CORPS-1887
RED CROSS on overcoats and blouses
WHITE GENEVA CROSS on helmets,
forage caps and side buttons
US ARMY HOSPITAL CORPS 1902
OFFICERS.
Cross of the “Knights of St John”Hospitallers
ENLISTED
Modified Maltese cross
1902. CAPTAIN FREDERICK P. REYNOLDS,
ASSISTANT SURGEON US ARMY
Letter to the Surgeon General,
March 20th, 1902
…”I wish particularly to call attention to the
desirability of changing the insignia from the
cross to the caduceus and to the adoption of
Maroon as the color of the Corps in lieu if the
Green now used. The Caduceus was for years
the insignia of our Corps and it is inalienably
associated with things medical. It is in use by
several of the foreign powers, notably the
English”………
Capt. Frederick P. Reynolds
George Miller Sternberg
NO
…….”the present insignia of the Medical Department
(the Maltese cross) was adopeted after careful
consideration, and is now generally recognized as
indicating this corps…. ”
1902. CAPTAIN FREDERICK P. REYNOLDS,
ASSISTANT SURGEON US ARMY
Letter to the Surgeon General,
June 14th, 1902
…”I wish particularly to call attention to the
desirability of changing the insignia from the cross to
the caduceus and to the adoption of Maroon as the
color of the Corps in lieu if the Green now used. The
Caduceus was for years the insignia of our Corps
and it is inalienably associated with things medical. It
is in use by several of the foreign powers, notably
the English”………
Capt. Frederick P. Reynolds
William H Forwood
YES
........”The Acting Surgeon General concurs in the opinion
that a change in thepresent insignia as well as the green
color trimming for the medical Corps of the Army is
desirable. I am favorably impressed with the suggestions
made by Capt Reynolds and Major Border….. ”
July 28th, 1902
USE OF THE ROD OF ASCLEPIUS INSTEAD OF
CADUCEUS
• English medical corps: 1898
• Prussian/ German : 1868
• French medical corps: 1798
….” I have the honor to submit herewith a
drawing suggesting a crest or emblem for the
use of the medical Department……… The cock
of Aesculapius is the same as on the old
emblem…….” November 26th, 1902
Capt. Reynolds
INTERESTING LETTERS
Dr. Gerhard 1909. JAMA
•
•
…” In the United States Army ”..” the
device of a surgeon is mercury ’s
wand……Carefully examining the literature
on the subject of Mercury we learn many
facts arguing against the use of
this…emblem in the healing art. We shall
see that I belongs strictly to commerce and
trade”
“Whoever recommended its [caduceus]use
as a medical emblem in this country has
either been conducted by mercury, his titular
deity, to join the souls of the dead in the
world below, or is keeping unusually quiet ”
•
…”A badge of neutrality appropriate to
the medical officer as a noncombatant.. ”
Colonel Hoff 1928
• “ has really no medical bearing
whatever, and what significance it has is
indeed not at all complimentary….
Whatever its real symbolism may be…
the bearing is certainly not medical, and
our use if the caduceus is therefore, not
correct”. Lieutenant Colonel C.C.
McCulloch 1917.
20TH CENTURY
• 1902: US Army medical corps
• 1910: AMA Rod of Asclepius as
insignia
• 1924: La Presse Medicale
• 1924: AMA
• 1917: WWI Caduceus “exposed”
• Caduceus: doctor’s insignia for cars.
• 1918: RAF caduceus in logo
• Rod of Asclepius: button/pin clasp
• Later: Korea, Paraguay, Iran and
Luxemburg (1962 > Asclepius)
• 1925: AMA dropped use of caduceus
LA PRESSE MEDICALE, 1924
“During
the last war some of our
confreres with an interest in
antiquity have commented on the
use of the caduceus of mercury
used by the medical men in certain
allied armies….”
CADUCEUS IN MEDICAL ORGANIZATIONS?
AAMC
AMA
• Founded in 1847
• JAMA 1883
• Founded in 1876
• Caduceus insignia
in 1987-88
• Changed logo
recently
BOSTON MEDICAL AND SURGICAL JOURNAL
“…advisable for physicians to adopt the caduceus, which has the
approval of the AMA, as an emblem for the doctor’s car? For a
number of years past it has been customary in this vicinity to
display the green cross on white field, and before a change is
made it would be well to be certain that the cross is unsatisfactory.
The caduceus is a winged rod entwined by two serpents, and is the
badge of Mercury, the god of commerce, and incidentally of
thieves. If a change is desired, why not adopt the staff of the god of
Medicine, Asclepius…”
Dr. Henry Bowditch, Boston 1923
CADUCEUS APPEARANCE IN THE DICTIONARY
France, UK, US
Before 1903
After 1907
Non-Medical dictionaries
(12) NO mention of its
association with medicine
3/9 stated its association with
medicine
Medical Dictionaries
(11) Not definition of
caduceus AT ALL
5/8 reported its association
with medicine
Both medical and nonmedical dictionaries
NO RELATIONSHIP
8/17 (47%) reported its
association
Chance of this difference NOT related to the introduction of caduceus as the emblem for
the US Army Medical Corps in 1902 is 1:1,000
WHERE DO WE STAND NOW (LATE 20TH CENTURY
1970-80S) AND HERE (USA)?N=242
Logo or insignia
Rod of Asclepius
Caduceus
PROFESSIONAL MEDICAL
ORGANIZATIONS
62 %
38 %
COMMERCIAL MEDICAL
ORGANIZATIONS
24 %
76 %
HOSPITALS
Rod of Asclepius
Caduceus
38 hospitals out of 242
“medical organizations”
analyzed
37% (14/38)
63% (24/38)
SUMMARY
CADUCEUS’S ASSOCIATION TO MEDICINE DUE TO
1. Confusion
2. Lack of recognizing
of traditional Hermes with other Hermes
difference between 2 serpentine objects
Although, many lay people may think this is appropriate, it seems unlikely that most
medical people, if they understood the underlying meaning of this object, would find it
suitable.
Walter J. Friedlander.
QUESTIONS??
Claude Lorrain. Asclepius reviving Hippolytus
BIBLIOGRAPHY
1.
The Golden Wand of Medicine. A history of the caduceus Symbol in Medicine. W.J. Friedlander. 1992
2.
3.
Asklepios: Ancient Hero of medical Caring. J.E Bailey. Annals of Internal Medicine 124 (2) 1996
The Symbol of Modern Medicine: Why one snake is more than two. RA Wilcox; EM Whitham. Annals of Internal Medicine 138 (8). 2003
4.
Asclepius. The perfect discourse of Hermes trismegistus. Clement Salaman. 2010
5.
The way of Hermes
Sandro Botticelli: Aphrodite in La Primavera. 1492