What does the caduceus represent?
You may know that the caduceus is the symbol for the profession of medicine, but do you know what the serpent(s) wrapped around a stick represent? Well, it’s a pretty cool story.
The caduceus (or the staff of Asclepius with a single serpent encircling a staff) is a pictogram of one of the oldest medical therapies known. It shows a parasite that was described in Egypt in the 15th century BCE and may even been have mentioned in the Bible as the “fiery serpent” the Israelites encountered. The parasite I am talking about is Dracunculus medinensis, also known at the Guinea worm.
Guinea worm disease or dracunculiasis is initially acquired by ingestion. At first, there are no symptoms. About one year later, the infected individual develops a painful burning feeling as the female worm forms a blister in the skin, usually on the lower limb, often just above the ankle. The worm then comes out of the skin over the course of a few weeks. During this time, it may be difficult to walk or work.
The worm that pokes its way through the skin is long and thin. Although it is only about one to two millimeters wide, the adult female worm is 60 to 100 centimeters long; it may be longer than a yardstick. One treatment for dracunculiasis, still used today, is to extract the worm by wrapping the live worm around a stick. As the worm protrudes, the stick is turned gently and slowly until the entire worm is extruded. The process can be long, taking anywhere from hours to a week. (This is treatment is noted in the famous ancient Egyptian medical text, the Ebers papyrus from 1550 BC.)
This is what you see in the caduceus. A Guinea worm being loosely wrapped around a stick.
Dracunculus medinensis literally means the “little dragon from Medina.” The moniker “Guinea worm” refers to its formerly high prevalence along the Gulf of Guinea. This parasite was once a substantial cause of disability in tropical and subtropical Africa and Asia but, largely thanks to the WHO and the Carter Center, it is down to only 4 countries: Chad, Ethiopia, Mali and South Sudan. In 2015 only 22 cases were identified.
To date, there have been only two types of infection that have been completely eradicated from their susceptible host populations: variola (smallpox) in humans and the rinderpest virus of cattle. D. medinensis is in the running to be the third pathogen eradicated.
Winkler G. Weinberg, MD
I have been an Infectious Disease physician for over 3 decades. I am the author of No Germs Allowed!. If you liked this article, check out the book on Amazon.
