Why There’s One and Sometimes Two Snakes in This Medical Symbol
Featuring a mistake that later turned out to be “correct”
For the curious observers, the World Health Organization’s (WHO) logo will surely raise questions. For one, why would an institution devoted to saving lives have a snake, an animal known for having a diverse arsenal for subduing, immobilizing, and killing their prey, be a part of its symbol? Isn’t that a bit ironic? Well, yes, it sure is. And like irony, its origins go back to ancient Greece.
A single snake coiled around a staff is a symbol called the Rod of Asclepius, after the Greek god of healing named, you guessed it, Asclepius. But mere ownership of the staff doesn’t suffice as a clear explanation of why snakes are related to medicine. In order to better understand this, we need to take a closer look at the story of Asclepius himself.
From tragedy to divinity
An almost complete account of Asclepius’ birth comes from Pindar’s Pythian. He writes that Asclepius was the son of the Greek god Apollo and the mortal Coronis. When Coronis was pregnant with Asclepius, she fell in love with a mortal and married him, earning Apollo’s ire. Filled with rage and contempt, the god had his twin, Artemis, shoot Coronis with her powerful bolts, killing the forlorn mother. However, the wrath of the gods overflowed, and their fury extended to Coronis’ family and immediate neighbors. It was only when the people in her village placed the dead mother’s corpse on a pyre that Apollo’s rage softened. According to Pindar, upon seeing Coronis’ lifeless body on the heap, Apollo uttered these words: “I can no longer endure in my soul to destroy my own child by a most pitiful death, together with his mother’s grievous suffering.”
Apollo then saved his son, slowly rescuing him from his mother’s womb. Pindar then tells us that the god “gave him to the Magnesian Centaur to teach him to heal many painful diseases for men.” The centaur mentioned here is Chiron, “whose mind was friendly to men” and mentor to many of the ancient world’s heroes, among which were Achilles and Heracles. Molded by the centaur’s legendary guidance, Asclepius grew to be a “gentle craftsman who drove pain from the limbs that he healed, that hero who cured all types of diseases.”
Under the centaur’s instruction, Asclepius was able to realize the potential of his divine lineage. An Orphic hymn devoted to him shows the full extent of his development:
“Asclepius healer of all, master physician,
You charm the many pains, misery, and disease of man,
Soothing, doughty one, come bring back health,
And end my maladies and the strident certainty of death.
Oh life-giving Boy, averter of ills, blessed one!
Mighty honored son of Phoebus Apollo,
Foe of disease, perfect ally of Hygeia
Come, happy saviour, lead my life to a fortunate end.”
(Names have been spelled in their modern conventional forms.)
Despite his tragic beginnings, Asclepius has now become a “life-giving Boy”. A “blessed one” who has the power to lead people towards a “fortunate end”. What this devotional shows is the completion of Asclepius’ ascension into divinity. He has transcended mortality and entered the realm of mythology.
Now, as a deity, temples devoted to him sprang across the Mediterranean. These temples became centers of rest and healing, where visitors can place votive offerings to the god for his healing intercession. It is in one of his temples that an errant snake, according to Pausanias in Description of Greece, ended up in. He writes that a ship from Epidaurus had a snake onboard which managed to escape while they were at sea. Near the ship was the island of Cythera which had “altars to Asclepius where the snake disappeared.” The rod is now complete.
However, other accounts tell a different story. One take is more symbolic, postulating that the snake is an embodiment of healing because of its regular shedding, and was only added later to the Asclepius mythos. Another has a pastoral theme where Asclepius reared the snake himself, thereafter becoming his accomplice. Whatever the real story may be, the diversity of sources is making it more complicated to frame a definitive explanation, so to “[d]etermine the meaning of the serpent in connection with Asclepius is very difficult”, wrote Emma and Ludwig Edelstein in Asclepius: Collection and Interpretation of the Testimonies.
A “correct” mistake
From antiquity onward, many medical institutions accepted the Rod of Asclepius as emblematic of medicine. However, a mistake happened along the way which still shows its residues today. The scars of this glaring gaffe can be seen in some American health institutions who have two snakes instead of one in their logos, resulting in a Caduceus, a staff not attributed to Asclepius but to Hermes (or Mercury for the Romans).
The first recorded use of the Caduceus as an insignia was in 1518. The publisher Johann Froben used it as a personal seal in his publication of Thomas More’s Utopia. From thereon, it became a regular sight in his prints. His use wasn’t in any way to represent a medical mission, but it was likely to invoke the commercial promise of Hermes, as the god was seen as a patron of merchants. (The Froben publishing house did print many medical texts, in fairness to them.)
A few centuries later, the Caduceus was first used as an explicit medical symbol. In 1856, the United States Congress allowed its Secretary of War to appoint medical stewards. These stewards were soldiers chosen to act as assistants to the surgeons and physicians in the army. To highlight their role, they wore chevrons that had a Caduceus (image below). Its use was later followed by the United States Public Health Service (USPHS) in 1877.
No one knows exactly why the Caduceus was chosen. Maybe it was an honest mistake, or perhaps a quick flash of ignorance. But voices were inevitably raised to contest the choice. In turn, those who defended the selection also rallied in defiance. The loudest defense for its use came from Lt. Gen. Fielding Garrison who in 1919 wrote to the Journal of the American Medical Association (JAMA) with a justification for its use. He first made the claim that the Caduceus was originally an import from ancient Babylon, so its meaning went beyond what Hermes embodies. He then wrote that in this early form, the Caduceus was associated with the serpent deity Ningishzida who was the messenger of Ishtar, the Babylonian goddess of fertility and “the awakener of life”. From this connection, Garrison assumed a healing theme in the use of the symbol, hence its appropriateness as a medical symbol.
Historians and physicians readily renounced the resistance. Even the editor of JAMA wrote rather sarcastically in 1919 that the choice of using the Hermes’ staff was “surely not because the caduceus was used by Mercury as conductor of the souls of the dead to the world below” (emphasis by the editor). He then later argued that there was “no doubt that” the Rod of Asclepius “is a much more appropriate emblem for the medical profession than the wand of Mercury.”
In the end, a number of health and medical institutes incorporated the rod of Asclepius in their logos. But there are others who still retain their use of the caduceus, like the USPHS. Still, independently of which iconography was eventually used, the story echoes a familiar Greek irony. The erroneous use of the caduceus turned out to be the more correct choice for America given how commercialized and expensive US healthcare is. Hermes would be proud.
