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The Medical Emblem

Greek ASKLEPIOS, Latin AESCULAPIUS (or Asculapius), Greco-Roman god of medicine.

The Myth:

Asclepius is the god of Healing. He is the son of Apollo and the nymph, Coronis. While pregnant with Asclepius, Coronis secretly took a second, mortal lover. When Apollo found out, he sent Artemis to kill her. While burning on the funeral pyre, Apollo felt pity and rescued the unborn child from the corpse. Asclepius was taught about medicine and healing by the wise centaur, Cheiron, and became so skilled in it that he succeeded in bringing one of his patients back from the dead. Zeus felt that the immortality of the Gods was threatened and killed the healer with a thunderbolt. At Apollo's request, Asclepius was placed among the stars as Ophiuchus, the serpent-bearer.

Mercury (Hermes) & merchant approach disapproving Asclepius (Physician) and the naked Graces ( Meditrine , Hygeia and Panacea )

The children of Asclepius included his daughters Meditrina, Hygeia and Panacea who were symbols of medicine, hygiene and healing (literally, "all healing") respectively. Two of the sons of Asclepius appeared in Homer's Illiad as physicians in the Greek army (Machaon and Podalirius [?Podiatry]).

Note that the classic Hippocratic Oath is sworn "by Apollo the physician, by Æsculapius, Hygeia, and Panacea, ....." This is the modern version: Hippocratic Oath

Homer, in the Iliad, mentions him only as a skilful physician; in later times, however, he was honoured as a hero and eventually worshiped as a god. The cult began in Thessaly but spread to many parts of Greece. Because it was supposed that Asclepius effected cures of the sick in dreams, the practice of sleeping in his temples became common, whereby people believed they could be cured from their diseases.

Asclepius was frequently represented standing, dressed in a long cloak, with bare breast; his usual attribute was a staff with a serpent coiled around it. This staff is the only true symbol of medicine. A similar but unrelated emblem, the caduceus, with its winged staff and intertwined serpents, is frequently used as a medical emblem but is without medical relevance since it represents the magic wand of Hermes, or Mercury, the messenger of the gods and the patron of trade.

Beneath the towering Parthenon, on the southern cliffs of the Acropolis, is a sacred spring in a small cave. While details of its earliest use and deities are lost in antiquity, it is known that the spring became the focal point of a sanctuary to the healing god Asklepios by the 5 th century BC. The sacred spring of Asklepios was converted into a Christian place of worship by the 6th century AD and rededicated to the Aghioi Anargyroi, or Doctor Saints. Below the cave and spring shrine are extensive ruins of other temples to Asklepios and also of Hygieia, the goddess of health.

The cult of Asklepios spread from the island of Kos (home of the famous physician Hippocrates) throughout Greece and Asia Minor. In the classical and Hellenistic periods, many cities and towns had sanctuaries dedicated to Asklepios, but there were particular sites that had a greater prominence than others, including Epidauros in mainland Greece, Kos in the Aegean, Trikka in Thessaly, Pergamon in Asia Minor, and Lebena in southern Crete. Each of these healing sanctuaries drew large numbers of pilgrims from distant parts of the Greek world for well over one thousand years.

The temples of Asklepios were always associated with sacred springs, whose waters carried the healing powers of the Earth spirits. Because it was believed that Asklepios effected cures of the sick in dreams, those patients seeking the god's help first drank and bathed in the waters of his spring and then slept within the temple precincts (called an abaton). During dreams, Asklepios or his serpents would appear to the sick, giving them clues regarding their healing.

The means by which cures were effected were abstinence from food before and during the time in the abaton, ritual bathing, sacrifice, incubation, dreams, and then healing. While priests were present at the shrines, they did not function as doctors nor is there any evidence for medical treatment in any of the Asklepion. Those persons who received cures at the Asklepieia recovered through their faith in Asklepios, through the therapeutic suggestions they received in dreams, or simply in the natural course of events.

Patients in Asklepion shrines also participated in rituals involving snakes, which were believed to be assistants of the healing god. Asklepios is frequently shown standing with a long wooden staff, around which is entwined a large snake. This staff, symbolizing the tree of life, and its coiling snake represent the mysterious healing powers of the primal earth and are themselves remnants of pre-Grecian cults that worshipped the Earth.

Asklepion Shrine, Athens

Spring and shrine of Asklepios at the Acropolis
Athens, Greece

How did the medical emblem of two snakes intertwined around a dagger originate?

The serpentine staff is called a caduceus. It has Greek origins -- Hermes, the messenger of the gods, carried it as a symbol of peace. Ancient Greeks created the caduceus as a badge of honour; ambassadors and noblemen carried a long staff entwined with garlands or ribbons to announce their presence. The garlands were later interpreted as snakes, and a pair of wings was added to denote Hermes, the winged messenger. Here's where it gets tricky. The U.S. Army medical corps adopted the caduceus as their insignia because of its similarity to the staff carried by Asclepius, the god of medicine. The staff of Asclepius is considered the "true symbol of medicine" -- it features only one snake, and no wings. It's the emblem of the American Medical Association. The two symbols are quite similar in appearance, and both are derived from Greek mythology. The caduceus generally stands for peace, although it may also serve as a symbol of trade and communication, while the staff of Asclepius stands for healing.

Futher mythology:

For much of recorded history, serpents and serpent-staffs have been associated with the healing arts. 1 - 4 One modern emblem of medicine, for example, is the single-serpented staff of Aesculapius, the Greek god of healing. Although such serpentine symbolism is quite prevalent, many consider the connection between serpents and medicine obscure. One interpretation is that just as the serpent represents the forces of life and death as a messenger between the earth's surface and the netherworld, the physician stands as an intermediary in the struggle between healing and destruction. 1 - 2 , 5

Worshipped and feared in countless cultures, the serpent is a central figure in various accounts of the creation. The ancient Mesopotamians portrayed their goddess Ishtar, the source of all life, as a snake. In Oriental, Hebrew, and Greek cultures, the serpent was sometimes known as "the mother of all." Some Hebrew scholars even believe the name Eve to be derived from the word for serpent. Similarly, the ancient Chinese depicted our first parents with human upper bodies and entwined serpentine lower bodies. 1 To these ancient cultures, the serpent was a source of endless meditation on the mystery of life and creation.

Not only did the serpent have the power to create life: it also had the power to preserve life. The snake's unique ability to shed its old skin represents a triumph of self-renewal over aging. This metaphor is conveyed in a legend shared by several cultures, which states that God intended to tell humans to cast off their old skins as they aged and to become young again, but the message was instead delivered to the serpent. 1 , 6

According to the Sumerian account, a serpent shed its skin after swallowing the "herb of new life" it had stolen from Gilgamesh. 2 Similarly, blood from the right side of a serpentine monster, the Gorgon, gave Aesculapius the power of resurrection, while blood from her left side was poison.

With its seeming power over death, the serpent became a symbol of deliverance. Moses raised a bronze serpent on a staff upon which the afflicted might look and be healed (Numbers 21:6-9). The blind Roman emperor Theodosius regained his sight when a serpent placed a stone on his eyes. Aesculapius assumed the form of a serpent to deliver a city from plague, and those who suffered were healed when licked by snakes in his temples. 1 Further, Kannon, the Japanese goddess of mercy who was believed to deliver people from their difficulties, is often depicted with a snake. 1

When twined around a staff, the serpent stands as a clearer symbol of the healing art. Staffs represent sacred trees. In Near Eastern cultures, these trees were viewed as a type of the cosmic axis connecting this world with the underworld and the heavens.

The image of Trees of Life, central to ancient creation accounts, permeates modern culture. Spires and steeples are cultural remnants of this archetype. Mystical powers as well as practical applications were attributed to such staffs. 3 , 5 Aesculapius' knotty staff, for example, assisted the god in his wanderings to serve humankind. It also served as a walking staff for a priest or a crutch for the ailing. 1 In its support for those in search of healing, the Aesculapian staff differs from other derivatives of sacred trees, including the mace, wand, and sceptre, that command subservience. 4

Strangely, in contrast to its beneficent associations, the snake has also represented destruction and death. Several ancient accounts portray the serpent as the enemy of life. 1 - 3 The serpent's dual nature represented the struggle between life and death as well as the potential for resurrection and immortality. 1 - 2

As a creature that could travel between the surface and the subterranean worlds with an uncanny undulating motion, the serpent assumed the role as messenger between this world and the underworld. 1 - 2

As symbols of life and death, serpents and their associated staffs represent both the aspirations and dangers of medical practice. When pursued with wisdom and beneficence, medicine is often able to heal the ailing. However, the dark forces of chaos and sickness may still triumph. Our modern serpentine symbols, vestiges of ancient thought and culture, inform us that this struggle continues.

Nathan W. Williams

University of Colorado Health Sciences Centre

JAMA. 1999;281:475


REFERENCES 1. Russel FE. Snake Venom Poisoning. Philadelphia, Pa: JB Lippincott Co; 1980.

2. Bunn JT. Origin of the caduceus motif. JAMA. 1967;202:615-619.

3. Metzer WS. The caduceus and the Aesculapian staff: ancient eastern origins, evolution, and western parallels. South Med J. 1989;82:743-748

4. Geelhoed GW. The caduceus as a medical emblem: heritage or heresy? South Med J. 1988;81:1155-1161.

5. Merrill JM. Snake imagery and healing. J Lab Clin Med. 1991;117:431-432

6. Parry DW. Temples of the Ancient World. Salt Lake City, Utah: Deseret Book Co; 1994.