The emergency medical services' Star of Life features a rod of Asclepius

In Greek mythology, the Rod of Asclepius (⚕; Ancient Greek: Ῥάβδος τοῦ Ἀσκληπιοῦ, Rhábdos toû Asklēpioû, sometimes also spelled Asklepios), also known as the Staff of Aesculapius and as the asklepian,[1] is a serpent-entwined rod wielded by the Greek god Asclepius, a deity associated with healing and medicine. In modern times, it is the predominant symbol for medicine and health care, although it is sometimes confused with the similar caduceus, which has two snakes.[1]

Greek mythology and Greek society

Asclepius with his serpent-entwined staff; Archaeological Museum of Epidaurus

The Rod of Asclepius takes its name from the Greek god Asclepius, a deity associated with healing and medicinal arts in ancient Greek religion and mythology. Asclepius' attributes, the snake and the staff, sometimes depicted separately in antiquity, are combined in this symbol.[2]

The most famous temple of Asclepius was at Epidaurus in north-eastern Peloponnese. Another famous healing temple (or asclepeion) was located on the island of Kos, where Hippocrates, the legendary "father of medicine", may have begun his career. Other asclepieia were situated in Trikala, Gortys (Arcadia), and Pergamum in Asia.

In honour of Asclepius, a particular type of non-venomous snake was often used in healing rituals, and these snakes – the Aesculapian snakes – crawled around freely on the floor in dormitories where the sick and injured slept. These snakes were introduced at the founding of each new temple of Asclepius throughout the classical world. From about 300 BCE onwards, the cult of Asclepius grew very popular and pilgrims flocked to his healing temples (Asclepieia) to be cured of their ills. Ritual purification would be followed by offerings or sacrifices to the god (according to means), and the supplicant would then spend the night in the holiest part of the sanctuary – the abaton (or adyton). Any dreams or visions would be reported to a priest who would prescribe the appropriate therapy by a process of interpretation.[3] Some healing temples also used sacred dogs to lick the wounds of sick petitioners.[4]

The original Hippocratic Oath began with the invocation "I swear by Apollo the Healer and by Asclepius and by Hygieia and Panacea and by all the gods ..."[4]

The serpent and the staff appear to have been separate symbols that were combined at some point in the development of the Asclepian cult.[5] The significance of the serpent has been interpreted in many ways; sometimes the shedding of skin and renewal is emphasized as symbolizing rejuvenation,[6] while other assessments center on the serpent as a symbol that unites and expresses the dual nature of the work of the Apothecary Physician, who deals with life and death, sickness and health.[7] The ambiguity of the serpent as a symbol, and the contradictions it is thought to represent, reflect the ambiguity of the use of drugs,[8] which can help or harm, as reflected in the meaning of the term pharmakon, which meant "drug", "medicine", and "poison" in ancient Greek.[9] However the word may become less ambiguous when "medicine" is understood as something that heals the one taking it because it poisons that which afflicts it, meaning medicine is designed to kill or drive away something and any healing happens as a result of that thing being gone, not as a direct effect of "medicine". Products deriving from the bodies of snakes were known to have medicinal properties in ancient times, and in ancient Greece, at least some were aware that snake venom that might be fatal if it entered the bloodstream could often be imbibed. Snake venom appears to have been 'prescribed' in some cases as a form of therapy.[10]

The staff has also been variously interpreted. One view is that it, like the serpent, "conveyed notions of resurrection and healing", while another (not necessarily incompatible) is that the staff was a walking stick associated with itinerant physicians.[11] Cornutus, a Greek philosopher probably active in the first century CE, in the Theologiae Graecae Compendium (Ch. 33) offers a view of the significance of both snake and staff:

Asclepius derived his name from healing soothingly and from deferring the withering that comes with death. For this reason, therefore, they give him a serpent as an attribute, indicating that those who avail themselves of medical science undergo a process similar to the serpent in that they, as it were, grow young again after illnesses and slough off old age; also because the serpent is a sign of attention, much of which is required in medical treatments. The staff also seems to be a symbol of some similar thing. For by means of this it is set before our minds that unless we are supported by such inventions as these, in so far as falling continually into sickness is concerned, stumbling along we would fall even sooner than necessary.[12]

In any case, the two symbols certainly merged in antiquity as representations of the snake coiled about the staff are common. It has been claimed that the snake wrapped around the staff was a species of rat snake, Elaphe longissima, the Aesculapian snake.[13]

Dracunculiasis

Using a matchstick to wind up and remove a Dracunculus medinensis worm from the leg of a human

Reviews of the history of parasitology have often interpreted the rod of Asclepius as a direct representation of one traditional treatment of dracunculiasis, the Guinea worm disease:[14] by slowly pulling the worm out of its erupting blister over a period of hours to weeks, while winding it around a stick. Modern treatment may replace the stick with a piece of sterile gauze, but is otherwise largely identical.[15] The shared benefit of both methods, when done right, is that rupture of the worm is avoided. This prevents anaphylaxis, which can otherwise occur when antigens in the worm's body fluid enter the patient's wound.

The hypothesis that the rod of Asclepius represents a stick with a rolled up Dracunculus proposes a factual historical basis to this ancient symbol, unlike the various mythologized versions of Asclepius' encounter with a venomous snake, in which he killed this serpent with his staff but then witnessed that it was brought to life again by a second snake.[16] Nevertheless, support in ancient texts for a connection with Guinea Worms instead of snakes is scanty and fragmentary. Greek medical texts such as the Hippocratic Corpus do not mention any evidence of the disease in peloponnesian and anatolian ancient Greece: Guinea worm infections were exclusively found elsewhere, in some parts of Egypt and the Arabian peninsula, as recently pointed out by Simonetti and coauthors[17]

Other pre-Hippocratic texts (from Egypt and Mesopotamia) specify treatment by lancing or some other form of surgery.[18] Muller[19] has interpreted Rigveda VII.50.2. (13th century BCE) to refer to the rolling of a Dracunculus worm on a stick, although the wording of the mantra in question is ambiguous.[20]

Relief in the Temple of Seti I (Abydos) of Thoth giving the ankh to pharaoh Seti I.

Another confounding aspect is that depictions of one or two staffs with winding snake(s) are known from bronze age Egypt, such as for example the famous 13th century BCE relief depicting Thoth giving life to the deceased Seti I in the temple of Abydos. Thoth, master of the underworld but also one of half a dozen egyptian gods involved in medicine, holds two staves in his left hand. Each staff has a winding cobra around it, with each snake wearing a miniature royal headdress of respectively the upper versus lower halves of Egypt, while raising its upper body in typical uraeus posture with splayed hood. There is no ambiguity here about the intention to depict snakes and not guinea worms.

A biblical equivalent

In the biblical Book of Numbers and Books of Kings, the nehushtan (Hebrew: נחשתן‎ nəḥuštān or נחש הנחושת‎) was a brass or bronze serpent on a pole that God told Moses to erect, saying that anyone who saw it would be protected from dying from the bites of the "fiery serpents" that God had sent to punish them for speaking against him and Moses.[21][22] The image of a snake wrapped around a staff or a dagger is common in Jewish and modern-day Israeli symbols of medicine, with origins often attributed to the nehushtan's healing powers.

Confusion with the caduceus

Main article: Caduceus as a symbol of medicine
The US Army Medical Corps plaque. The adoption, in 1902, of the caduceus for US Army medical officer uniforms popularized the (mis)use of the symbol throughout the United States medical field.

It is relatively common, especially in the United States, to find the caduceus, with its two snakes and wings, (mis)used as a symbol of medicine instead of the Rod of Asclepius, with only a single snake. This usage was popularized by the adoption of the caduceus as its insignia by the U.S. Army Medical Corps in 1902 at the insistence of a single officer (though there are conflicting claims as to whether this was Capt. Frederick P. Reynolds or Col. John R. van Hoff).[23][24]

The Rod of Asclepius is the dominant symbol for professional healthcare associations in the United States. One survey found that 62% of professional healthcare associations used the rod of Asclepius as their symbol.[25] The same survey found that 76% of commercial healthcare organizations used the Caduceus. The author of the study suggests that professional associations are more likely to have a historical understanding of the two symbols, whereas commercial organizations are more likely to be concerned with the visual impact a symbol will have on sales.[25]

The long-standing historical association of the caduceus with commerce has engendered significant criticism of its use in medicine. Medical professionals argue that the Rod of Asclepius better represents the field of medicine.[26]

As god of the high-road and the market-place Hermes was perhaps above all else the patron of commerce and the fat purse: as a corollary, he was the special protector of the traveling salesman. As spokesman for the gods, he not only brought peace on earth (occasionally even the peace of death), but his silver-tongued eloquence could always make the worse appear the better cause.[27] From this latter point of view, would not his symbol be suitable for certain Congressmen, all medical quacks, book agents and purveyors of vacuum cleaners, rather than for the straight-thinking, straight-speaking therapeutist? As conductor of the dead to their subterranean abode, his emblem would seem more appropriate on a hearse than on a physician's car.

— Stuart L. Tyson, "The Caduceus", in the Scientific Monthly, 1932[28]

Unicode

Rod of Asclepius
In UnicodeU+2695 ⚕ STAFF OF AESCULAPIUS
Related
See alsoU+269A ⚚ STAFF OF HERMES

A symbol ⟨⚕⟩ for the rod of Asclepius has a code point in the Miscellaneous Symbols table of the Unicode Standard.

Modern use

The flag of the World Health Organization, with a rod of Asclepius

A number of organizations and services use the rod of Asclepius as their logo, or part of their logo. These include:

Asia

Africa

South Pacific

Canada

Europe

United States

Worldwide

Variation

In Russia, the emblem of Main Directorate for Drugs Control features a variation with a sword and a snake on the shield.

See also

  • Aaron's rod – Staves carried by Moses's brother, Aaron, in the Torah
  • Bowl of Hygieia – Symbol of pharmacy
  • Chakra – Subtle body psychic-energy centers in the esoteric traditions of Indian religions
  • Nāga – Serpentine mythological creatures in Indian religions
  • Nehushtan – Brass serpent in Torah
  • Ningishzida – Mesopotamian god
  • Phurba – Tibetan ritual implement

References

  1. 1 2 Wilcox, Robert A; Whitham, Emma M (15 April 2003). "The symbol of modern medicine: why one snake is more than two". Annals of Internal Medicine. 138 (8): 673–7. doi:10.7326/0003-4819-138-8-200304150-00016. PMID 12693891. S2CID 19125435. Retrieved 15 June 2007.
  2. ↑ See for example Pausanias, Description of Greece 2.26.1–28.1 (here translated by Jones) 2nd A.D.: "The image of Asklepios is, in size, half as big as Zeus Olympios at Athens, and is made of ivory and gold. An inscription tells us that the artist was Thrasymedes, a Parian, son of Arignotos. The god is sitting on a seat grasping a staff; the other hand he is holding above the head of the serpent."
  3. ↑ Sigerist. Chapter 3, Religious medicine: Asclepius and his cult, p. 63ff.
  4. 1 2 Farnell, Chapter 10, "The Cult of Asklepios" (pp. 234–279)
  5. ↑ Stephen Lock, John M. Last, George Dunea, The Oxford Illustrated Companion To Medicine, 2001, p261 "In early statues of Asclepius the rod and serpent were represented separately."
  6. ↑ "Asklepios' reptile was a healing creature: in ancient mythology the snake, whose skin was shed and rejuvenated, symbolized eternity and restoration of life and health" Albert R. Jonsen, The New Medicine and the Old Ethics, Harvard University Press, 1990, p122; this interpretation was current in Antiquity, as can be seen in an account of Apollodorus: "your marvel at the serpent curling around him and say that it is the symbol of the healing art, because just as the serpent sloughs the skin of old age, so the medical art releases from illness." (in E. Edelstein and L. Edelstein (eds.), Asclepius: A Collection and Interpretation of the Testimonies, Baltimore, 1945, p12)
  7. ↑ "[...] the ancient conception of the serpent as the embodiment of the mystery of one absolute life of the earth, which entails a continual dying and resurrection [...] the combination of corruption and salvation, of darkness and light, of good and evil in the Asklepian symbol." Jan Schouten, The Rod and Serpent of Asklepios, Symbol of Medicine, 1967, p2
  8. ↑ Albert R. Jonsen, The New Medicine and the Old Ethics, Harvard University Press, 1990, p122-123
  9. ↑ Henry E. Sigerist, A History of Medicine, Oxford University Press, 1987, p27-28
  10. ↑ James A. Kelhoffer, Miracle and Mission, Mohr Siebeck, 2000, p438-439 "[...] it was known, at least by some people in antiquity, that a snake's venom is not harmful if imbibed, but rather only if it enters directly into a person's blood stream. For example, the first-century CE historian Lucan writes that the younger Cato, when leading his troops through Libya during the Roman Civil War, informed his men about this very point [...] 'The poison of snakes is only deadly when mixed with the blood; their venom is in their bite, and they threaten death with their fangs. There is no death in the cup.'" He also mentions an account of Cornelius Celsus (first century CE) "'For a serpent's poison, like certain hunter's poisons..., does no harm when swallowed, but only in a wound'". "Likewise, Galen relates a rather peculiar healing by Asclepius involving viper's venom. The god appeared to a wealthy man in Pergamum and prescribed 'that he should drink every day of the drug produced from the vipers and should anoint the body from the outside.' [...] The elder Philostratus describes a similar practice of 'the wise Asclepiads,' who 'heal the bites of venomous creatures... using the virus itself as a cure of many diseases.'"
  11. ↑ Andre Menez, The Subtle Beast, Snakes From Myth to Medicine, 2003, p14
  12. ↑ Emma J. Edelstein; Ludwig Edelstein (27 February 1998). Asclepius: Collection and Interpretation of the Testimonies. Baltimore: Johns Hopkins University Press. p. 13. ISBN 0801857694.
  13. ↑ Gerald David Hart, Martin St. J. Forrest, Asclepius: The God of Medicine, 2000, p42
  14. ↑ Dickson Despommier, People, Parasites, and Plowshares: Learning from Our Body's Most Terrifying Invaders, Columbia University Press, 2016 (first edition in 2013), pp. 147–163 (chapter 7 on Dracunculus medinensis), ISBN 9780231161954.
  15. ↑ "Management of Guinea Worm Disease (GWD)". Centers for Disease Control and Prevention. Retrieved 1 May 2012.
  16. ↑ "ASKLEPIOS (Asclepius) was the god of medicine". www.theoi.com. Retrieved 25 December 2023.
  17. ↑ .Simonetti O, Zerbato V, Di Bella S, Luzzati R, Cavalli F (2023). "Dracunculiasis over the centuries: the history of a parasite unfamiliar to the West". Le infezioni in medicina. 31 (2): 257–264.
  18. ↑ Adamson PB (1988). "Dracontiasis in Antiquity". Medical History. 32: 204–209.
  19. ↑ Muller, Ralph (2002). Worms and human disease 2nd edition. Wallingford: CABI. p. 232. ISBN 9780851995168.
  20. ↑ Mukhopadhyay AK (2013). "Skin in Health and Diseases in Ṛgveda Saṃhiṭa: An Overview". Indian Journal of Dermatology. 58 (6): 413–416.
  21. ↑ Numbers 21:8
  22. ↑ 2 Kings 18:4
  23. ↑ F.H. Garrison, "The Use of the Caduceus in the Insignia of the Army Medical Officer", in Bull. Med. Lib. Assoc. IX (1919-20), 13-16
  24. ↑ Engle, Bernice (December 1929). "The Use of Mercury's Caduceus as a Medical Emblem"". The Classical Journal. 25 (1): 205.
  25. 1 2 Friedlander, Walter J (1992). The Golden Wand of Medicine: A History of the Caduceus symbol in medicine. Greenwood Press. ISBN 0-313-28023-1.
  26. ↑ Bohigian, George (2019). "The Caduceus vs. Staff of Aesculapius - One Snake or Two?". Missouri Medicine. 116 (6): 476–477. "The Staff of Aesculapius has represented medicine since 800 BCE and most authorities support its use as the symbol of medicine
  27. ↑ An allusion to John Milton's description of Belial in Paradise Lost II.113-114.
  28. ↑ Tyson, Stuart L (1932). "The Caduceus". Scientific Monthly. 34 (6): 495.
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