Tuesday, January 19, 2010

The meaning of the medicine logo (Caduceus)

The caduceus ☤ (pronounced /kəˈdjuːsiəs, -ʃəs/, from Greek kerykeion κηρύκειον) is typically depicted as a short herald's staff entwined by two serpents in the form of a double helix, and is sometimes surmounted by wings. This staff was first borne by Iris, the messenger of Hera. It was also called the wand of Hermes when he superseded Iris in much later myths.
In later Antiquity the caduceus might have provided the basis for the astrological symbol representing the planet Mercury and in Roman iconography was often depicted being carried in the left hand of Mercury, the messenger of the gods, guide of the dead and protector of merchants, shepherds, gamblers, liars and thieves.[
The caduceus is sometimes erroneously used as a symbol for medicine, especially in North America, due to confusion with the traditional medical symbol, the rod of Asclepius, which has only a single snake and no wings.
As early as 1910, Dr. William Hayes Ward discovered that symbols similar to the classical caduceus sometimes appeared on Mesopotamiancylinder seals. He suggested the symbol originated some time between 3000 and 4000 BCE, and that it might have been the source of the Greek caduceus.[4] A.L. Frothingham incorporated Dr. Ward's research into his own work, published in 1916, in which he suggested that the prototype of Hermes was an "Oriental deity of Babylonian extraction" represented in his earliest form as a snake god. From this perspective, the caduceus was originally representative of Hermes himself, in his early form as the Underworld god Ningishzida, "messenger" of the "Earth Mother".[5] However, more recent classical scholarship makes no mention of a Babylonian origin for Hermes or the caduceus.[6]

Hermes hastens bearing his kerukeion, on an Atticlekythosca 480-470 BC, attributed to the Tithonos Painter
Among the Greeks the caduceus is thought to have originally been a herald's staff. The Latin word caduceus (possibly caduceum) is an adaptation of the Greek kerukeion, meaning "herald's wand (or staff)", deriving from kerux, meaning "herald" or "public messenger", which in turn is related tokerusso, meaning "to announce" (often in the capacity of herald).[7] The staff of the herald is thought to have developed from a shepherd's crook, in the form of a forked olive branch, which for this purpose has been adorned with first two fillets of wool, then with white ribbons and finally with two snakes intertwined.[8]
One Greek myth of origin of the caduceus is part of the story of Tiresias,[9] who found two snakes copulating and killed the female with his staff. Tiresias was immediately turned into a woman, and so remained until he was able to repeat the act with the male snake seven years later. This staff later came in to the possession of the god Hermes, along with its transformative powers. Another myth relates how Hermes played a lyre fashioned from a tortoise shell for Apollo, and in return was appointed ambassador of the gods with the caduceus as a symbol of his office.[10]Another tale suggests that Hermes (or Mercury) saw two serpents entwined in mortal combat. Separating them with his wand he brought about peace between them, and as a result the wand with two serpents came to be seen as a sign of peace.[11]
In Rome, Livy refers to the caduceator who negotiated peace arrangements under the diplomatic protection of the caduceus he carried


Two caduceuses without wings above a door in Ztracená street,Olomouc, Czech Republic
In some vase paintings ancient depictions of the Greek kerukeion are somewhat different from the commonly seen modern representation. These representations feature the two snakes atop the staff (or rod), crossed to create a circle with the heads of the snakes resembling horns. This old graphic form, with an additional crossbar to the staff, seems to have provided the basis for the graphical sign of Mercury widely used in works on astronomy, astrology and alchemy.[12] Another simplified variant of the caduceus is to be found in dictionaries, indicating a “commercial term” entirely in keeping with the association of Hermes with commerce. In this form the staff is often depicted with two winglets attached and the snakes are omitted (or reduced to a small ring in the middle).[13]

[edit]Confusion with the rod of Asclepius

The caduceus is sometimes used as a symbol for medicine or physicians (instead of the rod of Asclepius) even though the symbol has no connection withHippocrates and any association with healing arts is something of a stretch;[14] its singularly inappropriate connotations of theft, commerce, deception and death have provided fodder for academic humor:[15]
The printer's symbol of Johann Froben
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. 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 therapist? As conductor of the dead to their subterranean abode, his emblem would seem more appropriate on a hearse than on a physician's car.[16]
— Stuart Tyson, Scientific Monthly
However, attempts have been made to argue that the caduceus is appropriate as a symbol of medicine or of medical practitioners. Apologists have suggested that the sign is appropriate for military medical personnel because of the connotations of neutrality. Some have pointed to the putative origins of the caduceus in Babylonian mythology (as described above), particularly the suggested association with Ishtar as "an awakener of life and vegetation in the spring" as justification for its association with healing, medicine, fertility and potency.[17]
A 1992 survey of American health organizations found that 62% of professional associations used the rod of Asclepius, whereas in commercial organizations, 76% used the caduceus.[18]
The first known use of the caduceus in a medical context was in the printer's vignette used by the Swiss medical printer Johann Frobenius (1460-1527), who used the staff entwined with serpents, not winged but surmounted by a dove, with the biblical epigraph "Be ye therefore wise as serpents and harmless as doves"[19] The caduceus was also apparently used as a symbol by Sir William Butts, physician to Henry VIII.[20] A silver caduceus presented to Caius College, Cambridge by John Caius and carried before him on the cushion he supplied in official visits to the college remains in the College's possession.[21]

Widespread confusion regarding the supposed medical significance of the caduceus appears to have arisen as a result of events in the United States in the 19th century.[22] It had appeared on the chevrons of Army hospital stewards as early as 1856.[23] In 1902 it was added to the uniforms of Army medical officers. This was brought about by one Captain Reynolds,[24] who after having the idea rejected several times by the Surgeon General, persuaded the new incumbent —Brig. Gen. William H. Forwood — to adopt it. The inconsistency was noticed several years later by the librarian to the Surgeon General, but the symbol was not changed.[22] In 1901 the French periodical of military medicine was named La Caducée. The caduceus was formally adopted by the Medical Department of the United States Army in 1902.[22] After World War I the caduceus was employed as an emblem by both the Army Medical Department and the Navy Hospital Corps. Even the American Medical Association used the symbol for a time, but in 1912, after considerable discussion, the caduceus was abandoned by the AMA and the rod of Asclepius was adopted instead.
There was further confusion caused by the use of the caduceus as a printer's mark (as Hermes was the god of eloquence and messengers), which appeared in many medical textbooks as a printing mark, although subsequently mistaken for a medical symbol.[22]

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