Received: August 12, 2023. Revised: August 26, 2023. Accepted: September 13, 2023 © The Author(s) 2023. Published by Oxford University Press on behalf of Fellowship of Postgraduate Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com Postgraduate Medical Journal, 2023, 1–3 https://doi.org/10.1093/postmj/qgad093 On Ref lection Caduceus vs. Rod of Asclepius: A Serpentine Dilemma in Medical Iconography Muhammad Hamza Shah 1,2, *, Salim Usman 3 , Sakshi Roy 1 , Arjun Ahluwalia 1 , Amer Harky 4 1 School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast, Belfast, BT9 7BL, United Kingdom 2 Centre for Anatomy, Deanery of Biomedical Sciences University of Edinburgh, Edinburgh, EH8 9XD, United Kingdom 3 School of History, Anthropology, Philosophy & Politics, Queen’s University Belfast, Belfast, BT7 1NN, United Kingdom 4 Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, L14 3PE, United Kingdom *Corresponding author. School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, United Kingdom. E-mail: mshah03@qub.ac.uk Abstract This scholarly inquiry delves into the historical significance of two enduring medical symbols: the Rod of Asclepius and the Caduceus. Tracing their origins back to ancient Greek mythology, we uncover their distinct identities and profound meanings as symbols of healing, unity among medical practitioners, and ethical responsibilities. Beyond aesthetics, these emblems serve as powerful educational tools, fostering universal understanding and connecting modern medicine to its historical heritage. Consequently, embracing their true essence can inspire genuine dedication to the noble mission of caring for others. Keywords: medical history; medical education & training; medical iconography Introduction In the realm of medicine, symbols often hold profound meanings, evoking a sense of heritage and tradition which stretches back through the ages. Among the various symbols used to represent healing and the medical profession, one stands out as the emblem of the American Medical Association: the single staff with a snake entwined around it. However, the true origin and significance of this ancient symbol remain enshrouded in the fog of history, leading to widespread confusion among both physicians and the general public [1]. Unbeknownst to many, there are, in fact, two distinct symbols commonly associated with medicine, each with its own unique origins. The first, and arguably more authen- tic, symbol is the Staff of Aesculapius, a rough-hewn branch entwined by a single snake. Aesculapius, the god of medicine and son of Apollo, was renowned for his healing skills. Tragically, his remarkable abilities led to his downfall, as his grandfather Zeus struck him down with a thunderbolt, fearing that too few souls were journeying to the underworld due to Aesculapius’ interventions. This confusion surrounding the true symbol of medicine has persisted over the years. In a survey conducted in 2014 in India, it was revealed that only a meager 6% of physicians knew that the Staff of Aesculapius was the authentic emblem of healing [2]. Similarly, in a 1992 survey, a staggering 76% of US hospitals were found to be misusing the Caduceus as a medical symbol [3]. As we delve into the historical significance of these symbols and their appropriation in modern times, it becomes evident that unraveling the true symbol of medicine is an essential endeavor. By understanding their distinct origins and meanings, we can gain a deeper appreciation for the rich heritage that underlies the med- ical profession and the symbols that have come to represent it. Tracing the historical footprint In the annals of history, the captivating tales of ancient Greek mythology have left an indelible mark on cultural symbols and beliefs. Among the revered figures stands Asclepius, a remarkable demigod blessed with a lineage that blends divine powers and mortal virtues. Born as the son of Apollo, the illustrious god of light, the sun, medicine, and healing, and Princess Coronis, a mortal Greek woman, Asclepius inherited a unique blend of talents and abilities [4]. Under the wise and nurturing guidance of the benevolent centaur Chiron, Asclepius honed his skills in medicine, including herbology, surgery, and the art of adminis- tering remedies. Chiron’s teachings left a lasting impression on the young protégé, complementing his innate gift for healing and providing the perfect foundation for him to become ancient Greece’s most powerful healer. As word of Asclepius’s extraordinary abilities spread far and wide, he attracted followers from every corner of Greece. His reputation soared to unparalleled heights, and he achieved feats that were thought impossible. One such tale tells of how Asclepius ventured to the brink of death to heal a serpent, and in return, the grateful snake imparted its secret knowledge of healing and medicine to the Greek hero. Additionally, Asclepius is said to have demonstrated his mastery over the deadliest of venomous snakebites, curing victims of their afflictions with astonishing skill. These connections with serpents forever bound Asclepius to their symbolism [5]. In various depictions of art, he is often portrayed holding a staff with a serpent entwined around it, a symbol that later became known as the Rod of Asclepius, signi- fying healing and medicine [3]. Conversely, the Caduceus draws its origins from Hermes or Mercury, the winged messenger of Greek mythology. This emblem Downloaded from https://academic.oup.com/pmj/advance-article/doi/10.1093/postmj/qgad093/7301419 by Universitet i Oslo user on 10 October 2023