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OpenAthens Shibboleth
February 3, 1999

Serpents, Staffs, and the Emblems of Medicine

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Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999American Medical AssociationThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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JAMA. 1999;281(5):475. doi:10.1001/jama.281.5.475-JMS0203-3-1

For much of recorded history, serpents and serpent-staffs have been associated with the healing arts.14 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 scepter, 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.13 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.

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