Cold Blooded Hot Topics: Snake iconography, Symbolism, and the Stories behind some Snake-Related Health Care Symbols.

When examining symbols of medicine, one is generally confronted with one of two images: the Rod of Asklepios or Hermes’ caduceus. The Rod of Asklepios can be easily identified by its singular snake coiling up a staff.

This symbol is clearly associated with health care through its connection to Asklepios , the Greek god of healing and medicine. He is the son of the Greek god Apollo, inheriting both his healing abilities and affiliation with snakes.[1] The second most depicted symbol is the Greek god Hermes’ caduceus or just “caduceus”. Interestingly, it is not affiliated with a health care deity or healing, it has been mistakenly used as a medical symbol due to its visual similarities to the Rod of Asklepios .

Figure 1 – Statue of Asklepios . Photo taken by the Museum of Health Care. Accession Number: 018017001

Instead of one, Hermes’ staff has two snakes coiling upwards with heads turned inwards and wings at the top. Hermes is not a health care deity, but is instead a god of commerce, trickery in the Roman empire, and serves as a messenger god.[2] There is a third piece rarely invoked of snake imagery, the iconography of a snake feeding out of a bowl. This is often accompanied by a young woman, the Greek goddess of health and safe recovery, Hygeia.[3]

Figure 2. Copper coin depicting Hermes’ Caduceus. Photo taken by the Museum of Health Care. Accession Number: 1997.2.17

The caduceus is often mistaken for the symbol of health care, appearing in place of the Rod of Asklepios . With a mistaken symbol so often appearing, it begs the question as to why snakes emerge in health care related iconography and how long have they held these associations?  

Figure 3. Ceramic Ackers Hygeia bowl. Photo taken by the Museum of Health Care. Accession Number: 018012001

Shedding some light on the snake-tuation 

Nearly every culture that has snakes or snake-like creatures in their region has some sort of snake mythology. Snakes are viewed as dualistic in nature, representing both aspects of good (healing, fertility, wisdom, rebirth) and evil (death, poison, trickery, harming). To understand snakes further, let's examine their life and death properties.

One of the most notable features of snakes is their ability to shed their skin. Many ancient cultures considered it to be a form of healing, rebirth, and/or immortality.  A myth echoing this sentiment comes from the Epic of Gilgamesh. The eponymous hero Gilgamesh was in search of a plant that would grant him immortality and render his body youthful again. Before consuming the plant, he took a nap, and instead, a snake ate it. The snake’s skin then began to loosen, and the outer shell of its skin was shed, revealing a healthy youthful snake underneath.[4] It was thought that snakes could shed any illness through this process. This seemingly infinite ability has fueled snakes’ long-standing connections with healing and health care. 

Rebirth necessitates death. Snakes are also associated with many chthonic deities. For many cultures including the Ancient Greeks, the underworld is a physical location. While snakes can live above ground, they also live underground associating them with chthonic powers. Additionally, some snakes are venomous, further strengthening their associations with death. The most prolific manifestation of these associations is the idea of snakes as embodiments of the dead. So common in fact, that Dr. Jastrow, Professor of Semitic Languages at the University of Pennsylvania said that the origin of the word “snake” is identical with the word for “life” in semitic languages. He also claims that this linguistic connection lies at the foundation of snakes embodying dead ancestors in Indo-European people, as they are “life” from the underworld.[5] This belief is also held beyond Indo-European cultures as the Zulu people of South Africa share this belief, but the snakes are always pleased or displeased ancestors.[6]

Snakes’ connection to health care becomes apparent through an understanding of both their life and death aspects. There are many chthonic deities with snakes as their symbol who share in healing properties as well. For example Ninazu, a Sumerian deity, is considered “lord physician” and ruler of the underworld.[7] Another example is Hecate, the Greek goddess of witchcraft. It may seem unconnected, but Ancient Greek witchcraft was about skilled herb and drug usage, not about casting fireballs.[8]

Coiled around History: Examining Snakes and Staffs 

The earliest known iconography of a snake coiled up a rod dates back to around c. 3000-4000 BCE, although some scholars argue that it could be dated to c. 2100 BCE.[9] The staff belongs to the chthonic Sumerian deity Ningishzida. He was a “herald of the earth” and “Lord of the Good Tree” with associations of protection and fertility.[10]

At first glance the staff appears to be two snakes, but it is actually one two-headed snake. It shares similarities to the Caduceus, except the heads are facing outwards. 

Figure 4 - Image of a libation vase featuring Ningishzida’s staff. Taken by Ernest de Sarzec - Choquin de Sarzec, Ernest (1832-1901).

The correct medical symbol is the Rod of Asklepios. There is one account of the myth explaining the origins of the staff written by Roman mythographer Pseudo-Hyginus around the end of the first century BCE. Asklepios had been startled by a snake that had climbed up his staff and in response used his staff to kill it. Later, another snake arrived and placed an herb into the mouth of the dead snake, reviving it as both snakes quickly escaped.[11] Ever since, the iconography of a snake coiled around a staff has become a symbol of Asklepios. While primarily a healing god, Asklepios touches on chthonic elements as death and illness are facets of health care. In fact, his powers were so great he could cross the threshold between the dead and living, once bringing a mortal man back to life.[12] 

The mistaken symbol of health care is Hermes’ caduceus. Hermes is not a health care deity, but he does hold a connection to the underworld as the transporter of souls.[13] When discussing myths and origins of specific symbols like the caduceus, no one myth is more “correct” than the other, just more popular. There are at least four different myths explaining the origin of Hermes’ staff:

1. Hermes received it from Iris, messenger goddess of Hera.[14] 

2. Apollo traded Hermes his staff in exchange for his lyre. This is the oldest myth and dates c. 7th century BCE.[15] 

3. Tiresias, a prophet, found two snakes mating, killed the female one and was turned into a woman for seven years until he found another pair of snakes mating, killed the male, and returned back to a man. Tiresias then gave the rod with the two remaining snakes to Hermes.[16]

4. Hermes made the staff himself after using his staff to separate two snakes fighting.[17]

Each myth has their own implications but illustrate the dualistic nature of snakes. For example, in the second myth, Hermes receives the caduceus through a peace trade with Apollo because Hermes stole Apollo's cows, tried to eat them, and then remembered that gods can't even eat food. When asked if Hermes had stolen the cows, he deceived Apollo claiming he was only born yesterday so how would he even know about cows.[18] The third myth connects to fertility as the snakes were caught mating, in fact, the phallus is one of the many symbols of Hermes. Hermes too shares in this dualism as he holds associations with both fertility and the dead. Some physicians have even cynically argued that the caduceus is a more accurate symbol of medicine as a commentary on the greed and trickery of capitalistic pharmaceutical corporations. 

Conclusion

Snake mythology and iconography has persisted for thousands of years. Its iconography is dualistic, symbolizing both good and evil. The staff of Asklepios is the “correct” symbol of medicine and the caduceus is the mistaken symbol of medicine. Next time you’re out, take some time to examine the symbols and crests and what iconography they choose to invoke. Complex, longstanding, and rich history can manifest itself in surprisingly casual settings.

Endnotes

1.  “Asklepios,” ASCLEPIUS (Asklepios) - Greek God of Medicine & Doctors, accessed August 7, 2025, https://www.theoi.com/Ouranios/Asklepios.html.

2.  “Hermes - Greek God of Herds & Trade, Herald of the Gods,” Theoi Greek Mythology, https://www.theoi.com/Olympios/Hermes.html.

3.  “Hygeia,” HYGEIA - Greek Goddess of Good Health (Roman Salus), accessed August 7, 2025, https://www.theoi.com/Ouranios/AsklepiasHygeia.html.

4.  “Gilgamesh Part 6 – The Plant of Immortality,” Storynory, accessed August 10, 2025, https://www.storynory.com/gilgamesh-part-6-the-plant-of-immhttps://www.storynory.com/gilgamesh-part-6-the-plant-of-immortaliy/ortaliy/.

5.  A. L. Frothingham, “Babylonian Origin of Hermes the Snake-God, and of the Caduceus I,” American Journal of Archaeology 20, no. 2 (April 1, 1916): 175–211, https://doi.org/10.2307/497115, 195.

6.  Abigail Smagala, “Snakes in South African Culture,” COVE, April 18, 2023, https://editions.covecollective.org/chronologies/snakes-south-african-culture.

7.  Joshua J. Mark, “The Mesopotamian Pantheon,” World History Encyclopedia, August 5, 2025, https://www.worldhistory.org/article/221/the-mesopotamian-pantheon/.

8.  “Hekate,” HECATE (Hekate) - Greek Goddess of Witchcraft, Magic & Ghosts, accessed August 7, 2025, https://www.theoi.com/Khthonios/Hekate.html.

9.  1. A. L. Frothingham, “Babylonian Origin of Hermes the Snake-God, and of the Caduceus I,” American Journal of Archaeology 20, no. 2 (April 1, 1916): 175–211, https://doi.org/10.2307/497115, 180.

10.  Ibid

11.  Pseudo-Hyginus, Astronomica 2. 14 (trans. Grant) (Roman mythographer Circa 1st century BCE) 

12.  Pindar, Pythian Ode 3. 54 ff (trans. Conway) (Greek lyric C5th B.C.)

13.  Pausanias, Description of Greece 8. 32. 4

14.  Gary Lachman, The Quest for Hermes Trismegistus: From Ancient Egypt to the Modern World (Edinburgh: Floris Books, 2011), 82.

15. Ibid

16. Ibid

17. Ibid

18.  Homeric Hymn 4 to Hermes (trans. Evelyn-White) (Greek epic C7th to 4th B.C.)

Ancient Sources

Homeric Hymn 4 to Hermes (trans. Evelyn-White) (Greek epic C7th to 4th B.C.)

Pausanias, Description of Greece 8. 32. 4 (trans. Jones) (Greek travelogue C2nd A.D.) 

Pindar, Pythian Ode 3. 54 ff (trans. Conway) (Greek lyric C5th B.C.)

Pseudo-Hyginus, Astronomica 2. 14 (trans. Grant) (Roman mythographer C2nd A.D.) 

Bibliography

“Asklepios.” ASCLEPIUS (Asklepios) - Greek God of Medicine & Doctors. Accessed August 7, 2025. https://www.theoi.com/Ouranios/Asklepios.html. 

Friedlander, Walter J. The Golden Wand of Medicine: A History of the Caduceus Symbol in Medicine. New York: Greenwood Press, 1992. 

Frothingham, A. L. “Babylonian Origin of Hermes the Snake-God, and of the Caduceus I.” American Journal of Archaeology 20, no. 2 (April 1, 1916): 175–211. https://doi.org/10.2307/497115. 

“Gilgamesh Part 6 – The Plant of Immortality.” Storynory. Accessed August 10, 2025. https://www.storynory.com/gilgamesh-part-6-the-plant-of-immhttps://www.storynory.com/gilgamesh-part-6-the-plant-of-immortaliy/ortaliy/. 

“Hekate.” HECATE (Hekate) - Greek Goddess of Witchcraft, Magic & Ghosts. Accessed August 7, 2025. https://www.theoi.com/Khthonios/Hekate.html. 

“Hermes - Greek God of Herds & Trade, Herald of the Gods.” Theoi Greek Mythology. Accessed August 7, 2025. https://www.theoi.com/Olympios/Hermes.html. 

“Hygeia.” HYGEIA - Greek Goddess of Good Health (Roman Salus). Accessed August 7, 2025. https://www.theoi.com/Ouranios/AsklepiasHygeia.html. 

Lachman, Gary. The Quest for Hermes Trismegistus: From Ancient Egypt to the Modern World. Edinburgh: Floris Books, 2011. 

Mark, Joshua J. “The Mesopotamian Pantheon.” World History Encyclopedia, August 5, 2025. https://www.worldhistory.org/article/221/the-mesopotamian-pantheon/. 

Smagala, Abigail. “Snakes in South African Culture.” COVE, April 18, 2023. https://editions.covecollective.org/chronologies/snakes-south-african-culture. 

About the Author

Abby Baillargeon