| Literature DB >> 27731851 |
Claus Hamann1, MaryKate Martelon.
Abstract
BACKGROUND: History supports the staff and single serpent, the asklepian, as the symbol of healing and medicine, yet its confusion with the caduceus (a winged staff with two snakes wrapped around it) persists. No population-based information on serpent symbol use exists.Entities:
Keywords: Asclepius; Asklepios; caduceus; emblems; history; history of medicine; humanities; insigne; insignia; medical symbol
Year: 2016 PMID: 27731851 PMCID: PMC5041356 DOI: 10.2196/mededu.5515
Source DB: PubMed Journal: JMIR Med Educ ISSN: 2369-3762
Figure 1Asklepian from a Roman Aesculapian temple and caduceus from a Florentine sculpture. (a) Tiber Island, Rome 2004 [2]. The arrow indicates the travertine ship's prow, which is seen in (b,c); (b,c) Asklepian carved into the travertine ship's prow from the 1st century BCE at the site of an Aesculapian temple [2], 300 m from the current-day Ospedale Fatebenefratelli (photo by author, 2008); (d) Bronze by Gianbologna, Mercurio (Mercury, the Roman name for Hermes), 1580, Museo Nazionale del Bargello, Florence, Italy (excerpt of photo by author, 2013).
Figure 2a [28], d [31], e [32] traditional asklepians; b [29], c [30], i [36] variant asklepians; f [33] traditional caduceus; g [34] variant caduceus; h [35] double-helix in emblem; j [37], k [38] change in AAMC emblem.
Display of asklepians and caducei among current and past emblems in Google Images for US and Canadian medical and other health professional schools in 2014.
| Schools | Longevitya, mean | Traditional | Traditional | Traditional | Traditional | Neither/ | |
| All schools (n=482) | 75.8 (58.5, 1-249) | 107(22.2) | 205 (42.5) | 18 (3.7) | 25 (5.2) | 252 (52.3) | |
| All (n=159) | 98.5(61.3, 1-249) | 21 (13.2) | 65 (40.9) | 14 (8.8) | 16(10.1) | 78 (49.1)b | |
| USc(n=137), | 97.7(62.0, 1-249) | 18 (12.8) | 54 (38.3) | 14 (9.9) | 16 (11.3) | 71 (50.4) | |
| Canada (n=18) | 104.5 (58.1, 9-185) | 3 (17) | 11 (61) | 0 (0) | 0 (0) | 7 (39) | |
| Northeast (n=44) | 119.9 (72.8, 1-249) | 6 (14) | 20 (45) | 3 (7) | 3 (7) | 21 (48) | |
| Midwest (n=33) | 97.9 (53.2, 1-178) | 4 (12) | 14 (42) | 2 (6) | 2 (6) | 17 (52) | |
| South (n=56) | 87.9 (58.8, 2-207) | 8 (14) | 22 (39) | 7 (13) | 7 (13) | 27 (48) | |
| West (n=26) | 86.0 (47.0, 6-195) | 3 (12) | 9 (35) | 2 (8) | 4 (15) | 13 (50) | |
| All (n=323) | 65.8 (53.5, 1-193) | 86(26.6) | 140(43.3) | 4 (1.2) | 9 (2.8) | 174 (53.9)e | |
| US (n=287), | 65.1 (53.8, 1-193) | 81 (27.9) | 130 (44.8) | 3(1.0) | 7 (2.4) | 153 (52.8) | |
| Canada (n=33) | 71.8 (44.0, 5-154) | 5 (15) | 10 (30) | 1 (3) | 2 (6) | 21 (64) | |
| Northeast (n=78) | 74.3 (55.3, 1-193) | 10 (13) | 19 (24) | 1 (1) | 1 (1) | 58 (74) | |
| Midwest (n=75) | 86.9(49.3, 1-164) | 19 (25) | 33 (44) | 1 (1) | 4 (5) | 38 (51) | |
| South (n=106) | 51.7 (46.7, 1-173) | 36 (34.0) | 54 (50.9) | 0 (0) | 1 (0.9) | 51 (48.1) | |
| West (n=64) | 53.9 (46.1, 1-144) | 21 (33) | 34 (53) | 2 (3) | 3 (5) | 27 (42) | |
| All (n=40) | 32.3 (33.6, 1-122) | 16 (40) | 25 (63) | 1 (3) | 1 (3) | 14 (35) | |
| US (n=34) | 33.1 (36.2, 1-122) | 16 (47) | 25 (74) | 0 (0) | 0 (0) | 9 (26) | |
| Canada (n=6) | 27.5 (11.7, 11-33) | 0 (0) | 0 (0) | 1 (17) | 1 (17) | 5 (83) | |
| All (n=35) | 82.5 (45.5, 16-162) | 19 (54) | 28 (80) | 0 (0) | 0 (0) | 7 (20) | |
| US (n=30) | 82.8 (45.0, 16-162) | 17 (57) | 24 (80) | 0 (0) | 0 (0) | 6 (20) | |
| Canada (n=5) | 81.0 (58.3, 28-152) | 2 (40) | 4 (80) | 0 (0) | 0 (0) | 1 (20) | |
| All (n=10) | 60.9 (47.2, 5-119) | 2 (20) | 6 (60) | 0 (0) | 0 (0) | 4 (40) | |
| US (n=9) | 66.6 (47.1, 5-119) | 2 (22) | 6 (67) | 0 (0) | 0 (0) | 3 (33) | |
| Canada (n=1) | 10.0 (N/Af) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (100) | |
| All (n=74) | 80.7 (47.9, 1-174) | 18 (24) | 33 (45) | 1 (1) | 2 (2) | 39 (53) | |
| US (n=64), | 80.2 (49.7, 1-174) | 18 (28) | 30 (46) | 1 (2) | 1 (2) | 34 (52) | |
| Canada (n=9) | 83.8 (40.5, 43-139) | 0 (0) | 3 (33) | 0 (0) | 1 (11) | 5 (56) | |
| All (n=141) | 64.0 (55.5, 1-193) | 29 (20.6) | 44 (31.2) | 2 (1.4) | 4 (2.8) | 93 (66.0) | |
| US (n=130), PR (n=1) | 62.2 (55.8, 1-193) | 26 (19.8) | 41 (31.3) | 2 (1.5) | 4 (3.1) | 86 (65.6) | |
| Canada (n=10) | 88.6 (49.0, 5-154) | 3 (30) | 3 (30) | 0 (0) | 0 (0) | 7 (70) | |
| All (n=23) | 65.4 (46.5, 1-168) | 2 (9) | 4 (17) | 0 (0) | 2 (9) | 17 (74) | |
| US (n=20), | 64.5 (47.7, 1-168) | 2 (10) | 4 (19) | 0 (0) | 2 (10) | 15 (71) | |
| Canada (n=2) | 75.5 (51.1, 47-104) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (100) | |
aNumber of years since founding: t =-6.21; P<.001.
bIncludes 3 medical schools (1.9%: the United States) displaying both symbols.
cUS: the United States.
dPR: Puerto Rico.
eIncludes 2 health professional schools (0.6%: dentistry and pharmacy, both in the United States) displaying both symbols.
fN/A: not applicable.
Adjusted analysis of asklepian and caduceus in the emblems of US, Puerto Rican, and Canadian medical versus other health professional schools in 2014.
| Symbols | Traditional asklepian | Traditional or variant (any) asklepian | Traditional caduceus | Traditional or variant (any) caduceus | |
| Total, n | 107 | 205 | 18 | 25 | |
| Adjusted ORa,b | 0.41 | 0.92 | 7.70 | 3.32 | |
| 95% CI | 0.24-0.71 | 0.62-1.38 | 2.50-23.80 | 1.43-7.75 | |
| .001 | .70 | <.001 | .005 | ||
| Total, n | 36c | 77d | 7 | 8 | |
| Adjusted ORb | 0.38 | 1.08 | 2.75 | 1.92 | |
| 95% CI | 0.14-1.02 | 0.62-1.89 | 0.61-12.50 | 0.47-7.80 | |
| .06 | .79 | .19 | .36 | ||
aOR: odds ratio.
bAdjusted for school's geographic region and longevity; health professional school was the reference variable. We found no significant interaction effects in the analysis of current and past emblems in Google Images.
cSignificant interaction effects in the analysis of current emblems on home pages were newer health professional schools displaying traditional asklepian more than older health professional schools (OR 1.020, 95% CI 1.002-1.040, P=.03).
dSignificant interaction effects in the analysis of current emblems on home pages were western medical schools displaying any asklepian less than western health professional schools (OR 0.22, 95% CI 0.06-0.80, P=.02).
Display of asklepians and caducei among current emblems on Internet home pages of US and Canadian medical and other health professional schools in 2014.
| Schools | Longevitya, mean | Traditional | Traditional | Traditional | Traditional | Neither/ | |
| All schools (n=482) | 75.8 (58.5, 1-249) | 36 (7.5) | 77 (16.0) | 7 (1.5) | 8 (1.7) | 397 (82.4) | |
| All (n=159) | 98.5 (61.3, 1-249) | 5 (3.1) | 23 (14.5) | 4 (2.5) | 4 (2.5) | 132 (83.0) | |
| USb(n=137), | 97.7 (62.0, 1-249) | 5 (3.5) | 22 (15.6) | 4 (2.8) | 4 (2.8) | 115 (81.6) | |
| Canada (n=18) | 104.5 (58.1, 9-185) | 0 (0) | 1 (6) | 0 (0) | 0 (0) | 17 (94) | |
| Northeast (n=44) | 119.9 (72.8, 1-249) | 2 (5) | 8 (18) | 0 (0) | 0 (0) | 36 (82) | |
| Midwest (n=33) | 97.9 (53.2, 1-178) | 0 (0) | 5 (15) | 1 (3) | 1 (3) | 27 (82) | |
| South (n=56) | 87.9 (58.8, 2-207) | 1 (2) | 7 (13) | 1 (2) | 1 (2) | 48 (86) | |
| West (n=26) | 86.0 (47.0, 6-195) | 2 (8) | 3 (12) | 2 (8) | 2 (8) | 21 (81) | |
| All (n=323) | 65.8 (53.5, 1-1931) | 31 (9.6) | 54 (16.7) | 3 (0.9) | 4 (1.2) | 265 (82.0) | |
| US (n=287), | 65.1 (53.8, 1-193) | 30 (10.3) | 52 (17.9) | 2 (0.7) | 3 (1.0) | 235 (81.0) | |
| Canada (n=33) | 71.8 (44.0, 5-154) | 1 (3) | 2 (6) | 1 (3) | 1 (3) | 30 (91) | |
| Northeast (n=78) | 74.3 (55.3, 1-193) | 2 (3) | 5 (6) | 1 (1) | 1 (1) | 72 (92) | |
| Midwest (n=75) | 86.9 (49.3, 1-164) | 5 (7) | 9 (12) | 0 (0) | 0 (0) | 66 (88) | |
| South (n=106) | 51.7 (46.7, 1-173) | 9 (8.5) | 16 (15.1) | 0 (0) | 0 (0) | 90 (84.9) | |
| West (n=64) | 53.9 (46.1, 1-144) | 15 (23) | 24 (38) | 2 (3) | 3 (5) | 37 (58) | |
| All (n=40) | 32.3 (33.6, 1-122) | 10 (25) | 14 (35) | 1 (3) | 1 (3) | 25 (63) | |
| US (n=34) | 33.1 (36.2, 1-122) | 10 (29) | 14 (41) | 0 (0) | 0 (0) | 20 (59) | |
| Canada (n=6) | 27.5 (11.7, 11-33) | 0 (0) | 0 (0) | 1 (17) | 1 (17) | 5 (83) | |
| All (n=35) | 82.5 (45.5, 16-162) | 6 (17) | 10 (29) | 0 (0) | 0 (0) | 25 (71) | |
| US (n=30) | 82.8 (45.0, 16-162) | 6 (20) | 9 (30) | 0 (0) | 0 (0) | 21 (70) | |
| Canada (n=5) | 81.0 (58.3, 28-152) | 0 (0) | 1 (20) | 0 (0) | 0 (0) | 4 (80) | |
| All (n=10) | 60.9 (47.2, 5-119) | 1 (1) | 4 (40) | 0 (0) | 0 (0) | 6 (60) | |
| USA (n=9) | 66.6 (47.1, 5-119) | 1 (1) | 4 (44) | 0 (0) | 0 (0) | 5 (56) | |
| Canada (n=1) | 10.0 (N/Ad) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (100) | |
| All (n=74) | 80.7 (47.9, 1-174) | 5 (7) | 7 (9) | 1 (1) | 1 (1) | 66 (89) | |
| US (n=64), | 80.2 (49.7, 1-174) | 5 (8) | 7 (11) | 1 (2) | 1 (2) | 57 (88) | |
| Canada (n=9) | 83.8 (40.5, 43-139) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 9 (100) | |
| All (n=141) | 64.0 (55.5, 1-193) | 8 (5.7) | 16 (11.3) | 1 (0.7) | 1 (0.7) | 124 (87.9) | |
| US (n=130), | 62.2 (55.8, 1-193) | 7 (5.3) | 15 (11.5) | 1 (0.8) | 1 (0.8) | 115 (87.8) | |
| Canada (n=10) | 88.6 (49.0, 5-154) | 1 (10) | 1 (10) | 0 (0) | 0 (0) | 9 (90) | |
| All (n=23) | 65.4 (46.5, 1-168) | 1 (4) | 3 (13) | 0 (0) | 1 (4) | 19 (83) | |
| US (n=20), | 64.5 (47.7, 1-168) | 1 (5) | 3 (14) | 0 (0) | 1 (5) | 17 (81) | |
| Canada (n=2) | 75.5 (51.1, 47-104) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (100) | |
aNumber of years since founding: t =-6.21; P<.001.
bUS: the United States.
cPR: Puerto Rico.
dN/A: not applicable.