Petach Tikvah, Israel
In some ancient cultures, especially around the Near East, the snake was involved in healing. Today this seems counterintuitive. There are as many as 130,000 deaths from snake bites worldwide each year and three times that number of amputations and severe disabilities. Ophidiophobia is one of the more common phobias, even though the fear of a snake is rational. Antipathy towards snakes is best summed up by the message on a large billboard in outback Australia: “If you have been bitten by a snake, first make peace with your God, then go to the hospital.”
Asclepius was the god of medicine in Ancient Greece. He represented the healing aspect of the medical arts (along with Apollo) and was known as Paean, the Healer. His daughters included Hygeia, the goddess of cleanliness, and Panacea, the goddess of universal remedy. Asclepius used a snake-entwined staff as part of his medical toolbox, which is today a symbol of medicine and part of the flag of the World Health Organization.1
The association of snake, staff, and healing dates back at least to the Old Testament. In the Book of Exodus (4:2), in the episode of the burning bush, God miraculously transforms Moses’ staff into a snake and then back into a staff.
The Old Testament records a curious story of the serpent and a pole. The Ancient Israelites had been punished for slander with a deadly plague of snakes. God then told Moses to place an icon of a copper snake high on a pole so that whoever looked up would be healed and not die (Numbers 21:4–9).
Why the snake?
Ever since Eve’s transgression in the Garden of Eden, snakes in Judeo-Christian tradition have been associated with lies, evil, and temptation. But in other cultures, such as indigenous North America, snakes symbolize fertility, rebirth, renewal, and even immortality
The significance of the serpent has been interpreted in many ways:
- The snake sheds its old skin and the new skin symbolizes rejuvenation.
- The snake represents both life and death. For an apothecary physician in ancient Greece, medications— pharmakon—meant both “poison” and “medicine.” Today the snake’s venom is milked to make anti-venom and other medications. A Freudian interpretation would suggest a life-giving symbolism.
- In the Old Testament the copper serpent held high on a pole was meant to lift the people’s eyes and heart to heaven, to God who alone controls life and death.
These interpretations bespeak belief, faith, and magical thinking, which can be effective as placebos even without double-blind randomized studies. Nevertheless, we have not accounted for why the snake, of all the world’s dangerous animals, should be used as a symbol for healing. A clue might be found in the Old Testament’s prescription of copper to make the snake icon.
The periodic table
Copper, silver, and gold are in Group 11 of the periodic table and are known as the coinage metals because of their former numismatic use. They were likely the first metals discovered, since all are readily accessible in elemental form. They are relatively inert, corrosion-resistant, malleable, and excellent conductors of electricity.
Since copper, silver, and gold are soft metals, they must be alloyed with other metals to afford greater usability and durability. Copper is used as wire to conduct electricity, as a building material, and in metal alloys such as bronze and brass.
Why use copper to make the snake-icon?
In the Old Testament, the Hebrew words for snake and copper share the same three-letter root— n-ch-sh —suggesting a common meaning. Many biblical translations use the word “brass” in describing the snake icon, although philological purists prefer a copper snake.
The linguistic connection between copper and snake is possibly because of copper’s innate physical and chemical characteristics:
- Copper can be drawn out into thin, flexible, strong wire. Similarly, a snake is long and muscular.
- Copper is an excellent transmitter of electrons and data. Many biblical commentators note that healing did not occur from looking at the copper snake (it had no power), but rather because it encouraged the people to look up and see that God provided the healing. The copper snake acted as a conduit and a messenger.
There is a third word in Hebrew built on the three-lettered root n-ch-sh.
One of the most difficult yet crucial aspects of medicine is prognosis. Should we treat this patient or not, given the risk-benefit ratio? Will replacing the hip in this ninety-year-old do more harm than good? Why did this patient respond but not that one?
The third meaning derived from the three-letter root n-ch-sh is “guess.” In medicine, to prognosticate means to make an educated guess in the face of an uncertain future.
I postulate that creating the snake-rod myth was a cultural way of coping with and explaining the uncertain outcome of illness. Even an implausible explanation may provide an illusion of control for a sick patient, thereby reducing anxiety and increasing well-being.
There are religions and cultures that believe God alone has the power to heal—doctors are merely agents of a higher power. Hence, in the larger picture the notion of a copper snake being used to heal raises the question of attribution of power and prognostication. Just as the copper snake does not heal per se, neither does the doctor who is acting as a messenger of God.
At first glance it does not seem reasonable, given the advances of modern medicine, to attribute the power of healing to God. Mankind does many things today—surgery, procedures, medications—that heal, prolong life, and defer death. Ultimately, however, even today these religions and cultures insist that life and death is in God’s hands only.
Religious commentators differ as to where lies the line that demarcates God’s control and human control. According to the copper-snake understanding, our ability to prognosticate is and always will be limited. The future is not really ours, and never will be. We can only guess at outcomes. God, who knows the future, is the great prognosticator.
Would people want to know all the gruesome details of the future absolutely and irrevocably? It is a blessing not to know the moment of one’s death, a lacuna of ignorance into which we blissfully hope.
Conversely, if we as a society decide that life and death is in our purview, then as evidenced by recent history we will eventually take it as our right to decide who will live and who will die. It is from there a short step to euthanasia and genocide. It is not the weapon in our hand that is dangerous—rather the thought that we are the Masters of Life.
The reason for our inability to prognosticate with one hundred percent certitude that this patient will survive and that one will die is not clear. It might be because we lack sufficient data or that the future will always be opaque.
When we hold Asclepius’ snake-entwined staff at the bedside, are we acknowledging that we need guidance from a higher source—or are we saying that we are the power?
- Sandlow, L.J. and Dunea, George. “Asclepius at Epidaurus.” Hektoen International Summer 2020.
SIMON WEIN, MD, graduated medicine at the University of Melbourne and subsequently specialized in medical oncology, psycho-oncology, and palliative medicine. Currently he directs the Pain and Palliative Care Service at the Davidoff Comprehensive Cancer Center at Beilinson Hospital, in Israel. His main interests are the interaction of psychological and physical symptoms, improving the interaction of palliative care with medical oncology, and educating the next generation of oncologists.