The original Hippocratic oath begins with the statement  “I swear by Apollo the physician, and Asclepius, and Hygeia, and Panacea, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation . . .”

Hygeia was the goddess of health, cleanliness and sanitation.  Her father, Asclepius, was the god of medicine.  In fact, the serpent-entwined rod of Asclepius is still a symbol of medicine today.  This symbol is not to be confused with the caduceus, which features two serpents coiled around a staff surmounted by wings.

Use of the caduceus to symbolize medicine was popularized after its adoption by the US Army Medical Corps in 1902.  Additionally, it appeared in many medical textbooks as a printing mark.   The appropriateness of this use is questionable because the caduceus has no connection to Hippocrates.  It was the wand of Hermes, patron of commerce, theft and deception.

Hygeia was responsible for the prevention of disease, while Asclepius was in charge of disease treatment.  These two figures can be said to exemplify two different perspectives in the practice of healthcare.

The viewpoint represented by Hygeia holds that the primary role of a healer should be to ensure optimal health through the teaching of natural laws.  This way of thinking considers health to be a normal state that is accessible by following a lifestyle based on natural principles.  In contrast, the approach endorsed by Asclepius sees a healer as one who restores health by eradicating disease.

Hygeia and Asclepius personify the paradigm distinction between public health and clinical medicine today.  Public health places emphasis on prevention and seeks to promote health behaviors, while medicine emphasizes diagnosis and treatment of disease.

There will always be a need for medical services that can address acute illness, infection and trauma.  In the developed world of today, however, populations and health systems suffer the burden of chronic disease.

The only effective method for addressing chronic disease lies in the domain of public health and prevention.  The magic bullet approach of pharmaceuticals and surgical techniques cannot be expected to successfully manage long-term wellness outcomes.  We cannot find health by simply controlling or eliminating its opposite.  I am not questioning the validity of medical science, only its monopoly over our fundamental assumptions regarding health and disease.