Caduceus as a symbol of medicine worth noting that hospital stewards were not physicians; they played a supporting role preparing drugs for surgeons, supervising nurses and cooks, maintaining accounting and medical records, and in emergencies sometimes performed minor surgery or provided prescriptions. Later, in 1871, the Surgeon General designated the caduceus as the seal of the Marine Hospital Service (destined to become the U.S. Public Health Service in 1912). Gershen states that the change was for aesthetic reasons, whereas Friedlander states the caduceus was adopted by the Marine Hospital Service "because of its relationship with merchant seamen and the maritime industry". The caduceus was formally adopted
Christ with a Staff "Self-Portrait as the Apostle Paul" - these may have influenced this work. In an image by the copper-plate engraver Schelte a Bolswert, after a drawing by Gerard Seghers, St James the Less is shown with a book. The work is first mentioned in 1836, when it was in the collection of Christopher Bethell-Codrington. When his estate was auctioned on 12 May 1843 it was sold for £252 to the art dealer Christianus Johannes Nieuwenhuys. On 11 December 1854 it was sold at auction for 13,000 francs to count Raczyński from the collection of 'baron de Mecklembourg' in Paris. In 1898