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
Caduceus as a symbol of medicine when few people understand the visual signs with which he was so familiar." In support of the idea that the caduceus had a long-standing association with medicine, Garrison also mentioned the fact that the English medical printer Churchill used the symbol as a printer's device, beginning some time around 1844. Friedlander has examined this subject in detail, and shows that Churchill was well aware that the rod of Asclepius was the accepted symbol of medicine. He is, it seems, inclined to think that the adoption of the caduceus in this context probably had something to do with the relation between