Caduceus as a symbol of medicine why he chose a herald's wand as a symbol, making it clear that he chose it as a symbol of prudence. This same passage was also earlier referenced by Engle in refuting Garrison's claim. Engle and Friedlander are not the only ones to have noted that the use of the Caduceus by Caius had nothing to do with supposed medical symbolism; as indicated in a publication produced by the Royal College of Physicians itself: "[...] by introducing the caduceus into the ceremony of the College of Physicians, Caius unintentionally added to the confusion between the two emblems for later times,
Caduceus as a symbol of medicine ancient and authentic claim to be the emblem of medicine". Most attempts to defend its use in a medical context date from the last quarter of the 19th century through the first quarter of the 20th, and have been characterized as "based on flimsy and pseudo-historical research". In a survey of 242 logos used by organizations related to health or medicine, Friedlander found that professional associations were more likely to display the rod of Asclepius (62%), while organizations with a commercial focus were more likely to use the caduceus (76%). Hospitals were an exception (37% used a staff of Asclepius