Two gate keepers as "lion-birds" draw back the portals of a shrine revealing the Divine Serpent Ningishzida in his dual aspect. From the votive cup of the king of Lagash, Sumer 2,025 BCE.

The Goddess Inanna stands on two lions while holding in Her right hand the caduceus of entwined serpents. From a cylinder seal dated 1,800 BCE.

Aztec priest offering gifts at the altar of the Caduceus. Pre-Colombian.