On Good Friday, I shared the following excerpts from a longer article entitled “The Crucifixion & Death of a Man Called Jesus.” If you would like to read the entire text, you can access it on line at www.iamtheway.com/crucifixion.htm.

First published in the March 1989 issue of the Journal of the Mississippi State Medical Association, this article depicts the physical effects of crucifixion upon a person, and the specific circumstances that surrounded Jesus’ death upon the cross. Today, there are those who doubt whether Jesus really died on the cross. Some feel that because Pilate marveled at the fact that Jesus died so quickly (Mark 15:43-45) that perhaps He really hadn’t been dead at all. Muslims are taught that He did not die, and conspiracy theories abound that propose he somehow manipulated the circumstances to make it appear as though He died, or that He had swooned, and was later revived. However, the gospel account is clear, Jesus gave up His life for us upon the cross that day. He was dead when they took Him off the cross, and, as we see in this article, those facts are corroborated by medical science.

The point is this: Jesus paid the price of sin. He substituted His life for yours and mine and today we can rejoice in His death and glorious resurrection! He is Risen…

 Lloyd
“He is not here, but is risen!” (Luke 24:6)
 

Excerpts from:
The Crucifixion & Death of a Man Called Jesus

No matter what one’s faith might be, I think it would be safe to say that no man’s death has been more questioned, more studied, and more revered than has the death of Jesus Christ.  

Through the scrutinizing eyes of history, the resurrection has shaped and continues to shape the destiny of mankind as no other singular event in all of recorded history.  If, however, this man Jesus did not truly die, then a cruel hoax has been perpetrated on mankind, for without the death of Jesus, the resurrection has no meaning.  Therefore, the death of Jesus must be validated, and who is more qualified to evaluate and judge the data relating to the death of Jesus than the modem physician?  It is for that reason we are obligated to carefully re-evaluate the events surrounding the death of Jesus.

Any study of the death of Christ has to begin with the trial because it was inhumane, illegal, and exhausting.  It lasted all night as Jesus was dragged from one "judge" to another.  He was mocked, ridiculed, slapped, spit upon and falsely accused.  When he was finally "convicted," he was beaten unmercifully with a Roman flagrum.

In the JAMA reference article, Edwards et al, comment,
"The severe scourging, with its intense pain and appreciable blood loss, most probably left Jesus in a preshock state.  Moreover, hematidrosis [bloody sweat in Gethsemane] had rendered his skin particularly tender.  The physical and mental abuse meted out by the Jews and the Romans, as well as the lack of food, water and sleep, also contributed to his generally weakened state.  Therefore, even before the actual crucifixion, Jesus’ physical condition was at least serious and possibly critical."

Roman Flagrum
We sometimes overlook or underestimate the severity of the flogging Jesus received.  The reason might be in part because we tend to think of the whip as a platted leather instrument capable of raising painful blisters and even superficial bleeding if applied repeatedly and with enough force.  The Roman flagrum was something entirely different, however.  It was, indeed, composed of leather strips; but tied to the end of each of these were pieces of metal, glass, and bone.  This whip was designed to cut away at the flesh and render the subject nearly moribund.

C. Truman Davis, M.D., describes the flogging in very graphic terms . . .
Preparations for the scourging were carried out.  The prisoner was stripped of his clothing and his hands tied to a post above his head.  It is doubtful whether the Romans made any attempt to follow the Jewish law in the matter of the scourging.  The Jews had an ancient law prohibiting more than forty lashes.  The Pharisees, always making sure that the law was strictly kept, insisted that only thirty-nine lashes be given.  In the case of a miscount, they were sure of remaining in the law.  The Roman legionnaire stepped forward with the flagrum, or flagellus, in his hand.  This was a short whip consisting of several heavy, leather thongs with two small balls of lead attached near the ends of each.  The heavy whip was brought down with full force again and again across Jesus’ shoulders, back and legs.  At first the heavy thongs cut through the skin only.  Then, as the blows continued, they cut deeper into the subcutaneous tissues producing first an oozing of blood from the capillaries and veins of the skin, and finally spurting arterial bleeding from vessels in the underlying muscles.  The small balls of lead first produced large deep bruises which were broken open by subsequent blows.  Finally, the skin of the back was hanging in long ribbons and the entire area was an unrecognizable mass of torn, bleeding tissue.  When it was determined by the Centurion in charge that the prisoner was near death, the beating was finally stopped.

Mechanics of Crucifixion
Following the near death scourging, the victim was forced to bear his cross to the place of execution.  There is good evidence that this usually consisted only of the crosspiece or patibulum, which was strapped to the victim’s back and outstretched arms. (We shall look more at this later.)

The first option available to the executioner was whether or not to nail the victim to the cross.  The Romans seemed to favor nailing their victims to the cross, and the Bible is explicit in this detail of Jesus’ crucifixion (John 20:24-29).  However, we need to understand that death would ensue even if nails were not used and the victims were tied to the cross.  It would simply take longer for death to occur if the victims were tied to the cross.

The next consideration in the execution process was the positioning of the spikes on the cross and the manner in which the executioners secured the victim to the cross.  Three spikes were necessary to secure the victim - one in each of the upper extremities and one single spike through both lower extremities.

With both wrists thus fixed to the crosspiece or patibulum, and the victim suspended in this manner, his lungs would remain passively hyperinflated.  In order to exhale so that new air could be inhaled, the victim of crucifixion had to actively lift himself on the cross14 so that he could force air out of his lungs.

But, if the positioning of the hands is important, then I would have to say that my studies suggest the positioning of the feet is critical.  There are two factors here that must be considered.  First is the point of attachment of the feet to the vertical portion of the cross.  If the feet were secured toward the lower reaches of the suspended body, then obviously the victim would not be able to lift himself much in his effort to exhale.  Consequently, he would expend maximum effort and inhale minimum fresh air.  If, however, the feet were fixed further upward on the vertical piece, then the victim would be able to push himself up considerably more.  This would enable him to exhale more completely and to take in more fresh air.  Therefore, all other things being equal, he would live longer on the cross.

Understanding these factors would make possible the Romans’ "tailoring" of the crucifixion agony to fit the victim.  We know that Jesus had to be dead by sundown because he was crucified on the day of preparation (John 19:31) with the Sabbath / Passover beginning at 6:00 p.m.  We also know that Jesus was crucified at 9:00 AM (Mark 15:25).  Since Jewish law would not allow a victim to remain on the cross past sundown, we can presume that the Romans would have designed Jesus’ crucifixion to be "short-lived."  This would mean, in all likelihood, that Jesus’ feet were plantar flexed with the soles nailed to the uprights.  Even so, we have pointed out that Pilate was still surprised at his early death.  This would suggest other causes for the early death.  Therefore, we need to look closely at some of the mechanics of crucifixion.

As we have seen, each respiratory cycle required that Jesus lift himself on the cross, exhale and gently let himself down as he inhaled.  His back was laid bare from the scourging so that each cycle of breathing necessitated that he rub his back against the upright and agonize as the raw flesh was further macerated.  Each time he took a breath, his leg muscles quivered as his feet pushed against the spike.  Each time he sought relief by resting his legs, the spikes in his wrists would spit fire into the stretched and lacerated median nerve. There was no relief.

In terms of those physiologic processes of crucifixion, what actually happens during the terminal hours on a cross?   

1.    Respiratory efficiency is decreased because of the following:
Relative hyperinflation of the lungs produces an increase in residual lung volume. Lifting the body on the cross during each respiratory cycle produces an enormous increase in energy expenditure

2.    Respiratory inefficiency is usually accompanied by an increase in respiratory rate as a means of compensation. This is not possible during crucifixion due to pain and effort of breathing. Therefore, respiratory acidosis develops.
           
3.    With diminished oxygen exchange, hypoxemia develops.
            
4.    Hypoxemia leads to anaerobic metabolism.  During crucifixion there is continued and significant muscle activity associated with respiration.  Since this occurs in an oxygen deprived state, the energy efficient Krebs Cycle cannot supply the energy to sustain this activity.  Pyruvate is then broken down to lactic acid.  This, of course, is a very inefficient source of energy.  But, perhaps just as important in the crucifixion scenario is that the production of lactic acid causes severe muscle cramps, which further reduces respiratory efficiency
            
5.    Hypoxemia, hypovolemia (secondary to blood loss and sweating), and the increased workload previously described, all contribute to produce a compensatory tachycardia.
            
6.    As the acidosis (combined respiratory and metabolic) continues and the pH drops, muscle cramps worsen. It then becomes more difficult for the victim to lift himself to breathe.
            
7.    In the final stages, blood is shunted from skeletal muscle to vital organs in an effort to salvage the body.
            
8.    At this point, skeletal muscle becomes relatively anoxic, therefore respirations are further inhibited and a vicious cycle ensues leading to a quiet death by exhaustion and asphyxiation because there is simply no energy left to resist.

The usual means of death on the cross was by exhaustion and asphyxiation.  That was its design.  Jesus did not die that way.  We can be sure of it.  The Bible provides the details necessary for us to make this conclusion.

In Luke 23:46 we read: "And when Jesus had cried with a loud voice, he said, Father, into thy hands I commend my spirit, and, having said this, he gave up the spirit."

Matthew 27:50 and Mark 15:37 repeat the part about Jesus’ crying with a loud voice and then suddenly giving up the spirit.  If Jesus had died of exhaustion and asphyxiation, then he would not have had the air in his lungs to have cried out with a loud voice saying, "Father into thy hands I commend my spirit . . . " and then suddenly die.

Instead, the scriptures indicate that something happened suddenly causing Jesus to cry out in pain and then suddenly die.  That is not the picture of death by exhaustion and asphyxiation.   

If Jesus had intentionally tried to pretend death, then he would have had to breathe without anyone in the crowd noticing it, an impossible feat considering that each breath required the victim to lift himself on the cross so he could exhale and then inhale fresh air.  Everyone would have seen this - in particular, the soldiers who were trained executioners.

If Jesus had simply swooned, as some insist, then he would have died anyway because he would not have been able to lift himself to breathe.  That was the design of the crucifixion process.  That was the purpose of breaking the legs of the victims who were not already dead.  Once their legs were broken, they could not lift themselves on the cross to breathe.  Then death would ensue quickly.

The final proof, however, of Jesus’ death was the "coup de grace" of the sword in his side.  This was the soldier’s surety of the victim’s death, a trained maneuver to lay to rest the question of a live victim.  We will look at this maneuver more closely in a moment.

Probable Cause of Death
I think you will agree that a true rupture of the myocardium is the most likely probable cause. I think this process can be documented with a high degree of probability.

Even though there was no formal postmortem examination, I think we can substantiate this mode of death because the Bible again provides us the critical details.

John 19:34 says, "But one of the soldiers, with a spear, pierced his side and immediately came there out blood and water. "  The significance of this comment is incalculable from a medical point of view.  That makes it all the more interesting when we realize that Dr. Luke doesn’t even mention it.  That’s because he had no way of knowing the significance.  Had Dr. Luke been the one to relate these details, no doubt some antagonist would have insisted that the evidence had been planted.

The truth is, John didn’t even know the significance of what he wrote.  He simply knew something unusual was happening and wanted to be sure it was recorded for posterity.

John 19:35 says, "And he that saw it bore witness, and his witness is true; and he knoweth that he saith true, that ye might believe."

Ordinarily when a dead man is cut, no blood flows.  John and the rest of us know that.  That is probably why he insisted that his witness of the event was true.  But, it is also why this bit of evidence is doubly important.  Since no one present at the crucifixion knew the significance of the blood and water, and indeed, it appeared to be even contrary to the expected norm, we can be assured that this account was not fabricated, but was simply an honest rendering of the crucifixion events.

If indeed a rupture of the free wall of the left ventricular myocardium occurred (as I believe it did), then there would certainly be cause for sudden death with rapid development of cardiac tamponade.  Ordinarily, there is approximately 30 cc of clear fluid in the pericardial cavity.  However, due to the stress of the terminal events of the crucifixion (with congestive heart failure and decreased venous return to the heart resulting from hypovolemia and hyperinflation of the lungs), there could have been 100 cc or more of pericardial fluid present. Rupture of the free wall of the ventricle would have added another 200 or 300 cc of blood before tamponade would have effectively produced cardiac standstill.  This blood would probably be noncoagulating, and with the demise of the victim there would be some settling of the cellular components to the bottom of the pericardial cavity.  (There certainly could be some clotting, also, which would likewise contribute to the separation of red blood cells and "clear fluid.")

As soon as (the sword) pierced the pericardium, the pressurized contents gushed forth.  The blood, which was on the bottom came first, followed by the clear "water" on the top.  That is exactly the way the Bible says it happened.

If Jesus had been alive at the time, the blood would have flowed as soon as the sword pierced the myocardium and would have stopped as soon as the heart stopped.  There would have been no water to flow.

If Jesus had been dead, but the heart had not ruptured, then not much at all would have happened with the sword piercing.  Perhaps a little blood would have flowed, but not much, because the contents of the heart would not have been under pressure since the heart would have been in asystole.  Therefore, when the sword was removed, the wound would close and simply ooze a little blood. Again, there would have been no flow of water.

The Bible gives us solid evidence of the death of Jesus and of the cause of that death.  

One explanation which made this death so quickly as well… Jesus’ outstretched arms were tied to the crosspiece.  When he fell, he had no way to break the fall, so he fell straightforward into the street.  With the weight of the crosspiece on his back, this was sufficient to inflict significant injury to the chest wall, which would have borne the brunt of the force.  The resultant injury would have been similar to blunt chest trauma sustained in an automobile accident when the chest collides with the steering wheel of a car.