Medical Aspects of the Crucifixion of Jesus Christ
David Terasaka, M.D.
Heb 12:2 "Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God."
In the last few hours of Jesus' life what did He endure, and what shame did He suffer?
EXCRUCIATE: to cause great agony, torment
Latin : ex : out of, from cruciate : cross
"from the cross"
The tone of this presentation can best be summarized in the word "excruciate", (the root of the word "excruciating") which refers to something which causes great agony or torment. The Latin roots of the word are :"ex", meaning from or out of, and "cruciate", meaning cross. The word "excruciate" comes from the Latin for "from, or out of, the cross".(Websters)
Jesus spent the last hours before the crucifixion at several places in Jerusalem. He started the evening in the Upper Room, in southwest Jerusalem. At the Last Supper, He told the disciples that His body and His blood were to be given for them.(Matt 26: 26-29) He went outside of the city to the Garden of Gethesemane. He was then arrested and brought back to the to the palace of the High Priest. where He was questioned by Annas, a former High Priest, and Caiaphas, Annas' son in law . Afterwards, He was tried by the Sanhedrin, and found to be guilty of blasphemy by proclaiming Himself the Son of God. He was sentenced to the death penalty. Since only the Romans were able to execute criminals, He was sent to Pontius Pilate at the Antonia Fortress. Pilate, not finding anything wrong, sent Him to King Herod , who returned Him back to Pilate. Pilate, submitting to the pressure of the crowd, then ordered that Jesus be flogged and crucified. He was finally led out of the city walls to be crucified at Calvary.
THE HEALTH OF JESUS AND DEMANDS OF THE ORDEAL
It is reasonable to assume that Jesus was in good health prior to the ordeal that He faced in the hours before His death. Having been a carpenter and traveling throughout the land during His ministry would have required that He would be in good physical condition. Before the crucifixion, however, He was forced to walk 2.5 miles over a sleepless night, during which He suffered great anguish through His six trials, was mocked, ridiculed and severely beaten, and was abandoned by His friends and Father. (Edwards)
THE UPPER ROOM OR CENACULUM
The ordeal began in an upper room of a house at what we now call the Last Supper, where Jesus, in giving the first communion, predicted that His body and blood would be given.(Matt 26:17-29) Today in Jerusalem, one can visit the Cenacle or Cenaculum (Latin for dining hall), a room which is built over what is believed to be the site of the Upper Room, (Kollek) which was located on the southwestern aspect of the old city.
GETHESEMANE : oil press
Luke 22:44And being in anguish, he prayed more earnestly, and his sweat was like drops of blood falling to the ground.
"the Spirit of God ....crushed"
From the upper room, Jesus went outside of the city walls where he spent time in prayer at the Garden of Gethesemane. The garden has many ancient olive trees today, some of which may have grown from the roots of the trees that were present in Jesus' time. (All trees in and around Jerusalem were cut down when the Romans conquered the city in 70 A.D. Olive trees can regenerate from their roots and live for thousands of years.) The name "Gethesemane", comes from the Hebrew Gat Shmanim, meaning "oil press" (Kollek). Since "oil" is used in the Bible to symbolize the Holy Spirit, it may be said that the garden is where "the Spirit of God was crushed".(Missler). It was here that Jesus agonized in prayer over what was to occur. It is significant that this is the only place in the KJV where the word "agony" is mentioned.(Strong's concordance) The Greek word for agony means to be "engaged in combat" (Pink) Jesus agonizes over what He is to go through, feeling that He is at the point of death.(Mark14:34) Yet He prays, "Not my will, but thine be done."
Of medical significance is that Luke mentions Him as having sweat like blood. The medical term for this, "hemohidrosis" or "hematidrosis" has been seen in patients who have experienced, extreme stress or shock to their systems. (Edwards) The capillaries around the sweat pores become fragile and leak blood into the sweat. A case history is recorded in which a young girl who had a fear of air raids in WW1 developed the condition after a gas explosion occurred in the house next door.(Scott)) Another report mentions a nun who, as she was threatened with death by the swords of the enemy soldiers," was so terrified that she bled from every part of her body and died of hemorrhage in the sight of her assailants."(Grafenberg) As a memorial to Jesus' ordeal, a church which now stands in Gethesemane is known as the Church of the Agony. (also called the Church of the Nations because many nations donated money to its construction.(Kollek)
ABANDONED BY MAN
Matthew 26:56 "Then all the disciples deserted him and fled."
Psa 22:11 "Do not be far from me, for trouble is near and there is no one to help."
While in Gethesemane, Jesus is betrayed by Judas and arrested by the Jews. His disciples all desert Him, even at the expense of running away naked (Mark 14:51-52). He is bound (John 18:12) then brought back to the city to the court of the High Priest, which is located near the Upper room.
ILLEGAL ASPECTS OF THE TRIAL OF JESUSFollowing are some of the illegal aspects of the trial of Jesus:
THE ISSUE OF WITNESSES
Deut 19:15 "One witness is not enough to convict a man accused of any crime or offense he may have committed. A matter must be established by the testimony of two or three witnesses."
Deut 17:6 "On the testimony of two or three witnesses a man shall be put to death, but no one shall be put to death on the testimony of only one witness."
Mark 14:56 "Many testified falsely against him, but their statements did not agree."
While in the court of the High Priest, He was questioned by Annas (John 18:13) and struck by a soldier (John 18: 22). He was then brought to Caiaphas and the Sanhedrin. who sought to put Jesus to death by the false testimony of many witnesses. The witnesses brought against Him did not agree. By the law, no one could be put to death without the agreement of two or three witnesses. Although the witnesses did not agree, He was found guilty of blasphemy when He told them of His identity as the Son of God. He was sentenced to death. Jesus suffered ridicule from the palace guards, who spat on Him, beat Him and slapped Him on the face.(Mark 14:65) During the trial, Peter denies Him three times. The proceedings of Jesus' trial violated many of the laws of His society. Among some of the other broken laws were:(Bucklin)
Today, one can visit the palace of the High Priest. where one can stand in the midst of the ruins of the courtyard. A model of the structure in Jesus' time is available for viewing.
Mark 15:15 "Wanting to satisfy the crowd, Pilate released Barabbas to them. He had Jesus flogged, and handed him over to be crucified."
The Sanhedrin met early the next morning and sentenced Him to death. (Matthew 27:1) Because the Jews were not, and the Romans were, able to carry out an execution, Jesus was brought before Pilate. The charge was now changed to an allegation that Jesus claimed to be King and forbade the nation to pay taxes to Caesar. (Luke 23:5) In spite of all the charges, Pilate finds nothing wrong. He sends Jesus to Herod. Jesus is speechless before Herod, except to affirm that He is King of the Jews. Herod sends Him back to Pilate. Pilate is unable to convince the crowds of Jesus' innocence and orders Jesus to be put to death. Some sources state that it was Roman law that a criminal that was to be crucified had to be flogged first.(McDowell) Others believe that Jesus was flogged first by Pilate in the hope of getting Him off with a lighter punishment.(Davis) In spite of his efforts, the Jews allow Barabbas to be released and demand that Jesus be crucified, even crying that ,"His blood be on us and on our children!" (Matthew 27:25) Pilate hands Jesus over to be flogged and crucified.
It is at this point that Jesus suffers a severe physical beating. (Edwards) During a flogging, a victim was tied to a post, leaving his back entirely exposed. The Romans used a whip, called a flagrum or flagellum which consisted of small pieces of bone and metal attached to a number of leather strands. The number of strikes is not recorded in the gospels. The number of blows in Jewish law was set in Deuteronomy 25:3 at forty, but later reduced to 39 to prevent excessive blows by a counting error. (Holmans). The victim often died from the beating. (39 hits were believed to bring the criminal to "one from death".) Roman law did not put any limits on the number of blows given. (McDowell) During the flogging, the skin was stripped from the back, exposing a bloody mass of muscle and bone ("hamburger " : Metherall). Extreme blood loss occurred from this beating, weakening the victim, perhaps to the point of being unconscious.
ROMAN SOLDIERS MOCK AND BEAT JESUS
Matthew 27:28-30 The soldiers stripped him and put a scarlet robe on him and then twisted together a crown of thorns and set it on his head. They put a staff in his right hand and knelt in front of him and mocked him. "Hail, king of the Jews!" they said. They spit on him, and took the staff and struck him on the head again and again. Jesus was then beaten by the Roman soldiers. In mockery, they dressed Him in what was probably the cloak of a Roman officer, which was colored dark purple or scarlet .(Amplified Bible) He also wore the crown of thorns. Unlike the traditional crown which is depicted by an open ring, the actual crown of thorns may have covered the entire scalp.(Lumpkin) The thorns may have been 1 to 2 inches long. The gospels state that the Roman soldiers continued to beat Jesus on the head. The blows would drive the thorns into the scalp (one of the most vascular areas of the body) and forehead, causing severe bleeding.
THE CROWN OF THORNS AND THE ROBE
Genesis 3:17-18 "Cursed is the ground because of you; through painful toil you will eat of it all the days of your life. It will produce thorns and thistles for you, and you will eat the plants of the field." Isaiah 1:18 "Come now, let us reason together," says the LORD. "Though your sins are like scarlet, they shall be as white as snow; though they are red as crimson, they shall be like wool." The significance of the scarlet robe and crown of thorns is to emphasize Jesus' taking the sins of the world upon His body. The Bible describes sin by the color of scarlet (Is 1:18) and that thorns first appeared after the fall, as a sign of the curse. Thus, the articles that He wore are symbols to show that Jesus took on the sins (and the curse) of the world upon Himself. It is not clear that He wore the crown of thorns on the cross. Matthew describes that the Romans removed His clothes after the beating, and that they put His own clothes back on Him. (Matt 27:31)
THE SEVERITY OF THE BEATINGIsaiah 50:6 "I offered my back to those who beat me, my cheeks to those who pulled out my beard; I did not hide my face from mocking and spitting."
Isaiah 52:14 "..... Just as there were many who were appalled at him -- his appearance was so disfigured beyond that of any man and his form marred beyond human likeness--"
The severity of the beating is not detailed in the gospels. However, in the book of Isaiah, it suggests that the Romans pulled out His beard.(Isaiah 50:8) . It is also mentions that Jesus was beaten so severely that His form did not look like that of "a son of a man" i.e. that of a human being. The literal translation of the verse reads, "So marred from the form of man was His aspect, that His appearance was not as that of a son of a man." People were appalled to look at Him (Isaiah 52:13). His disfigurement may explain why He was not easily recognized in His post resurrection appearances.(Missler) Today, one can visit a site known as the Lithostrotos, traditionally believed to be the floor of the Antonio Fortress.(although recent excavations may cast doubt on this theory (Gonen)) The floor is marked for games once played by the Roman soldiers
From the beating, Jesus walked on a path, now known as the Via Dolorosa or the "way of suffering", to be crucified at Golgotha. The total distance has been estimated at 650 yards. (Edwards). A narrow street of stone, it was probably surrounded by markets in Jesus' time. He was led through the crowded streets carrying the crossbar of the cross (called a patibulum) across His shoulders. The crossbar probably weighed between 80 to 110 pounds. He was surrounded by a guard of Roman soldiers, one of which carried a titulus, a sign which announced His crime of being "the King of the Jews" in Hebrew, Latin and Greek. On the way, He was unable to carry the cross. Some theorize that he may have fallen while going down the steps of the Antonio Fortress. A fall with the heavy patibulum on His back may have led to a contusion of the heart, predisposing His heart to rupture on the cross. (Ball) Simon of Cyrene (currently North Africa (Tripoli)), who apparently was affected by these events, was summoned to help.
The present Via Dolorosa was marked in the 16th century as the route over which Christ was led to His crucifixion.(Magi) As is the location of Calvary, the true location of the Via Dolorosa is disputed. Much tradition as to what happened to Jesus is encountered on the Via Dolorosa today. There are 14 stations of 'events' that occurred and 9 churches on the way today. The stations of the cross were established in the 1800's. (Magi) Today, there is one section of the path where one can walk on the stones which were used during Jesus time.
SUFFERING ON THE CROSSPsalm 22:16-17 Dogs have surrounded me; a band of evil men has encircled me, they have pierced my hands and my feet. I can count all my bones; people stare and gloat over me."
The crucifixion event is prophesied in several places throughout the Old Testament. One of the most striking is recorded in Isaiah 52:13, whereit says that , "My servant will act wisely (or prosper). He will be raised and lifted up and greatly exalted." In John 3, Jesus talks about His fulfillment of that prophecy when He says, "Just as Moses lifted up the snake in the desert, so the Son of Man must be lifted up that everyone who believes in Him may have eternal life." He refers to the events recorded in Numbers 21:6-9. The Lord had sent a plague of fiery serpents on the people of Israel and they bit the people so that many of the people died. After the people confessed their sin to Moses, the Lord for gave them by having a bronze serpent made. Bronze is a symbol for judgment and the serpent is a symbol of the curse. Whoever was bitten by a serpent and then looked at the bronze serpent, was saved from death. These verses are prophecies that point to the crucifixion, in the Jesus would be (lifted up ) on the cross for the judgment of sin, so that whoever believed in Him should not die (an eternal death), but live an eternal life. II Cor 5 :21 amplifies this point, in that "He (the Father) made Him who knew no sin (the Son) to be sin on our behalf, so that we might become the righteousness of God in Him."(Pink) It is interesting that the sign of Aesculapius which is the symbol of the medical profession today, had its roots from the making of the bronze serpent.(Metherall) Indeed, Jesus is the healer of all! Jesus is led to the place of the skull (Latin Calvary, Aramaic :Golgotha) to be crucified. The actual location of Calvary is also in dispute. At the end of the Via Dolorosa, there is a "T intersection". If one turns left, we go to the Church of the Holy Sepulcher. If one turns to the right, one goes to Gordon's Calvary. The Church of the Holy sepulcher has long been believed to be the traditional site of the crucifixion.
Gordon's Calvary has a possible prophetic reason for being the actual site of the crucifixion. In Genesis 22, Abraham is tested by God to sacrifice Isaac on the top of a mountain. Realizing that he is acting out a prophecy, that "God Himself will provide a Lamb", Abraham calls the place of the event "Jehovah Jireh", meaning "In the mount of the Lord it shall be seen." If we take this as a prophetic event of Jesus' death, then Jesus' died on the high ground of Jerusalem. Gordon's Calvary is the highest point of Jerusalem, 777 meters above sea level.(Missler: Map from Israel tour book) Today, at Gordon's Calvary, caves in the rock are situated which give the site the appearance of a skull.
Jesus was then crucified. Crucifixion was a practice that originated with the Persians and was later passed on to the Carthaginians and the Phoenicians. The Romans perfected it as a method of execution which caused maximal pain and suffering over a period of time. Those crucified included slaves, provincials and the lowest types of criminals. Roman citizens, except perhaps for soldiers who deserted, were not subjected to this treatment. (McDowell)
The crucifixion site "was purposely chosen to be outside the city walls because the Law forbade such within the city walls... for sanitary reasons ... the crucified body was sometimes left to rot on the cross and serve as a disgrace, a convincing warning and deterrent to passers by." (Johnson) Sometimes, the subject was eaten while alive and still on the cross by wild beasts. (Lipsius)
The procedure of crucifixion may be summarized as follows. The patibulum was put on the ground and the victim laid upon it. Nails, about 7 inches long and with a diameter of 1 cm ( roughly 3/8 of an inch) were driven in the wrists . The points would go into the vicinity of the median nerve, causing shocks of pain to radiate through the arms. It was possible to place the nails between the bones so that no fractures (or broken bones) occurred. Studies have shown that nails were probably driven through the small bones of the wrist, since nails in the palms of the hand would not support the weight of a body. In ancient terminology, the wrist was considered to be part of the hand. (Davis) Standing at the crucifixion sites would be upright posts, called stipes, standing about 7 feet high.(Edwards) In the center of the stipes was a crude seat, called a sedile or sedulum, which served a support for the victim. The patibulum was then lifted on to the stipes. The feet were then nailed to the stipes. To allow for this, the knees had to be bent and rotated laterally, being left in a very uncomfortable position. The titulus was hung above the victim's head.
There were several different types of crosses used during crucifixion. In Jesus' time, it was most likely that the cross used was a T shaped (or tau cross,), not the popular Latin, or t shaped cross which is accepted today.(Lumpkin)
PHYSICAL SUFFERING ON THE CROSS
Psalm 22:14-15 "I am poured out like water, and all my bones are out of joint. My heart has turned to wax; it has melted away within me. My strength is dried up like a potsherd, and my tongue sticks to the roof of my mouth; you lay me in the dust of death."
Having suffered from the beatings and flogging, Jesus suffered from severe hypovolemia from the loss of blood. The verses above describe His dehydrated state and loss of His strength.
When the cross was erected upright, there was tremendous strain put on the wrists, arms and shoulders, resulting in a dislocation of the shoulder and elbow joints.(Metherall) The arms, being held up and outward, held the rib cage in a fixed end inspiratory position which made it extremely difficult to exhale, and impossible to take a full breath. The victim would only be able to take very shallow breaths.(This may explain why Jesus made very short statements while on the cross). As time passed, the muscles, from the loss of blood, lack of oxygen and the fixed position of the body, would undergo severe cramps and spasmodic contractions
ABANDONED BY GOD -- SPIRITUAL DEATH
Matthew 27:46 "About the ninth hour Jesus cried out in a loud voice, 'Eloi, Eloi, lama sabachthani?'-- which means, My God, my God, why have you forsaken me?"
With the sin of the world upon Him, Jesus suffered spiritual death (separation from the Father ). Isaiah 59:2 says that sins cause a separation from God, and that He hides His face from you so that He does not hear. The Father must turn away from His Beloved Son on the cross. For the first time, Jesus does not address God as His Father.(Courson)
DEATH BY CRUCIFIXION : SLOW SUFFOCATION
The slow process of suffering and resulting death during a crucifixion may be summarized as follows:
"...it appears likely that the mechanism of death in crucifixion was suffocation. The chain of events which ultimately led to suffocation are as follows: With the weight of the body being supported by the sedulum, the arms were pulled upward. This caused the intercostal and pectoral muscles to be stretched. Furthermore, movement of these muscles was opposed by the weight of the body. With the muscles of respiration thus stretched, the respiratory bellows became relatively fixed. As dyspnea developed and pain in the wrists and arms increased, the victim was forced to raise the body off the sedulum, thereby transferring the weight of the body to the feet. Respirations became easier, but with the weight of the body being exerted on the feet, pain in the feet and legs mounted. When the pain became unbearable, the victim again slumped down on the sedulum with the weight of the body pulling on the wrists and again stretching the intercostal muscles. Thus, the victim alternated between lifting his body off the sedulum in order to breathe and slumping down on the sedulum to relieve pain in the feet. Eventually, he became exhausted or lapsed into unconsciousness so that he could no longer lift his body off the sedulum. In this position, with the respiratory muscles essentially paralyzed, the victim suffocated and died. (DePasquale and Burch)
Due to the shallow breathing, the victim's lungs begin to collapse in small areas. causing hypoxia and hypercarbia. A respiratory acidosis, with lack of compensation by the kidneys due to the loss of blood from the numerous beatings, resulted in an increased strain on the heart, which beats faster to compensate. Fluid builds up in the lungs. Under the stress of hypoxia and acidosis the heart eventually fails. There are several different theories on the actual cause of death. One theory states that there was a filling of the pericardium with fluid, which put a fatal strain on the ability of the heart to pump blood (Lumpkin). Another theory states that Jesus died of cardiac rupture." (Bergsma) The actual cause of Jesus' death, however, "may have been multifactorial and related primarily to hypovolemic shock, exhaustion asphyxia and perhaps acute heart failure."(Edwards) A fatal cardiac arrhythmia may have caused the final terminal event. (Johnson, Edwards)
A LAST DRINK OF WINE VINEGAR
John 19:29-30 "A jar of wine vinegar was there, so they soaked a sponge in it, put the sponge on a stalk of the hyssop plant, and lifted it to Jesus' lips." When he had received the drink, Jesus said, 'It is finished'. "With that, He bowed His head and gave up His spirit."
Having suffered severe blood losses from His numerous beatings and thus in a dehydrated state, Jesus, in one of His final statements, said "I thirst." He was offered 2 drinks on the cross. The first, which He refused, was a drugged wine (mixed with myrrh). He chose to face death without a clouded mind. Edersheim writes:
"It was a merciful Jewish practice to give to those led to execution a draught of strong wine mixed with myrrh so as to deaden consciousness" (Mass Sem 2.9; Bemid. R. 10). This charitable office was performed at the cost of, if not by, an association of women in Jerusalem (Sanh. 43a). The draught was offered to Jesus when He reached Golgotha. But having tasted it....He would not drink it. ....He would meet Death, even in his sternest and fiercest mood, and conquer by submitting to the full....(p.880).
The second drink, which He accepts moments before His death, is described as a wine vinegar. Two points are important to note. The drink was given on the "stalk of a hyssop plant". Remember that these events occurred at the Feast of the Passover. During this feast, (Exod 12:22) hyssop was used to apply the blood of the Passover lamb to the wooden doorposts of the Jews. It is interesting the end of this hyssop stalk pointed to the blood of the Perfect Lamb which was applied to the wooden cross for the salvation of all mankind. (Barclay) In addition, the wine vinegar is a product of fermentation, which is made from grape juice and yeast. The word literally means "that which is soured" and is related to the Hebrew term for "that which is leavened". (Holmans) Yeast or leaven, is a Biblical symbol of sin. When Jesus took this drink, (i.e. a drink which was "leavened") it is thus symbolic of His taking the sins of the world into His body.
CELEBRATION OF THE OPPOSITION