The following is a transcription of a talk given by Keith Maxwell, a medical doctor in Asheville, N.C.
This talk is approached from the perspective of how a physician would assess the injuries of Jesus if he were there to see the actual physical trauma he experienced. Dr. Maxwell speaks plainly, with as little medical jargon as possible. His development of this topic began to evolve one night when Dr. Maxwell, in the emergency room, thought to himself, "If they brought the Lord in here, exactly what would his physical injuries be like?"
He hopes through this talk to reveal some things that will make us meditate on the actual suffering Jesus experienced in the last hours of his life. In the notes that follow are his conclusions about the death of Jesus based on his research, experience as a trauma physician and his understanding of scripture.
"You may or may not have thought of some of the things I'll point out to you tonight, but I hope I can share some things with you that will make the life and death of our Savior a little bit more precious.
By the time he was crucified, Jesus had been up about thirty-six hours without any sleep. We know from biblical accounts that Jesus was an early riser. There are several places in the gospels where he arose early and went and prayed. We have no reason to believe that he did anything other than that the day he had his last meal with his disciples. He likely arose early that morning, spent his day, and subsequently had dinner with the disciples that night - the last supper in the upper room. He was then taken prisoner in the garden of Gethsemane, was led all about the old city of Jerusalem and was tried at least twice. The next day at about daybreak he was actually hung on the cross, and hung there throughout that day. Between the time he arose and the time he actually died on the cross, a period of about thirty-six hours had passed, with no sleep or rest.
Something else you may not have thought of was how far Jesus actually walked about the old city of Jerusalem. We know he was led about from the chief priest's house to Herod's to Pilot's during the time that he was being tried, and we know he was led all about the old city of Jerusalem. If you add it up, he walked about two and one half miles that last night. Also, as best we can ascertain from historical accounts, Jesus carried his cross about a third of a mile before he collapsed and wasn't able to carry it anymore. These are some physical exertions that added up, place stress on a person.
The next thing I want to talk about is a phenomenon called hemathidrosis. Hemathidrosis is a very rare medical phenomenon that's been reported about twelve to fourteen times in world medical literature and is only seen in people who are under tremendous stress and agony. In hemathidrosis, a person actually exudes blood from every sweat gland in their body. Each sweat gland has a small capillary that surrounds it, and in hemathidrosis, that small capillary ruptures. As it bursts, a person actually bleeds into their sweat glands. Instead of perspiring sweat, if you will, they actually perspire blood. The Bible gives an excellent description of this phenomenon, saying that the Lord's sweat became as great drops of blood. Indeed, every pore of Jesus' body oozed and drained blood.
Now, I believe that Christ was a man just as much as any one of us. But at the same time, I believe that Christ was God and knew the terrible fate that lay ahead of him. He knew the job he had come to this earth to do, the mission he had to fulfill, and I believe the man part of Christ dreaded this agonizing death and torture that lay a few hours ahead of him just as much as any one of us would. We know he prayed in the garden of Gethsemane, saying 'Father, if it be your will, let this cup pass from me.' But he submitted his will to his Father's. There in the garden of Gethsemane, Jesus was under about as much anxiety and physical stress from an emotional standpoint that a human could experience, knowing that in a few hours he would be delivered into one of the most agonizing and brutal deaths ever recorded in history.
Why didn't the Lord bleed to death if he bled out of every sweat gland in his body? If you've been to Israel, as I have, you know that this time of year you have warm days and cool nights. It was this cool night air that probably cause the Lord's damp skin, covered with sweat and blood, to chill, causing the capillaries to constrict and stop the bleeding. This same chilling in the cold night air has kept many a drunk and hoodlum who I've seen shot or stabbed and who's then lain in a ditch all night, from dying. It causes the blood vessels to constrict and causes the blood loss to be minimal. But by the time Jesus was taken by the soldiers from the garden of Gethsemane, he probably had a mixture of sweat and blood over his entire body surface. I can imagine this was some sight to behold.
Let's talk about the scourging. Scourging was such a horrible torture that Roman citizens were forbade to be scourged - only slaves and traders could be scourged. It was one of the worst punishments the Romans had to inflict on a human body. Typically, the victim was stripped completely naked and tied by his wrists to a post or wall with his back exposed. He was then whipped from the back of his arms, down his shoulders and back, across his bare buttocks, down the back of his legs and calves, all the way down to his heels by two Roman legionnaires, one on either side, alternating blows. The historical accounts tell us that the traditional scourging consisted of thirty-nine lashes. If you can, imagine two large, strong, burly Roman legionnaires (someone that we would equate to say, a pro football player today) with a wooden handled whip about eighteen inches long that had nine leather thongs, something akin to what we would call a cat-o-nine tails. The nine leather thongs were about six to seven feet long, and at the end of each thong was some lead shod, like a sinker you'd use to go fishing. Attached to the lead shod were pieces of sheep and cattle bone. The idea of those small pieces of bone was that, as the Roman legionnaire would beat his victim, snapping his wrist would cause the weight of the metal shod to dig into the back, while the sheep/cattle bone cut the skin. As the sheep/cattle bone lacerated the skin and actually dug in under the surface of the skin, the skilled and trained legionnaire could whip his wrist and literally lift small shards of skeletal muscle out through the skin, leaving small ribbons of muscle, about two inches long, hanging through the skin."
"When I was working on this, I looked at in the cadaver lab and did some dissection, trying to figure out what one blow like this would mean to you and me. As best I could tell, and from some of the information I was able to gather from the Shroud of Turin exhibit, one lash with this whip - one thong - would make a cut about two inches long and about three quarters to an inch deep. To put that into medical terms, that's a cut that takes about twenty stitches to close. So with one lash, one swing of the whip, a total of nine lacerations could be inflicted on the victim, each laceration two inches long and three quarters to one inch deep. With one blow, one Roman legionnaire could inflict enough wounds to take one hundred eighty stitches to close. If you multiply that times thirty-nine, those two Roman legionnaires inflicted enough lacerations to take about 2,000 stitches to close. I've seen people who've gone through the windshield of a car or wrecked a motorcycle into a barbed wire fence, and I've still never seen anyone that tattered up in any of my medical experience. This gives you an idea of the amount of the physical trauma that was inflicted upon Jesus just from the scourging.
Again you'd ask why Jesus didn't bleed to death. And again, you have to remember that this was done in the cold night air, the very thing that caused his blood vessels and capillaries to constrict and actually cause the blood loss from this beating to be minimal.
As mentioned, the idea of the lead weight was to lift the skeletal muscle out. Imagine having a cut on your skin with an inch of muscle pulled out through the cut, exposed to the night air. We see this sometimes in stab wounds or when people are stabbed with sharp objects like sticks and the muscles are pulled back through the skin. The purpose this served in the scourging was, that as the victim hung on the cross in the heat of the day, birds could light on him and actually peck and pull at these pieces of muscle, just like a robin trying to pull a worm out of the ground. Frequently, how long a person actually survived on the cross during the crucifixion was determined by how severely he was scourged. Sometimes they would beat a man nearly to death before they put him on the cross and he would only live a few hours. Most of the time, though, the scourging was intended for public humiliation and embarrassment, because it was such an inhumane method of torture.
Another thing you may not have considered... TV has done a real injustice to trauma, depicting men in bar room fights who take blows to the face or head and jump up and beat up three or four men. I can tell you that it's really not that way in real life. If I took any one of the men here, tied his hands behind him and then let any other man of average size and build beat him in the face with his fists open and closed, I cannot begin to tell you the amount of trauma this would inflict on him.
We know that Jesus was beaten in the face and head as he was mocked. I can assure you with all confidence that by the time the Lord was crucified after his beatings, it's almost certain that both of his eyes were swollen shut and no doubt his nose was pouring blood. I can also tell you that when people are struck in the mouth with a fist, the first thing that happens is that the lower teeth come right through the lip. I've taken care of many people in the emergency room who've come in beaten up in fights with their teeth sticking through their lips, both upper and lower sides. If Jesus was tied and held and beaten in the face by these strong legionnaires, I don't think there's any doubt that his lips were tattered like paper and some of his teeth were knocked loose or maybe even knocked out. You might ask if his jaw bones were broken. Normally they would be, but not in Jesus' case, and I'll tell you why in a few minutes.
During Jesus' trials and humiliation we also know that a crown of thorns was plaited and placed on his head. In Christ's case this was done to mock him as being King of the Jews. Some of you have been to Israel and have seen these thorns. They're about an inch and one half to two inches long, and they're as sharp as an ice pick. The custom was to take a small three or four foot long reed and slap the thorns on top of the head of the victim in order to drive the thorns into the skull. Those thorns laid upon someone's head and then tapped down with a reed were hard enough to penetrate the outer table or the outer bone of the skull. Imagine the bleeding from three or four hundred puncture wounds in the scalp and around the forehead from these thorns.
So, before Jesus' crucifixion ever begins, his face has been beaten to a pulp, no doubt his eyes were swollen shut, his nose is bloodied, and I remind you that every pore in his skin has wept and oozed blood. Every visible surface on the good Lord Jesus, I am confident, was covered and caked with dried blood. And his back and his arms and his buttocks and the back of his legs were literally torn to shreds from the scourging. This was the shape Jesus was in before they ever gave him his cross to head out to Calvary."
"Now, one of the things I take issue with from agnostics who I've heard debate this: I do not think the Lord died from shock secondary to blood loss. There is nothing that Jesus said on the cross and nothing in the description of the crucifixion in any of the gospels that gives us any idea that Jesus was in shock before he died. How do I know that? When someone is shot or hit by a car and comes to the emergency room, they're not sitting up talking to you. Their eyes are glassy, their color is pale, their blood pressure is about sixty over nothing and they're barely conscious, if conscious at all. Jesus never lost consciousness. There's nothing in the description of his trials, his scourging or his time on the cross that tells us he was incoherent mentally or lost consciousness.
Something else, physical stress - everything the Bible tells us about the life of Jesus is that he was a healthy, early thirties male who lived a rough life. He didn't have a home, he probably slept outside, and he walked every where he went. He was probably, as we would say, as tough as a pine knot. I think Jesus was a hardy young man, very strong and stout physically, and that there was nothing weak or puny about him from a medical standpoint, prior to the crucifixion. As far as emotional stress, I don't think Jesus had any kind of nervous breakdown. He was certainly under stress in the garden of Gethsemane, but nothing that he said on the cross gave any indication whatsoever that he was decompensating mentally, even during his gravest hours on the cross.
I've also heard cardiac arrhythmia debated as a cause of Jesus' death. When people go into cardiac arrhythmia, if it's ventricular tachycardia or some of the other types of cardiac arrhythmia's, one of the first things that happens is that the heart, even though it beats fast or funny, doesn't function very well as a pump. When it doesn't function well as a pump, your blood pressure drops, and you lose consciousness. Again, nowhere in the gospels do we have an account where Jesus ever lost consciousness until he died.
Let's talk about the cross for just a minute. We know from Corinthian and Roman history that the crosses were usually in two parts. First, the cross bar, that from very good historical accounts can be estimated to have a weight of 125 to 150 pounds, and to be about the size of a cross tie. Many of us have stacked or used cross ties at one time or another or have certainly seen what they look like on the railroad tracks. I want to remind you that this was a rough, unplaned, unfinished piece of wood with splinters and spikes and rough places in it, just like you would expect to see in a railroad cross tie. When the victim's final trial and condemnation had taken place, to maximize the shame and suffering, the custom was to tie the cross bar to the victim, and have him carry it through the city from his point of condemnation to his point of execution. Part of the custom was that many times these people would be forced to stagger through the streets after being scourged and beaten, with the cross bar tied to their arms, and to add to the ultimate humiliation, the victim had to bear the cross naked. Imagine how humiliating that would be in this day and time, much less how humiliating and agonizing it must have been for Jesus.
The other part of the cross was an upright part, which is just like a post in the ground. Every major city at that time had an area outside their gates where they performed crucifixions. It was really not only a form of execution, but of entertainment as well. Many of the major cities had areas outside their walls where they would have three or four of these upright posts that were permanent fixtures. Someone condemned to crucifixion would bear the cross bar through the streets to the point of crucifixion, and once there, would be thrown onto the ground. Nails would then be driven through their hands into the cross bar. Then two forks, something similar to pitch forks, would be placed around each end of the cross bar, and they would be boosted up and the cross bar hung on top of the upright post. Once they were braced on the upright post, both feet would then be nailed to the foot piece.
The nail wounds... The Romans practiced crucifixion for hundreds of years, and they perfected the art of pain and suffering. How could a man have spikes driven through his hands and feet and not bleed to death? The Romans figured out that if they drove the spike through a man's wrist right at the middle, they could avoid hitting any arteries or veins. If you go back and look at the Hebrew word for hand, it's inclusive from the fingertips to about where your wristwatch crosses your wrist. So the hand didn't necessarily mean the palm, and I can tell you, from having been a hand surgeon at one time and from dissecting cadavers to try to see if the muscle was strong enough to hold the body weight, it's not. You can not drive a spike through a man's palm and hang him by it without it pulling right out between his fingers. It is an accepted medical fact that the muscle in your palm is not strong enough to support your body weight.
In order to be able to drive spikes through the Lord's hands, they had to drive them through at the wrists. There, there's a very strong ligament, called the traverse carpal ligament, that's strong enough to support the body weight. The Romans figured out that if they came about where the crease in the wrist is and drove the spike through this area, they would miss the radial artery (the artery people cut when they try to kill themselves by cutting their wrist - right where the doctor takes your pulse), and they would also miss what we call the ulnar artery over on the little finger side. What they would do though, is drive the nail right through the biggest nerve in the hand, called the median nerve. If any of y'all have ever had carpal tunnel syndrome, you know how uncomfortable any inflammation or irritation to that median nerve can be. When the median nerve is transected, it gives about the sensation of having an electric cattle prod stuck to your wrist and a constant electrical shock going through your hand, and causes the fingers to claw. In essence, the Romans devised a way they could drive a spike through a man's hand and not lose one drop of blood, while maximising the amount of pain and suffering that man would endure.
The Romans did the same thing with the feet. They calculated where they could drive a spike through both a man's feet and not cause blood loss that would cause the victim to bleed to death. The spike would have been placed between the first and second metatarsal bones, missing the dorals pedis artery. There again, they drove the spike through the feet with no blood loss. The spike misses the artery, but does hit the plantar nerves, thereby causing that same horrible shock sensation.
Let's talk now about Jesus hanging on the cross. When hanging by their arms, as a crucifixion victim's body weight sags down, their diaphragm functions like a billows. As the diaphragm drops into the abdomen it pulls in air, so someone hanging on the cross had no difficulty whatsoever pulling air into their lungs. The tough part for people hanging on the cross was breathing out. In order for a crucifixion victim to exhale, they would have to pull up against the spikes with their hands, and push up against the spikes with their feet. I want to remind you - here's Jesus hanging on the cross, probably naked in front of the whole city of Jerusalem. I've already described his back to you. Every time he took a breath, that tattered, lacerated and riddled back was drug and scraped across the splinters and the rough knobs and spikes protruding from the cross. Each time he breathed out, each time he uttered a word, he would have to pull up with his arms and push up with his legs. That's why I want to remind you just how precious Jesus' words from the cross were. That's why he couldn't say more than three or four words at a time. Because when you talk, you only talk as you breathe out, not as you breathe in. Every word Jesus spoke on the cross was spoken as he was pulling up against the nails and dragging his back across the cross. That's why what the Lord tells us - what he spoke from the cross - is very precious to me, because I know what it cost him and how badly it hurt him. Every time I give this talk it reminds me how he died for us and just how every word hurt and how he suffered just to give us every word. What did he say? He said, 'Behold your son." And then he said 'Behold your mother.' Jesus knew he had just about finished his job and done everything that he'd come into this world to fulfill and do. Finally, when he had done all of that, he said, 'It is finished.' And when he said 'It is finished", that's the last time he pulled up with his hands and pushed up with his feet, dragging his back across the cross as he hung there naked before the city of Jerusalem in total shame and humiliation. Convicted and tortured and condemned for something of which he was not guilty.
If you go back and look at historical accounts, you find that people actually lived on the cross, crucified, for up to six days. If you can, imagine a man hanging on a cross outside the gates of a city with the birds pecking at his eyes and roosting on his head, as he hangs there naked as a spectacle for the whole city. That was the point of this. It was part of the shame and humiliation that a man hang there so people could come by for a day or two and stand and mock and jeer and shout accusations and railings and blasphemy at him. The idea was to make him suffer as much as possible. Crucifixion was never intended to kill anybody. It was only intended to make a human being suffer as much as could be inflicted upon him before killing him by breaking his legs.
But I don't believe Jesus died from crucifracture or from exhaustion asphyxia either. Crucifracture is what they would do when they simply grew tired of watching this agony and suffering or when they had something better to do and wanted to end a crucifixion. They would take a spear and swing it like a ball bat and hit the victim in the shins to break his shin bones. They'd break the tibula and the fibula bone. Many times they would have to beat the legs for five or ten minutes until they finally could break the shin bones - it takes a lot of force to break your shin bone. With the shin bone broken, the victim could no longer push up to breathe.
Why didn't they break Jesus' legs? If you go back to the Psalms - I believe the 34th chapter - it says "Not a bone of his body was broken." This is why Jesus' nose and jaws and cheekbones should have been broken but couldn't have been. The 34th chapter of Psalms wouldn't let that take place. And that's why the Roman centurion didn't break his legs, because the Bible says "Not a bone of his body was broken." That was totally uncharacteristic of the crucifixion, because that's how crucifixion victims died. When they grew tired of you and got bored with the situation they'd break your legs and in about four to six minutes you'd smother to death, because you could no longer push up with your legs. You laid there sagging, unable to breathe out, and you were asphyxiated in about four to six minutes. That's how the two thieves died. But Jesus was dead already.
Let's go back to the 19th chapter of John. What happened? What did they do when they went to the first thief? The Roman centurion broke his legs. What did he do when he went to the second thief? He broke his legs. But when the centurion went to Jesus, the Bible says he was dead already.
Now why would a young, strapping, healthy man be dead after being on the cross for six hours? There's absolutely no medical explanation for it at all. Excuse my interpretation here, but the Lord had no business being dead. He should have been alive just like the other two. He wasn't beaten to the point of death, his blood loss was minimal and we know he wasn't in shock, because everything he told us from the cross made sense. He identified his mother standing at some distance from the foot of the cross. He was able to see enough to identify her and to identify one of the disciples. And everything he said was coherent. He was not out of his mind and he was not having a nervous breakdown, and he wasn't even in shock from blood loss. The Lord was perfectly coherent and sane up to the moment he died.
The spear wound to the Lord's side was not the cause of his death either. When the centurion saw that Jesus was dead already, he thrust a spear into Jesus' side. The Bible says in Zachariah that they may look upon him who they've pierced. The spear thrust was biblical prophecy fulfilled. That was one of the reasons why Jesus was already dead; God had a plan that we were to look upon the one they had pierced - Zachariah had to be fulfilled.
Roman centurions were trained killers. They were taught how to deliver death blows that would take a man's life in a matter of seconds. I've taken care of many gunshot victims to the chest. A person can take a .22 through the left side of the heart and likely come in sitting up talking to you. However, if you're stabbed or shot on the right side of the heart, where the inferior and superior vena cava are emptying into the right side of the heart, you're unconscious and pretty close to dead in about twenty to thirty seconds. This blow to Jesus was no doubt delivered from the right side through the right lung into the heart and on into the spine. It would have penetrated somewhere between the seventh and eighth intercostal space probably on the right.
But the Bible says that blood and water came out of Jesus' side after the spear was thrust in. Now if you take a unit of blood, drain it out of a human being's body, put it in a quart jar and set it on top of a desk, in about thirty minutes the red blood cells begin to settle out and the plasma rises to the top. The plasma separates from the red blood cells. When the soldier thrust the spear into the Lord's side, Jesus had already been dead for thirty or forty-five minutes. Maybe you've never thought about that. The spear wound did not take the life of the Lord Jesus; he was dead already when they thrust the spear into his side.
So let me conjecture a little about what I think. I think there's a very good description of the crucifixion in the Bible and there's very good medical evidence that can be pulled out of that description that tells us that the Lord did not die in the manner that most crucifixion victims die. When the Roman centurion went to him to break his legs, he was dead already. They couldn't break his legs because the Bible said in Psalms, "Not a bone of his body shall be broken." Why then would the soldier thrust a spear into his side? Because Zachariah told us hundreds of years before that we'd look upon him that we'd pierced. And what came out? Blood and water - I think there's enough medical evidence there that the Lord was dead at least a half an hour.
So what took the Lord's life? No man did. No man, no Roman centurion, no cross took Jesus' life. He was able to do something I've never seen another human being do - he laid down his life. When it was finished and with a loud voice, he gave up the ghost. Jesus gave his life."
"The reason my Father loves me is that I lay down my life - only to take it up again. No one takes it from me, but I lay it down of my own accord. I have authority to lay it down and authority to take it up again. This command I received from my Father." (NIV) John 10:17,18
Jean
