On the Physical Death of Jesus Christ William D. Edwards, MD; Wesley J. Gabel, MDiv; Floyd E. Hosmer, MS, AMI Jesus of Nazareth underwent Jewish and Roman trials, was flogged, Talmud, and by the Jewish historian and was sentenced to death by crucifixion. The scourging produced deep Flavius Josephus, although the au¬ stripelike lacerations and appreciable blood loss, and it probably set the thenticity of portions of the latter is stage for hypovolemic shock, as evidenced by the fact that Jesus was too problematic.26 weakened to carry the crossbar (patibulum) to Golgotha. At the site of The Shroud of Turin is considered crucifixion, his wrists were nailed to the patibulum and, after the patibulum by many to represent the actual buri¬ was lifted onto the upright post (stipes), his feet were nailed to the stipes. al cloth of Jesus,22 and several publi¬ The major pathophysiologic effect of crucifixion was an interference with cations concerning the medical as¬ normal respirations. Accordingly, death resulted primarily from hypovolemic pects of his death draw conclusions shock and exhaustion asphyxia. Jesus' death was ensured by the thrust of a from this assumption."' The Shroud soldier's spear into his side. Modern medical interpretation of the historical of Turin and recent archaeological evidence indicates that Jesus was dead when taken down from the cross. findings provide valuable information (JAMA 1986;255:1455-1463) concerning Roman crucifixion prac¬ tices.2224 The interpretations of mod¬ ern writers, based on a knowledge of THE LIFE and teachings of Jesus of credibility of any discussion of Jesus' science and medicine not available in Nazareth have formed the basis for a death will be determined primarily by the first century, may offer addition¬ major world religion (Christianity), the credibility of one's sources. For al insight concerning the possible have appreciably influenced the this review, the source material mechanisms of Jesus' death.2"17 course of human history, and, by includes the writings of ancient When taken in concert, certain virtue of a compassionate attitude Christian and non-Christian authors, facts—the extensive and early testi¬ toward the sick, also have contributed the writings of modern authors, and mony of both Christian proponents to the development of modern medi¬ the Shroud of Turin.'40 Using the and opponents, and their universal cine. The eminence of Jesus as a legal-historical method of scientific acceptance of Jesus as a true histori¬ historical figure and the suffering investigation," scholars have estab¬ cal figure; the ethic of the gospel and controversy associated with his lished the reliability and accuracy of writers, and the shortness of the time death have stimulated us to investi¬ the ancient manuscripts.2622,293' interval between the events and the gate, in an interdisciplinary manner, The most extensive and detailed extant manuscripts; and the confir¬ the circumstances surrounding his descriptions of the life and death of mation of the gospel accounts by crucifixion. Accordingly, it is our Jesus are to be found in the New historians and archaeological find¬ intent to present not a theological Testament gospels of Matthew, Mark, ings2627—ensure a reliable testimony treatise but rather a medically and Luke, and John.' The other 23 books from which a modern medical interpre¬ historically accurate account of the of the New Testament support but do tation of Jesus' death may be made. physical death of the one called Jesus not expand on the details recorded in Christ. the gospels. Contemporary Christian, GETHSEMANE SOURCES Jewish, and Roman authors provide After Jesus and his disciples had additional insight concerning the observed the Passover meal in an The source material concerning first-century Jewish and Roman legal upper room in a home in southwest Christ's death comprises a body of systems and the details of traveled to the Mount literature and not a or scourging Jerusalem, they physical body and crucifixion.5 Plu¬ of northeast of the its skeletal remains. Accordingly, the Seneca, Livy, Olives, city (Fig 1). tarch, and others refer to crucifixion (Owing to various adjustments in the practices in their works.828 Specifical¬ calendar, the years of Jesus' birth and From the Departments of Pathology (Dr Edwards) ly, Jesus (or his crucifixion) is men¬ death remain controversial.2' How¬ and Medical (Mr Hosmer), Mayo Clinic, Graphics tioned the Roman historians Cor¬ ever, it is that Jesus was born Rochester, Minn; and the Homestead United Meth- by likely odist Church, Rochester, Minn, and the West Bethel nelius Tacitus, Pliny the Younger, in either 4 or 6 BC and died in 30 United Methodist Church, Bethel, Minn (Pastor and Suetonius, by non-Roman histori¬ AD."2'' During the Passover observ¬ Gabel). ans Thallus and the satir¬ ance in 30 the Last would Reprint requests to Department of Pathology, Phlegon, by AD, Supper Mayo Clinic, Rochester, MN 55905 (Dr Edwards). ist Lucian of Samosata, by the Jewish have been observed on Thursday, Downloaded From: by Robert Zirpoli on 03/26/2018 To Sychem N . and Damascus t o 500 1,000 1,500 Vi n\ S ' ' .^^^nv—" ' ' ' I ^Meters F°rtress of \\ 0 250 500 y/\Jrpossib|e\ Antonia SS v, Golgotha£°HT \\,/ \\ nX sí' x\/ Gethsemane II j j^AW-^^^i\ To Joppa \\ y^ //^—1| J^jFx. ^S./? Traditional l/>^>\lC@ 9^^^%.M°"nt of olives ^¿y/ Golgotha II J T l\Il¿ 111 \^ I ^5^\\ i^7 ^ >JASuburtx\. VMa. T I VV~L==To Bethany <^^ \\ (Calvary) ^"7* h*. l\y"J |.J I IL.- Herod Antipas' N\ __---=ia)l^^^^< »11 Temple I /%/ Herod's^// Jf I ÀC\ ^1^ ß S^/ CaiaDhas' II 1 x-- ftLower City I / Kidron Valley -//-J— -*—V-4^ / i Residence II m -/f"—^v I If // Hinnom Valley n? \ To Bethlehem "y/s and Hebron il To Salt Sea Fig 1. — Map of Jerusalem at time of Christ. Jesus left Upper Room and walked with disciples to Mount of Olives and Garden of Gethsemane (1), where he was arrested and taken first to Annas and then to Caiaphas (2). After first trial before political Sanhédrin at Caiaphas' residence, Jesus was tried again before religious Sanhédrin, probably at Temple (3). Next, he was taken to Pontius Pilate (4), who sent him to Herod Antipas (5). Herod returned Jesus to Pilate (6), and Pilate finally handed over Jesus for scourging at Fortress of Antonia and for crucifixion at Golgotha (7). (Modified from Pfeiffer et al.M) April 6 [Nisan 13], and Jesus would have suggested that hematidrosis ably at the temple (Fig 1), Jesus was have been crucified on Friday, April 7 produced hypovolemia, we agree with tried before the religious Sanhédrin [Nisan 14].2') At nearby Gethsemane, Bucklin5 that Jesus' actual blood loss (with the Pharisees and the Saddu- Jesus, apparently knowing that the probably was minimal. However, in cees) and again was found guilty of time of his death was near, suffered the cold night air,' it may have pro¬ blasphemy, a crime punishable by great mental anguish, and, as de¬ duced chills. death.1' scribed by the physician Luke, his sweat became like blood.' TRIALS Roman Trials Jewish Trials Although this is a very rare phe¬ Since permission for an execution nomenon, bloody sweat (hematidrosis Soon after midnight, Jesus was had to come from the governing or hemohidrosis) may occur in highly arrested at Gethsemane by the tem¬ Romans,' Jesus was taken early in the emotional states or in persons with ple officials and was taken first to morning by the temple officials to the bleeding disorders.'*2" As a result of Annas and then to Caiaphas, the Praetorium of the Fortress of Anton¬ hemorrhage into the sweat glands, Jewish high priest for that year (Fig ia, the residence and governmental " the skin becomes fragile and tender.2 1).' Between 1 am and daybreak, Jesus seat of Pontius Pilate, the procurator Luke's description supports the diag¬ was tried before Caiaphas and the of Judea (Fig 1). However, Jesus was nosis of hematidrosis rather than political Sanhédrin and was found presented to Pilate not as a blas¬ eccrine chromidrosis (brown or yel¬ guilty of blasphemy.' The guards then phemer but rather as a self-appointed low-green sweat) or stigmatization blindfolded Jesus, spat on him, and king who would undermine the Ro¬ (blood oozing from the palms or else¬ struck him in the face with their man authority.' Pilate made no where).182' Although some authors fists.' Soon after daybreak, presum- charges against Jesus and sent him to Downloaded From: by Robert Zirpoli on 03/26/2018 Fig 2.—Scourging. Left, Short whip (flagrum) with lead balls and sheep bones tied into leather thongs. Center left, Naked victim tied to flogging post. Deep stripelike lacerations were usually associated with considerable blood loss. Center right, View from above, showing position of lictors. Right, Inferomedial direction of wounds. Herod Antipas, the tetrarch of Ju- his closest friends (the disciples), and (lictors) or by one who alternated dea.' Herod likewise made no official a physical beating (after the first positions.'7"28 The severity of the charges and then returned Jesus to Jewish trial). Also, in the setting of a scourging depended on the disposition Pilate (Fig 1).' Again, Pilate could traumatic and sleepless night, he had of the lictors and was intended to find no basis for a legal charge been forced to walk more than 2.5 weaken the victim to a state just against Jesus, but the people persist¬ miles (4.0 km) to and from the sites of short of collapse or death.8 After the ently demanded crucifixion. Pilate the various trials (Fig 1). These phys¬ scourging, the soldiers often taunted finally granted their demand and ical and emotional factors may have their victim." handed over Jesus to be flogged rendered Jesus particularly vulnera¬ (scourged) and crucified.