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A Physician Looks at Jesus' Death by Crucifixion
Following the last supper, Jesus retired across the Kidron Valley to the Garden of Gethsemene. As He entered the garden, He withdrew from His disciples to pray. This was probably the most traumatic experience Jesus faced during the next 12 to 18 hours. Who could possibly measure the anguish that Jesus experienced as he submitted His will to that of the Father, as He anticipated His separation from the Father when He would bear the sin of the world?
This night, begun as a sleepless one, would be marked by an extreme spiritual struggle: "And being in agony he prayed more earnestly: and his sweat was as it were great drops of blood falling down to the ground," Luke says (22:44). This bloody sweat is known medically as hematidrosis, and in the gospel narratives is mentioned only by the physician Luke. We are indeed indebted to the astute observation of this medical doctor. This phenomenon has been documented on other rare occasions among persons undergoing extreme psychological or physiological stress. It is caused by tiny capillaries under the skin surface distending and ultimately going into arterial spasm with necroses, and rupturing into the sweat glands. This results in a bloody secretion, blood mixed with sweat, exuding through the pores of the skin. The loss of this bloody, sweaty mixture would create profound dehydration and early stages of shock.
Unless you reflect on this point, it is easy to overlook the fact that an angel appeared to Jesus to strengthen Him. Certainly the intercessory ministry of this angel empowered our Lord to sustain the brutal trauma which was yet to occur.
After the battle with His will, Jesus looked across the night sky toward Jerusalem and saw the torches illuminating the rolling hillside. He could clearly identify the soldiers, high priests, some members of the Sanhedrin, and his own disciple, Judas, leading the mob to arrest Him. Preliminary collusion with Judas, and the cleverness of Caiaphas was manifested in the nighttime arrest of Jesus. They evidently feared a rebellion of the people if they attempted to take Jesus openly.
Not only had the conspirators judged the trial before the arrest, they literally participated in the actual arrest of Jesus in the Garden of Gethsemene. Jesus was then taken to the high priestís house at night and under clandestine circumstances, a gross violation of Jewish jurisprudence. In addition, according to Mosaic law, no trial was to take place on the eve of the Sabbath or holiday or on a holiday itself. All four Gospels indicate that this was on the eve of the Sabbath, and more than that, on the eve of the Passover.
The first trial occurred sometime after midnight and was concluded before 3:00 a.m. The Gospels record that Jesus was led away with His hands bound - the same hands that had healed the sick, opened the eyes of the blind, and raised the dead. But this was only the beginning of the indignities to which Jesus would be subjected. Before Annas, Jesus was directly cross-examined in contradiction to the Jewish law. The Sanhedrin and Council were not allowed to apply duress and pressure during a trial, and frank confessions were not accepted by Jewish law.
The law itself required two witnesses to bring accusations, but Jesus was being directly intimidated and cross-examined before Annas, In fact, one of the officers of the high priest accompanying Jesus struck him with his hand because of the manner of Jesusí reply to Annas.
In Luke 22:63,64, we are told that the man holding Jesus mocked Him, beat Him, blindfolded Him, and asked Him to prophesy. The same Jesus who had performed so many miracles and who had been so willing to gather these in His arms, now sustains the indignity of their mockery and ridicule before being led away to Caiaphas and the full Sanhedrin.
During the course of this second trial, even the charges against Jesus were changed because of the inability of the false witnesses to agree in their testimony. In modern terminology, Jesus was tried for an alleged plot to desecrate a national shrine (He had claimed to be able to tear down the temple and rebuild it within three days). Caiaphas as the high priest now took an active role in the interrogation of Jesus. He commanded Jesus by the living God to speak. By Jewish tradition, this was a compelling oath which a suspect could not refuse. When all else failed, Caiaphas demanded a complete confession. Following the testimony, he rent his clothing. This Middle East custom depicted great emotion and undoubtedly prejudiced and influenced the other members of the Sanhedrin.
The trial was so prejudiced, it was beyond any consideration of mercy. Jesus then was taken before Pilate early in the morning. While being very liberal concerning the trial by their own Jewish law, the accusers now resume their legalistic stance by not entering the Roman courtyard and thereby defiling themselves on the eve of the Passover. This indicates their extreme concern over the minutia of the law versus the more important weightier matters, just as Jesus had accused them.
As we see Jesus now, Heís exhausted from lack of sleep, the two preceding interrogations, abuse, dehydration and ridicule. Yet he stands before this Roman governor with supernatural power. His compassionate, soul-searching countenance is bowed in humility. No reviling or bitterness comes from His parched, swollen lips. Indeed, He makes no self-defense at all.
Now Pilate, in an attempt to appease the mob, has Jesus scourged. This was not ordinarily part of a crucifixion. And there was a difference between Jewish and Roman law in regard to it. Under Jewish law, scourging was limited to 40 lashes. The Jews were so intent that the law be upheld, the beating often was stopped at 39 lashes to be sure that a miscount had not taken place. Roman law knew no such limitations. The prisoner was beaten to the verge of death as measured by a rapidly increasing, thready pulse and/or a shallow, irregular respiratory rate.
Wooden-handled leather whips with three strands were most frequently used. Each strand had a small piece of bone or metal attached to the end which would chip and gouge out pieces of bone and tissue with each lash as it was withdrawn sharply backwards to the readied position. The prisoner was tied across an object that would support his weight after he had lost consciousness. This position also provided easy access to areas of the legs, arms, thighs, and upper chest. Such an atrocity stripped the skin into long, ribbon-like segments, causing profuse arterial bleeding.
The crown of thorns, in the form of a circlet, now was pressed deeply into His scalp by the soldiers. This resulted in additional arterial bleeding which added to the extreme reduction and contraction of His total vascular space, thereby deepening His state of shock.
A purple robe was then thrown across Jesusí shoulders and back. It perhaps acted as a temporary compressive dressing, helping to congeal some of the blood pouring from the gaping lesions across His thorax, abdomen and legs. The gospel narratives continue the description of the atrocity, including the mockery by the soldiers, Jesus being spat upon, beaten with reeds, ridiculed, and hailed as the "King of the Jews."
Isaiah 50:6, a Messianic passage, states, "I gave my back to the smiters, and my cheeks to them that plucked off the hair. I hid my face from shame and spitting." Anyone who has had any hair pulled from his face or eyebrows knows the pain and resultant swelling.
Then Jesus came forth, wearing the crown of thorns and the purple robe. And Pilate saith unto them, Behold the man," John records (l9:5). As Jesus stood before the howling mob, no doubt He experienced the clammy, lifeless sensation of advanced shock. Medically, Jesus would demonstrate cold, pale sweaty skin. The mucous membranes would be bluish and cyanotic and His countenance would be haggard and drawn. His reflexes would be depressed, His pulse pounding, His respiration shallow and barely perceptible. His physical strength would be at the point of prostration at best.
Pilate now succumbs to the manipulation by Jewish leaders, and Jesus is condemned to death by crucifixion. The purple robe is stripped away and Jesus is given the cross to bear to the place of the skull, Golgotha. The rough removal of His garments would be similar to the careless removal of a surgical dressing, causing the wounds to bleed freely once more.
Atonement throughout the Old Testament, beginning in the Garden of Eden where God made skins to cover Adam and Eve following their sin, required the sacrifice of blood to provide the covering. Blood atonement reoccurred as the theme through the temple worship. And now in Jesus we have the profuse loss of blood as the atonement for our sins.
It is interesting that the gospel writers simply indicate that Jesus was taken to the place of the skull and there crucified. We are left with no further information other than that which can be deduced from the writings of Roman and Jewish historians. This was such a common practice that no elaboration was necessary. This act, originally practiced by the Phoenicians, was perfected and embellished by the Romans. It was known in the Palestinian area from approximately 200 B.C. until 300 A.D. when it was abolished by Constantine.
Many of the crosses of Jesusí day were shaped like the Greek letter Tau. The upright post, the stipes, was permanently fixed in the ground at the execution site, and the transverse beam, carried by the condemned, would be joined to the stipes by a mortise joint which locked into a self-retaining position. This expedited the work of the executioner. The transverse beam weighed as much as l00 pounds. So if Jesus carried only that portion of the cross, or an entire cross, it is no wonder that he fell.
As Jesus arrived at the execution site, the beam or cross was thrown upon the ground and Jesus was roughly thrown backwards onto it. His arms were extended to a pre-selected position. The executioners would be careful not to draw his arms to a fully extended position, for that would hasten His death.
Large triangular construction-grade nails then would be used to secure Jesus to the cross. The Bible states that these were driven through His hands. Many authorities believe that they were driven through the lower portion of his forearm near the wrist. There they would compress the median nerve trunks to the hand. These nerve trunks then would impinge on the tendons of the palm causing the thumbs to bend toward the palm.
It is interesting to note the Latin word for hand, manus, also is used by such early writers as Virgil and Josephus to designate the part of the wrist which joins the hand. If, indeed, the nails were driven through His hands, as the Bible says, it is not clear how this kept Him suspended, for a nail through the center palm would tear through it.
Next, with the nails in place, Jesus would be literally hoisted upright. His feet would be secured with a single nail, the left foot extended slightly over the right with the knees flexed, and the nail driven through the arches of the feet.
The Romans had perfected this brutal art to where the length of time required for the condemned person to die could be computed by how much flexion was left in the knees to expedite breathing. His position on the cross forced a condemned person into a horribly cruel exercise. In order to breathe and to relieve the pain in the arms as the body sagged downward, he would have to push up on the nail in the feet forcing an up and down slithering motion upon the cross until he expired.
Dangling by the arms in this position would result in severe muscular pain in the upper extremities. It also would cause a progressive pain from joint separation. Continual hanging by the arms would gradually result in paralyzation of the intercostal muscles of the thoracic wall. As a result, air could be drawn into the lungs easily but could not be exhaled. As carbon dioxide accumulated, progressive degrees of asphyxiation would occur. Accumulated carbon dioxide and lactic acid would create an intense muscular hyper excitability and violent tetanic muscle spasm throughout the body.
As the suffering sensation became overwhelming, the condemned man would be compelled to push up on the nail in his feet to gasp for breath. It is undoubtedly in this position that Jesus uttered His famous seven last words. It is indeed amazing, as Jesusí physical body was ravaged by shock, exhaustion, incredible thirst, central nervous system pain, stimulation beyond our comprehension, and gradual asphyxiation, that no reviling or words of condemnation were uttered by Him. Rather, He expressed concern for those about Him.
As the crucifixion continued, the chest wall would further elongate and become grossly distorted. The stomach area would sink. The altered hemodynamics of the thoracic cavity would result in a progressive effusion of fluid into the pericardial sack, creating a searing, sharp, pleuritic type pain with each heartbeat and each attempted movement on the cross.
These events are accurately depicted in Psalm 22, which was written hundreds of years before crucifixion was ever practiced: "All they that see me laugh me to scorn: they shoot out the lip, they shake the head...I am poured out like water, and all my bones are out of joint; my heart is like wax; it is melted in the midst of my bowels. My strength is dried up like a potshard; and my tongue cleaveth to my jaws; and thou hast brought me into the dust of death. For dogs have compassed me; the assemble of the wicked have enclosed me: they pierced my hands and my feet. I may tell (count) all my bones: they look and stare upon me. They part my garments among them, and cast lots upon my vesture."
Jesus was placed upon the cross at about the sixth hour. The crucifixion lasted at least through the ninth hour when the darkness fell upon the land. Therefore, by inference, it was approximately six hours before Jesus released his spirit.
Because it was the eve of the preparation for the Passover, the Jews had asked that the bodies be removed from the crosses. So the soldiers came to break the legs of the prisoners, to hasten their death. But when they came to Jesus, they found that he already was dead, so as John says (l9:33), " they brake not his legs...for these things were done that the Scripture should be fulfilled, a bone of him shall not be broken" (Psalm 34:20).
In death, Jesus was numbered with the transgressors, yet provided a rich manís burial. (This, too, was prophesied in the Old Testament: Isaiah 53:9). So Joseph of Arimathea and Nicodemus, whose lives had been touched by Jesus, tenderly provided for the funeral arrangements in a near-by tomb. The garden tomb area of the old city has a beautiful representative tomb carved out of solid rock which fits the Protestant tradition. One of the most moving experiences during a trip to the Holy Land occurs as you walk into the empty inner chamber. There the guide points out that other believers would say that the burial occurred in the Church of the Holy Sepulcher, or over here, or over there. But the exact place is not really important, he says. Whatever tomb contained the body of our Lord Jesus, it is empty. What a dramatic testimony to the power of our risen Lord Jesus Christ.
We need to keep considering Calvary, and the blood that was spilled as payment in full for our sins. We need also to remember the empty tomb and the testimony of hundreds of witnesses who saw Jesus physically following His resurrection. Then we need to answer the same haunting question that Pilate faced, "What shall I do with this man called Jesus?"