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Exegetical and Medical Aspects of Jesus’ Death and Their Coherence with the Shroud

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Roman Bogacz
Pontifical University of John Paul II, Kraków, Poland

Władysław Sinkiewicz
Collegium Medicum Nicolaus Copernicus University, Toruń, Poland

The account in the canonical gospels of Jesus’ trial, passion and death on the cross (Mattt 26:47–68; 27:1–2, 11–49; Mark 14:43–65, 15:1–37; Luke 22:39–53.63-65; 23:13–34.44–46; John 18:12–19, 37) presents the historical events (selectively) together with the theological ones. It is on this basis that an attempt is made to show the exegetical and medical aspects of Christ’s death. The juxtaposition of the textual data with an analysis of the traces left on the image visible on the Shroud of Turin, which recorded the suffering and the type of death inflicted, makes it possible to affirm or deny the overlap of the identity of the figure in the gospels and the one on the cloth.

Crucifixion, as we know from ancient sources, was among the most severe and degrading punishments in the ancient world. The Jewish historian Josephus Flavius, describing the siege of Jerusalem by the Romans in 66–70 after Christ, rated this punishment as the most repulsive of deaths (Josephus Flavius 2022). Crucifixion probably originated in Assyria and Babylon. In the 4th century BC, Alexander the Great introduced this cruel way of inflicting death in the Mediterranean countries, while the Romans took it over from the Phoenicians in the 3rd century BC. Crucifixion became common between the death of Herod I the Great (4 BC) and the fall of Jerusalem (70 BC). It was only abolished by Emperor Constantine the Great in 337 and replaced by hanging on the patibulum (gallows), which was, one might say, humane compared to the cross. The difference between the first and second means of inflicting the death penalty was explained by Isidore of Seville (560–636): (…) one hanging on the patibulum dies immediately, while one nailed on the cross suffers for a long time (…) (Isidorus Hispalensis, Etymologiarum sive Originum libri XX, 5: 27, 33–34, [in:] Kobielus 2000, p. 20; Sławiński 1997, p. 26).

When crucifixion was performed, nails were most often driven into the tree through the hands and feet; rarely the victim was tied to the cross. Josephus mentioned that after the fall of Jerusalem in 70 AD, giving vent to anger and hatred, soldiers nailed captured Jews to the cross in various body positions even for fun (Josephus Flavius 2022). The large number of condemned required the executioners to be “efficient.” Tying the victim to a tree or cross with his hands suspended directly above his head resulted in death within minutes. The skeleton of a young person in his 20s, crucified decades after Christ, found in 1968 in a Jerusalem suburb during construction work, is evidence of the use of nails.

Archaeological research and historical records reveal that the Romans were most likely to carry out executions using a low T-shaped cross (Latin: crux commissa; English: low tau cross), which consisted of a vertical pole (Latin: stipes) 1.8–2.4 m high and a transverse beam (Latin: patibulum) 1.5–1.8 m long. In different regions of the empire also other types of crucifixion were performed, including the so-called Latin cross (Latin: crux immissa).

The condemned person generally had to carry the cross from the place where he had been subjected to scourging to the place of execution, which was usually outside the city walls. As the weight of the entire cross was about 140 kg, the condemned man carried only the crossbeam, weighing between 37 and 54 kg, which was placed around his neck and tied to his shoulders with thongs. At the execution site, the patibulum was pivoted to a post and this fastening was reinforced with ropes. If the agony was to be prolonged, a piece of uncut block or board (Latin: sedulum) was fastened in the middle of the lower part of the post. Very rarely, and probably in the times after Jesus, an additional block was attached under the feet, which made it possible to nail them to the cross.

It was Jewish law to give the condemned person a mild intoxicant: a mixture of strong wine and myrrh or gall before crucifixion. The victim was thrown to the ground, his arms spread out and attached to the beam he was carrying. The Romans would nail the victims rather than tie them with thongs.

Nails (similar to those used today for railway sleepers or railroad ties) were between 13 and 18 cm long and 1 cm in diameter. Once the condemned was fastened to the beam, he was lifted and the beam was fixed to the post. In the case of the cross on which Jesus hung, this task could easily be done by two soldiers without the use of a ladder. The feet were then nailed, usually to the front of the post. To attach them effectively, the legs had to be bent at the knees and the feet laterally twisted. The marks on the Shroud show that in Jesus this resulted in a dislocation of the right foot.

The condemned lived on the cross for three to four hours, but there were cases where he could have been dying for up to three days; the length of life on the cross was inversely proportional to the intensity of the torture. Soldiers could shorten the agony by breaking the legs below the knees. If the family of the condemned did not obtain permission for burial, dead bodies fell prey to insects, wild birds or predatory animals. The corpse was not released until it was established with certainty that death had occurred. The Roman custom was for one of the soldiers to deliver a fatal blow from the right side of the chest with a sword or spear as confirmation that the condemned had died. Spears of between 1.5 and 1.8 metres in length were most commonly used as they were easy to apply to a low cross, and therefore to one on which Jesus probably hung.

Death on the cross is now believed to have been the result of a number of factors. One of these was that the hanging body was positioned in such a way as to prevent proper breathing. If the victim was hung by his arms stretched above his head, death occurred within an hour, especially if the legs were so nailed together that the condemned could not use his arms to raise his body to exhale. Studies monitoring the respiratory and circulatory function which were carried out on volunteers by Frederick Zugibe showed that after just six minutes the respiratory volume in the subjects dropped by an average of 70%, the blood pressure by 50% and the heart rate doubled. After 12 minutes, breathing was only possible via the diaphragm. Twenty seconds of body elevation significantly improved circulation and respiration. The experiment had to be stopped after 30–40 minutes, usually because of excruciating pain in the wrists. In Roman times, prior to crucifixion, victims were subjected to cruel scourging which, if not resulting in death, caused considerable exhaustion due to pain and blood loss.

The Shroud of Turin, which continues to be the subject of multidisciplinary scientific study, is considered a highly probable testimony to Jesus’ suffering and crucifixion. It is a pictorial record of the cruel execution and crucifixion, giving an idea of the great suffering endured by the condemned. It shows the image of a dead man, 180–183 cm tall, with Semitic facial features and a strong, proportionate body. The examination of the Shroud has shown that the body remained inside it for up to 36 hours, as there are no signs of decomposition on it. Traces of blood clots were left intact on the linen, and there were no traces of them being torn off, which may indicate that the body was not removed from it. The presence of bile dye was detected. As is well known, excessive bilirubin can appear in blood due to the increased production of bilirubin after great physical exertion (suffering, pain) and as a result of the liver’s inability to capture excess bilirubin during haemolysis of blood cells, especially in acute haemolytic conditions.

The evangelist Luke describes the first symptoms of mental and physical suffering, and these took place after the Last Supper, during Jesus’ prayer in the Garden of Olives. The bloody sweat (haematidrosis) that appeared on Christ’s body is very rarely described in world medical literature. It is thought to be caused by terrible fear, unusually intense mental experiences or excessive exertion. Increasing fear of impending suffering and imminent cruel death along with loneliness and strong psychological experiences, compounded by abandonment by the loved ones, may have caused such symptoms.

All the evangelists wrote about Jesus’ prayer in the Garden of Olives (Matt 26:36–46; Mark 14:32–42; Luke 22:39–46; John 18:1–18). Matthew’s and Mark’s accounts are quite extensive and similar. They write that Jesus got up from prayer on three occasions and woke the apostles, inviting them to watch and pray. Although the evangelist Luke describes this prayer more briefly, he is the one who gives an extremely important detail: Jesus was in such agony and he prayed so fervently that his sweat became like drops of blood falling on the ground (Luke 22:44). There are two important points contained in this verse. One is highlighted above. Jesus prayed so fervently that his sweat became like thick drops of blood. The second point clarifies the first. In this passage, the evangelist Luke uses the Greek term ἡ ἀγωνία, not meaning agony—that is, death—but struggle. The word was used to describe Olympic wrestling matches, as well as other sporting competitions. The term was also used to refer to the struggles of orators, who competed in the art of oratory. The word may also have referred to verbal disputes between advocates in court. The term ἡ ἀγωνία referred to a physical, spiritual, mental struggle, overcoming fear or trepidation. So, St Luke very accurately described Jesus’ struggle in the Garden of Olives: it was so great that it caused a bloody sweat.

The Shroud represents the entirety of the victim’s ordeal. More than 700 traces of various wounds were found there. The prelude to the crucifixion was the beating of the condemned, especially on the face. The blows or slaps were dealt with fists or a stick. From the marks on the Shroud, it is evident that the injury was mainly to the right side of the face, which was almost massacred. A large haematoma under the eye made it very difficult, if not impossible, to see. The wide wound from the nose through the cheek, the swelling, the numerous haematomas, and the fractured jaw testify to the particular cruelty of the torturers.

The trial of Jesus of Nazareth described in the canonical Gospels had two stages. The first was religious in nature and was conducted by the High Council led by the high priest. The second trial was political in nature and was conducted by the political authority exercised on behalf of the occupying Romans in Israel by Pontius Pilate, who acted as procurator in Palestine. The wounds on Jesus’ face referred to above occurred during the religious trial. Once Jesus had been captured in Gethsemane—the oil press located in the Garden of Olives—he was led to the house of Caiaphas and then to the Sanhedrin’s council chamber. Edward Szymanek notes that St Mark’s account portrays this trial as a biased one, which aimed at a guilty verdict. However, since some serious charge against Jesus had to be found, false witnesses were used (Mark 14:58n), whose testimony, however, was not consistent. They spoke of how Jesus claimed that he would tear down the temple and that he would rebuild it in three days without human labour. Then the high priest asked: Are you the Messiah, the son of the Blessed One? (Mark 14:61) This question did not refer to Jesus’ deity, for such a thing was probably not contemplated, but concerned his messianic dignity, for the Old Testament texts already referred to the Messiah as the Son of God (cf. 2 Sam 7:5–16; Ps 2:7; Ps 89:27). Jesus’ response is very surprising when he openly confessed: I am (Mark 14:62). The high priest treated Jesus’ confession as blasphemy, and the whole crowd lashed out at the condemned man: Some began to spit on him. They blindfolded him and struck him (…). And the guards greeted him with blows. (Mark 14:65; Matt 26:67). Feliks Gryglewicz and Franciszek Jóźwiak conclude that Jesus was abused not only for the crowd to give vent to great anger, but also to make a mockery of his prophetic message (Prophesy!—Mark 14, 65; in Matthew’s version somewhat more broadly: Prophesy for us, Messiah: who is it that struck you—Matt 26, 68). The slap was usually administered with the right hand wrapped in cloth. The blow was delivered with vigour from the left side so that the condemned person, facing the executioner, received a blow on the right cheek. If the blow was inflicted by a servant holding the other end of the rope with which the condemned man was bound, then his hand was wrapped in that very rope, which intensified the blow and injured the victim’s face. In St John’s account, the beating of Jesus during the religious trial was more vicious. Annas asked Christ about his teaching and his disciples. Thereupon Jesus replied that he had spoken openly and that the high priest ought to ask those who were listening to him (cf. John 18:21), which caused the servant’s reaction: When he had said this, one of the temple guards standing there struck Jesus and said, “Is this the way you answer the high priest?” (John 18, 22). The Greek term used by St John, τò ῥάπισμα, describes not so much a slap dealt by hand as a blow dealt with a rod or stick. Therefore Jesus, protesting, replied, If I have spoken wrongly, testify to the wrong; but if I have spoken rightly, why do you strike me? (John 18:23). The Polish translation of this passage is not accurate. The verb δέρω used here means “to wound, to skin, to strip off the skin.” Jesus’ statement should therefore be translated: “Why are you wounding me?” The blow was so severe that it broke the nose, separated the cartilage from the bone and cut the skin on the nose and cheek.

The night after his arrest, Jesus walked about 2–3 km, being pushed and beaten on the march and during interrogation. A sleepless night in prison, probably in harsh conditions, a forced position, remaining without any opportunity to quench his thirst—all of this must have severely weakened the condemned man before his pending scourging and crucifixion.

The Shroud contains traces of 121 deep whip wounds. We can conclude from these that Jesus was flogged with short-handled whips with several thongs ending in iron balls or sharp animal bones (Latin: flagellum) which often ripped out the victim’s flesh during the blows, rupturing vessels, exposing nerves and penetrating to the bones.

In the Roman Empire, there was a ban on the whipping of Roman citizens, issued in 195 BC in the Lex Porcia, and renewed in 123 BC in the Lex Sempronia. Flagellation, however, was commonly used against members of conquered nations. Scourging was used to extract confessions or admissions of guilt. Roman law did not specify the number of strokes: it was decided by the lictor—the soldier administering the punishment.

Scourging customarily preceded crucifixion. It did not apply to women, senators and soldiers, except for deserters. Before inflicting this torture, the condemned was stripped naked and tied to a pole with his hands raised. This was carried out by two soldiers, on whose physical disposition and mental attitude towards the victim the strength of the blows depended, which could cause the victim to faint or even die. The infliction of this punishment often resulted in the body being massacred, while the severe pain and blood loss often caused shock and affected the duration of the agony on the cross.

The evangelist Matthew focuses on the theological significance of Jesus’ passion. He wrote about the physical suffering and torture to which Christ was subjected very briefly. He mentions the scourging in just one word (Matt 27:26). For him, it was more important that the leaders of the nation took responsibility for Jesus’ death. Josephus Flavius, on the other hand, states that the scourging preceded the crucifixion (Bell 2, 14, 9; 5, 11, 1).

The marks left on the Shroud by the thorny branches plaited into the shape of a coif and imposed on Jesus’ head as a parody of the coronation attest to the authenticity of the condemned man’s ordeal. This cynical act underlined the main accusation made against Jesus (that he dared to call himself king), since neither before nor since such a custom had been reported. The deep spikes of the coif of thorns that pierced the skin and often reached the periosteum caused neuralgia of the trigeminal nerve. On the forehead, 13 piercings can be counted, while on the back of the head—20. The shroud does not make the sides of the head visible, so it is assumed that there may have been about 50 total thorn injuries.

In Palestine, such a coif was made from the many thorny plants growing in the region. It could have been the thorn of Christ (Ziziphus spina-christi). Hanna Górska speculates that the most likely shrub used to crown Jesus was the thorn bloodroot (Sarcopoterium spinosum). It was commonly used in Jerusalem as fuel. The Gospel accounts of the Passion mention the burning of a fire in the courtyard of the high priest, at which the soldiers warmed themselves (Mark 14:67; Luke 22:55–56; John 18:22). Probably the same fuel was gathered in the fortress of Antonia, where Jesus’ political trial took place. The soldiers therefore did not need to look for a special bush. To describe the plant from which the crown was made, the evangelists used the Greek term ἡ ἄκανθα—‘thorn, thorny bush’ (cf. Matt 27:29; Mark 15:17; John 19:2). This is a common term and not a proper name, so it is not possible to resolve which plant the soldiers used when crowning Jesus.

On the cloth of the Shroud there are numerous traces of deep wounds on the arms, especially on the right arm. The crossbeam, which weighed about 60 kg, was fixed asymmetrically on the shoulders, which meant that the condemned could not cushion his fall or support himself with his hand, which meant that he usually fell on his left knee or on his face. The knee was so damaged that the victim was most likely unable to walk on his own. On the last part of the path—the uphill path—he was probably dragged. The marks on the Shroud also show the last act of suffering: the nailing of the outspread hands and feet and the suspension of the body.

Because of the loss of strength caused by the suffering inflicted on Him, it is most likely that Jesus could not carry the cross Himself. On the 600–650 m route between the Praetorium of Pilate’s palace, where the scourging took place, and the place of crucifixion, the condemned fell several times.

Taking into account the loss of blood, the strong emotional ordeal and the great physical suffering along with the lack of sleep, meals or drink (which was of vital importance in the hot Mediterranean climate), it can be assumed that Jesus was already in a critical condition before the crucifixion. When the victim was knocked to the ground before being nailed to the cross, the dried wounds would reopen, resulting in further blood loss. With every breath, the unhealed wounds on contact with the rough and rugged tree of the cross would open, releasing blood.

The Evangelists did not write about the wounds suffered on the way of the cross. The information they provided is very sparse. Matthew only indicated that Jesus was led to the crucifixion (Matt 27:31) and then that they forced Simon to carry His cross. Mark added that Simon was the father of Alexander and Rufus (Mark 15:20–21). Luke supplemented this information by stating that a multitude of people followed Him. He also wrote of the weeping women—whom Jesus admonished to weep over themselves and their sons—and of two other condemned who were led with Christ to be executed (Luke 23:26–32). St John, on the other hand, wrote that Jesus himself carried the cross (John 19:17).

The nails were driven into the wrists, not the palms because, as has been shown, only the bones and ligaments of the wrist can support the weight of the body. Nails were driven between the radius bone and the wrist bones or between the wrist bones themselves, proximal to the flexor muscle trochlea and wrist ligaments. Although the nail mostly passed between the bones and did not cause fractures, the damage to the periosteum itself caused unbearable pain. The driven nail could crush or damage the median nerve, causing excruciating pain in both arms along with the paralysis of the hand. The feet were usually nailed to the anterior cruciate through the first or second metatarsal space, distal to the junction of the tarsal and metatarsal bones. It is very likely that the nerves, the vessels and muscles of the foot were traumatised, which resulted in increased bleeding from the wounds and excruciating pain (causalgia), which, as we know today, is difficult to alleviate even with narcotics.

The Evangelists, however, did not convey the details of the nailing or the type of torture inflicted. Mark indicated that Jesus was given wine laced with myrrh to act as an intoxicant, but Jesus did not accept it (Mark 15:23). He also gave information about the separation of garments (Mark 15:24) and the mocking on the cross (Mark 15:29–32).

The question of the time of the crucifixion is of interest. Mark indicates that it was the third hour (Mark 15:25). The third hour of the day would mean the ninth hour of the morning. Exegetes surmise that it is rather the time of day between 9 a.m. and 12 p.m. This can be inferred from the text. According to Matthew, the crucifixion took place later, but this information refers to the time of the dying. He wrote that from six o’clock to nine o’clock darkness enveloped the whole earth (cf. Matt 27:45). Given Matthew’s account, Jesus’ death occurred at around 3 p.m. Luke gave a similar time, writing that from the sixth hour of the day until the ninth hour Jesus’ moribund state continued (Luke 23:44–46).

The most devastating, pathophysiological consequence of the crucifixion was the inability to breathe properly, especially to exhale properly. The weight pulling the body down on outstretched arms and bent knees forced the intercostal muscles into an inspiratory position and prevented passive exhalation. The latter could only be done with the diaphragm muscles. Respiration was therefore shallow, inefficient, with rapidly developing hypercapnia and respiratory acidosis. To exhale, the victim had to raise his arms and, resting on his feet, spread his knees. This movement in turn caused severe pain in the pierced feet and wrists from irritated and nail-damaged nerves, and increased bleeding from the wounds along with pain in the injured back that was rubbing against the uncut wood of the cross. The tetanic muscle cramps that followed fatigue plus water and electrolyte disturbances made breathing impossible.

The Gospel account states that Jesus only spoke from the cross seven times. Each spoken word must have caused great suffering, as the utterances could only take place in a phase of active, non-physiological exhalation forced by the position of the hanging body. The first of these utterances is recorded by St Luke: Father, forgive them, they know not what they do (Luke 23:34). Jesus’ prayer for his persecutors is very deeply rooted in his teaching (cf. Luke 6:28). Exegetes question the authenticity of these words because they are missing from several codices (e.g. 3rd century P75, 4th century Codex Vaticanus (B), 5th century Codex Bezae (D)). It appears that some copyists deleted this prayer for persecutors because of the conflict that arose at the end of the 1st century between Judaism and Christianity after the destruction of the Jerusalem temple. However, this prayer was known to Tatian the Syrian when he created the Diatessaron around 170, as well as to St Irenaeus (†204). It must therefore be accepted as authentic. This rather lengthy utterance of Jesus must have cost Him a great deal of effort because of the severe respiratory distress resulting from the dangling position of His body on the cross. By uttering these words at just such a moment, Christ set an example of how to pray for persecutors. At the end of his journey to Jerusalem, he taught that one should always forgive (Luke 17:3–4). The use of the past imperfect tense (imperfectum) in this statement is significant: “Jesus said…” (orig. Ὁ δὲ Ἰησοῦς ἔλεγεν). It follows that the words of the prayer “Father, forgive them, they know not what they do” were repeated by Him many times. They were spoken with a certain insistence and resembled the insistence of the widow in the parable, the same one who repeatedly asked the dishonest judge to grant her request (cf. Luke 18:1–8).

Despite so much suffering, Jesus, hanging on the cross, noticed even the repentant thief. To him he addressed his second utterance: Amen, I say to you, today you will be with me in Paradise (Luke 23:43). Two terms are significant. The first is the Greek ὁ παράδεισος—‘paradise.’ This term is derived from ancient Iranian, in which pairi-daēza means a garden surrounded by an irrigating ditch or a beautiful valley. The Septuagint translates the Hebrew gan in this way. Thus, the word primarily means a garden of paradise. It is a symbol of exceptional fertility and a garden in which man is happy (Gen 2:8; Song 4:13; Eccl 2:5; Neh 2:8). The Slavonic Book of Enoch, which is probably a translation from the Greek original dating from the 1st century BC, presents the third heaven as paradise. God, on the other hand, has His throne in the seventh heaven. From time to time, He descends into the third heaven (EnochSl 8–9). Such views are also expressed by St Paul, writing that he was raptured into the third heaven (2 Cor 2:2.4). The second term with theological significance is σήμερον—‘today.’ This today points to the present moment in which salvation takes place. Jesus, hanging on the cross, saves man, and the repentant thief, as one of the first men, shares not only in Jesus’ passion, but also in the work of salvation, and together with Jesus he will receive salvation, entering paradise with him on the same day.

A third statement is given by St John the Evangelist: Woman, behold, your son (…). Behold, your mother (John 19:26n). In the light of the law, these words have a very significant meaning. It is a testament in which the dying Christ placed his mother in the care of the beloved disciple, by which the disciple became her son. The second dimension of this statement is of theological significance and is the revelation of God’s design. It is the culminating moment of the revelation of God’s sonship: Jesus as Son of God bequeaths to his mother the beloved disciple. In turn, he entrusts his mother to the beloved disciple. Through this act of will, Jesus does not cease to be the only son of his mother. At the hour of his death, Christ calls forth a new family—God’s family. He dies as the Son of God because His Father is God. He also dies as the Son of Man, for He took humanity from His mother. He now establishes her as the mother of all His beloved disciples.

The fourth utterance of Jesus from the cross is recorded by St Matthew: My God, my God, why have you forsaken me? (Matt 27:46). The evangelist noted that it was the ninth hour of the day. On the day before Passover at this hour in the temple, the people of God slaughtered the Passover lambs. It is the hour of sacrifice and prayer. Jesus then cried out in a loud voice, literally: φωνῇ μεγάλῃ—with a great voice. This phrase in the Bible means the cry of the orant. Jesus’ great prayer is heard from the cross. Christ had been abandoned by the disciples, while the people who stand beneath the cross mocked Him. It can be said that He was also abandoned by His own people, who handed Him over to the Romans for crucifixion. He therefore cries out to God. The author of the Letter to the Hebrews records: he offered prayers and supplications with loud cries and tears to the one who was able to save him from death, and he was heard because of his reverence. Son though he was, he learned obedience from what he suffered; and when he was made perfect, he became the source of eternal salvation for all who obey him (Heb 5:7–9). Jesus, feeling abandoned by the people, cries out to God with full confidence, turning to Him: “My God.” This is a God who is very close and can be fully trusted. The words of the prayer taken from the psalm (Ps 22:2) are full of pain, a sense of abandonment, but also hope, which speaks from the further verses of the song.

Another, the fifth, statement of Jesus from the cross is recorded by St John. It is just: I thirst (John 19:28). The cry of the dying Christ is very powerful. At the end of his passion, he cries out “I thirst,” thus praying the words of the psalm: Instead they gave me poison for my food; and for my thirst they gave me vinegar (Ps 69, 22). This one phrase expresses the desire to live and to give the gift of life to those for whom He offers Himself. This thirst is of a personal nature, to which Jesus refers in this prayer. It is God who gives life. Jesus desires all this to happen so that those for whom He gave life might also have life and have it in abundance (cf. John 10:10).

The sixth statement also comes from the Gospel according to St John: It is finished (John 19:30). These words are like a seal put on the whole work of Jesus. He affirmed that everything the Father had commanded him had been accomplished. John portrays Christ as God and Lord. Even the scene on the cross is more reminiscent of sitting on a royal throne than of a terrible dying. Jesus is Lord, which is why He uttered the words ‘it is done,’ and then He Himself gave up the ghost and bowed His head. In John’s account, from the cross of Jesus flows the majesty of God who accomplishes man’s salvation. This expresses the truth that salvation was “accomplished” on the cross. The last words from the cross recorded by St Luke are similarly eloquent: Father, into your hands I commend my spirit (Luke 23:46). These words are taken from Ps 30:6 in the Septuagint version. It is a prayer of lamentation by a man who, being in a difficult situation in life, turns to God. He trusts God because only He can help him. At the moment of death, Jesus cites a prayer of complete trust in God. Luke records that after these words Christ gave up the ghost. Leaving aside the exegetical question which words of Jesus were actually spoken and which were woven into the account of the evangelists to give Jesus’ death salvific significance, the effort of the condemned man to say anything was medically overwhelming.

When the soldiers came to Golgotha again, they broke the shins of the two villains, and seeing that Jesus had already died, they only pierced his side with a spear, and then blood and water flowed from the wound (John 19:34). The blow thus inflicted left a mark measuring 3.4 × 1.4 cm at the level of the fifth and sixth ribs of the right side of the chest, at a distance of 13 cm from the sternum. It was inflicted with a broad stabbing instrument, probably one of the Roman spears. The Evangelist John, in his description of the crucifixion, does not specify whether it was the left or right side of the body. According to Roman custom, it was the right side, and the large amount of blood flowing out came from the filled cavities on the right side of the heart rather than from the thick-walled, shrunken left ventricle.

From a medical point of view, the question of whether water or blood flowed out first is difficult. Although John states that the blood flowed out first, this does not necessarily correspond to reality, since in the ancient Greek tradition the order of the words was rather due to their meaning.

The word ‘water’ can be understood as a serous fluid from the pleura or pericardial sac. Blood may have flowed from the right heart cavity or from the pericardial sac. Also, in the pleural cavity there could have been bloody fluid resulting from damage to the chest from the blows inflicted on Jesus with a stick (acute lung injury), as well as from the whipping that ruptured the skin, muscles, vessels and intercostal nerves, which also led to serious bone injuries.

Jesus died relatively quickly, between three and six hours after the crucifixion. The fact that he hung his head and died after a loud cry may suggest an additional sudden cause of death. There may have been a myocardial infarction with rupture of the left ventricular free wall and spillage of blood into the pericardial sac with secondary cardiac tamponade; however, this complication rarely occurs in the first few days of an infarction. Shock due to the loss of blood and body fluids, severe trauma and great physical suffering could also have been the cause of disseminated intravascular coagulation (DIC) with possible embolization of the coronary vessels of the heart by small thrombi and secondary myocardial infarction.

The literature also cites the toxic effects on the heart of high concentrations of catecholamines released due to excessively strong physical sensations and emotions as a possible cause of death. These substances in such concentrations damage the left ventricular muscle, lead to a dramatic decrease in ejection fraction, pulmonary oedema and cardiogenic shock. They also trigger fatal arrhythmias, including ventricular fibrillation.

Many factors contributed to Jesus’ death, while each of those mentioned above – post-traumatic, post-haemorrhagic and hypovolaemic shock; acute respiratory and circulatory failure, caused by severe penetrating chest injuries, with massive pneumonia and exudative fluid in the pleural cavities; suffocation from expiratory failure caused by crucifixion; myocardial infarction or dangerous cardiac arrhythmias—could have independently led to a rapid death.


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Sources of Images

1., 5., 7. Fragment of the exhibition “Who is the Man from the Shroud?” at the John Paul II Centre in Krakow. Collection and ownership of the Polish Syndonological Centre in Krakow

2., 3., 8., 12. Sindonology.org, Shroud Scope, http://www.sindonology.org/shroudScope/shroudScope.shtml (copyright: Roman Catholic Archdiocese of Turin; educational use)

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13. Wikimedia Commons, https://commons.wikimedia.org/wiki/File:Fra_Angelico_027.jpg (public domain)

Roman Bogacz

Professor of the Pontifical University of John Paul II (UPJPII), has been working since 1991 at the Faculty of Theology of the Pontifical Academy of Theology (now the Pontifical University of John Paul II in Krakow). Since 1994, lecturer in Sacred Scripture and Biblical Archaeology. Since 2008, Head of the Chair of Biblical Theology and Biblical Informatics at the Faculty of Theology of UPJPII. Vice-Dean of the Faculty of Theology at UPJPII from 2012 to 2019, Head of the Theology Department in 2019/2020. He specialises in the study of the Epistle to the Hebrews, biblical archaeology and theology, and in exploring the biblical environment. Since 1992, he has organised regular trips to the Middle East (Israel, Egypt, Jordan, Turkey, Greece) in the form of research expeditions for students (archaeology, biblical studies) and pilgrimages for religious, educational and cognitive purposes; he cooperates with ecclesiastical and secular travel and travel agencies. He holds licenses as a tour guide and spiritual animator for pilgrimages for Israel. Head of the Biblical Section of the Polish Theological Society, member of the Board of the Association of Polish Biblical Scholars and the Board of the Association of Tour Group Guides Gaudeamus.

Władysław Sinkiewicz

Graduate of the Faculty of Medicine at the Medical University of Gdańsk. Co-founder and first head of the Second Chair and Department of Cardiology at the University Hospital No. 2 in Bydgoszcz. Author of over 400 scientific publications and author or editor of nine monographs on bioethics. Member of the National Examination Committee of the Postgraduate Medical Education Center in the field of cardiology. Reviewer in four scientific journals and member of the Scientific Council of four scientific journals. Member of the European Society of Cardiology, the Polish Society of Cardiology, the Polish Society of Arterial Hypertension, the Polish Society of Internal Medicine, the Polish Brain Stroke Society and the Polish Society for Spiritual Care in Medicine. Associate of the Polish Syndonological Centre in Krakow. Co-founder of the Club of Catholic Intelligentsia in Bydgoszcz. Chairman of the Bioethics Committee of the Bydgoszcz Medical Chamber, chairman of the Ethics Team at University Hospital No. 2 in Bydgoszcz, and former chairman of the Kujawsko-Pomorskie Division of the Catholic Association of Polish Physicians.

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