How Would the Crucifixion Event be Described Medically

It’s invaluable to recognize the horrors and shame that Jesus Christ willingly submitted to in an effort to somewhat comprehend the depth of His unmatched love for us. Although crucifixion was generally practiced in ancient societies, it’s a familiar idea to the modern mind, so many do not truly consider the physical realities of it. Crucifixion is the most severe and agonizing forms of sanctioned execution that has ever existed. The punishment was so torturous that the Romans found it necessary to create a new term to describe it. The Latin word excruciare meant to thoroughly cause pain/ anguish/ torment and included the root word crucis that meant cross. The modern word excruciating is derived from excruciare that was used to characterize the intense experience of those who were crucified.

The Biblical narrative provides the most detailed account of any one crucifixion. The suffering of Jesus Christ actually started the night before His crucifixion in the Garden of Gethsemane where "being in agony He prayed more earnestly, and His sweat was as great drops of blood falling to the ground” (Luke 22:44). The notion that someone could sweat blood does not seem possible, but there is a rare condition called hematohidrosis where the capillary blood vessels that feed the sweat glands can rupture and express blood. The condition is usually the result of extreme physical or emotional stress. The Son of God knew exactly what He would be facing in the ensuing hours as He prayed, “Father, if you be willing, remove this cup from me: nevertheless not my will, but yours be done” (Luke 22:42). A short time later, He was arrested, fearfully forsaken by His followers, and taken to the High Priest Caiaphas where the chief priests and elders were assembled for questioning. During the inquisition, Jesus was “blindfolded” (Luke 22:64), “spit upon His face and struck” (Matthew 26:67). Some disfigurement of the face would certainly have resulted from the harsh treatment and the inability to anticipate blows.

Christ was then brought to Pontius Pilate who was the Roman prefect of the Judean province after a restless trial that has lasted though the night. Pilate could find nothing that warranted execution, so he "took Jesus and scourged Him” (John 19:1). The Roman soldiers began the process of scourging, which typically involved a short whip called a flagrum that included several leather thongs 18-24 inches long with bits of metal, bone, or glass embedded into the leather. The clothing was stripped and His hands were tied to a post. The whip was brought down with full force repeatedly across the shoulders, back, and legs. The weighted thongs would have produced lacerations and deep contusions (bruising) that would have broken open with subsequent blows. Initially, the layers of skin would have been affected producing an oozing of blood from the broken capillaries, but as the lashings cut into the darker subcutaneous tissue a dark venous blood would start to flow freely. Finally, the skin on His back would have been hanging in long ribbons where the underlying muscle and skeletal structures were exposed. The whole area would have been an unrecognizable mass of torn and bleeding flesh. Scourging was an extreme form of punishment where the victim suffered considerable pain and hemorrhaging. Some even died from the process, but the Roman tormentors were experts at determining when a person was near death, so the beatings would stop. Furthermore, the Romans saw a great joke in a provincial Jew claiming to be a king, so “they stripped Him and put on Him a scarlet robe; and when they had platted a crown of thorns, they put it upon His head, and a reed in his right hand: and they bowed the knee before Him and mocked Him, saying, Hail, King of the Jews” (Matthew 27:28-29). Once they were finished mocking Him, they “took the reed and struck Him on the head” (Matthew 27:30) and “struck Him with their hands” (John 19:3). It’s possible that the eyelids would have swollen shut and there were other areas of facial edema (swelling) due to trauma induced subcutaneous hematomas, which are abnormal collections of blood outside the blood vessels and under the skin. The crown would have pressed into the scalp through the layers of skin and being struck with the reed would have driven the thorns even deeper causing acute pain and profuse bleeding due to the significant vascularity of the area. It’s also highly probable that He sustained a concussion and possibly a skull fracture from the blunt force trauma of the reed, which would have caused hemorrhaging in the space surrounding the brain and increasing intracranial pressure while compressing the brain tissue, leading to oppressive headaches and vomiting.

Jesus was then brought back to Pilate where he pushed for release, but the mob was unrelenting. To appease the crowd and quell any possible rioting “he delivered Him over to them to be crucified” (John 19:16). As the soldiers led Him away, they “mocked Him and took off the robe from Him” (Mark 15:20). The garment would have assuredly become adherent to the blood and serum of the wounds, so the removal would have caused sharp pain much like the careless removal of a surgical bandage. The combination of the beatings and the scourging alone would have stimulated an irreversible process of hypovolemic shock and cardio-respiratory failure, but the brutality continued. It was customary for the condemned to carry the crossbar, called a patibulum, on their shoulders with their outstretched arms tied to the wood. The weight of the patibulum was approximately 75 – 125 pounds and the prisoners were expected to carry it to the site of crucifixion outside the city walls; that would have been a 650-yard journey in Jerusalem. The rough wood of the beam surely gouged into the lacerated skin and muscle of Christ’s back and shoulders creating constant agony for the distance that He was able to bear it, before being overtaken by severe blood loss, dehydration, and total muscular exhaustion. At that point, a man named Simon was then “compelled to bear His cross” (Matthew 27:32). Permanently located outside the city walls were the heavy upright posts where the patibulum would be secured, called stipes. When they arrived at the site, Jesus would have been placed on His back with outstretched arms, and nails driven into His wrists. The nails were about 7” – 9” long with a square shaft measuring 3/8” and their placement would have been where the bones of the forearm (radius and ulna) meet the small carpal bones of the hand because only the ligaments and bone would have been able to hold the body upon the cross. The thrusting of the nails would have immediately severed the large medial nerve running to the hand and produced tormenting bolts of fiery pain across the arms that would not subside, as well as possible contracture of the hands into a claw-like grasp. The patibulum was then lifted onto the stipes and most commonly the feet were fixed to the front of the stipes with flexion at the knees of about 45° and one foot pressed backwards against the other in a toes down position. One iron nail would have been hammered through the arches of His feet between the navicular and cuneiform bones, and piercing the deep peroneal nerve as well as branches of the medial and plantar nerves, causing extreme shocks of torturous pain up the legs that would remain constant.

The major effect of crucifixion beyond the unbearable pain was an acute interference with normal respiration. The weight of the Christ’s body pulling down on His arms would have created dislocations at the shoulders, elbows, and wrists elongating the arms approximately 6” – 9” and transferring the weight to the chest. The intercostal muscles of the chest would have remained stretched in a fixed state of inhalation thereby hindering passive exhalation. Consequently, He would have been forced to agonizingly push off His pinned feet and nerves just to move up far enough to exhale. The onset of powerful muscle cramps and spasms throughout the body from dehydration and fatigue would add further difficulty. As time progressed, the ability to endure such a cycle would diminish and set in motion a series of catastrophic physiological effects. During respiration the lungs release carbon dioxide from the body and exchange it for oxygen that is needed for normal cellular function. The inability to maintain adequate ventilation would cause the blood oxygen levels to decrease while causing the carbon dioxide levels to increase, stimulating the heart to beat faster in an attempt to push more oxygen to the cells. Gradually the lungs would begin to collapse in areas leading to hypoxia, which is a lack of adequate oxygen perfusion in the tissues. The strain on the heart would escalate and it would beat even faster to compensate, but it would not take long for the heart to begin failing due to the blood loss sustained throughout the entire process. Within hours the coalescence of collapsing lungs, a failing heart, and a lack of blood volume would prove to be fatal. Other possible contributing factors include dehydration, stress induced irregular heartbeats called arrhythmias, congestive heart failure which is the impairment of the heart to pump adequately, and the rapid buildup of fluid in the lungs or heart called pleural effusion and pericardial effusion respectively. Although the cascade of events would eventually lead to death, that moment did not arrive until Jesus Christ was willing to give up His life. As it’s recorded in Luke 23:46, “Father, into your hands I commend my spirit; and having said this, He gave up the ghost”. To confirm the death, “one of the soldiers pierced His side with a spear, and at once there came out blood and water” (John 19:34).

The very Son of God suffered limitless waves of severe injury, hours of excruciating pain, and perpetual cycles of asphyxiation, yet through it all His perfect love radiated as He said, “Father, forgive them, for they know not what they do” (Luke 23:34). He chose to do it all for them…..He chose to do it all for us. That is a love that cannot be defined, only experienced.

“His appearance was so disfigured beyond that of any human being, and His form marred beyond human likeness”

Isaiah 52:14