Adam B. Johnson, MD
April 2, 2014
Review Christ’s dual natures
Discuss the events preceding Christ’s death
Explain the major hypothesized mechanisms of
Christ’s death
Pulmonary Embolism
“Broken Heart”
Suspension trauma
Fatal stab wound
Review Christ’s dual natures
Learning about the physiologic mechanisms
of death can be troubling to some. This is
arguably even more distressing when talked
about in the context of Jesus Christ.
I will include medical terms but strive to
explain the medical jargon used.
Please stop me at any point during the
presentation with questions you may have.
Fully Man
 Gal. 4:4 “But when the fullness of time had come, God
sent forth his son, born of a woman, born under the law.”
 John 1:14 “The Word became flesh and made his dwelling
among us…”
 John 4:6 “…so Jesus, wearied as he was from his journey…”
Fully God
 Titus 2:13 “waiting for our blessed hope, the appearing of
the glory of our great God and Savior, Jesus Christ.”
 John 1:14 “…We have seen his glory, the glory of the one
and only Son, who came from the Father, full of grace and
As man, He was able to die a human death
 Mark 15:37 “And Jesus uttered a loud cry and breathed
his last.”
As God, only Jesus himself could actually take his
 John 10:17-18 ”For this reason the Father loves me,
because I lay down my life so that I may take it again.
No one has taken it away from me, but I lay it down
on my own initiative. I have authority to lay it down,
and I have authority to take it up again.”
Emotional, Spiritual, and Physical Stress
leading up to the Crucifixion:
 Hematidrosis – phenomenon seen during times of
immense stress, when sweat gland capillaries
break, leading to the sweating of blood.
▪ Luke 22:44 “And being in agony, He was praying very
fervently; and his sweat became like drops of blood…”
Scourging – beatings at the hands of Roman
soldiers consisted of the victim being tied to
an upright post, stripped of his clothes, and
repeatedly hit with strands of leather
embedded with pieces of metal and bone.
Crown of thorns
 Both events likely produced marked blood loss.
 The blood loss coupled with lack of food, water,
and sleep left Jesus in a critically weakened, preshock, hypovolemic state.
Seven major proposed hypotheses:
 Pulmonary Embolism
 “Broken Heart”
 Suspension Trauma
 Suffocation
 Fatal Stab Wound
 Shock
 Trauma-Induced Coagulopathy
PE refers to a blockage within
an artery supplying blood to
the lungs.
Symptoms include: chest pain,
difficulty breathing, poor
oxygenation, and possibly
Three factors predispose
someone to blood clots and
possible PE (Virchow’s Triad):
 Injury to the blood vessels
 Increased blood clotting
 Poor blood flow
Proponents of this hypothesis note that there
are some genetic conditions within the Jewish
population that predispose to increased blood
 In addition, impaired blood flow while hanging
on a cross and vascular injury from the events
preceding the crucifixion, may have predisposed
Jesus for a PE.
 If Jesus’ body was in a state of DIC
(Disseminated Intravascular Coagulation), he
may have been bleeding in some parts of the
body, but forming blood clots in others.
An argument against the Pulmonary
Embolism hypothesis is Jesus was not truly
immobilized on the cross.
In addition, because of genetic drift over the
past 2000 years, the current disorders may
have been quite different in Jesus’ day.
Others note that Jesus may have been more
likely to bleed, given the state of shock, as
opposed to forming blood clots.
Term refers to Cardiac Rupture.
Usually happens after a large myocardial
infarction (heart attack), weakening the heart
Death usually occurs quickly.
An argument against the Cardiac Rupture
hypothesis is that the beatings leading up to
the crucifixion, rather than the crucifixion
itself, would have been most likely to produce
a cardiac rupture.
With prolonged suspension,
blood tends to pool in the legs.
 In someone who is already
dehydrated, suspension can
cause blood return to the heart
to decrease.
 If blood return decreases, by
rule, the blood outflow to the
vital organs will decrease. What
goes in must come out.
 This phenomenon is an extreme
form of the feeling of dizziness
and near passing out in a person
who suddenly stands up after a
period of lying down.
An argument against the Suspension Trauma
hypothesis is that Jesus had his feet nailed to
the cross, and therefore, was not truly
suspended by the upper half of his body.
In addition, volunteer re-enactments of
people suspended to a cross did not produce
a phenomenon of suspension trauma.
Literally the inability to breathe.
When suspended by the arms/hands,
breathing becomes more and more difficult
due to the muscle strength it takes to expand
the chest.
In addition, there was excruciating pain with
each breath because the body would have to
be lifted up by either the hands or pushed up
by the feet. The nails, piercing the nerves of
the hands and feet would cause waves of pain
with each and every movement of the body.
Suffocation was seen in Nazi concentration
camp victims, who during torture of being
suspended only by their hands, usually died in
approximately 3 hours.
An argument against the Suffocation
hypothesis is that many victims of crucifixion
would stay alive for days on the cross without
The practice of Crurifracture, or breaking of both
legs, would hasten suffocation because the body
would then be supported only by the arms. We
do not have any indication that Jesus had his
legs broken.
 John 19:33-34 “ But coming to Jesus, when they saw
that He was already dead, they did not break his
If suffocation was the primary means by which
Christ died, he should have died sooner than the
approximate 6 hours he was on the cross.
John 19:33-34 “But
when they came to
Jesus and found that
He was already dead,
they did not break his
legs. Instead, one of
the soldiers pierced
Jesus’ side with a
spear, bringing a
sudden flow of blood
and water.”
The flow of water is likely related the spear’s
piercing of the lung, and the presence of a
pleural effusion, an accumulation of fluid
between the lining of the lung.
The presence of a pleural effusion was likely
given the beatings and blunt trauma leading
up to the crucifixion.
The flow of blood is likely related to the
spear’s piercing of the heart.
An arguments against this hypothesis is that
the Roman centurions were well-trained, and
would not make the mistake of thinking
someone was still alive when thrusting the
spear into the victim’s side.
The Biblical text infers that Christ was already
dead when this event happened, and was
therefore not the inciting event.
Defined as inadequate delivery of oxygen to the
body’s tissues and organs, usually from a relative
inadequacy of blood flow.
 Several different types of Shock:
 Hypovolemic
 Cardiogenic
 Distributive
With inadequate delivery of blood and oxygen, the
body cannot perform normal metabolism, and death
occurs first on a cellular level. This produces acid and
toxic break-down products. Complete organ damage,
and death, will ensue if shock goes untreated.
In states of shock, the body can attempt to
compensate for the excess acid levels
through hyperventilation. However, with
crucifixion, Jesus’ respirations and hence,
compensatory mechanism, would have been
With the events leading up to the crucifixion,
there is little doubt that Jesus’ body was likely
in hypovolemic shock.
Coagulopathy refers to a state in which the
body’s ability to form blood clots is impaired.
 Trauma-induced Coagulopathy is also referred to
as Acute Trauma Coagulopathy (ATC).
 The mechanism of ATC is related to increased
activation of Protein-C, an anti-thrombotic
protein after extensive trauma.
 When several factors are present: shock, internal
injury, hypothermia, and acid build-up in the
blood, ATC is more likely to occur.
Even with modern medicine, when Traumainduced coagulopathy is present, the
mortality rates can be 60% or greater.
Proponents of the coagulopathy argument
note that as Jesus’ side was pierced, he bled,
even though he had already died.
Seven proposed hypotheses:
 Pulmonary Embolism
 “Broken Heart”
 Suspension Trauma
 Suffocation
 Fatal Stab Wound
 Shock
 Trauma-Induced Coagulopathy
Raised from the dead
 Rom. 6:4 “…just as
Christ was raised from
the dead through the
glory of the Father…”
 Rom. 8:34 “Christ Jesus
who died—more than
that, who was raised to
life—is at the right hand
of God and is also
interceding for us.”
Will return again
 Heb. 9:28 “so Christ was sacrificed once to take
away the sins of many; and he will appear a
second time, not to bear sin, but to bring salvation
to those who are waiting for him.”
Bergeron, J.W. The crucifixion of Jesus: review of hypothesized
mechanisms of death and implications of shock and traumainduced coagulopathy. Journal of Forensic and Legal Medicine.
2012. Vol 19, Issue 3, P 113-116
Edwards, W.D., Gabel W.J., Hosmer F.E. On the Physical Death of
Jesus Christ. JAMA. 1986. Vol 255, No. 11, P1455-1463
Terasaka D. Medical Aspects of the Crucifixion of Jesus Christ.
Davis C. T. A Physician’s View of the Crucifixion of Jesus Christ. (The Christian Broadcast Network)
Cohen, M and Kutcher M. Coagulopathy associated with Trauma.

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