by Larry H. Lytle, MD “Jesus replied, ‘The hour has come for the Son of Man to be glorified.'”
-John 12:23

It is difficult to have proper gratitude, appreciation and thankfulness for Jesus’ sacrifice without knowing the price that was paid for our salvation. Understanding the death of Jesus is also the key that unlocks our understanding of the character of God. God’s love, God’s holiness, God’s righteousness, God’s justice and God’s judgment are clearly revealed and confirmed by Jesus’ death and resurrection. The reason God cannot “grade on a curve” or accept man’s attempts at reconciliation becomes clear at the cross.

In Mark 14, Jesus asked His disciples to wait and pray while he found privacy to seek the Father in prayer. A critical moment having eternal ramifications was at hand. He began to be troubled, “…’My soul is overwhelmed with sorrow to the point of death…Father,’ he said, ‘everything is possible for you. Take this cup from me. Yet not what I will, but what you will'” (Mark 14:33-36). An angel appeared in order to comfort and strengthen Him. “And being in anguish, he prayed more earnestly, and his sweat was like drops of blood falling to the ground” (Luke 22:44).

Hematohidrosis is a rare disorder characterized by the secretion of blood from intact skin often in association with extreme stress or anxiety. In an attempt to explain the physiological determinants, several mechanisms have been proposed. Most medical explanations involve the sympathetic/parasympathetic nervous system interplay with resulting alterations of constriction and dilatation of blood vessels surrounding the sweat glands. The most significant commonality in all the medically reported cases is the association with extreme mental anguish. Jesus had a full comprehension of the severity of the upcoming scourging and crucifixion. In addition, he had the added mental, psychological and emotional agony, combined with the spiritual burden, of knowing He was to shortly become the focused sin-penalty for the full panoply of humankind’s sin and unrighteousness. Jesus knew that God the Father will soon do something never done before-the Father was going to turn His back on Jesus.

After intense scourging, multiple beatings and trauma to His head from thorns, Jesus was led to Calvary for execution. After an agonizing, brutal, cruel, degrading and excruciating death, the soldiers came to Jesus and, upon finding him dead, thrusted a spear into his side for confirmation. This added traumatic injury left nothing to chance. Greek word order can follow importance rather than strict chronology. Seeing blood would be important in a Jewish context of animal sacrifices, whereas water would be less important. It is likely that the “water” flowed first, representing fluid (effusion) from traumatically induced water in the lung lining as a result of the severity of the scourging and possibly blunt chest trauma from falling on the road to Calvary. The effusion itself could have caused Jesus to have chest pain and shortness of breath. The ensuing blood was likely intra-chamber cardiac blood.

In 1968, archaeologist V. Tzaferis excavated a site near Jerusalem called Giv’at ha-Mivtar where a tomb was uncovered. It contained the bones of a man, estimated to be 26 years old, who had died from Roman crucifixion. The bones were found in an ossuary or bone box, that had the victim’s name, Jehohanan, inscribed several times.[2] Examination showed that each one of his feet had been nailed to the cross separately and laterally, through the heel bone, and not the front of the foot. There was a nail hole, but no nail, found in the left heel bone. In the right heel bone, a nail was found with the tip bent presumably from hitting a knot in the wood making it impossible to remove the nail without removing the foot, the nail and a piece of wood from the cross all together. There was an indentation on the right radius of the forearm suggesting a nail injury, although this was interpreted differently by later investigators. Also, the bones in the lower legs, both tibia and fibula, had been fractured.

Genesis 3:15 says, “And I will put enmity between you and the woman, and between your offspring and hers; he will crush your head, and you will strike his heel.” We now have evidence in this finding of the nail penetrating the heel bone, as to allow for a literal interpretation in addition to the traditional metaphorical one. Few, if any, of the observers would realize that each blow or strike from the hammer represented Satan’s accomplishment and direct fulfillment of prophecy. To the disciples, at the time, it would have appeared hopeless. Within three days, however, the entire passage would be fulfilled. Jesus’ faithfulness, obedience and resurrection crushed Satan’s head!

Prior to His death, Jesus said, “…I lay down my life-only to take it up again. No one takes it from me, but I lay it down of my own accord…” (John 10:17-18). And John 19:30 says, “…Jesus said, ‘It is finished.’ With that, he bowed his head and gave up his spirit.” In Matthew 27:50, it says, “And when Jesus had cried out again in a loud voice, he gave up his spirit.”

These verses taken together can be interpreted as either prescriptivistic or descriptivistic. If prescriptivistic, then Jesus made a conscious decision. He determined volitionally to end His life at a certain point when He felt that it was finished (be it pain and suffering finished, or redemption complete, or both). Jesus could say to the Father, “into your hands I entrust my spirit” (Luke 23:46, NASB), because He was supernaturally releasing His spirit and determining the exact timing of His death.

If descriptivistic, however, the utterances describe what Jesus felt in that moment. He sensed and knew that something catastrophic was occurring internally. Something that felt like death was imminent, and the reason he might have known this could be explained by the phenomenon of impending doom. This phenomenon can occur in individuals immediately prior to death in certain clinical situations, including heart arrhythmias and heart attacks. Jesus was fully man and fully God, but He chose to voluntarily limit and not use His powers of deity outside of what was clearly the direct will of the Father. This voluntary and temporary non-use of, or limitation of, divine power is described in the second chapter of Philippians as an emptying of Himself by assuming the form of a slave and taking on the likeness of men. His life showed that He never used his special power of deity to tend to his own pain, personal gain, comfort, convenience or safety, but rather He used it for teaching others, showing compassion and obeying the Father. Therefore, a natural process of death where Jesus sensed the end but didn’t interfere to define the moment of death seems reasonable. Jesus didn’t make the decision as to when the full price of the sin penalty was paid, but rather He deferred to the Father. Jesus spent His entire life deferring to the will of the Father, and the decision concerning the exact moment of his death was likely included in that spectrum.

Numerous healthcare professionals have offered explanations as to the actual cause of Jesus’ death. They include the following: cardiac rupture, cardiac tamponade, myocardial infarction, exhaustion asphyxia, hypovolemic shock, non-hemorrhagic shock, traumatic shock, pulmonary embolism, coagulopathy, acidosis and electrolyte imbalance. Lloyd Davies, among others, has advanced the idea that Jesus did not actually die on the cross.[3] What all the “swoon theories” seem to have in common, though, is a penchant for historical revisionism, a vivid imagination and unrestrained medical speculation.

It is clear Jesus had no loss of consciousness but rather retained full mentation and cognition up to the point of death. This would be highly unlikely in either exhaustion asphyxia or severe hypovolemic shock as a cause of death where mental obtundation prior to death is the rule. He likely experienced a sense of impending doom a few seconds or minutes before His death, allowing Him to cry out and make several brief statements. A consideration of all the data points in Jesus’ death would suggest He died of a sudden acute cardiac event (probably ventricular tachycardia) in the face of severe trauma complicated by physical exhaustion (but not exhaustion asphyxia) and hypovolemia (but not severe shock.)

Conclusion
Jesus’ faithfulness is the evidence of EASTER. Enormous price paid!
Atonement accomplished!
Salvation secured!
The value of the gift-indescribable!
Eternal blessings!
Resurrection certain! Table 1
A representative selection of medical hypotheses for the cause of death of Jesus, or crucifixion in general.

About the Author
Larry H. Lytle, MD, is a graduate of the Ohio State College of Medicine. He completed his internal medicine residency at Riverside Methodist Hospital in Columbus, Ohio. He is the founder of Worthington Medical Center and has served as the area director for the Columbus/Central Ohio chapter of CMDA.

[1] Hengel, Martin Crucifixion in the Ancient World and the Folly of the Message of the Cross. London and Fortress Press, 1977

[2] Hass, N. “Anthropological Observations on the Skeletal Remains from Giv’at ha-Mitvar.” Israel Exploration Journal 20 (1970), 38-59

1991 Apr;25(2):163-170