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To help us understand the injury from the nails, Dr. Barbet experimented with cadavers. He estimated Christ’s weight to be approximately 160 pounds.  But, His body sagged with the arms forming an angle of 65 degrees.  From the physics of vectors, it can be shown that the force exerted on each nail was not what we might expect (half of 160 pounds or 80 pounds). Because of the oblique angle of the arms, there were approximately 209 pounds of force exerted on each nail. In experiments, Barbet showed that a nail through the palm of the hand, as depicted by many artists, could not support the force.  The nail would tear through the skin very quickly, and probably tear off part of the hand.  But, the Roman guards were very skilled at performing a Crucifixion.  They had done this hundreds of times before.  We believe both from his experiments and from the Shroud of Turin, that the nails were skillfully passed through the wrist between the eight carpal bones.  The nails penetrated Destot’s space and were supported by the transverse carpal ligament. 

Although this location would not result in significant bleeding, it did result in a significant injury and possibly partial transection of the Median Nerve in the wrist.  This large nerve trunk supplies motor function to the thumb, causing it to flex.  It is also a major sensory nerve to the first three fingers.  Injury to the nerve would result in excruciating pain known as Causalgia.  Patients who have experienced such a critical injury have considered suicide for relief.

The nails in the feet are thought to have penetrated the second intermetatarsal space. No major vessels were injured by this placement, although it is likely the Peroneal Nerve and the Plantar Nerves, which supply sensation to the bottom of the foot, would be pierced by the nail.

When we observe pictures of Christ on the cross, or watch Mel Gibson’s movie, “The Passion of the Christ,” we are lulled into the assumption that Christ simply hung in one position for 3 long hours.  Nothing could be further from the truth.  Death by Crucifixion was a gruesome, morbid torture that involved asphyxiation or suffocation. We all have a major muscle below our lungs called the diaphragm.  In order to breathe in, this muscle contracts expanding the chest cavity.  This function is aided by the accessory muscles of respiration, the pectoralis major and the intercostal muscles.  When these muscles contract, our chest cavity expands and we inspire.  Then to expire, the muscles simply relax and our chest cavity compresses.

But when Christ hung down on the cross, He had no difficulty breathing in.  He just couldn’t breathe out.  So after He was lifted up, His respirations became more shallow. He turned blue from cyanosis. In order to keep from passing out, He pulled on the nails in His hands and pushed on the nails in His feet.  This allowed Him to raise up to a higher position, dropping His arms to a lower position.  He was able to take a few normal breaths.  Then He was  overcome by the pain of the nails and dropped back to a lower position.  So for three long hours, Jesus was involved with dynamic, exhausting up-and-down movements.  And each time He moved, the open wounds across His shoulders and back, created by the scourging, were scraped across the splinters in the raw wood.

After the exquisite pain of the nails being driven into His body had dulled somewhat, the muscles of His arms tightened with contractions that became more and more violent.  For 3 long hours, He experienced waves of cramps throughout most of the muscles of His body.  We have all awakened in the night and experienced the acute pain in the calves of our legs from a cramp. We have felt the intense burning pain and the need to relax the muscles and stretch in order to alleviate the pain.  Jesus suffered from tetany, a horrible series of muscle spasms without relief.  Occasionally, the muscles of His neck would spasm, throwing His head backward, driving the thorns from the crown more deeply into His sacred scalp.

People often ask, “What was the cause of Jesus’ death on the cross?”  We really don’t for certain; many theories have been offered.  Although we believe that Christ was in good health, His extreme suffering and severe pain could have brought about a sudden, catastrophic heart attack.  He could have suffered from a cardiac arrhythmia or arrest.  He may have developed blood clots in the calves of His legs early on.  If these clots migrate to the lungs, they cause a pulmonary embolus, which would shut off the respirations.  This is one of the common causes of death in older people in the hospital.

There is another interesting theory.  If Christ had suffered a heart attack early on, blood supply to a portion of the heart would have been blocked.  As a result, a portion the heart muscle would die and the area would become soft or mushy.  With continued torture, it is possible that the heart muscle could have been torn open.  Doctors would refer to this as a ruptured heart; lay people would call this a “broken heart.”  Christ would have experienced bleeding into the sac that surrounds the heart, the pericardium.  He would have died from internal hemorrhage.
There is no question that Jesus experienced shock.  Shock represents inadequate blood flow, depriving vital tissues of oxygen and nutrients.  When this develops, a patient becomes weakened and nauseated.  He vomits. He lapses into unconsciousness or coma and slowly dies.  There are three principal forms of shock.  Traumatic shock results from tissue injury and pain.  Hypovolemic shock results from diminished circulating fluid volume, due to bleeding and dehydration.  Cardiogenic shock develops when the heart is no longer strong enough to pump blood under sufficient pressure to vital organs.  Breathing would become more labored as the lungs fill with fluid (congestive heart failure).  In my opinion as a surgeon, shock was the ultimate cause of Christ’s death on the cross.


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