It is commonly taught that the victim of crucifixion would die from asphyxiation.  Many of those crucified would live three or more days before their neck muscles would no longer be able to support the 12 lbs (5.5 kg) weight of their head.  Airway obstruction subsequently would set in and the victim would suffocate to death.

Such a patho-physiologic event is sometimes ascribed to the death of Jesus.

However, biblical narrative and medical correlation would indicate that Jesus’s cause of death was multifactorial, and that He died suddenly from an acute internal event and not suffocation.

But first let us review some of Christ’s stresses and injuries that set up his unusually quick death on the cross.

1. Less than 18 hours before his death, the physician and evangelist Luke tells us that Jesus was in extreme physical and psychological anguish: “being in an agony, He prayed more earnestly; and His sweat became like great drops of blood.” (Luke 22:44)  Luke may be referring to the phenomenon of hemohydrosis where sweat glands may bleed under extreme stress, just like in the case of coagulation disorders.  This may be indicative of the extreme level of stress the Savior was under as He was approaching the time of God’s wrath being poured on Him.

2. Jesus probably walked 2-3 miles between various places (trials and questioning) in the 12 hours prior to crucifixion, likely without hydration.

3. Jesus received blows to the face and His body as part of being mocked (Luke 22:63-65).

4. Friday morning before being delivered to be crucified, Jesus was severely flogged (John 19:1). This was a Roman judicial penalty where the victim was beat with a multi-lashed whip containing embedded pieces of bone and metal.  As the blows landed on Jesus’s back and thighs, the whip ripped into skin, subcutaneous tissue and muscle, tearing blood vessels and nerves in the process.  This particular event weakened the Savior tremendously due to blood loss and severe pain.  Exposing His tissues on a cold early morning also initiated hypothermia which led to coagulation defects and further loss of blood.

5. The severe beating and blood loss likely led to orthostatic hypotension (low blood pressure when standing) as Jesus was unable to carry the crossbar of the cross (75-100 lbs) and was forced to walk or perhaps drag Himself on Via Dolorosa.

6. At this point, even before crucifixion, Jesus was in critical medical condition.  An older man with medical issues would have died by now.  Even by modern medical standards, a 33-year-old healthy man would likely have to be taken to the operating room for wound debriment, tissue reconstruction, fluid resuscitation, warming, and blood transfusion.  All this followed by a long recovery in the intensive care unit with possible complications of infection and kidney failure.

Up to this point Jesus suffered severe trauma and was in dire need of resuscitation.  In this critical state He is delivered up for crucifixion.

It was the custom for nails to be driven in the hands (wrists) and legs of the victim during crucifixion which compounded blood loss.  In the case of Jesus, the hemorrhage became critical as His wounded back was pressing and rubbing against the tree.  As a trauma victim who sustained significant hemorrhage, Jesus became very thirsty and cried: “I thirst.”  They offered Him an analgesic consisting of wine and myrrh, but He refused.

This brings us to the climatic event.  What exactly caused Jesus’s death?

Biblical narrative demonstrates that Jesus had a sudden death, and not a prolonged period of suffocation as was the case in most crucifixions.  All four Gospels present Jesus as crying out with a loud voice (in the case of John, He says: “It is finished”) and immediately dies.  This is unlikely to be a death from asphyxiation.

There is no evidence in the narrative of the Gospels that in the short time Jesus was on the cross (less than 6 hours) He was suffocating.  On the contrary, despite His weakened state, we see Him conversing with various people while on the cross.  This is strong evidence that He was able to maintain a patent airway up until His last breath!

It is more likely that Jesus died of a sudden internal catastrophe. The highest ranking possibility is a lethal arrhythmia (abnormal heart rhythm) potentially caused by electrolyte disturbances from severe dehydration and hemorrhage.

Others have postulated a tension hemothorax (accumulation of blood around one lung) which led to an acute drop in blood pressure and immediate death.  This diagnosis may be supported by the blood that flowed from the Savior’s side after His spearing.  Red blood flowed from His side (settled red cells), followed by serum (clear fluid that may look like water) which is found at the top of any settled blood sample that does not circulate.

Other possibilities include a trauma-induced tear in one of the atria of the heart leading to cardiac tamponade (blood around the heart), or perhaps a sudden pneumothorax (dropped lung).

All of the above descriptions would correlate well with the Gospel accounts of a sudden death after what appeared to be a loud statement by Jesus.  A prolonged dying process by suffocation can thus almost be ruled out.

Whatever the exact pathologic event was that caused the Savior to give His last breath, one thing remains certain.

He died with certainty.

And this is important because His death made His resurrection a truly miraculous event, the greatest event in the history of the universe to date!

For a JAMA article on the scourging and crucifixion of Jesus, click here