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Weanne Myrrh. 20. Filipina Seventh-day Adventist.

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Sunday, November 1
Pathophysiology of the Cross

Nursing student, this is for you. Yes, you - someone who has spent countless hours in case conference classes, dissecting the intricacies of diseases. You - someone like me who spends 70% of my waking hours memorizing signs, symptoms, physiologies and pathophysiologies while I unwittingly neglect the Creator Himself. Someone who watches out for signs and symptoms of hypovolemic shock yet forgets the blood spilled out on Calvary. Someone who winces over the mere mention of Grade IV bed sores but cares not for nail scarred hands. You, yes you. This is for you.

Yes, I know, this note is quite long. But pardon me. If you can make it through four hours of your classmate's monotonous mumbling while you enter a "hypoglycemic hypoosmolar" nonketotic coma in casecon class, then you can make it through the ten minutes it will take you to read this. And maybe, just maybe, the sacrifice on Calvary might mean so much more.

(facts taken from thecrucifixion.org)

The Roman legionnaire stepped forward with the flagrum, or flagellum, in his hand. This was a short whip consisting of several heavy, leather thongs with two small balls of lead attached near the ends of each. As the flogging continued, the lacerations would tear into the underlying skeletal muscles and produce quivering ribbons of bleeding flesh. Pain and blood loss generally set the stage for circulatory shock.

During the scourging, there is "first an oozing of blood from the capillaries and veins...finally spurting arterial bleeding from vessels in the underlying muscles. As for Jesus' specific case, he probably had one of the most severe that was possible by Jewish law. As for the crown of thorns that he bore, it was not simply a few briars. The mocking crown of thorns "had thorns up to six inches long."

The scourging prior to crucifixion served to weaken the condemned man and, if blood loss was considerable, to produce orthostatic hypotension and even hypovolemic shock. When the victim was thrown to the ground on his back, in preparation for transfixion of the hands, his scourging wounds most likely would become torn open again and contaminated with dirt. Furthermore, with each respiration, the painful scourging wounds would be scraped against the rough wood of the stipes. As a result, blood loss from the back probably would continue throughout the crucifixion ordeal. Likewise, after the scourging, "when the soldiers tore the robe from Jesus' back, they probably reopened the scourging wounds" (Edwards, Gabel, Hosmer Par. 14). Thus, "even before the actual crucifixion, Jesus' physical condition was at least serious and possibly critical."


The Via Delarosa is by no means characterized by having a man carry a little board of wood as used on a building. It is reported that the "weight of the entire cross was probably well over 300 lb. (136 kg), only the crossbar was carried" (Edwards, Gabel, Hosmer). In spite of Jesus' efforts to walk erect, the weight of the heavy wooden beam, together with the shock produced by copious loss of blood, was too much. He stumbled and fell. The rough wood of the beam gouged into the lacerate skin and muscles of the shoulders. He tried to rise, but human muscles had been pushed beyond their endurance. After that point of Jesus falling, Simon of Cyrene had to carry the heavy cross the rest of 650 yards to Golgotha.


With arms outstretched but not taut, the wrists were nailed to the patibulum. It has been shown that the ligaments and bones of the wrist can support the weight of a body hanging from them, but the palms cannot. Accordingly, the iron spikes probably were driven between the radius and the carpals or between the two rows of carpal bones, either proximal to or through the strong bandlike flexor retinaeulum and the various interearpal ligaments. Although a nail in either location in the wrist might pass between the bony elements and thereby produce no fractures, the likelihood of painful periosteal injury would seem great. Furthermore, the driven nail would crush or sever the rather large sensorimotor median nerve. The stimulated nerve would produce excruciating bolts of fiery pain in both arms. Although the severed median nerve would result in paralysis of a portion of the hand, isehemie contractures and impalement of various ligaments by the iron spike might produce a clawlike grasp.

The nails in the wrists were putting pressure on the median nerve, large nerve trunks which traverse the mid-wrist and hand. As He pushed Himself upward to avoid this stretching torment, He placed His full weight on the nail through His feet. Again there was searing agony as the nail tore through the nerves between the metatarsal bones of this feet.

It is important to note that, "the major pathophysiologic effect of crucifixion, beyond the excruciating pain, was a marked interference with normal respiration, particularly exhalation" (Edwards, Gabel, Hosmer Par. 30). Even the very effort to breathe was intensely painful. It is written that "each respiratory effort would become agonizing and tiring and lead eventually to asphyxia" (Edwards, Gabel, Hosmer Par. 31). The further effects of lack of air show, for Bradley says, "Air is sucked in, but cannot be exhaled until the buildup of carbon dioxide in the lungs and the blood stream stimulates breathing to relieve the cramps". The weight of the body, pulling down on the outstretched arms and shoulders, would tend to fix the intercostal muscles in an inhalation state and thereby hinder passive exhalation. Accordingly, exhalation was primarily diaphragmatic, and breathing was shallow. It is likely that this form of respiration would not suffice and that hypercarbia would soon result. The onset of muscle cramps or tetanic contractions, due to fatigue and hypercarbia, would hinder respiration even further.

Adequate exhalation required lifting the body by pushing up on the feet and by flexing the elbows and adducting the shoulders. However, this maneuver would place the entire weight of the body on the tarsals and would produce searing pain. Furthermore, flexion of the elbows would cause rotation of the wrists about the iron nails and cause fiery pain along the damaged median nerves. Lifting of the body would also painfully scrape the scourged back against the rough wooden stipes. Muscle cramps and paresthesias of the outstretched and uplifted arms would add to the discomfort. As a result, each respiratory effort would become agonizing and tiring and lead eventually to asphyxia.

In reference to Christ's heart, Bradley writes that it is the very struggle of his heart to "pump the thick blood as each of His billions of cells die one at a time" . Although it was very hard to speak, Christ still uttered those infamous phrases showing His love and forgiveness and lack of bitterness toward his persecutors.

The actual cause of death by crucifixion was multifactorial and varied somewhat with each ease, but the two most prominent causes probably were hypovolemic shock and exhaustion asphyxia.Other possible contributing factors included dehydration, stress-induced arrhythmias, and congestive heart failure with the rapid accumulation of pericardial and perhaps pleural effusions.

Acute Pain. Fluid Volume Deficit. Decreased Cardiac Output. Impaired Tissue Perfusion. Impaired Skin Integrity. Ineffective Breathing Pattern. Social Isolation.

All for you. All for me. Our debt paid in full. Promise fulfilled.

Goal met.