(See Part IV, Chapter 32)
A Possible Cause Of The Lord's Death?
Did the Lord
Jesus die from a broken heart?
Not a few commentators of recent
years have suggested that He did, and the evidence adduced in
such a work as that by Dr. William Stroud carries considerable
weight. (263) Yet
I believe it is important to distinguish between dying with
a broken heart and dying from, or as a result of,
a broken heart. In the Lord's case the former, I am persuaded,
may be a sad truth but the latter is a profound error. I believe
that the circumstantial evidence from the Gospels lends some
support to the view that the Lord's heart was broken, ruptured
in the most literal sense, when He died. But I am also persuaded
that this was not the cause of his dying, nor even a contributing
factor in it. But this, in turn, means it must be possible for
a man with a ruptured heart to continue an active life. It means
that heart rupture is not necessarily immediately fatal. Is
this the case? Can a man survive for any length of time after
the heart has ruptured, and what would be the symptoms during
that survival time? And what are the known causes of heart rupture
in the first place?
Poets speak of a broken heart without
meaning that the organ itself is physiologically ruptured: and
we commonly speak of men and women (and upon occasion of pets,
too) as having died of a broken heart in consequence of bereavement
or very great disappointment. History also shows that great and
unexpected joy can be fatal in a strikingly similar manner. Commonly,
we suppose that such an experience is so emotionally overwhelming
that the rhythm of the pulse is severely disturbed causing a
fatal malfunction of the vagus nerve which regulates the beat.
We do not necessarily mean the actual rupture of the walls of
the heart's chambers. It is as though the engine were "stalled,"
rather as a car engine may be stalled by feeding it too strong
a mixture of fuel.
But actual heart rupture is well
known in medical histories and if autopsies were performed as
frequently and as routinely today as they were during the last
century, we might well find as frequent reference in current
medical literature to it as there was a century ago, especially
in Europe. However, there are still many accounts of death by
heart rupture, verified by post mortem examination. And
in a surprising number of instances rupture was not immediately
fatal. From some quite extensive accounts it is clear that a
man may live for some
263. Stroud, William, The Physical Cause
of the Death of Christ, New York, Appleton, 1871, 422 pp.
hours and, though in
great discomfort, may continue the daily round of activities
until, suddenly, there comes a dramatic end ‹ sometimes in
great pain, but sometimes quietly during sleep.
Is this, then, the cause of the
death of the Lord Jesus? Personally, I do not think so: but let
us look at some of the evidence which has led not a few commentators
to assume that heart rupture was indeed the immediate cause of
the Lord's death. It is a view which has a certain sentimental
appeal and should therefore be examined all the more carefully.
on a brief historical summary of the evidence regarding heart
rupture, it will be proper to note a fact which helps to account
for the comparative paucity of medical reports on the subject
in the enormous literature of the present day. One is hard put,
in fact, to find many references in current medical literature
guides such as Index Medicus, and one may note also that
the world famous authority on human stress, Dr. Hans Selyc of
Montreal, scarcely even mentions the subject in his very extended
bibliographies. Is this because heart rupture is now so rare
and therefore seldom considered a likely cause of premature death,
and is therefore unrecognized because not expected? One contributing
factor may be that post mortems, so common formerly at least
in Europe, are now somewhat rarer because it is necessary today
to obtain permission either beforehand from the patient or afterwards
from the nearest of kin, whereas previously this was not a requirement.
As a consequence such post mortems are less often carried out,
especially since the rather general term 'heart failure' seems
to be accepted as a sufficient description of the cause of death.
The literature of antiquity and
the medical literature of the last century or two abounds in
detailed accounts which we have no reason to suppose are not
authentic and quite correctly diagnosed.
In a recent study of this aspect
of medical diagnosis, Dr. George L. Engel of Strong Memorial
Hospital, New York, published the results of a survey of 275
newspaper reports of sudden death attributed to heart failure
due to traumatic shock. (264) He commences by saying, "Few folklore notions
have enjoyed as widespread and persistent popularity as those
that ascribe sudden death to emotional shock. As far back as
written records exist, people are described as dying suddenly
while in the throes of fear, rage, grief, humiliation, or joy."
He notes that physicians writing before 1900 often ascribe sudden
deaths to intense emotion, but with the coming of the germ theory
of disease in the late nineteenth century which cast doubts on
much folklore about medical matters, such notions fell into disfavor.
"In the eighteenth and nineteenth centuries medical
264. Engel, George L., "Sudden and Rapid
Death During Psychological Stress," Annals of Internal
Medicine, vol.74, no.5, 1971, p.771‹783 with extensive
writings abounded in
such accounts. . . . Since then consideration of the relationship
between emotion and sudden death has virtually disappeared from
the medical literature." Yet he adds: "Many physicians
in private conversations are quite ready to recount from their
own practices examples of patients who apparently died suddenly
under precisely such circumstances."
Engel gives a breakdown of his
findings, stating that of the 275 reports studied, clearly the
most common cause (in 135 deaths) was an exceptional traumatic
disruption of a close human relationship, whether actual or anticipated,
or confrontation with events of great emotional consequence impossible
to escape. He observes that in experiments with animals this
was most likely to occur with already damaged hearts, but it
was not a hard and fast rule. Animals with undamaged hearts also
suffered heart rupture under certain conditions of stress. And
as to humans, an 88 year old man without known heart disease
was reported to have developed acute pulmonary edema after receiving
tragic news, dying just as the doctor reached the house. A similar
report of an otherwise healthy 27 year old captain is also noted.
As to the cause: it frequently
appears to be the result of severe derangement of the cardiac
rhythm ‹ particularly in the case of humans. Certain hormonal
substances are secreted in excess during stress which predispose
the heart to lethal arrhythmias.
Engel comments: "We can only
speculate about the mechanism of death in such cases. Most would
agree that effective cardiac arrest, whether caused by ventricular
asystole or by ventricular tachyarrhythmias, is probably responsible
for the death of those who die within a few minutes. . . But
such are not present in all cases. . . Some of the lethal influences
may involve rapid shifts between sympathetic and parasympathetic
Such shifts back and forth can
be invoked experimentally in animals and the usual consequence
is sudden death for no other accountable reason. This has been
demonstrated in squirrel monkeys. Engel therefore concludes:
"Certainly, the use of 'folklore' or 'old wives' tales'
as pejorative labels, as some skeptics are wont to do, is hardly
compatible with the scientific attitude requisite for the study
of natural phenomena involving life and death."
It is curious that there seem to
be as many reports from antiquity of death from heart rupture
caused by sudden joy as there are by sudden grief! Later
reports tend in the opposite direction.
Valerius Maximus (c. 30 A.D.) tells
us that Sophocles, the writer of Greek tragedies, had died in
405 B.C. in consequence of a decision being pronounced in his
favour in a contest concerning his honour. (265) The Roman
265. Valerius Maximus, Factorum et Dictorum,
Memorabilium, Bk. IX. 12.
historian Livy, writing
about the same time, mentions the case of an aged mother, who
while she was in the depths of distress due to tidings of her
son having been slain in battle, died in his arms from excess
of joy on his safe return. (266) Pliny, writing somewhere around 100 A.D., informs
us that the Lacedemonian, Chilo, died upon hearing that his son
had won a prize in the Olympic Games. (267) The Greek physician, Galen (about 175 A.D.), mentions
death from joy, commenting that the emotion of joy is more dangerous
to the heart than anger. (268) Aulus Gellius (second century A.D.) mentions the
remarkable example of such in the case of the Greek poet Diagoras
of Melos whose three sons were crowned the same day as victors
in the Olympic Games, one as a pugilist, the second as a wrestler,
and the third in both roles. (269)
Among the fragmentary remains of
a kind of official Journal of contemporary events authorized
by the Roman Emperors and known under the title Ephemerides,
there are instances of death from sudden joy. Similar reports
are also known from Marcellus Donatus (1586) and other writers.
(270) In recent
times Gould and Pyle, speaking of this fact, observed that heart
rupture is known to have occurred from sudden joy by post mortem
examination; in one particular case the pericardium (the sac
around the heart) being filled with blood as a consequence. (271) The general assumption
made by these writers is that rupture resulted from the sudden
and excessive increase in cardiac output. (272) Such medical histories seem to bear out not only
that excessive joy is as damaging to the heart as excessive grief
but that the damage is likely to be more immediately fatal. Perhaps
this is a reflection of the fact that we are less accustomed
to joy than to grief and therefore build up a greater capacity
to sustain the shocks of the latter. At any rate, it seems as
though the individual may survive heart rupture caused by an
excessive disappointment for several hours, or even for days.
Nor is heart rupture from external injury always immediately
If not all, at least the great
majority, of instances of heart rupture are probably because
the heart tissue has already been weakened by fatty degeneration
or some other damage such as infarct, for example, due to strain,
although a surprising number of post mortems of the last century
were unable to demonstrate any such predisposing condition, the
walls of the organ being firm and healthy at the time of actual
266. Titus Livius, History of Rome,
Bk. XXII. 7.
267. Gaius Pliny, Bk. VII (on Man), § 7.
268. Galen: quoted by Gould and Pyle, Anomalies and Curiosities
of Medicine, New York, Julian Press, 1966, 6th printing,
269. Aulus Gellius, Noctes Atticae, (130‹180 A.D.),
270. Donatus, Marcellus, De Medica Historia Mirabili,
Libri Sex. 4, Mantua, 1586.
271. Gould, G. M. and W. L. Pyle, Anomalies and Curiosities
of Medicine, New York, Julian Press, 1966, 6th printing,
272. Gould, G. M. and W. L. Pyle, ibid., p.625.
we have already noted, one of the most complete studies vis-a-vis
the death of the Lord Jesus is that undertaken by William Stroud.
Stroud quotes from many sources, especially during the nineteenth
century when such interest in the subject of heart rupture was
evidenced by the numerous reports in the medical literature.
Thereafter, interest seems to have declined, partly as a result
of the greater restrictions imposed upon post mortem examination.
Today, however, there is renewed concern. MD of Canada recently
had the following note under the title, "Subacute Heart
Rupture of the heart has now
become the second major cause of death in the coronary care unit,
second only to myocardial failure. Investigation by Dr. Michael
O'Rourke of Sydney, Australia, (274) shows
that in some instances heart rupture is not sudden and dramatic
but subacute. If recognized early, this rupture can be repaired
factors have contributed to this resurgence of interest: life
is more hectic and heart failure of one kind or another has become
more common. At the same time, the tremendous advances in heart
surgery technique, and perhaps the temptation of surgeons to
prove their own skills, has improved chances of survival by corrective
In the meantime, it is now rather
well established that rupture can be sustained for a remarkable
length of time without fatal consequences though not without
severe pain. It is not at all impossible, therefore, that Jesus
may have indeed suffered some form of subacute heart rupture
in Gethsemane and yet have sustained the subsequent abuse at
the hands of the soldiers and the final torture of crucifixion
some hours later, without succumbing to the effects of the rupture
itself. We have some well authenticated instances of survival
for several days after severe heart rupture which were later
fully confirmed by a post mortem examination. But it must still
be borne in mind that such examination generally suggested previous
tissue degeneration, a circumstance which it is difficult to
admit in Jesus' case.
A German physician, Dr. Daniel
Fischer, whose chief interest was heart pathology, in the December,
1817, issue of the Journal der Prachschen Heilkunde, reported
such a case in some detail. (275) A summary statement of the case is given herewith.
A gentleman, aged 68 (his initials
only are given as V.K.), in apparently robust health, was forced
273. MD of Canada, vol.14, no.10, Oct.,
274. O'Rourke, Michael, reporting in Lancet, 21 July,
275. Fischer, Daniel, The London Medical Repository, vol.XI,
to retire from a prominent position in the German court. The
experience proved excessively burdensome to his sensitive nature.
On the 16th of October, 1817, he was suddenly seized with a violent
pain while walking, which he supposed to be a stomach cramp.
He reached home half a mile distant only with great difficulty,
but after some medication (Hoffman's Anodyne) he quickly recovered
and did not complain further that day.
On the 17th, after a good night,
he felt so fully recovered that he visited a neighbour travelling
by carriage, there held a conference, and returned home again
later on foot accompanied by his coachman. During the return
trip, however, he sustained another attack of pain so violent
that he had to be entirely supported by his servant. Arriving
home he rested, soon recovered, had supper, and slept as usual.
On the morning of the 18th, he
sent a note to his physician, Dr. Fischer, and gave him an account
of his health, requesting his advice. His appetite and digestion,
he said, were quite unimpaired. Dr. Fischer prescribed a diaphoretic
mixture to relieve what appeared to be gas, and the rest of the
day and the succeeding night were spent comfortably.
On the 19th, he went to church
and exerted himself in singing with the congregation. He then
returned home, and almost at once experienced a dreadful pain
in the region of his stomach. Dr. Fischer was called and arrived
within one hour to find the paroxysm had almost completely subsided,
but he noted that circulation was poor as evidenced by coldness
of the extremities. In the afternoon the patient seemed improved,
and by evening he felt so much better that he wanted to get up
and join his family for dinner.
Early on the 20th, Dr. Fischer
learned that his patient had passed a fairly good night, and
that body functions seemed to have responded to the medication
prescribed for his stomach. The patient, however, after sending
off the messenger with this report, got out of bed, smoked a
pipe, and began to walk about. The pain instantly returned accompanied
by a paroxysm "with the rapidity of lightning." The
doctor was at once called, arriving about ten o'clock. The patient's
suffering subsided slowly and the doctor left at 11:30 ‹
but he was at once re-summoned to find his patient in an awful
agony "roaring for relief or death." After several
heroic attempts to relieve his suffering, some of which were
partially successful, the doctor again left. But the next morning,
the 21st, he received the unexpected news that his patient had
died very suddenly during the night.
Eighteen hours after death a post
mortem examination was carried out. The sternum being removed,
and the pericardium punctured, it having the appearance of being
distended by a substance of dark blue colour, a
quantity of reddish fluid
escaped followed by bright red blood to the amount of two or
three pounds. The pericardium was then opened up completely and
the heart itself was found to be surrounded by a coagulum of
more than three pounds in weight. When this was cleared away,
a rupture was disclosed in the aortic ventricle. The heart was
then removed entirely and the rupture was found to extend upwards
about an inch and a half on the external surface while the internal
rupture was about half an inch in length. This indicated that
rupture was caused by excess pressure from the inside. According
to the methods of tissue analysis then available, the heart tissue
itself was otherwise found to be firm and healthy.
Whether this conclusion would be
accepted in the light of present diagnostic technique is difficult
to say. However, the subsequent discussion which followed the
publication of Fischer's report showed that other similar cases
of heart rupture were known where the heart tissue was in no
way pathological. (276)
A Dr. Portal is quoted as stating in two medical reports dated
1784 and 1794 that the aortic ventricle "commonly bursts
without any previous weakening of the substance of the heart."
And in the second of these reports, Portal quotes a certain Dr.
Whytt as "having seen the heart burst from protracted grief"
and therefore "not regarding the term broken heart in
the light of a mere metaphor." (277) Dr. Portal also notes some authorities who do not
believe that heart rupture can occur unless the heart has been
subject to insidious inflammation or overburdened with excess
adipose tissue. Heart rupture would then be the fatal termination
of a previously existing morbid state. But as Dr. Fischer observed,
such was clearly not the case in the instance of his report.
Possibly rupture is not therefore fatal at once in a healthy
heart but only in a diseased one. Fischer reported in this case
"no morbid state of heart capable of diminishing its cohesive
Survival for some hours or even
some days would thus seem to be quite possible, though undoubtedly
accompanied by considerable pain. Moreover, the protracted survival
of Fischer's patient must be viewed in the light of his mature
age (68 years), and we must assume therefore that in the case
of the Lord Jesus who was still in the prime of life, emotional
stress and not a diseased condition could have caused rupture
if indeed rupture did occur. Fischer believed on the basis of
all the evidence that rupture had "occurred gradually"
over the previous few days. The first pains felt on the 16th
he believed to have been due to the violent extension or aneurysm
rather than actual rupture. Actual rupture probably occurred
at the first devastating attack of pain while the subject was
276. The London Medical Repository, vol.
XII, 1819, p.164‹168.
277. Portal: quoting Dr. Baillie, "Treatise on Morbid Anatomy,"
Anatomie des Krankhaften, Baucs, etc., Berlin, 1794, translated
by by Soemmering.
walking on the 17th.
That would mean that this particular individual survived heart
rupture with a surprising amount of activity in the interval
for about three days.
A number of other cases established
by post mortem examination are cited in the follow-up of Dr.
Fischer's article, in one of which the left ventricle was found
to have ruptured in three places. Heart rupture was also reported
as having occurred during sleep, although severe pain in the
area had been experienced for some time previously.
From current literature one gathers
that most authorities would now attach greater importance to
pathological conditions than to sudden emotional stress, and
in view of Stroud's fascinating conclusions regarding the case
of Jesus, I think this fact has to be kept in mind. Krumbhaar
and Crowell attribute rupture to coronary disease which has produced
infarction and partial or complete aneurysm. Death is then said
to be due to haemopericardium, i.e., infusion of blood
into the pericardial sac. (278) Karsner observes that in haemopericardium from
rupture of the heart wall, the intraventricular pressure is communicated
directly to the pericardial sac. (279) This compresses intrapericardial pulmonary veins
and also inhibits cardiac diastole. The result is usually rapidly
fatal. It is referred to as cardiac tamponade. History is replete
with cases of men who have died from this form of heart failure
in their prime upon hearing shocking news. J. G. Zimmerman noted
that Philip V of Spain died suddenly on learning of a major defeat
of his army: and autopsy showed that his heart had ruptured
in this way. (280)
It seems highly likely that there are other examples if we had
an adequate medical history of every individual whose death has
been attributed to some form of heart failure.
Charles K. Friedberg, in his Diseases
of the Heart, observes that rupture of the heart is "one
of the commoner causes of sudden death" but only in the
first two weeks after acute myocardial infarction. (281) Nearly 5% of one thousand
consecutive cases of acute myocardial infarction confirmed at
autopsy indicated death due to rupture. Much higher percentages
(up to 19%) were reported by other investigators in 1960. In
all such cases, rupture occurs at the point of infarction and
usually while the infarcted area is still soft and freshly damaged.
After some weeks it hardens somewhat and the patient is then
likely to survive for some time. In mental institutions where
hypertension is frequent, the incidence of rupture in acute myocardial
infarction has been recorded as high as 73%, but this high relationship
between hypertension and rupture has not been observed
278. Krumbhaar, E. B. and C. Crowell, "Spontaneous
Rupture of the Heart, A Clinical Pathological Study," American
Journal of Medical Science, vol.170, 1928, p.828f.
279. Karsner, Howard T., Human Pathology, Philadelphia,
Lippincott, 1938, p.379.
280. Zimmerman, J. G., On Experience in Physic (translated
from German), London, 1782, vol.II, p.268f.
281. Friedberg, Charles K., Diseases of the Heart, Philadelphia,
Saunders, 1966, p.854f.
in a normal population.
In all cases it is a general rule that rupture occurs only when
previous degeneration of the heart tissue has occurred.
A suffusion of blood is commonly
found in the pericardium in various amounts depending upon time
of death, severity of rupture, and level of activity. It may
exceed one liter (2.2 lbs.) but averages 250 c.c. (about 0.5
lbs.). Death may occur within a few minutes, but occasionally
there is a survival period of a half hour to several hours. However,
mention is made of survival in one instance for more than five
years due to the formation over the rupture of fibrous pericardial
While older reports seem to indicate
cases of rupture in healthy hearts, the general consensus of
opinion at the present time is that rupture only occurs where
previous degeneration of heart tissue exists. The issue is crucial,
if this is really the case, for it implies either that the Lord's
heart had in this sense already "degenerated" and the
Lamb was not therefore without blemish, or that the phenomenon
of bloody sweat and the escape of "water and blood"
from the wound on the cross must be explained in some other way.
That the rule is not hard and fast, however, is suggested
by Friedberg's remarks under a general heading Traumatic Heart
He observes: "There are instances
of so-called spontaneous rupture, perforation or tear of
a cardiac structure, in which physical strain may be a significant
contributory factor." Yet if applied in the Lord's case,
this would still not be the cause of death but merely
an accompaniment. In other words, the Lord died with a
broken heart perhaps but, in my view, not from it. To
my mind the distinction is a real one and one of great importance.
The actual course of events in
the case of rupture, considered from the purely physiological
point of view, was many years ago very ably described by a Dr.
Allan Burns who shows what happens to the blood escaping from
the rupture into the enveloping pericardium. Newer, more recent,
knowledge has not required any essential change of this descriptive
The immediate cause is a sudden
and violent contraction of one of the ventricles, usually the
left, on the column of blood thrown into it by a similar contraction
of the corresponding auricle. Prevented from resuming backward
by the intervening valve, and not finding a sufficient outlet
forward in the connecting artery, the blood reacts against the
ventricle itself which is consequently torn open at the point
of greatest distention, or least resistance.
A quantity of blood is thereby
discharged into the pericardium, and having no means of escape
from that capsule, stops the circulation by compressing the heart
from without and induces almost instantaneous death.
In young and vigorous subjects,
the blood thus collected in the pericardium soon divides into
its constituents parts, namely, a pale watery liquid called serum,
and a soft clotted substance of a deep red colour termed crassamentum.
282. Friedberg, Charles K., ibid.,
283. Burns, Allan, On Diseases of the Heart, Edinburgh,
Now we are told in Luke 22:44 that in Gethsemane the
agony of spirit which anticipation of the horror of the pending
ordeal brought upon the Lord was so severe that, as it were,
great drops of blood burst like sweat from his forehead and poured
down his face. Luke, the physician, was the one who obtained
this piece of information from some eye witness to the event.
The disciples may not have been asleep at the beginning of Jesus'
spiritual struggle but had fallen asleep by the time He returned
to them after it was over. Luke may have received his information
from one of them, for he certainly records it as though it was
an eye witness account. He makes no effort to explain the phenomenon.
In Hebrews 5:7 we seem almost certainly
to have a further reference to this event. We are told here that
in the days of his flesh, the Lord offered up prayers and supplication:
evidently under the stress of pending death and was heard and
preserved at that time. This clearly cannot refer to his death
a few hours later on the cross, since He could not possibly be
spared from this if man was to be redeemed. What prospect of
immediate death was He then preserved from if not death by heart
Certainly the Greek verb sodzo
appearing here in the phrase "able to save him,"
often means "to preserve." Probable instances of this
meaning in other places where the same word occurs will be found
as follows: 1 Timothy 2:15, the preservation of the woman in
childbearing; 1 Timothy 4:10, the Lord who preserves all men
but takes particular care of the redeemed; 2 Timothy 4:18, Paul
is preserved against every evil device brought against him. One
might argue, therefore, that in Gethsemane the Lord's heart suffered
a subacute rupture, and that the Lord Himself was fully aware
of what had happened within his body. Certainly the form and
functions of the human body were of his design in the first place
and He was Himself the master Physician. There is no reason at
all why He may not have correctly recognized the symptoms in
his own case. It could be, therefore, that the trauma of anticipation
of what was to be truly an awful spiritual and physical agony,
was sufficient to rupture his otherwise perfectly sound
heart, with fatal consequences to Himself and to his mission
if death ensued prematurely as a result. He would have recognized
this only too well.
The question then arises as to
whether, if weakened by this serious internal wound, his frame
would be able to sustain the ordeal that it was about to undergo.
We have to remember that although He was made with the potential
of unending life, that life could still be destroyed. If such
an internal wound should prove fatal now, the whole plan of salvation
‹ for which the Universe was created as a setting and to
which all history had moved up to this moment ‹ would have
commentators have habitually associated Hebrews 5:7 with the
events of Gethsemane, as Barnes does for example, though he does
not indicate any awareness of the possibility of heart rupture.
(284) In response
to the Lord's cry for help, an angel came to strengthen Him (Luke
22:43), a circumstance which suggests that the prayer was indeed
for physical support, since it is most unlikely that He
would appeal for spiritual help from an angel. Almost
immediately after this appeal, the bloody sweat broke out on
his forehead as though in confirmation of the internal injury
which may have prompted his cry for help.
of "sweating" blood as a physiological phenomenon is
not clear, although a great deal is known about the sweating
mechanism itself. It is referred to technically as haematridrosis.
It has, however, been observed to be always associated with
deep emotional stress. It was reported frequently enough in antiquity,
during the Middle Ages, and even in modern times.
When a man's body overheats, several
automatic corrective measures are at once initiated. These include
an increased flow of blood through the vascular bed just below
the skin surface, causing a sudden reddening or flushing, and
resulting in a much greater transport of deep body heat via the
blood fluid to the skin surface where it is radiated away if
conditions permit. If this proves insufficient and body temperature
continues to rise, then the sweat glands are triggered into activity.
A very pure water, filtered from the blood vessels, is expressed
via about two million sweat glands onto the skin surface where
it evaporates and in so doing removes a quite remarkable store
of heat very efficiently, provided that the surrounding air has
the requisite capacity to absorb the water vapour. In conditions
of high humidity it is therefore characteristically difficult
to keep cool.
This filtrated water is one of
the purest fluids in the body, since it contains a total of less
than 1% of other substances such as uric acid, lactic acid, etc.
Under normal circumstances this exudate contains no other blood
components than water. However, under very great emotional stress,
perhaps in part due to a rise in pulse rate and blood pressure,
red blood cells may find their way into individual sweat glands,
chiefly those which are under the control of the sympathetic
nervous system ‹ which the majority of sweat glands are not.
The areas particularly involved here are the forehead, the axillary
vaults (the arm pits), and some areas of the hands. The forehead
region is especially involved, being for some reason highly supplied
with sweat glands that are particularly active.
According to Shelley and Hurley,
such coloured sweat does not relate normally to a rise in body
284. Barnes, Albert, Notes on the New Testament,
Grand Rapids, Kregel, 1962, p.1260, loc. sit.
but only to emotional
stress. (285) The
coloured droplets are turbid and they suggest a possible connection
with hysterical stigmata in the hands. Rothman, in his classic
work on the biochemistry and physiology of the skin, believes
that this form of sweating (which may also be found in the palm
of the hand) probably accounts for the phenomenon associated
with the well-known Theresa of Konnersreuth. (286) Bloody sweat has been reported also among primitive
people, especially shamans from Siberia when seeking a state
of ecstasy, as reported by Bogoras. (287) William Stroud refers to a number of works from the
sixteenth to the nineteenth centuries in which are to be found
case histories of men who, being condemned to death under
unexpected circumstances, have broken out into a bloody sweat.
(288) One young
boy is mentioned who, having taken part in a crime for which
two of his older brothers were hanged, was exhibited to public
view under the gallows at the time and was thereupon observed
to sweat blood from the exposed parts of his body (presumably
his hands and his face). In a Commentary on the Four Gospels
published in 1639 in Paris, Joannes Maldonatus refers to
a robust and healthy man who had, on hearing a sentence of death
passed upon him, been bathed in a bloody sweat. (289) In 1743 J. Schenck, in
a work entitled Medical Observations, referred to the
case of a nun who, falling into the hands of soldiers threatening
her with instant death, was so terrified that "she discharged
blood from every part of her body and died of hemorrhage."
(290) In 1800 S.
A. D. Tissot, in a work on the nervous system, referred to a
sailor who was so alarmed by a storm that he collapsed, sweating
blood from his face continuously throughout the whole episode.
He mentions that the bloody sweat renewed itself like ordinary
sweat as fast as it was wiped away. (291)
One of the
best known and most famous examples is that of Charles IX of
France, a monarch of great cruelty but also of great energy both
in mind and body, who died of a similar cause in his 25th year.
According to Voltaire, he suffered a fatal hemorrhage, the blood
flowing from the pores of his skin. He expressed the opinion
that it is usually the result either of excessive fear or of
great passion. (292)
In his Histoire d'France, the
285. Shelley, W. B. and H. J. Hurley, "Methods
of Exploring Human Apocrine Sweat Gland Physiology," Archives
of Dermatology and Syphilis, vol.66, 1952, p.156‹161.
286. Rothman, Stephen, Physiology and Biochemistry of the
Skin. Chicago University Press, 1955, p.187.
287. Bogoras: quoted by Alexander Goldenweiser, Anthropology,
New York, Crofts, 1945, p.251.
288. Stroud, William, The Physical Causes of the Death of
Christ, New York, Appleton, 1871, p.97.
289. Maldonatus, Joannes, Commentary on the Four Gospels,
Paris, 1639, p.601.
290. Schenck, Joannes, Rarer Medical Observations (Observ.
Medicae Rariores), Frankfort, 1609, Bk. III, p.458.
291. Tissot, S. A. D., Traites des Nerfs, Avignon, 1800,
292. Voltaire, F. M., Complete Works, Baslc, 1785, vol.18,
historian de Mezeray,
refers to the same circumstance noting that it was on the 8th
of May, 1574. (293)
He says that in his last illness near the end, Charles was found
on one occasion bathed in bloody sweat. There is an interesting
discussion of this subject, from a purely medical point of view,
in the work by Gould and Pyle to which reference has already
been made. (294)
I would conclude,
then, that while heart rupture may not have been the cause
of the bloody sweat on the Lord's brow, extraordinary emotional
stress might have been the common cause which lay behind both
phenomena. The agony of Gethsemane was the agony of anticipation
of the events which were about to transpire, and the effect of
that agony upon the Lord's body may have been sufficient to cause
both subacute heart rupture and bloody sweat. But I would go
further and say also that heart rupture was, nevertheless, not
the cause of the Lord's death on the cross. In Gethsemane
his cry for help was heard and this injury was not permitted
in the interval between Gethsemane and his death to anticipate
the sacrifice of his life which He was to make voluntarily and
in his own time.
Adding enormously as it must have
done to the ordeal of all that He endured from the evening of
his arrest to the moment when He dismissed his spirit by an act
of will, and no doubt contributing largely to the sheer physical
impossibility of carrying the crossbar of his own instrument
of death to the place of execution, the Lord Jesus still did
not succumb to death ‹ did not die ‹ because
of heart rupture. He died perhaps with, but not because of,
a broken heart, for the circumstance of the outflow of 'blood
and water' (John 19:34) seems to indicate that the pericardium
had indeed been pierced by the soldier's spear. Extravasated
blood, which had escaped through what was perhaps a very small
rupture, had accumulated and separated out into coagulum and
serum. This could possibly account for a phenomenon which Scripture
has seen fit to include in the record as a circumstance of significance.
But his death was entirely of his own doing, not forced upon
Him because of the failure of his heart. Sentiment might favour
such a supposition, but I believe that theology demands recognition
of something of greater consequence.
His death was in no sense a final
collapse of the life support system of his body, but a glorious
triumph of will, of spirit over body. On this supernatural
fact Scripture has spoken unequivocally and with beautiful precision,
as we have seen in Part IV, Chapter 32. These signs of possible
rupture may serve perhaps to give us
293. de Mezeray, Histoire d'France,
Paris, 1685, vol.III, p.306.
pg.13 of 14
294. Gould, G. M. and W. L. Pyle, Anomalies and Curiosities
of Medicine, New York, Julian Press, 1966, 6th printing,
some idea of the awful prospect the Lord faced and the
unimaginable burden it placed upon his nervous system and therefore
also upon his heart. It could have been a literal fulfillment
of Psalm 69:20, "Reproach hath broken my heart: and I am
full of heaviness: and I looked for some to take pity but there
was none: and for comforters, but I found none." "Could
ye not watch with Me one hour?" (Matthew 26:40).
Copyright © 1988 Evelyn White. All rights
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