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Case closed? A controversial hypothesis may explain what Jesus actually died of.

Hans Baldung,The Crucifixion of Christ (1512)

Did an Unholy Trinity Kill Jesus?

There is no death certificate for Jesus of Nazareth—and many believe that he still lives on in a spiritual sense. But that hasn't stopped physicians and medical scholars from trying to diagnose the exact physiological mechanisms that caused the crucified revolutionary to die 2 millennia ago. Now, an American doctor has offered a new hypothesis involving Christ's blood-clotting ability—but other researchers are skeptical.

"As a kid going to church, I'd heard that Jesus died of a 'broken heart,' " says Joseph Bergeron, a private physician associated with The Pain Clinic in Terre Haute, Indiana. But that idea—technically known as the "cardiac rupture" hypothesis, and first published in 1847 by British physician William Stroud—"didn't really make sense, given what we know about the crucifixion." Bergeron became even more intrigued after he was asked to speak to a group of Christian medical students and started looking for a topic that they might find interesting. He discovered that a flock of researchers have tried to explain exactly how Jesus died, and "I just couldn't stop reading," he says.

There are at least six major hypotheses about Christ's death, Bergeron notes in a paper published online this month in the Journal of Forensic and Legal Medicine. Beatings and the stress associated with being nailed to a cross could have caused a blood clot to block a vessel in Christ's lung, for example, leading to death by pulmonary embolism. Other possibilities are that he was unable to breathe due to his awkward hanging position and suffocated, or that he went into lethal shock—ideas supported by studies of what has killed modern torture victims. And although the Bible's book of John reports that Roman soldiers found that Jesus was already dead when they removed him from the cross, it's possible he wasn't and that the final blow was a subsequent spear thrust to his chest that caused a "sudden flow of blood and water," Bergeron writes, quoting from the New Testament. "The idea ... is based on the assumption blood cannot flow from a corpse."

None of these explanations, however, seems to fully fit the harrowing story of the beatings and abuse Jesus suffered prior to and during the crucifixion, Bergeron says. Nor do they jibe with Christ's apparently rapid death just six or so hours after being nailed to the cross.

Instead, Bergeron proposes that a mechanism called "trauma-induced coagulopathy" played a key role. Over the past decade or so, emergency room physicians and others have described a combination of factors that occurs in about 25% of trauma patients and dramatically increases the risk of rapid death. The "lethal triad" includes a rapid drop in body temperature (hypothermia); a failure of the body's blood-clotting ability, leading to uncontrolled bleeding; and abnormal blood acidity, which causes a range of biochemical reactions to go haywire. "Even today's best trauma centers can't control [the lethal] cascade of events," Bergeron says.

Jesus' hypothermia could have been caused by his naked exposure to the cold temperatures of early April, when religious documents say the crucifixion occurred, Bergeron says. And trauma-induced coagulopathy would also explain why Jesus died so rapidly—and "how blood could flow from Jesus' corpse when his chest was impaled," because the condition can cause fluids to pool.

Bergeron's hypothesis isn't going over well with at least one other researcher who has studied death by crucifixion. "I am quite disappointed that this article was accepted for publication," Piers Mitchell, a biological anthropologist at the University of Cambridge in the United Kingdom, writes in an e-mail. The coagulopathy concept "is hardly a radical idea," he says, and Bergeron has failed to fully credit past studies, including a 2006 paper that Mitchell and a colleague wrote for the Journal of the Royal Society of Medicine, which reviewed 10 hypotheses and found most "unsubstantiated by the available data." In part, that's because Roman-era crucifixions left behind little physical evidence, often because the corpses were "left on a rubbish dump to be eaten by wild dogs and hyenas," according to the paper.

Another problem, Mitchell says, is that Bergeron's study and others rely on "English language translations of historical descriptions for crucifixion in the past, which leads to mistakes from potentially poor translations."

Informed of Mitchell's complaints, Bergeron sounded a bit taken aback. "I really liked their paper, that's why I cited it," he said. It's not yet clear, however, whether the researchers will be able to turn the other cheek.