Injury, Int. J. Care Injured 45S (2014) S142–S148
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How was the Turin Shroud Man crucified? M. Bevilacqua a,*, G. Fanti b, M. D’Arienzo c, A. Porzionato d, V. Macchi d, R. De Caro d a
Hospital-University of Padua, Italy Department of Industrial Engineering, University of Padua, Italy c Orthopaedic Clinic, University of Palermo, Italy d Institute of Anatomy, University of Padua, Italy b
A R T I C L E I N F O
A B S T R A C T
Keywords: Turin Shroud Man Crucifixion technique Nailing Causalgia Cause of death
As the literature is not exhaustive with reference to the way the Turin Shroud (TS) Man was crucified, and it is not easy to draw significant information from only a ‘‘photograph’’ of a man on a linen sheet, this study tries to add some detail on this issue based on both image processing of high resolution photos of the TS and on experimental tests on arms and legs of human cadavers. With regard to the TS Man hands, a first hypothesis states that the left hand of the TS Man was nailed twice at two different anatomical sites: the midcarpal joint medially to the pisiform between the lunate/ pyramidal and capitate/uncinate bones (Destot’s space) and the radiocarpal joint between the radio, lunate and scaphoid; also the right hand would have been nailed twice. A second hypothesis, preferred by the authors, states that the hands were nailed only once in the Destot’s space with partial lesion of the ulnar nerve and flexion of the metacarpophalangeal joint of the thumbs. With regard to the TS Man feet, the imprint of the sole of the right foot leads to the conclusion that TS Man suffered a dislocation at the ankle just before the nailing. The entrance hole of the nail on the right foot is a few inches from the ankle, and excludes a double nailing. The nail has been driven between the tarsal bones. The TS Man suffered the following tortures during crucifixion: a very serious and widespread causalgia due to total paralysis of the upper right limb (paradoxical causalgia); a nailing of the left wrist with damage to the ulnar nerve; a similar nailing of the right wrist; and a nailing to both feet using one only nail that injured the plantaris medialis nerves. The respiratory limitation was probably not sufficient to cause death by asphyxiation. Also considering the hypovolemia produced by scourging and the many other tortures detectable on the TS, the principal cause of death can be attributed to a myocardial infarction. ß 2014 Elsevier Ltd. All rights reserved.
Introduction For more than a century the mode of crucifixion of the Turin Shroud (TS) Man has been studied [1], but no reliable conclusions have yet been reached because it is not easy to draw significant information from only one ‘‘photograph’’ of a man on a linen sheet, with many peculiar bloodstains coherent with a human body. Little historical information is available about the means of crucifixion in
* Corresponding author. Tel.: +39 049 827 6804. E-mail addresses: [email protected] (M. Bevilacqua), [email protected] (G. Fanti), [email protected] (M. D’Arienzo), [email protected] (A. Porzionato), [email protected] (V. Macchi), [email protected] (R. De Caro). http://dx.doi.org/10.1016/j.injury.2014.10.039 0020–1383/ß 2014 Elsevier Ltd. All rights reserved.
the Roman period and limited studies involved direct experiments on cadavers [2,3]. Barbet made studies on crucified cadavers more than half a century ago [2]. More recently, many researchers have investigated aspects of the TS; for example, the forensic pathologist, Zugibe [3] studied many cadavers. Nevertheless, none of the researchers has conducted direct experiments on cadavers or parts of them to study nailing procedures. The Archbishop of Bologna, Paleotto, who accompanied St. Charles Borromeo over the Alps to Turin in 1598, was the first to note that wounds appeared to be in the wrists and not in the middle of the hand [4]. The iron nails were then mainly considered to have been driven between the radius and the carpus or between the two rows of carpal bones [5,6] either proximal to or through the strong bandlike flexor retinaculum and the various intercarpal ligaments [7]. Barbet performed some experiments on amputated limbs and
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argued that nailing took place through the so-called Destot’s space, between the lunate/pyramidal and capitate/uncinate bones on the ulnar side of the wrist. He also reported movement in opposition and slight flexion of the thumb, after nailing, and ascribed this phenomenon to injury of the median nerve [5]. However, it was contested that a lesion of the median nerve at the wrist is not compatible with the nailing in the Destot’s space, because its course is away from the radial side [3]. So, in the authors’ opinion, the absence of fingerprint of the thumb needs another explanation. According to the preferred nailing practice by the Romans [8], the TS Man had his feet touching each other, the left on the right, fastened with a single nail on the cross, without suppedaneum, passing between the metatarsal bones [2,9]. Caselli [10] identified two nail wounds on the right foot, ‘‘one in its true place on the metatarsal bones, the other on the heel’’, and attributed the second wound to displacement of the TS Man caused by arrangement of the body on the anointing stone, which is the bench for burial preparation. In the authors’ opinion, the bloodstain on the heel is due to a blood leakage from the nail imprint ‘‘on the metatarsal bones’’. The heel is not completely visible on the TS because the TS was not in contact with the entire foot. Specific analyses have been conducted on the trickles of blood on the upper limbs. Fasola [11] attributed the divergence of the blood flow from the wrist wound to a slight rotation of the arm. Ricci [12] suggested that the divergence of the blood flow was due to the variable position of the arms on the cross that allowed the TS Man to breathe. Massey [13] determined the position of the arms on the cross deriving it from the corner of the trickles of blood on his forearms with the axis of the respective arms. In the authors’ opinion, these trickles formed when the arms were moved after unnailing. Zugibe [3] proposed that the body of the TS Man was washed before it was buried to remove the ‘‘mask of blood’’, which he would have had after the cruel scourging (more than 370 wounds by the scourge [14]). Conversely, the postmortem blood on the TS Man (spilled from the chest after the spear, from the head after removal of the crown of thorns, and from the wrist and feet after unnailing) was not supposed to be removed because according to Jewish custom it was forbidden to touch postmortem blood as it would make the person ‘‘impure’’ [3]. The authors share this opinion. In a recent publication [15] the authors proposed that the TS Man could have suffered a violent trauma to the right side of the neck, chest and shoulder, causing an underglenoidal dislocation of the humerus, with injury of the entire brachial plexus, right flattened hand and enophthalmos. The blunt chest trauma, which resulted in the body falling forward, was also a direct cause of a lung contusion and haemothorax. A sign of this chest trauma, which was probably caused by the cross falling on the body, can perhaps be seen on the dorsal TS body image as the two darker areas beneath the shoulders. The aim of the present study was to provide further hypotheses about the possible anatomical sites of nailing of the TS Man, through a renewed analysis of the TS bloodstains and experimental procedures of nailing on cadavers. The following questions were considered: How many nails were used on the hands and feet, and where? What is the meaning of the trickles of blood on the forearms and feet? What is the most likely posture of the TS Man? What are the possible clinical consequences of such a nailing? Materials and methods
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limbs and their segments, and particular consideration given to feet, hands and fingers. Another evaluation specifically involved the bloodstains, assessing their orientation with respect to the upper limb axis. Experimental procedures on limbs Analyses were performed on three right upper limbs resected from cadavers at the shoulder, and on another anatomic specimen consisting of the trunk and both inferior limbs. The donors gave specific consent. Cadavers were managed by the Body Donation Programme of the Section of Human Anatomy of the Department of Molecular Medicine of the University of Padua. In 2011, the Body Donation Programme achieved certification by an accredited third-party registrar (Certiquality Srlß , Quality Certification Body, Milan, Italy), which audited the quality management system and certified that the Body Donation Programme of the University of Padova met EN ISO 9001:2008 criteria [16]. The use of cadavers for medical training and scientific research is performed according to European, National and Regional normative references [17,18]. The experimental procedures performed were as follows. The upper limbs were nailed in the following points: - radiocarpic joint between the radio, lunate and scaphoid; - midcarpal joint line between the scaphoid/lunate and trapezoid/ capitate; - midcarpal joint medially to the pisiform between the lunate/ pyramidal and capitate/uncinate (Destot’s space). With regard to the inferior limbs, the following procedures were performed: - dislocation of the right ankle joint, through increasing weights applied with a rope to the ankle (this tension technique of the limbs with ropes was usual in the crucifixion [19]); - nailing of the right foot between the 1st and 2nd metatarsal bone, with a 10 cm-long nail; - nailing of the left foot between the scaphoid and cuboid, proximally, and third cuneiform, distally, with a 25 cm-long nail; - further nailing of the right foot, with the long nail passing through the left one, at the level of the right tibiotarsal joint. The points of entrance were identified under radioscopic control (OEC C-Arms, 9600; GE medical system) with the help of small lead semi-spheres. Nailing of feet was performed on a wooden plank. CT axial scans (Philips Brilliance iCT, Philips Medical Systems; Best, The Netherlands) of the specimens were acquired. Analysis and post-processing of the CT scans were carried out on an Aquarius Workstation (version 3.6.2.3; TeraRecon, San Mateo, California). Source images and 2D-3D reconstructions were reviewed at the workstation. Specific anatomical dissections were then performed to confirm the CT findings and to verify the condition of vessels and nerves. Results TS analysis
TS analysis
Right hand The posture of the right hand is compatible with a flat paralytic hand.
Various high-resolution images of the TS, taken by G. Enrie, G.B. Judica Cordiglia, G. Durante and Haltadefinizione, were analysed after proper image processing with reference to posture of the four
- The hand is slightly flexed towards the ulna, as normal, not contracted (the angle between a line drawn between the 3rd and 4th metacarpus and a line coaxial to the forearm is 158 38) (Fig. 1).
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- The thumb is also absent in the right hand that is stretched out on the thigh.
Bloodstains on the left wrist
Fig. 1. Left arm: the trickles on the wrist and forearm have the same angle (388 28) with a line drawn between the 3rd and 4th metacarpus. The hand is slightly flexed radially (the angle between a line drawn between the 3rd and 4th metacarpus and a line coaxial to forearm is 68 38) and dorsally flexed, which is suggestive of a ‘‘claw hand’’. Right arm: the trickles are almost unidirectional, coaxial to the arm. The hand is slightly flexed towards the ulna (the angle between a line drawn between the 3rd and 4th metacarpus and a line coaxial to forearm is 158 38, which is normal).
- The flexion is not due to the recomposition of the body in the sheet with support of the outstretched hand on his thigh, because rigor mortis would have prevented a change in posture at this point. - The flexion is not due to distortion related to the superimposition because there are clear fingerprints of the metacarpophalangeal joints and the proximal, intermediate and distal phalanges of the fingers II–V; phalanges are normal and in proportion to each other and they are not flexed as in his left hand; - The almost uniform colour intensity of the thigh below confirms the flattening of the hand.
Left hand The posture of the left hand is suggestive of a ‘‘claw hand’’ [15], in a slight radial abduction (the angle between a line drawn between the 3rd and 4th metacarpus and a line coaxial to the forearm is 68 38, Fig. 1). The two last phalanges are flexed, which is characteristic of damage to the lower brachial plexus with proximal ulnar nerve palsy; this was probably due to stretching of the limb with ropes during nailing until the arm dislocated. However, a claw hand is also characterised by abduction and extension of the thumb, which is lacking in the TS image.
- A proper contrast enhancement of a square-like area of different luminance on the TS image (probably the exit hole of the nail; Roman nails were typically square), enables the visualisation of the lower trickle, which is possibly in the intercarpal Destot’s space identified by Barbet. The drain of blood to the wrist originates from this point located on the extension of a line drawn between the 3rd and 4th metacarpus. - An additional contrast enhancement of a second quadrangular area enables visualisation of what is perhaps the upper trickle, slightly shifted towards the radial side, in the radiocarpal articulation between the radio, lunate and scaphoid. - The two trickles are directed towards the ulnar side spreading apart at an angle of 388 28 with reference to the above mentioned line (Fig. 1).
Bloodstains on the left forearm
- Trickles of blood have a diagonal course from the wrist to the medial part of the elbow, with an angle of 388 28 (like that of the wrist) with small streams slanting towards the outside of the forearm, due to the radial flexion of the hand (Fig. 1).
On the right forearm
- The bloodstain is almost unidirectional, coaxial to the arm (Fig. 1). The authors believe that the course of the trickles on the left wrist and on the forearms does not reflect the position of the arms on the cross, but it is simply due to the movements undergone by the arms after the wrists were unnailed. The blood was not removed because this would be ‘‘impure’’, as mentioned above.
The lack of thumb imprint The lack of a thumb imprint is compatible with a tendon retraction.
On the sole of the right foot Two areas of greater extravasation of blood are recognisable. The first of these areas is in the middle of the central bloodstain, where there appears to be a square hole that is the probable location of nailing; the second area, which is 10.5 0.5 cm from the first, is at the height of the heel on the medial side and can be due to a blood accumulation coming from the nail hole (Fig. 2). The lack of continuity of the blood flow is due to the arch of the foot, which caused a local detachment from the cloth. This interpretation is confirmed by the blood rivulets outside the image of the foot.
- There is an area around the left hand where the imprint is almost absent. It reflects the distance of the body from the TS; this distance is about 2 cm between the ulnar margin of the left hand and the 2nd and 3rd finger of the right hand below, and about 6 cm between the left radial margin of the hand and right distal forearm below. A hand in dorsal flexion, documented by the more developed imprints of the first metacarpal phalangeal joint, explains this difference. - Even with a just flexed left hand resting on the right hand, the thumb would be more on the side of the index and would imprint somehow on the TS.
On the back of the right foot A detailed study of the TS frontal and dorsal body image, also supported by an anthropometrical analysis [20], shows that the bloodstain on the front right foot is located in a position 5 3 cm distant from the ankle. This implies that TS Man had a single nailing in the centre of the foot. As already suspected in the past [20,21], the right ankle joint appears dislocated and tilted forward; if this was not the case, it would be difficult to explain the plantar foot imprint on the TS. Like the hands, the bloodstain on the foot is due to the unnailing.
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Fig. 2. Left image: legs and feet of the TS frontal image where the right bloodstain on the foot is 5 3 cm from the ankle. Central image: legs and feet of the TS dorsal image. Right image: the most probable position of the nail piercing the right foot.
On the sole of the left foot The trickles of blood along the medial border of the foot assume the shape ‘‘ ’’ (Fig. 2). At the centre of this shape there is a vaguely recognisable area of increased blood. This is probably the exit hole of the nail and it is placed on the front of the heel. The branches of blood from this core are probably due to movements during unnailing, transportation to the tomb, or TS overlapping.
Experimental procedures on limbs Radiocarpic joint between the radio, lunate and scaphoid The identification of this spot was quite simple on the volar surface of the wrist. It is at the level of the superior skin fold of the wrist, between the two tendons of the flexor carpi radialis and palmaris longus, near the scaphoid tubercle. Nailing did not cause bone fractures, but there was dislocation of the lunate and scaphoid from the radial articular surface. The nail produced a deviation of the tendon of the flexor pollicis longus. As a consequence of the action of the nail on this tendon, the thumb was slightly adducted during nailing, with partial flexion of the distal phalanx (Fig. 3). The nail also partially deviated and minimally injured the median nerve. The acquired position of the thumb is consistent with the TS, where the left thumb is not visible probably due to adduction and flexion. Midcarpal joint between the scaphoid/lunate and trapezoid/capitate Nailing in this spot did not cause bone fractures, but the lunate was dislocated. The median nerve was not injured. The thumb was partially adducted and the distal phalanx was flexed during nailing. These findings are consistent with the lack of thumb imprint on the TS. Midcarpal joint medially to the pisiform (Destot’s space) This point is located at the level of the inferior skin fold of the wrist medially to the tubercle of the pisiform bone. On the basis of the above references, the Destot’s space was quite easy to identify. The nailing procedure did not cause bone fractures; however, the ulnar nerve and artery and the flexor digitorum superficialis were completely injured. No adduction of the thumb was noted (Fig. 4).
Dislocation of the right ankle joint This dislocation was achieved with a force of 2000 N applied to the ankle using a rope. This is consistent with the possible dislocation of such a joint before nailing. Nailing of the right foot This procedure was possible with a 10 cm-long nail passing at the bases between the 1st and 2nd metatarsal bones. After nailing, with repeated hammering, the right foot leaned on the plank with the calcaneus, while a distance of about 2 cm was measured between the plank surface and the plantar surface at the nail exit point. Nailing of the left foot Under radioscopic control, the 25 cm-long nail entered between the scaphoid and cuboid, proximally, and the third cuneiform, distally. The exit point was located on the medial of the calcaneus, at the posterior extremity of the plantar arc. This finding is consistent with the TS body image. Discussion The data from our experimental tests on arms and legs of human cadavers and evaluation of the TS body image with its various bloodstains enable us to propose the nailing method of hands and feet used for the TS Man. Two different nailing procedures for the wrists were hypothesised by the authors at the beginning of the present study: the first procedure involved two double nailings per wrist in coherence with the apparently double bloodstains coming out from the left wrist; the second procedure comprised a single nailing per wrist assuming that these bloodstains came out from a single larger hole. The relative experiments on parts of cadavers, although limited for obvious reasons, covered both hypotheses and also investigated the possibility of a double nailing of the right foot. The very recently discovered position of the entrance hole of the nail 5 3 cm distant from the ankle (Fig. 2) is against the hypothesis of a double nailing in the right foot. The single nailing is instead located between the tarsal bones, perhaps just in the position where the nail was put in the left foot, that is, between the scaphoid and cuboid, proximally, and the third cuneiform, distally. Therefore,
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Fig. 3. Nailing in the radiocarpal space between the radio, scaphoid and lunate. (A) Hand before nailing: the thumb is in the abducted position. The two points of nailing are highlighted: the higher superficial fold (radiocarpic space) and the lower fold (Destot’s space). (B) The exit hole is visible of the plastic facsimile nail driven in the radiocarpic space (replaces the iron nail). (C) Radiological control. (D) The nailing in the radiocarpic space induces retraction of the thumb. (E) Dissection of the wrist: deviation of the tendon of the flexor pollicis longus and slight lesion of the median nerve. (F) Three-dimensional reconstructions of CT exam of a hand specimen. The nail deviates the tendon of the flexor pollicis longus.
the authors prefer the hypothesis of the single wrist nailing, because it is also not easy to explain why the crucifiers should have made two holes in the same wrist at a distance apart of only a very few centimetres, and a single nail was used to pierce the feet. According to the authors, the respiratory limitation, plus the presence of a haemothorax, which pressed down the right lung [14], was not sufficient to cause death by asphyxiation (i.e. by ventilatory failure characterised in the terminal phase by loss of consciousness and coma). A probable cause of death, also considering the hypovolemia produced by scourging, bleeding and the many other tortures, is myocardial infarction. A more detailed description follows, but it should be emphasised that all these tortures are coherent with the Passion of Jesus Christ described in the Gospels. Hands On the basis of the analysis of the left hand in the TS, the exit hole of the nail seems to be located in the Destot’s space, as
previously proposed by Barbet [2]. However, this anatomical site is quite far away from both the median nerve and the tendon of the flexor pollicis longus to explain the retraction of this finger. Our single experiment showed that nailing through the Destot’s space completely injured both the ulnar artery and nerve, and this fact seems in contrast with the assumption of a thumb retraction. According to our experimental data, the retraction of the thumbs seems to be due to the stretching of the tendon of the flexor pollicis longus by nailing the radiocarpal joint. Damage of the median nerve could also have contributed to retraction of this finger, causing deficit of the abductor pollicis brevis and opponent muscles, with adduction of the first metacarpus and thumb. The first hypothesis analysed at the beginning by the authors states that it is possible that the left hand of the TS Man was nailed twice at two different anatomical sites: the Destot’s space, where a quadrangular area of the nail appears after image contrastenhancement, and the radiocarpal joint between the radio, lunate and scaphoid, about 1.5 cm proximally with respect to the Destot’s space.
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Fig. 4. The nailing in the Destot’s space (between the lunate/pyramidal and capitate/uncinate) does not cause the thumb retraction in a cadaver, but a partial injury of the ulnar nerve produced by this nailing can cause thumb retraction in a living person.
The second hypothesis, preferred by the authors, states that a unique hole was made in the wrists by the nail put in the Destot’s space. If we suppose a possible partial tear of the ulnar nerve that saves its deep branch, we can explain the contracture of the deep head of the flexor pollicis brevis and a flexion of the metacarpophalangeal joint, coherent with the lack of thumbs in the TS image. Therefore, we think that probably Barbet confused the ulnar nerve with the median nerve. The significant drain of blood on the forearms may be explained by the injury to the ulnar artery; intravascular bleeding and haematoma gathered around the nail, and followed recomposition of the limbs. The people who were arranging the burial could have raised his arms to prevent the blood spilling from the holes to the ground. The different arrangement of blood on both forearms is explained by the different posture of the limbs and the different angle of the hands with the forearms: the right upper limb paralysed with the hand and forearm in axis; the left arm with the wrist abducted and flexed dorsally, not in line with the forearm (Fig. 1). Feet The footprint of the entire sole of the right foot (Fig. 2) seen on the TS and the partial absence of a left footprint shows that the TS was not wrapped around the feet, but simply left lying on the ‘‘mattress’’ of resin powders of myrrh and aloe. This indicates that the TS Man suffered an ankle dislocation during nailing. Otherwise, the foot would have been raised thus avoiding its imprint on the TS. The suspicion that the bloodstain on the heel of the right foot may have been caused by a second nailing led the authors to undertake a test of nailing through the ankle to obtain the exit hole corresponding to the sole of the right foot at the heel (and not outside just near to its tuberosity). Nevertheless, image processing showed the bloodstain to be just under the ankle, thereby excluding a double nailing, so the authors accept the hypothesis of a single nail in the right foot and then the two feet were nailed together, in agreement with the Latin Church.
Posture of the limbs The nailing procedure confirms the posture of TS Man in accordance with a computerised anthropometric analysis [21]. The TS Man on the cross did not collapse with the body on his knees, but he was stretched once he was pulled and dislocated with ropes [4]. His arms were moderately lowered by about 158 (Fig. 5) compared with the patibulum and not by 658 as supposed by Barbet [2]. His head was bent forward and his knees were slightly bent due to the human body dejection after death, with feet rotated after ankle dislocation. The left foot was nailed over the right dislocated foot and was flexed forward, thereby generating a distance greater than 10 cm between the body and the enveloping TS, which explains the partial absence of frontal body image in the area of the ankles. Clinical implications The TS Man certainly suffered a very serious and widespread causalgia (burning pain and shock to the tiniest movements of the limbs) due to: total paralysis of the upper right limb (paradoxical causalgia); nailing of the left hand with damage to the ulnar nerve; and nailing of both feet with injury to the plantaris medialis nerves, which pass on the site where there is a bloodstain due to the nailing. The nailing of the TS Man on the cross could have affected his breathing in two ways: a) with arms raised above the shoulders by about 158, and therefore with a more expanded rib cage, the lungs were more filled with air and there was less ability to exhale, but they were not hindered so much to seriously reduce their ventilation capacity; b) every deep inspiration obtained by leveraging on the arms and/ or legs, even with the slightest movement that the TS Man was trying to do, reduces the alveolar hypoventilation and brings oxygen to a body already exhausted by the endless torture, caused him stabbing pain.
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Fig. 5. Scheme of force distributions in the arms of crucified TS Man; FTSM is the vertical force divided between the arms; Farm is the tensile force of each arm needed to bear the vertical force; a is the angle between the arm and the patibulum. As it is not conceivable to obtain an additional lengthening greater than about 2 cm of the arm about 60 cm long previously stretched, an elongation of 3.6% (2 cm/60 cm 3.6%) seems the allowable limit to match an angle of about 158.
Conflicts of interest The authors declare that there are no conflicts of interest. Acknowledgments The authors want to thank Dr. Lorenzo Tavera and Maurizio Franceschi of GE Medical System Italia; Dr Tommy Siviero for skillful radiological assistance; Dr Gloria Sarasin, Dr. Anna Rambaldo, Dr Maria Martina Sfriso and Dr Edgardo E. Picardi, for management of anatomical material; Salvatore Serra for the dimensional analysis of hands. References [1] Vignon P. The Shroud of Christ. New York: E. P. Dutton & Co; 1902. [2] Barbet P. A doctor at Calvary: the passion of our Lord Jesus Christ as described by a surgeon. In: Earl of Wicklow (trans). Garden City, NY: Image Books Ed.; 1963. p. 176–7. [3] Zugibe FT. The crucifixion of Jesus, a forensic inquiry. New York: M. Evans & Co; 2005. [4] Paleotto A. Esplicazione del Sacro Lenzuolo ove fu avvolto il Signore (Cap. 26). Bologna: Rossi Ed.; 1598. [5] Barbet P. A doctor at Calvary: the passion of our Lord Jesus Christ as described by a surgeon. In: Earl of Wicklow (trans). Garden City, NY: Image Books Ed.; 1963. p. 103–20. [6] Lumpkin R. The physical suffering of Christ. J Med Assoc Ala 1978;47(8):10–47. [7] Edwards WD, Gabel WJ, Hosmer FE. On the physical death of Jesus Christ. JAMA 1986;255(11):1455–63.
[8] Tzaferis V. Jewish tombs at near Giv’at ha-Mivtar Jerusalem. Israel Explor J 1970;20:18–32. [9] Bucklin R. The Shroud of Turin: viewpoint of a forensic pathologist. Shroud Spectrum Int 1984;13:3–8. [10] Caselli G. Constatazioni della medicina moderna sulle impronte della Sacra Sindone. In: La Santa Sindone nelle ricerche moderne. Atti dei Convegni di Studio Torino 1939, Roma e Torino 1950. L.I.C.E. – R. Berruti & C. Torino; 1950. p. 23–36. [11] Fasola U. Scoperte e studi archeologici dal 1939 ad oggi, che concorrono a illuminare i problemi della Sindone di Torino. In: La Sindone e la scienza. II Congresso di Sindonologia. Paoline; 1978. p. 59–83. [12] Ricci G. The Holy Shroud. Rome, Italy: Center for the Study of the Passion of Christ and the Holy Shroud; 1981. [13] Massey EW. An interpretation of the hand and arm marking of the Shroud of Turin. The Hand 1980;12(1):75–80. [14] Fanti G. La Sindone una sfida alla scienza moderna. Roma: Ed. Aracne; 2008. 77. [15] Bevilacqua M, Fanti G, D’Arienzo M, De Caro R. Do we really need new medical information about the Turin Shroud? Injury 2014;45:460–4. [16] Porzionato A, Macchi V, Stecco C, Mazzi A, Rambaldo A, Sarasin G, et al. Quality management of Body Donation Program at the University of Padova. Anat Sci Educ 2012;5:264–72. [17] De Caro R, Macchi V, Porzionato A. Promotion of body donation and use of cadavers in anatomical education at the University of Padova. Anat Sci Educ 2009;2:91–2. [18] Riederer BM, Bolt S, Brenner E, Bueno-Lopez JL, Chirculescu AR, Davies DC, et al. The legal and ethical framework governing Body Donation in Europe – 1st update on current practice. Eur J Anat 2012;16:13–33. [19] Barbet P. A doctor at Calvary: the passion of our Lord Jesus Christ as described by a surgeon. In: Earl of Wicklow (trans). Garden City, NY: Image Books Ed.; 1963. 48. [20] Fanti G, Basso R, Bianchini G. Turin Shroud: compatibility between a digitized body image and a computerized anthropomorphous manikin. J Imaging Sci Technol 2010;54(5). 050503-1/8. [21] Hynek RW. Science and Holy Shroud. Chicago: Benedectine Press; 1936.
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Injury journal homepage: www.elsevier.com/locate/injury
How was the Turin Shroud Man crucified? M. Bevilacqua a,*, G. Fanti b, M. D’Arienzo c, A. Porzionato d, V. Macchi d, R. De Caro d a
Hospital-University of Padua, Italy Department of Industrial Engineering, University of Padua, Italy c Orthopaedic Clinic, University of Palermo, Italy d Institute of Anatomy, University of Padua, Italy b
A R T I C L E I N F O
A B S T R A C T
Keywords: Turin Shroud Man Crucifixion technique Nailing Causalgia Cause of death
As the literature is not exhaustive with reference to the way the Turin Shroud (TS) Man was crucified, and it is not easy to draw significant information from only a ‘‘photograph’’ of a man on a linen sheet, this study tries to add some detail on this issue based on both image processing of high resolution photos of the TS and on experimental tests on arms and legs of human cadavers. With regard to the TS Man hands, a first hypothesis states that the left hand of the TS Man was nailed twice at two different anatomical sites: the midcarpal joint medially to the pisiform between the lunate/ pyramidal and capitate/uncinate bones (Destot’s space) and the radiocarpal joint between the radio, lunate and scaphoid; also the right hand would have been nailed twice. A second hypothesis, preferred by the authors, states that the hands were nailed only once in the Destot’s space with partial lesion of the ulnar nerve and flexion of the metacarpophalangeal joint of the thumbs. With regard to the TS Man feet, the imprint of the sole of the right foot leads to the conclusion that TS Man suffered a dislocation at the ankle just before the nailing. The entrance hole of the nail on the right foot is a few inches from the ankle, and excludes a double nailing. The nail has been driven between the tarsal bones. The TS Man suffered the following tortures during crucifixion: a very serious and widespread causalgia due to total paralysis of the upper right limb (paradoxical causalgia); a nailing of the left wrist with damage to the ulnar nerve; a similar nailing of the right wrist; and a nailing to both feet using one only nail that injured the plantaris medialis nerves. The respiratory limitation was probably not sufficient to cause death by asphyxiation. Also considering the hypovolemia produced by scourging and the many other tortures detectable on the TS, the principal cause of death can be attributed to a myocardial infarction. ß 2014 Elsevier Ltd. All rights reserved.
Introduction For more than a century the mode of crucifixion of the Turin Shroud (TS) Man has been studied [1], but no reliable conclusions have yet been reached because it is not easy to draw significant information from only one ‘‘photograph’’ of a man on a linen sheet, with many peculiar bloodstains coherent with a human body. Little historical information is available about the means of crucifixion in
* Corresponding author. Tel.: +39 049 827 6804. E-mail addresses: [email protected] (M. Bevilacqua), [email protected] (G. Fanti), [email protected] (M. D’Arienzo), [email protected] (A. Porzionato), [email protected] (V. Macchi), [email protected] (R. De Caro). http://dx.doi.org/10.1016/j.injury.2014.10.039 0020–1383/ß 2014 Elsevier Ltd. All rights reserved.
the Roman period and limited studies involved direct experiments on cadavers [2,3]. Barbet made studies on crucified cadavers more than half a century ago [2]. More recently, many researchers have investigated aspects of the TS; for example, the forensic pathologist, Zugibe [3] studied many cadavers. Nevertheless, none of the researchers has conducted direct experiments on cadavers or parts of them to study nailing procedures. The Archbishop of Bologna, Paleotto, who accompanied St. Charles Borromeo over the Alps to Turin in 1598, was the first to note that wounds appeared to be in the wrists and not in the middle of the hand [4]. The iron nails were then mainly considered to have been driven between the radius and the carpus or between the two rows of carpal bones [5,6] either proximal to or through the strong bandlike flexor retinaculum and the various intercarpal ligaments [7]. Barbet performed some experiments on amputated limbs and
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argued that nailing took place through the so-called Destot’s space, between the lunate/pyramidal and capitate/uncinate bones on the ulnar side of the wrist. He also reported movement in opposition and slight flexion of the thumb, after nailing, and ascribed this phenomenon to injury of the median nerve [5]. However, it was contested that a lesion of the median nerve at the wrist is not compatible with the nailing in the Destot’s space, because its course is away from the radial side [3]. So, in the authors’ opinion, the absence of fingerprint of the thumb needs another explanation. According to the preferred nailing practice by the Romans [8], the TS Man had his feet touching each other, the left on the right, fastened with a single nail on the cross, without suppedaneum, passing between the metatarsal bones [2,9]. Caselli [10] identified two nail wounds on the right foot, ‘‘one in its true place on the metatarsal bones, the other on the heel’’, and attributed the second wound to displacement of the TS Man caused by arrangement of the body on the anointing stone, which is the bench for burial preparation. In the authors’ opinion, the bloodstain on the heel is due to a blood leakage from the nail imprint ‘‘on the metatarsal bones’’. The heel is not completely visible on the TS because the TS was not in contact with the entire foot. Specific analyses have been conducted on the trickles of blood on the upper limbs. Fasola [11] attributed the divergence of the blood flow from the wrist wound to a slight rotation of the arm. Ricci [12] suggested that the divergence of the blood flow was due to the variable position of the arms on the cross that allowed the TS Man to breathe. Massey [13] determined the position of the arms on the cross deriving it from the corner of the trickles of blood on his forearms with the axis of the respective arms. In the authors’ opinion, these trickles formed when the arms were moved after unnailing. Zugibe [3] proposed that the body of the TS Man was washed before it was buried to remove the ‘‘mask of blood’’, which he would have had after the cruel scourging (more than 370 wounds by the scourge [14]). Conversely, the postmortem blood on the TS Man (spilled from the chest after the spear, from the head after removal of the crown of thorns, and from the wrist and feet after unnailing) was not supposed to be removed because according to Jewish custom it was forbidden to touch postmortem blood as it would make the person ‘‘impure’’ [3]. The authors share this opinion. In a recent publication [15] the authors proposed that the TS Man could have suffered a violent trauma to the right side of the neck, chest and shoulder, causing an underglenoidal dislocation of the humerus, with injury of the entire brachial plexus, right flattened hand and enophthalmos. The blunt chest trauma, which resulted in the body falling forward, was also a direct cause of a lung contusion and haemothorax. A sign of this chest trauma, which was probably caused by the cross falling on the body, can perhaps be seen on the dorsal TS body image as the two darker areas beneath the shoulders. The aim of the present study was to provide further hypotheses about the possible anatomical sites of nailing of the TS Man, through a renewed analysis of the TS bloodstains and experimental procedures of nailing on cadavers. The following questions were considered: How many nails were used on the hands and feet, and where? What is the meaning of the trickles of blood on the forearms and feet? What is the most likely posture of the TS Man? What are the possible clinical consequences of such a nailing? Materials and methods
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limbs and their segments, and particular consideration given to feet, hands and fingers. Another evaluation specifically involved the bloodstains, assessing their orientation with respect to the upper limb axis. Experimental procedures on limbs Analyses were performed on three right upper limbs resected from cadavers at the shoulder, and on another anatomic specimen consisting of the trunk and both inferior limbs. The donors gave specific consent. Cadavers were managed by the Body Donation Programme of the Section of Human Anatomy of the Department of Molecular Medicine of the University of Padua. In 2011, the Body Donation Programme achieved certification by an accredited third-party registrar (Certiquality Srlß , Quality Certification Body, Milan, Italy), which audited the quality management system and certified that the Body Donation Programme of the University of Padova met EN ISO 9001:2008 criteria [16]. The use of cadavers for medical training and scientific research is performed according to European, National and Regional normative references [17,18]. The experimental procedures performed were as follows. The upper limbs were nailed in the following points: - radiocarpic joint between the radio, lunate and scaphoid; - midcarpal joint line between the scaphoid/lunate and trapezoid/ capitate; - midcarpal joint medially to the pisiform between the lunate/ pyramidal and capitate/uncinate (Destot’s space). With regard to the inferior limbs, the following procedures were performed: - dislocation of the right ankle joint, through increasing weights applied with a rope to the ankle (this tension technique of the limbs with ropes was usual in the crucifixion [19]); - nailing of the right foot between the 1st and 2nd metatarsal bone, with a 10 cm-long nail; - nailing of the left foot between the scaphoid and cuboid, proximally, and third cuneiform, distally, with a 25 cm-long nail; - further nailing of the right foot, with the long nail passing through the left one, at the level of the right tibiotarsal joint. The points of entrance were identified under radioscopic control (OEC C-Arms, 9600; GE medical system) with the help of small lead semi-spheres. Nailing of feet was performed on a wooden plank. CT axial scans (Philips Brilliance iCT, Philips Medical Systems; Best, The Netherlands) of the specimens were acquired. Analysis and post-processing of the CT scans were carried out on an Aquarius Workstation (version 3.6.2.3; TeraRecon, San Mateo, California). Source images and 2D-3D reconstructions were reviewed at the workstation. Specific anatomical dissections were then performed to confirm the CT findings and to verify the condition of vessels and nerves. Results TS analysis
TS analysis
Right hand The posture of the right hand is compatible with a flat paralytic hand.
Various high-resolution images of the TS, taken by G. Enrie, G.B. Judica Cordiglia, G. Durante and Haltadefinizione, were analysed after proper image processing with reference to posture of the four
- The hand is slightly flexed towards the ulna, as normal, not contracted (the angle between a line drawn between the 3rd and 4th metacarpus and a line coaxial to the forearm is 158 38) (Fig. 1).
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- The thumb is also absent in the right hand that is stretched out on the thigh.
Bloodstains on the left wrist
Fig. 1. Left arm: the trickles on the wrist and forearm have the same angle (388 28) with a line drawn between the 3rd and 4th metacarpus. The hand is slightly flexed radially (the angle between a line drawn between the 3rd and 4th metacarpus and a line coaxial to forearm is 68 38) and dorsally flexed, which is suggestive of a ‘‘claw hand’’. Right arm: the trickles are almost unidirectional, coaxial to the arm. The hand is slightly flexed towards the ulna (the angle between a line drawn between the 3rd and 4th metacarpus and a line coaxial to forearm is 158 38, which is normal).
- The flexion is not due to the recomposition of the body in the sheet with support of the outstretched hand on his thigh, because rigor mortis would have prevented a change in posture at this point. - The flexion is not due to distortion related to the superimposition because there are clear fingerprints of the metacarpophalangeal joints and the proximal, intermediate and distal phalanges of the fingers II–V; phalanges are normal and in proportion to each other and they are not flexed as in his left hand; - The almost uniform colour intensity of the thigh below confirms the flattening of the hand.
Left hand The posture of the left hand is suggestive of a ‘‘claw hand’’ [15], in a slight radial abduction (the angle between a line drawn between the 3rd and 4th metacarpus and a line coaxial to the forearm is 68 38, Fig. 1). The two last phalanges are flexed, which is characteristic of damage to the lower brachial plexus with proximal ulnar nerve palsy; this was probably due to stretching of the limb with ropes during nailing until the arm dislocated. However, a claw hand is also characterised by abduction and extension of the thumb, which is lacking in the TS image.
- A proper contrast enhancement of a square-like area of different luminance on the TS image (probably the exit hole of the nail; Roman nails were typically square), enables the visualisation of the lower trickle, which is possibly in the intercarpal Destot’s space identified by Barbet. The drain of blood to the wrist originates from this point located on the extension of a line drawn between the 3rd and 4th metacarpus. - An additional contrast enhancement of a second quadrangular area enables visualisation of what is perhaps the upper trickle, slightly shifted towards the radial side, in the radiocarpal articulation between the radio, lunate and scaphoid. - The two trickles are directed towards the ulnar side spreading apart at an angle of 388 28 with reference to the above mentioned line (Fig. 1).
Bloodstains on the left forearm
- Trickles of blood have a diagonal course from the wrist to the medial part of the elbow, with an angle of 388 28 (like that of the wrist) with small streams slanting towards the outside of the forearm, due to the radial flexion of the hand (Fig. 1).
On the right forearm
- The bloodstain is almost unidirectional, coaxial to the arm (Fig. 1). The authors believe that the course of the trickles on the left wrist and on the forearms does not reflect the position of the arms on the cross, but it is simply due to the movements undergone by the arms after the wrists were unnailed. The blood was not removed because this would be ‘‘impure’’, as mentioned above.
The lack of thumb imprint The lack of a thumb imprint is compatible with a tendon retraction.
On the sole of the right foot Two areas of greater extravasation of blood are recognisable. The first of these areas is in the middle of the central bloodstain, where there appears to be a square hole that is the probable location of nailing; the second area, which is 10.5 0.5 cm from the first, is at the height of the heel on the medial side and can be due to a blood accumulation coming from the nail hole (Fig. 2). The lack of continuity of the blood flow is due to the arch of the foot, which caused a local detachment from the cloth. This interpretation is confirmed by the blood rivulets outside the image of the foot.
- There is an area around the left hand where the imprint is almost absent. It reflects the distance of the body from the TS; this distance is about 2 cm between the ulnar margin of the left hand and the 2nd and 3rd finger of the right hand below, and about 6 cm between the left radial margin of the hand and right distal forearm below. A hand in dorsal flexion, documented by the more developed imprints of the first metacarpal phalangeal joint, explains this difference. - Even with a just flexed left hand resting on the right hand, the thumb would be more on the side of the index and would imprint somehow on the TS.
On the back of the right foot A detailed study of the TS frontal and dorsal body image, also supported by an anthropometrical analysis [20], shows that the bloodstain on the front right foot is located in a position 5 3 cm distant from the ankle. This implies that TS Man had a single nailing in the centre of the foot. As already suspected in the past [20,21], the right ankle joint appears dislocated and tilted forward; if this was not the case, it would be difficult to explain the plantar foot imprint on the TS. Like the hands, the bloodstain on the foot is due to the unnailing.
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Fig. 2. Left image: legs and feet of the TS frontal image where the right bloodstain on the foot is 5 3 cm from the ankle. Central image: legs and feet of the TS dorsal image. Right image: the most probable position of the nail piercing the right foot.
On the sole of the left foot The trickles of blood along the medial border of the foot assume the shape ‘‘ ’’ (Fig. 2). At the centre of this shape there is a vaguely recognisable area of increased blood. This is probably the exit hole of the nail and it is placed on the front of the heel. The branches of blood from this core are probably due to movements during unnailing, transportation to the tomb, or TS overlapping.
Experimental procedures on limbs Radiocarpic joint between the radio, lunate and scaphoid The identification of this spot was quite simple on the volar surface of the wrist. It is at the level of the superior skin fold of the wrist, between the two tendons of the flexor carpi radialis and palmaris longus, near the scaphoid tubercle. Nailing did not cause bone fractures, but there was dislocation of the lunate and scaphoid from the radial articular surface. The nail produced a deviation of the tendon of the flexor pollicis longus. As a consequence of the action of the nail on this tendon, the thumb was slightly adducted during nailing, with partial flexion of the distal phalanx (Fig. 3). The nail also partially deviated and minimally injured the median nerve. The acquired position of the thumb is consistent with the TS, where the left thumb is not visible probably due to adduction and flexion. Midcarpal joint between the scaphoid/lunate and trapezoid/capitate Nailing in this spot did not cause bone fractures, but the lunate was dislocated. The median nerve was not injured. The thumb was partially adducted and the distal phalanx was flexed during nailing. These findings are consistent with the lack of thumb imprint on the TS. Midcarpal joint medially to the pisiform (Destot’s space) This point is located at the level of the inferior skin fold of the wrist medially to the tubercle of the pisiform bone. On the basis of the above references, the Destot’s space was quite easy to identify. The nailing procedure did not cause bone fractures; however, the ulnar nerve and artery and the flexor digitorum superficialis were completely injured. No adduction of the thumb was noted (Fig. 4).
Dislocation of the right ankle joint This dislocation was achieved with a force of 2000 N applied to the ankle using a rope. This is consistent with the possible dislocation of such a joint before nailing. Nailing of the right foot This procedure was possible with a 10 cm-long nail passing at the bases between the 1st and 2nd metatarsal bones. After nailing, with repeated hammering, the right foot leaned on the plank with the calcaneus, while a distance of about 2 cm was measured between the plank surface and the plantar surface at the nail exit point. Nailing of the left foot Under radioscopic control, the 25 cm-long nail entered between the scaphoid and cuboid, proximally, and the third cuneiform, distally. The exit point was located on the medial of the calcaneus, at the posterior extremity of the plantar arc. This finding is consistent with the TS body image. Discussion The data from our experimental tests on arms and legs of human cadavers and evaluation of the TS body image with its various bloodstains enable us to propose the nailing method of hands and feet used for the TS Man. Two different nailing procedures for the wrists were hypothesised by the authors at the beginning of the present study: the first procedure involved two double nailings per wrist in coherence with the apparently double bloodstains coming out from the left wrist; the second procedure comprised a single nailing per wrist assuming that these bloodstains came out from a single larger hole. The relative experiments on parts of cadavers, although limited for obvious reasons, covered both hypotheses and also investigated the possibility of a double nailing of the right foot. The very recently discovered position of the entrance hole of the nail 5 3 cm distant from the ankle (Fig. 2) is against the hypothesis of a double nailing in the right foot. The single nailing is instead located between the tarsal bones, perhaps just in the position where the nail was put in the left foot, that is, between the scaphoid and cuboid, proximally, and the third cuneiform, distally. Therefore,
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Fig. 3. Nailing in the radiocarpal space between the radio, scaphoid and lunate. (A) Hand before nailing: the thumb is in the abducted position. The two points of nailing are highlighted: the higher superficial fold (radiocarpic space) and the lower fold (Destot’s space). (B) The exit hole is visible of the plastic facsimile nail driven in the radiocarpic space (replaces the iron nail). (C) Radiological control. (D) The nailing in the radiocarpic space induces retraction of the thumb. (E) Dissection of the wrist: deviation of the tendon of the flexor pollicis longus and slight lesion of the median nerve. (F) Three-dimensional reconstructions of CT exam of a hand specimen. The nail deviates the tendon of the flexor pollicis longus.
the authors prefer the hypothesis of the single wrist nailing, because it is also not easy to explain why the crucifiers should have made two holes in the same wrist at a distance apart of only a very few centimetres, and a single nail was used to pierce the feet. According to the authors, the respiratory limitation, plus the presence of a haemothorax, which pressed down the right lung [14], was not sufficient to cause death by asphyxiation (i.e. by ventilatory failure characterised in the terminal phase by loss of consciousness and coma). A probable cause of death, also considering the hypovolemia produced by scourging, bleeding and the many other tortures, is myocardial infarction. A more detailed description follows, but it should be emphasised that all these tortures are coherent with the Passion of Jesus Christ described in the Gospels. Hands On the basis of the analysis of the left hand in the TS, the exit hole of the nail seems to be located in the Destot’s space, as
previously proposed by Barbet [2]. However, this anatomical site is quite far away from both the median nerve and the tendon of the flexor pollicis longus to explain the retraction of this finger. Our single experiment showed that nailing through the Destot’s space completely injured both the ulnar artery and nerve, and this fact seems in contrast with the assumption of a thumb retraction. According to our experimental data, the retraction of the thumbs seems to be due to the stretching of the tendon of the flexor pollicis longus by nailing the radiocarpal joint. Damage of the median nerve could also have contributed to retraction of this finger, causing deficit of the abductor pollicis brevis and opponent muscles, with adduction of the first metacarpus and thumb. The first hypothesis analysed at the beginning by the authors states that it is possible that the left hand of the TS Man was nailed twice at two different anatomical sites: the Destot’s space, where a quadrangular area of the nail appears after image contrastenhancement, and the radiocarpal joint between the radio, lunate and scaphoid, about 1.5 cm proximally with respect to the Destot’s space.
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Fig. 4. The nailing in the Destot’s space (between the lunate/pyramidal and capitate/uncinate) does not cause the thumb retraction in a cadaver, but a partial injury of the ulnar nerve produced by this nailing can cause thumb retraction in a living person.
The second hypothesis, preferred by the authors, states that a unique hole was made in the wrists by the nail put in the Destot’s space. If we suppose a possible partial tear of the ulnar nerve that saves its deep branch, we can explain the contracture of the deep head of the flexor pollicis brevis and a flexion of the metacarpophalangeal joint, coherent with the lack of thumbs in the TS image. Therefore, we think that probably Barbet confused the ulnar nerve with the median nerve. The significant drain of blood on the forearms may be explained by the injury to the ulnar artery; intravascular bleeding and haematoma gathered around the nail, and followed recomposition of the limbs. The people who were arranging the burial could have raised his arms to prevent the blood spilling from the holes to the ground. The different arrangement of blood on both forearms is explained by the different posture of the limbs and the different angle of the hands with the forearms: the right upper limb paralysed with the hand and forearm in axis; the left arm with the wrist abducted and flexed dorsally, not in line with the forearm (Fig. 1). Feet The footprint of the entire sole of the right foot (Fig. 2) seen on the TS and the partial absence of a left footprint shows that the TS was not wrapped around the feet, but simply left lying on the ‘‘mattress’’ of resin powders of myrrh and aloe. This indicates that the TS Man suffered an ankle dislocation during nailing. Otherwise, the foot would have been raised thus avoiding its imprint on the TS. The suspicion that the bloodstain on the heel of the right foot may have been caused by a second nailing led the authors to undertake a test of nailing through the ankle to obtain the exit hole corresponding to the sole of the right foot at the heel (and not outside just near to its tuberosity). Nevertheless, image processing showed the bloodstain to be just under the ankle, thereby excluding a double nailing, so the authors accept the hypothesis of a single nail in the right foot and then the two feet were nailed together, in agreement with the Latin Church.
Posture of the limbs The nailing procedure confirms the posture of TS Man in accordance with a computerised anthropometric analysis [21]. The TS Man on the cross did not collapse with the body on his knees, but he was stretched once he was pulled and dislocated with ropes [4]. His arms were moderately lowered by about 158 (Fig. 5) compared with the patibulum and not by 658 as supposed by Barbet [2]. His head was bent forward and his knees were slightly bent due to the human body dejection after death, with feet rotated after ankle dislocation. The left foot was nailed over the right dislocated foot and was flexed forward, thereby generating a distance greater than 10 cm between the body and the enveloping TS, which explains the partial absence of frontal body image in the area of the ankles. Clinical implications The TS Man certainly suffered a very serious and widespread causalgia (burning pain and shock to the tiniest movements of the limbs) due to: total paralysis of the upper right limb (paradoxical causalgia); nailing of the left hand with damage to the ulnar nerve; and nailing of both feet with injury to the plantaris medialis nerves, which pass on the site where there is a bloodstain due to the nailing. The nailing of the TS Man on the cross could have affected his breathing in two ways: a) with arms raised above the shoulders by about 158, and therefore with a more expanded rib cage, the lungs were more filled with air and there was less ability to exhale, but they were not hindered so much to seriously reduce their ventilation capacity; b) every deep inspiration obtained by leveraging on the arms and/ or legs, even with the slightest movement that the TS Man was trying to do, reduces the alveolar hypoventilation and brings oxygen to a body already exhausted by the endless torture, caused him stabbing pain.
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Fig. 5. Scheme of force distributions in the arms of crucified TS Man; FTSM is the vertical force divided between the arms; Farm is the tensile force of each arm needed to bear the vertical force; a is the angle between the arm and the patibulum. As it is not conceivable to obtain an additional lengthening greater than about 2 cm of the arm about 60 cm long previously stretched, an elongation of 3.6% (2 cm/60 cm 3.6%) seems the allowable limit to match an angle of about 158.
Conflicts of interest The authors declare that there are no conflicts of interest. Acknowledgments The authors want to thank Dr. Lorenzo Tavera and Maurizio Franceschi of GE Medical System Italia; Dr Tommy Siviero for skillful radiological assistance; Dr Gloria Sarasin, Dr. Anna Rambaldo, Dr Maria Martina Sfriso and Dr Edgardo E. Picardi, for management of anatomical material; Salvatore Serra for the dimensional analysis of hands. References [1] Vignon P. The Shroud of Christ. New York: E. P. Dutton & Co; 1902. [2] Barbet P. A doctor at Calvary: the passion of our Lord Jesus Christ as described by a surgeon. In: Earl of Wicklow (trans). Garden City, NY: Image Books Ed.; 1963. p. 176–7. [3] Zugibe FT. The crucifixion of Jesus, a forensic inquiry. New York: M. Evans & Co; 2005. [4] Paleotto A. Esplicazione del Sacro Lenzuolo ove fu avvolto il Signore (Cap. 26). Bologna: Rossi Ed.; 1598. [5] Barbet P. A doctor at Calvary: the passion of our Lord Jesus Christ as described by a surgeon. In: Earl of Wicklow (trans). Garden City, NY: Image Books Ed.; 1963. p. 103–20. [6] Lumpkin R. The physical suffering of Christ. J Med Assoc Ala 1978;47(8):10–47. [7] Edwards WD, Gabel WJ, Hosmer FE. On the physical death of Jesus Christ. JAMA 1986;255(11):1455–63.
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