By W. W. Keen, M.D., LL. D
IT is a noticeable fact that of the four Evangelists, Luke, who was the only physician among them, is also the only one who records the “bloody sweat" of our Lord. And it is noticeable also that, as would be naturally his bent in describing it, he uses technical terms not occurring elsewhere in the New Testament. In fact, the very same Greek word “Thrombos" which he uses to designate the clotted “drop" of blood, is at the present time used technically in medicine to indicate a clot of blood in certain pathological conditions.
A question would naturally arise first, as to how Luke obtained his information. Plumptre (Ellicott's “New Testament Commentary," i. 351) suggests very reason ably that it was from one of the disciples present in the garden, or from one of the women, from whom he obtained much information. The sweat must have stained his clothing (see case cited below), and therefore probably would have been observed by the soldiers and Mary Magdalene or Nicodemus, and Joseph may have seen its remains on the body itself.
The meaning of the passage both in Greek or English seems to be very clear that the sweat was really a bloody sweat, and not something merely resembling blood, or falling like clotted blood. The question then naturally arises whether such bloody sweat is impossible in the human body, and therefore, whether the bloody sweat of our Lord was miraculous, or whether it is a possible and natural, though extremely rare, phenomenon.
Apart from wounds, there are two forms of hemorrhage in connection with the unbroken skin. The first is a cutaneous hemorrhage, such as is seen in scurvy, and especially in what is called Purpum hemorrhagica. In these diseases the blood is thin and disorganized, and exudes into the skin under the scarf-skin or epidermis, but does not escape upon the surface of the skin as a free liquid. The second is a true bloody sweat, that is, sweat mingled with blood in which the mixed fluid escapes upon the surface of the unbroken skin in distinct drops. This is what we have here to consider.
The sweat is derived from small sweat-glands in the skin that are richly supplied with blood. This blood-sup ply is directly under the control of the nervous system, as is especially well seen in blushing or pallor under the influence of emotion. But little added pressure in the blood-vessels would be sufficient to carry the process. beyond blushing into true diapedesis, or escape of the blood from its vessels. Under circumstances of great peril, or great mental emotion from any other cause, it is a fact that the blood escapes directly from the blood-vessels through the sweat-glands on to the surface of the skin Most of the recorded cases show that it occurs usually in Persons of a highly nervous temperament or in conditions involving great nervous strain. The same result some times also follows great physical exertion. The blood is then mingled with the sweat, and is therefore a true “bloody sweat." Not only is the sweat sometimes bloody (henatohidrosis or hematidrosis), but other discolorations 0f the sweat occur. For example, the bile pigments sometimes discolor the sweat in jaundice; there is also blue sweat from indigo' or Pyocyanin (the blue coloring matter of pus or “ matter"), or from the phosphate of the oxide of iron. All of these variously colored sweats occur very rarely, and are called cases of chramidrosis, i.e., “colored sweat."
It must be remembered that in the case of our Lord, the bloody sweat accompanied the most fearful and extra ordinary scene in any human being's life, with the possible exception of the Crucifixion itself. No mortal ever passed through such an agony as did our Lord during that eventful night. Hence the efficient cause or nervous element of such a bloody sweat was not wanting.1
In confirmation of the possibility of such a phenomenon, there are recorded in medical works and reliable histories numerous instances of much less severe mental strain or agony, and even of severe physical exertion, which were accompanied by undoubtedly authentic bloody sweats.
Up to the present time, writers upon this subject have been compelled to search almost exclusively in mediæval literature. Many of the cases recorded in those days, when the Church desired to support itself by miracles, are not above suspicion, though undoubtedly many of these earlier cases are authentic. The reader who desires to follow out this somewhat curious investigation will find in Dr. Stroud's “Physical Cause of the Death of Christ" (London, 1847, and New York, 1871), on page 342 of the notes; in Millingen's “Curiosities of Medical Experience" (London, 1839, p. 487); Copland's “ Dictionary of Practical Medicine" (London, 1858, vol. ii., p. 72), and in McClintock and Strong's Cyclopædia (New York, 1867, vol. i., p. 837), the full references to the earlier cases. But since that time there have been published a comparatively large number of cases of bloody sweat, which have been investigated with care by competent medical writers. A very few of these later cases, as well as some of the earlier ones, are mentioned in an article on bloody sweat by Dr. Pooley, in the Popular Science Monthly (1884-85, vol. xxvi., p. 357), and he states that he has collected in all forty seven cases. One curious fact in his article is that even an animal with so thick and tough a hide as the hippopotamus sweats blood when brought to this country and kept in a state of confinement, a fact of which he has been him self a witness. The same statement is made as to the hippopotamus in London, by Dr. Wilks (Guy's "Hosp. Reports," 3d series, vol. xvii., 1872, p. 220). Similarly, Copland mentions the fine Arabian horse which his friend Dr. W Hutchinson rode in the Ukraine, “whose sweat upon most occasions of exertion was sanguineous, and was nearly pure blood upon great exertion. It was generally un attended by any other signs of disease."
Those who are interested in the matter will find the most complete study of bloody sweat, especially in its relation to the nervous system, in an article by Dr. Jules Par rot, in the Gazette Hebdomadaire (Paris, 1859,v01. vi-, P 633), and still further in the paper by Dr. Samuel Wilks (loc. cit.) and in a paper by Dr. McCall Anderson, in the Journal of Cutaneous Medicine (London, 1868, vol. i., p. 328)
Is the bloody liquid that exudes really blood? Wilks quotes Mr. Jones' examination of the sweat of the London hippopotamus as proving it was not blood (since the red blood-corpuscles were not present though the white appatently were). But in Chambers' cases the microscope revealed true red blood-corpuscles, and also in Turk's case (Rev. Méd. Char. de, Paris. 1850, viii., 247).
Sometimes the exudation is partial and limited, as for instance, to the face or arm or chest, etc., and Orlovius (“Pr. de Hemorrhag. Spontan.," Regiomontan., I 786) gives an instance in which it was limited to the tip of the left thumb, and Secretain (Rap. Gén. Trav. Soc. des Sci. Méd. du Garmat, 1851-52, vi., 98) another in which it took place from the tip of the left forefinger.2
To give some idea of what the cases of general bloody sweat are like, and the attending phenomena, I will give a brief account of a few instances.
In the Lancet (1361, vol. i., p. 207) Dr. T. K. Chambers states that the following symptoms were noticed in his patient:
The following remarkable case is quoted from Hebra, the great Vienna authority on the skin, from his work on “Diseases of the Skin" (New Sydenham Soc., London, 1866):
Paulini (quoted by Schneider, London Med. Gaz, 1848, vii., 95 3, from Casper's Wochenschrift, 1848), who was surgeon on board the vessel, gives the following account of a use under his own observation:
Those who may desire to follow up the subject more fully, and especially the modern cases, can do so best by consulting the Index Catalogue of the Surgeon-General's Office of the U.S. Army, under the following heads (the headings arranged in the order of importance): 1. Perspiration, bloody; 2. Hemorrhage, cutaneous; 3. Diapedesis; 4. Ecstasy; 5. Chromidrosis.
W.W. KEEN, M.D.
Jefferson Medical Collage, Philadelphia.
1 The attacks are often very sudden (as in the case of our Lord) and even instantaneous. Thus McCall Anderson's patient would exclaim, "Oh, I feel a place on my arm!" and upon turning up the sleeve a spot two inches by one was seen; and in Parrot's case “suddenly the blood would inundate the face, and she would look, as the nurses said, like a woman just assassinated."
2) An Italian officer, in 1552, threatened with a public execution, was so agitated at the prospect of an ignominious death that he sweated blood from every part of his body.
A young Florentine, unjustly ordered to death by Pope Sixtus V. , when led to execution, through excess of grief was observed to shed bloody tears and to discharge blood instead of sweat from his .whole body ("Thiranus Hist, sui Temp.," i., 373; iv., 300).
The similar phenomenon at the death of the wretched Charles IX. , related by de Mezeray (and accepted even by Voltaire), is historic, and the same author relates the case of the governor of a town taken by storm who was condemned to die, and was seized with a profuse sweating 0f blood the moment he beheld the scaffold ("Hist. de France," iii., 306).