Jesus died "suddenly" on the cross in Jerusalem only three to four hours after being crucified by the Romans, apparently due to a pulmonary embolism caused by the lack of movement of his limbs and not from hemorrhaging, a Technion Medical School and Rambam Medical Center expert on thrombosis suggests for the first time in the latest issue of the Journal of Thrombosis and Haemostasis.

Prof. Benjamin Brenner writes in a long letter to the editor published in the journal – backed up by 20 separate references from medical texts and the Christian Bible – that the 34-year-old Jesus of Nazareth may have had additional risk factors because he was Jewish.

"Born in Israel to a Jewish family, [it] is not unlikely that he had inherited a hypercoagulable state, since thrombophilia is linked to a mutation common in Israel and especially in people residing in the Galilee area," Brenner writes.

An article in the Journal of the American Medical Association two decades ago was only one of numerous medical journal articles that speculated about the suffering and death of Jesus, Brenner writes. The authors had suggested that he went for at least 12 hours without food and water after the "last supper." During that time, "from Thursday 9 p.m. to Friday 9 a.m., Jesus was under great emotional stress, endured beating and had to walk four kilometers to and from the sites of various Jewish and Roman trials. It is therefore clear that even before scourging [being lashed] and crucifixion, Jesus was in a state of dehydration."

The JAMA article added that the scourging on his back, buttocks and legs – which was a legal preliminary to every Roman execution – leads to significant tissue damage and causes pain and blood loss leading to a pre-shock state.

After scourging, Jesus was forced to carry on his shoulders the patibulum of the cross, which weighed 34 to 57 kilos for 600 meters to the site of crucifixion. This led to further dehydration and exhaustion.

But Brenner contends that the amount of blood he lost could not itself have resulted in circulatory failure.

Instead, he believes that multiple trauma associated with significant activation of the coagulation system, mainly by tissue factor, was what killed him. Being nailed to the cross at the wrists and ankles, wrote Brenner, led to further release of tissue factor and increased procoagulant activity. This prolonged immobilization in the upright position resulted in an increase in the risk of clots in his legs, which were likely to have traveled to his lungs.

"While on the cross, a victim experienced severe stress, prolonged sun exposure and developed rapid shallow breathing, which dramatically intensified dehydration," Brenner suggests. "Moreover, Jesus was also given wine for pain relief, probably causing increased production of urine. Experts say that crucified victims could survive on the cross between three hours to four days. But according to religious texts, Jesus was put on the cross on Friday before noontime and died at 3 p.m., thus his death was sudden. A Roman soldier stabbed him in his right chest after his death; the Romans did not, however, fracture his legs, causing death from asphyxia within minutes, even though this was done to the 'two thieves' to speed up their deaths."