In reading What significance does John perceive in the piercing of Christ's side and the flow of blood and water?, I wondered if there is anything unusual about both blood and water flowing from the spear-wound in Jesus' side (see John 19:34). If the soldier who pierced Jesus' side had also pierced the side of one of the malefactors with whom Jesus was crucified, would blood and water also have come out of the malefactor's body?

I understand that the primary interpretation of the verse concerns the reality of Jesus' death from John's perspective as an eyewitness, which reality the soldiers bore witness to, since they refused to break Jesus' legs because He was already dead.

In the answers to Matthew Miller's question, though, one contributor's answer "spiritualized" the significance of "blood and water," suggesting that the water signified eternal life and the blood signified mortal life, both of which poured from Jesus' side.

I heard a sermon years ago that makes me wonder about this secondary (?) interpretation. In that sermon, the preacher spoke of the physiological aspect of the occurrence. He may have even involved medical science in some way, such that from a doctor's point of view something unusual had taken place after Jesus was pierced by the spear.

We know that Jesus' blood did not contain the taint of sin, since Jesus was of the seed of a woman, not a man; His blood therefore did not carry the "death" gene, as it were. Is there more to Jesus' blood, however, that can be explained by not spiritualizing the blood and water?

I do not disagree with the legitimate symbolism and significance of both blood and water in Scripture in general and in John's gospel in particular, but I cannot help but wonder if in addition to the spiritual factors involved here there is also a very human and physiological explanation.

Is there a medical or physiological explanation? Is it normal for blood and water to both flow from a body in these circumstances?

  • "... since they refused to break Jesus' legs because He was already dead." and for the fulfilment of prophecy. I want to take you to task that you explain how you justify that you say, "We know that Jesus' blood did not contain the taint of sin, since Jesus was of the seed of a woman, not a man" - in chat if necessary.
    – Willtech
    Aug 11, 2018 at 3:17
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    @Willtech: Jesus' blood did not contain the taint of sin because he was conceived by the Holy Spirit (Mt 1:18; Lk 1:35). Since he was a son born to Mary, Jesus was the Son of Man ("man" in the generic sense of hu-man), but he was also the Son of God, since he had no earthly father, but a heavenly Father. As for the "seed of the woman" through whom the head of the serpent would be crushed (Genesis 3:15), a careful reading of Romans 5 reveals that in (or through) Adam, all die. As titular head of both the woman given to him by God and the human race in general, Adam carried the death gene (to Aug 11, 2018 at 15:32
  • put things in modern parlance). That means physical and spiritual death entered the human race through Adam (the seed of the man), not Eve. Now Eve died, but that was because she came from (or out of) man. Jesus was both sinless and immortal because he was conceived by the Holy Spirit, who "overshadowed" the conception process, resulting in both a sinless conception and a sinless birth. Jesus proved he was born sinless by living a perfect and sinless life. He once asked, "Which one of you convicts Me of sin?" The obvious answer: "No one." Aug 11, 2018 at 15:52
  • So, you argue that the commandment not to eat the fruit was upon Adam not Eve although she knew it herself and that Adam should have [ruled/cared for/loved/?] woman so that she also was subject to the commandment and then ruled himself that he also not eat since God's commandment was given to Adam, so Adam sinned and not Eve? Even being Eve was made from Adam's rib?
    – Willtech
    Aug 11, 2018 at 20:54
  • @Willtech: As difficult as it is, in this age of political correctness and hypersensitivity, the concept of the man being the head of the woman (1 Corinthians 11:3) may be distasteful to some, but it is very biblical. No superiority of man over woman is implied, mind you, just as there is no superiority of Father over Son within the Godhead. I may be wrong, but Adam seemed to have sinned with his eyes wide open, whereas Eve was deceived. A fairly common surmise is that Adam knew that he would be separated from his helpmeet forever, if she were the only one to sin, so he chose to sin. Aug 12, 2018 at 0:09

6 Answers 6


The horrific and agonizing death by crucifixion which our dear Lord endured on our behalf is described in detail at Blue Letter Bible.

We know that after being centrifuged in a laboratory, the resulting components of blood include a clear solution of blood plasma. Blood plasma is the straw-colored/pale-yellow liquid component of blood that normally holds blood cells in suspension. By volume it contains 92 percent water.

If the pericardium of Jesus' heart, which the soldier's spear may have penetrated, was filled with plasma from the intense pressure being exerted upon the heart during crucifixion, blood from the ventricle (left or right), plasma ("water") from the pericardium, and pleural fluid from the lungs would issue from the wound, particularly with Jesus positioned, as he was, vertically; hence John's descriptors of "a sudden flow of blood and water" (NIV).

Some scriptures for additional meditation: Isaiah 52:14; 53:5,10; Psalm 22:12-21; Exodus 12:46, Numbers 9:12, and Psalm 34:20; also Zechariah 12:10.

  • Death by crucifixion is normally a horrific ordeal but fortunately Jesus only endured the first few hours, before he became exhausted so his ordeal was a relatively easy affair. Can you provide any sources for the anatomical details you supply?
    – user10231
    Jul 11, 2016 at 14:46
  • @WoundedEgo, I just added a citation for this. Dec 12, 2016 at 21:23
  • (-1) @JamesShewey Does the "Blue Letter Bible" provide a primary source? Sorry, but honestly I find this and the "Jesus sweated blood" stuff all nonsense and the "experts" who "explain" this completely derelict. Jesus' heart didn't pop. It was a few brief hours of the easiest part of the ordeal. Hence, Psalm 22, where the sufferer praises God that he has delivered him from the "horn of the unicorn".
    – user10231
    Dec 12, 2016 at 21:36
  • @WoundedEgo: No, the source I added was not the BLB - it was Dr. Cathleen Shrier, Ph.D Professor of Biology and Human Physiology at APU, a top-10 school in the nation for nursing. She explains that Crucifixion stretches the victims body to the point that their shoulders dislocate and the weight of the victims body places enough weight on the diaphragm it causes the victim to slowly asphyxiate. Dec 12, 2016 at 22:14
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    The O2 level causes cellular damage to capillaries and tissues in the pericardium and lungs which causes fluid to build up inside of the pericardial sack and lungs. If you doubt that this would be the effect of a sustained low O2 Sat. level, the Health SE or Biology SE ought to be able to verify. @Susan might also be able to comment - she has about 6000 reputation between the two sites. Dec 12, 2016 at 22:18

The findings of three medical doctors who asked and answered similar questions are given below.

If the soldier who pierced Jesus’s side had also pierced the side of one of the malefactors with whom Jesus was crucified, would blood and water also have come out of the malefactor’s body?

One of the doctors quoted below, Dr. Pierre Barbet, purposely created a similar scenario on several corpses for autopsies because he had similar questions. He was able to derive blood and "water" (hydropericardium) from the heart of those corpses.

I heard a sermon years ago that makes me wonder about this secondary (?) interpretation.

Further reading shows that Dr. Barbet quotes St. Jerome (Epist. 83, ad Oceanum): “This double flow consecrates at the same time the Baptism of Water and the Baptism of blood of the martyr.”

Is there more to Jesus’s blood, however, that can be explained by not spiritualizing the blood and water?

That's a tough one. I don't know how to refrain from spiritualizing a dead person because they are seen as spirits. In the case of Christ, I don't know how we would separate the "spirit" he was known to resurrect with from a body that had the same blood and water. For those that believe Christ's blood was needed for the Holy "Spirit" to enter the world and that living "water" was brought through his resurrection, it seems fair to say that the answer to that question is spiritual, regardless of it also being physiological -that one doesn't cancel out the other.

Is there a medical or physiological explanation?

Yes, according to the medical doctors quoted below, and I think their answers are better left intact.

Is it normal for both blood and water to both flow from a body in these circumstances?

Reading further, the links provided show how the act of angling the spear in a certain direction with great force caused blood and “water” (hydropericardium) to flow from Christ’s “side,” which technically was not his side since, according to these doctors, it flowed from his heart.

Publisher: Apologetics Press
Article: "An Examination of the Medical Evidence for the Physical Death of Christ"
By: Bert Thompson, PhD; Brad Harrub, PhD

“Much speculation has centered on the exact location of the puncture wound and thus the source of the resulting blood and water. However, the Greek word (pleura) that John used clearly denotes the area of the intercoastal ribs that cover the lungs (Netter, 1994, p. 184). Given the upward angle of the spear, and the thoracic location of the wound, abdominal organs can be ruled out as having provided the blood and water. A more likely scenario would suggest that the piercing affected a lung (along with any built up fluid), the pericardial sac surrounding the heart, the right atrium of the heart itself, the pulmonary vessels, and/or the aorta. Since John did not describe the specific side of the body on which the wound was inflicted, we can only speculate about which structures might have been impaled by such a vicious act. However, the blood could have resulted from the heart, the aorta, or any of the pulmonary vessels. Water probably was provided by pleural or pericardial fluids (that surround the lungs and heart).

This article can be found at: http://apologeticspress.org/apcontent.aspx?category=13&article=145 ("Piercing Christ's Side")


Publisher: Journal of American Medical Association (JAMA)
Article: "On the Physical Death of Christ"
By: William D. Edwards, MD; Wesley J. Gabel, MDiv; Floyd E. Hosmer, MS, AMI)

“The gospel of John describes the piercing of Jesus’s side and emphasizes the sudden flow of blood and water. Some authors have interpreted the water to be ascites or urine, from an abdominal midline perforation of the bladder. However, the Greek word (πλευρα, or pleura) used by John clearly denoted laterality and often implied the ribs. Therefore, it seems probable that the wound was in the thorax and well away from the abdominal midline. Although the side of the wound was not designated by John, it traditionally has been depicted on the right side. Supporting this tradition is the fact that a large flow of blood would be more likely with a perforation of the distended and thin-walled right atrium or ventricle than the thick-walled and contracted left ventricle. Although the side of the wound may never be established with certainty, the right seems more probable than the left. Some of the skepticism in accepting John’s description has arisen from the difficulty in explaining, with medical accuracy, the flow of both blood and water. Part of this difficulty has been based on the assumption that the blood appeared first, then the water. However, in the ancient Greek, the order of the words generally denoted prominence and not necessarily a time sequence. Therefore, it seems likely that John was emphasizing the prominence of blood rather than its appearance preceding the water. Therefore, the water probably represented serous plural and pericardial fluid, and would have preceded the flow of blood and been smaller in volume than the blood. Perhaps in the setting of hypovolemia and impending acute heart failure, pleural and pericardial effusions may have developed and would have added to the volume of apparent water. The blood, in contrast, may have originated from the right atrium or the right ventricle or perhaps from a hemopericardium.”


Publisher: Doubleday & Company, New York
Book: "A Doctor at Calvalry: The Passion of our Lord Jesus Christ as Described by a Surgeon" By: Pierre Burbet, MD

From Chapter 7: "Wound in the Heart" (p. 129-147)

“I say 'wound in the heart' and not wound in the side, because this is attested by tradition, and it has been confirmed for me by experiment. The blow of the lance which was given to the right side reached the auricle of the heart, perforating the pericardium… May I be forgiven if I seem to lay down the law, but I fail to see that St. John declares that there was a miracle. He certainly seems to be astonished, but is this not the issue of water alongside the blood the cause of this? Does he not mean: there issued blood, and also water? Perhaps he knew that blood can issue from a corpse; but the water would seem extraordinary to him, as at first it would even to a doctor in our day… The blood then comes quite naturally from the heart and it could only come from there in such a quantity. But whence comes the water? In my first autopsies I noticed that the pericardium always contained a quantum of serum (hydropericardium) sufficient for one to see it flowing on the incision of the parietal layer. In some cases it was most abundant. I, therefore, took my syringe once again, but I pushed the syringe very slowly, drawing into the syringe the whole time… Then, as the needle proceeded on its way, I drew out some blood from the right auricle. I then took my knife, and, inserting it with the same precautions, I saw the serum flowing and then, as I pressed on, the blood. Finally, if one inserts the knife vigorously, a large flow of blood is seen to issue from the wound; but on its edges one can also see that a lesser amount of pericardial fluid is also flowing. The water was then pericardial fluid. And one can imagine that after an exceptionally painful death-agony, as was that of the Saviour, this hydropericardium would have been particularly abundant, so much so that St. John, who was an eye- witness, was able to see both blood and water flowing. He would have imagined that the serum was water, for it has that appearance. As there was no other water than the serous fluid, it could not have been pure water. We ourselves use the word hydropericardium, which means the water contained in the pericardium… Yes, St. John was certainly clear-sighted. What he saw was the blood from the auricle and the water from the pericardium. I also have seen them, et verum est testimonium meum.”

This book is available in its entirety at: http://nebula.wsimg.com/1606eb418228091a9d54f2ad76e4b88a?AccessKeyId=C2057F426D77725ABA68&disposition=0&alloworigin=1


A medical or physiological explanation would probably eliminate the possibility of a miracle, even if only a minor, symbolic miracle. However, some medical experts doubt that the blood and water can be explained in this way.

ICC New Testament Commentary says that a flow of blood from a dead body, when pierced with a spear, is abnormal and for that reason, various physical explanations have been offered. One suggestion (W. Stroud) is that the death of Jesus had been caused by rupture of the heart, and that the “blood and water” were the separated clot and serum of the escaped blood in the pericardial sac, which the lance had pierced. The commentary says this assumes that the wound was on the left side, of which there is no evidence, tradition (whatever it be worth) indicating the right side. Furthermore, Stroud’s arguments have not approved themselves to all physicians. Dr. C. Creighton (and others) object that “the blood escaping into a serum cavity from rupture of a great organ” does not show any tendency to separate into clot and serum, “but remains thick dark-red blood.” On the basis of expert advice, this does not seem a plausible explanation for what John describes.

Michael R. Cosby (Portraits of Jesus, page 185) says that the attempts by some modern doctors to provide physiological explanations for how water could be separated from the blood in Jesus' heart are no doubt sincere, but they fail to recognise the symbolic nature of the witness in John 19:34-37.

Elizabeth Danna (From Gethsemane to Pentecost, page 95) believes that this account was included by John's author to counter an emerging Gnostic tradition that Jesus was not crucified in the flesh, it being only a phantom of Jesus that appeared to be on the cross. An alternative theological explanation is also provided in this answer.

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    The ICC Commentary appears to be that of J.H. Bernard.
    – Susan
    Jul 11, 2016 at 7:23
  • (+1) for answering the question and for addressing some of the problems with the "Christian doctor" propositions..
    – user10231
    Dec 12, 2016 at 21:44
  • "a flow of blood from a dead body, when pierced with a spear, is abnormal". Could the lance cut on Jesus' body have been what finally made him succumb? And if so, is that normal? Jul 31, 2017 at 22:47
  • @Constantthin The spearing did not kill Jesus because he was already dead according to John's Gospel: 19:30: "...he bowed his head, and gave up the ghost." 19:3: "and saw that he was dead already..." It was not normal to spear, but apparently sometimes normal to break the legs in order to hasten death. In this case, John wants to portray Jesus as the sacrificial lamb which, according to Jewish custom, must have no bone broken. Aug 1, 2017 at 3:37
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    @Constantthin en.wikipedia.org/wiki/Premature_burial and of course: Two hunters are out in the woods when one of them collapses. He doesn't seem to be breathing and his eyes are glazed. The other guy whips out his phone and calls the emergency services. He gasps, "My friend is dead! What can I do?" The operator says, "Calm down. I can help. First, let's make sure he's dead." There is a silence; then a gun shot is heard. Back on the phone, the guy says, "OK, now what?"[4] en.wikipedia.org/wiki/World%27s_funniest_joke
    – Ruminator
    Aug 11, 2018 at 12:26

I studied medicine for 15 years and practiced for 35. Hematidrosis (bleeding from every pore) can be a response to terrible pain/stress/infection. I have seen it three times in my career, in hospital as we struggled--late in the process--to keep patients alive. Without a very good, modern lab it cannot be distinguished from several other equally uncommon conditions, such as DIC (diffuse intravascular coagulopathy). However, an absolutely unbiased reporter, who was a careful but not scientifically-trained observer goes on to describe what he considered to be out-of-the-ordinary: in response to chest spear-stabbing, a gush of water (clotting-factor-depleted plasma=serum) and unclotted blood. Without laboratory work that is as close as we can get.


While there is a clear fluid around the heart to lubricate its movements sometimes an infection causes inflammation and up to 2 quarts of fluid. So being observant one might see both blood and water from a sword wound in battle for example. So there is known a physiological basis from water from a spear thrust though it is unlikely that it would be noticeable.

My thought is that Jesus would not likely to have been in such bad shape or have the appropriate diseases that his heart would have naturally been in such a mess from a beating and a few hours on a cross. Without supernatural intervention he would not have died for several days. His heart should have been fine.

John, I believe is either reporting the penultimate miracle of his ordeal (the ultimate being his resurrection of course) which would call to mind the trailing fountain rock:

1Co 10:4  And did all drink the same spiritual drink: for they drank of that spiritual Rock that followed them: and that Rock was Christ. 

Num_20:11  And Moses lifted up his hand, and with his rod he smote the rock twice: and the water came out abundantly, and the congregation drank, and their beasts also.

This was a miracle. John wrote of many signs. I believe the water that flowed from Jesus' side likewise is best understood as a miracle sign. My thought is, yes there was some fluid there but to my mind John isn't reporting what he sees with his natural eyes but with his divinely inspired imagination and that is, he sees rivers of living water flowing through Jesus' chest.:

Joh_4:14  But whosoever drinketh of the water that I shall give him shall never thirst; but the water that I shall give him shall be in him a well of water springing up into everlasting life.

Rev_21:6  And he said unto me, It is done. I am Alpha and Omega, the beginning and the end. I will give unto him that is athirst of the fountain of the water of life freely.

Rev_22:1  And he shewed me a pure river of water of life, clear as crystal, proceeding out of the throne of God and of the Lamb.

Rev_22:17  And the Spirit and the bride say, Come. And let him that heareth say, Come. And let him that is athirst come. And whosoever will, let him take the water of life ["flowing water?"] freely.

KJV unless otherwise noted.

  • While not denying the possibility of a supernatural element in Jesus' crucifixion, I suggest that minimizing Jesus' suffering is not the way to go. (In other words, saying that Jesus' suffering was somehow "cut short" because he had the power to commit his spirit into the hands of his Father is pure conjecture.) Closer to the truth is that Jesus suffered until the sin debt of the world was paid in full. Only then would he cry "Finished!" Aug 11, 2018 at 20:34
  • Even to suggest that Jesus could have (or should have) suffered more or that his agony was minimal because it was not drawn out for days instead of hours is not to understand what he both experienced and accomplished on the cross, not to mention why he suffered the way he did. Aug 11, 2018 at 20:35
  • @rhetorician So why just 3 hours?
    – Ruminator
    Aug 11, 2018 at 20:36
  • As I said before, because the work of redemption was finished after three hours. Who should know better when that would be than the Lamb of God who bore away the sin of the world? Or put differently, who would know better than the God-Man, Jesus? No one, I suggest. Aug 12, 2018 at 0:12

It seems an appropriate time now to continue considering this question.

It’s important to note that Jesus was not the first nor by any means the last Jew crucified by the Romans. It was a fairly common punishment and means of execution.


The medical aspects of crucifixion have been studied numerous times. Here’s a recent (2021) summary published by the U.S. National Institutes of Health, not known to have any religious affiliation.


In addition to the medically reasonable and the crackpot theories mentioned in the study, Roman soldiers were known to be pretty adept at killing people and making sure that their victims weren’t just “mostly dead.” The criminals executed along with Jesus died when their legs were broken. But it’s likely that if they had also been stabbed in the side with a spear, blood and serum (90% water) would have flowed out.

In I John 5:6-8 ESV, the Apostle John writes

“This is he who came by water and blood—Jesus Christ; not by the water only but by the water and the blood. And the Spirit is the one who testifies, because the Spirit is the truth. For there are three that testify: the Spirit and the water and the blood; and these three agree.”

Certainly, one might draw symbolism for the “water and blood” that came out of the not-so-superficial spear wound in Jesus’ side, but putting a human to death by crucifixion is not exclusively symbolic nor medically unique as previously discussed on Biblical Hermeneutics as you noted. It does mean that the person is truly dead. Here’s a discussion on BH closer to your own question.

Is there an interpretation of the blood and water that poured from Jesus' side (John 19:34) that involves, in part, some physiological component?

The symbolism of the witnesses that John is listing here are asserted to be unique to Jesus Christ by the Apostle John. Jesus had three significant events in his life on earth. His birth (blood and water), his baptism (water and Spirit), and his death (body and blood). Jesus specifically asked his disciples to remember him symbolically in the Passover wine (blood) and the unleavened bread (broken body).

One might add to these life-event witnesses, Jesus’ transfiguration, his resurrection from the dead, and the eyewitness testimonies of his disciples: Matthew, Peter, Luke, John, James, and Jude.


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