“And being in an agony he prayed more earnestly: and his sweat was as it were great drops of blood falling down to the ground.” (Luke 22:44)

This simple verse expresses profound truths which many medical professionals have been hesitant to believe for many years as a true medical condition. The medical term is hematohidrosis, a rare condition that cause a person under severe stress to literally sweat blood. “Hematohidrosis also known as Hematidrosis, hemidrosis and hematidrosis, is a condition in which capillary blood vessels that feed the sweat glands rupture, causing them to exude blood, occurring under conditions of extreme physical or emotional stress.”1)H. R. Jerajani, Bhagyashri Jaju, M. M. Phiske, and Nitin Lade, “Hematohidrosis-A Rare Clinical Phenomenon,” Indian Journal of Dermatology, 2009 Jul-Sep; 54(3):291 Due to the religious overtones and the Catholic Church throughout history relating events of stigmatas, many medical personal simply do not believe this was real.

However, recently an Italian patient was treated for this condition and was reported in the Canadian Medical Association Journal. “A 21-year-old woman was admitted to a general medical ward with a three-year history of self-limited episodes of bleeding from her palms and face despite no evidence of skin lesions. There was no obvious trigger for the bleeding, which could occur while she was asleep and during times of physical activity. She stated that more intense bleeding occurred during times of perceived emotional stress. Episodes lasted from one to five minutes.”2)Roberto Maglie MD, Marzia Caproni MD, “A Case of Blood Sweating: hematohidrosis syndrome,” Canadian Medical Association Jpournal, Oct. 23, 2017, Vol. 189, Issue 42, E1314 Though this condition is, indeed, very rare, it also has a long history of documentation.

Aristotle, perhaps the earliest to record such accounts, wrote around 350 B.C. stated: “Instances, indeed, are not unknown of persons who in consequence of a cachectic state have secreted sweat that resembled blood…”3)Aristotle, On the Parts of Animals, 3:5; Translated by William Ogle; accessible at http://classics.mit.edu/Aristotle/parts_animals.3.iii.html He further related that even animals have been observed to experience similar conditions. “If the blood get exceedingly liquid, animals fall sick; for the blood then turns into something like ichor, or a liquid so thin that it at times has been known to exude through the pores like sweat.”4)Aristotle, History of Animals, 3:19; Translated by D’Arcy Wentworth Thompson; accessible at http://classics.mit.edu/Aristotle/history_anim.3.iii.html

Lucretius, writing during the first century B.C., stated, “And let the weary sweat their life-blood out…”5) Lucretius, De Rerum Natura, 5:1105-1135; William Ellery Leonard. E. P. Dutton. 1916. Accessible at http://www.perseus.tufts.edu/hopper/text?doc=Perseus:text:1999.02.0131:book=5:card=1105&highlight=blood%2Csweat Marcus Annaeus Lucnanus (39-65 A.D.) wrote rather morbid poetry describing this condition: “A sable poison: from the natural pores Of moisture, gore profuse; his mouth was filled And gaping nostrils, and his tears were blood. Brimmed full his veins; his very sweat was red; All was one wound.”6)Marcus Annaeus Lucanus, Pharsalia , 9:734-838; Sir Edward Ridley. London. Longmans, Green, and Co. 1905. Accessible at http://www.perseus.tufts.edu/hopper/text?doc=Perseus:text:1999.02.0134:book=9:card=734&highlight=blood%2Csweat Appian (95-165 A.D.) writing with an apocalyptic literary style, most probably borrowing from the biblical account, spoke of statutes sweating blood miraculously as a sign. “Sweat issued from statues; some even sweated blood.”7)Appian, The Civil Wars, Book 4, Chap. 1; Horace White, Ed., London. MACMILLAN AND CO., LTD. 1899. Accessible at http://www.perseus.tufts.edu/hopper/text?doc=Perseus:text:1999.01.0232:book=4:chapter=1&highlight=blood%2Csweat This last comment obviously hold no historical credibility, but acknowledges that it was understood in the ancient world to have occurred on occasions.

As mentioned above, the Catholic Church has probably viewed this medical condition superstitiously as stigmata events which would place them more in line with the pagan author Appian. “Jacobi (1923), quoted by Klauder, reported 300 instances of stigma (stigmata). Most of the stigmata patients were females both Catholics and non Catholics.”8)H. R. Jerajani, Bhagyashri Jaju, M. M. Phiske, and Nitin Lade, “Hematohidrosis-A Rare Clinical Phenomenon,” Indian Journal of Dermatology, 2009 Jul-Sep; 54(3):290 Other historical cases have been documented as well. “For example, in 1627, Georg Sporlin, a physician from Basel, reported on a 12-year old boy with a high fever who sweated blood through his shirt. In 1628, the papal physician, Paolo Zacchia, described a young Belgian condemned to death who, in his anguish, sweated blood (Quaestiones medio-legales [Lib. III, Tit II, Q II]). Several other writers observed the same phenomenon in prisoners facing execution. Samuel Ledelius described a case associated with scurvy.”9)Jacalyn Duffin, MD. Ph.D., “Sweating blood: history and review,” Canadian Medical Association Journal, Oct. 23, 2017, Vol. 189, Issue 42, E1314

Adam Clark commented on this verse in his Bible Commentary in 1832, stated:

There have been cases in which persons in a debilitated state of body, or through horror of soul, have had their sweat tinged with blood. Dr. Mead from Galen observes,… “Cases sometimes happen in which, through mental pressure, the pores may be so dilated that the blood may issue from them; so that there may be a bloody sweat.” And Bishop Pearce gives an instance from Thuanus (De Thou) of an Italian gentleman being so distressed with the fear of death that his body was covered with a bloody sweat. 10)Adam Clark, “Commentary on Luke 22:44”. “The Adam Clarke Commentary”. 1832; https://www.studylight.org/commentaries/acc/luke-22.html

Jacalyn Duffin, MD. Ph.D., reviewed medical journal of recent history and brings out some illuminating information. “The 42 medical articles from 1880 to 2017 appeared at an average rate of one every three years, Of this total, however, five appeared in 2013, four in 2014, three in 2015, four in 2016, and two in 2017 (so far). In other words, almost half the total output from more than a century came in the last five years. Is the incidence of this condition increasing?”11)Jacalyn Duffin, MD. Ph.D., “Sweating blood: history and review,” Canadian Medical Association Journal, Oct. 23, 2017, Vol. 189, Issue 42, E1317 Out of “the 28 new cases in the peer-reviewed literature between 2004 and 2017 were analyzed. They came from nations on every continent, except North America. Twenty-four were female, four male. Most were young, with an average age of 14.1 years for female (range 7 mo to 34 yr) and 26.5 years for the four males (9, 10, 15 and 72 yr).”12) Jacalyn Duffin, MD. Ph.D., “Sweating blood: history and review,” Canadian Medical Association Journal, Oct. 23, 2017, Vol. 189, Issue 42, E1317 According to Duffin’s review of these peer-reviewed article: “All [of the 28 cases] experienced transient but recurring blood sweat from normal-appearing skin on multiple occasions through time, ranging from one month to four years. The most common sites were forehead, scalp, face, eyes and ears, but blood sweat could also appear on the trunk and limbs, sometimes heralded by pain or tingling. Several had associated hypertension or headache…. At least 15 (54%) had suffered severe psychological stress, either with mental illness, such as depression or anxiety, or in the posttraumatic setting, having witnessed violence at home, school or beyond (the abduction of a sibling; the beheading of a neighbor).”13) Jacalyn Duffin, MD. Ph.D., “Sweating blood: history and review,” Canadian Medical Association Journal, Oct. 23, 2017, Vol. 189, Issue 42, E1317 In 2009, the Indian Journal of Dermatology reported a case with a 72 years-old patient and further discussed the cause in other cases reviewed. “Acute fear and intense mental contemplation are the most frequent causes, as reported in six cases in men condemned to execution, a case occurring during the London blitz, a case involving fear of being raped, a case of fear of a storm while sailing, etc.”14)H. R. Jerajani, Bhagyashri Jaju, M. M. Phiske, and Nitin Lade, “Hematohidrosis-A Rare Clinical Phenomenon,” Indian Journal of Dermatology, 2009 Jul-Sep; 54(3):291

Roberto Maglie MD and Marzia Caproni MD indicated that this anomaly is still not fully understood. “In the literature, there is no single explanation of the source of bleeding in hematohidrosis. Despite the fluid’s sweat-like appearance, the hypothesis that blood passes through eccrine ducts, induced by abnormal constrictions and expansions of periglandular vessels, has not yet been proven.15)Manonukul J, Wisuthsarewong W, Chantron R, et al. Hematidrosis: a pathologic process or stigmata. A case reported with comprehensive histopathologic and immunoperoxidase studies. AM J Dermatopathol 2008; 30:135-9. Bleeding has also reportedly occurred through areas without sweat glands16)Wang Z, Yu Z, Su J, et al. A case of hematidrosis successfully treated with propranolol, Am J Clin Dermatol 2010; 11:440-3. or through the follicles,17)Manonukul J, Wisuthsarewong W, Chantron R, et al. Hematidrosis: a pathologic process or stigmata. A case reported with comprehensive histopathologic and immunoperoxidase studies. AM J Dermatopathol 2008; 30:135-9. and the presence of dermal defects leading to blood-filled spaces exuding via follicular openings or directly into the skin surface has been proposed.18) Manonukul J, Wisuthsarewong W, Chantron R, et al. Hematidrosis: a pathologic process or stigmata. A case reported with comprehensive histopathologic and immunoperoxidase studies. AM J Dermatopathol 2008; 30:135-9.19)Roberto Maglie MD, Marzia Caproni MD, “A Case of Blood Sweating: hematohidrosis syndrome,” Canadian Medical Association Jpournal, Oct. 23, 2017, Vol. 189, Issue 42, E1314

It should come to no surprise that “Luke, the beloved physician” (Colossians 4:14) would take an interest to record this rare condition in his gospel account.  Luke’s documentation of Christ’s suffering from this condition should also remind us of the fact that Jesus Christ truly did take upon Himself human nature (John 1:1-3, 14; 1 Timothy 3:16; 1 John 1:1, 4:2; 2 John 7). He was prone to the same sicknesses (Luke 22:44), grew weary (John 4:6), experienced emotional traumas (Matthew 26:37-38), physical pains (Hebrew 5:7-8), hungered (Matthew 4:2), thirsted (John 19:28) and suffered, bled and died for the salvation of mankind (Isaiah 53:3-6).

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