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Injury
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A R T I C L E I N F O A B S T R A C T
Keywords: As the literature is not exhaustive with reference to the way the Turin Shroud (TS) Man was crucied, and
Turin Shroud Man it is not easy to draw signicant information from only a photograph of a man on a linen sheet, this
Crucixion technique study tries to add some detail on this issue based on both image processing of high resolution photos of
Nailing the TS and on experimental tests on arms and legs of human cadavers.
Causalgia
With regard to the TS Man hands, a rst hypothesis states that the left hand of the TS Man was nailed
Cause of death
twice at two different anatomical sites: the midcarpal joint medially to the pisiform between the lunate/
pyramidal and capitate/uncinate bones (Destots 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 Destots space with partial lesion of the
ulnar nerve and exion 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 crucixion: 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 sufcient 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.
2014 Elsevier Ltd. All rights reserved.
Introduction the Roman period and limited studies involved direct experiments
on cadavers [2,3]. Barbet made studies on crucied cadavers more
For more than a century the mode of crucixion of the Turin than half a century ago [2]. More recently, many researchers have
Shroud (TS) Man has been studied [1], but no reliable conclusions investigated aspects of the TS; for example, the forensic patholo-
have yet been reached because it is not easy to draw signicant gist, Zugibe [3] studied many cadavers. Nevertheless, none of the
information from only one photograph of a man on a linen sheet, researchers has conducted direct experiments on cadavers or parts
with many peculiar bloodstains coherent with a human body. Little of them to study nailing procedures.
historical information is available about the means of crucixion in The Archbishop of Bologna, Paleotto, who accompanied St.
Charles Borromeo over the Alps to Turin in 1598, was the rst 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
* Corresponding author. Tel.: +39 049 827 6804. driven between the radius and the carpus or between the two rows
E-mail addresses: matteo.bevilacqua@alice.it (M. Bevilacqua),
of carpal bones [5,6] either proximal to or through the strong band-
giulio.fanti@unipd.it (G. Fanti), michele.darienzo@unipa.it (M. DArienzo),
andrea.porzionato@unipd.it (A. Porzionato), veronica.macchi@unipd.it (V. Macchi),
like exor retinaculum and the various intercarpal ligaments
raffaele.decaro@unipd.it (R. De Caro). [7]. Barbet performed some experiments on amputated limbs and
http://dx.doi.org/10.1016/j.injury.2014.10.039
00201383/ 2014 Elsevier Ltd. All rights reserved.
M. Bevilacqua et al. / Injury, Int. J. Care Injured 45S (2014) S142S148 S143
argued that nailing took place through the so-called Destots space, limbs and their segments, and particular consideration given to feet,
between the lunate/pyramidal and capitate/uncinate bones on the hands and ngers. Another evaluation specically involved the
ulnar side of the wrist. He also reported movement in opposition and bloodstains, assessing their orientation with respect to the upper
slight exion of the thumb, after nailing, and ascribed this limb axis.
phenomenon to injury of the median nerve [5].
However, it was contested that a lesion of the median nerve at Experimental procedures on limbs
the wrist is not compatible with the nailing in the Destots space,
because its course is away from the radial side [3]. So, in the Analyses were performed on three right upper limbs
authors opinion, the absence of ngerprint of the thumb needs resected from cadavers at the shoulder, and on another anatomic
another explanation. specimen consisting of the trunk and both inferior limbs. The
According to the preferred nailing practice by the Romans [8], donors gave specic consent. Cadavers were managed by the Body
the TS Man had his feet touching each other, the left on the right, Donation Programme of the Section of Human Anatomy of the
fastened with a single nail on the cross, without suppedaneum, Department of Molecular Medicine of the University of Padua. In
passing between the metatarsal bones [2,9]. 2011, the Body Donation Programme achieved certication by an
Caselli [10] identied two nail wounds on the right foot, one in its accredited third-party registrar (Certiquality Srl , Quality Certi-
true place on the metatarsal bones, the other on the heel, and cation Body, Milan, Italy), which audited the quality manage-
attributed the second wound to displacement of the TS Man caused ment system and certied that the Body Donation Programme of
by arrangement of the body on the anointing stone, which is the the University of Padova met EN ISO 9001:2008 criteria [16]. The
bench for burial preparation. In the authors opinion, the bloodstain use of cadavers for medical training and scientic research is
on the heel is due to a blood leakage from the nail imprint on the performed according to European, National and Regional norma-
metatarsal bones. The heel is not completely visible on the TS tive references [17,18].
because the TS was not in contact with the entire foot. The experimental procedures performed were as follows.
Specic analyses have been conducted on the trickles of blood on The upper limbs were nailed in the following points:
the upper limbs. Fasola [11] attributed the divergence of the blood
ow from the wrist wound to a slight rotation of the arm. Ricci [12] - radiocarpic joint between the radio, lunate and scaphoid;
suggested that the divergence of the blood ow was due to the - midcarpal joint line between the scaphoid/lunate and trapezoid/
variable position of the arms on the cross that allowed the TS Man to capitate;
breathe. Massey [13] determined the position of the arms on the - midcarpal joint medially to the pisiform between the lunate/
cross deriving it from the corner of the trickles of blood on his pyramidal and capitate/uncinate (Destots space).
forearms with the axis of the respective arms. In the authors opinion,
these trickles formed when the arms were moved after unnailing. With regard to the inferior limbs, the following procedures
Zugibe [3] proposed that the body of the TS Man was washed were performed:
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 - dislocation of the right ankle joint, through increasing weights
scourge [14]). Conversely, the postmortem blood on the TS Man applied with a rope to the ankle (this tension technique of the
(spilled from the chest after the spear, from the head after removal limbs with ropes was usual in the crucixion [19]);
of the crown of thorns, and from the wrist and feet after unnailing) - nailing of the right foot between the 1st and 2nd metatarsal bone,
was not supposed to be removed because according to Jewish with a 10 cm-long nail;
custom it was forbidden to touch postmortem blood as it would - nailing of the left foot between the scaphoid and cuboid,
make the person impure [3]. The authors share this opinion. proximally, and third cuneiform, distally, with a 25 cm-long nail;
In a recent publication [15] the authors proposed that the TS - further nailing of the right foot, with the long nail passing
Man could have suffered a violent trauma to the right side of the through the left one, at the level of the right tibiotarsal joint.
neck, chest and shoulder, causing an underglenoidal dislocation of
the humerus, with injury of the entire brachial plexus, right The points of entrance were identied under radioscopic
attened hand and enophthalmos. The blunt chest trauma, which control (OEC C-Arms, 9600; GE medical system) with the help of
resulted in the body falling forward, was also a direct cause of a small lead semi-spheres. Nailing of feet was performed on a
lung contusion and haemothorax. A sign of this chest trauma, wooden plank. CT axial scans (Philips Brilliance iCT, Philips Medical
which was probably caused by the cross falling on the body, can Systems; Best, The Netherlands) of the specimens were acquired.
perhaps be seen on the dorsal TS body image as the two darker Analysis and post-processing of the CT scans were carried out on an
areas beneath the shoulders. Aquarius Workstation (version 3.6.2.3; TeraRecon, San Mateo,
The aim of the present study was to provide further hypotheses California). Source images and 2D-3D reconstructions were
about the possible anatomical sites of nailing of the TS Man, reviewed at the workstation. Specic anatomical dissections were
through a renewed analysis of the TS bloodstains and experimental then performed to conrm the CT ndings and to verify the
procedures of nailing on cadavers. The following questions were condition of vessels and nerves.
considered: How many nails were used on the hands and feet, and
where? What is the meaning of the trickles of blood on the Results
forearms and feet? What is the most likely posture of the TS Man?
What are the possible clinical consequences of such a nailing? TS analysis
Various high-resolution images of the TS, taken by G. Enrie, G.B. - The hand is slightly exed towards the ulna, as normal, not
Judica Cordiglia, G. Durante and Haltadenizione, were analysed contracted (the angle between a line drawn between the 3rd and
after proper image processing with reference to posture of the four 4th metacarpus and a line coaxial to the forearm is 158 38) (Fig. 1).
S144 M. Bevilacqua et al. / Injury, Int. J. Care Injured 45S (2014) S142S148
- The thumb is also absent in the right hand that is stretched out on
the thigh.
- There is an area around the left hand where the imprint is almost On the back of the right foot
absent. It reects the distance of the body from the TS; this A detailed study of the TS frontal and dorsal body image, also
distance is about 2 cm between the ulnar margin of the left hand supported by an anthropometrical analysis [20], shows that the
and the 2nd and 3rd nger of the right hand below, and about bloodstain on the front right foot is located in a position 5 3 cm
6 cm between the left radial margin of the hand and right distal distant from the ankle. This implies that TS Man had a single nailing in
forearm below. A hand in dorsal exion, documented by the more the centre of the foot.
developed imprints of the rst metacarpal phalangeal joint, As already suspected in the past [20,21], the right ankle
explains this difference. joint appears dislocated and tilted forward; if this was not
- Even with a just exed left hand resting on the right hand, the the case, it would be difcult to explain the plantar foot imprint
thumb would be more on the side of the index and would imprint on the TS. Like the hands, the bloodstain on the foot is due to
somehow on the TS. the unnailing.
M. Bevilacqua et al. / Injury, Int. J. Care Injured 45S (2014) S142S148 S145
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 Dislocation of the right ankle joint
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 This dislocation was achieved with a force of 2000 N applied to
recognisable area of increased blood. This is probably the exit hole the ankle using a rope. This is consistent with the possible
of the nail and it is placed on the front of the heel. The branches of dislocation of such a joint before nailing.
blood from this core are probably due to movements during
unnailing, transportation to the tomb, or TS overlapping. Nailing of the right foot
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 supercial fold (radiocarpic space) and the lower fold (Destots 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 exor 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 exor pollicis longus.
the authors prefer the hypothesis of the single wrist nailing, because previously proposed by Barbet [2]. However, this anatomical site is
it is also not easy to explain why the cruciers should have made two quite far away from both the median nerve and the tendon of the
holes in the same wrist at a distance apart of only a very few exor pollicis longus to explain the retraction of this nger.
centimetres, and a single nail was used to pierce the feet. Our single experiment showed that nailing through the Destots
According to the authors, the respiratory limitation, plus the space completely injured both the ulnar artery and nerve, and this
presence of a haemothorax, which pressed down the right lung fact seems in contrast with the assumption of a thumb retraction.
[14], was not sufcient to cause death by asphyxiation (i.e. by According to our experimental data, the retraction of the
ventilatory failure characterised in the terminal phase by loss of thumbs seems to be due to the stretching of the tendon of the
consciousness and coma). A probable cause of death, also exor pollicis longus by nailing the radiocarpal joint. Damage of
considering the hypovolemia produced by scourging, bleeding the median nerve could also have contributed to retraction of this
and the many other tortures, is myocardial infarction. nger, causing decit of the abductor pollicis brevis and opponent
A more detailed description follows, but it should be muscles, with adduction of the rst metacarpus and thumb.
emphasised that all these tortures are coherent with the Passion The rst hypothesis analysed at the beginning by the authors
of Jesus Christ described in the Gospels. states that it is possible that the left hand of the TS Man was nailed
twice at two different anatomical sites: the Destots space, where
Hands a quadrangular area of the nail appears after image contrast-
enhancement, and the radiocarpal joint between the radio, lunate
On the basis of the analysis of the left hand in the TS, the exit and scaphoid, about 1.5 cm proximally with respect to the
hole of the nail seems to be located in the Destots space, as Destots space.
M. Bevilacqua et al. / Injury, Int. J. Care Injured 45S (2014) S142S148 S147
Fig. 4. The nailing in the Destots 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 Posture of the limbs
unique hole was made in the wrists by the nail put in the Destots
space. If we suppose a possible partial tear of the ulnar nerve that The nailing procedure conrms the posture of TS Man in
saves its deep branch, we can explain the contracture of the deep accordance with a computerised anthropometric analysis [21].
head of the exor pollicis brevis and a exion of the metacarpo- The TS Man on the cross did not collapse with the body on his
phalangeal joint, coherent with the lack of thumbs in the TS image. knees, but he was stretched once he was pulled and dislocated with
Therefore, we think that probably Barbet confused the ulnar nerve ropes [4]. His arms were moderately lowered by about 158 (Fig. 5)
with the median nerve. compared with the patibulum and not by 658 as supposed by
The signicant drain of blood on the forearms may be explained Barbet [2]. His head was bent forward and his knees were slightly
by the injury to the ulnar artery; intravascular bleeding and bent due to the human body dejection after death, with feet rotated
haematoma gathered around the nail, and followed recomposition after ankle dislocation.
of the limbs. The people who were arranging the burial could have The left foot was nailed over the right dislocated foot and
raised his arms to prevent the blood spilling from the holes to the was exed forward, thereby generating a distance greater
ground. than 10 cm between the body and the enveloping TS, which
The different arrangement of blood on both forearms is explains the partial absence of frontal body image in the area of
explained by the different posture of the limbs and the different the ankles.
angle of the hands with the forearms: the right upper limb
paralysed with the hand and forearm in axis; the left arm with the Clinical implications
wrist abducted and exed dorsally, not in line with the forearm
(Fig. 1). The TS Man certainly suffered a very serious and widespread
causalgia (burning pain and shock to the tiniest movements of the
Feet limbs) due to: total paralysis of the upper right limb (paradoxical
causalgia); nailing of the left hand with damage to the ulnar nerve;
The footprint of the entire sole of the right foot (Fig. 2) seen on and nailing of both feet with injury to the plantaris medialis nerves,
the TS and the partial absence of a left footprint shows that the TS which pass on the site where there is a bloodstain due to the
was not wrapped around the feet, but simply left lying on the nailing.
mattress of resin powders of myrrh and aloe. This indicates that The nailing of the TS Man on the cross could have affected his
the TS Man suffered an ankle dislocation during nailing. breathing in two ways:
Otherwise, the foot would have been raised thus avoiding its
imprint on the TS. a) with arms raised above the shoulders by about 158, and
The suspicion that the bloodstain on the heel of the right foot therefore with a more expanded rib cage, the lungs were more
may have been caused by a second nailing led the authors to lled with air and there was less ability to exhale, but they were
undertake a test of nailing through the ankle to obtain the exit hole not hindered so much to seriously reduce their ventilation
corresponding to the sole of the right foot at the heel (and not capacity;
outside just near to its tuberosity). Nevertheless, image processing b) every deep inspiration obtained by leveraging on the arms and/
showed the bloodstain to be just under the ankle, thereby or legs, even with the slightest movement that the TS Man was
excluding a double nailing, so the authors accept the hypothesis trying to do, reduces the alveolar hypoventilation and brings
of a single nail in the right foot and then the two feet were nailed oxygen to a body already exhausted by the endless torture,
together, in agreement with the Latin Church. caused him stabbing pain.
S148 M. Bevilacqua et al. / Injury, Int. J. Care Injured 45S (2014) S142S148
Fig. 5. Scheme of force distributions in the arms of crucied 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.
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The authors declare that there are no conicts of interest. Spectrum Int 1984;13:38.
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