This is a medical condition where a person appears to sweat blood. It typically occurs when someone is under extreme stress, and it has been associated with a few historical figures. When someone experiences extreme stress, the capillaries that go to the sweat glands can rupture causing the blood from the capillaries to pour into the sweat glands. When the person starts to sweat, the blood comes out through the sweat glands. This is what happened to Jesus. An article in the Journal of the American Medical Association diagnosed Jesus with this condition.

William D. Edwards, Wesley J. Gabel, and Floyd E. Hosmer, “On the Physical Death of Jesus Christ,” Journal of the American Medical Association 255, no. 11 (1986): 1455–63

When scholars say Scripture is inerrant, they are referring to the original manuscripts.

The problem with trying to figure out what the original copy of the Gospel of Luke said is not that there is not enough information but that there is so much! There are so many copies of the New Testament from so many different time periods throughout church history that synthesizing all the data can be an overwhelming task.

The Greek New Testament used by most scholars puts Luke 22:43–44 in brackets to indicate that the editors of the Greek New Testament were not confident the verses were original. The ESV, NIV, and NASB all contain footnotes mentioning that some ancient manuscripts don’t have these verses. The HCSB puts these verses in brackets and provides a similar footnote after verse 44. The translations are not ignoring or trying to cover up this issue.

The initial question of Jesus’ sweating blood relates to the originality of this verse. The best and earliest manuscripts either do not have the verses; or, if they have it, they put an asterisk or some other symbol next to it to indicate the person making the copy didn’t think those verses were original. However, there is more evidence from four church fathers: Justin (d. 165), Irenaeus (d. 202), Hippolytus (d. 235), and Eusebius (d. 339). All of these men date to the time of those earliest manuscripts or earlier; all of them are familiar with these verses. Therefore, either an independent historical account was circulating containing these verses, or early copies of Luke had them. So where does that leave us?

Robert Stein, concluding that these verses should not be regarded as part of the original Gospel of Luke, comments:

For some believers who have been raised on the King James Version of the Bible, to speak of “omitting” certain verses from the Bible seems heretical, and the warning of Rev 22:19 comes to mind. What is at issue here, however, is not “omitting” something from the sacred text but rather not allowing something that was never in the sacred text to be added to it. It is just as wrong to add something to the Scriptures as it is to take away something from them. When we therefore speak of “omitting” Luke 22:43–44 from the text, we mean that we should not include what some later scribe added to the original Gospel penned by the Evangelist Luke.

Several important Greek MSS (𝔓75 א1 A B N T W 579 1071*) along with diverse and widespread versional witnesses lack 22:43–44. In addition, the verses are placed after Matt 26:39 by f13. Floating texts typically suggest both spuriousness and early scribal impulses to regard the verses as historically authentic. These verses are included in א*,2 D L Θ Ψ 0171 f1 𝔐 lat Ju Ir Hipp Eus. However, a number of MSS mark the text with an asterisk or obelisk, indicating the scribe’s assessment of the verses as inauthentic. At the same time, these verses generally fit Luke’s style. Arguments can be given on both sides about whether scribes would tend to include or omit such comments about Jesus’ humanity and an angel’s help. But even if the verses are not literarily authentic, they are probably historically authentic. This is due to the fact that this text was well known in several different locales from a very early period. Since there are no synoptic parallels to this account and since there is no obvious reason for adding these words here, it is very likely that such verses recount a part of the actual suffering of our Lord. Nevertheless, because of the serious doubts as to these verses’ authenticity, they have been put in brackets. For an important discussion of this problem, see B. D. Ehrman and M. A. Plunkett, “The Angel and the Agony: The Textual Problem of Luke 22:43–44,” CBQ 45 (1983): 401–16.

The absence of these verses in such ancient and widely diversified witnesses as 𝔓(69vid), 75 אa A B T W syrs copsa, bo armmss geo Marcion Clement Origen al, as well as their being marked with asterisks or obeli (signifying spuriousness) in other witnesses (Δc Πc 892c mg 1079 1195 1216 copbo mss) and their transferral to Matthew’s Gospel (after 26:39) by family 13 and several lectionaries (the latter also transfer ver. 45a), strongly suggests that they are no part of the original text of Luke. Their presence in many manuscripts, some ancient, as well as their citation by Justin, Irenaeus, Hippolytus, Eusebius, and many other Fathers, is proof of the antiquity of the account. On grounds of transcriptional probability it is less likely that the verses were deleted in several different areas of the church by those who felt that the account of Jesus being overwhelmed with human weakness was incompatible with his sharing the divine omnipotence of the Father, than that they were added from an early source, oral or written, of extra-canonical traditions concerning the life and passion of Jesus. Nevertheless, while acknowledging that the passage is a later addition to the text, in view of its evident antiquity and its importance in the textual tradition, a majority of the Committee decided to retain the words in the text but to enclose them within double square brackets.

Virtually all major modern translations include this word as a translation of the Greek word hōsei. This Greek word is a relatively weak marker of a relationship between two things.

Luke uses a different word in his Gospel when he wants to communicate a more emphatic marker of similarity between two things: hōsper. For example, Luke 18:11 says, “The Pharisee took his stand and was praying like this; ‘God, I thank You that I’m not like other people—greedy, unrighteous, adulterers, or even like this tax collector’” (emphasis added). The Pharisee was being emphatic; he is absolutely not like the sinner he is about to discuss.

The Greek language provides ways to mark the degree of similarity between things, and the word Luke chose in Luke 22 does not communicate a strong relationship but a weak relationship.

The mistake of skipping over the word like occurs in other places in the New Testament as well. For example, Matthew 3:16 says, “The heavens suddenly opened for Him, and He saw the Spirit of God descending like a dove and coming down on Him” (emphasis added). Every time I have seen this verse depicted in a movie or a picture, it is always a literal dove. But Matthew 3 does not say the Holy Spirit possessed a dove. Matthew is saying the way that the Holy Spirit came down from the sky reminded him of the way that a dove descends from the sky.

(1) It could refer to color, that the sweat was like blood because it was red. However, if it was red, it probably would not be like blood; it would be blood itself. Therefore, the comparison is probably not about color.

(2) It could be about consistency. In talking with medical personnel, they affirm that blood is thicker than sweat. So it could refer to the thickness of the sweat.

(3) It could refer to size, the most likely option.

Notice what the following translations say:

• “His sweat became like great drops of blood” (ESV, emphasis added).

• “His sweat was as it were great drops of blood” (KJV, emphasis added).

• “His sweat became like great drops of blood” (NKJV, emphasis added).

• “His sweat fell to the ground like great drops of blood” (NLT, emphasis added).

These translations are interpreting the comparison (“like”) as being about size. They all believe the sweat drops were large. Luke is saying that, in the intensity of the moment, Jesus sweat large drops of sweat.

First, the text of Scripture is reliable even though in some places deciding on the original reading is difficult. No major doctrine is impacted by the different readings available. We can trust the Bible we have.

Second, read the footnotes in your Bibles. Many modern translations have footnotes in them. Pay attention to them.

Third, pay attention to the small words like as and like.

Fourth, understanding the extreme sacrifice of Jesus should lead to a thankful, obedient life. Jesus truly did have an intense time of prayer in the garden of Gethsemane.