Passage of a nail through the hand or wrist, with resultant distal median nerve damage, would not result in this hand posture, as finger and thumb flexors in the forearm #IAP inhibitor randurls[1|1|,|CHEM1|]# would be spared. This crucified clench, on the other hand, results from median nerve dysfunction at the elbow/proximal forearm, likely as a consequence of prolonged upper extremity abduction, extension, and external rotation on the

cross. Figure 2 Image from the United States National Gallery of Art, Washington, D.C.; The Crucifixion, c. 1475 engraving, Israhel van Meckenem, German, c. 1445-1503. Rosenwald Collection Inhibitors,research,lifescience,medical 1943.3.103. Starting in the 5th century, artistic renditions of the crucifixion began to appear on ivory caskets and grew to be a popular subject of focus of all art media Inhibitors,research,lifescience,medical in the 13th century and throughout the renaissance era. In many works, the condemned was shown with the half-clutched hand position, the thumb and index finger extended, the middle only partially flexed, and the ring and Inhibitors,research,lifescience,medical little finger fully flexed. This hand position on the crucifix appears to have been first seen in art in a rendition in the late 8th to early 9th century made in Constantinople (Byzantine 8th–9th century), though earlier renditions, such as that of a 6th century reliquary casket

found in Bawit (6th century), illustrate a partial crucified clench through obvious failure of flexion of thumb and index fingers. Though the crucified clench is popular in many works depicting crucifixion, the earliest versions show only straight hand position with no flexion

of any fingers. Representations of crucifixions began to appear Inhibitors,research,lifescience,medical only after Inhibitors,research,lifescience,medical the practice of crucifixion was banned by Constantine I in the fourth century; however, crucifixions continued in non-Christian countries into the early 1800s (Gibson and Cohn 2007). This leads to debate of whether the crucified clench was from an invented artistic style or based on true observation. This crucified see more clenched described here is also a well-known benediction sign used in the churches by priests and popes; however, the origin of this hand position and its relation to Christianity is unclear (Elworthy 1900). The extension of the thumb and first two fingers with the flexion of the ring and little fingers has been described in the late 2nd century by Apuleius in his Metamorphoses as the gesture of an orator, though the sign was believed to be sacred even at that time (Elworthy 1900; Apuleius et al. 1915). The benediction sign is clearly depicted in the 6th century Ravenna mosaics picturing angels, prophets, priests, and Christ himself, many of times denoting Christ’s death on the cross, but rarely illustrating the act of crucifixion itself.