The Anointing of the Sick

Below is an article / essay on the meaning of this Mystery or sacrament in the life of the Church, and in the life of every Orthodox Christian.

How does the Church approach sickness and death?  What are the main themes in the rites of healing and of funerals? What is the connection between sickness, death and sin?

Christ the Great Physician

The reality of the frailty and impermanence of the human condition, the subjection of the life and body of every man, woman, and child who enters into the realm of earthly life to the inescapable finality of the dissolution of the temporary condition of human existence by death, is a matter which has preoccupied the speculation, philosophy, and religious activity of cultures and individuals across the globe in every epoch of human society. So, also, has the perennial plague of bodily weaknesses in the various forms of human sickness and affliction which are, likewise, inescapable parts of the lived experience, and which often seem to presage the final passing of the personhood of “every man that comes into the world” which comes at death, ever challenged mortal humanity. The teaching and life of the Orthodox Church is not separated from engaging and transforming this fundamental human experience. On the contrary, as the reality of sickness and of death are central and profound concerns to mankind and to the Divine Creator of man and of the Cosmos, the Church is deeply engaged in this aspect of life. The worldview of the Body of Christ, the Church, is profoundly shaped by the recognition of the facts of illness and mortality as part and parcel of the life of human beings. At the same time, the Christian view of existence sees these phenomena as the tragic, yet temporary, aftereffects of the sundering of the original plan of God for His creation by disobedience and sin. While the redemptive action of the Triune God in the Incarnational activity of Jesus Christ carries and makes real the promise and the reality of the ultimate restoration of the human person by participation in that restoring activity, sickness and death are still unavoidable, often close-at-hand. The sacramental ministry and mission of the Church, in all of her holy mysteries, brings the temporal frailty of life into contact with the Holy Trinity towards recovery of its lost, original wholeness and holiness, even here in the valley of shadows and death. The mysteries or sacraments of Baptism, Chrismation, Holy Eucharist, and Penance incorporate, sustain, and restore the believer during his or her life’s journey. So, too, the mystery of the Anointing of the Sick and the funeral service of the Orthodox Church both recognize the brokenness of the earthly person, while extending the healing power and the promise of the everlasting life of the Risen Christ and the fullness of the Holy Trinity to the individual, and to the community of which he or she is a part within the Church.

In his study The Anointing of the Sick, Orthodox liturgical scholar Paul Meyendorff presents a detailed investigation of the origins, development, liturgical and theological importance, and practical celebration of this ministry of Christ performed in and through His Church. The introductory preface of this volume calls attention to the fact that modern medicine, for all of its technological advances, does not – and, indeed, is not able to – adequately fill all the needs which are part of the totality of healing and health. Rather, and as the Church has always emphasized, the human person stands in need of healing which does not merely address physical externals, but deals with the human person in his or her fullness, as it was created by God, and as it has been marred by sin, sickness, and death.

The Sacrament or Mystery of the Anointing of the Sick, although perhaps not of as central an importance as the initiatory rite of Baptism and the ongoing celebration of the Holy Eucharist in Christian life, nevertheless addresses a fundamental crisis of human life at precisely the time or times when it is most needed. The healing ministry of Jesus Christ, Himself, is recorded and transmitted from generation to generation in the stories of the Holy Gospels. In the evangelists’ accounts and throughout the New Testament, the nature of healing is consistently related to the reality of sin, and the need of sin for forgiveness. This repeated association continues in the liturgical life of the Church from that time, through the ages, unto the present.

The miraculous healings which were so central a part of the public ministry of Christ during His life on earth were continued in the early Church from the first apostolic generation, as attested by the Acts of the Apostles and in many of the Epistles. The “good works” done by Jesus during the years of his earthly ministry were the heralding proclamation of the Kingdom of God, coming in fullness. As Dr. Meyendorff’s examination emphasizes, two fundamental components of healing in the New Testament were 1.) faith; and 2.) repentance (The Anointing of the Sick, 14-15). Belief in Jesus, His person and His mission, on the part of both Jewish and Gentile individuals was a key factor or precondition in the healings performed by Jesus. The other was the recognition of the power of sin: its ability to evidence this power is sickness, corruption, and death, which are overcome by the greater power of forgiveness of sin by Jesus. These important factors continue in the healing stories of another major portion of the New Testament, apart from the Gospels: the ministry of the Apostles recorded in Acts. Much of the remainder of the New Testament corpus emphasizes, however, rather than miracles of healing, the communal nature of the new people joined together as the new People of God called by Jesus, including their responsibility to love and care for one another. This responsibility is emphasized again and again in the Pauline Epistles. Incorporation into this community by Baptism, emphasized as a matter of healing and new life in the scriptural texts, as well as partaking of the Eucharist in the assembly of believers, were lived out in the daily life in Christ, and were seen from the times of the creation of the New Testament canon to have healing and restoration to life as profound and fundamental aspects of their celebration and reality (16 ff.). As the life of the Church continued and developed over the centuries following the Apostolic age, the fullness of its life together in community continued with rites and ways of prayer and liturgy which kept central the role of healing: chrismation, the reconciling mystery of penance, marriage, and the developing of daily and annual liturgical cycles all kept within view of the Church’s community the necessity, reality, and profundity of healing in the lives of individuals, in the Church, and in the whole of creation (20-30).

The crucial text in the Epistle of James (Jas. 5:13-16) makes clear the importance of the healing ministry in the early Church, and is the model for the later development of the sacrament or mystery of healing within the Orthodox Church. The key elements of the case of sickness of a believer being met with a gathering of the Church’s elders (v. 14, “let him call for the elders of the church,” προσκαλεσάσθω τοὺς πρεσβυτέρους), prayers, the use of olive oil, and confession of sins all included in this brief passage would form the core of the later developments in Byzantine celebration of the healing sacrament. Dr. Meyendorff’s survey The Anointing of the Sick notes the long tradition of olive oil as a curative ointment and a medicinal agent in the ancient Middle East, both within Judaism and throughout the wider Mediterranean world. Early surviving liturgical texts from areas such as Egypt and Syria attest to a special prayer of blessing or consecration over oil to be used on the sick. Such blessings often included prayer that demonic influence and sickness be driven away. The earliest Christian healing rituals may have been the use of such set-apart oil in the domestic setting of the homes of the ill, with participation of visiting clergy (32-38). Even at this early stage, evidence exists of an inclusion of penance and forgiveness as a fundamental part of the rite. Both the Third Century exegete Origen of Alexandria and the Fourth Century Syrian holy man Aphraates record the use of sanctified oil in the reconciliation of penitent sinners. Some textual evidence from this early period (as from the Latin father Caesarius of Arles, fl. early Sixth Century) also seems to suggest a eucharistic connection for the anointing of the sick with oil, although this does not necessarily mean that the anointing exclusively and everywhere was limited to the eucharistic assembly.

In the eastern portion of the Roman Christian world, the first surviving mentions of a rite of the anointing of the sick from the East Roman (Byzantine) Empire testifies that the anointing unto healing was administered following, and in the context of, the celebration of the eucharist and partaking of communion (40). In the centuries following, however, the ritual of the Anointing of the Sick in the Byzantine liturgical sphere developed from a simple service of a few prayers for the sick and two prayers blessing the oil of anointing (cf. Codex Barberini 336, latter part of the Eighth Century) into, ultimately, a highly elaborate rite composing seven cycles of lengthy Gospel readings and prayers. The full performance of the rite according to the Eleventh Century manuscript Coislin 213 required not only seven serving priests but seven full days in which to accomplish the full celebration of the mystery (43 ff; cf. also the Twelfth Century Sinai gr. 973). This service was to be performed in a “domestic church,” a striking rubric which seems to bridge the earlier usage of the sacrament as a semi-private matter administered in the homes of the sick by representatives of the wider Church community and the later performance of the rite within the church building (as in the modern usage during Holy Week). The question may arise, however, if this indicates that the service was mostly limited to the homes of the wealthy – and, if so, given the commonality of such home chapels in the medieval world, notably in Constantinople (43, n. 21), this stipulation might nonetheless have meant that the healing rite was readily available to the sick of all levels of society. Later centuries saw a degree of abbreviation of the rite, including the separation of the anointing ritual from the eucharistic communion, reduction of the required number of presbyter celebrants, and an eventual development of various traditions, including the Greek and the Slavic practices.

Whatever the variances in local practice and the current state of the development of the Anointing of the Sick, some fundamentals remain constant and central to the rite in contemporary Orthodox usage. The emphasis on sin, its destructive power, and the healing power of repentance and forgiveness are cornerstones of the myriad prayers of the rite, just as these themes were central to the healing stories of Jesus in the Gospels. Today, as in all prior ages of human existence, the reality of sin and of sickness are painfully, powerfully, and immediately evident in the world around us. Sickness and sin are inextricably intertwined, and,therefore, release from sickness and decay requires freedom from sin through turning from sin (on the part of humanity and of individual persons) and the forgiveness of sins, which have been committed but repented of (on the part of the merciful and loving God). As the nature of sin and of sickness are to “depersonalize” (75) the person created in the image and likeness of God, healing and true fullness of life need the reintegration of personhood by peace with, and participation in, the life of the Holy Trinity. This is accomplished through tangible, “real” means by the sacramental ministry of the Church, through which Christ, the Incarnate Second Person of the Holy Trinity, acts in human lives. By recognizing that the human being has both physical and spiritual components, the sacramental action of the Church, evidenced in the prayers and physical actions of the Anointing of the Sick (as, also, in Baptism, Chrismation, Penance, the Eucharist, and all the Church’s mysteries) addresses this bipartite nature of sickness and of healing. A truly “holistic” approach to healing is thus offered by the Church, which does not seek to replace the good which may be accomplished by modern medical technology and its ministrations, but which integrates such scientific medicine into a fuller view of the human being and of humanity as a whole: fallible and broken, yet capable of being redeemed and made whole by God. Within the liturgical theology and the anthropological outlook of the Orthodox Christian Church, this healing action is not merely to be reserved for certain moments of crises, nor limited only to private “hospital visits” or once-annual parish celebrations. The prayers and sacramental actions toward healing are an integral part of the totality of the Church’s daily experience, in all of her services and mysteries, and, ideally, in the whole of Christian life.

The funeral service of the Orthodox Church reflects and continues the same view of life, sickness, and death as the rite of the Anointing of the Sick, with a focus on the fact of the connection between sin and mortality. The funeral service combines a Trisagion service, the recitation of Psalm 118 (in the Septuagint; 119, Hebrew Canon), the lengthy psalm of the righteous man, as a remembrance of the departed, scripture readings focusing on the coming (but still future) resurrection, prayers for the deceased, and a final Kiss of Peace between the departed and the living faithful. The pain of separation for those left behind and the tragedy of the sundering of death is acknowledged in hymns which speak of the mortal condition, such as this:

“I weep and lament when I think upon death, and behold our beauty created in the likeness of God lying in the tomb disfigured, bereft of glory and form. O the marvel of it! What is this mystery concerning us? Why have we been delivered to corruption? Why have we been wedded unto death? Truly, as it is written, by the command of God Who giveth the departed rest (Funeral Hymns)”. *

The mortal condition is thus seen as a tragedy which has befallen the human being, made originally for good and in the image and likeness of God, with the pain and sorrow of death’s separation emphasized as a “rest” for the departed. The coming of death is not seen as the “end of the story,” however; the scripture readings and the “Evlogeitaria” hymns recalling Christ’s death and resurrection, and the promise of eternal life for those united with him, emphasize that, despite the sorrow and seeming finality at the time of death, the triumph of Christ and, with Him, His servants, is the ultimate message of the Church and of its Faith. **

In the course of life and even in departing life, then, the Orthodox Church recognizes the reality of pain, sickness, suffering, and death, and confronts these painful realities of the fallen world of human existence. By recognizing that sorrow, physical illness, and mortality are the result of sin, the Church is able to offer healing and hope to the Faithful, by carrying on and holding out the sacramental ministry which was begun, and made possible, through the taking on of flesh, suffering, death, and resurrection of Jesus Christ. The tangible healing given through the mystery or sacrament of the Anointing of the Sick and the mingled grief and hope offered in the Orthodox Funeral service embrace the broken condition of humanity with the power of Christ’s divine and transcendent incarnational reality, unto reconciliation, healing, comfort, and, ultimately, participation in the unending, resurrected life to come.



** icon of Christ the Great Physician from

by Ross Cooper