Article I: On the Institution of the Sacrament

S. Th., Suppl., q. 29, a. 1-3.

688. State of the question. - The innovators expressly denied to the anointing of the sick the dignity of a sacrament; against them the Council of Trent vindicated it and defined that it must be believed by all as of faith, sess. 14, on Extreme Unction, can. 1.

Already formerly the Waldenses and Wicleffites seem to have neglected or contemned this sacrament. But Luther denied that it was a sacrament, yet retained anointing as a rite similar to sacramentals. Calvin thinks it was once a charism, but now is wholly useless and reeks of theatrical hypocrisy. Present-day Protestants, with the Ritualists for the most part excepted, wholly deny the power of a sacrament, and they understand the words of St. James, V, 14-15, of the gift of healing bodily diseases, by which many at that time rejoiced. Liberal Protestants and Modernists assert that the custom of the Jews, who used oil for healing wounds, was adopted by Christians for pious use and only slowly transformed into a symbol of grace. To this pertains proposition 48 of the Modernists: "James in his epistle does not intend to promulgate any sacrament of Christ, but to commend some pious custom; and if in this custom perhaps he sees some means of grace, he does not take it with that strictness with which the theologians who instituted the notion and number of the sacraments took it."

689. Thesis. There is in the Church a true and properly so-called sacrament, instituted by Christ the Lord and promulgated by the Apostles, to be given to the sick by extreme anointing. - It is of faith from the Council of Trent, sess. 14 on Extreme Unction, c. 1, and can. 1 and 3; which thus confirms the profession of faith emitted in the Council of Lyons and the doctrine of the Council of Florence.

It is proved: A. From the Scriptures, in which this sacrament:

1. Is insinuated and as it were foreshown, Mk. VI, 12-13: Going forth they preached that men should do penance; and they cast out many demons, and anointed with oil many sick, and healed them.

There the effect of bodily health alone is attributed to the anointing and to the power of the Apostles; yet because this power was ordered to the health of souls and the kingdom of God, it insinuated a sacramental anointing to be instituted for the salvation of soul and body.

2. Also was expressly promulgated and commended to the faithful, Jas. V, 14-15: Is anyone sick among you? Let him bring in the presbyters of the Church, and let them pray over him, anointing him with oil in the name of the Lord, and the prayer of faith shall save the sick man, and the Lord shall raise him up, and if he be in sins, they shall be remitted to him.

By these words is indicated a) a sensible sign, namely, matter and form: anointing with oil and the prayer of faith; b) instituted by Christ the Lord: in the name, that is, by the command and authority, of the Lord, namely Jesus (I, 1; II, 1; V, 7, 8); c) conferring grace ex opere operato: the prayer of faith shall save the sick man and the Lord shall raise him up; these things are obtained once the sign is posited and are not to be understood of the body alone but also of the salvation of the soul (I, 21; II, 14; IV, 12; V, 20) and of relief, especially since it is added: if he be in sins, they shall be remitted to him, which cannot happen without the infusion of grace; d) remaining in perpetuity: for it is commended without restriction to all faithful gravely sick, and therefore has force for all. That these things are to be understood thus is most certainly clear from Tradition.

Therefore there is not question of the gift of healing diseases: for then a) presbyters would not have to be called, but charismatics who have the gift of healings; nor b) for a miraculous healing would matter, namely anointing, have to be prescribed, for miracles are done by diverse signs according to divine inspiration; nor c) would it be added: if he be in sins, they shall be remitted to him, because those endowed with the power of miracles cannot by this power forgive sins.

1. From the usage of the New Testament, the word asthenei (v. 14) and kamnonta (v. 15) signify grave infirmity.

B. From Tradition. In the ninth century, in the Church both Western and Eastern, Extreme Unction was universally held as a sacrament to be conferred upon the sick for the salvation of soul and body; from the eighth century down to the fourth, several explicit testimonies about it also exist; indeed in the third century rather clear allusions are found. From these it is historically probable that this sacrament existed from the beginning and that tradition rises up to the testimony of James; but theologically it is wholly certain, because under the assistance of the Holy Spirit faith is preserved incorrupt in the Church, and therefore from the fact that unanimous tradition admits some point of faith in whatever century, it is proved that it was always believed in the Church and handed down by the Apostles.

a) The consensus of the ninth century is clear, both from the Councils of various regions - of Ticinum, Mainz I, Aachen, Chalon II - or from statutes of bishops: Isaac, bishop of Langres, Herard, archbishop of Tours, Theodulf, bishop of Orleans, St. Boniface, apostle of Germany, Egbert, bishop of York, etc.; and from diverse testimonies, such as those of Amolo of Lyons, Jonas of Orleans, Prudentius of Troyes, Amalarius of Metz, Haymo of Halberstadt. For the East it is clear from the Euchologies, even those of the Orthodox, and from the writings of Eastern theologians of later age who testify to the ancient faith of their Churches in this sacrament.

b) Before that, testimony is furnished: in the eighth century, by Bede the Venerable (on Jas. V, P. L. CXIII, 39); in the seventh century, by St. Eligius of Noyon (de Rectitudine cath. conversationis, P. L. XL, 1172); in the sixth century, by Cassiodorus (Complexiones in ep. Ap., P. L. LXX, 1380) and Caesarius of Arles (P. L. XXXIX, 2238), and also by a synod celebrated by the Patriarch of the Nestorians; in the fifth century, by Victor of Antioch (on Mk. VI, 13), Cyril of Alexandria (de Ador. in sp. et ver.), Augustine (Spec. de S. S.), John Mandakuni among the Armenians, and Innocent I (ep. 25, c. 8); in the fourth century, by the Euchology of Serapion, the Canons of Hippolytus VI, 4, and John Chrysostom (de sac. III, 6).

c) In the third century, the following seem to allude to Extreme Unction: St. Aphrahat (Dem. 23), Eusebius (P. G. XXIV, 267, 1111), and Origen (hom. 2 in Lev.), who nevertheless, like Chrysostom (l. c.), does not distinguish it altogether clearly from the penance of the dying.

The silence of earlier times does not stand in the way. For a) only few writings survive, and many have been lost; b) they were wholly occupied in catecheses in which they explained the fundamental dogmas and the sacraments to be received by catechumens, or in defending the truth of the Christian religion; c) there are also few testimonies concerning Penance, much more concerning Extreme Unction, which is only its complement for the sick; d) moreover, in the time of persecutions prudence warned that sacred rites be reduced to a minimum; but the anointing of the sick is not a necessary sacrament; e) the sacrament of Penance itself was less in use, nor was it received for venial faults; similarly Extreme Unction, as being the complement of Penance; f) until the fourth century Baptism was often deferred until the end of life, and Extreme Unction was not given to public penitents, as Innocent I says, ep. 25, n. 8; g) the ancient commentaries on the epistle of James have perished, so that the first extant one is that of Venerable Bede; but the Gospel of Mark did not find an interpreter before Victor of Antioch in the Greek Church, before Venerable Bede in the Latin Church; h) but if today, when the use of Extreme Unction has become altogether universal, speech about this sacrament is made very rarely in pious or doctrinal books, it should not seem strange that very few things, or even none, concerning it have come down to us from certain times.

C. By reason of fittingness, which Billuart declares thus, taking it from St. Thomas, a. 1:

Christ instituted the sacraments so that he might aid the faithful for every time and according to every state: thus at the entrance into the Church there is Baptism; in the progress and course of life, Confirmation, Eucharist, Penance, etc.; therefore also at the exit, at which our adversary strains all the sinews of his cunning to destroy us, as the Council of Trent has it, sess. 14, on Extreme Unction, in the proem. But there is no other than Extreme Unction, which therefore is called the sacrament of those departing.

690. Extreme Unction is one sacrament, although it is ministered under several anointings, or by several priests, each of whom places a different anointing with its respective form. St. Thomas shows this thus, a. 2:

"Any sacrament is called one insofar as the many things which are in one sacrament are united for signifying, or causing, one thing, because the sacrament causes by signifying. And therefore when one action suffices for perfect signification, the unity of the sacrament consists in that action alone, as is clear concerning Confirmation. But when the signification of the sacrament can be both in one action and in many actions, then the sacrament can be perfected both by one action and by several, as Baptism by one immersion and by three, because washing, which is signified in Baptism, can be by one immersion and by many. But when perfect signification cannot be except by several actions, then several actions belong to the perfection of the sacrament, as is clear in the Eucharist, because bodily refection, which signifies spiritual refection, cannot be except by food and drink. And it is similar in this sacrament, because the healing of interior wounds cannot be perfectly signified except by the application of medicine to the diverse roots of wounds. And therefore several actions belong to the perfection of this sacrament." And "although those actions are several simply, nevertheless they are united in one perfect action, which is the anointing of all the exterior senses by which the interior disease is drawn in" (ad 2). "Nor does the plurality of ministers take away the unity of this sacrament, because he works only instrumentally; but the changing of hammers does not take away the unity of the operation of the craftsman" (ad 3).

691. Observation. It is uncertain when and how Christ instituted this sacrament. Yet it seems that he did not institute it before the sacrament of Penance, and therefore not before the Resurrection; he did not exhibit it, because immediate preparation for entrance into glory was not to be granted before the Ascension; nor does it seem that he determined it perfectly, nor did he promulgate it himself, but left it to be promulgated by the apostles (n. 18 and 71).