Anointing the sick: ritual or teaching?

With the emphasis on the Healer rather than the healers, the Lord clearly shines through.

Davide Mozzato is a Seventh-day Adventist pastor in Florence, Italy.

What does God tell us through the anointing of the sick (James 5:14, 15)? After more than two thousand years should we continue to practice this ritual? And if so, why? And further, why is it that over time this rite has gone from being considered a caelestis medicina (heavenly cure) against sickness to being considered a spiritual rite to be performed only on those about to die?

In the Bible is there a difference between sacred and mundane anointing? Hebrew1 uses basically2 two verbs for anointing: mashah and suk. In the Old Testament these two verbs express two different aspects of anointing. Mashah occurs 130 times compared to a meager 12 times for suk. The two terms express different connotations, with only four exceptions.3 Mashah always refers to ritualistic and formal activities such as an inauguration, dedication, or consecration. Suk refers to the common use of a cosmetic or medicinal ointment. The most frequent use of the verbal root suk refers to the application of an ointment or lotion to the body for cosmetic use usually after bathing.4 The references in 2 Chronicles 28:15 and Ezekiel 16:9 suggest a possible medicinal use of the lotion.

In Greek, as in Hebrew, there are two distinct terms for anointing, Chrio/Chrisma, and Aleifo. In the New Testament, Chrio occurs only five times, and Chrisma occurs only three times, in 1 John.5 The terms Chrio/Chrisma are used metaphorically to refer to the descent of the Holy Spirit, which implies consecration. In four occurrences the reference is to the anointing of Jesus by God the Father.6 The background in these texts is probably to Jesus’ baptism where our Lord symbolically receives the royal and priestly anointing that constitute Him as the Christos.

In the Septuagint the term Aleifo7 is usually used to translate the Hebrew suk in its literal sense of application of lotion for the care of the body or after bathing. Only occasionally is this term a synonym for Chrio when it is used to translate the Hebrew mashah (to anoint with a symbolic meaning). These exceptional texts are Genesis 31:13, where a pillar is anointed, and in Exodus 40:15 and Numbers 3:3, where we find priestly consecration. In the New Testament Aleifo occurs only eight times, in the four Gospels and in James. Here the term is used exclusively to designate the physical act of anointing of people for the following purposes: lotion for the body (Matt. 6:17); in a sign of hospitality (Luke 7:38, 46; John 11:2, 12:3); to honor Jesus’ body (Mark 16:1); and to care for the sick (Mark 6:13; James 5:14). H. Schlier raises an interesting question in regard to the interpretation of these texts.8 The German scholar says that to understand them, we need to analyze the meaning that anointing for the purpose of healing had in Hellenism and Judaism. His research presents the evidence for the use of oil as medicine in Hellenistic Judaism for healing and relief for numerous conditions, such as back problems, skin disorders, headaches, injuries, and more.

Oil used as a magical-medical remedy

In addition to being used as a medicinal drug, oil was also used as a magical-medical remedy, in particular in exorcisms. The ancient world had established a relationship between sickness and sin.9 The concept of sickness was directly associated with a demonic presence. This makes clear what lay behind the use of oil in exorcism. Thus, according to Schlier, the medicinal and exorcistic values of oil are found in Christianity as well. Specifically Schlier argues that Christians also attributed this relationship to holy oil. He documents his case with references to Tertullian,Palladius, and a quote from the Acts of Thomas in which Jesus is asked to go and anoint people who have been bothered by demons.

On the basis of philological considerations, we can affirm that the Bible generally distinguishes between two types of anointing by using two distinct terms. For the concept of an anointing to consecration, the biblical writers use mashah and Chrio/ Chrisma. On the other hand, for the cosmetic-therapeutic-exorcistic purposes they use suk and Aleifo. Having examined the terminology the Bible uses for anointing, we are ready now to uncover the meaning of James 5:13-18.

An exegetical understanding of James 5:13-18

It appears to us that there is a concentric structure in this text. We shall study the passage in that format: verses 13, 17, 18; 14, 16c; 15a, 16b; 15c, 16a; 15b.

13 Is any one of you in trouble? He should pray. Is anyone happy? Let him sing songs of praise. 17 Elijah was a man just like us. He prayed earnestly that it would not rain, and it did not rain on the land for three and a half years. 18 Again he prayed, and the heavens gave rain, and the earth produced its crops.

James refers often to those who live in a state of suffering.10 Now in verse 13 he makes reference to another category of people: those who are well (eutsumei). The epistle writer invites (using the imperative) some to pray and others to sing songs (psalleto) or, better, to play a stringed instrument.11 Prayer and singing are in relationship to the concepts of suffering and joy.12 Prayer and singing are a demonstration of an enduring faith, a mature faith that understands what the center of Christianity is: to live in the present a promise that will be fully realized in the future.13 This teaching is in harmony with Jesus’ instructions in Luke 18:1 and those of Paul in 1 Thessalonians 5:17, where we are encouraged to persevere in prayer regardless of what may happen.

Elijah is brought in as a model. He was human just like us, capable of both depression and joy. He was also a man of prayer. The statement that Elijah prayed earnestly that it would not rain is not found in the passage in 1 Kings. Given that James uses Elijah in a peripheral manner, how should we understand this text? Perhaps the idea is as follows: Whether people are sad or happy, they should pray earnestly as the farmer waits for his crops (cf. 5:17) or as a pregnant woman waits to give birth (John 16:20-22). This is exactly how Elijah prayed. Although he suffered, seeing the state his people were in (1 Kings 18:21, 22), he continued to pray and to act until the Israelites professed their faith in Yahweh (1 Kings 18:39). Then when Elijah was at last satisfied by this positive response, the prophet continued to pray (verse 42) so that the famine would end and Israel might rejoice. In response to this request, rain came.

14 Is any one of you sick? He should call the elders of the church to pray over him and anoint him with oil in the name of the Lord. 16c The prayer of a righteous man is powerful and effective (energumene).

It is the sick person who asks for help. Thus the text teaches a personal action of the person who is suffering and who is conscious of his or her state. Again we are dealing with someone who is very aware of their situation, both the possibilities of healing as well as the present risk. It is clear that this is in stark contrast to the practice of anointing those on their deathbed. James is not describing this sort of situation.14

The suffering person is to call the elders of the church (presbuterous). This name, always used in the plural in the New Testament, refers to those who lead the various local churches. They had, and have, according to Spicq, a role that they have inherited from the Old Testament. In the Old Testament, for the most part, “elders” were honored and influential people who exercised a public function.15

This body of elders is requested to act and put to use powerful prayer. More precisely, they are to use a “powerful and effective [energoumene]” prayer. This is not merely a “fervent” prayer. The false prophets of Baal who battled Elijah on Mount Carmel were certainly not lacking in fervor or zeal. If we think of a merely“fervent” prayer we will misunderstand this text and think that the efficacy of a prayer is related to the strength of the person who offers the prayer. Such an understanding could also lead us to see such a prayer as a sort of powerful, almost magic, formula. In reality, our prayers should be prayers of intercession and not commands that demand an answer.

The elders’ prayer is effective in the sense that they pray and anoint: “let them pray over him, anointing [Aleipsantes].” The text suggests an energetic action toward the sick person who needs help. What is needed is a faith that works through love (Gal. 5:6). The use of the verb aleifo leads us to think of the church elders as a sort of personal paramedic, ready to give immediate care supported by a working faith and prayer. We’ve seen above how cosmetic-therapeutic-exorcistic qualities were attributed to oil. Who would be able to administer such a remedy if not the most respected persons of the community? A Christian could not, of course, go to a pagan doctor who would have invoked over him every sort of spirit in his cure.

Effective prayer can do much but not everything. When we pray for the sick, according to E. G. White, we should remember that we don’t know how to pray as we ought (Rom. 8:26). In addition we should keep in mind that God’s inscrutable love is much greater than ours.16

A righteous man is a person who is justified by the grace of God. Nonetheless the righteous accepts the challenge of praying for the sick by clinging to the promises of God in spite of appearances. And the righteous will continue to believe in God’s promises regardless of the outcome of their prayers, because they know that not all will receive healing. This fact, underlined by Ellen White, should eliminate completely the idea that lack of healing is to be attributed either to the sick person or to those who pray.17

At any rate the spotlight will always be focused on the Lord (“the heavens” 5:18). To pray in the Lord’s name means to recognize that both prayer and the successive act, albeit energetic, will always be merely a tool that certifies our cooperation with the divine and sovereign Physician.

15a And the prayer offered in faith will make the sick person well. 16b Pray for each other so that you may be healed.

What is the concept of faith that James has in mind? Is it a mystic or mysterious faith? We can find an answer to this question in another text from his letter, namely James 2:15-26. For the author, faith is something that one does rather than possesses (2:18). For James, faith and religion have a practical demonstration (1:27). We are helped in our desire to understand the phrase “the prayer of faith will save the sick person” because in James 2:14 we have an identical construction: “can faith save him?”

This question is immersed in the context of the treatment of practical faith. According to Karl Barth, prayer is to accept God’s invitation to participate in His work and His government. 18 We must not task Him to give us what we want. On the contrary, we must seek to understand His plans and carry them out.

Prayer to God the Creator is an important sign of our having accepted His plans. Nonetheless it will be God in His freedom who will intervene for salvation. The Lord, not prayer or oil, saves.

In fact the author doesn’t use the verb to heal but the verb to save in the future tense (sosei). This verb occurs often in the New Testament in cases of miraculous recovery of health.19 The context of healing in which we find this verb and the fact that miraculous healing is part of its semantic range prohibits us from seeing here a reference to future salvation at the return of Christ.

15c If he has sinned, he will be forgiven. 16a Therefore confess your sins to each other.

The Old Testament saints leave their sicknesses before God. It is to God that they offer their supplication (Ps. 38). And it is from God that they receive healing (Ps. 6:4). According to the Israelites’ experience, in a mysterious way sickness is tied to sin and evil. In addition, for the Israelites it is faithfulness to God in the form of His law that brings life (Exod. 15:26).

The ancient world had established a relationship between sickness and sin. We are not discussing here the issue of sin as transgression of the law as cause or effect. The Bible accepts this connection, at least in the sense that evil is opposed to God’s original plan for human beings. Thus suffering and death are seen as the consequences of sin (Gen. 3:16-19). This is the context in which Jesus lived, although He did not share it (John 9:2 ff.).

The conditional particle “if” (kan) eliminates once and for all the relationship of causality between sin and sickness. For James, sins indicate single transgressions, in particular those that generate death (1:15; 5:20).20 Confession of sin also has an important psychosomatic effect. Worrying about ourselves weakens us and increases our chances of getting sick. If we have a positive attitude, our chances of getting better are higher. For as Psalm 33:18 (NIV) says, “But the eyes of the Lord are on those who fear him, on those whose hope is in his unfailing love.” The psychosomatic aspect should not be underestimated, even though not long ago it was thought that this was relevant only for things such as ulcers.

15b The Lord will raise him up.

Even though this text is not at the structural center of the passage it is nonetheless crucial. Everything that was implicit in the other verses is rendered explicit here.

The sick person was lying down (the elders of the church pray over him, cf. verse 14); the Lord will raise him up. As Ellen White writes, “In Him there is healing balm for every disease, restoring power for every infirmity.”21 The power of healing is in the Lord, not in prayer and much less in the oil used. The Savior wants us to encourage the sick, the afflicted, and the desperate to count on His strength.

The text in James puts the emphasis on the Healer rather than on healers, the sick person, or the instruments used in healing. The Lord is the One on whom the spotlight shines throughout this text. The employment of the verb Aleifo increases the idea that the passage presupposes (though does not state explicitly) that here we have a “nonreligious” use of oil, that is as a mere medicinal lotion.

This brief investigation allows me to see with different eyes the act James mentioned 2,000 years ago. The biblical writer seems to be promoting a lifestyle rather than a sacrament, a way of seeing life rather than a rite. James isn’t a mystic. He encourages and exhorts us to an action that makes our faith visible. He would not mind a paraphrase of his message in the following words:

Is there someone sick among you? Let him or her call other members of the body of Christ. And let those members of the church bring, in addition to their support, medicine and let them treat the sick person. The prayer associated with a faith that works will save the sick person, whom the Lord will lift up of the church.

If a member of the body of Christ gets sick, don’t think that this is necessarily due to some sin. Nonetheless, if the sick person has sinned, the Lord will forgive him/her.

No one is exempt from sin. Confess your sins to each other and pray for one another so that you might be healed (including from your biases). Prayer, when it moves from thought to action, when it becomes sincere interest in other people, has a powerful efficacy.

1 See John N. Oswalt, “Anoint,” in Willem A. VanGemeren, New International Dictionary of Old Testament Theology and Exegesis, Zondervan Reference Software version 3/26/01.

2 There are however some references to anointing or similar that do not employ the words that we will analyze below. For example: 2 Chron. 16:14; Isa. 1:6; Isa. 61:3; Jer. 50:2; Jer. 51:8.

3 2 Sam. 1:21; Isa. 21:5; Jer. 22:14; Amos 6:6.

4 Exod. 30:32; Judges 3:24; Ruth 3:3; 2 Sam. 12:20; 14:2; 2 Chron. 28:15; Dan. 10:3 [2x]

5 1 John 2:20; 2:27 (2x).

6 Luke 4:18 (Isa. 61:1); Acts 4:27 (Ps. 2); 10:38; Heb. 1:9 (Ps. 45:7).

7 W. Brunotte, “Anointing,” in Colin Brown, New International Dictionary of New Testament Theology (Grand Rapids: Zondervan Corporation, Software version 22/2/99).

8 H. Schlier, “Aleipho,” Theological Dictionary of the New Testament, Italian version, coll. 617–626.

9 G. Boggio, “Unzione” [anointing], Schede Bibliche Pastorali [Pastoral Biblical Fact Sheets], (Bologna: Dehoniane, 1989), coll. 3998–4008.

10 1:2, 12, 14; 2:6, 15; 3:14-16; 4:7; 5:6.

11 See Eph. 5:19; Col. 3:16. See Louis Simon, Une Ethique de la Sagesse (Geneve: Labor et Fides, 1961), 176.

12 Seventh-day Adventist Bible Commentary (Washington, D.C.: Review and Herald, 1957), 7:540.

13 “When we have prayed for the recovery of the sick, whatever the outcome of the case, let us not lose faith in God.”—Ellen G. White, The Ministry of Healing (Nampa, Idaho: Pacific Press Pub. Assn., 1942), 233.

14 In verse 15 the author addresses the sick person with the word kamnonta which literally means “burdened, discouraged” (Heb. 12:3).

15 Cited by Louis Simon, Une Ethique de laa Sagesse (Geneve: Labor et Fides, 1961), p. 180. It is interesting that a term with political and social connotations, and not religious ones (priest or similar), was chosen for church leaders.

16 White, The Ministry of Healing, 229.

17 Ibid., 230.

18 Cited by Simon, 182.

19 Matt. 9:22; Mark 6:56; Acts 3:7; 14:8-10.

20 Boggio, 4007.

21 White, The Ministry of Healing, 226.



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Davide Mozzato is a Seventh-day Adventist pastor in Florence, Italy.

October 2005

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