The term “Last Rites” in common use typically refers to the Sacrament of Extreme Unction, but in a wider context, it can refer to the whole complex of rites used to assist the dying, or at least those who are in danger of death from illness, injury, or the decay of old age. The principal part of this complex consists of Penance, Viaticum (the final reception of Holy Communion), and Extreme Unction. To these three Sacraments, there are auxiliary rites which have come down through the past twenty centuries of Catholic use. These consist of the Apostolic Blessing in articulo mortis and the Commendation of the Soul, along with the Seven Penitential Psalms, the Litany of the Saints, and a ceremony that can be used for the visitation and care of the sick in general. These various parts of the rites for the sick are found in the Roman Ritual of Pope Paul V (1614, called Pauline) reissued with very little revision under Bl. Pius XI (1925).
That the Sacrament of Extreme Unction was established by Jesus Christ is de fide, and there is the testimony of St. James in his Epistle, Is any man sick among you? Let him bring in the priests of the Church, etc. But the precise liturgical history of the Sacrament in the first eight centuries is somewhat obscure, and there seems to have been a great multiplicity of local customs. The eighth-century Gelasian Sacramentary provides a series of older prayers within the context of rites for the sick, and the Carolingian supplement to the Gregorian Sacramentary (Hadrianum) supplies some further detail. It would be the Ritual of Theodulph d’Orleans (AD 797) and the Pontifical of St. Alban’s Abbey in Mainz (AD 950) which would do the most to lift the mists, and both of these had a great influence on the rituals used throughout the Middle Ages and into the Tridentine era, at which point the Pauline Ritual definitively codified those rites, as we shall now consider.
The priest enters the home or room of the sick person with the invocation mandated by Our Lord Jesus Christ when he sent out the twelve apostles and the seventy-two disciples (cf. Mt, ch. 10; Lk ch. 10). He commanded them: And when you come into the house, salute it, saying: Peace be to this house (pax huic domui). To this priestly greeting the response is given: Et omnibus habitantibus in ea – And to all who dwell therein. He sprinkles the infirm, the sickbed, and the room with holy water, reciting the Asperges. The oldest extant rituals contain this rite, and that of Theodulph indicates that a small amount of ashes were to be mixed into the water. The three prayers which follow this aspersion in the rite of Extreme Unction were already in established use by the ninth century. The first prayer begins: Along with our lowly coming, O Lord Jesus Christ, let there enter into this home unending happiness, divine blessing… Drive forth from this place the spirits of evil, let thine angel of peace come hither… O Lord, extol thy holy name in our esteem, and bless + what we are about to do. Sanctify the coming of thy unworthy servant, for Thou are kind, Thou art abiding with the Father and the Holy Ghost through all eternity. Amen.
At this point the sick person, if able, will make his Confession using the customary ritual for the reception of this Sacrament, and will be given Absolution and a private penance according to his condition. To his private penance, earlier centuries added some trace of public penance as well. It was the practice of St. Isidore of Seville (†636) to have an assisting priest clothe the infirm in a hairshirt and sprinkle him with ashes. There is a detailed account of this rite written by one of St. Isidore’s priests, and the practice became widespread through the High Middle Ages. This final public penance of previous ages harkened back to the words of St. Ambrose: If anyone has a hidden sin, let him assiduously do penance for Christ… Let him implore Christ with tears, implore Him with sighs, and implore the whole people with cries. At this point, the Confiteor, Misereatur, and Indulgentiam are said, and the rites continue.
Having made his Confession, the infirm is prepared for his reception of Holy Communion for the last time, potentially, and it is of grave precept that he receive It. Receiving the Panis Vitae – Our Lord substantially present, Who said, “I am the Bread of Life” – will be the most suitable accompaniment of the infirm to the threshold which separates this life from the next. Viaticum, in fact, means an assistance or accompaniment for the journey. The ceremony of Viaticum is the same as for the ordinary administration of Holy Communion to the sick, except for the very act of reception, at which point the priest says: Accipe, frater, Viaticum Corporis Domini nostri Jesu Christi, qui te custodiat ab hoste maligno, et perducat in vitam aeternam. Amen. – Receive, brother, the Viaticum of the Body of the Lord Jesus Christ. May He protect thee from the hostile foe, and lead thee into life everlasting. Amen.
In earlier centuries, it was the customary practice for those surrounding the sickbed to recite the Seven Penitential Psalms and the Litany of the Saints for the spiritual aid of the infirm as the priest continued with the rite, and in particular during the anointings. The Litany contained some special invocations, such as: Ut fructuosam atque salutiferam poenitentiam tribuere digneris – That Thou wouldst vouchsafe to give fruitful and saving penance; Ut infirmum nostrum visitare et confortare digneris – That Thou wouldst vouchsafe to visit and confirm our sick. The Gelasian Sacramentary of the eighth century includes references to specific prayers added to the end of the Litany. The infirm was also aided by the priest in professing the Apostle’s Creed and praying the Our Father. A monastic ritual of AD 811 provides the rubric: canet, si valet – may he sing them, if able. The Penitential Psalms and the Litany, though not required, still hold their place among the rites dedicated to the sick, and the Pauline Ritual places them in their own chapter following the rite of Extreme Unction.
The principal part of the rite consists of the anointing of the five senses of the infirm preceded by the imposition of the priest’s hands with an accompanying prayer. The prayer for the imposition of hands is exorcistic in nature and comes from at least the eleventh century. As the priest makes the sign of the cross thrice over the infirm and imposes his hand, he says: In the name of the Father + and of the Son + and of the Holy + Ghost. May all power of the devil become extinct in thee through the laying on of my hand and through the invocation of the glorious and blessed Virgin Mary, Mother of God, of St. Joseph, her illustrious spouse, and of all the holy angels, archangels, patriarchs, prophets, apostles, martyrs, confessors, virgins, and all the other saints. Amen.
It is the anointing of the senses that constitutes the matter of the Sacrament, and the eyes, ears, nostrils, lips, hands, and usually the feet are each anointed in the form of the cross. The Oil of the Sick (Oleum Infirmorum) is used for the Sacrament, the Holy Oil having been solemnly blessed by the bishop at the Chrismal Mass on the preceding Holy Thursday. Additional parts of the body were also anointed in earlier centuries, such as the chest, back, loins, joints, and especially the places feeling the most pain (locus maximi doloris, per the rituals), although some excesses were seen; a ritual from Reims (ca. AD 800) listed 24 anointings in all. There is a longstanding custom that when priests receive the Sacrament, the palms of their hands are not anointed, as these were already consecrated with Holy Oil at his ordination, thus his hands are anointed on the outside for Extreme Unction.
During the anointings, the form of the Sacrament is pronounced: Per istam sanctam Unctionem, et suum piissimam misericordiam, indulgeat tibi Dominus quidquid per N. deliquisti. Amen. – Through this holy anointing and through His tender mercy may the Lord forgive thee whatever sins thou hast committed by the sense of N. Over the past centuries, the form has adhered to the following four types, seen in the rituals of the ninth to eleventh centuries: (1) Euchological, formed as a prayer: “Turn the ear of Thy goodness to our prayers, merciful God, etc.”; (2) Optative, expressing a desire: “May this anointing, through the sign of the cross, the holy oil, and the gift of the Holy Ghost, be to thee propitious unto salvation”; (3) Indicative, stating a fact: “I anoint thee with holy oil that thou wouldst be eternally saved”; (4) Imperative, expressing a command: “Accept health of body and the remission of all of thy sins, etc.” The current form, which is optative/deprecative, was already in use in the tenth century.
The anointings are followed by three prayers which implore of God the fruit of the anointing. They are also from the ninth and tenth centuries. An additional element of concluding the rite is the placing of the cross before the infirm, which is counseled in the current ritual (n. 14), “so that he may frequently glance at it and also kiss and embrace it for sake of devotion.” Although the priest currently presents the crucifix to the infirm for him to kiss immediately upon his entrance, after Pax huic domui, the ceremonial placing of the cross before him as the priest takes his leave was developed into an expressive rite of its own during the Medieval period, with accompanying prayers.
Plenary indulgences were first extended to the Crusaders and to Jubilee pilgrims, and the Portiuncula Indulgence secured for the faithful by St. Francis of Assisi is another fruit of the same era. In the thirteenth and fourteenth centuries, plenary indulgences were extended to the unfortunate souls struck by the plague. In 1747, Pope Benedict XIV amplified the indulgences for the sick by giving the faculty to grant the Apostolic Blessing with a plenary indulgence to all of the dying, and he prescribed its rite. It is recognized that all priests have this delegated faculty from the Apostolic See. The plenary indulgence imparted during grave illness takes effect at the moment of death (in articulo mortis). The principal text for conferring the Apostolic Blessing is as follows: May Our Lord Jesus Christ, Son of the Living God, Who hath given to His blessed Apostle Peter the power of binding and loosing, mercifully receive thy confession, and restore unto thee the pristine robe of baptism. And I, by the power given to me by the Apostolic See grant thee a Plenary Indulgence and remission of all sins. In the name of the Father, and of the Son, + and of the Holy Ghost. Amen.
This rite intended for those at the point of death is already found in the texts of the seventh century, and are certainly of even greater antiquity. A candle is lighted by the deathbed, and an abbreviated version of the Litany of the Saints is prayed for the infirm (libera eum, Domine), followed by the prayer Proficiscere, anima christiana de hoc mundo – Go forth, Christian soul, from this world. Two exorcistic formulae follow, including a litany for the dying, then three prayers invoking God’s pardon for the dying man’s soul. Two subsequent prayers to Our Lady and St. Joseph were incorporated in the 1925 revision of the Ritual. A complementary part of the rite can be used as needed; it includes the reading of the Priestly prayer of Christ (Jn, ch. 17) and the Passion. The Irish monks once used also the Canticle of Canticles, which St. Thomas Aquinas remarked upon in his last illness (Come, my chosen one…). A prayer attributed to St. Augustine is added, with portions of Psalms 117 and 118, and three final prayers resume the whole tenor of the rite. During the final agony, some short verses are prayed for the infirm’s eternal repose, including In manus tuas, Domine, commendo spiritum meum. At the moment the soul is breathed forth from the body (ex-spiration), the infirm having called repeatedly on the Holy Name (Jesu, Jesu, Jesu), the deathbed candle is blown out and the living begin their prayers for the dead: Subvenite, Sancti Dei – Come to his aid, ye saints of God!
Providing spiritual succor to the sick and the dying is one of the privileges of the Christian life, and especially of the Priesthood. It is one of the corporal works of mercy, and the prime example given is that of the life of Our Lord Himself, whose public ministry regarded so frequently the care of the sick. He admonishes all to follow His example, as He rebukes the goats on His left, but praises the sheep on His right, who are destined for eternal life: Infirmus fui, et visitastis me – I was sick and you came to visit me.