Why do we have the Sacrament of Anointing of the Sick? A Historical Overview From The Old Testament to Vatican II
The Church’s sacramentals developed from a biblical foundation, in which Scripture established physical objects and actions as instruments of divine power and blessing. There are accounts in the Old Testament that recognize material reality as a conduit for God’s transformative power; for example, there is Moses’s creation of anointing oil per God’s direction (Exod 30:22-23), and the blood applied to the doorpost during Passover as a sign of God’s protection of the firstborn Israelite children (Exod 12:7-13). The concept of applications of material matter is also present in the New Testament; for example, Paul’s personal item carried to the sick removed disease and evil spirits (Acts 19:11-12), the hemorrhaging woman touching Jesus garment (Matthew 9:20–22, Mark 5:25–34, Luke 8:43–48), the dead man touching Elisha’s bones during his burial (2 Kings 13:20-21), and the people bringing the sick into streets hoping Pauls’ shadow would fall on them and heal them (Acts 5:15-16).
The key contributions of sacramentals include clarifying the nature of the sacred signs that dispose the faithful to receive grace. They extend beyond the reach of the Paschal Mystery, emphasize the Baptismal priesthood, integrate popular piety and devotions, and sanctify everyday life (CCC 1667-1676). The sacramentals connote spiritual effects obtained through the Church’s intercession, helping the faithful recognize visible signs that mediate spiritual realities (CCC 1667). Sacramentals position and prepare individuals to receive grace through prayers, blessings, and rituals that permeate daily life (CCC 1668, 1670). Sacramentals sanctify various circumstances and events by showing that the effects of Jesus’ saving work extend beyond the sacraments into all aspects of Christian life (CCC 1668). Sacramentals emphasize the baptismal priesthood by affirming that every baptized person is called to be a blessing and to bless others, which broadens the understanding of participation in the Church’s sanctifying mission beyond ordained ministers (CCC 1669).[1]
Additionally, sacramentals are closely linked to popular devotions and piety that, when harmonized with the liturgy, help the faithful understand and internalize the mysteries (CCC 1674-1676). Besides sacramental liturgy and sacramentals, the Church recognizes various forms of popular piety such as veneration of relics, pilgrimages and processions, the rosary and medals, and stations of the cross, as well as blessings, consecrations, dedications, and exorcisms.[2] By blessing people, objects, and events, sacramental blessings show that everyday life can be directed toward God and sanctified, reinforcing the theological principle that God’s grace is not limited to formal sacramental rites but is present in the ordinary circumstances of life.
The distinction between sacraments and sacramentals was established relatively late in Christian History. Hugh of St. Victor, in the 12th century, distinguished between major and minor sacraments: the major sacraments were authored by Jesus, and the minor sacraments were instituted by the Church, which he called sacramentals.[3] The Second Council of Lyons in 1274 established seven sacraments as Jesus-instituted and efficacious, while reclassifying other ritual elements as sacramentals, including the sign of the cross, blessed ashes, and religious vows, which had previously been called sacraments.[4] They came to be understood as signs pointing to sacred reality rather than as affecting it. In the fifteenth century, the Council of Florence (1439-1445) issued a dogmatic definition affirming that Jesus instituted the seven sacraments.[5]
The Church instituted sacramentals as sacred signs resembling the sacraments, signifying spiritual effects obtained through the intercession of the Church (CCC 1667). Sacramentals do not confer the grace of the Holy Spirit in the same way as the sacraments, but, through the Church’s prayer, they prepare us to receive and cooperate with the grace given in the sacraments (CCC 1670). Liturgy includes both sacraments and sacramentals that sanctify the events of the faithful’s lives through divine grace flowing from the Paschal Mystery, the source of power for the sacraments and sacramentals (CCC 1670). By making the Paschal Mystery present in daily life through sacramentals, the Church fulfills its mission to sanctify the world and lead people to deeper participation in Jesus’ redemptive work.
The relationship between sacramentals and the seven sacraments is grounded in Christology. Jesus is the mystery of salvation, and his saving work is the sacrament of salvation, which is revealed and active in the Church’s sacraments. The seven sacraments function as signs by which the Holy Spirit spreads the grace of Jesus through the Church. Although sacramentals have distinct mechanisms of grace, they participate in the same sacramental economy as the sacraments by extending the Church’s sacred action beyond the seven principal rites.[6]
The Church employs a mystagogic approach to sacramental catechesis, which aims to initiate people into the mystery of Jesus by proceeding from the visible to the invisible, from the sign to the thing signified, and from the sacraments to the mysteries (cf. CCC 1075). This movement from the external sign to the inner reality applies to sacramentals, which serve as openings that invite deeper participation in the Church’s sacramental ministry. Sacramentals sanctify Christian existence in continuity with the seven sacraments.[7]
The key difference between sacraments and sacramentals is their origin and function. The Church establishes sacramentals, not Jesus directly. More importantly, unlike sacraments, sacramentals do not bestow the Holy Spirit's grace; instead, they prepare us to receive grace and help us cooperate with it through the Church’s prayer. This is their core distinction—sacramentals do not generate sanctifying grace solely through their rites. Sacramentals are categorized into two types: those that are things considered holy and persist after the liturgical act (e.g., holy water, palm branches), and those that end with the ritual itself (e.g., the blessing of a home).[8] When sacramentals are celebrated, the Church’s role as intercessor is fulfilled through the efficacy of Jesus’ prayer, and their effects may include actual grace, recovery, or an increase in sanctifying and temporal graces.[9]
My Personal Conversion Narratives 1-4 can be viewed at
https://www.catholic365.com/author/dr-valerie/
[1] Catechism of the Catholic Church, 2nd ed. (Vatican City: Libreria Editrice Vaticana, 1997).
[2] Anscar J. Chupungco, What, Then, Is Liturgy? Musings and Memoir (Collegeville, MN: Liturgical Press, 2010), 83–94.
[3] Herbert Vorgrimler, Sacramental Theology, trans. Linda M. Maloney (Collegeville, MN: The Liturgical Press, 1992), 200-233.; Chupungco, What, Then, Is Liturgy?, 83-94.
[4] Ibid.
[5] Ibid.
[6] José Granados. Introduction to Sacramental Theology: Signs of Christ in the Flesh, trans. Michigan J. Miller (Washington, D.C.: The Catholic University of America Press, 2021).
[7] Ibid., 220- 238.
[8] Chupungco, What, Then, Is Liturgy?, 87.
[9] Anscar J. Chupungco, “Sacraments and Sacramentals,” in Sacraments and Sacramentals, ed. Anscar J. Chupungco, Handbook for Liturgical Studies (Collegeville, MN: The Liturgical Press, 2000), 4:xxiv–xxvi.