It is well to remember that someday you will die.
1 Now, the body is the instrument of the soul, and an instrument is for the use of the principal agent: therefore, the disposition of the instrument necessarily must be such as becomes the principal agent. Hence, the body is disposed in harmony with the soul.
Therefore, from the infirmity of the soul which is sin infirmity sometimes flows into the body, when the divine judgment so disposes. To be sure, this bodily infirmity is at times useful for the soundness of the soul: so far as a man bears bodily infirmity humbly and patiently, and so far as it is reckoned as satisfying punishment for him.
At times, also, it tends to hinder spiritual health: so far as bodily infirmity hinders the virtues. Therefore, it was suitable to employ some spiritual medicine against sin, in accord with the fact that bodily infirmity flows out of sin; indeed, this spiritual medicine cures the bodily infirmity at times, namely, when this is helpful to salvation. And for this a sacrament was established extreme unction, about which James (5:14-15) says: “Is any man sick among you? Let him bring in the priests 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 heal the sick man.”
Notes It is now, in the West, an utterly baffling notion that one should suffer for anything.
2 Nor is the power of this sacrament prejudiced if at times the sick on whom it is conferred are not wholly cured of this bodily infirmity, for the restoration of bodily health—even in those who receive the sacrament worthily—sometimes is not useful for salvation. And they do not, for all that, receive it in vain, although bodily health may not follow on it.
For, since this sacrament is set against bodily infirmity so far as this follows on sin, this sacrament manifestly was established against the other consequences of sin, which are proneness to evil and difficulty in good, and it is set so much the more as the soul’s infirmities of this sort are closer neighbors to sin than bodily infirmity is. Indeed, spiritual infirmities of this sort are to be cured by penance, in that the works of virtue which the penitent performs when he makes satisfaction withdraw him from evils and incline him to good.
But, since man, whether due to negligence, or to the changing occupations of life, or even to the shortness of time, or to something else of the sort, does not perfectly heal within himself the weaknesses mentioned, a healthful provision for him is made by this sacrament: it completes the healing aforesaid, and it delivers him from the guilt of temporal punishment; as a result, nothing remains in him when the soul leaves the body which can obstruct the soul in the perception of glory.
And therefore James adds: “And the Lord shall raise him up.” Perhaps, also, a man has neither awareness nor memory of all the sins which he has committed, so that they may be washed away individual by penance. There are also those daily sins without which one does not lead this present life. And from these a man ought to be cleansed at his departure by this sacrament, so that nothing be found in him which would clash with the perception of glory. And therefore James adds: “If he be in sins, they shall be forgiven him.”
3 Hence, it is clear that this sacrament is the last, that it somehow tends to consummate the entire spiritual healing, and that in it a man is, as it were, prepared for the perception of glory. For this reason also it is named extreme unction.
4 From this it is apparent that this sacrament is not to be given to anyone at all who is sick, but only to those who seem in their weakness to be approaching the end. Nevertheless, if they get well, the sacrament can be conferred on them again if they return to a similar situation. For the anointing in this sacrament involves no consecration, as does the anointing in confirmation, or the washing in baptism, and certain other anointings which are never repeated—simply because the consecration always remains, so long as the thing consecrated endures, because of the effectiveness of the divine power which consecrates. But the anointing of this sacrament is ordered toward healing, and healing medicine ought to be repeated as often as the weakness is repeated.
5 We grant that some are in a state close to death even without infirmity—this is clear in the case of those condemned to death—and they nevertheless would need the spiritual effects of this sacrament, but it is not to be given unless such a one is sick, since it is given under the appearance of bodily medicine, which is fitting only for one who has been weakened in the body. For in the sacraments the character of the sign must be maintained. Therefore, just as baptism requires that washing be used on a body, so this sacrament requires that medicine be applied for bodily weakness. Hence, also, oil is the special matter of this sacrament, because it has effectiveness for bodily healing by alleviating pain; just as water which cleans the body is the matter of the sacrament in which spiritual cleansing takes place.
6 Therein one also sees that, just as bodily medicine must be applied at the source of the infirmity, so this anointing is used on those parts of the body from which the weakness of sin proceeds: such are the organs of the senses, and the hands and feet by which the works of sin are carried On, and—in accord with the custom of some—the loins in which the libidinous force is strong.
Notes I recall some 1970s kung fu movie in which a man purposely sits in oil from the waist down so that his peccant parts waste away. That is going too far.
7 But, since sins are forgiven by this sacrament, and no sin, of course, is forgiven except by grace, manifestly grace is conferred in this sacrament.
8 Now, when things bestow enlightening grace on the mind, their use is proper only to priests, for their order tends to enlighten, as Dionysius says. Neither does this sacrament require a bishop, since this sacrament does not confer a state of excellence, as is the case with those whose minister is a bishop.
9 Nonetheless, since this sacrament has a perfect cure as its effect, and an abundance of grace is required in it, it becomes this sacrament to have many priests present, and to have the prayer of the whole Church help in the effect. Hence, James says: “Let him bring in the priests of the Church… and the prayer of faith shall save the sick man.” If, nonetheless, only one priest is present, it is understood that he fulfills this sacrament in the power of the entire Church whose minister he is, and which, in person, he represents.
10 Of course, the effect of this sacrament is obstructed by pretense in the receiver, just as can be the case with the other sacraments.