Here we find the elders of the church visiting those who are sick. Astheneo is the Greek word that is translated "sick" in this verse. It means "to be weak, infirm, deficient in strength, feeble; to be sick, frail, without energy." It is a word often used in the New Testament writings to cover a wide variety of physical illnesses. The word which is translated "sick" in the next verse (vs. 15) is kamno, which means "to tire with exertion, to be weary; exhausted." It is a "weariness of mind" (W.E. Vine's Expository Dictionary of NT Words). It is very likely that James is referring to physical illness in vs. 14, and to emotional and spiritual weariness in vs. 15. The former thus requires physical healing, the latter emotional/spiritual revitalizing.

The elders of the church, who have been summoned by the one who is experiencing some form of physical illness (Albert Barnes, in his Notes on the New Testament, discusses at length the fact that members of the church who are sick must inform the spiritual leaders of their need, and not "presume that they know all about it, and then wonder why they do not come to see them, and think hard of them because they do not"), are instructed to do two things during the course of this "pastoral visit." They are to offer a prayer on behalf of the one who is sick, and they are to anoint him with oil in the name of the Lord. It should not be overlooked that the emphasis in this verse is upon prayer. "'Let them pray over him' is the main verb, while 'anoint' is a participle. Moreover, the overall emphasis of the paragraph is on prayer. So the anointing is a secondary action" (Expositor's Bible Commentary, Vol. 12, p. 203-204).

As to the act of anointing, it should be noted that there are two different Greek words which are translated "anoint" within the pages of the New Covenant writings. They are: Aleipho, which is the word used here in James 5:14, and chrio. "The difference is material, and is lost when both verbs are translated 'anoint;' only the second verb (chrio) should be translated in this way, for it is used with reference to the sacred act while the first (aleipho) refers to the common use of oil. This difference in Greek usage cannot be ignored! 'Anointing' in our English versions leaves the wrong impression" (R.C.H. Lenski, The Interpretation of the Epistle of James, p. 660-661). "'Aleipho' is a general term used for an anointing of any kind, 'Chrio' is more limited in its use and is confined to sacred and symbolical anointings" (W.E. Vine's Expository Dictionary of NT Words).

"'Aleipho' is the mundane & profane, and 'Chrio' is the sacred & religious word" (R.C. Trench). "The word 'Aleipho' is not the usual word for sacramental or ritualistic anointing. James could have used the verb 'Chrio' if that had been what he had in mind. The distinction is still observed in modern Greek, with 'aleipho' meaning 'to daub, to smear,' and 'chrio' meaning 'to anoint'" (Expositor's Bible Commentary, Vol. 12, p. 204). This is an important distinction in light of the fact that this verse is one of the primary passages the Catholic Church uses to justify its doctrine of Extreme Unction. In their Douay version of the Bible they write, in a footnote to this verse, "St. James promulgated here the Sacrament of Extreme Unction. Presbyters is certainly used here in the sense of priests." They further write, "We see here a plain warrant of Scripture for the Sacrament of Extreme Unction, and any controversy against its institution would be against the express words of the sacred text in the plainest terms."

NOTE: To further examine this distinction between the two words, compare the use of "Aleipho" in Luke 7:38, 46; John 11:2; 12:3; Mark 16:1 with the use of "Chrio" in Luke 4:18; Acts 4:27; 10:38; Hebrews 1:9.

There have been two major interpretations put forth over the centuries as to what this "anointing" is, and what it might signify:

#1 --- A Symbolic Act --- The sick person was miraculously healed by the elders, and the anointing with oil "served as a token of the power of God by which the healing was accomplished" (Guy N. Woods, A Commentary on the Epistle of James, p. 301). "James in this remarkable paragraph plainly has under consideration the charismatic gift of healing, one of the special gifts that attended the early propagation of Christianity for the purpose of confirming the word of God" (Burton Coffman, Commentary on James, p. 124). "If the healing which James has in mind is miraculous, the oil was ceremonial; prayer was a part of the preparation both of the miracle worker and the onlookers (Matthew 17:21; John 11:41f). The reason for the elders being called is not so apparent. But it is probably because (since the gifts were distributed by the laying on of the apostles' hands, Acts 8:17f; 19:6) when these gifts were imparted, the elders would be the most likely to be selected to receive them. If this is the correct interpretation of the instruction of James, then the passage has no direct bearing on the practice of the church today" (J.W. Roberts, The Living Word Commentary: The Letter of James, p. 168-169). "One of the earliest books concerning Church administration is the Canons of Hippolytus, which goes back to the end of the second century or the beginning of the third. It is there laid down that men who have the gift of healing are to be ordained as presbyters, when investigation has been made to ensure that they really do possess the gift, and that it comes from God" (William Barclay, The Letters of James and Peter, p. 153).

#2 --- A Medicinal Act --- "It is a well-documented fact that oil was one of the most common medicines of biblical times. It is evident that James is prescribing both prayer and medicine" (Expositor's Bible Commentary, Vol. 12, p. 204). "It means that the sick person's body is to be rubbed with oil just as the nurse now rubs a patient's body with alcohol. When James directs the elders to do it when they visit a patient, this means that the church, for which the elders act, is concerned about the body as well as about the soul" (R.C.H. Lenski, An Interpretation of the Epistle of James, p. 661-662). "What is here recommended was to be done as a natural means of restoring health, which, while they used prayer and supplication to God, they were not to neglect. I am satisfied that it has no other meaning than as a natural means of restoring health; and that St. James desires them to use natural means while looking to God for an especial blessing" (Adam Clarke's Commentary, Vol. 6, p. 827).

With respect to the medicinal qualities and uses of oil, see: Isaiah 1:6; Jeremiah 8:22; 46:11; Luke 10:34. Josephus, Philo, Pliny, and the papyri all refer repeatedly to the medicinal use of oil at that particular time in history. The great physician Galen described it as "the best of all remedies." In ancient Egypt it was used as a treatment for plague, and in Europe it was later used as a cure for dropsy.

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