Just as for the other sacraments, reference to the composition of the holy unction can be traced back to the New Testament, and specifically, in James' Epistle:

(chapter E´, verses 14 -15).
Is someone ailing amongst you ?
Let him invite the elders of the church
and may prayers be offered for his sake,
while anointing him with oil in the name of the Lord;
and the prayer of faith shall save him that does this,
and the Lord shall raise him up;
and even if he has committed sins,
he shall be delivered from them. 

Because the first mention of holy unction is found in James' Epistle, the authorship of the Service for the Holy Unction has been attributed to Saint James, the brother to Christ, without this being the actual case. The reason that the fatherhood of the Service for the Holy Unction has been attributed to Saint James is the frequent mention of his name in the benedictions, as well as the interspersed hymns that are sung in his honour. 

The service for the holy unction can take place "within a church or a home". In the ancient liturgical books are found special benedictions for the blessing of the oil, by which it acquires healing powers. These simple benedictions evolved during the course of time, into a formal service, which was performed in church in conjunction with the divine service, like all the other sacraments. In the event that the ailing person was not confined to his bed, he would be present during the service, otherwise, immediately after the divine service, the priests would go to the ailing person's home and anoint him with the sanctified oil.

At a later date, the service for the holy unction was isolated from the divine service, which eventually led to performance of the rite in the home. This was also inspired by the words of Saint James "Let him invite the elders of the church…", hence the implication of performing the rite inside the home.

The service for the holy unction is performed "for the healing of the spirit and the body". According to the teaching of our Church, all physical ailments are considered to be the bitter fruits of sin. Any ailment whatsoever - which is accepted as a disturbance of the body's harmonious functioning - has its spiritual causes, and specifically, the upset relations between man and God. Consequently, any transgression of divine law has its effects, even on our very health.

In all holy scriptures, we not only encounter the close affiliation between illness and sin, but simultaneously observe the recommended therapy: sincere repentance, and our return to God. There have been numerous occasions, where doctors themselves have admitted that in cases of incurable mainly illnesses, it is imperative to resort to spiritual means of assistance. These mainly arouse the necessary feelings of repentance in the patient, and the regaining of a peaceful communion with God.

Quite often, there are cases of severe physical afflictions, where special philanthropic care is obviously needed for the suffering person, in collaboration with God's omnipotence. These ailments are cured, either by invoking divine assistance, or, parallel to natural medicinal aids, through the use of supernatural means of divine grace, through its respective sacraments, such as the holy unction. 

The divine service for the holy unction, as performed today, consists of various liturgical elements: pacific hymns and the benediction of the oil, seven pairs of biblical passages (apostolic and evangelic) along with an equal number of supplications and blessings, and finally, the supplication for the absolution of those attending the service.

Performance of the rite requires the placing of the Gospel on a table, as well as a small icon of Christ, a lit oil-lamp, and a vessel containing wheat flour, in which are placed seven lit candles.

The oil-lamp must be perfectly clean and situated in the center of the table, together with the icon of Christ. The lamp must be filled with pure oil, representative of our pure and wholehearted offering to God. To many people, olive oil was not only a basic food item, but also an invaluable medicinal item. This is why we read that the Good Samaritan ( in the parable in Saint Luke's Gospel ) attended to the injured man by pouring oil on his wounds. The therapeutical, magical or symbolic use of oil is widely in use, by many peoples and religions.

But the oil of the holy unction is different. Neither the therapeutic use of oil, nor its magical implementation by ancient peoples or its ceremonial use in worship during the Old Testament, can diminish the value of this Christian sacrament. In general, when oil is used in divine worship, it is acknowledged as a symbol of divine charity, spiritual power and God's abundant provision of His gifts to the faithful. In other words, this oil, after receiving benedictions by the minister, is no longer ordinary oil, just as the water in the baptismal font is no longer ordinary water, after it has received the blessings of the minister.

At the end of the service, the anointing with the sanctified oil takes place. Normally, anointing is cruciform: on the forehead, the chin, both cheeks, both palms and the outer side of both hands. With this anointing, we beseech the Lord to cure our spirit, our thoughts and our entire inner world; furthermore, to give strength to those parts of the body with which we perform most tasks : our hands, the members of our body that execute most of the commands of our mind.

It is not inappropriate, in cases of illness, for the ailing part of the body to be anointed if possible with the holy unction. The anointing of other members of the family that may not have been present during the rite of the sacrament may be done by any secular Christian, after the departure of the minister. The act of anointing comprises the visible and tangible part of the sacrament of the holy unction.

In the vessel containing the flour, we place seven candles, which are lit for the duration of the service. This is a contemporary reenactment of an old custom, according to which, wheat was used instead of flour. Wheat grain was an item found in every household of those times, just as the flour that has replaced it, is common in every household today. These days, the flour is used to prepare an offering loaf for divine service; in this way, it is appropriate that the holy Eucharist also follows. The flour has no special symbolism; it is simply material which is quite ordinary and suitable for standing the seven candles in. The number seven is symbolic of "the charismas of the Holy Spirit", as saint Simeon of Thessaloniki explains. 

Certain misapprehensions, objections or superstitions have been attached to the sacrament of the holy unction.

First of all, there are those who believe that during the service for the holy unction, the supplications for absolution of sins are a substitute for confession, which they do not observe for various reasons. We must therefore stress that every sacrament has its own special value, and it can never substitute another sacrament. Participation in every sacrament and generally, in the entire liturgical life of the Church, will ensure the faithful of the grace of God and life in Christ.

With the prayer for forgiveness that the priest reads at the end of one's confession, he asks God to forgive the sins for which the penitent has repented and has just confessed to. With the supplication for the absolution of sins during the holy unction, we ask God to cure the patient of his illness, even if the cause of the illness is sin, for which he has confessed and repented in the meantime. During the holy unction, we are in effect asking to be strengthened in our weakness. The blessing of forgiveness during the holy unction does not replace confession; it supplements it, and rephrases the petition for the absolution of sins.

Another misinterpretation is of the flour in which the candles are placed. Certain faithful are not content with being anointed with the sanctified oil; they also use the flour for various purposes: they place it under their child's pillow in the hope that God will show them their fortune or that evil will leave their home, or, they thin it with water and give it to the patient to drink. As all this behaviour verges on superstition, we must stress that the sacrament is called the "holy unction"and not "holy flour". It is the oil that is sanctified, and not the flour. The flour is used for strictly practical purposes. It could very well not be used at all. The sacrament for the holy unction can be performed without flour; without oil, it is not possible. The only thing that can be done - and is being done anyway - is to make bread out of the flour of the holy unction, and offer it for the divine service. Any other use for the flour is a deviation from what is proper.

There is another misapprehension about the purpose of the holy unction. There are many who ask for holy unction to consecrate their new home or their store. We already clearly described above what the purpose of the holy unction is: the cure of physical and spiritual ailments. It is perfectly clear. For houses, stores, vehicles and such like, there are other, specialized consecration rites. Furthermore, there are many who ask the minister to perform both holy water and holy unction rites together, which makes it evident how confused and misled they are. As if we need more than one sanctification rite at a time, to ask for God's grace. One question that relates to the performing of the rite of the holy unction is if we are allowed to anoint unbaptized infants with the consecrated oil of the holy unction. It is a known fact that baptism is a prerequisite for participation in the remaining sacraments of the Church. Consequently, someone who has not been baptized cannot receive Holy Communion, or be anointed with Holy Unction. Exceptionally, a baptized child - even if it is only an infant and devoid of adult sins that require absolution - is permitted to receive the blessing of the Holy Unction.

Lastly, another misunderstanding related to the belief that the unction is intended for the dying and all those who are in the final stages of their illness. This idea was bred mainly amongst the orthodox of Russia, probably due to the Roman Catholic Church's influence. Also observed amongst us - albeit rarely - is an avoidance to perform the service of the holy unction, for fear that it might provoke or accelerate the patient's death. However, this fear is unjustified. Relatives are afraid to mention the sacrament. The patient is afraid to ask for it. The holy unction is for health and for life. Every single supplication and prayer of this sacrament speaks of health and life.

Finally, one could voice an objection: why doesn't the unction always heal? The sacrament of the holy unction was not established for the purpose of defeating every ailment, death and medical science. Quite often, it indirectly restores health; besides, healing does depend on a person's faith. The same divine grace is bestowed on everyone, but not everyone is healed. Recovery may not always be for the broader benefit of a person. The ailment persists, perhaps in order to educate the patient and to lead him with certainty to salvation in Christ; in which case, the ultimate goal of the sacrament is again attained. 

From the above brief information, we can appreciate the value of the sacrament of the Holy Unction. Its value is not only mystical or liturgical. The sacrament also has educational value

The divine readings (apostolic and evangelic), the petitions and the supplications have a beneficial effect, both on the patient and the patient's environment. As it has been astutely observed, the sacrament of the Holy Unction serves as a kind of family therapy.

Even if there is no immediate need of the sacrament for serious reasons of health, it is still recommended to perform the rite. First of all, apart from an obvious, serious illness, there is always the possibility of another, latent illness which may possibly not have shown any symptoms as yet, to make its presence apparent. Secondly, the faithful are shown another dimension through which they can confront an illness. The gift of health comes to be appreciated by the other participants of the sacrament, and they are offered another way of facing illness: the spiritual way. The patient and his supporting kin are asked to patiently and ungrudgingly bear this physical tribulation. Even if the illness remains an incurable one, the patient's dedication and his hope in God will be made apparent, and he will be led to a peaceful, Christian demise from this life, with his complete trust and love towards God, this being one of the basic liturgical petitions of the sacrament.

Finally, the performing of the sacrament at home comprises a good opportunity for the minister to communicate with the members of the family. Beyond its mystical character, the sacrament can also expand its influence to human levels, by assisting the participants - especially the children and the youngsters - towards a closer contact with their parish and its various activities. The least it can do is to offer a valuable or possibly a primitive experience to the faithful who abstain from the liturgical life of the Church.

Archmandr. Georgios Chrysostomou