12 - The Sick

THE SICK

I. GENERAL THE sick, for the purpose of spiritual treatment, may generally be divided into four classes as regards their condition of infirmity 1. The aged or permanently infirm.

2. Sickness of considerable duration, but not permanent.

3. Temporary and not immediately dangerous sickness.

4. Dangerous or mortal sickness, again subdivided into (a) Slow and long continued.

(b) Comparatively rapid.

(c) Hurried cases, e.g. where the patient has but a few days or hours to live. In connection with any of these, special treatment may be required for cases in which the powers of the mind are affected, whether by way of exhaustion or aberration. A different and carefully thought-out method will have to be undertaken in each of these several classes. No extemporary or haphazard treatment should be practised. It may be well in each case to have a method drawn out in writing, including subjects of reading and exhortation, prayers, Offices used, and so forth. Of course these will have to be modified by circumstances, and by any peculiarities of character and disposition which the patient may develop. Under the skilful touch of the experienced practitioner the patient may develop conditions of soul entirely novel and unexpected. With regard to their spiritual condition patients may roughly be divided into five classes 1. Faithful and devout Church-people.

2. The careless, formal, and indifferent.

3. The manifestly irreligious, Churchmen or other wise.

4. Dissenters, religiously minded.

5. The sceptical or unbelieving.

It may be difficult to decide into which category his patient is to be assigned, but the pastor must, like the physician, carefully note all the symptoms, taking into consideration whatever knowledge he may possess of his patient’s lack of conversion, and form his judgment and regulate his treatment accordingly. The best course will usually be to ascertain the patient’s own view of his condition by direct questions, plain and straightforward, yet carefully chosen; any bluntness or harshness, or anything which is likely to wound the feelings unnecessarily, being carefully avoided. The class to which the patient belongs, and the treatment to be pursued, must at the outset be a matter of careful consideration and prayer for guidance. The pastor must avoid the two opposite forms of error, (i) depending on his own powers, (2) neglecting to exercise those powers to the utmost, as expecting spiritual guidance apart from that exercise. It is said somewhere, " To pray without working is presumption; to work without praying is atheism." The man who, instead of exercising careful self-preparation, allows himself to approach this duty unprepared has no right to expect that the hurried uplifting of a prayer for help and guidance, at the moment when it is needed, will draw down such spiritual aid as to make up for the deficiency caused by his own laziness and negligence. As to the length of the visit, better too short than too long. Twenty minutes may perhaps as a general rule represent a duration which is sufficient without being too lengthy. In cases of extremity it will often be necessary to cut down the visit to a much shorter period, five minutes being sometimes as long as a patient’s condition will bear. The priest must, of course, make a point of keeping himself in cordial touch with the doctor. Difficulties between the two professions often arise with regard to this matter of sick visitation. Such difficulties, how ever, as the writer’s experience would tend to suggest, are in most cases the consequence of lack of judgment on the part of the clergyman. Whenever he manifests a readiness to place himself in the doctor’s hands as regards time, the duration and character of his visits, he will seldom find much serious objection on the part of the latter. In fact, the experienced physician will generally recognise that the ministrations of a wise and gentle clergyman have a beneficial effect in the way of quieting and soothing the patient’s nerves, and there fore, even when no one else is admitted to the sick-bed, the priest’s visits will be allowed under proper restrictions. In the sick-room the doctor’s word is law. The priest may indeed recognise his own rights as guardian of the soul, as the doctor is of the body, but practically speaking, he will not find it feasible to pit himself as a matter of right against the physician of the body.

Hence his only course is to make it a matter of earnest effort to establish and maintain friendly relations and mutual confidence between himself and the doctor. In cases where the patient’s condition is not of that extreme character calling for special brevity on this account, a little general conversation on ordinary topics may be a suitable opening for the visit, and may tend to do away with anything like stiffness or formality. In proceeding to the really spiritual ministrations it is absolutely necessary to secure the kindly and cordial attention of the patient, to avoid anything which may have the effect of repelling or irritating him. To this end the very greatest patience is requisite. The priest should avoid pressing his exhortations if the patient appear tired or fretful. He should in this case desist with a good grace and in a good humour, and let them stand over for another occasion. He must himself beware of the very slightest loss of temper. At the same time let it be understood that these matters are standing over, not abandoned.

It is a matter of great importance that the priest should make a point of seeing the patient alone from time to time, especially in his earlier visits. This is necessary in order that he may come to an under standing with the patient as early as possible, and the attainment of this object must be brought about carefully and deliberately, and in no wise hurried over.

Arrangements for his being left alone with the patient should be made with the friends before entering the sick-room, in order that it may be brought about easily and naturally so as to avoid the possibility of disturbing the patient’s feelings by making the request in his presence. It will, however, be desirable that friends should be present during a portion at any rate of each visit (except in cases of extreme weakness or nervousness), and in general, that the family should be present during a brief office of reading and prayer with which the clergyman will usually close his visit. In many cases it will be found desirable from time to time for the priest to pray with the patient alone after having attained his confidence as to the needs which the prayer should specially express. The main reason for being often alone with the patient is that of affording opportunities for the reposal of such confidence. The faithful priest will always make it a matter of earnest endeavour and careful thought to invite and draw out this confidence. He must feel that he has not attained his true position as pastor until he has won the patient over to speak freely and confidentially to him. For the attainment of this end he should make it manifest that he regards sin from the standpoint of a fellow-sinner with heartfelt sympathy for the offender, without censoriousness, and at the same time with a deep and awful sense of its ruinous character. If, by reason of the patient’s weakness or disinclination, he drops the subject for a while and speaks of other things, he must return to it again at an early opportunity (perhaps his next visit, made as early as possible for the purpose) with gentle firmness, and seek, by a manner expressive of great earnestness coupled with loving sympathy, to overpower the disinclination to approach a subject so tender, which a patient unaccustomed to spiritual things will often manifest.

It is certainly desirable that the pastor should not confine himself to spiritual topics in his conversation with the patient. He will generally find him ready to speak on the subject of his malady; sometimes also on more general topics: but the pastor must carefully avoid allowing this kind of conversation to take up any considerable portion of the time of his visit, unless indeed he is in the habit of paying visits more frequently than necessary for spiritual intercourse, that is, more than once a day. As regards the office of prayer to be used, it may be somewhat as follows, 1. A few introductory words giving the keynote to the exercise that follows.

2. A short reading, followed by some words of definite application.

3. Prayers bearing some reference, if possible, to (a) The subject of the reading and exposition.

(b) The patient’s condition and needs.

4. Some closing form of Benediction. The priest should then take his leave at once, always making the act of worship the last thing, and not allowing its effect to be impaired by subsequent conversation on ordinary topics. The prayers had better be, in part at any rate, extempore. The great value of sound forms of prayer should be kept before the view of the flock, and emphasised by the pastor’s use of them, even though meanwhile he includes the use of extempore prayer as needful to meet certain objects which are not included within the printed forms. The priest should see that the patient’s friends are provided with suitable prayers, and should make it one of his first acts to instruct them in the use of these, and to urge that use upon them. He should also point out portions of Scripture suitable to be read to the sick person.

II. EMERGENCY CASES OF GREATER OR LESS URGENCY The priest will naturally provide himself with forms of offices to suit all classes of cases, from those with reference to whom time is no object to those who are in urgent extremity. Some cases may mean even minutes, when the priest can hardly do more than point to the cross of Jesus. Even in such a case he should remember that there are two objects to be sought: (i) Confession of sin in the heart of the sufferer, i.e. repentance the act of turning from sin; (2) the act of grasping the personal Jesus Christ as the Saviour from sin. There must be a realising (i) of sin as sin, and as separating from God, and (2) of Love, infinite and perfect, as the bond of union between Saviour and sinner.

Remember it is not enough, in cases where the sufferer is conscious, to pray for him; the act of renunciation of sin and the act of acceptance of Christ must be his own, and it is the priest’s part to help him to make it. Even the case of one apparently unconscious is not necessarily to be despaired of in this sense.

It will often be found suitable to address a word or two to one in this state, such as: " Brother, draw nigh to God, and He will draw nigh to you." The priest will in such a case frame his prayer in brief, simple phrases with perhaps a short interval between each, embodying what he realises as the actual need of the sufferer in his present position. Let him thus plead for him, at the same time wording his prayer in such a manner as to make it suitable to be the prayer of the sufferer for himself. It would be well that the priest should beforehand prepare suitable forms for such an occasion, in order that there may be no waste of words, no hesitation, no room for regret afterwards at having left out something of importance. When the time for preparation is longer, but yet only a few days or perhaps weeks in duration, or when the condition of weakness makes it necessary to lay as little strain as possible on the patient’s attention and feeling, it is important that the priest should carefully consider what is the minimum in the way of treatment which he is justified in exercising on account of the taxing of the patient’s powers. Of course this will vary almost indefinitely in different cases in accordance with the different stages of spiritual condition which the patient may exhibit, as also with the patient’s capacity for apprehending spiritual truth. The actual requirements may perhaps be divided somewhat as follows, (1) The love of Christ.

(2) The actual effective presence of Christ, and the love of Christ as we are concerned in it, i.e. as shown as a love for sinners.

Hence the patient must be led to realise the fact of his position as a sinner as being the point of touch between him and the love of Christ as the Lamb of God Who takes away sin. And for the attaining of this end his sin must be in some way brought clearly home to him. If his conscience, unaided by external influence, is sufficient to bring about this object, it is well; but this will be the case only in a small minority of instances. The natural tendency to put sin on one side is one of the most frequent and serious difficulties attending the office of the spiritual director to convince the ordinary patient of this condition of sin.

There is danger, no doubt, of offending and repelling a patient to such an extent as to be fatal to the priest’s influence, but there is greater danger of confirming his apathy and impenitence, which is still more fatal. The priest must be loving, gentle, humble, ready to speak of himself as a fellow-sinner, eager to point out to his erring brother the source of peace and deliverance which he has already found for himself. Let the intensity of his earnestness appear in his manner, but let him avoid the smallest approach to harshness or impatience. He must beware of wearying the patient; physical weariness is oftentimes utterly subversive of spiritual benefit. The priest should if possible avoid carrying his ministrations to the point at which such a condition begins to manifest itself, unless of course time is very pressing and the end very near. He should break off the interview with a kindly, pleasant word the moment he perceives any approach to irritation or impatience on the part of the patient: a watchful eye should be kept on the patient’s frame of mind and feeling, and the treatment adapted accordingly. In the framing of the diagnosis the treatment would, of course, be modified according to the confidence felt as to spiritual attainment on the part of the patient; but its general principles would be applicable to all. Having thus awakened in the penitent a true consciousness of sin, that is, of his own special and particular sins, the priest now goes on to set before him the duty of repentance; carefully explaining the difference between that sorrow which is the result of regret for, or dread of, the consequences of sin and which is only a form of selfishness and on the other hand, sorrow for the sin itself as being offensive to a loving Father, the root of which sorrow is therefore love. The next step to be enforced is confession clear, definite, explicit, special as well as general to be made by the penitent to Christ as the great High Priest, Who, although He knows all things, requires confession as a condition of forgiveness in order that the penitent may fully realise his own need of such forgiveness. The act of confession must, of course, be accompanied by 1. An act of contrition.

2. An act of faith, or acceptance of the pardon desired, as effected through the atonement accomplished by the Blood of Christ.

3. An act of resolution, including the abandonment of motives governing the past life, and the adoption of the new motive of love of God for the life which is to follow. To make these steps effectual the exercise of faith, or the reposal of the trust on the Saviour’s willingness and power to grant what is asked, is an essential requirement. The patient, when truly in earnest, will often be found to complain of weakness of faith, or even of absence of faith. He must be assisted by the explanation of the difference between faith and assurance, and reminded of the fact that faith may often be truly present and effectual even though it be hampered and clouded by much of doubt and mental uneasiness. He should be taught that it is an act which he is to perform, that is, an act of self-surrender, and not merely a feeling for him to entertain. He should be supported by the declaration that Christ’s promise is an absolutely sure thing; that it applies to his case as much as to that of any other person, and that the only question is whether he is willing to accept it and to yield his whole heart and life in return.

Lastly, the penitent must be reminded of the necessity of steady and consistent effort on his own part to carry on the process of grace and " work out his own salvation with fear and trembling," remembering that such a crisis as this calls forth Satan’s strongest efforts to counteract the Spirit’s influence; and that on this account special watchfulness, instant prayer, and active effort will be necessary to maintain and carry forward the benefit which has been gained. In the application of this method of special treatment it is, of course, most necessary to take into consideration the patient’s physical condition. The priest must avoid wearying him by remaining with him too long; he must be careful not to repel him by the slightest note of harshness or severity of manner or tone, not to frighten him by abruptness or by a dictatorial air. With St. Paul, he must be "all things to all men, that by all means he may save some." 1 He is to angle for souls. His whole bearing must be kindly and soothing, avoiding anything like gloom or dismalness of aspect or manner. He must aim at appearing cheering and sunshiny, yet, with all this, his treatment of the patient’s soul must be firm and decided, avoiding anything like timidity or false diffidence. He must sum up his manhood, his sense of responsibility, and speak plainly and straight to the point. He will find this method of treatment to be most satisfactory to the patient, as well as most effectual in its results. On first entering upon a case it may not be desirable to proceed abruptly to spiritual matters, but while exercising his judgment in this matter as to what other topics he shall touch upon, he must be careful not to waste time and the patient’s strength should the patient be very weak and unfit for much talk or thought.

1 1 Corinthians 9:22 b. A frequent fault in pastoral visits is that they are too long. A visit is better too short than too long.

It is absolutely essential that the clerical visit should be regarded by the patient as something pleasant and desirable. It may ^sometimes appear difficult to reconcile the attainment of this object with that degree of faithfulness and effective spiritual treatment which is the main object of all pastoral ministration, and possibly there are times when the condition of the patient’s mind may render it impossible to make the visit an agreeable and pleasant thing in his eyes. But this unsatisfactory frame of mind may generally be avoided by (i) kindly and affectionate gentleness on the priest’s part, and (2) the manifestation of profound earnestness and eager interest in the patient’s spiritual welfare. Those two sentiments evidenced by the priest’s manner towards the patient will generally be found irresistible in winning his good will and securing a welcome on his part for the priest’s presence.

Supposing a visit to be necessarily unwelcome in its character, it should be made as brief as possible in its duration, and there should be an effort to close it with some expression of kindly and affectionate interest such as might win the patient’s good will for the next visit, time having clasped for the present feeling of irritation to pass away. It is most important that the priest and the penitent should always part at the close of such a visit in a spirit of cordiality on both sides.

One great secret of success in making his presence welcome and pleasing to his patient is that of a cheerful manner. Carefully avoiding anything like levity, an air of quiet cheerfulness, even brightness, of manner should always be aimed at. A gloomy manner, even without harshness, is always repellent. The writer can never forget an instance which was brought to his notice in his earlier years. A parishioner of his own, a man who had lived a worldly life, was suddenly stricken down by erysipelas whilst on a visit in the course of business to a distant city. The clergyman of the parish, an earnest, faithful man, was sent for to visit him. The wife of the sick and as it turned out, dying man described with indignation the manner in which he had made his approach to the patient. " Mr. ," he said, in a loud, harsh voice, " is your soul saved? " The sick man turned his face to the wall and refused to listen to, or accept any effort of ministration from, the clergyman whose presence in the first instance he had desired. And so he died.

Cases of such glaringly injudicious conduct would no doubt be rare, still there is need of constant watch fulness to guard against even slighter approach to undue severity of manner: suaviter in modo fortiter in re (gently in manner, strongly in matter) is a safe motto for clerical conduct. The attitude of feeling the spiritual as well as the physical pulse, metaphorically speaking, is one of the great secrets of success in this branch of work; and the main secret in attaining this attitude is the cultivation of personal love towards the patient. Remember that love is a thing to be cultivated, and not only and solely spontaneous in its production.

Sin, then, is to be viewed, and brought before the patient’s view, in its relation to the love of Christ Who bore sin, and the Blood of Christ, the outcome of that love, which takes away sin. The priest must avoid the common error of practically appearing to do all for the patient, while the patient merely watches him do it. His work is a failure until he has led the patient distinctly to undertake two acts for himself: (i) renunciation of sin, (2) grasp upon Christ. For both, of course, the Spirit’s power is necessary and must be sought for accordingly by the priest for the patient, and by the patient for himself. The capability for setting these fundamental truths in a plain and practical manner before the penitent, and of moving and assisting him to act upon them, must necessarily call for diligent and careful planning and preparation in the solitude of the study. To relegate it to the spur of the moment is sinful remissness which can hardly escape failure. The above-stated view is, of course, that of the fundamental aspect of the object to be sought. But the objective point to be aimed at in the treatment of the patient must always be the Sacrament of the Holy Communion, not as an end in itself, but as a means of supplying the end, recognition of which and the longing for its supply have already been awakened.

It cannot be too often insisted upon that the object to be kept in view is the love of Christ, rather than the dread of judgment. At the same time, due stress must be laid upon the fact of Christ’s awful purity which makes the contact of sin intolerable to Him, though not the contact of the sinner longing to be freed from it. The case of the leper in St. Mark 1:40 may be taken as representing the ideal view of the approach of the sinner to Christ: "If Thou art willing, Thou art able to cleanse me." The reference is not to deliverance from the consequences of sin, but to the cleansing from sin itself, and the recognition of the fact of that cleansing as following necessarily on the touch of Christ’s personality " Jesus put forth His hand and touched him." The personal apprehension of the personal, loving, present Jesus, listening, speaking, touching, is the only effective presentment which will prevail upon the penitent in his work of conversion. A very important point is the aspect of Christ to bq set before the penitent. It is possible that he will simply view Him as a mere invisible man, differing from any ordinary human being only in the fact of being invisible and of being specially powerful and specially kind. This inadequate view must be guarded against. It is Jesus as God as well as man Who must be set before the eyes of the penitent, and Who must be kept in view as the ultimate Object of his love and trust and obedience, as well as the Father as Father.

It is true that the presentment of Christ may come first he who sees Him sees the Father x but this should be only a stepping-stone to the view of the Father as Father. The penitent must learn to approach the Father’s presence as brought to it by the Son, the barrier between the sinner and the Father being removed by the Father’s acceptance of the Son’s blood-shedding.

"I go to My Father and your Father " 2 is amongst our Lord’s parting words. The Father is ours because His. He is the Only-Begotten, the Only SON. We are sons simply through our share in the single sonship of the Only-Begotten, because through the Incarnation we are made one with Him, so that His life is our life, His sonship our sonship. The Latin term " adoption," so often used to distinguish our relation to the Father from that of the Only-Begotten Son, is altogether misleading, as implying a fiction. The Greek term vloOtvia 3 is capable of a much deeper sense, that of our transference to the actual condition of sonship, not a mere supposition of such relationship.

1 St. John xiv. Qb. 2 St. John 20:17.

8 Ephesians 1:5; Galatians 4:5; Romans 8:15, Romans 8:23; Romans 9:14. The sinner must learn to approach the Father for himself, at the same time holding fast to the Mediator Who has taken him into union with Himself, and Who is the means of extending the Father’s love to Himself as Son so as to make it the possession of the sinner who has become one with Him by His Incarnation, made individually effective by the use of sacraments. The Holy Spirit must, of course, be kept in view for His work’s sake. The aid of His energetic operation is requested for the purpose of enabling the penitent to turn to due account the means of the approach to the Father through the Son in which his salvation consists. Such collects as that for the Nineteenth Sunday after Trinity and that at the beginning of the Communion Service are amongst the most suitable for this purpose.

III. THE USE OF THE VISITATION OFFICE

There are probably few clergymen who have not been conscious of a sense of disappointment on first taking up this Office, even while recognising the fact that the acts of worship of which it consists are, as regarded in themselves, most beautiful and suitable. The disappointment arises from the fact that it lacks any distinct act of supplication for the patient’s relief from his present sickness and restoration to health. With the exception of the phrases " assuage his pain " and (with reference to a sick child) " deliver him in Thy good appointed time from his bodily pain,"we have no definite prayer for bodily relief or recovery. l Ancient offices on this subject were well provided 1 This was written before the revision of the Canadian B.C. P. ED. with acts of intercession of this sort. The following beautiful prayer is founded on the Greek, " O Lord our God, Who curedst by a word alone terrible and deeply rooted diseases, and didst heal a fever of the mother-in-law of Peter; do Thou, O Lord, now also heal this Thy servant of the plague which afflicts him, Thou Who chastenest in compassion and healest in mercy, Thou who canst remove all disease and weakness, raise him from a bed of sickness and a couch of suffering, laying upon him the balm of Thy mercy. 1 Grant him perfect health and soundness, for Thou art the Healer of our souls and bodies. To Thee we ascribe glory, Father, Son and Holy Spirit, now, always, and for ever and ever. Amen." The Gospel used in connection with this prayer is St. Mark 5:24-34, * ne healing of the woman with the issue. This deficiency in the matter of direct and definite supplication for removal from bodily sickness and

1 " Laying on him the balm of Thy mercy " there may not be any actual reference in this expression to the practice of anointing the sick, though it looks somewhat like it. The question, however, of the observance of this sacramental ordinance is being revived at the present time, and it will probably pass into general use in the near future. This is not the place for discussing the general subject, but it is the writer’s opinion that its use may be found most helpful in consideration of the fact that the Church has the deepest interest and responsibility in the welfare of the bodies, as well as the souls, of its members. And the analogy of our Saviour’s own practice and that of His Apostles, together with the charge expressed in the oft-cited passage in St. James (v. 14, 15), would seem likely to imply the Church’s duty in taking her part in working for the welfare of the bodies as well as the souls of her children. It is not a miraculous cure that is sought, or one directly effected by the agency of prayer irrespective of external means; it is rather an act of invoking a blessing on the use of those means, and of appealing for their salu tary effect. The sacramental use of the outward and visible sign thus prescribed will no doubt be most helpful in stimulating the faithful recipient at a moment when, owing to physical weakness, he may be expected to stand in most extreme need of such assistance. restoration to bodily health is a very serious one, and if, as is generally suggested, our present Office be taken as a model on which to found our method of ministration, in this branch of its application it will be necessary for the priest, in this respect, to deviate widely from the example here set before him. Prayer, clear, definite and explicit, for succour in bodily need must form a conspicuous feature in ministrations of this kind.

It is most essential that a sick person should be brought to converse with the pastor easily and freely, and not that he should merely listen to reading, ex hortation, and prayer. The priest cannot feel that he has made any satisfactory progress in the work of dealing with his patient until he has succeeded in leading him to open his heart as to his spiritual condi tion. In many cases there will be difficulty in bringing this about. The utmost gentleness as well as firmness and unconquerable patience will be necessary. The patient’s reserve of diffidence should be overcome by "drawing him into the expression of feeling or opinion, not necessarily at first in direct reference to his own case, then gently drawing him into saying something about himself. The main secret consists in the manifestation of heartfelt interest on the priest’s part in everything concerning the welfare, whether spiritual or temporal, of the patient. A great help towards giving point and purpose to instruction and exhortation, and also towards drawing forth the confidence of the patient, will be found in making the Holy Communion the preparation for it, and the blessings attached to it a leading subject of consideration. This should in fact, in the case of serious or prolonged sickness, after the diagnosis has once been determined, be made the principal topic towards which the patient’s attention is directed. Of course this subject, the Holy Communion, is only applicable to baptised members of the Church. It may be said that the subject of the Holy Communion to our own people, and baptism or confirmation to out siders, will be the key to the regulation of all sorts of spiritual intercourse; and this as a goal in each case that is, an embodiment of the means for the attain ment of the object to be ever kept in view the love of Christ in its constraining effect upon the love of the member of Christ. The method of preparation and the qualifications exacted must indeed vary according to the patient’s capabilities and the character of the case, its urgency, and the probable duration of the sickness. The priest, like his Master, must judge a man " according to what he hath," and not " according to what he hath not." l He must in each case consider how " much has been given " in the way of light and capability, and then judge how " much will be required." Where there is a sufficiency of time, full and careful preparation should be made if present readiness is lacking. One form of error, which is very generally prevalent, to be carefully avoided is that of endeavouring to teach the patient too much at a time, or to carry him along too rapidly. Even in the case of the most intelligent, the priest must be prepared for what will seem to him a considerable degree of obtuseness on the part of his learner. He must therefore be careful to make sure, by conversation, that each step of the instruction he is endeavouring to impart is followed and apprehended by the patient. Hence it is always better to limit the instruction to matters absolutely essential. In any case he should satisfy 1 2 Corinthians 8:12. * St. Luke 12:48. himself that the patient has attained the following requisites, 1. A consciousness of sin, definite and specific, in himself personally.

(a) As a condition of general ruin and disorder.

(b) As exhibited in definite acts of transgression.

2. Sorrow for sin, as an outrage against the love of a Father.

3. Confession of sin, both general and particular.

(The question whether this should be through the human priest, or to the Saviour alone, is one to be settled according to the priest’s best judgment.), 4. Renunciation of sin as accompanying the act of confession.

5. The possession of faith, that is, faith in general such as consists of belief in the facts of the Christian system. (For this purpose the interrogatory form of the Creed is most suitable, with expansion and possibly pauses for audible answers if the priest thinks necessary.), The priest must take particular care in the matter of the examination, as also of exhortation or consolation, lest the patient should be inclined to listen to these with a general sense of vagueness and lack of definite application. He must avoid the condemnation of crying " Peace, peace, when there is no peace." l Many souls have certainly suffered, it may be perhaps shipwreck, from their hurts thus being healed slightly. The patient will generally be satisfied with the vague and indecisive method of treatment referred to, at all events, will appear to be satisfied; for there can be no doubt that many, under these circumstances, are

1 Jer, viii. n. conscious of needs and desires which this superficial treatment does not reach, and which, through diffidence or reserve, they are led to repress. In some instances this lack of faithfulness on the part of the priest is followed by the melancholy (for the Church’s credit) result that the patient will open his grief to some other adviser with whom he feels more at ease, or whose greater plainness of speaking has succeeded in extracting those expressions of fear, desire, or aspiration, which the pastor has failed to elicit. Many are lost to the Church and gained to Dissent in this way.

Whatever may be the reason, it is certain that conversation on directly spiritual subjects is more usual among Dissenters than among Church-people; to our shame be it spoken.

Great plainness and directness of speech, therefore, is amongst the first requisites for profitable visitation of the sick. It must, however, be chastened by sympathetic tenderness and gentleness, for no doubt some have been lost to the Church through harshness and abruptness, what may be called " clumsiness " in the priest’s method of dealing with them. As in the treatment of physical disease, each case will call for its separate method of dealing. A pastor’s first duty, therefore, on undertaking a case of spiritual visitation, is to make a diagnosis of it on the same principle as though it were one of physical disease.

He must first carefully note and combine the symptoms as they are presented to his view, partly by inquiry, partly from observation, and partly from his previous knowledge of the person. Any inquiries which he may make must, of course, be carefully and cautiously conducted; that is, in such a manner as not to repel or irritate. It is generally desirable to seek some sort of information as regards the patient’s spiritual state from his friends, say parents or husband, but in so doing he must guard against what may appear intrusive or impertinent; good taste must be his guide. His method of inquiry must vary according to the patient’s position in life, habits, education, and so forth. The poor will accept and expect much more direct and paternal treatment than those in what are termed the " upper " classes. Priests are warned to be " wise as serpents " 1 to entrap souls, using various kinds of " bait," of " play," to land different kinds of fish. The priest will find a great secret for success in the practice of keeping plainly before his own eye, and the eyes of all concerned, his position of responsibility and authority which gives him the right of interposition such as belongs to no other relation of life in the spiritual instruction of those under his charge.

Yet this assertion of responsibility and authority must be carefully guarded against any appearance of self assertion. His attitude, so far as regards his own personality, must be one of humility, gentleness, and unfailing kindliness. Remember that you have to lead the patient not merely to place himself in your hands (as in the Roman system) for you to manage the work of his salvation, but that you have rather to lead him to " work out his own salvation in fear and trembling," the Holy Spirit working in him " both to will and to do." 2 The priest must carefully ascertain the patient’s own view of his spiritual condition, and, knowing how liable human nature is to ruinous error on this point, his manifest duty is to set before him clearly and fully the tests on which his act of self -judgment should be 1 St. Matthew 10:16. Php 2:13. founded. He must especially guard him against the false peace which is expressed in such assertions as: " I know that I have sinned; but I am not worse than others; " I trust in God’s mercy, and I hope that all will be well in the end." The duty of self-examination must be clearly explained and strictly enforced. The question as to how far the priest is justified in seeking an explicit confession of sin from the sick member is a difficult one; in deciding it the strong prejudice on this subject which is generally current among Church-people must be taken into consideration. The Rubric in the Visitation Service seems to direct that the priest should not insist upon any such confession unless he perceives, or has strong reason to believe, that the patient has that on his conscience which will render its quieting impossible by any other means. It is under such circumstances as we are now considering that the priest’s possession of that principle of tact which is one of the most radically essential of all his qualifications for the satisfactory fulfilment of his official duties may be effectually tested. It will seldom be found difficult to elicit such a degree of confidential acknowledgment on the part of the patient as may suffice for all essential purposes, without exciting the ever-ready suspicion of sacerdotalism, if only the priest be capable of exercising wise judgment in his manner of dealing with him. It may often be found the best course to enumerate the various forms of sin one after another, giving sins of omission their due place, touching with gentle and firm hand those sins of the flesh from the acknowledgment of which men usually shrink most of all. This enumeration should expressly be made for the purpose of aiding the patient in self-examination, and may well be put in the form of questions with a pause at the close of each inquiry, and the patient be invited to answer each one silently in his own heart to God, if not audibly to his pastor. Such treatment will not only conduce towards the patient’s self-acknowledgment, and hence selfconviction, but will often have the effect of disposing him, either then and there, or later, to acts of confession to the priest as suggested in the Prayer Book. The priest should beware of allowing in himself any false diffidence in accepting, and indeed urging, the direct confidence of his people on such occasions, remembering the unspeakable benefit, if not absolute necessity, of free and unrestrained intercourse between penitent and pastor on the subject of spiritual difficulties, and above all on that of the crowning difficult}/, namely, sin. He should be on the alert to watch for the smallest indication of desire on the part of the patient to communicate to the priest any expression of spiritual feeling. Care must be taken, however, to avoid any possible substitution of this explicit confession to the priest for the direct and personal confession to Christ, and committal of sin to Him, as made consciously by the sinner. This must be kept clearly before his view, Christ the true Confessor, the true Absolver. Hence the main object aimed at in seeking a confession of sin from the sinner should be that of leading him to bring his sin not so much to the priest as to Christ Himself, to commit it directly to Him, and seek from Him the pardon for the past and the grace for the future. Otherwise there is danger lest the priest suffer himself to be intruded into that position of mediator which belongs to Christ Himself, a procedure which has been the cause of fatal error in the Church.

Yet, on the other hand, it is most important that the priest should win the perfect confidence of the patient, and should invite and encourage it, and in many cases urge it, with all his power. Thus it is most important that the patient should clearly understand that his confidence will be fully respected, that what he may say under this seal of confidence will never be repeated without his consent. The frame of mind which the clergyman will find most generally prevalent amongst those who have lived a worldly and unspiritual life is not that of terror, or even uneasiness, in the prospect of death, but rather that of apathy and indifference. Such persons will readily listen to his words of exhortation and admonition, to the reading of the Scriptures and to the prayers he may offer on their behalf; yet he will find as a general rule that such acts of ministration, although they may evidently be attended with a soothing and cheering effect on the mind (probably from the impression, however vague and uncertain, that something spiritual is being done for the hearer), nevertheless will have little or no effect in promoting any actual result of good to the sick person. Such result can only be brought about, humanly speaking, by leaving the patient to express himself freely to his director on the subject of his spiritual condition. Hence the necessity of endeavouring to lead him, by such means as have been suggested above, to a definite consciousness of sin, and especially of his own particular and personal sins. Should the priest always accept the request to receive a definite act of confession? He certainly should do so when once he feels himself to have acquired the necessary knowledge and experience, for it by no means follows that he possesses such knowledge and experience simply because he is a priest. He should bear in mind especially the case oi those who stand in actual need of personal direction, young men or lads and, more particularly, converts from Romanism who have been accustomed to personal guidance and nurture. 1

If the priest should find difficulty, from the shyness or. reserve of the patient, in deciding in what way he may enter upon subjects of this character, he will often find the topic of the Holy Communion an excellent means for introducing a conversation which may bring about the result sought for. He would naturally ask whether the patient was desirous of receiving the Sacrament, at the same time setting forth its special benefits for one in his condition; and, whether his answer should be in the affirmative or negative, or simply expressive of doubt and uncertainty, the priest would certainly find in it an opening for the introduction of the subject so needful at this stage. In the case of those who are manifestly strangers to the religious life, it is absolutely necessary to ascertain that the patient is seriously in earnest as regards under taking a new life. When this has been ascertained, some kind of mental retrospect (proportionate to physical strength and intellectual capacity) over his whole past life should be gently urged upon him; also an..effort at self-examination which may place clearly before him a view of his leading sins and habits of sin.

Unless this is done, the apathy produced by a protracted course of irreligion or indifference to religion will blind his eyes to his sins, and his confession will be simply that of the sinfulness of the race rather than the sins of an individual. The priest needs to bear in mind the dreadful possibility of confirming a sinner in his unrepentant condition by acquiescing in an act See also notes on Auricular Confession, p. 66. of worship and devotion which is merely formal and utterly unreal. In many cases, especially those of the most ignorant, specific questions will be found absolutely necessary to convey the true recognition of sin. It is probably on this particular point that the success of our Church as a saving institution mainly depends, and on which its failure hitherto (in so far as there has been failure) has been chiefly owing. We are afraid oi pressing individual confession in its completeness as a sacramental act, whilst on the other hand, we are hardly provided with anything to serve as an adequate substitute -I mean, anything that is direct, systematic, exhaustive, habitual 1 To the lack of this, probably, is due in great measure the deficiency of spirituality so often lamented in our Church. Of course regard must be paid to cases in which such questions will only repel the patient owing to prejudice or suspicion of Romanising methods. In such cases his confidence should be invited by the manifestation of very deep and sympathetic interest in his spiritual condition, and care should be taken to avoid such terms and expressions as would naturally be associated in the patient’s mind with Romanism or ritualism. It may even be found desirable in some cases, as has already been suggested, to put the questions without insisting on an audible answer, the patient being urged to make his confession to our Lord in the secrecy of his heart, under each head, a pause being left for him to do so. The Absolution in the Visitation Office is directed to be used only if the patient "humbly and heartily desire it/ and then only after "a special confession of his sins/ 2 The priest must ascertain whether the 1 See also notes on Sacramental Confession, p. 72 bb.

2 B.C.P. Rubric. See also section on Sacramental Confession. desire exists, and must make himself perfectly sure of the patient’s repentance and faith. It is clear that the Absolution should never be used except after a full and explicit confession to be conducted in accordance with the priest’s own judgment. He must assure himself of its completeness by such questions as may seem to him necessary for the purpose. The frequency with which clinical Communion should be celebrated must vary according to the patient’s habitual practice in this respect, his own sense of need and desire for it, the priest’s own judgment in the matter, and the probable duration of the sickness; but it should certainly be, if possible, at regular intervals.

IV. INFECTIOUS DISEASES Should the clergyman visit all infectious cases?

Yes, certainly; even those of young children where his instructions and consolation are not needed, and of persons in a state of unconsciousness or delirium.

It is most important that the priest should not exhibit any timidity or dread of infection on his own account or that of his own family. True he may have a family at home, yet let him remember that although celibacy is not required by the Church of England of her clergy, it is not meet that this relaxation should be suffered to become a hindrance to their usefulness, and thereby place them in an inferior position as regards readiness for work to that occupied by our Roman brethren. As taught in our Saviour’s answer to the man who asked leave of absence to bury his father, family ties must be disregarded when duty to the Church is in question on the other side. 1 The least sign of shrinking from the bedside of a sufferer, 1 St. Luke 9:60. from personal motives, produces an impression on the minds of the sufferer and his friends more unfavourable than he who exhibits such a sign can have any idea of.

He may not take encouragement from the acquiescence of the sufferer and his friends, for this will in most cases be given without question. He must beware of allowing unfavourable comparisons to be drawn between his conduct and that, for example, of the doctor. Let him feel that his place is where his Master’s was, that is, wherever sorrow and suffering are, and let him go there fearlessly, commending himself to his Master’s care. Yet, on the other hand, it is not only the part of prudence, but of imperative duty, to take every precaution against contracting infection himself or imparting it to others. He has no right to expect special or miraculous exemption from the dangers which others would incur under the same circumstances. He may not allow himself in that presumptuous idea which some clergy have been known to express that he bears, as it were, a charmed life while in the fulfilment of his duty. To expose oneself rashly or wilfully and unnecessarily to danger must always be regarded as directly sinful. The priest should therefore inform himself as to suitable disinfectants. He should take care not to inhale the patient’s breath, and should take precaution against carrying away in his clothes particles which may be germs of disease. His best plan is to have a special coat for the visitation of infectious diseases; after every such visit he -should go straight home before entering any non-infected house; he should remove his coat outside, shake and brush it well, and then hang it up in the open air. Of course his next action would be to wash his face, head, and hands thoroughly.