Introduction
On March 17, 1722, the novelist and famous defender of the novel, Daniel Defoe, published ‘A Journal of the Plague Year: being observations or memorials of the most remarkable occurrences, as well public as private, which happened in London during the last great visitation in 1665’. While Defoe was only 6 years old in 1665, the year of the last great outbreak of the plague in England, the novel is written as a first-hand account, and the specificity of the details he provides means that they were probably drawn both from the accounts of his uncle, Henry Foe, as well as from the author’s own experience. Defoe was not alone in the language he used to describe this last gasp of the plague: in Defoe’s library alone was the weekly collection of the list of the dead, titled ‘London’s Dreadful Visitation’ [1665] and the Revd Thomas Vincent’s God’s Terrible Voice in the City [1667].Footnote 2 The latter’s description is harrowing:
Now many houses are shut up where the Plague comes and the inhabitants are shut in, lest coming abroad they should spread infection. It was very dismal to behold the Red Crosses, and read in great letters, LORD HAVE MERCY UPON US, on the doors, and Watchman standing before them with Halberts, and such a solitude about those places, and people passing them so gingerly, and with such fearful looks, as if they had been lined with enemies in ambush, that waited to destroy them.Footnote 3
In the famous journals of the most comprehensive chronicler of the restoration period, Samuel Pepys, phrases such as ‘the plague grows mightily’ are scattered liberally throughout. In a moment of sobriety, he admits that ‘the plague [is] making us cruel, as dogs, to one another’ and his anecdotes are full of pathos, such as the ‘odd story of Alderman Bence’s stumbling at night over a dead corps in the streete, and going home and telling his wife, she at the fright, being with child, fell sicke and died of the plague’. Or this, from September 24, 1664: ‘We were told to-day of a Dutch ship of 3 or 400 tons, where all the men were dead of the plague, and the ship cast ashore at Gottenburgh.’Footnote 4
I want to suggest that sickness and plague as a visitation from God is the Prayer Book’s overarching theological hermeneutic, and one that is not unique to the Prayer Book. While judgment for sin is one of the types of divine visitation, it is not the only one. Notably, this theme is also one of the items which those who revised Prayer Books in the twentieth century specifically excised. In Massey Shepherd’s Oxford American Prayer Book Commentary for the 1928 American book, he notes that, ‘In the older form of the Office [for the Visitation of the Sick], before the 1928 revision, the suffering of the sick person was described as “God’s Visitation” for the purpose of either trying his faith or of punishing his sin. Naturally Christian sentiment rebelled against this point of view.’Footnote 5 And if the revisions do not reflect this sentiment specifically, the Ministration to the Sick in twentieth-century Prayer Books are nonetheless very different sorts of rites from the 1662 English book. In both the 1928 and 1979 American Prayer Books, as well as the 1962 Canadian Prayer Book, the Exhortation to the sick person, the rehearsal of the faith, and the theme of divine visitation have nearly disappeared.Footnote 6 Thus, the theological orientation toward sickness in the 1662 book is one that most contemporary Christians have never encountered, liturgically or otherwise.
Many of the contemporary theological responses to our current pandemic bear this out, sidestepping, or completely rejecting, any possibility that divine judgment may be at least one part of trying to understand where God is in the present moment. For example, in N.T. Wright’s God and the Pandemic, the word judgment never appears, despite swaths of biblical examples of sickness and plague as God’s judgment. Instead, he focuses on the biblical theme of lament and then encourages Christians to actually engage in lament with the language of the Scriptures.Footnote 7 Fr James Martin, the Jesuit and public intellectual, wrote in The New York Times that the story of the man born blind in John 9 and his response to the fall of the Tower of Siloam in Lk. 13.4 tell us that Jesus categorically discards any notion that God might bring calamity or sickness in response to sin. He concludes: ‘This is Jesus’s definitive rejection of the image of the monstrous Father.’Footnote 8
Context
A challenge that faces every liturgical scholar is the temptation to look only at the text of the liturgy. But this can only tell us very little. To fail to consider the space in which the rite was celebrated, the manner in which it was celebrated, the clothing worn to celebrate, and the degree of familiarity that the participants had with the rite is to understand the liturgy dimly, as through a glass darkly. The Prayer Book tradition is no exception. Despite the ubiquity of the book in the lives of people for centuries, the book reflects the experiences and concerns of the period in which they were compiled, to greater and lesser degrees. In the case of the rites for the sick, there are at least two contexts that weighted heavily upon their development: the various reformations and resulting ecclesial separations, and the history of devastating sickness in England.
The reformational context is a perfect example of what should have been one of Anton Baumstark’s famous laws of liturgical history, namely, that there can be no organic development of the liturgy after the Reformation. Instead, development will henceforth always have in mind an other, a different Christian body from whom we wish to distinguish ourselves.Footnote 9 The English Prayer Books reflect a clear and concerted rejection of certain theological positions of the Western Church, such Eucharistic sacrifice and a sacrificing priesthood (though the list is much longer, of course). In Richard Mant’s influential commentary on the English Prayer Book, he quotes Dean Comber on what was ‘corrected’ in the reformed English Office for the Sick. He differentiates it first with Rome and then with the apostolic age:
In St. James’ time, and as long as the miraculous gift of healing continued, “they anointed the sick with oil in the name of Jesus,” not to convey any grace to the soul (as the Papists now pretend to do by their extreme unction, lately made a sacrament), but to work a miraculous cure, which was the usual effect in those ages. But the power and gift being now ceased, the reformed churches left off the oil, which was the sign, because the thing signified was now taken away. But yet we retain all the substantial parts of this office.Footnote 10
In Dean Comber’s view, whatever the purposes of this Office are, it is most definitely not for the giving of sacramental grace in anointing. And he also expresses what we might call a dispensational view of the gift of healing, that it was a gift given for a time, but that time has now ceased. We should keep in mind, however, that unction with oil was retained as an optional rite in Cranmer’s first Prayer Book of 1549, where the priest anoints on the forehead or the breast in the sign of a cross. And the prayer itself assumes the possibility of bodily healing: ‘And vouchsafe for his great mercy (if it be his blessed will) to restore unto thee thy bodily health, and strength, to serve him and send thee release of all thy pains, troubles and diseases, both in body and mind.’Footnote 11 In fact, the 1662 book holds out such a possibility: ‘If it shall by thy good pleasure to restore him to his former health.’Footnote 12
John Henry Blunt’s gives a decidedly different view of ministry to the sick in well-known nineteenth-century commentary. He explains that this visit is not merely one of ‘civility or neighborly kindness’. Rather, the priest comes ‘in the Name of Christ to pray with and for the sick man; if necessary, to reconcile him to the Church by the blessing of absolution, and to communicate to him the Sacrament of our Lord’s Body and Blood’. He goes on to quote Polycarp, the Life of St. Augustine, the Council of Milan, and the Provincial Constitutions of Canterbury as defenses for this view. He argues that what is contained in the Prayer Book office is ‘to be found in the ancient Manuals of the Church of England, and some of the prayers can be traced to almost primitive times. Where some variation has been made from these originals … the spirit of the original is still adhered to.’Footnote 13 As with many of the Prayer Book rites, the Ministration to the Sick has engendered a range of interpretations, particularly when it concerns the extent to which they are actually reformed. Nonetheless, it is clear that the absence both of administration of the Sacrament from the reserve and of anointing the sick with oil after 1549 reflects reformation concerns.Footnote 14
When we consider specifically the approach to sickness, plague, and natural disaster in the 1662 Prayer Book, we do well to have some sense of the English experience of these catastrophes. We come to the Prayer Book as people who, until quite recently, knew only about plagues and great sicknesses by way of books or documentaries. There are not many alive who remember the 1918 pandemic of the H1N1 virus known as the Spanish Flu, which infected ‘about 500 million people … [which was] one-third of the world’s population … The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States’ and 228,000 in the UK.Footnote 15 We might think of that cataclysm as an anomaly. But it turns out that the experience of the English from the fourteenth century through the seventeenth was far beyond what most of us can imagine. Even twenty-first-century vocabulary that was once limited to the medical sphere but now is commonplace – such as quarantine – can be found in the seventeenth-century literature. Pepys, for example, mentions on 26 November 1663 that in light of the growing plague in Amsterdam, all ships coming from there and from Hambrough had ‘to perform their Quarantine for thirty days’.Footnote 16
The sometime professor of anatomy at Cambridge, Charles Creighton, chronicled the bracing history of England’s epidemics, plagues, and other disasters in a remarkable 1891 monograph. The plague, or the Black Death as it came to be known in the eighteenth century, is the most well known of these. One of the earliest plagues in England is described by the Venerable Bede in his Ecclesiastical History, and its ferocity seems to have left a lasting impression, as he was able to speak to some of the survivors. The Plague of 1664 is said to have ‘depopulated’ the southern parts of England, spread into Northumbria, and then finally moved into Ireland, where the devastation ‘was so vast that only a third of the people were left alive’.Footnote 17 Bede seems to connect the plague’s spread to the East Saxons to their lapse into idolatry, one the first recorded instances of a theological connection between sin and plague in England.Footnote 18 The plague likely came to England in 1348 via the port of Bristol and devastated the population equally, that is, more scarcely populated rural areas just as much as the more densely crowded urban ones. Once exposed, a person had a 4 in 5 chance of dying within two weeks.Footnote 19
The list of plagues and famines in England outside that of 1348–49Footnote 20 is startlingly long:
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Before the plague, there were devastating famines in 1194–97, 1257–99, and 1315–16;
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The Middle Ages also knew leprosy,Footnote 21 smallpox, and measles;
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French Pox arrived in Scotland and England in 1497;
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The Sweating Sickness began in 1485 and reoccurred in 1508, 1517, 1528, and 1551; between the publication of the first and second Prayer Books, which resulted in direct reference to ‘Swette’, in addition to plague ‘or suche other lyke contagious tymes of syckenesses or dyseases’ added in 1552;Footnote 22
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The Fever of 1643;
The plague returned to England in 1563, then again in 1592–93, and yet again in 1603, 1625, and 1636. Just to get a sense of the scale and severity, in 1563, the first appearance of the plague after the reformation, over 80,000 died in London alone, which was ‘somewhere between a quarter and a third’ of the city’s population. ‘Elizabeth moved her court to Windsor Castle, and ordered that anyone coming from London was to be hanged’, and no goods from the city were allowed into the castle.Footnote 23
And finally, the Great Plague of London in 1665, just a few years after the publication of a revised Prayer Book in the wake of the restoration.Footnote 24 The last instance of the plague was capped off by the great fire of London in 1666, which destroyed the dwellings of 70,000 of the city’s 80,000 inhabitants and decimated over 85 parish churches along with St Paul’s Cathedral. It is likely, in fact, that the fire played a significant role in ending the epidemic.Footnote 25
And those are just the major events. As the list indicates, the seventeenth century suffered a whole series of major epidemics that ‘devasted urban communities at regular intervals … Such outbreaks often killed between 10 and 12 per cent of the urban population in less than six months.’ As one historian put it, ‘the plague hung over England as a dark cloud for a thousand years prior to that final epidemic’.Footnote 26 The situation was not only the plague itself, but the constant fear that it evoked: ‘no disease evoked the dread and terror in contemporaries as bubonic plague’. Thus, ‘there was a certain terror accompanying outbreaks of plague that was distinct to that disease’.Footnote 27 Concern about the spread of plague is certainly one of the many reasons that Cranmer’s desire (along with many of the other reformers) for more regular reception of Communion never really became the norm.Footnote 28
As Natalie Mears, Alasdair Rafee, Stephen Taylor, and Philip Williamson have documented, between 1549 and 1662 special services, fasts, or thanksgiving for the end of sicknesses or natural disasters were directed approximately 43 times and some 25 prayers were introduced.Footnote 29 While these came at times through the initiation of archbishops or bishops, they were all issued by the crown.Footnote 30 And that does not count fasts that were called simply in the wake of ‘general anxieties’ or ‘general sinfulness’. Fasts called by Parliament were so common that it was easy to miss them, as Samuel Pepys documents in his journal on January 15, 1661. After eating breakfast with a Mr Berkenshaw, his friend wonders aloud whether ‘we had not committed a fault in eating to-day’. Berkenshaw explains that:
it is a fast day ordered by the Parliament, to pray for more seasonable weather; it having hitherto been summer weather, that it is, both as to warmth and every other thing, just as if it were the middle of May or June, which do threaten a plague (as all men think) to follow, for so it was almost the last winter; and the whole year after hath been a very sickly time to this day. I did not stir out of my house all day, but conned my musique, and at night after supper to bed.Footnote 31
Such special services and fasts were not new to reformation England, but go back to ‘at least the early fifth century in Ireland, the early eleventh century in England and probably from the late thirteenth century in Wales’.Footnote 32 Appeal was made to the special worship in the Old Testament in the face of significant events, whether boon or disaster. Furthermore, the theological posture that assumes God’s intervention in the world, both in the lives of individuals and in the course of nature, is not unique to English Protestantism (or Protestantism in general), but is a mainstay in both pre- and post-Reformation Catholicism as well.Footnote 33
Weekly or monthly fasts, which consisted of ‘a day of abstinence, supplemented with lavish offerings of sermons and prayers in the local parish churches’ were the necessary counterpart to medical intervention, limited as they were. ‘Only when added to such godly remedies could medicine be properly used and have any hope of success. Medicine was considered part of God’s Creation and accordingly could only work through the grace of God.’Footnote 34 Ole Peter Grell argues that because of this, ‘a religious rationale and approach to the outbreaks continued to play a prominent role in the response’ to the plague.Footnote 35 The view that plague was God’s judgment against sin and the vision that sin and disease were closely linked, was especially strong among English Puritans, ‘as can be seen from the influential tract published by the Puritan minister, William Gouge, entitled, Gods three Arrows. A Plaister for the Plague [London, 1631]’.Footnote 36
This approach to sickness as an act of divine judgment and retribution was quite widespread in the sixteenth through eighteenth centuries. All agreed: ‘His most potent weapon being plague.’Footnote 37 Beyond the services provided by royal and parliamentary injunction, other prayers and meditations were published, such as the following in Great Britains Prayers in This dangerous time of Contagion:
We pardon crave for all our sinnes committed,
Good Lord forgive them, let them be remitted,
Draw back thy plaguing hand, Lord sheath thy sword
Of vengeance drawn, and comfort us afford.Footnote 38
In fact, Christi Sumich has concluded ‘that it is difficult to find a publication of any kind, religious or secular in nature, which not begin with this premise, whether published in 1500 or 1700’.Footnote 39 As physicians slowly began to gain some sense of the natural causes of the plague, they began to introduce into the conversation theological language that has a long history of Western tradition, namely, secondary causality: ‘The Cause is chiefly the sins of Mankind, provoking the great God to send this Postiferous distemper as a judgment on them for Impiety. The Cause (next to God’s judgment) is a sharp venomous and contagious volatile Salt in the Air.’Footnote 40 Sumich’s history of this development, and the complex responses that it engendered with preachers and theologians, is rich and worthy of careful study.
Divine Visitation
In contrast to how most Christians have been approaching the pandemic caused by COVID-19, Divine Visitation – along with the broader idea that sickness is an experience of God – is the central theme of the Prayer Book’s Office of the Sick, beginning in 1549 and going all the way through the 1662 book. The very name of the Office places this theme front and center: the Visitation of the Sick, with its clear double meaning – the visitation of the priest to the home as well as the visitation from God to the sick. While there is a strong emphasis on the relationship between sin and sickness or plague in the OfficeFootnote 41 and throughout the Prayer Book, I think the vision of God’s Visitation is actually broader than this, as I hope to demonstrate.
‘Visit’ or ‘Visitation’ has a number of related meanings and its use in the Prayer Book reflects these different shades and senses. The most literal sense of the term simply refers to when a person makes a brief stay at a location, such as in the comment to ‘visit the fatherless and the widows in their affliction’ in James 1 (the Epistle on Easter V) or in the feast Visitation of the Blessed Virgin to her cousin Elizabeth. While in many contemporary Prayer Books, this is a major feast, the commemoration only enters the English Prayer Book tradition in 1604, and then only as a commemoration and not a major feast. Further, the second half of Luke 1 is never read at Holy Communion, but only in course at Morning or Evening Prayer.Footnote 42 This means that the Prayer Book does not place this biblical account before the Christian with much regularity and, as such, it is probably not one of the key influences on how ‘visitation’ might have been understood by the regular church-goer. The rubrics that introduce The Communion of the Sick use ‘visitation’ as a synonym for sickness, and in a very interesting context. The priests are exhorted to celebrate Communion because sickness comes so quickly and thus people are in need to be ready to die at any time, which is one of the benefits of the Sacrament. Thus, ‘sudden visitations’ of sickness should lead to frequent celebrations of Holy Communion.Footnote 43
The principal meaning of the term in the Oxford English Dictionary, interestingly, is the act of one in authority to go to a place and make an inspection to see if everything is in order, such as when a bishop or archdeacon visits a parish church.Footnote 44 This too is probably not the sense that the term is used in the Prayer Book. However, it could be that the term suggests ‘divine visitation’ in this broadest of senses: sickness as an opportunity for God to check on the individual Christian and see if things are ‘in order’.
Instead, the way ‘visitation’ is used in the Prayer Book fits within the OED’s second main meaning of the term, which is ‘the action, on the part of God or some supernatural power, of coming to, or exercising power over, a person or people for some end’.Footnote 45 This meaning is quite broad, however, and can have a number of distinct senses. The first of these is when God comes ‘in order to encourage, comfort, or aid’.Footnote 46 The most repeated and well-known uses of this sense of the word in the Prayer Book is found twice in the Benedictus, the dominical canticle at Matins: ‘Blessed be the Lord God of Israel: for he hath visited and redeemed his people’; and then again at the end: ‘through the tender mercy of our God, whereby the day-spring from on high hath visited us; to give light to them that sit in darkness and in the shadow of death; to guide our feet into the way of peace.’ We see the same sense of the term in Luke 7, which is the Gospel on the Sixteenth Sunday after Trinity, the story of when Jesus raised from the dead the son of the Widow of Nain. The response of the people is significant: ‘And there came a fear on all: and they glorified God, saying, That a great prophet is risen up among us; and, That God hath visited his people.’Footnote 47 A similar approach is encapsulated in the great Advent collect, repeated daily until Christmas Day: ‘Almighty God, give us grace that we may cast away the works of darkness, and put upon us the armour of light, now in the time of this mortal life in which thy Son Jesus Christ came to visit us in great humility.’Footnote 48 While the word itself is not used, the Gospel for Advent I, the triumphal entry of Jesus into Jerusalem, echoes this theme: ‘Tell ye the daughter of Sion, Behold, thy King cometh unto thee … And when he was come into Jerusalem, all the city was moved, saying, Who is this? And the multitude said, This is Jesus the prophet of Nazareth of Galilee. And Jesus went into the temple of God’ (Mt. 21.5, 10-12a).
In each of these instances, visitation is a way to speak broadly of the appearing of God among mortals to engage in the work of salvation, ‘the redemption of the world by our Lord Jesus Christ’: to bring salvation and to destroy the work of sin, death, and Satan. Judgment is a part of this, to be sure, but scripturally it is not the dominant theme. Instead the focus is on the appearing of God for salvation. As an American, I would note that it is only this sense of divine visitation that remains in the 1979 American Prayer Book: the appearing of God.Footnote 49
The other senses of divine visitation have a much sharper sense of the judgment of God against sin. In some cases, the judgment is not retribution for specific sins, but the appearing of God ‘to test, try, examine, or judge’ on the last day as judge, as is declared in the Athanasian and Nicene Creeds. The earliest use of ‘visitation’ in this way is in Wyclif’s translation of the New Testament and retained in the subsequent Authorized Version and the King James Version: in Lk. 19.44 (which is the Gospel lesson on Trinity X), ‘they shall not leave one stone upon another, because thou knewest not the time of thy visitation’; and 1 Pet. 2.12, which is the Epistle for Easter III: ‘glorify God in the day of visitation’.Footnote 50 In both of these, God’s appearing has a definite connotation to judgment.
Then there is the more specific kind of divine judgment that is ‘to afflict with sickness or other trouble, especially by way of trouble for wrongdoing’, a sense that is perhaps first used in Wyclif’s collected works.Footnote 51 These related but distinct senses are expressed in a dramatic form in an early English drama published in 1567 entitled ‘The Trial of Treasure’, which has a character named ‘Visitation’. At his first entrance, he says:
I am Gods minister, called Visitation,
Which divers and many waies you may understande;
Sometime I bring sickness; sometime perturbation;
Sometime trouble and misery throughout the lande;
Sometime I signifie God’s wrath to be at hande;
Sometime a forerunner of distruction immenent,
But an executer of paine I am at this present.Footnote 52
The Office tends toward this last sense of divine visitation. But as we will see, the Office also goes well beyond it.
The Prayer Book Visitation of the Sick
The Office begins with a declaration of Peace to the dwelling of the sick, a feature which goes all the way to the 1549 Prayer Book and which Cranmer took directly from the Sarum rite. A penitential tone is set immediately, as the Minister is directed to kneel in the presence of the sick person and ask for God’s mercy using the first petition in the Litany that follows the Trinitarian opening, which also is taken directly from the Sarum rite. The Kyrie and the Our Father are then said, followed by a set of suffrages, all drawn from the psalms, many of which are also found in the service of Holy Matrimony and in the Commination Against Sinners.Footnote 53
The two collects that follow the suffrages broach this theme of visitation for the first time, directly and repeatedly (they too are drawn from the opening in the Sarum rite’s office, which began with a series of nine collectsFootnote 54 ). The first collect begins, ‘O Lord, look down from heaven, behold, visit, and relieve this thy servant. Look upon him with the eyes of thy mercy, give him comfort and sure confidence in thee, defend him from the danger of the enemy, and keep him in perpetual peace and safety.’ The priest begins by asking that God make a visitation here and now, and the rest of the Office proceeds as if this is most certainly what is happening.
The second collect underwent a good deal of editing from its first version in 1549:
Heare us, almightie and moste merciful God, and Saviour: Extende thy accustomed goodnesse to this thy servaunt, which is greved with sickenesse: Visite hym, o Lorde, as thou diddest visite Peters wifes mother, and the Capitaines servaunt. And as thou preservedst Thobie [Tobit] and Sara by thy Aungel from daunger: So restore unto this sicke person his former helth, (if it be thy will), or els geve hym grace so to take thy correccion, that after this painfull lyfe ended, he maye dwell with thee in lyfe everlastyng.Footnote 55
Again, the request is made for divine visitation within the Office itself. Three biblical events are cited as examples of God’s consistency and constancy, and thus as the basis for a favorable response to the request for divine visitation:Footnote 56 two sequential healings in Matthew 8, first of the servant of the centurion, whom Jesus heals from a distance at the prompting of the centurion; the home of Peter’s mother-in-law, sick with a fever, whom Jesus touched and healed; and finally the reference to God’s assistance by way of the angel Raphael’s to heal Tobit from blindness and to deliver Sarah from a demon so that she could marry Tobit (see Tob. 3.17). It is these Scriptural references that undergo a good deal of editing in subsequent editions. But before we look at those, it is important to note that in none of these instances is there any sense that the sickness of any of these individuals was a result of their sin. Rather, the emphasis is on the general appearing of God for the purpose of bringing healing and salvation.
In the 1552 revision, the reference to Tobit is removed, likely because it comes from the Apocrypha. But while it removes one Scriptural reference, it also adds a second reference to God’s visitation: no longer does the priest ask that God merely ‘restore unto this sick person his former health’ but that God would both ‘visit and restore’. The prayer doubles down on the notion that sickness is an opportunity for experience of the appearing of God in one’s midst. Visitation is given even more prominence in the 1552 as well, when the word ‘correction’ is replaced by ‘visitation’, thereby muting somewhat the penitential vision of the person’s illness and bringing the number of uses of the term ‘visitation’ to three in this relatively brief collect.Footnote 57
In 1662, however, the collect is revised in a number of significant ways. The two remaining biblical references are removed and replaced with a moral reading of illness that presents a vision of sickness as divine correction. The sickness is now described as God’s ‘fatherly correction’ to the end that ‘the sense of his weakness may add strength to his faith, and seriousness to his repentance’.Footnote 58 Another important edit takes place. Instead of a straightforward request for both a divine visitation and a restoration to health, the parenthetical ‘if it be thy will’ (in reference to healing) now becomes the qualifier of the last sentence, which makes the sense of the possibility of healing now sound much more remote. Furthermore, by removing the request again that God visit this person at the beginning of this last sentence, it makes it sound that visitation may only concern a sickness unto death: ‘or else, give him grace so to take thy visitation, that, after this painful life ended, he may dwell with thee in life everlasting’.Footnote 59
The reasons for these edits are not completely clear. But one has to wonder if the devastation of the last 100 years led the revisers to wonder if hammering on the theme of visitation with such intensity, and also whether setting out the possibility of healing, were both pastorally wise, given the devastation wrought by plagues and pandemics of the past century. In fact, most references to healing were removed: in the one Psalm included in the rite, Psalm 71, the last five verses are removed, with their promise of hope and thanksgiving for recovery.Footnote 60
But what remained steady in the liturgy from 1549 through 1662 (but what is removed in all the twentieth-century revisions) is the Exhortation to the Sick person that follows the collects,Footnote 61 and it is worth reading the main part of it, as it sets out in narrative form the theology of sickness:
Dearly beloved, know this, that Almighty God is the Lord of life and death, and of all things to them pertaining, as youth, strength, health, age, weakness, and sickness. Wherefore, whatsoever your sickness is, know you certainly, that it is God’s visitation. And for what cause soever this sickness is sent unto you; whether it be to try your patience for the example of others, and that your faith may be found in the day of the Lord laudable, glorious, and honourable, to the increase of glory and endless felicity; or else it be sent unto you to correct and amend in you whatsoever doth offend the eyes of your heavenly Father; know you certainly, that if you truly repent you of your sins, and bear your sickness patiently, trusting in God’s mercy, for his dear Son Jesus Christ’s sake, and render unto him humble thanks for his fatherly visitation, submitting yourself wholly unto his will, it shall turn to your profit, and help you forward in the right way that leadeth unto everlasting life.Footnote 62
Like the opening to the liturgy for Holy Matrimony, an exhortation is given which provides a set of causes for which sickness (or matrimony) were ordained. What is most noteworthy here is that the first cause given is not judgment for sin. Rather, it is a means of holiness: that the sick person may find in this the chance for an increase in faith ‘to the increase of glory and endless felicity’.Footnote 63 A longer exhortation is added, the rubrics say, ‘if the person visited be very sick’. This longer exhortation doubles down on the second reason given in the first, more brief address: ‘to correct and amend in you whatsoever doth offend the eyes of your heavenly Father’.Footnote 64 The heart of the Exhortation is an assumption that sickness is a particular kind of appearing of the Lord: ‘know you certainly, that it is God’s visitation’. And as such, this demands a response from the Christian. When God is revealed in the Scriptures, whether by means of an angel or in the person of Jesus himself, the response that is lifted up as a model is one of humility, of awe, of repentance. Similarly, in this rite, the response that is enjoined on us is the following:
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(1) to repent;
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(2) to treat one’s sickness with patience by trusting in God’s mercy;
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(3) to render thanks to God for his visitation, for his appearing;
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(4) to submit wholly to his will.
The second Exhortation begins by placing a much greater emphasis on sickness as ‘the chastisement of the Lord’, quoting Hebrews 12 about how the Lord loves those whom he disciplines. He does this ‘for our profit’, the text explains, ‘that we might be partakers of his holiness’. The text then turns and picks up a small phrase in the first exhortation – trusting in God’s mercy for the sake of Jesus Christ – and then reminds the Christians that ‘there should be no greater comfort to Christian persons, than to be made like unto Christ, by suffering patiently adversities, troubles, and sicknesses’. It then goes on and uses language that users of the 1979 American Prayer Book known as the collect for Friday at Matins and the collect for Monday in Holy Week: ‘For he himself went not up to joy, but first he suffered pain; he entered not into his glory before he was crucified.’Footnote 65 It continues: ‘So truly our way to eternal joy is to suffer here with Christ; and our door to enter into eternal life is gladly to die with Christ; that we may rise again from death, and dwell with him in everlasting life.’Footnote 66 The person is then encouraged to recall the profession made at baptism, the heart of which the rite is the Apostles’ Creed, which the sick person will be enjoiced to rehearse.
The theme of repentance remains strong in the rest of the rite. After the profession of faith, the priest is then to exhort the person to confess their sins and also forgive ‘from the bottom of his heart all persons that have offended him, and if he hath offended any other, to ask them forgiveness’.Footnote 67 In fact, they are basically encouraged to help the person to prepare to die, should that come: to make sure the person has a will; to resolve any outstanding debts; to give liberally to the poor. And then opportunity is given for the sick person ‘to make a special confession of his sin, if he feel his conscience troubled with any weighty matter’, the only explicit permission for private confession in the Prayer Book tradition until the twentieth century, after which an absolution is provided, which is by far the strongest form of absolution in the whole Prayer Book tradition and which emphasizes the sacerdotal authority of the priest to forgive sins, as the Ordinal makes clear the ordination of a priest: ‘Whose sins thou dost forgive, they are forgiven; and whose sins thou dost retain, they are retained.’Footnote 68 Whether or not a private confession is made, the rite continues with a collect for mercy and forgiveness, followed by Ps. 71.1-17. The antiphon that went with Psalm 71 in the Sarum rite is then included here: ‘O Saviour of the world, who by thy Cross and precious Blood hast redeemed us, Save us, and help us, we humbly beseech thee, O Lord.’ The Office then concludes with the assurance of God’s merciful presence in the well-known prayer, ‘The Almighty Lord, who is a most strong tower to all that put their trust in him’ and the Aaronic blessing.
Conclusion
It is very clear that sickness as a visitation from God presented in the 1662 book is deeply connected to both the judgment of God in response to sin, which is in conformity with the long-standing and widespread approach in the Western church, before and after the reformations. But I have also shown that this picture of judgment in the 1662 Prayer Book is not as punitive as one might initially think. It is important to see that there is a robust theology of providence in the Prayer Book, including the assumption that God will act intentionally in history for our good. All of the thanksgivings after plague, sickness, or drought assume that if there is respite from famine or plague or sickness, this too is a direct act of God. The first thanksgiving for deliverance from the Plague or other common sickness declares, ‘O Lord God, who has wounded us for our sins, and consumed us for our transgressions, by thy late heavy and dreadful visitation; and now, in the midst of judgment remembering mercy, hast redeemed our souls from the jaws of death.’Footnote 69
The collects that are provided in times of sickness, however, tend to draw a straighter line between sin and sickness. For example, the prayer ‘For Fair Weather’, recalls the judgment of God through the flood and declares that ‘we for our iniquities have worthily deserved a plague of rain and waters’. Even further, it makes a direct connection between repentance and a relenting of the droughts: ‘Yet upon our true repentance thou wilt send us such weather, as that we may receive the fruits of the earth in due season.’Footnote 70 Both collects ‘In Time of Dearth and Famine’, returned to the Prayer Book in 1662 after having been removed in 1559, draw a direct line from the natural disaster to divine judgment for sin, ‘which we do now most justly suffer for our iniquity’. The collect for ‘any common Plague or Sickness’, introduced in 1552, draws biblical examples like the earlier versions of the second collect in the Visitation of the Sick. But this time they are examples of plague sent as direct judgment: ‘O Almighty God, who in thy wrath did send a plague upon thine own people in the wilderness, for their obstinate rebellion against Moses and Aaron; and also, in the time of king David, didst slay with the plague of Pestilence threescore and ten thousand, and yet remembering thy mercy didst save the rest.’Footnote 71
In light of all of this, I think it is fair to say that the Prayer Book does not simply speak from a fully worked-out theology of sickness. Rather, I wish to suggest that the Prayer Book reflects the picture of sickness that is given in Scripture, which also is not fully worked out into a coherent theory, like a systematic theologian might do. I think it is clear that how the Scriptures speak about the relationship between sin and sickness, plague, or natural disaster is complex, but a few things nonetheless are clear.
There are passages that say very clearly that God acts within the natural order and directs it in such a way as to inflict judgment on sinners, and the Prayer Book reflects this position very clearly.Footnote 72 At the same time, Jesus makes it clear that not all sickness is the result of God’s judgment, such as in Lk. 13.1-5, where Jesus says that the Galileans who suffered at the hands of Pilate were not worse sinners than the Galileans who were not killed by Pilate. Perhaps the most famous of this teaching by Jesus is in John 9, when Jesus and his disciples pass by a man born blind from birth: ‘And his disciples asked him, saying, Master, who did sin, this man, or his parents, that he was born blind? Jesus answered, Neither hath this man sinned, nor his parents: but that the works of God should be made manifest in him’ (Jn 9.2-3).Footnote 73
We must also ask ourselves if the notion that God might act in history in response to our sin is as outrageous as some have claimed. The question really comes down to the question of prayer at all. If we believe that our prayer is more than a psychological exercise, that when I pray that God, for example, might spare my daughter when she had open heart surgery at 5 days old, I actually believed that God might act within the natural world, and not only through the means of her remarkable surgeon. In other words, if we believe that God sometimes responds to our prayers by intervening in the natural world, then it means we believe that God intervenes in the natural world. If we trust that God can do so for our good, it means that God can also do so for our correction and sanctification, as we read in Hebrews 12 and which the second exhortation quotes specifically:
For they verily for a few days chastened us after their own pleasure; but he for our profit, that we might be partakers of his holiness. Now no chastening for the present seemeth to be joyous, but grievous: nevertheless afterward it yieldeth the peaceable fruit of righteousness unto them which are exercised thereby. (Heb. 12.10-11)
The Epistle for Easter II from 1 Peter 2 also speaks directly to this: ‘For what glory is it, if, when ye be buffeted for your faults, ye shall take it patiently? But if, when ye do well, and suffer for it, ye take it patiently, this is acceptable with God.’Footnote 74 The assumption of the passage is that there will be suffering as a result of sin and that it is folly to try and do anything but accept this.
The picture of divine visitation in the 1662 Office for the Visitation of the Sick has a scope beyond a simple cause-and-effect relationship between sin and sickness or plague. This seems to be less the case for the specific prayers that were issued arising the sixteenth and seventeenth centuries in the wake of specific instances of illness and sickness. There, the relationship seems to be presented in a more straightforward way. And I think that has a great deal to do with an attempt to make sense of the simply overwhelming series of calamities that England experienced.
It is worth wondering what type of experience Christians will have through this pandemic. And it is also worth asking what might the spiritual effects be if it was obvious that we should join in the thanksgiving for deliverance from the Plague, as we find in the 1662 book:
O Lord God, who has wounded us for our sins, and consumed us for our transgressions, by thy late heavy and dreadful visitation; and now, in the midst of judgment remembering mercy, hast redeemed our souls from the jaws of death; We offer unto thy fatherly goodness ourselves, our souls and bodies which thou hast delivered, to be a living sacrifice unto thee, always praising and magnifying thy mercies in the midst of thy Church; through Jesus Christ our Lord. Amen.Footnote 75