Insufflation

Insufflation (Latin "insufflatio" "blowing on "or" into") is the practice of inhaling substances into a body cavity. Insufflation has limited medical use, but is a common route of administration with many respiratory drugs used to treat conditions in the lungs (asthma or emphysema) and paranasal sinus (allergy).

The technique is common for many recreational drugs and is also used for some entheogens. Nasal insufflation is commonly used for many psychoactive drugs because it causes a much faster onset than orally and bioavailability is usually, but not always, higher than orally. This bioavailability occurs due to the quick absorption of chemical molecules into the bloodstream through the soft tissue in the mucous membrane of the sinus cavity. Some drugs have a higher rate of absorption, and are thus more effective in smaller doses, through this route.

The intranasal route (administration through the nose) may allow certain drugs and other molecules to bypass the blood-brain barrier via diffusion or axonal transport along olfactory and trigeminal nerves. [William H. Frey. [http://www.drugdeliverytech.com/cgi-bin/articles.cgi?idArticle=61 "Bypassing the Blood-Brain Barrier to Deliver Therapeutic Agents to the Brain and Spinal Cord."] Drug Delivery Technology.]

Medical uses

As a medical procedure

Inert, nontoxic gases, such as carbon dioxide, are often insufflated into a body cavity, in order to expand the cavity and increase workroom, or reduce obstruction during investigative surgery.

As a method of administering drugs

Insufflation can also be synonymous with inhalation. Psychoactive substances are often inhaled nasally for the purpose of intranasal absorption through the mucous membrane, which is often more rapid, or more complete, than gastrointestinal absorption. For a substance to be effective when insufflated, it must be water soluble so it can be absorbed into the mucous membranes. This practice is commonly referred to as "snorting".

Commonly insufflated psychoactive substances include:

*Cocaine - benzoylmethyl ecgonine - a strong stimulant
*Ketamine - dissociative anesthetic
*Heroin/Morphine - powerful opiates
*Opioids - a class of narcotics, typically semi-synthetic (e.g. oxycodone and hydromorphone) or completely synthetic (e.g. meperidine)
*Phencyclidine - dissociative anesthetic, more commonly known by the acronym "PCP" or slang term "angel dust"
*Amphetamines - d-methamphetamine (speed) and d,l-amphetamine
*Ritalin - methylphenidate, a stimulant closely related to amphetamine, but often reported to have effects similar to that of cocaine when insufflated
*MDMA/Ecstasy - an entactogen
*Zolpidem (Ambien) - a sedative hypnotic that can have various hallucinogenic effects with certain people and/or at high doses
*Tobacco snuff - contains nicotine, a mild stimulant that is highly addictive. Various other drugs can be snorted so long as they are water soluble, though the substances listed are insufflated regularly.

Note: Some psychoactive substances such as benzodiazepines (valium, oxazepam, clonazepam) are water soluble to a small degree (about 350ml/1000mg). Though this means they will be somewhat effective when insufflated, they will not be as readily absorbed into the mucous membrane as highly soluble substances such as amphetamines and opiates. Even despite this, many benzodiazepines are still occasionally insufflated.

Liturgical use

In religious and magical use, insufflation and exsufflation (they are frequently indistinguishable and are considered together here) are ritual acts of blowing, breathing, hissing, or puffing that signify variously expulsion or renunciation of evil or of the devil (the evil one), or infilling or blessing with good (especially, in religious use, with the Spirit or grace of God).

In historical Christian practice, such blowing appears most prominently in the liturgy, and is connected almost exclusively with baptism and other ceremonies of Christian initiation, achieving its greatest popularity during periods in which such ceremonies were given a heavily prophylactic or exorcistic significance, and were viewed as essential to the defeat of the devil or to the removal of the taint of original sin. [See Franz Josef Dölger, Der Exorzismus im altchristlichen Taufrituel, Studien zur Geschichte und Kultur des Altertums 3 (Paderborn, 1909), chap. 7 "Die Exsufflatio" (pp. 118-130); Edmond Martène, De antiquis ecclesiae ritibus libri tres (Venice, 1763), I.1.viii-xiv ("Ritus instituendi catechumeni"); Rudolf Suntrup, Die Bedeutung der liturgischen Gebärden und Bewegungen in lateinischen und deutschen Auslegungen des 9. bis 13. Jahrhunderts (Munich, 1978), pp. 307-310; and Henry A. Kelly, The Devil at Baptism: Ritual, Theology, and Drama (Ithaca, 1985).]

An act or acts of ritual blowing occur in the liturgies of catechumenate and baptism from a very early period and flourished there, surviving into the modern Roman Catholic, Greek Orthodox, Maronite, and Coptic rites. [Alongside Martène and Suntrup (cited above), convenient collections of illustrative material include W. G. Henderson, ed., Manuale et Processionale ad usum insignis Ecclesiae Eboracensis, Surtees Society Publications 63 (Durham, 1875 for 1874), especially Appendix III "Ordines Baptismi" [cited below as York Manual] ; Joseph Aloysius Assemanus, Codex liturgicus ecclesiae universae, I: De Catechumenis and II: De Baptismo (Rome, 1749; reprinted Paris and Leipzig, 1902); J. M. Neale, ed., The Ancient Liturgies of the Gallican Church...together with Parallel Passages from the Roman, Ambrosian, and Mozarabic Rites (London, 1855; rpt. New York, 1970); Enzo Lodi, Enchiridion euchologicum fontium liturgicorum (Rome, 1978); Johannes Quaesten, ed., Monumenta eucharistica et liturgica vetustissima, Florilegium Patristicum tam veteris quam medii aevi auctores complectens, ed. Bernhard Geyer and Johan Zellinger, fasc. 7 in 7 parts (Bonn, 1935-1937); E. C. Whitaker, Documents of the Baptismal Liturgy, 2nd ed. (London, 1970); and Thomas M. Finn, Early Christian Baptism and the Catechumenate: Italy, North Africa, and Egypt (Collegeville, MN: Liturgical Press, 1992).] Catholic liturgy post Vatican-II (the so-called 'novus ordo' 1969) has largely done away with insufflation (except in a special rite for the consecration of chrism on Maundy Thursday), [F. L. Cross, ed., The Oxford Dictionary of the Christian Church, 3rd ed., rev. by F. L. Cross and E. A. Livingstone (Oxford, 1998), "s.v." "insufflation," p. 839.] and Protestant liturgies typically abandoned it very early on, but the Tridentine Catholic liturgy retained both an insufflation of the baptismal water and (like the present-day Orthodox and Maronite rites) [The Oxford Dictionary of the Christian Church, 3rd ed., 840. For the Maronite rite, derived from the ancient Syrian liturgy, see Mysteries of Initiation, Baptism, Confirmation, Communion according to the Maronite Antiochene Church, (Washington, DC, 1987); summarized by Bryan D. Spinks, Early and Medieval Rituals and Theologies of Baptism..., (Aldershot, Hants., 2006), 89-91.] an exsufflation of the candidate for baptism, right up to the nineteen-sixties:

[THE INSUFFLATION] "He breathes thrice upon the waters in the form of a cross, saying:" Do You with Your mouth bless these pure waters: that besides their natural virtue of cleansing the body, they may also be effectual for purifying the soul. [Saint Andrew Daily Missal..., by Dom Gaspar Lefebvre (Bruges [Belgium] : Biblica, 1962), 492 [liturgy for the Easter vigil] .]

THE EXSUFFLATION. "The priest breathes three times on the child in the form of a cross, saying:" Go out of him...you unclean spirit and give place to the Holy Spirit, the Paraclete. [Saint Andrew Missal (Bruges, 1962), 1768 [ceremonies of baptism] .]

Insufflation vs. exsufflation

From an early period, too, as illustrated here, the act had broadly speaking two distinct but not always distinguishable meanings: it signified on the one hand the derisive repudiation or exorcism of the devil; and, on the other, purification and consecration by and inspiration with the Holy Spirit. The former is sometimes called "exsufflation" and the latter "insufflation" (i.e., "blowing out" and "blowing in") but the ancient and medieval texts (followed by modern scholarship) only occasionally honor this distinction. For example, the texts use not only Latin "insufflare" ('blow in') and "exsufflare" ('blow out') (or their Greek or vernacular equivalents), but also the simplex "sufflare" ('blow'), "halare" ('breathe'), "inspirare," "exspirare," etc. [P. Pashini, "et al.," ed., Enciclopedia Cattolica (Florence, 1949-1954), "s.v." "insufflazione," pp. 55-56. Compare Neale, The Ancient Liturgies of the Gallican Church..., p. 266, note m; Whitaker, Documents of the Baptismal Liturgy, p. 256; Kelly, The Devil at Baptism, p. 235. Döger, Der Exorzismus im altchristlichen Taufrituel, p. 130 similarly distinguishes between exsufflation and "halation"; and Suntrup, Die Bedeutung der liturgischen Gebärden, p. 307 warns that the distinction is a hard one to maintain. The Episcopal Dictionary of the Church, "s.v. insufflation" (accessed 14 Jan 2007) similarly says that "the distinction between insufflation and exsufflation has not always been preserved." And the Oxford Dictionary of the Christian Church, 3rd ed., p. 839, is content to give both inspirational ("to symbolize the influence of the Holy Spirit") and exorcistic ("the expulsion of evil spirits") meanings under the single heading of "insufflation."]

Typical is the 8th-century Libellus de mysterio baptismatis of Magnus of Sens, one of a number of responses to a questionnaire about baptism circulated by Charlemagne. In discussing "insufflation" as a means of exorcising catechumens, he unhesitatingly combines under that heading a variety of mostly exsufflation-like functions: "Those who are to be baptised are insufflated by the priest of God, so that the Prince of Sinners [i.e. the devil] may be put to flight from out of them, and that entry for the Lord Christ might be prepared, and that by his insufflation they might be made worthy to receive the Holy Spirit." [Patrologia Latina, 102:982D.] This double role appears as early as Cyril of Jerusalem's 4th-century Mystagogic Catacheses: as Yarnold says, "Cyril attributes both negative and positive effects [to insufflation] .... The rite of breathing on the [baptismal] candidate has the negative effect of blowing away the devil (exsufflation) and the positive effect of breathing in grace (insufflation)." [Cyril of Jerusalem, by Edward J. Yarnold (London: Routledge, 2000), p. 203.]

History

Early period

What might neutrally be called "sufflation" is found in some of the earliest liturgies dealing with the protracted process of initiation known as the "catechumenate," which saw its heyday in the fourth and fifth centuries. The earliest extant liturgical use is possibly that of the Apostolic Tradition attributed to Hippolytus of Rome, perhaps from the fourth century, and therefore contemporary with Cyril in the east: [The date is controversial. The text is usually connected with practice in Rome and dated in its earliest form to the early third century. But the surviving text is fragmentary, many portions surviving only in much later versions in several different languages. Chapter 20, the relevant chapter, is perhaps from the fourth century (see Maxwell E. Johnson, The Rites of Christian Initiation: Their Evolution and Interpretation (Collegeville, MN: Liturgical Press, 1999), 78-81). For the standard reconstruction of the text, see Bernard Botte, La "Tradition Apostolique," 42-45 (chapter 20). Whitaker, Documents, p. 4, reprints the translation of Gregory Dix, The Treatise on the Apostolic Tradition, p. 32 (sect. xx.8). Botte renders the Coptic original of the sufflation passage as "exsufflet," though Kelly (Devil at Baptism, p. 87) points out that the significance of the gesture is uncertain. Geoffrey Cumming gives the more neutral translation "breathe on": Hippolytus: A Text for Students (Bramcote, Notts, 1976), p. 18, as reproduced more fully below.]

Those who are to be baptized should ... be gathered in one place.... And [the bishop] should lay his hands on them and exorcize all alien spirits, that they may flee out of them and ever return into them. And when he has finished exorcizing them, he shall breathe on their faces; and when he has signed their foreheads, ears, and noses, he shall raise them up. [Cuming's translation, reprinted by Maxwell Johnson, Rites of Christian Initiation, p. 74.]

Distribution, geographical and functional

The practice entered the baptismal liturgy proper only as the catechumenate, rendered vestigial by the growth of routine infant baptism, was absorbed into the rite of baptism. Both exsufflation and insufflation are well established by the time of Augustine and in later centuries are found widely. By the Western high Middle Ages of the twelfth century, sufflation was geographically widespread, and had been applied not only to sufflating catechumens and baptizands, [Nearly universally. E.g. (1) in Egypt: Canons of Hippolytus, Canon 19 (or §110), trans. Riedel 211, Achelis 93, Whitaker 88; Horner's translations of the Ethiopic, Arabic, and Sahidic versions may be found on pp. 152, 252, and 316. (2) In western Syria: Cyril, Procatechesis, cap. 9, ed. F. L. Cross, St. Cyril of Jerusalem's Lectures on the Christian Sacraments: The "Procatechesis" and the "Five Mystical Dialogues" (London, 1951), 5-6, trans. 45 = Patrologia Graeca 33:347-50 (translated also by E. H. Gifford, Catechetical Lectures, Nicene and Post-Nicene Fathers, 2nd series (N.Y., 1894), 3); and the "Testamentum Domini nostri Jesu Christi", ed. and trans. Ignatius Ephraem II Rahmani (Mainz, 1899), 125, 127 (rpt. by Quasten, Monumenta, 5:266-67. (3) In Spain: Isidore, De ecclesiasticis officiis II.xxi.3, ed. C. M. Lawson, CCSL 113 (1989), 96/21 (Patrologia Latina 83:815A; trans. Whitaker, 117); the Spanish rites in general are discussed by Kelly, 234-36 and 244-52. (4) In northern Italy: see Kelly, 232-34 and 236-38; Whitaker, 143; and Cyrille Lambot, ed., North Italian Services of the Eleventh Century, Henry Bradshaw Society 67 (London, 1931 for 1928), 5, 6, 16. (5) In the Byzantine and other eastern rites: see, e.g., Lodi, 1303 (§2925) and Whitaker, 74; the eastern rites are treated extensively by Kelly, 136-200. (6) In Roman North Africa: Augustine is the most important witness; cp. also Quodvultdeus, De Symbolo III.1.3, ed. R. Braun, CCSL 60 (1976), 349 (Patrologia Latina 40:661).] but also to exorcism of readmitted heretics ; [Council of Constantinople (A.D. 381), Canon VII, ed. N. P. Tanner, Decrees of the Ecumenical Councils [based on the text of G. Alberigo, "et al."] (London, 1990) 1:35: "We exorcize them by breathing thrice their faces and ears." This canon is evidently a fifth-century addition: see Kelly 144, Tanner 1:22 note 8. ] to admission of pagans to the catechumenate; [E.g. in the Gelasian Sacramentary, ed. L. C. Mohlberg, Liber Sacramentorum Romanae Aeclesiae Ordinis Anni Circuli... (Sacramentum Gelasianum), Rerum Ecclesiasticarum Documenta, Serie maior, Fontes, 4 (Rome, 1981), 93 (§598) (trans. Whitaker, 192); and the Fulda Sacramentary, ed. Gregor Richter and Albert Schönfelder, Sacramentum Fuldense Saeculi X, Quellen und Abhandlungen zur Geschichte der Abtei und der Diözese Fulda 9 (Fulda, 1912), rpt. Henry Bradshaw Society 101 (1977 for 1972-7) 354 (§2723). Cp. Assemani, 1:20.] to renunciation of the devil on the part of catechumens; [In Dionysius, De ecclesiasticis hierarchiis 2.6 (Patrologia Graeca 3:395/6:B); rpt. Quasten, Monumenta, 6:281; trans. Whitaker, 57. In Ephraem Syrus, In secundum adventum domini, cited by Kelly, 135 note 30. And in the Byzantine rite (see Whitaker, 70, 77). For Western sources, see further below.] to consecration and/or exorcism of the baptismal font and water; [Very commonly, e.g. in the Byzantine rite (Whitaker, 80); the (Milanese) Ambrosian Manual (Whitaker, 138, 145); other North Italian rites (Lambot, 33); the Liber Ordinum (ed. Férotin, 29; trans. Whitaker, 118); the Missale Gothicum; the Gregorian Sacramentary ("Hadrianum"); the Ordo Romanus L; and in the Sarum Missal (ed. J. Wickham Legg (Oxford: Clarendon, 1916; rpt. 1969), 129) and other English texts (see below).] to consecration or exorcism of ashes; [In the Ambrosian Manual (Kelly, 228) and in Beroldus (twelfth century Milan; trans. in Whitaker, 149).] and to the consecration of the chrism or holy oil. [In the Byzantine rite (Whitaker, 81); in the Ethiopic rite (A. Salles, trans., Trois antiques rituels du baptême, Sources Chrétiennes 59 (Paris, 1958), 50); in several Ordines Romani (e.g., Ordo XXIV 18, Ordo XXVII 31, Ordo XXVIII 22, all ed. Michel Andrieu, Les Ordines Romani du Haut Moyen Âge, vol. 3, Spicilegium Sacrum Lovaniense, Études et Documents, fasc. 24 (Louvain, 1951), 291, 354, 396; also in the "Ordo" quoted by Amalarius, Liber Officialis, I.xii.27-8, ed. Jean-Michel Hanssens, Amalarii Episcopi Opera Liturgica Omnia, vol. 2, Studi e testi 139 (Vatican City, 1948), 75-76; and in the nine twelfth-century English pontificals printed as Appendix 3.1 to the Bainbridge Pontifical (W. G. Henderson, ed., Liber Pontificalis Chr. Bainbridge Archiepiscopi Eboracensis, Surtees Society Publications 61 (Durham, 1875 for 1873), 254, 256).]

Medieval period

Most of these variations persist in one branch or another of the hybrid Romano-Germanic rite that can be traced from fifth-century Rome through the western Middle Ages to the Council of Trent, and beyond that into modern (Tridentine) Roman Catholicism. As the 'national' rites such as the Ambrosian tradition in northern Italy and the Spanish Mozarabic rite faded away or were absorbed into international practice, it was this hybrid Roman-Gallican standard that came to dominate western Christendom, including Anglo-Saxon and medieval England, from the time of Charlemagne, and partly through his doing, through the high and late Middle Ages and into the modern period. Roman practice around the year 500 is reflected in a letter by a somewhat mysterious "John the Deacon" to a correspondent named Senarius. The letter discusses the exsufflation of catechumens at length. [John the Deacon, Epistola ad Senarium, ed. A. Wilmart, "Analecta Reginensia (Vat. Reg. Lat. 69)," Studi e testi 59 (1933), 172; trans. Whitaker, Documents of the Baptismal Liturgy, 155.] The Stowe Missal, Irish in origin but largely Gallican in form, contains a prebaptismal sufflation of unclear significance. [F. E. Warren, Liturgy and Ritual of the Celtic Church (Oxford, 1881; rpt. with introduction by Jane Stevenson, Woodbridge, Suffolk, 1987), 209; The Stowe Missal, ed. George F. Warner, Henry Bradshaw Society 32 (London, 1915), 25.] The other Gallican rites are largely devoid of sufflation, though the so-called Missale Gothicum contains a triple exsufflation of baptismal water, [Neale, Gallican Liturgies, 97; or L. C. Mohlberg, ed., Missale Gothicum, Rerum Ecclesiasticarum Documenta, Series Maior, Fontes 5 (Rome, 1961), 67.] and a prebaptismal insufflation of catechumens is found in the hybrid Bobbio Missal [Neale, Gallican Liturgies, 266] and the tenth-century Fulda sacramentary, alongside the more common baptismal exsufflation. [Fulda Sacramentary, 332 (§2631) and 343 (§2679-80).] The eleventh-century North-Italian baptismal ritual in the Ambrosian Library MS. T.27.Sup. makes heavy use of the practice, requiring both insufflation and triple exsufflation of the baptismal candidates "in modum crucis", and insufflation of the font as well. [Lambot, North Italian Services, 5, 11, 16, 33.] The "Hadrianum" version of the Gregorian Sacramentary, sent to Charlemagne from Rome and augmented probably by Benedict of Aniane, contains an insufflation of the baptismal font, [Jean Deshusses, Le Sacramentaire Grégorien, vol. 1, Spicilegium Friburgense 16 (Fribourg, 1971), 188; the rubric here is reconstructed by Deshusses from a wide variety of variants. On the attribution of the Hadrianum supplement to Benedict, see Deshusses, 1:63-7 and vol. 3, Spicilegium Friburgense 28 (Fribourg, 1982), 66-75, as well as his earlier article "Le 'Supplément' au sacramentaire grégorien: Alcuin ou S. Benoît d'Aniane?" Archiv für Liturgiewissenschaft 9.1 (1965): 48-71.] as does the mid-tenth-century Ordo Romanus L, [Ordo L, xxxix.50; Michel Andrieu, ed., Les Ordines Romani du Haut Moyen Age, vol. 5, Spicilegium Sacrum Lovaniense, Études et Documents, fasc. 29 (Louvain, 1961), 281.] the basis of the later Roman pontifical. Ordo Romanus L also contains a triple exsufflation of the candidates for baptism, immediately preceding the baptism itself. [Ordo L, xx.5; Andrieu, 5:131. This section was probably also originally found in Ordo XI according to Andrieu (2:376).]

Most of the numerous Carolingian expositions of baptism treat sufflation to some extent. [See Jean-Paul Bouhot, "Explications du rituel baptismal à l'époque carolingienne," Revue des études augustiniennes 24 (1978): 278-301; and Susan A. Keefe, "Carolingian Baptismal Expositions: A Handlist of Tracts and MSS," in Carolingian Essays, ed. Uta-Renate Blumenthal (Washington, DC, 1983), 169-238.] One anonymous ninth-century catechism is unusual in distinguishing explicitly between the exsufflation of catechumens and the insufflation of baptismal water, [André Wilmart, "Une catéchèse baptismale du IX^e siècle," Revue Bénédictine 57 (1947): 199 (Keefe, "Expositions," text 50).] but most of the tracts and florilegia, when they treat both, do so without referring one to the other; most confine themselves to exsufflation and are usually content to quote extracts from authorities, especially Isidore and Alcuin. [E.g. in Keefe's texts 34/6 and 3: Jean-Paul Bouhot, "Alcuin et le 'De Catechizandis Rudibus,'" Recherches Augustiniennes 15 (1980): 224; and Wilmart, Analecta, 158.] Particularly popular was Isidore's lapidary remark in the Etymologies to the effect that it is not the human being ("God's creature") that is exsufflated, but the prince of sinners to whom that person is subjected by being born in sin, ["Sciendum est quod non creatura Dei in infantibus exorcizatur aut exufflatur, sed ille sub quo sunt omnes qui cum peccato nascuntur; est enim princeps peccatorum." Etymologiarum,VI.xix.56; ed. W. M. Lindsay (Oxford, 1911).] a remark that echoed Augustine's arguments against the Pelagians to the effect that it was not the human infant (God's image) that was attacked in sufflation, but the infant's possessor, the devil. Particularly influential was Alcuin's brief treatment of the subject, the so-called "Primo paganus," which in turn depended heavily on John the Deacon. [Alcuin's comments are contained in two genuine letters (numbers 134, to Odwin, and 137, to monks in the south of France), ed. Ernst Dümmler, Epistolae Karolini Aevi, 2, MGH Epistolae 4 (Berlin, 1895), 202 and 214; and in a third letter of dubious authenticity, ostensibly to Charlemagne, ed. Patrologia Latina 98:938B. The three letters are nearly verbatim identical in their description of exsufflation: "Primo paganus catechumenus fit, accedens ad baptismum; ut renuntiet maligno spiritui et omnibus eius pompis. Exsufflatur etiam; ut, fugato diabolo, Christo Deo nostro paretur introitus" (MGH, 214, = Keefe text 9, Bouhot, 280-82.] The "Primo paganus" formed the basis of Charlemagne's famous circular questionnaire on baptism, part of his effort to harmonize liturgical practice across his empire; and many of the seventeen extant direct or indirect responses to the questionnaire are happy to echo Alcuin, making the process a little circular and the texts a little repetitious. [For the various replies, see Wilmart, 154; Bouhot, 286-93; and Keefe, "passim."] The burden of Alcuin's remarks, in fact, appears above in the quotation from the Libellus of Magnus of Sens, one of the respondents. [The Libellus of Magnus of Sens is Keefe's text 15 (Bouhot, 287).] The questionnaire assumed that exsufflation of or on the part of the candidate for baptism was generally practiced--it merely asks what meaning is attached to the practice: "concerning the renunciation of Satan and all his works and pomps, what is the renunciation? and what are the works of the devil and his pomps? why is he breathed upon? ('cur exsufflatur?') why is he exorcised?" [See J. D. C. Fisher, Christian Initiation: Baptism in the Medieval West (London, 1965), 59. The text (Keefe's text 14; Bouhot, 286) is readily available in Dorothy Bethurum's edition of the Homilies of Wulfstan (Oxford, 1957), 302-3, and less readily in Jean Michel Hanssens, Amalarii...opera 1, Studi e test 138 (1948), 235-6.] Most of the respondents answered that it was so that, with the devil sent fleeing, the entry of the Holy Spirit might be prepared for.

In England

On the other side of the Channel, in Anglo-Saxon England, sufflation is mentioned in Bishop Wulfstan's collection of Carolingian baptismal expositions, the Incipit de baptisma, and in the two vernacular (Old English) homilies based on it, the Quando volueris and the Sermo de baptismate. The Incipit de baptisma reads: "On his face let the sign of the cross be made by exsufflation, so that, the devil having been put to flight, entry for our Lord Christ might be prepared." ["In cuius...facie a sacerdote per exsufflationem signum crucis sit, ut effugeto diabolo, Cristo Domino nostro preparetur introitus." Wulfstan, Homilies, ed. Bethurum, Homily VIIIa (p. 169, ll. 8-10). For the relationship between the three pieces, see pp. 302-4. For the parallel passages in the vernacular homilies, see Homily VIIIb (p. 172, ll. 14-22) and Homily VIIIc (pp. 176-7, ll. 29-35). Wulfstan's collection draws on a variety of Carolingian sources, but in this passage quotes almost verbatim the De Ordine Baptismi of Theodulf of Orleans (yet another Alcuin-derivative reply to Charlemagne; Keefe text 16), ed. in Patrologia Latina 105:225B.] Among English liturgical texts proper, the tenth-century Leofric Pontifical (and Sacramentary) dictates an insufflation of baptizands, a triple insufflation of the baptismal water, and an 'exhalation' of holy oil. [F. E. Warren, ed., The Leofric Missal as used in the Cathedral of Exeter during the Episcopate of its First Bishop, A. D. 1050-1072 (Oxford, 1883), 236-37, 259. This text may, however, originate on the Continent: see H. M. J. Bantin, Two Anglo-Saxon Pontificals, Henry Bradshaw Society 104 (London, 1989), xxiii-xxv. The contemporary, and genuinely English, Egbert Pontifical, from York, lacks mention of sufflation.] In the eleventh century, the Salisbury Pontifical (BL Cotton MS Tiberius C.1) and the Pontifical of Thomas of Canterbury require insufflation of the font; the Missal of Robert of Jumièges (Canterbury) has an erased rubric where it may have done likewise, as well as having an illegible rubric where it probably directed the exsufflation of catechumens, and retaining the old "ordo ad caticuminum ex pagano faciendum," complete with its sufflation ceremony; and an Engish Ordo Romanus (BL Cotton MS Vitellius E.12) contains a triple exsufflation of baptizands. [W. G. Henderson, ed., York Manual, 144, 136, 133, 142; H. A. Wilson, ed., The Missal of Robert of Jumiège, Henry Bradshaw Society 11 (London, 1896), 93, 98, 101.] Various twelfth-century texts include signing and triple exsufflation of the holy oil (Sarum), triple exsufflation of baptizands (the Ely, Magdalene, and Winton Pontificals), and insufflation of the font "in modum crucis" (Ely and Magdalene, followed by most later texts). [See the Bainbridge Pontifical, appendix 3, 254; York Manual, 147, 149.] Such are the origins of the late medieval sufflation rites, which were in turn retained in regularized form in post-Tridentine Catholicism.

ufflation in Protestantism

Sufflation did not last long in any of the churches arising from the magisterial or radical reformations. Martin Luther's first attempt at a baptismal liturgy, the Tauffbuchlin (Taufbüchlein) of 1523 (reprinted 1524 and 1525) did retain many ceremonies from the late Medieval ritual as it was known in Germany, including a triple exsufflation of baptizands. But in an epilogue, Luther listed this ceremony among the adiaphora--i.e., the inessential features that added nothing to the meaning of the sacrament:

The least importance attaches to these external things, namely breathing under the eyes, signing with the cross, placing salt in the mouth, putting spittle and clay on the ears and nose, anointing with oil the breast and shoulders, and signing the top of the head with chrism, vesting in the christening robe, and giving a burning candle into the hand, and whatever else ... men have added to embellish baptism. For ... they are not the kind of devices that the devil shuns. [Luther's Works 53:103, Weimar Ausgabe 12:48; cited in Spinks, Reformation and Modern Rituals, 10.]

The Lutheran Strassbourg Taufbüchlein of June 1524, composed by Diobald Schwartz, assistant to Cathedral preacher Martin Zell, on the basis of the medieval rite used in Strassbourg combined with elements of Luther's 1523 rite, also retains baptismal exsufflation; [Text in F. Hubert, Die Strassburger liturgischen Ordnungen in Zeitalter der Reformation (Göttingen: Vandenhoek und Ruprecht, 1900), 25ff.; transl. in Fisher, Christian Initiation: the Reformation Period, 30-33.] so does Andreas Osiander in Nuremberg, in the same year. [Fisher, Christian Initiation, 18. The dependence of Schwartz and Osiander on Luther appears from their use of his distinctive rubric "breathe "under the eyes" -- not found in the medieval rites.]

But thereafter the practice vanished from Lutheranism, and indeed from Protestantism generally. Luther's revised edition of 1526 and its successors omit exsufflation altogether, as do the Luther-influenced early reformed rites of England (Thomas Cranmer's Prayer Book of 1549) and Sweden (the Manual of Olavus Petri), despite the former's conservative basis in the medieval Sarum ritual and the latter's strong interest in exorcism as an essential part of the baptismal ritual. [For a handy comparison, see The Manual of Olavus Petri, 1529, ed. Eric E. Yelverton (London: SPCK, 1953), p. [110] .]

Similarly in the Swiss Reformation (the Zwinglian/Reformed tradition), only the very earliest rites retain sufflation, namely the ceremony published by Leo Jud, pastor of St. Peter's in Zurich, in the same year (1523) as Luther's first baptismal manual. [English translation in Fisher, Christian Initiation: the Reformation Period, 126ff.; discussed briefly in Spinks, Reformation and Modern Rituals, 31, and fully in H. O. Old, The Shaping of the Reformed Baptismal Rite in the Sixteenth Century (Grand Rapids, MI: Eerdmans, 1992).]

ufflation in Protestant-Roman Catholic debate

Though sufflation does not appear in Protestant practice, it definitely appears in Protestant polemic, where it is usually treated as an un-Scriptural and superstitious (i.e., in the Protestant view, a typically Roman Catholic) practice, and even one reeking of enchantment or witchcraft. It appears as such, for example in the work of Henry More (the 'Cambridge Platonist') on evil. His argument essentially reverses that of Augustine. Augustine had said to the Pelagians (to paraphrase): "you see that we exorcize and exsufflate infants before baptising them; therefore they must be tainted with sin and possessed by the devil since birth." More replies, in effect, "Infants cannot be devil-possessed sinners; therefore, ceremonial exorcism and exsufflation is presumptuous, frightening, and ridiculous," in a word "the most gross and fundamental Superstitions, that look like Magick or Sorcery":

The conjuring the Devil also out of the Infant that is to be baptized would seem a frightful thing to the Infant himself, if he understood in what an ill plight the Priest supposes him, while he makes three Exsufflations upon his face, and uses an Exorcistical form for the ejecting of the foul Fiend.... And it is much if something might not appear affrightful to the Women in this approaching darkness. For though it be a gay thing for the Priest to be thought to have so much power over the Stygian Fiend, as to Exorcize him out of the Infant; yet it may be a sad consideration with some melancholick women laden with Superstition, to think they are never brought to bed, but they are delivered of a Devil and Child at once. [Henry More, A Modest Enquiry into the Mystery of Iniquity (London, 1664), 68.]

Sufflation appears in Roman Catholic anti-Protestant polemic, as well. The relative antiquity of the practice, and its strong endorsement by the Protestants' favorite Father, Saint Augustine, made it a natural element in Catholic arguments that contrasted the Protestant with the ancient and Apostolic church. A true church, according to Roman Catholic apologists, would be:

A Church that held the exorcismes exsufflations and renunciations, which are made in baptisme, for sacred Ceremonies, and of Apostolicall tradition.... A Church which in the Ceremonies of baptisme, vsed oyle, salte, waxe, lights, exorcismes, the signe of the Crose, the word Epheta and other thinges that accompanie it; to testifie ... by exorcismes, that baptisme puts vs out of the Diuells possession. [Jacques Davy Du Perron, The reply of the most illustrious Cardinall of Perron, to the ansvveare of the most excellent King of Great Britaine (Douay. 1630) 72.]

This was argued on the grounds that some of these ceremonies were demonstrably ancient, and all of them might be.

Sundry Ceremonies vsed in baptisme, and other Sacraments, as Exorcismes, Exsufflations, Christening, and the like mentioned by S. Augustine and by diuers other ancient Fathers ..., these being practised by the Primitiue Church (which is graunted to be the true Church) and compared to the customes of Protestants, and vs, in our Churches, will easily disclose, which of the two, they or we, do more imitate, or impugne the true Church of antiquity. [Humphrey Leech; Robert Parsons, Dutifull and respective considerations vpon foure seuerall heads of proofe and triall in matters of religion ... By a late minister & preacher in England (Saint-Omer, 1609), 210]

To which a Protestant reply was that sufflation was not ancient "enough", and could not be proved to be apostolic:

It was plain then there was no clear Tradition in the Question, possibly there might be a custome in some Churches postnate to the times of the Apostles, but nothing that was obligatory, no Tradition Apostolicall. But this was a suppletory device ready at hand when ever they needed it; and S. Austin confuted the Pelagians, in the Question of Original sinne, by the custome of exorcisme and insufflation, which S. Austin said came from the Apostles by Tradition, which yet was then, and is now so impossible to be prov'd, that he that shall affirm it, shall gaine only the reputation of a bold man and a confident. [Jeremy Taylor, Treatises of 1. The liberty of prophesying, 2. Prayer ex tempore, 3. Episcopacie : together with a sermon preached at Oxon.... (London, 1648), 87]

Sufflation was judged by Protestant critics to be irrational, mysterious, and obscure, an increasingly important factor by the close of the seventeenth century and the dawn of the Enlightenment:

Mystery prevail'd very little in the first Hundred or Century of Years after Christ; but in the second and third, it began to establish it self by Ceremonies. To Baptism were then added the tasting of Milk and Honey, Anointing, the Sign of the Cross, a white Garment, &c. ... But in later times there was no end of Lights, Exorcisms, Exsufflations, and many other Extravagancies of Jewish, or Heathen Original ... for there is nothing like these in the Writings of the Apostles, but they are all plainly contain'd in the Books of the Gentiles, and was the Substance of their Worship. [John Toland, Christianity Not Mysterious, Or, A Treatise Shewing that there is Nothing in The Gospel Contrary to Reason, nor Above it and that no Christian Doctrine can be Properly Call'd a Mystery (London, 1696), 163-165.]

It was said to be a human invention, imposed by the arbitrary whim of a tyrannical prelate against the primitive Gospel freedom of the church:

[Some bishop] ... taking it into his head that there ought to be a trine-immersion in baptism; another the signation of the cross; another an unction with oil; another milk and honey, and imposition of hands immediately after it; another insufflation or breathing upon the person's face to exorcise the Devil... Thus, I say, that inundation of abominable corruptions, which at present overwhelms both the Greek and Romish Churches, gradually came in at this very breech which you are now zealously maintaining, namely, the Bishop's Power to decree rites and ceremonies in the Church. [Micaiah Towgood, A dissent from the Church of England fully justified, 5th ed. (London, 1779), p. 145]

To all of which, Roman Catholic apologists replied that insufflation was not only ancient and Apostolic, but had been practiced by Christ himself:

"When he [Christ] had said this he breathed upon them, and said to them, Receive the Holy Ghost...." When the Pastors of our Church use the Insufflation or Breathing upon any, for the like mystical Signification, you cry aloud, Superstition, Superstition, an apish mimical action, &c. [James Mumford, The Catholic scripturist, or the plea of the Roman Catholics, 4th ed. (London(?), 1767), p. 86.]

Prospects

Though liturgical sufflation is almost gone, at least from the Western churches, its revival is not inconceivable. Liturgical renewal movements always seem to look to the 'classic' catechumenate of the fourth and fifth centuries for inspiration. Insufflation has indeed been re-introduced into the Catholic "new catechumenate." But many ceremonies dating from that or the medieval period have been re-imported even into Protestant rites during the last couple of decades. Perhaps even more likely is a revival in the context of the growth of the African and Asian church, in which locally and culturally meaningful ceremonies have often revolutionized practice, and in which, often, the exorcistic function of baptism has enjoyed a new vitality. For example, a pure insufflation is apparently practiced in the Independent Church of the Philippines, [Peter Jagger, Christian Initiation 1552-1969... (London, 1970), 292. This is a basically Roman rite with some Anglican-like features.] and Spinks mentions a pre-baptismal ceremony used by the Christian Workers' Fellowship of Sri Lanka, in which the candidates are struck with a cane and their faces are breathed upon. [Spinks, Reformation and Modern Rituals, 203, citing Francis Wickremesinghe, "An Asian Inculturation of the Baptismal Liturgy," in David R. Holeton, ed., Growing in Newness of Life (Toronto: Anglican Book Centre, 1993), 213-217.] It is not clear whether the latter represents a revival of historical sufflation, or a wholly new ceremony derived from local custom.

ignificance and associations

There were apparently at least three kinds of association that particularly influenced how liturgical sufflation came to be understood: Biblical antecedents; liturgical setting; and extra-liturgical (cultural) analogs.

Biblical antecedents

Three Biblical passages recur repeatedly with reference to insufflation properly speaking, all of them referring to some kind of life-giving divine breath. The first and most commonly cited is Genesis 2:7 (echoed by Wisdom 15:11 and Job 33:4), in which God first creates man and then breathes into him the breath of life, in order to give him (as the passage was later interpreted) a human soul. ["His life is of less worth than clay, because he failed to know the one who formed him and inspired him with an active soul and breathed into him a living spirit [Vulg. 'insufflavit ei spiritum vitalem'] " Wisdom 15:10-11 (RSV); "The spirit of God has made me, and the breath of the Almighty gives me life" Job 33:4 (RSV). Cp. Psalm 33:6.] The second passage, Ezekiel 37:9, reinterprets the Genesis passage prophetically, in foreseeing God resurrecting the dead bones of exiled Israel by means of his life-giving breath. ["Come from the four winds, O breath, and breathe upon these slain [Vulg. 'insuffla super interfectos istos'] , that they may live.... And the breath came into them, and they lived, and stood upon their feet" Ezekiel 37:9-10 (RSV).] And finally, in John 20:22, Christ is represented as conveying the Paraclete to his disciples, and so initiating the commissioned church, by breathing on them, here too, very possibly, with implicit reference to the original creation. ["He breathed [on them?] [Vulg. 'insufflavit'] and said to them, 'receive the Holy Spirit'" John 20:22 (RSV).] The two passages were certainly so connected in later Christian exegesis: the same breath that created man re-created him.

[Insufflation] signifies, To blow into, Gen. 2. 7. This sheweth mans soul not to be of the earth, as his body was, but of nothing, by the insufflation of God, and so differing from the spirit of beasts, Eccl. 3. 21. This word is used also, when Christ to make men new creatures, inspired his Apostles with the holy Ghost, Joh. 20. 21. [Thomas Wilson, A complete Christian dictionary wherein the significations and several acceptations of all the words mentioned in the Holy Scriptures of the Old and New Testament are fully opened, expressed, explained ... (London, 1661) p. 337.]

The Lord God, saith the Text, formed man of the dust of the ground, and breathed into his Nostrils the breath of life, and man became a living Soul. His Body made of Earth, but his Soul the Breath of God.... We must not understand it grosly; for so Breath is not attributable unto God, who is a simple and perfect Spirit; but ... as a figurative expression of God's communicating unto Man that inward Principle, whereby he lives and acts, not only in common with, but in a degree above other Animals.... The Learned P. Fagius takes notice of three things in the Text of Moses, which do conclude the Immortality of the Soul of Man. I. "Insufflatio illa Dei:" This Inspiration from God spoken of: For he that breaths into another, contributes unto him "aliquid de suo" somewhat of his own: And therefore, saith he, when our B. Saviour would communicate his Spirit to his Disciples, he did it with Insufflation, breathing on them, thereby to signifie, "se Divinum & de suo quiddam illis contribuere" [i.e., that he was himself divine and was infusing something of his own into them] . [Benjamin Camfield, A theological discourse of angels and their ministries wherein their existence, nature, number, order and offices are modestly treated of... (London, 1678) 184-185.]

The associations with creation, rebirth, initiation, and revivification created by these interconnected passages of Scripture suited insufflation for a role in baptism as it has been most commonly regarded: as figuring the waters of creation (over which the Spirit brooded); as figuring the womb of rebirth; and as figuring (in Saint Paul's metaphor) the tomb, into which the Christian joins Christ in descending, and from which the Christian likewise joins Christ in ascending, dead to the old life but made alive again in Christ. [Romans 6:3-5.]

There are also Biblical antecedents for exsufflation, properly speaking, that is, exorcistic blowing, especially the numerous Old Testament passages in which "the breath of God" is the vehicle or symbol not of life but of death and destruction--an expression of the wrath of God: "by the breath of God they perish / and by the blast of his anger they are consumed" (Job 4:9, RSV). [Cp. Isaiah 11:4 ("with the breath of his lips he shall slay the wicked").] The same power is attributed metaphorically to Christ, "The lawless one will be revealed, and the Lord Jesus will slay him with the breath of his mouth" (2 Thessalonians 2:8, RSV). Even less obvious passages could be associated with liturgical exsufflation. Jesse of Amiens, for example, interprets Psalm 34 (Vulg. 35):5 as descriptive of the fate of exsufflated devils: ""Let them be like chaff before the wind, with the angel of the Lord driving them on!" [Psalm 34:5 (RSV) (Vulg. 35:5); Jesse of Amiens, Patrologia Latina 105:786D.] And the apocryphal Acts of Thomas describes a baptismal ceremony which, though it does not explicitly contain a breathing ceremony, appears to imply one, "Let the gift come by which, breathing upon thine enemies, thou didst make them draw back and fall headlong, and let it dwell in this oil, over which we name thy holy name." [Acts of Thomas, §157; trans. in New Testament Apocrypha, ed. Edgar Hennecke; rev. by Wilhelm Schneemelcher; trans. R. McL. Wilson (Cambridge, 1992), 2:401. The Biblical allusion is apparently to John 18.6.]

God's breath can be fiery, consuming all it touches: "I will blow upon you with the fire of my wrath" (Ezekiel 21:31, RSV). [Vulg. "In igne furoris mei sufflabo in te." Cp. the fiery brimstone breath of God in Isaiah 30:33.] Some of the interpretations of exsufflation may reflect this. Cyril of Jerusalem, for example, when he discusses exsufflation in his catechetical sermons, interprets the liturgical practice in terms of fire:

The breathing of the saints and the invocation of the name of God, like fiercest flame, scorch and drive out evil spirits. [Catechesis XX.3, Patrologia Graeca 33:1079/80; trans. Gifford, 147. In the pre-catechetical lectures he seems to combine the fire of God's wrath and the Biblical motif of the refiner's fire (Malachi 3:2, 1 Peter 1:7, Revelation 3:18): "as the goldsmith..., as it were breathing on the gold which is hid in the hollow of the forge, stimulates the flame it acts upon and so obtains what he is seeking; so also exorcizers..., setting the soul on fire in the crucible of the body, make the evil spirit flee." Procatechesis §9; ed. F. L. Cross, 5-6 (Patrologia Graeca 33:347/8-349/350); trans. Cross, 45.]

Fire remains a theme in later liturgical exorcisms, for devils, as Nicetas is reported to have said, "are purged by exorcisms as by fire": [Nicetas quoted in Bouhot, De catechizandis rudibus, 225 (§67).] "we come against you, devil, with spiritual words and fiery speech; we ignite the hiding places in which you are concealed." [Liber Ordinum, ed. Férotin, 75; trans. in Kelly, 248 (cp. 237-37). Cp. Lambot, North Italian Services, 16.]

Liturgical context

More importantly, perhaps, fire is physically and symbolically associated with sufflation because of the traditional placement of baptism within the Paschal vigil--a setting heavy with symbolism of light and fire: the blessing of the Paschal candle, the lighting of the "new fire," and the singing of the "exultet" and the "lumen christi." The intimate connection between divine breath and divine fire appears in its most visually arresting form during the benediction of the font, in which, according to most orders, the candle is dipped in the font while the priest declares the power of the Holy Spirit to have descended into the water: the sufflation of the font in most cases directly precedes or accompanies the immersion of the candle. [Amalarius, Liber Officialis, I.xxv.2 (ed. Hanssens, 2:134-5) and I.xxvi (2:136-8); the Gellone Sacramentary, ed. Dumas, 99 (§704d); many manuscripts of the Hadrianum (ed. Deshusses 1:188, §374e); Ordo Romanus L xxxix.50 (ed. Andrieu 5:280-1); the Missal of Robert of Jumiège, 98-9; the York Manual, 15, 136*, 144*, 149*, 153*; Suntrup, 417-8.] Their close association can again be illustrated from Wulfstan's baptismal homilies:

By the breath that the priest breathes into the font when he blesses it, the devil is straightway driven out from it. And when the priest dips the consecrated candle in the water, then that water forthwith becomes imbued with the Holy Ghost. [Wulfstan, Homily VIIIb (ed. Bethurum, p. 173, ll. 39-43); cp. Homily VIIIa (p. 170, ll. 36-40) and Homily VIIIc (p. 179, ll. 73-6).]

Similar considerations bind sufflation closely to imagery of light and darkness, specifically of the movement of the baptizand from the kingdom of darkness into the kingdom of light (a very common theme), and to the sign of the cross (a very common action), among others that could be mentioned. On light-dark imagery, for example, consider John the Deacon:

The exsufflated person is exorcised so that ... having been delivered from the power of darkness, he might be translated into the kingdom ... of God. [Wilmart, 172; thence also in many of the Carolingian expositions, e.g. in Keefe's tet 32, ed. Friedrich Stegmüller, "Bischof Angilmodus über die Taufe...," Römische Quartalschrift für Christliche Altertumskunde und Kirchengeschichte 52 (1957): 20; and text 25, the tract by Archbishop Liedrad of Lyons, Patrologia Latina 99:856D.]

So also Augustine ("The church exsufflates and exorcises [infants] that the power of darkness might be cast out from them" [Contra Julianum (opus imperf.) 1.50, ed. Michaela Zelzer, CSEL 85/1 (Vienna, 1974), 43 (Patrologia Latina 45:1073) Cp. 3.182, CSEL 85/1, 482 (PL 45:1323); the Contra Julianum 1.4.14 (PL 44:649), 1.5.19 (PL 44:653), 3.3.8 (PL 44:705), 3.5.11 (PL 44:707-8), and 6.5.11 (PL 44:828-9); and the Ennarationes in Psalmos 76.4, ed. E. Dekkers and J. Fraipont, CCSL 39 (1956), 1055.] ), and Isidore ("The power of the devil is ... exsufflated in them, so that ... being delivered from the power of darkness, [they] might be translated unto the kingdom of their Lord" [De ecclesiastics officiis, II.xxi.3, ed. C. M. Lawson, CCSL 113 (1989), 96/20-24 (PL 83:815A), and thence into various Carolingian texts, e.g. the Pseudo-Maxentius Collectanea (= Keefe text 37), PL 106:54C.] ).

And as regards signation (the sign of the cross), in Western texts from as early as the Gelasian Sacramentary, the one gesture almost always precedes (or precedes and follows) the other, [Mohlberg, Sacramentarium Gelasianum 93 (§598) ("exsufflas in faciem eius et facis ei crucem in fronte"); the same doublet is applied to the baptismal water in the Gellone Sacramentary, ed. A. Dumas, Liber Sacramentorum Gellonensis, CCSL 159 (1981), 335 (§2317-18) and 346 (§2379), and in the North Italian rituals, ed. Lambot, 33. Signing precedes and follows in the Missale Gothicum, ed. Neale, 96-97.] and their significance is often complementary if not identical. In Raban Maur's discussion of the baptismal liturgy, for example, the exsufflation is said to expel the devil, the signing to keep him from coming back. [Alois Knöpfler, ed., Rabani Mauri de institutione clericorum, Veröffentlichungen aus dem kirchen-historischen Seminar München 5 (Munich, 1900), I.xxvii, p. 48 (PL 107:311D-12A).] The two signs are frequently combined, the blowing done in the form of a cross, e.g. in the Syrian rite described by James of Edessa, [Whitaker, Documents, 59.] in the modern Coptic rite, [Lodi, 1557] in the late ninth-century Ordo Romanus XXXI, [Andrieu, 3:502, §80 ("Anhelet in modum cruce").] in Wulfstan's Anglo-Saxon homilies and their Continental sources, [Wulfstan, Homilies (ed. Bethurum), Homily VIIIa, p. 16; Theodulf of Orleans, De ordine baptismi, PL 105:225B.] in the tenth-century Ambrosian rites for catechumen and font, [Whitaker, 143, 145] in the eleventh-century North Italian catechumenal rites, [Lambot, 5, 6, 11, 16.] in the twelfth- through fifteenth-century English pontificals, [York Manual, 144* (11th cent.), 149* (12th cent.), 150* (13th cent.), and 153* (15th cent.).] in the Sarum Missal, [J. W. Legg, ed., Sarum Missal, 129.] and in the thirteenth-century Roman pontifical. [Michel Andrieu, Le Pontifical Romain au Moyen Age (Vatican City, 1940), 2:514.]

Extra-liturgical (hagiographic and magical) use

Patristic period

There are hints in some of the Church Fathers that Christians had a habit of breathing (or hissing) at evil spirits as a recognized act of revulsion or repulsion, even apart from the ceremonies of the church. Tertullian is perhaps the best witness. He seems to be talking about an extra-liturgical casting out of demons by means of exsufflation and signing when he declares that the pagan gods, "by our touch and by our breath" are driven from the bodies of men, and are thus "carried away by the thought and vision of the fire [of judgment] ." [Tertullian, Apologeticus, 23.15-16, ed. Henricus Hoppe, CSEL 69 (1939), 67; trans. by A. Souter, Apology (Cambridge, 1917), 82/83. Cp. De Anima, 1.5, ed. J. W. Ph. Borleffs, CCSL 2 (1954), 782.] He is talking about an ordinary gesture of aversion when he asks a Christian incense-dealer (regarded as hypocritical because he sells incense for the pagan altars), "with what mouth, I ask, will he spit and blow before the fuming altars for which he himself provided? with what constancy will he [thus] exorcise his foster children?" [Tertullian, De idolatria XI.7, ed. and tr. J. H. Waszink and J. C. M. Van Winden, Vigiliae Christianae Supplements 1 (Leiden, 1987), 42-5 (commentary, 210); also ed. J. W. Ph. Borleffs, CCSL 2 (1954), 111; trans. S. Thelwall, Ante-Nicene Fathers, 3:68.] And his remarks to his wife about the dangers of mixed marriage suggest that exsufflation was a distinctively Christian practice: " [If you marry again, to a non-Christian,] shall you escape notice when you sign your bed or your body? when you blow away some impurity? When even by night you rise to pray?" [Tertullian, Ad uxorem suam II.v.3, ed. and trans. Claude Munier, Tertullien: "A son Epouse," Sources Chrétiennes 273 (Paris, 1980), 138 (CCSL 1 (1954), 389; PL 1:1296); trans. Thelwall, Ante-Nicene Fathers 4:46.]

If such a custom did exist, it would clarify certain remarks by other Fathers, which might otherwise seem merely metaphorical. Eusebius, for example, says of the saints that they were men "who though they only breathed and spoke, were able to scatter the counsels of evil demons." [Historia ecclesiastica VII.x.4, ed. Eduard Schwartz, Eusebius Werke 2.2, Griechischen Christlichen Schriftsteller der ersten drei Jahrhunderte, 9 (Leipzig, 1908), 650 (Patrologia Graeca 20:659/60); trans. Arthur C. McGiffert, Nicene and Post-Nicene Fathers, 2nd series, 1:298.] Irenaeus describes the right response to Gnostic doctrine as "reviling" (καταφυσησαντασ; literally 'exsufflantes'). ["Adversus haereses" 1.16.3, ed. A. Rousseau and Louis Doutreleau, Contre les Hérésies 1, Sources Chrétiennes 263 (Paris, 1978), 262-3. ] Cyril of Jerusalem, speaking of resisting temptation, not of baptism, says that "the mere breathing of the exorcist becomes as a fire to that unseen foe." [Catechesis 16.19, Patrologia Graeca 33:945/6A-B; trans. Gifford, Nicene Fathers, 2nd series, 7:120.] And Augustine's remarks about blowing on images of the emperor suggest that the significance of the gesture was well enough established to be actionable: "Of the great crime of lese majesty ... is he held guilty, according to the laws of this world, who blows upon an image ... of the emperor." [Contra Julianum, opus imperf. 3.199, CSEL 85/1:498 (PL 45:1333).] Even as late as Bede, we may suspect that "exsufflate" in the sense of "revile" or "cast off" may be a living metaphor. [Historia ecclesiastica, in Charles Plummer, ed., Baedae opera historica (Oxford, 1896), 1:2231 and 1:7; cp. 2:226n.]

Hagiography

The extremely influential Life of Saint Martin by Sulpicius Severus, seems to have set in motion a hagiographic tradition in which saints cast out demons or repel tempting devils by blowing at them. [Vita Sancti Martini, ed. Carl Halm, CSEL 1.206-7 (cp. the Old English version in Aelfric, Lives of the Saints, ed. W. W. Skeat, EETS 76 (1890), 292-3 (II.xxxi.42)).] Of Saint Pachomius, for example, it is said that "defending his brow with the sign of the cross, he blew upon [the demon] and immediately he fled...; blowing upon him, he said, 'depart from me, devil.'" [Quoted in a note to Benedict of Aniane's Concordia regularum, PL 103:1020C-D.] And of Saint Goswin that "a demon stood before Saint Goswin saying 'surely you see that I am Christ...' and...therefore Saint Goswin exsufflated vigorously, saying 'depart foe...,' and immediately...the devil vanished." [Anecdota ex codicibus hagiographicis Iohannis Gielemans canonici regularis in rubea valle prope Bruxelles, ed. Hagiographi Bollandiani (Brussels, 1895), 23 (Sanctilogium 9.2).] Saint Justina is reported to have similarly unmasked a series of increasingly subtle and powerful demons, finally melting the prince of demons himself: "blowing upon the devil, she immediately melted him like wax and...felt herself freed from all temptation." [Th. Graese, ed., Jacobi Voragine Legenda Aurea..., 3rd ed. (Vratislaviae, 1890), cap. cxlii (p. 634; cp. 633).] And Saint Felix is said to have destroyed idols and uprooted (pagan) sacred trees by like means. [Graesse, ed., Legenda Aurea, cap. cxxvi (p.575) and cap. xix (102-3).]

The breath of the saints was credited with healing, as well as exorcistic, powers from an early period. Gregory of Nyssa says of Gregory Thaumaturgus ('Gregory the magician') that he needed to resort to "no finicking and laborious" magic, but "there sufficed, for both the casting out of demons and the healing of bodily ailments, the breath of his mouth." [PG 46:943/4A.] Similar powers are attributed to the Irish saints: kindling lamps, curing dumbness. [Charles Plummer, ed., Vitae Sanctorum Hiberniae (Oxford, 1910), 1:clxxviii.] This theme, too, persists in later hagiographic and quasi-hagiographic texts, appearing, for example in the Estoire del saint graal as the agency by which a madman is miraculously restored. Among English texts, Felix's Life of Saint Guthlac relates that in order to give relief to a boy afflicted by madness, he "washed him in the water of the sacred font and, breathing into his face the breath of healing [or 'spirit of salvation'] , drove away from him all the power of the evil spirit," [Bertram Colgrave, ed. and trans., Felix's Life of Saint Guthlac (Cambridge, 1956), 130/31.] illustrating the difficulty of distinguishing healing from exorcism in an era in which madness was attributed to demonic possession. The miracle that Bishop John performed, according to Bede, on behalf of Herebald, is another example, since it involved a sufflation that was seemingly exorcistic, catechetical, and curative simultaneously. [Bede, Historia ecclesiastica 5.6 (Plummer, 291; see also B. Colgrave and R. A. B. Myonrs, Bede's Ecclesastical History (Oxford, 1969), 468 note.]

Magic and folk medicine

It is difficult to draw a clear line between religious and magical uses of exsufflation: between legends of saints and legends of sorcerers, between magical and liturgical ceremonies, or indeed between beliefs and fictions. The religious use may in fact derive at least in part from magic, and certainly many folkloristic and magical uses (as commonly) were heavily influenced by liturgical ritual. Tertullian's remarks to his wife about Christian practices recognize this fact, since they conclude, "will you not seem to be doing magic?" i.e., in the eyes of a non-believer. [Ad uxorem II.v.3 (ed. Munier, 138). For additional references to blowing in ancient magic, see Waszink's and Van Winden's notes to Tertullian's De idolatria, 210.]

Celsus (according to Origen) reports the use of exufflation by Egyptian magicians. [Origen, "Contra Celsum" 1.68, ed. Marcel Borret, Origène: "Contre Celse," 1, Sources Chrétiennes 132 (Paris, 1967), 266 (PG 11:787/788A).] Plotinus seems to attack its use by Roman ones. [Plotinus, Enneads, II.ix.14, ed. and trans. A. H. Armstrong, Loeb Classical Library, vol. 2 (Cambridge, Mass., 1966), pp. 278/9.] One of Lucian's tall tales mentions a Chaldean pest-control sorcerer who causes toads and snakes to vanish by blowing on them. [M. D. Macleod, ed., Luciani opera, vol. 2 (Oxford, 1974), 182; trans. in "The Liar," The Works of Lucian of Samosata, trans. H. W. and F. G. Fowler, vol. 3 (Oxford, 1905), 236.] But it is possible to regard Jesus himself as a magician in at least one popular event in the apocryphal infancy gospels, in which he is portrayed as using sufflation in order simultaneously to heal his brother of a snakebite and kill the snake; [Gospel of Thomas, Greek text, Rescension A, cap. 16: Greek text in Constantin von Tischendorf, Evangelia apocrypha..., 2nd ed. (Leipzig, 1876), 154-5; English trans. in Wilhelm Schneemelcher, New Testament Apocrypha, 1:448 or M. R. James, Apocryphal New Testament (Oxford, 1924), 53-4. Also in the Latin version of the Gospel, chap. 14 (Tischendorf, 178; James, 65). And thence in the seminal Pseudo-Matthew gospel, chapter 41 (Tischendorf, 110). Finally, thence in the Syriac infancy gospel printed by E. A. Wallis Budge as The History of the Blessed Virgin Mary and the History of the Likeness of Christ..., 2 vols. (London, 1899), 73.] also in a rarer episode in which Jesus raises a boy from the dead by breathing on him. [Paris MS. of the Pseudo-Matthew, according to Tischendorf, Evangelia apocrypha, p. 178n.] Christianized healing magic, if that is what it is, appears also in Syria, where ceremonial breathing became formalized as part of the rite of visitation of the sick. Ephraem Syrus advises that "if medicine fails you when you are sick, the 'visitors' will help, will pray for health, and one of them will breathe in your mouth, the other will sign you [with the sign of the cross] ." [Quoted by Döger, Exorzismus, 125n.]

Whether it be originally Christian or originally pagan, similar methods of healing have been reported persisting till modern times: in Westphalia, the healing of a wound by triple signing and triple cruciform sufflation, or by exsufflation accompanied by a rhyming charm; and in Holland the alleviation of toothache by similar means. [Dölger, 125.] According to Drechsler, "Illnesses were blown away by the breath. If a child had bumped himself, one would blow three times on the place and it would 'fly away.'" [Paul Drechsler, Sitte, Brauch, und Volksglaube im Schlesien, vol. 2 (Leipzig, 1906), 280. Cp. 298 and chapter 14, "passim."] Burns, and conditions that in some fashion resemble burns, such as fevers, boils, sore throats and rashes, are naturally the most common objects of blowing among modern folk-remedies, [See HddA, i, "s.v." "Blasen," cols. 1357-58. See also from the Puckett collections nos. 6943, 8329, and 8401 (alleviation of a burn); 2750, 2889, 2890, 10566, and 2898 (thrush and sore mouth); and 9277 and 9279 (erysipelas): Popular Beliefs and Superstitions: A Compendium of American Folklore from the...Collection of Newbell Niles Puckett, ed. Wayland D. Hand, Anna Casetta, and Sondra B. Thiederman, 3 vols. (Boston, 1981).] for example the Shetland cure that requires blowing on a burn three times while reciting the charm "Here come I to cure a burnt sore. / If the dead knew what the living endure, / The burnt sore would burn no more." [T. F. Thiselton-Dyer, English Folklore, 2nd rev. ed. (London, 1880), 170.] But everything from jaundice, convulsions, and colic to bad luck and evil spells can apparently be alleviated by a bit of blowing. [HddA, "loc. cit."; cp. also the Puckett collection, nos. 23714, 23956, 23957, 9215, 25571, 19545, 9563, etc.] Wolters points out that exorcistic blowing was still (in 1935) found in the custom of blowing over bread that is about to be eaten. [Wolters cites Drechsler 2:15, a passage that describes how to avert the bad luck of biting into a piece of bread already bitten.] Moreover,

A Syrian blows over his child to avert the evil eye. Some still blow three times over a strange spoon before using it, and in Alaska the medicine man blows into the nose and mouth of a patient to drive out the daemon of disease. [Xavier F. M. G. Wolters, Notes on Antique Folklore on the basis of Pliny's "Natural History" Bk. XXVIII.22-29 (Amsterdam, 1935), 102.]

Finally, in one American example of superstition clearly derived from liturgical use, it is said that if at the baptism of a baby one turns at the door and blows three times, one can successfully prevent the devil from ever coming between the baby and the altar. [Puckett Collection, no. 3294 (reported from Cleveland, Ohio, 1956).]

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