although he do not receive the Sacrament with his mouth

I'm preparing for the second in a series of workshops on anointing and healing prayer, and tonight we are going to do some reflection on the rite as it appears in the Book of Alternative Services. I thought I would look at the Canadian Book of Common Prayer (1959), and I found this rubric:

But if a man, either by reason of extremity of sickness, or for
want of warning in due time to the Curate, or by any other just
impediment, do not receive the Sacrament of Christ’s Body and
Blood: he shall be instructed that if he do truly repent him of his
sins, and stedfastly believe that Jesus Christ hath suffered death
upon the Cross for him, and shed his Blood for his redemption,
earnestly remembering the benefits he hath thereby, and giving
him hearty thanks therefor; he doth eat and drink the Body and
Blood of our Saviour Christ profitably to his soul’s health,
although he do not receive the Sacrament with his mouth.

Repentance, believing in the redemption wrought on the cross, remembering the benefits of the crucifixion, and thankfulness for what was accomplished on the cross: this is a spiritual posture that results in the actual reception of communion, even of the bread and wine are absent.

Perhaps remembrance of the resurrection would lighten the mood of this particular liturgical doctrine, but talk about strong, theological, pastoral and liturgical teaching! Yes, you can have communion, even if the Curate is absent.

But this is not just a situational liturgical ethic. The doctrine of spiritual communion in the absence of a Curate is possible because it points to the significance that lies behind the sacrament, combining a strength of teaching that makes sense of a particual pastoral provision through the consideration of real life circumstance - a person is dying and the priest is stuck in the mud somewhere. So what do you do? Offer them communion anyway. It may start with a particular situation, but the provision is not simply responsive to the situation, but rather draws upon theological resources in order to make a certain pastoral response possible.

All that to say: pastoral discipline and doctrine are not so easily separated. When we do separate them, they both tend to dissolve in our hands, because pastoral responses are most sensible within the context of doctrine, and doctrine becomes intelligible through our pastoral practices. Pastoral liturgical responses are good when they draw upon a particular strand of a common tradition, because when we do that, a particular situational response becomes comprehensible to all who are held within this common tradition.

And the miracle of spiritual communion, the reception of bread and wine even in their very absence, makes sense - because we already understand the sacrament of communion through repentance and the recollection of the crucifixion and it's benefits. The recollection and practice of the doctrine of the crucifixion becomes sufficient for this particular miracle, spiritual communion.