The main fact to be noticed in the history of Eucharistic doctrine in the East from the sixth century to the present time is the continuance and unanimity of the teaching that the consecrated elements are the body and blood of Christ, that the consecration is effected by the work of the Holy Ghost elicited by the invocation of Him in the Liturgy, and that the Eucharist is a sacrificial presentation of Christ to God. In the earliest part of the period and often afterwards there is a tendency to confuse the outward and the inward parts of the Sacraments; from the eighth century onwards a distinction is clearly made that before consecration the elements are the image of the body of Christ, and that, on becoming His actual body at the consecration, they cease to be the image; in the fifteenth and later centuries elaborate distinctions are found between the substance and the accidents and between the natural and the sacramental presence of Christ, and the word Transubstantiation is used. The idea of the sacrifice during the greater part of the period is that of one sacrifice pleaded on the cross, in heaven, and on the altar, though in the latter part of it the connection between our Lord’s heavenly offering and the offering of the Eucharist is but seldom expressed. The description of the elements before consecration as the image of Christ’s body, taken with the way of regarding images customary in the East, is associated with the setting forth of the stages of Christ’s earthly life, passion, resurrection, and ascension in the Liturgy as a sacrificial presentation.