On 12 February 1612 Karmah was consecrated metropolitan bishop of Aleppo by Patriarch Athanasius II Dabbas, and he took the name of the saint of that day, ‘’Meletios’’.
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A few months after the bloody death of Patriarch Ignatius III Atiyah, he was elected as new Patriarch by the Christians of Damascus and consecrated on 1 May 1634, taking the name of Euthimios III.