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This verse succinctly states the lesson this whole psalm teaches. God blesses people who take care of those who cannot care for themselves, and He delivers them when they need help. "Blessed is" begins and closes the first book of Psalms (cf. Psalms 1:1), forming an inclusio or envelope for this part of the collection.
1. God’s blessings on the merciful 41:1-3
David assured the godly in this thanksgiving psalm that those who help the needy would experience deliverance themselves from the Lord. He had learned this lesson through a difficult experience, to which he referred.
More specific blessings are protection, long life, a good reputation on earth, protection from enemies, sustenance in sickness, and restoration to health. In the Mosaic Law, God’s promised blessings for the righteous were mainly physical, though there were spiritual blessings too. Under the Law of Christ (Galatians 6:2), most blessings are spiritual, though some are physical.
David had been in need of help at some time in the past. Apparently he had sinned and God had punished him with sickness. He then cried out to God for help.
2. God’s punishment of the treacherous 41:4-9
David continued to address the congregation of Israel, and he presented the alternative to caring for the helpless with its consequences. He did this by relating a personal experience.
His enemies, rather than being merciful, took advantage of his weakness. They hoped for his death, spoke hypocritically to him when they visited him, and spread gossip that he would not survive.
Even a former genuine friend of David had turned against him. Ahithophel, who betrayed David and then hanged himself (2 Samuel 16:20 to 2Sa_17:3; 2Sa_17:23), did this. Yet it is not certain that he was the person the psalmist had in mind here. David had more than one friend who later turned against him. Jesus quoted this verse and applied it to Judas (John 13:18).
David had asked God to restore his health so he might repay his enemies. This may seem to be an unworthy motive in view of the Lord Jesus’ instruction to love our enemies and do them good (Matthew 5:44). However, individuals in David’s time who opposed the Lord’s anointed king were opposing the Lord. The king was God’s agent of judgment in Israel. This situation has no direct parallel in the church.
3. God’s deliverance of the upright 41:10-13
The psalmist regarded his continuing success over his enemies as a sign that God was pleased with him. God had upheld him because he continued to do right. He was confident this situation would continue forever.
David concluded with a doxology. He was sure God would show mercy to those who were merciful. This consistency is in harmony with God’s character, and it had proved true in David’s personal experience. "Blessed" (Heb. baruk) means praiseworthy.
This verse also appropriately concludes the first major section of the Book of Psalms (chs. 1-41).
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Constable, Thomas. DD. "Commentary on Psalms 41". "Expository Notes of Dr. Thomas Constable". https://www.studylight.org/
the Week of Proper 13 / Ordinary 18