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A more literal translation of this verse would be, "O Lord, not in Your anger rebuke me; not in Your wrath chasten me." By putting the negative first, David emphasized the manner of the Lord’s discipline. David knew his was no ordinary illness, but God had sent it as the consequence of some sin. He felt God was dealing with him very severely and despaired of enduring much more suffering. Sometimes the Lord’s discipline can be so harsh that we may conclude, falsely, that He is angry with us.
1. Plea for relief 6:1-3
Many interpreters consider this one of the penitential psalms in which David repented for some sin he had committed and for which he was suffering discipline (cf. Psalms 32, 38, 51, 102, 130, 143). [Note: See the excursus on the penitential psalms in Chisholm, pp. 301-2.] This is the first of the seven.
"It was the practice of the early Christians to sing and read the [penitential] psalms on Ash Wednesday as part of their penance for sin. In a strict sense, however, it is not a penitence psalm, for there is no confession of sin or prayer for forgiveness. The psalm is now categorized as an individual lament psalm." [Note: VanGemeren, p. 96.]
Other individual lament psalms are 3-5, 7, 11, 13, 17, 22-23, 27, 31-32, 35, 38-39, 41, 51, 57, 63, 69, 71, 88, 102-103, and 130. We do not know what David did to bring on this illness that almost resulted in his death or how this incident fits into the Scriptural record of his life. Having been chastened by the Lord, David asked for forgiveness. Then, with the assurance that God had heard him, he warned his adversaries to leave him alone because God was about to shame them.
". . . the psalm gives words to those who scarcely have the heart to pray, and brings them within sight of victory." [Note: Kidner, p. 61. Cf. John 12:27.]
The king then expressed his request positively. He begged for relief from his extreme discomfort. David spoke of his bones as representing his whole body (cf. Psalms 31:10; Psalms 32:3; Psalms 38:3; Psalms 42:10; Psalms 102:3; Psalms 102:5). This is a figure of speech called synecdoche in which the writer uses a prominent part in place of the whole.
His suffering was not just physical. It had led to the distress of his soul (Heb. nephesh, entire life) as well. "How long?" expresses the frustration he felt.
David first appealed for deliverance from his ailment, claiming God’s loyal love to him. God had promised to bless David and had delivered him many times before. The king besought Him to prove faithful to His character and save him again.
2. Prayer for deliverance 6:4-5
The second reason David cited was this. If he died, he could not give God public praise for delivering him, and God would therefore not receive as much honor among His people as He would if He spared David’s life. Believers in David’s time had some revelation of life after death (cf. Job 19:25). David’s expression here does not deny that knowledge. He was saying God would lose praise among the living if David died. Sheol was the place where Old Testament saints believed the spirits of the dead went. This term often occurs in the Old Testament as a synonym for death and the grave.
3. Lament over illness 6:6-7
David described his condition in extreme (hyperbolic) language to indicate how terrible he felt. Evidently his adversaries had been responsible for his condition to some extent, perhaps by inflicting a wound.
"From my own experience and pastoral ministry, I’ve learned that sickness and pain either make us better or bitter, and the difference is faith." [Note: Wiersbe, The . . . Wisdom . . ., p. 100.]
4. Assurance of recovery 6:8-10
Apparently David received an answer to his petition. It may have come through a prophet or just the inner conviction that he would recover (cf. Psalms 20:6; Psalms 22:21; Psalms 28:6; Psalms 31:19; Psalms 56:9; Psalms 69:30; Psalms 140:13). In any case, he closed the psalm with a warning to his adversaries (Psalms 6:8) to get out of his way. He was on the mend and would frustrate their attempts to supplant him. Jesus may have quoted the first part of this verse to Satan (Matthew 7:23).
Physical sickness is sometimes, but not always, chastening from the Lord (cf. 1 Corinthians 11:30; 1 John 5:16; Job 1-2). God does not always grant recovery to His saints. Consequently believers should not use this psalm to claim physical healing from the Lord. Nevertheless, sometimes God does remove His hand of chastening in response to prayer (cf. Exodus 32:9-14; James 5:13-16). This psalm is a good example of a prayer for deliverance based on the grace (Psalms 6:2), loyal love (Psalms 6:4), and glory (Psalms 6:5) of God. God will or will not grant all such petitions, ultimately, on the basis of His sovereign will (Mark 14:36).
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Constable, Thomas. DD. "Commentary on Psalms 6". "Dr. Constable's Expository Notes". https://www.studylight.org/
the Week of Proper 8 / Ordinary 13