איוב, פרק ל׳, פסוק י״ז

Under the cover of darkness, the agony of severe illness reaches a breaking point, creating a sensation that the body is collapsing from both within and without. The night, rather than offering relief, becomes a time of unbearable heaviness that strips away any chance of rest. The pain penetrates so deeply that it feels as though the bones themselves are being shattered and forcefully pierced by a hammer [מצודת ציון, רלב״ג, מלבי״ם, ביאור שטיינזלץ, תקות אנוש]. Some interpret this deep aching as the physical manifestation of extreme poverty and hardship gnawing at the skeletal frame [אבן עזרא]. Others understand this physical devastation even more graphically, describing worms eating away the flesh directly off the bone [רש״י], or a terrible sensation that the bones have been entirely stripped and violently torn away from the body's soft tissues [אלשיך].

The primary approach among commentators views this ongoing internal torment as a relentless pounding of the veins and blood vessels [רש״י, אבן עזרא, רמב״ן, מצודת ציון]. Even during the quiet hours meant for sleep, the body refuses to settle. Intense pain and the burning heat of a high fever cause the pulse to throb forcefully and constantly [מצודת דוד, רלב״ג, מלבי״ם, תקות אנוש]. This endless beating is also described as a feeling that the blood vessels have been painfully severed from their natural place in the body [אלשיך].

Alternatively, this restless state is seen not as a bodily affliction, but as a reference to external threats. In this view, it is the people pursuing and hunting the sufferer who refuse to rest. Instead of sleeping through the night, these enemies actively prepare and rise early in the morning to confront him [רש״י, רמב״ן]. However, this perspective is challenged by those who maintain that the entire focus of the surrounding events is strictly on internal, physical deterioration, leaving no room for the sudden mention of human adversaries [תקות אנוש].