tc The consonants of the Hebrew text of this verse are similar to the consonants in v. 19. The LXX has a much longer reading: “Like vinegar is bad for a wound, so a pain that afflicts the body afflicts the heart. Like a moth in a garment, and a worm in wood, so the pain of a man wounds the heart” (NRSV follows much of the LXX reading; NAB follows only the second sentence of the LXX reading). The idea that v. 20 is a dittogram is not very convincing; and the Greek version is too far removed to be of help in the matter.

tn The second simile mentions pouring vinegar on soda. The LXX has “scab,” but that does not fit as a sensitive thing. The reference is to sodium carbonate (natural in Egypt) which can be neutralized with vinegar.

sn It is inappropriate and counterproductive to sing songs to a heavy heart. One needs to be sensitive to others (e.g., 1 Sam 19:9).