The argument that continues in verses 6 and 7 is that it is all right for people who are suffering bodily pain and mental distress to use intoxicating drinks, but “not for kings” (verse 4).

“Give strong drink to him who is perishing”: “Strong drink” and “wine” are the same terms as in verse 4. “Give” is an imperative, but in the context of the whole saying this does not seem to be a command to go and supply alcohol to all the people mentioned in verses 6 and 7. It is rather that “alcohol is [useful] for those who are. . .”; see Good News Translation and also Contemporary English Version “Beer and wine are only for. . ..” “Him who is perishing” is taken by many to mean “someone about to die” (New Jerusalem Bible) or “people who are dying” (Good News Translation).

“And wine to those in bitter distress”: This adds another group to those mentioned in the previous line. “In bitter distress” is literally “to those who are bitter of soul”; Scott renders this as “whose life is bitter,” New International Version “who are in anguish,” Good News Translation “who are in misery,” and Contemporary English Version “who have lost all hope.” Languages often have their own idiomatic ways of expressing discouraged people, such as “people who have big heavy things.”

Quoted with permission from Reyburn, William D. and Fry, Euan McG. A Handbook on Proverbs. (UBS Helps for Translators). New York: UBS, 2000. For this and other handbooks for translators see here .