Therefore links what follows with the previous verse. The prophet’s reaction in verses 3-4 is caused by his troubling vision about an attack by Elam and Media on Babylonia. Good News Translation leaves this connector implied. Verse 3a refers to the prophet’s physical state (loins) and verse 4 to his mental state (“mind”). Verse 3b describes why he is unable to hear and see.

My loins are filled with anguish: The Hebrew word rendered loins refers to the part of the body just below the waist. In Hebrew culture it was the place where strength was generated (see Psa 69.23), and where emotions resided. Here it is where the prophet felt pain and grief. Translators will need to use an appropriate term to convey that sense; for example, “heart,” “liver,” “limbs” (Revised English Bible), or “body” (New International Version). For my loins, Good News Translation simply says “me” (similarly Contemporary English Version). Anguish renders a Hebrew noun that comes from a root meaning “dance” or “writhe.” It refers to the physical action of dancing that is caused by pain and inner emotional turmoil. This Hebrew noun is onomatopoeic since the basic root is repeated (chul becomes chalchalah). The prophet uses this graphic term to express his strong reaction to the vision.

Pangs have seized me, like the pangs of a woman in travail: The intensity of the prophet’s pain is compared to that of a woman giving birth. This is a typical expression in the Old Testament (see 13.8; 26.17; 42.14; Jer 13.21; 22.23; 48.41; Hos 13.13). In some cultures it is not appropriate to refer openly to this natural process. If so, an alternative that mentions only the suddenness of acute pain without referring to a woman in childbirth will have to be found.

I am bowed down so that I cannot hear, I am dismayed so that I cannot see: These two parallel sentences further describe the prophet’s reaction to his vision. The main verbs are passive, but no agent is mentioned. So renders the Hebrew preposition min, which can have a variety of meanings when attached to infinitive construct verbs, as is the case here. It has two possible senses here:

(1) It may introduce a cause. A model that expresses this is “I am bowed down because of what I heard, I am dismayed because of what I saw” (similarly Good News Translation, New International Version, Bible en français courant, Die Bibel im heutigen Deutsch).
(2) It may introduce a negative result, as in RSV/NRSV with I am bowed down so that I cannot hear, I am dismayed so that I cannot see (similarly Contemporary English Version, Revised English Bible, New Jerusalem Bible, New Jewish Publication Society’s Tanakh).

Translators may choose either interpretation, but we prefer the first one. It seems more logical to consider what the prophet hears and sees as the cause of his distress, rather than his loss of hearing and sight as the result of it. He is distressed because of his vision, as he states in the first half of this verse.

I am bowed down means literally that the prophet is physically bent over, as if he were carrying a heavy burden. Obviously the verb here is used figuratively, in the sense of “distressed/anguished.” The Hebrew verb rendered dismayed actually refers to being terrified. See the comments on this verb at 13.8 (see also Job 23.15-16).

Consider the following examples for this verse:

• Therefore my whole being is full of anguish;
sharp pain seizes me as it does a woman giving birth.
I am overburdened by what I heard,
terrified by what I saw.

• So I am filled with a deep anguish;
stabbing pain grips me like a woman in childbirth.
I am crippled by what I have heard,
in terror because of what I have seen.

Quoted with permission from Ogden, Graham S. and Sterk, Jan. A Handbook on Isaiah. (UBS Helps for Translators). New York: UBS, 2011. For this and other handbooks for translators see here .