Responsa for Berakhot 108:13

יורדי הים מנלן דכתיב (תהלים קז, כג) יורדי הים באניות וגו' המה ראו מעשי ה' ואומר ויעמד רוח סערה יעלו שמים ירדו תהומות ואומר יחוגו וינועו כשכור ואומר ויצעקו אל ה' בצר להם וממצוקותיהם יוציאם ואומר יקם סערה לדממה ואומר וישמחו כי ישתוקו ואומר יודו לה' חסדו ונפלאותיו לבני אדם

"They who go down to the sea" — whence have we this ? For it is written, "They that go down to the sea in ships... these saw the works of the Lord... He raised the stormy wind... They mounted up to the heaven, they went down to the deeps... They reeled to and fro, and staggered like a drunken man... They cried unto the Lord in their trouble, and He brought them out of their distresses. He made the storm a calm... Then were they glad because they were quiet... Let them give thanks unto the Lord for His mercy, and for His wonderful works to the children of men" (Ps. cvii. 23-31).

Shut min haShamayim

They responded to the first question: "Lift your hands to the sacred!" (Psalms 134:2) Namely, wash your hands whenever you want to speak sacred words or study Torah. "And bless God!" (ibid.) - with the blessing instituted for washing hands. As for the second question, they responded: Do you not know that four need to give thanks (Berachot 54b:12), and this includes one who was sick. And none are more sick than such a person [who relieves themself], as it says (Isaiah 51:14): "Quickly the crouching one is freed."²cf. Rashi on Isaiah 51:14

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