Comments on English Translation of Common Terms in Traditional Chinese Medicine 對於《中醫藥常用名詞術語英譯》的一些意見

This paper offers criticism of “English Translation of Common Terms in Chinese Medicine”(2004) by Professor Xie Zhufan. Criticisms of specific term choices are listed under the following headings: 1. Selection of Chinese Terms; 2. Poor Term Choices; 3. Poor Grammar and Style; 4. One Term with Multiple Translations (Inconsistency); 5. Multiple Terms with one Translation; 6. Overuse of Pinyin; 7. Overuse of Modern Medical Terms. Introduction The Western Pacific Regional Office of the World Health Organization in collaboration with the SATCM held a meeting in Běijīng on 20 and 21 October, 20004, to discuss the standardization of Chinese medical Terms. The most important outcome of the meeting was to select English Translation of Common Terms in Traditional Chinese Medicine as the basis for further discussion of English terms of East Asian Medicine (EAM). In order to help to ensure the healthy development of the discussion, I offer some comments. Professor Xie has many years’ experience in English terms translation. The terms his English Translation of Common Terms in Traditional Chinese Medicine, published in 2004 by Zhōngguó Yīyào Chūbǎnshè中國中醫藥出版社 represents a great improvement over those of many Chinese-English Chinese medical terms lists because it asserts literal translation (loan translation) and avoids periphrastic equivalents (long explanations instead of terms). I am delighted that he has adopted many of the termed coined by myself and my colleagues. However, English Translation of Common Terms in Traditional Chinese Medicine, still contains many elements that are worthy of discussion. 1. Choice of Chinese Terms A list of terms intended as a standard should include all basic terms. English Translation of Common Terms in Traditional Chinese Medicine does not contain脅, 九竅, 煩, 心煩, 躁, 狂躁, 煩 燥 , 食欲不振 , 不思飲食 , 飲食少思 , 便難 , 歷節風 , 痛風 , 腸癰 , 清熱解毒 , 癥瘕積聚 . It includes infrequently used terms such as 瘀痰證, 流金凌木, 齠齔. Common phrases such as 心藏神, 肝開竅於目, 腎主骨生髓 that are used as terms in EAM medicine as missing. Prof Xie believes that phrases containing verbs have not place in a terms list. However, Chinese dictionaries of Chinese medicine all include such terms. Furthermore, to create a standardized language of Chinese medicine it is important for these terms to have a standard rendering. Finally, English Translation of Common Terms in Traditional Chinese Medicine in the diseases sections includes numerous modern medical terms. Although integrated Chinese and Western medicine uses many modern medical terms, there is no need to include them in a list of Chinese medical terms, since they can be accessed in Western medical dictionaries. In the following discussion the bracketed terms are page numbers in English Translation of Common Terms in Traditional Chinese Medicine. 2. Poor Term Choices Poor term choice means the choice of an English term that does not convey the meaning of the Chinese term or is no better than a widely used term. 五行 five elements [2]: “element” means a simple substance. This translation makes the five elements seem similar to the Four Elements of ancient Greek philosophy. The character行 means movement, not element. Most English-speaking translators for many years have translated the term as “five phases.” It seems pointless to promote the inferior translation “five elements” any longer. 君火 monarch fire [3]: “sovereign fire” is widely used in English-speaking countries. 營 nutrient [4]: The character 營 originally mean military camp. As a verb it is used to mean supply, transportation, management, and construction. In Chinese medicine, this 營 is paired with 衛. Both are military metaphors. 營 originally had nothing to do with “nutrition.” In the modern term 營養, nutrition, 營 means to supply. This problem is also seen on pages 92–93. 涎, 唾 (thin) saliva, (thick) saliva [5]: English has “drool” and “spittle,” whose meanings are very close to the Chinese涎 and唾. 三焦 triple energizer [6]: “energizer” comes from “energy,” which is often inappropriately used to represent 氣. Professor Xie himself no longer uses “energy” as the translation of 氣. The三焦 is related to qì, but it is also related water. So the term “triple energizer” does not cover the whole meaning of the Chinese term. “Triple energizer” is a term adopted by the WHO, but no Western translator use this term. 神明 mental activity [7]: 神 is the basis of consciousness and mental activity. It is not mental activity itself. 血脈 (1) blood vessel (2) blood circulation [7]: 血脈 in ancient literature meant 血 and 脈, not blood vessel. “Blood circulation” to English readers means the blood circulation system as anatomically understood in modern medicine. I use “blood and vessels.” 宣散 dispersion [8]: 宣散 means spread and fullfil its potential. “Dispersion” means spread and destroy. This is not the intended meaning. 經 meridian [9]: “meridian” is an astronomical term. Historians now believe that the physiological model of Chinese medicine in its formative period was influenced by the unification of China under the Qin. Just as parts of the country were joined together by roads, canals, and navigable rivers, so parts of the body were joined together by communication lines called 經. Hence the term “channel” is preferable to “meridian.” Channel is now more commonly used in English-speaking countries than meridian. 太陽, 陽明, 少陽等經絡名稱 taiyang, yangming, shaoyang [9]: In English-speaking countries, the pinyin terms are most commonly used. However, there should also be literal translations that explain the meaning of the terms for those who do not speak Chinese. 肌 muscle [11]: In ancient literature, 肌 meant the same as 肉, which, in modern anatomical terms, includes muscle and fat. The only correct translation is “flesh.” 筋 tendon [11]: The Chinese 筋 means the palpable elongated firm parts in the flesh corresponding in modern anatomy to tendons and muscles. Prof Xie is aware of this because he sometimes translates the term as “muscle.” See Single Terms with Multiple Translations below. 淚泉 lacrimal gland [14]: gland (腺)is a western medical concept. 泉 means spring and should be translated as such. 大/小眥 big/small canthus [14]: big/small are excessively, greater/lesser would be more appropriate. 邪 pathogen [16]: “pathogen” is widely used in English countries. It means a disease-causing entity (致病因素). “Pathogen” conceals the original metaphor. I use the literal translation “evil,” and this is also widely accepted in English-speaking countries. 虛, 實 deficiency, excess [22]: 虛實 and 不足, 有餘 are not entirely the same. “Deficiency” and “excess” mean not enough (insufficient) and too much. 虛, 實 emphasize the response of the body to insufficiency and superabundance. In view of the fact that holism is a major feature of Chinese medicine, this difference should be brought out in translation. I use “vacuity” and “repletion.” 脫 prostration/collapse [28, 29]: 脫 means to leave, shed. The ancient Chinese chose this term because they believed that qì could leave the body. Prostration means physical exhaustion that confines the patient to lying posture. “Collapse” means falling (due to syncope). Neither “prostration” nor “collapse” can express the idea of陽氣外脫. I used desertion (陽氣外脫 outward desertion of yáng qì). 大腸寒結 cold retention in large intestine [39]: 結 means to congeal, thicken, gather, concentrate. “Retention” means withholding. I use “bind.” 司外揣內 predict the interior by inspecting the interior [45]: “predict: means to declare in advance. 揣 means to speculate or surmise. I use “judge” (judging the inside by the outside). 近血 nearby bleeding [47]: “nearby” means close at hand. “Proximal” means close to a designated point (in this case the anus), and hence is better. Similarly, “distal bleeding” is better than “distant bleeding” (遠血). 裂紋舌 cracked tongue [48]: “cracked” means that the skin is broke and blood and flesh are showing. This is not what is meant in the context of the tongue, where the skin is not broken. 膩苔 greasy coating [49]: “greasy” means fatty or oil. The word “slimy” is the correct term. 問診 interrogation [51]: “interrogation” means ask questions, often with the sense of not sparing the feelings of the person interrogated (as in the case of criminals). I use “inquiry,” as many other translators. 身熱夜甚 fever aggravated at night [52]: “aggravate” is a transitive verb. “Aggravated” is usually follow by “by (the agent).” “Fever worsening at night” is the correct way to express the idea. 手足厥冷 cold hands and feet [52]: 手足厥冷 means severe cold in the extremities up to the elbows and knees due to a serious recession of yáng qì from the periphery. “Reversal cold of the extremities” expresses this idea, and English speaking students and practitioners are all familiar with this specially coined term. The same applies to 厥逆 as “coldness of the extremities.” 脘痛 epigastric pain [54]: “epigastrium” is modern medical terms meaning the upper part of the abdomen (上腹), it is equivalent to what is called 大腹 in Chinese medicine. 脘 is smaller in scope. 怪脈 paradoxical pulse [62]: 怪脈 is strange, rarely encountered pulse. “Paradoxical” means seeming to be true but actually false. I translate the term as “strange pulse.” 疾脈 swift pulse [62]: 疾脈 that is even more rapid than the rapid pulse (數脈). “Swift” means rapid, speedy, or prompt. It usually describes the positive aspect aspects of speed. I use “racing.” 陽虛水泛證 syndrome/pattern of yang deficiency and water diffusion [64]: 陽虛水泛 means water swelling (水腫) or phlegm-rheum (痰飲) due to kidney yáng vacuity (腎陽虛). “Diffusion” means spreading out. It could be used for 水腫, but it is not suitable for 痰飲, which means fluid concentrating in a particular location. The same applies to腎虛水泛證 [87]. The best word is “flood” (yáng vacuity water flood). 飲證 fluid-retention syndrome/pattern [76, 109]: 飲 is paired with痰. 景岳全書.痰飲論證 states, “飲清澈而痰稠濁”. Professor Xie (quite acceptably) translates 痰 as phlegm, but translates飲 as fluid retention. “Fluid retention” suggests a phenomenon, not a thing (while phlegm is a thing). “Phlegm" and “fluid retention” in English suggest two different categories, where 痰飲 in Chinese is simply two different, but similar things. I use “phlegm” for 痰 and “rheum” for 飲. 心虛膽怯證 syndrome/pattern of heart insufficiency with timidity [78]: 中醫大詞典 says: 心虛膽怯 證 “多因心血或心氣不足,膽氣怯弱所致”。Professor Xie's English equivalent does not contain the word gallbladder. (See also Single Terms with Multiple Translations, 虛實 [88, 22])。 脾虛濕困 syndrome/pattern of spleen insufficiency with damp harassment [81]: 困 means to be trapped or unable to extricate itself/oneself. Harass means to disturb, interfere (騷擾)。Dampness is a yīn evil, it does not cause any active effect like harassment. I use “encumber.” The same applies to 寒濕困脾證 on page 82. 太陽傷寒(證)cold-induced taiyang syndrome/pattern [90]: 傷寒 can be translated literally as cold damage. There is no need to translate it as “cold-induced.” When 傷寒 appears as an independent noun (without the word 證), “cold damage” can still but used, but “cold-induced” requires the addition of a word such as disease. There is no need for this. 濕熱蒸口證 syndrome/pattern of damp-heat inflammation of the mouth [100]: “inflammation” is a modern medical concept. I use “damp-heat steaming into the mouth.” This metaphor is quite intelligible to Westerners. 傷濕 dampness ailment [101]: 傷濕 means 傷於外濕. Dampness ailment means 濕病. I use “dampness damage.” 冒濕 dampness affliction [101]: 冒 means invade, while affliction means “illness.” 疫毒痢 fulminant dysentery [101]: 疫毒痢 is dysentery caused by 疫毒 , an epidemic toxin. “Fulminant dysentery" means sudden and violent dysentery. I use “epidemic toxin dysentery.” 瘧母 malarial splenomegaly [102]: From the Western medical point of view, this term is absolutely correct. However, it is not clear whether ancient Chinese physicians understood the condition to be splenomegaly. English speakers have for a long time been familiar with the term “mother of malaria” and know that it denotes a lump due to malaria. 五更咳 morning cough [103]: Translating 五更 as “morning” is not sufficiently precise. Professor Xi translates五更 in the term五更瀉 as “before dawn” in the term, which is somewhat better. I use “fifth-watch cough” (English speaker are aware that ancient China had a different chronological system. 健忘 amnesia [105]: “amnesia” is a Western medical term, usually meaning a large gap in a person’s mental picture of the past. 健忘 means poor memory. I use forgetfulness, the closest literal equivalent of the Chinese term. 脾約 splenic constipation [106]: 脾約 is a term appearing in the Shāng Hán Lùn傷寒論, denoting constipation due to the failure of the spleen to move the fluids of the stomach (脾不能為胃行其津液 而引起的便秘). However, this is not the only form of constipation resulting from splenic dysfunction. According to the 高等叢書中醫內科學.便秘, there is also constipation with sagging sensation due to spleen vacuity qì fall脾虛氣陷. Hence “splenic constipation” is an unacceptable translation. I use the literal “straitened spleen.” 膏淋(病)chylous stranguria [108]: “chylous” relates to the “chyle” (乳糜). This is not Chinese medical concept. I use “unctuous strangury.” 奔豚 up-rushing of qi [109]: In English-speaking countries, the literal translation “running piglet” is widely used. “Up-rushing of qì” (氣上沖) makes it difficult for Western readers to associate this term with the particular condition first described in the Jīn Guì Yào Luè金匱要略. 薄厥 flopping syncope [111]: 薄厥 is defined as因大怒而致氣血上逆的厥證. The character 薄 is believed to mean 迫. The English “flop” has many means collapse, jump, fail (垮下, 跳動, 失敗). “Flopping syncope” does not suggest anything. I used “vehement reversal” (a recent, unpublished change). 食厥(病)crapulent syncope [111]: The word “crapulent” is rarely used. I use “food reversal.” 雷頭風(病)thunder-headache [111]: Professor Xie's translation is fairly literal, but the word 風 is deleted in translation. I use “thunder head wind.” 痛〔寒〕痹 agonizing arthralgia [111]: “agonize” means “causing extreme pain.” “Painful” is quite sufficient. 梅核氣 plum-stone syndrome [113]: “plum-pit qi" is widely used in English-speaking countries. Besides, is it a syndrome? 凍瘡 chilblain [121]: 凍瘡 is principally “frostbite.” 月經澀少 scanty suppressed menstruation [123]: “suppressed menstruation” can only be interpreted to mean “amenorrhea” (經閉). I use “scant inhibited menstruation.” 經期延長 prolonged menstruation/menostaxis [125]: 根據 Dorland’s Illustrated Medical Dictionary (26th Edition), “menostaxis” means excessively prolonged menstruation, but according to Churchill’s Illustrated Medical dictionary (1989), “menostaxis” means amenorrhea (經閉). The definition of “menostaxis” is unclear, and hence the term is best avoided. 倒經 , 逆經 vicarious, retrograde menstruation [125]: 倒經 and 逆經 are both equivalent to menoplania or vicarious menstruation in Western medicine, i.e., bleeding from any surface other than endometrium during menstruation. “Retrograde menstruation” in Western medicine denotes flow of menstrual blood through the uterine tubes. This is completely different from the Chinese concept. 子嗽 gravid cough [128]: gravid means “pregnant” (懷孕); it can only qualify women, it cannot describe diseases or symptoms. “Gravidic,” which means relating to pregnancy is the correct form, although it is not often used. The same applies to子喑 and子淋. 食積 dyspepsia, indigestion [132]: 食積 lies within the scope of 傷食. However, there are many forms of dyspepsia(消化不良)due to disease of the spleen and stomach that do not fall within the scope of 傷食. Hence, Professor Xie’s translation is inappropriate. Professor translates食積證 as “syndrome/pattern of food stagnancy,” for reasons that are not apparent. 障 vision-disturbed ophthalmopathy [138]: 障 refers to an object obstructing the line of vision. The word “ophthalmopathy” means “eye disease.” The term “vision-disturbed ophthalmopathy” is cumbersome. See also 3. Poor Grammar and Style [138]. 喉風 acute throat troubles [147]: 喉風 denotes a serious acute red, sore, swollen throat with difficulty in swallowing and labored breathing. The English “troubles” is very colloquial and does not normally appear in formal medical discourse. It also tends to denote minor complaints. I use the literal translation “throat wind.” 距骨脫位 astragalus/talus dislocation [155]: “astragulus” is obsolete. Talus is the modern term. Astragalus now only denotes 黃耆. 陽中求陰 treat yang for yin [166]: The English translation treat yang for yin is very unclear. I use “seek yīn in yáng.” 清營透疹 clear nutrient (system) and let eruptions out [167]: “let out” is too colloquial. I use “clear construction and outthrust papules.” 歸經 meridian tropism [205]: English speakers most commonly use “channel entry" or “channels entered.” Tropism is a “scientific word” that most native English-speaking translators would tend to avoid, especially when a much simpler and self-explanatory option exists. 相使 mutual assistance [205]: 相 here means “in relation to another.” The relationship is only one way. “Mutual” is only used where the relationship is two-way. The same applies to 相畏, 相殺, and 相惡 on the same page. 3. Poor English Grammar and Style 熱入血分 entering of heat into the blood system [24]: The English term is awkward, mainly because there are two many prepositions and too many words. I use “heat entering the blood aspect.” 痰蒙心包 clouding of the pericardium by phlegm [31]: The form of the English term is heavy and cumbersome. “Phlegm clouding the pericardium” is much better style. There are numerous examples of this awkward construction. 肺失清肅 failure of lung in purification [38]: “in purification” is not idiomatic English. 寒熱錯雜 cold-heat in complexity [25]: “in complexity” is not idiomatic English. 芒刺舌 prickled tongue [48]: “Prickly” is the right word. 目癢 eye itching [55]: “itchy eyes” and “itching of the eyes” are acceptable. “Eye itching” is not idiomatic. The same applies to page 143. 朝食暮吐 evening vomiting of that eaten in previous morning [57]: “eaten in previous morning” contains a grammatical error. The whole phrase is awkward. It should be “vomiting in the morning of food eaten in the morning” (or “eaten the previous morning”). 風寒犯肺證 syndrome/pattern of wind-cold invasion of lung [80]: “invasion of the lung by wind-cold” and “wind-cold invading the lung” are idiomatic phrases, but “wind-cold invasion of the lung” is not(of course if the word “lung” were absent, then “wind-cold invasion” would be acceptable) . On page 80 and 81 there are numerous problems of this kind. On pages 98 and 99, nearly all the terms have this kind of problem. On page 91, 熱入血室(證) is translated as “heat entering blood chamber.” It is not clear why the clear and simple construction represented by this latter term could not be generally applied. 陰損及陽證 syndrome/pattern of yin impairment with yang involved [65]: “with yang involved" is too complex a construction. “involving(或 affecting)yáng” would be much more concise. 水氣凌心 attack of heart by retained water [29]: “Attack of” is incorrect; it should be “attack on.” I use “water qi intimidating the heart,” which is a much smoother construction. 雀啄脈 bird-pecking pulse [62]: 雀啄脈 means a pulse likened to a sparrow pecking at food. Professor Xie “bird-pecking pulse” is made of the noun pulse, qualified by an object-verb+ing construction, which can only be interpreted to mean a “pulse that is pecking a bird.” Other terms such as魚翔脈 fish-swimming pulse, 屋漏脈 roof-leaking pulse, 解索脈 rope-untying pulse, 轉豆 脈 bean-rolling pulse, and on page 138 vision-disturbed ophthalmopathy all evince the same kind of error. 齠齔 sevenor eight-years-old children [131]: In such constructions, the word year remains in the singular form without an s. The same applies to the following entry 稚子. 花翳白陷(病)cornea ulcer [141]: “corneal” is the right form. 骨鯁 bone sticking [147]: the intransitive verb to stick means to get stuck, become trapped. The transitive verb to stick means to cause to adhere (貼). Professor Xie’s term “bone sticking” therefore does not suggest what it is supposed to mean. The normal English way of expressing this phenomenon is to “bones stuck in the throat.” 瀉下攻積 remove accumulation with purgative [169]: “purgative” needs to be in the plural. 淡滲利濕 excrete damp with bland drug/medicinal [172]: “drug/medicinal” needs to be in the plural. 藥熨療法 medicated ironing therapy [186]: “iron” as noun means the substance iron or a smoothing iron (an instrument for pressing clothes). As a verb it means to press clothes with an iron. 藥熨療 法 does not involve the use of a smoothing iron. I use “hot medicinal compress therapy.” 4. Single Terms with Multiple Equivalents When a term has more than one meaning, it is appropriate to have different translations for each (e.g., the 滑 in 滑脈 and 滑脫). When a term (or meaning of a term) has two equivalents that is very difficult to chose between and both have currency, then the inclusion of both terms in a terms list is acceptable (e.g., Professor Xie systematically uses both “pattern” and “syndrome for 證). However, when a term only has one meaning, it should always be translated in the same way. English Translation of Common Terms in Traditional Chinese Medicine includes many terms, particularly in the realm of pathomechanism (病機) and symptoms, that contain verbs that are translated with multiple equivalents. I believe that these verbs were chosen for good reasons, so they ought to be translated with single equivalents. For example, 結 appears in countless terms, and arguably has the status of a technical term in EAM medicine. It describes numerous kinds to severe stagnation, congealing, and hardening (鬱滯, 凝固, 硬化). I always translate 結 as bind (which, like, 結 originally meant tie, and has taken on extended meanings similar to those of 結). If the word 結 is translated in different ways in different context, then the concept will lost. The reason for choosing fixed equivalents is not only to ensure that the concept survives in tact in the transmission process, but also to make things easier for the translator. If the word 結 is translated in different ways in different compound terms, then the translator cannot memorize the terminology. Whenever he comes across a terms containing 結, he has to look it up in the standard list. Avoiding unnecessary polyequivalence makes translation more efficient and help the terminology to be accepted. 宣 dispersion/ventilation: 宣發 dispersion [8],宣肺 ventilate lung [166]. Professor Xie also translated 不宣 as obstruction: 肺氣不宣 obstruction of lung qi [39]. (See 2. Poor Term Choices). 脫 prostration/collapse [28, 29]: 脫 only has one meaning in pathology. There is no need for two equivalents. (See 2. Poor Term Choices). 臟 viscus/zang organ: In 水火之臟 viscus of fire and water,臟 is translated a viscus. Elsewhere it is translated as zang organ. 筋 tendon/muscle/sinew/soft tissue [11]: 筋 tendon [11],經筋 muscle region [11],筋 (1) tendon; sinew (2) soft tissue [159]. See 2. Poor Term choices [11]. 逆 reverse/adverse/counter-flow: 氣逆 reversed flow of qì [24],肺氣上逆 adverse rising of lung qi [39],qi counter-flow syndrome/pattern [74]。I consistently use “counterflow.” 瘀 stasis, stagnant: 瘀血 stagnant blood [19],血瘀 blood stasis [28]。I use “static blood” and “blood stasis.” 結 retention/stagnancy/constipation/combined/accumulation: 大腸寒結 cold retention in the large intestine [39],熱結 heat retention [42],燥結 dryness constipation [43],燥結證 dryness constipation syndrome/pattern [70],痰氣互結 syndrome/pattern of combined phlegm and qi [71],結胸 thoracic accumulation [110]。I consistently use “bind.” 脈 vessel/meridian: 脈 vessel [6],奇經八脈 eight extra meridians [10]。Since Professor Xie translates 督脈, 任脈, 沖脈 as governor vessel, conception vessel, thoroughfare vessel, he ought to translate奇經八脈 as the eight extra vessels. (惡)寒 aversion to cold/chills [51]: 惡寒 is translated as “aversion to cold,” but 熱不寒 is translated as “fever without chills.” 脅痛 (1) lateropectoral pain (2) hypochondriac pain [54, 107]: 脅痛 in Chinese medicine is one concept. Why should it have two translations? 凝 coagulate/congeal: 陽虛痰凝 syndrome/pattern of yang deficiency with phlegm coagulation [64],寒凝氣滯證 syndrome/pattern of congealing cold and qi stagnation [74]. Normally, “coagulate” describes the blood, it is not suitable for痰凝. I use “congeal.” 鬱 depression/stagnancy/stagnation: 六鬱 six kinds of stagnancy [42],肝鬱氣滯證 liver depression with qi stagnation [85],膽鬱痰擾證 syndrome/pattern of gallbladder stagnancy with phlegm disturbance [86],鬱病 depression [109]。I consistently use “depression.” 擾 disturbance/agitation: 膽鬱痰擾證 syndrome/pattern of gallbladder stagnancy with phlegm disturbance [86],痰火擾心證 syndrome/pattern of agitation of heart by phlegm-fire [79]。筆者都用 harass。 虛 deficiency/insufficiency: In 肺脾兩虛證, 虛 is translated as “insufficiency” [88],but in 肺脾氣 虛證, it is translated as “deficiency.” 虛 is discussed under 2. Poor Term Choices [22]。 大厥 major reversal of qi; sudden loss of consciousness [111]: 厥 means flow in the wrong direction (逆). In Chinese medical terminology, it has the connotation of severe cold of the limbs (四肢厥冷) or loss of consciousness (昏厥), often simultaneously. 厥 is a technical term that should be translated with a single equivalent. I introduced the term “reversal” 20 years ago. English speakers are now familiar with it. 痹 impediment, arthralgia: 痹病 (1) Impediment disease (2) arthralgia。According to中醫大辭典 page 1627, 痹 means (1)風寒濕侵襲經絡,痹阻氣血,引起以關節, 肌肉疼痛, 拘急為主症的一 類疾病; (2) 泛指病邪閉阻肢體, 經絡, 臟腑所致的各種疾病,包括前義所指的病症。The narrow meaning of痹 is not the same as “arthralgia” (關節疼痛). Professor Xie translates痹 caused by wind-cold-damp as “arthralgia” [111],and translates 胸痹 as “chest impediment” [105],but 胸痹 心痛 as “angina pectoris” [105],and 皮痹 as “scleroderma.” I consistently translate 痹 as “impediment,” and the verb痹 as “impede.” (瀉)下 purge, catharsis, laxation: 峻下 drastic purgation [169],緩下 laxation [169],瀉下逐水 expel water by catharsis [170]. I consistently translate 瀉 as “drain” and 下 as “precipitation.” 利 induce diuresis, excrete, remove: 利水滲濕 induce diuresis and drain damp [172],淡滲利濕 excrete damp with bland drug/medicinal [172],利濕劑 dampness-removing formulas [215]。 消 disperse, eliminate, cure, relieve, resolve: 分消走泄 disperse and discharge [172],消痰軟堅 eliminate phlegm and soften hardness [173],消癰散結 cure abscess and dissipate nodulation [182], 利水消腫藥 edema-relieving diuretic [208],消腫 resolving swelling [electronic version 電子版]. I consistently use “disperse.” 清 clear, relieve: 清法 (heat)-clearing therapy [173],清燥 relieve dryness [173]. 補 tonify, reinforce: 補法 (1) tonification;tonifying therapy (2) reinforcement;reinforcing therapy. 補 has only one meaning, there is no need for two concepts. 禁忌 prohibited, contraindication: 配伍禁忌 prohibited combination [205],食忌 dietary contraindication. 5. Multiple Terms with Single Equivalents 結 , 停 , 蓄 , 阻 retention: 大腸寒結 cold retention in the large intestine [39],氣滯水停 syndrome/pattern of qi stagnation and water retention [77],蓄血 retention of blood [91],濕阻 retention of dampness [101]. The electronic version has the積 of 熱積膀胱 and the困 of 脾虛濕 困 as “retention.” Professor Xie’s English translation of 癃閉 and 飲 all contain the word “retention. 結, 滯, 鬱, 積 stagnancy: 結陰/陽 stagnation in yin/yang [22],氣滯 qi stagnation [28],六鬱 six kinds of stagnancy [42],食積證 syndrome/pattern of food stagnancy [70],膽鬱痰擾證 syndrome of gallbladder stagnancy with phlegm disturbance [86],肝著 liver stagnancy。 宣, 疏 disperse: 宣發 dispersion [8],疏風 disperse wind [166]。 痞, 塞 stuffiness: 痞 stuffiness[55],塞因塞用 treat stuffiness with tonic [165]。 納呆[56], 厭食 [133] anorexia: 納呆 is poor appetite with fullness due to impaired spleen movement and transformation. 厭食 means no desire to eat despite hunger and nausea and vomiting at the sight or thought of food. Both differ from poor appetite 食慾不振. 瀉, 泄, 下, 瀉下, 攻 purge: 實則瀉之 treat excess by purging [165],清氣泄熱 clear qi (system) and purge heat [167],下法 purgation [169], 瀉下攻積 remove accumulation with purgative,緩攻 mild purgation [169]。 遏 , 阻 , 不宣 obstruction/retention: 衛陽被遏 obstruction of defensive yang [24],痰濁阻肺 obstruction of the lung by phlegm turbidity [38],肺氣不宣 obstruction of lung qi [39]. 遏 and阻 may be synonymous. However, 宣發 (宣散) is only one function of the lung, and “obstruction” does not tell us which function of the lung is obstructed. 6. Excessive Use of Pinyin Professor Xie uses Pinyin transliteration for the names of channels and the names of formulas. In English-speaking countries, channels, medicinals, and formulas are often referred to by their Chinese names and written in Pinyin. However, it is now becoming common practice to always provide names in two languages for channels, medicinals, formulas, and books, e.g., 黃湯翻譯成 Ephedra Decoction (má huáng tāng), 傷寒論譯為“On Cold Damage” (Shāng Hán Lùn). Using only Pinyin is not ideal, because it is meaningless to those who do not speak Chinese. An English translation is needed as an explanation. Professor’s Xie’s system of half Pinyin half English, as in Guizhi Decoction, is not very helpful. If people know what “Guizhi” means, they almost certainly know what “Tang” (湯) means. Although Professor Xie has translations for book titles, he does not have translations for channel names and formula names. These seems to be inconsistent. 7. Excessive Use of Modern Medical Terms The use of modern Western medical terms as equivalents for traditional East Asian medical concepts is most commonly seen in the realm of disease names. Whether or not a modern medical term can be used depends on whether the “referent” is the same as that of the traditional EAM disease; it also depends on the whether the concept is the same. If the referent is not the same, then modern medical terms should definitely not be used. For example, translating 痹 as “arthralgia” is wrong because arthritis and痹 have different referents. 痹 is not only joint pain or disease of the joints because it includes what modern medicine calls sciatica. If the referents are the same, but the concepts are different, then the Western medical terms should not be used either. For example, translating 癭 癰 as acute thyroiditis [117] hides the Chinese disease concepts of癭 and 癰, and introduces the concepts of acuteness, the thyroid gland, and the inflammation. Especially when translating older Chinese texts, translations of these kinds introduce anachronisms. Furthermore, using modern medical terms to translate traditional EAM concepts, destroys the systematicness of the EAM conceptual system. For example, when疔 is translated differently (deep-rooted boil, pustule, whitlow/felon, -itis, gangrene, anthrax [114], boil [146]) depending on where it appears will cause the English reader to have no idea that there is a EAM has a concept called 疔. In EAM, a 疔 is lesion that is clearly defined. Any lesions that are called 疔, wherever they appear, belong to the same EAM category. The use of modern medical terms is problem from both the modern terminological and philological points of view. Terminologists stress that terms should represent the concepts. Thus, 疔 (also called 丁)”is so called because it is small in shape, has a deep root, and is hard like a nail”(因為其形 小,根深,堅硬如釘而得名。中醫大詞典). The terms “boil,” “pustule,” “whitlow,” “-itis” used by Professor Xie fail to reflect the features of疔. Hence from the point of view of terminology, they are unsatisfactory translations. From the point of view of philology (study of historical documents歷史文 獻學), it is important to have a translation that that reflects “why the term was originally chosen” (Unschuld 1989). Usually the only way to translate a term in such as to reflect why it was originally chosen is to translate literally. I translate 疔 as clove sore. “Clove” 丁香, from Latin clavus meaning a nail, 釘. I rejected “nail” on the grounds that it also denotes a body part (指甲) and hence is ambiguous. The use of modern medical terms to replace traditional EAM concepts makes it impossible for the English-speaking reader to understand the traditional Chinese medicinal concepts. Hence, it is of no help to the Westward transmission of EAM. Whether or not it can help the development of integrated Western and EAM medicine is also debatable. Chinese diseases lack quantifiably objective definitions, and so are not likely to be the subject of research. Furthermore, the modernization of traditional EAM does not mean the elimination of traditional EAM. There has to be a bridge between the new EAM and the old. Thus, for example, a report on a study in the use of EAM to treat acute rhinitis will point out that conditions of this kind in premodern times were referred to as鼻鼽. If such a report were translated into English using Professor Xie’s terminology, “acute rhinitis” and 鼻鼽 would end up being translated in the same way and the foreign reader would gain no insights into the traditional conception of the disease. The correspondence between EAM diseases and modern diseases is an important area of study in integrated medicine. However, this should not be confused with the task of translation. EAM disease names should be translated literally wherever possible, and the Western medical correspondence (very often there are multiple correspondences) should be noted in the definition. In modern medicine, many symptom terms created from Greek roots, such as dyschezia, menostaxis, polymenorrhea, are being used less and less, probably because subjective symptoms that cannot be quantified have increasingly little meaning. In the field of EAM, diagnosis is still largely based on symptoms rather than objective signs, and in fact many fine distinctions are made. This sophisticated area of vocabulary is best dealt with in translation by using plain and simple English (e.g., difficult defecation, prolonged menstruation), which has much greater descriptive power. In the各科疾病 section of English Translation of Common Terms in Traditional Chinese Medicine, the use of Western medical terms to represent traditional EAM concepts is highly prevalent. I provide only a few examples below. 五官 five sense organs [13]: 五官 include the lips, but the lips are not a sense organ. In ancient Chinese 官 was a living metaphor, it did not have the modern meaning of器官. I use “the five