1) Note on Terminology from Giovanni's latest book (to be published in 2008).
Please click here to download the PDF.

2) Extract of letter sent to 'Clinical Acupuncture and Oriental Medicine'

The following is an abridged version of a letter sent to the editor of "Clinical Acupuncture and Oriental Medicine" in response to an article by N Wiseman published in the same journal.

I would like to make a few comments on Wiseman's article Translation of Chinese medical terms: not just a matter of words (Clinical Acupuncture and Oriental Medicine, Vol. 2, no. 1).

Firstly I would like to correct some of the comments he makes on my book Foundations of Chinese Medicine. Wiseman asserts that in my book "the same area is described in terms of thorax, abdomen, chest, flank, hypochondrium, epigastrium, upper part of the abdomen, lower abdomen, lower (part of) the abdomen, upper part of the abdomen just below the xiphoid process and hypogastrium". I presume that when Wiseman says "is described in terms of" he means "is translated as".  This is simply not true. It is obvious to any reader that "chest" is a translation of xiong while epigastrium is a translation of wan. Although these terms are not in the glossary, some terms have an obvious translation e.g. an "elbow" in Chinese is the same as an "elbow" in English. Wiseman himself says in the following page that I translate xin xia as upper part of the abdomen just below the xiphoid process, thus contradicting himself because this proves that the terms he quotes above are not translations of the same term. Wiseman dislikes my translation of xin xia as upper part of the abdomen just below the xiphoid process: although long, my main priority is that this term is clinically useful. Moreover, Wiseman translates xin xia in his dictionary as region below the heart but this is imprecise because the region "below the heart" could be central or lateral towards the left of the chest: it is in fact, the midline area below the xiphoid process.^[1] The Concise Dictionary of Chinese Medicine confirms this when it says that pain in the xin xia region is pain in the pit of the stomach.^[2]

Secondly I would like to make some general observations on the translation of Chinese medical terms.  In my opinion, the most important issue facing practitioners is not how to transmit the language of Chinese medicine (an impossible task given the differences between Chinese and other languages) but how to transmit the clinical skills of Chinese medicine. What matters is not whether xian is translated as" wiry" or "bow-string" [pulse] but whether students are able to master that pulse quality and successfully identify it in the clinic. It could even be argued that the excessive (if not obsessive) attention dedicated to terminology with its ensuing "debate" distracts us from the main task, i.e. that of mastering and communicating the clinical skills of Chinese medicine. Of course, the language of Chinese medicine is important in as much as it helps us to understand the concepts behind it: thus what matters is not so much the translation of a term but understanding the idea conveyed by a particular Chinese character.  For this reason, when I lecture and I am introducing a new concept or disease of Chinese medicine, I would always draw the relevant character and explain its meaning and nuances: in my opinion that is what matters, not how we translate it.  I simply fail to see how translating zheng jia as "concretions and conglomerations" (rather than "abdominal masses") helps students and practitioners to understand the pathology, diagnosis and treatment of this disease (incidentally, according to the Oxford English Dictionary both "concretion" and "conglomeration" indicate a process, an action rather than a substance and therefore cannot have a plural form). In his quest to establish a "correct" terminology, Wiseman occasionally needs to invent new words such as outthrust, an absurd situation given the extremely rich English vocabulary.^[3] Another example of the narrowness of English translations of Chinese terms is Wiseman's translation of cou li as "interstice" and his explanation that this is an "anatomical entity of unclear identity".^[4] I suggest Wiseman looks at the article "The location and function of the San Jiao" by Qu Lifang.^[5]  Wiseman clearly reduces the meaning of "interstice" to that of "grain" which is not correct given than li indicates the "grain" (of various structures) while  cou indicates the "interstices" (in various parts of the body).  This is an example of how the rigid and reductive translation of a Chinese term actually reduces our understanding of it.

Also, it could be argued that the main issue facing us in the West is not how to translate the Chinese terms but how to find the correspondence between Chinese terms and what Western patients actually use. For example, most authors, even Wiseman, translate the word zhang  as "distension" (or "distention").  However, English patients will never use this word and will usually say "bloating" to indicate zhang, while Italian patients would say gonfiore (which strictly means "swelling") and German patients spannung. Thus, we may "correctly" translate zhang as "distension" but students will never hear that term in the clinic. Another example is that of men which is usually translated as a "feeling of oppression"; however, very few English patients will use the word "oppression" to describe this feeling and will usually say "tightness" or "a feeling of weight". Thus, what is the point of concentrating all our attention in getting the terminology "right" if it is not clinically relevant? There would be a case for producing a glossary re-translating the translated English terms into the expressions that patients actually use (in each Western country).

The very premise of Wiseman's article ("if we assume that it would be a good thing for all speakers to refer to each concept of Chinese medicine by the same term") is itself  debatable. Apart from the fact that this aim may be impossible to achieve, is it even desirable? Given that some Chinese medical terms are practically impossible to translate because they have so many nuances, do the differences in translation not actually enrich our understanding of Chinese Medicine? If someone translates xian [pulse quality] as "wiry" and another as "bow-string" does the reference to a bow string not help us to visualize the wiry pulse?  I translate Yang Qiao Mai as "Yang Heel Vessel" but "Yang Motility Vessel" is by no means wrong and it usefully conveys a particular aspect of this vessel. Why subject all authors to a rigid, autocratic uniformity?  In over 28 years of practice and teaching I have met thousands of students, practitioners, teachers and heads of colleges and  nobody has ever indicated to me that terminology is the main issue facing the successful development of Chinese medicine in the West: the most pressing issue facing practitioners is how to develop the diagnostic skills of Chinese medicine.  Since more and more people are learning Chinese, as long as authors use a glossary of terms, there is not a problem.

Furthermore, Wiseman's position is rather Anglo-centric by concentrating so much on the "correct" translation of Chinese terms into English. Chinese medicine is truly universal now and is used in practically all countries of the world. Even if we adopt the only "right" and "correct" English terminology, how does that promote the development of Chinese medicine in the world? Again, as more and more people are now studying at least the rudiments of Chinese, the only universal terminology is the Chinese one. I have taught in many countries with many different languages all over the world and whenever there is a doubt about a particular term I always use the Chinese term and this invariably clears up any misunderstanding.

Moreover,  Wiseman attributes a precision to Chinese medical terminology that the Chinese texts themselves often do not have. One only needs to look at the imprecise way the terms Heat and Fire are often used interchangeably in Chinese books, old and modern. Wiseman himself seems to have this difficulty in the article when he comments on the term xie which he translate as "to drain". However Wiseman seems at pains to distinguish xie (as in "to drain" from xie (as in "to discharge") _ as in his dictionary he asserts that xie (discharge) has the same meaning as xie (drain) which is clearly not the case^[6]. A confusion of these two treatment methods in herbal medicine would lead to dire consequences. The often imprecise use of terms (or different uses of the same term by different authors) is due to the fact that Chinese medicine was developed exclusively by practising doctors not linguists, anthropologists or ethnologists. In other instances Wiseman seems to deviate from his own rule of translating every term literally (e.g. "Foxy mounting pattern") quite a few times. For example, his dictionary translates Xu Li (the throbbing of the left ventricle of the heart and the Great Connecting channel of the Stomach) as "apical pulse" and then as Vacuous Li, leaving the word Li untranslated.

Please click here to download a PDF on Terminology from Giovanni's latest book
(to be published in 2008).