The Challenges of Translation in Chinese Medicine

Chinese medicine is enjoying a revival. Its popularity is resurging not only in China, South Korea and Japan, but in Western countries as well.

The practices of Chinese medicine include taichi, chigong, tuina, acupuncture, shiatsu, and a complex network of herbal remedies dating back thousands of years.

Advocates say Chinese medicine has a more holistic, in-depth approach to the patient’s well being, with roots in ancient wisdom. Detractors categorically dismiss Chinese medicine as psuedo-science, even though Western scientists have conducted very little serious research.

The Challenges of Translation in Chinese Medicine

The National Institute of Health, a division of the US Department of Health and Human Services, acknowledges: “TCM [Traditional Chinese Medicine] can be difficult for researchers to study because its treatments are often complex and are based on ideas very different from those of modern Western medicine.”

The standard Western view is that Chinese medicine is a mostly benign complementary practice to Western treatment. Patients can pursue it at their leisure, as long as they disclose it to their ‘real’ (e.g. Western) doctor. There’s a lot of antagonistic pressure to frame Chinese medicine as removed from and diametrically opposed to the precepts of Western medicine.

Consequently, proponents of Chinese medicine often find themselves artificially forcing the terminology of Chinese medicine into the language of Western doctors in an effort to legitimize Chinese practices. Unfortunately, this only reinforces the Western attitude of cultural superiority.

And it doesn’t really work. As the NIH notes, Chinese medicine is based on complex ideas very foreign to the Western worldview. Translation in Chinese medicine becomes paramount to understanding it, and to reconciling with its naysayers in the west.

But how do we translate concepts for which there are no Western equivalents?

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The Taoist Roots of Chinese Medicine

The techniques and terminology of Chinese medicine come from classical Taoism. It’s a philosophical system that views existence as one great, unknowable thing (the Tao). The Tao is first divisible into two major forces, yin and yang: that which is receptive or negative, and that which is active or positive, respectively.

From there, the world of material phenomena springs forth. The material world is classifiable by five phases of existence: water, wood, fire, earth, and metal.

These five phases, or elements, are the groundwork for understanding Chinese medicine. Translation in Chinese medicine can go no further until these concepts, along with other Taoist concepts, are clear.

Not Literal, But Beyond Metaphor

Tao is, by definition, untranslatable. From Lao Tzu’s seminal work, the Tao Te Ching, dating back at least as early as the 4th century, BCE:

The Tao that can be spoken is not the eternal Tao
The name that can be named is not the eternal name

To entertain with language concepts that are beyond speaking and naming is abhorrent to the linear Western mind. In the post-Enlightenment west, logic is lord, and knowledge goes hand in hand with technical language.

It’s hard for the Western thinker to accept an idea that transcends language. Dismantling language to behold something inexpressible is almost beyond the realm of Western experience, at least to the degree that one is committed to Western dogma.

But not so in Chinese medicine.

To understand the terminology of Chinese medicine, it’s important to first understand the relevance of metaphor. Chinese medicine and Taoist thinking hold that the human being is a mini-universe, so everything we see happening in nature can and does also happen within a person. It also says that every eternal, intangible truth has its manifestation in nature.

So the Taoist, and the practitioner of Chinese medicine, looks to nature to understand the truth about how the human being works. This is in step with metaphorical language: as steam rises from rice, symbolically the foundation of life, so qi or chi is the rising life force of the human being. They are two different manifestations of the same intangible thing.

The Intangible Chi

Chi is perhaps the most common term in Chinese medicine, and one of the most difficult to translate. At first glance, it refers to air, vapor, or vital energy.

This could be steam, gas, or breath, for example. It’s also the animating force behind psychological and physical activity, such as body strength, odors, and anger. If you’re animated, active, and intense, you have excess chi. If you’re lackadaisical and uninspired, your chi is empty.

The classical Chinese character for chi contains the character for ‘rice.’ So it’s tempting to think of ‘rice steam’ as the literal interpretation, and all else (like the animating force behind body strength) as a metaphor of rice steam.

But this is too simplistic. From the perspective of Chinese medicine, rice steam and your body’s animating force are not metaphors. They are two phenomenal manifestations of the same intangible idea. They share a root cause. That root cause, the intangible idea behind the phenomena, is chi itself.

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‘Wind,’ Not Wind

Therefore, when we think of the five Chinese elements, we must understand that ‘wind’ in Chinese medicine does not refer to the English ‘wind’: air moving through the atmosphere in the natural world. It refers to an intangible idea. Air moving through the atmosphere is only the most immediate example in nature.

So when a diagnosis in Chinese medicine says patient has ‘wind’ stuck in a certain organ, it’s not really a metaphor. Nor is it the literal belief that physical wind (air moving through the atmosphere) has entered the patient’s body and lodged there. The latter interpretation, which is easy to deride, is what  Western thinkers often use to combat the legitimacy of classical Chinese ideas. But its basis is a fundamental misunderstanding of translation in Chinese medicine.

In a doctoral thesis called Translation of Chinese Medical Terms: A Source-Oriented Approach, author N.A.R. Wiseman clarifies this point:

“Certain phenomena occurring in the body were not merely Translation of Chinese Medical Terms described as ‘wind’ by a linguistic metaphor, but were perceived as actually being ‘wind’ because they were understood to share the essential qualitative and functional characteristics of wind in the environment. Although our scientifically based view would not allow us to make such an identification, the Chinese world view appears to allow it. If we do not distinguish between linguistic metaphor and cognitive analogy, we cannot describe cognitive bases of knowledge that differ from our own.”

The English word ‘wind’ refers to a gross material phenomenon, measurable with the senses. It does not refer to an intangible concept behind the physical force. We don’t have a word for that, just as we don’t have a word for chi or Tao. These Chinese words have roots in a cultural worldview that perceives natural phenomena as the manifestation of principles.

Rethinking Western Thinking

This concept itself is not completely divorced from Western culture, but most mainstream medical and scientific thought has discarded it.

By discarding the idea that natural phenomena are manifestations of intangible principles, we discard all of Chinese medicine, which we can then only perceive as the fraudulent superstitions of silly and outdated peasants.

But if the Western-minded can adapt our thinking to include this principle, a world of translation becomes possible. We can see the five elements (water, wood, fire, earth, and metal) not as the physical objects to which the English words point, but as the principles behind them. Then the value of Chinese medicine arises, just like steam from a bowl of rice.

Who Can Perform Translation in Chinese Medicine?

To execute translation in Chinese medicine effectively, one must have a grounding in these principles of Taoist philosophy. They must also understand the greater Chinese cultural worldview, to say nothing of medicine and language itself.

Because of the cultural, philosophical, and historical complexities inherent in Chinese medicine, translation in Chinese medicine requires an array of knowledge almost too vast for any one person.

In a UCLA study called Considerations in the Translations of Chinese Medicine, researchers assessed that competent translation in Chinese medicine would require expert knowledge in the following arenas:

• Clinical Chinese medicine
• Classical, literary Chinese language
• Western biomedicine
• Chinese history
• Contemporary Western healthcare frameworks
• Genres of text in Chinese medicine

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“With this range of qualifications,” the study says, “it is rare indeed to find a single translator, especially a native English speaker, who can meet all of these requirements.”

Their conclusion: “Chinese medicine is therefore often best translated using a team approach.”

This team, ideally, would include at least one native Mandarin Chinese speaker and one native English (or target language) speaker. It would also include historians, physicians from both Chinese and Western backgrounds, and social scientists.

The Future of Translation in Chinese Medicine

Who would take it upon themselves to assemble such a team? With the growing popularity of Chinese medicine, it won’t be long before someone takes the initiative. Public trust in Western medicine is dwindling, down 39 percent since 1966.

Americans are flocking to alternative health modalities to provide what the traditional healthcare system has failed to. At some point, Western scientists, doctors and translators will have to start paying attention.

But until such teams are assembled to approach translation in Chinese medicine as a serious, transcultural inquiry, we in the west will remain largely in the dark about why Chinese medicine persists, and what it can do.

We may deride as we like. The fact remains, for thousands of years Chinese medicine has sustained one of the world’s most ancient and successful nations, and one of its most populous civilizations. Perhaps until we develop better translation in Chinese medicine, derision is only an admission of ignorance.