The Challenge of Translating Chinese Medicine
Published by Language Monthly, April, 1987
A. I suppose it's what our colleague in Mexico City recently called El Demonio de Traducción. While in England, I had done some play translations for the RSC and became fascinated with the overall problem of putting across one culture in terms of another without sacrificing either one's value system. Just because a line was funny in German or French didn't guarantee it would be in Englisha lot of other factors were at work: phonetics and usage of course, but also the totality of values shared by a culture. I started looking for other outcroppings of similar linguistic problems and collided with medicine. What different cultures accept as medical terminologyand even medical treatmentcould just turn out to be as arbitrary as what they accept as humor.
A. There you've hit on it. I don't think there are a lot of people in this field, and those that are involved are indeed specialists: the doctors and pharmacologists, whether Chinese or Western, don't know too much about foreign languages in general, much less the subtleties of translating (and far less still of linguistics), while most sinologists are fairly ignorant about both oriental and western medicine. Anthropologists have a fine overall view but often have a poor eye for clinical details or fail to relate to the other specialists.
A. I think there's something old and important. In their famous hypothesis, Benjamin Lee Whorf and Edward Sapir raised some eyebrows by suggesting that people speaking different languages may be discussing quite different things when they are allegedly talking about the same subject. And Louis Hjelmslev, Hans Jørgen Uldall and others of the Glossematics school actually maintained that linguistics may be logically prior to science, that instead of linguistics being that branch of science which deals with language, science may in fact merely be a branch of linguistics dealing with nature according to linguistically predetermined prejudices, a sort of Procrustean nightmare preset for error. It could just be that both these theories have been lying around like mathematical formulas awaiting a major application to prove their validity, and Chinese Medicine may be that application.
A. I'd be willing to bet there's both a qualitative and a quantitative difference, though the Arabic examples come closer than the German one. Let me start by telling you a story, and then I'll become more technical. When my wife and I lived in Italy, she did the shopping to help her learn Italian, and she came home complaining she couldn't get certain cuts of meat from the butchers. I told her to concentrate on speaking better Italian, and it would work out. But she still couldn't get the cuts of meat she wanted. Finally, I was forced to go with her to the market place and patiently explain to various butchers in Italian what she wanted. But we still couldn't get it. It doesn't even exist. The Italians cut their meat differently than we do. There are not only different names for the cuts but actually different cuts as well. The whole system is built around itthey feed and breed their cattle differently so as to produce these cuts. So you could argue it's not even the same steertechnically, anatomically, it might just qualify as a different subspecies.
A. Not at all, simply that we have to be aware that in their medical system they slice the human animal differently and use quite different terminology than we do. This drives some western medical peopleand others convinced our system must be not merely the best but the only possible oneup the wall. Probably most of the misunderstandings surrounding Chinese Medicine in the West spring from the fact that we are poor linguists, especially here in America.
A. In just about every way. The relationships they observe and measure are not the ones we do, the measurements and benchmarks are not the same as ours, their interpretation of such benchmarks will be different from ours, the diagnosis these suggest is not the same, and the treatment and interpretation of a patient's progress can also radically diverge from our own. Yet the whole process is quite logical and consistent, so logical that I am now working on a way to represent Chinese Medicine in terms of computer logic, using AI as a basis. The Chinese language, especially medical Chinese, is in fact similar to certain computer languages in its constant reiteration of If/Then/Else Structures.
A. That's exactly how many people experience
Chinese, especially if they don't get beyond a certain
learning stage. But this business of chaotic, illogical
sentences, isn't this all a bit familiar? Haven't
we heard this all before in another context, isn't
it just what the French say about English? Let's take
the classic example of "a French teacher,"
which the French quite correctly point out could mean
either un maître français or un
maître de français. Or the
example that Vinay and Darbelnet use, un moteur
de propulsion à jet, which we in English
hopelessly distort by calling it a "jet propulsion
motor," let alone a "jet motor."
A. Unfortunately not. Whether it's speeded up or simply more concise, I'm not sure. Everyone in translation is accustomed to seeing a text in other languages shrink when it turns into English. But characters are intrinsically more concise than wordsthey take up less room and also take less time to say. English shrinks when it goes into Chinese, Chinese expandssometimes double or triplewhen it becomes English. But not too many people want to admit or even hear this. It has to be linguistic chauvinism, though that's the last thing we need in this field. Chinese Medical Linguistics is so new that there really are no experts yet, but one practitioner who knows some Chinese recently generalized that "because Chinese has 5,000 characters and English has 20,000 words," anything expressed in English is thereby far more valid than anything expressed in Chinese. His figures were totally mistaken, and the whole notion is basically pretty shaky anyway, but this is typical of the blundering and blustering going on among those trying to build a bridge in this field on both the Chinese and Western sides. But the real relationship between the two languages may end up being a bit less favorable to us. Let's suppose for a moment that the Chinese only had 3,OOO characters...
A. That's a can of worms. About the only
thing people agree on is that you need from 2,000
to 3,000 for basic literacy. Beyond that we get into
grounds for technical disputesclaims run from
6,000 to 40,000, and even higher...But even with only
3,000, you have to remember a Chinese character is
not the same thing as a word. Benjamin Whorf said
it best and firstthere is no Chinese word for
This also explains how they have been able to swallow western medical terminology wholeand numerous other western technical vocab-ularieswith only a few predictable bouts of indigestion. But it also explains why we are still just nibbling at the edges of Chinese Medicine in this country and possessed by myriad preconceptions when we try to deal with it. We may be dealing with so vast a network of ideas that we are quite literally unable to conceive of its scope or import. Also, their translations of western medical terms are much more transparent than our originals...
A. By transparent and opaque mean how much we really understand of the meaning and structure of our own language. I once overheard a nine year old Italian boy make the following comment as his elder brother urinated in a gutter Ma, che inondazione! That is transparenta nine year-old Italian can know the word inondazione, because it is meaningfully related to onda, wave. Virtually no nine-year old English speakers will know the word "inundation" because it is a latin book word in our language. The equivalent anglicism, if it existed, would be something like infloodment, or even infloodscape. Chinese words are transparent in this way, at least when read and often when spoken as well. Thus, the Chinese phrase for adrenal gland is shenshangxian, kidney-atop-gland, quite similar to the Latin ad renem, and hence means a lot more to the Chinese than even the phrase "adrenal gland" does to most of us. All of western medical terminology is translated into Chinese this waywhat it loses in terms of "pure abstract conceptualizing" it gains in everyday understanding. Which is preferable?
A. Take the two bones in our lower arm.
The only names we have for them today are ulna and
radius. These are the "scientific names,"
the ones medical peopleand few otherslearn.
Those bones are important to you every day, yet you
have no everyday way of referring to them at all.
But there is clear evidence from historical linguistics
that these bones once had other names. The ulna was
once called the "el", the radius possible
something like the "spoke." We know about
the "el" from Seventeenth Century poetry
(maid to lover: "if I give you an inch, you'll
soon take an el") but also from modern German,
where the words are die Elle and die Speiche.
A. That's at the very heart of the way
the Chinese systematize and store their knowledge.
They like to sum up a whole subject in just four characters,
four syllables long, which they then use as a mnemonic.
Dah-dah-dah-dahit's like half of Big Ben ringing.
If it's a truly difficult concept then they will occasionally
go for eight syllables, or full Big Ben. It's very
close to being like a computer macro, a brief series
of keystrokes to stand for something much longer.
And they can, if need be, even macro-ize the four
character phrase down to two charactersor even
one. We have a few such structures even in English.
Here's one: Spring Ahead Fall Behind. It sums
up a specific procedure Americans go through twice
each year when they change from Standard Time to Day-light
Savings Time and tells them which way to move the
clock's hands. It's a fairly good example of Chinese-like
thinking in English.
How would you translate that into another
language? Would you imagine it as something poetic
and inspiring, such as "The vast wind beats on
my heart, sweeping my breath away?" Or is it
a tale or oarsmen being swept away while pursuing
a whale? Or could it be something overtly sexual?
these are the sort of errors awaiting anyone trying
to translate medical Chineseand some have fallen
into such traps.
A. I can give lots of examples. They're
used almost everywhere in Chinese medical texts, for
diagnosis, treatment procedures, theoretical explan-ationsand
almost always in these incredibly abbreviated forms
that sound either bizarre or quaint or poetic in translation.
That may be a good rule of thumb for determining a
bad translation in any context. A translation may
possess a certain cultural distance from its original,
but if it sounds too quaint or bizarre or poetic,
it's likely to be a poor one. People in other societies
do not normally go around being quaint or poetic or
bizarrethey wouldn't survive very long.
A. Not in the slightest. It's positively beautiful in Chinese. Medical technical language to be sure, but concise, incisive, elegant. Almost entirely phrased in these four character `aphorisms' (`slogans' might be closer) that Chinese uses to make a long story very short. We expect medical language to sound Greco-Latinate and, well, medical. But Chinese medical language and thought, beyond the problems posed by the four-character summaries, is much more geometrical, mathematical, even legalistic in feel. There is continual talk of confirmations, of evidence, of methods of proof. The language couldn't be more empirical in tone, but almost all of this gets lost in the translation. It hasn't helped that one of the chief `popularizing' books in the field mistranslates the term for `evidence' or `confirmation' as pattern.
A. Vast amounts have "survived." We tend to think in terms of Greek or Roman medicine, where we have allowed innumerable volumes to be lost. But the Chinese haven't made this mistake. With some exceptions, libraries were not allowed to burn. Consequently, a vast medical literature is still central to Chinese culture, even with the advent of western science. One library in Peking claims over 50,000 volumes. A few hundred new books are published each year, and there are several national and local journals. Varieties of Chinese medical language include ancient, modern, and a number of stages in between, all with their peculiarities in vocabulary, as is proper for an ongoing developing field of knowledge. If we fail to see this, it's only because of a disease I call "culture blindness."
A. Of course they can be reconciled. No intelligent observer would suggest the contrary. Western medicine has a more sophisticated view of some problems, but the Chinese view can be sophisticated in other ways. But we have to go beyond the unvoiced preconceptions on both sides, and to do this we have to recognize that they exist. We must become bimedical instead of merely monomedical. It's a task that linguists and translators can perhaps do best, by really looking carefully at the original, seeing what is actually there, and arriving at an accurate version in western languages. It represents an opportunity for linguists and translators to show that their skills are not just academic and parochial but can play an enormous part in a field that is not merely practical but absolutely central to human life and health.