A Skopos Theory-Based Study of Translation Strategies of Traditional Chinese Medicine Terms: a Case Study of Shāng Hán Lùn

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A Skopos theory-based Study of Translation Strategies of Traditional Chinese Medicine Terms: A Case Study of Shāng Hán Lùn

Riliu Huang

A thesis submitted in fulfilment of requirements

for the degree of Master of Arts (Research)

Faculty of Arts and Social Sciences

The University of Sydney

August 2020

STATEMENT OF ORIGINALITY

This is to certify that to the best of my knowledge the content of this thesis is my own work. I also declare that this thesis has not been submitted for any other degree or diploma at this or any other university.

I certify that the intellectual content of this thesis is the product of my own work and that all the assistance received in preparing this thesis and sources have been acknowledged.

Riliu Huang 5 August 2020

i ABSTRACT

After thousands of years of medical practice, traditional Chinese medicine (TCM) has developed into a unique medical theoretical system. As a result of the deepening exchanges between China and foreign countries and the extensive spread of TCM therapies and health culture, an increasing number of people are longing to develop a deeper understanding of TCM. TCM is imbued with Chinese cultural and historical elements, and its nomenclature and treatment methods are very different from Western medicine. Over the years, a large number of TCM practitioners and linguists have committed themselves to the translation of TCM. However, due to the lack of systematic theoretical guidance, translators resort to varying translation strategies, leading to inconsistency and confusion in TCM terminology translation. Therefore, in TCM terminology translation, special effort should be made to ensure target readers can comprehend the medical utility and meaning of TCM terms under the condition that the cultural connotations contained therein are well preserved. Skopos theory enables translators to give consideration to purposes of translation, cultural environment, and feelings of target readers, breaking through the language paradigm in translation. By referring to Skopos theory and TCM translation principles, this study aims to develop a target-reader oriented TCM terminology translation method, and concludes that translation methods and strategies can be flexibly selected according to the purposes of translation. To ensure the accuracy of TCM terminology translation and facilitate the acceptance and understanding of target readers, a domestication translation strategy is recommended for TCM terms that have counterparts in Western medicine; and for those that contain unique Chinese medical ideas or traditional Chinese cultural concepts and philosophical thoughts, a foreignisation translation strategy should be adopted to retain their underlying cultural uniqueness.

ii ACKNOWLEDGEMENTS

First of all, I would like to offer my special thanks to my supervisor, Associate Professor Christine Ji. The advice given by her has been a great help for me in determining the research purpose and direction of this thesis. Whenever I encountered problems and difficulties, it is her timely assistance that made me successfully overcome them; and it is her patient encouragement that propelled me to bravely move ahead.

My thanks also go to Dr Wei Wang, A/Prof. Linda Tsung and Prof. Bonnie McDougall, who provided constructive suggestions to my thesis in the Annual Progress Review. I would like to thank Dr Bronwen Dyson, whose courses Introduction to Thesis Writing and Writing a Thesis Chapter delivered me the knowledge about how to write a thesis with logic, and Dr Steve O’Shea (www.DrO- Editing.com) for his editing of a draft of this thesis. My special thanks also go to Mr Jinshan He, a friend of mine who provided me valuable suggestions when I encountered difficulties in learning.

My deepest gratitude goes to my mother, Liping Zhang, who has selflessly offered me superior growth and education environments. I would also like to thank my friends Yixin Liang, Zhengran Chen, Martin Ren, Zixin Lin, Xiaocheng Hu and Chenyu Liu, who have always encouraged me to keep a smile and heartened me during frustrating days. I also want to thank Dr Jiwei Lian for his exhortation when I was slackened, for his accompanying me through thick and thin.

iii TABLE OF CONTENTS

STATEMENT OF ORIGINALITY ...... i ABSTRACT ...... ii ACKNOWLEDGEMENTS ...... iii TABLE OF CONTENTS ...... iv LIST OF FIGURES ...... vii LIST OF TABLES ...... viii ABBREVIATIONS...... x Chapter 1 Introduction ...... 1 1.1 Introduction to the development of translation of TCM ...... 1 1.1.1 Study on English translation of ancient Chinese medicine classics .... 2 1.1.2 Summary of standardisation process of TCM terms ...... 3 1.2 Introduction to Shāng Hán Lùn and its three English versions ...... 7 1.2.1 Selection of Shāng Hán Lùn original texts ...... 8 1.2.2 Three English versions of Shāng Hán Lùn and their translators ...... 9 1.3 Research purposes and significance ...... 10 1.4 Thesis structure ...... 11 Chapter 2 Literature Review ...... 13 2.1 Research on the consistency and standardisation of traditional Chinese medicine terms ...... 13 2.1.1 Research on the international standardisation of TCM terms by Chinese medical scientists and linguists ...... 14 2.1.2 Research on international standardisation of TCM terms by Western medical scientists and linguists ...... 17 2.1.3 Remarks...... 22 2.2 Research on the translation strategies and methods of C–E translations of traditional Chinese medicine (TCM) terminology ...... 24 2.2.1 Introduction to translation methods and strategies ...... 25 2.2.2 Research on domestication and foreignisation in English translation of

iv traditional Chinese medicine terms ...... 30 2.2.3 Research on methods of English translation of traditional Chinese medicine terms ...... 34 2.2.4 Remarks...... 38 Chapter 3 Theoretical Framework and Analytical Methods ...... 41 3.1 Introduction...... 41 3.2 Theoretical framework ...... 41 3.2.1 Basic concepts of Skopos theory ...... 42 3.2.2 Applicability of Skopos theory to TCM term translation ...... 44 3.3 Principles of TCM terminology translation ...... 46 3.4 An integrated approach to TCM terminology translation evaluation...... 48 3.5 Analytical methods ...... 50 3.5.1 Selection of the original text and its English versions ...... 50 3.5.2 Collection methods of linguistic materials in Shāng Hán Lùn ...... 51 3.6 Research questions ...... 52 3.7 General remarks ...... 52 Chapter 4 Analysis and Discussion of TCM terms...... 53 4.1 Discussion on Chinese–English (C–E) translation of symptomatic terms 53 4.1.1 Analysis and discussion of the consistent translation of symptom names ...... 55 4.1.2 Analysis and discussion of the translation of symptom names with the same name in modern Western medicine ...... 58 4.1.3 Analysis and discussion of the translation of symptom names with the word “恶 wù” ...... 63 4.1.4 Analysis and discussion of partially consistent translation of symptom names ...... 66 4.1.5 Analysis and discussion of the translation of inconsistent symptom names ...... 74 4.1.6 Remarks...... 78 4.2 Discussions on Chinese–English (C–E) translation of disease terms in Shāng

v Hán Lùn ...... 81 4.2.1 Introduction to names of the six meridian diseases ...... 82 4.2.2 Comparison of translations of six meridian disease names ...... 86 4.2.3 Introduction to disease names ...... 90 4.2.4 Comparative analysis of English translation of disease names in Shāng Hán Lùn ...... 91 4.3 Summary ...... 99 Chapter 5 Conclusion...... 103 5.1 Major Findings ...... 103 5.2 Limitations of this study ...... 106 5.3 Suggestions for future research ...... 107 BIBLIOGRAPHY ...... 109 APPENDICES ...... 115 Appendix 1 Selected symptoms in Shāng Hán Lùn and their English translations ...... 116 Appendix 2 Selected diseases in Shāng Hán Lùn and their English translations

...... 118

vi LIST OF FIGURES

Figure 1 The movement of two translation strategies ...... 29 Figure 2 The relationship of four translation methods ...... 29 Figure 3 Principles of TCM terminology translation ...... 47 Figure 4 Evaluation methods for TCM terminology translation ...... 49

vii LIST OF TABLES

Table 1 Three methods and their application scope by Zhaoguo Li ...... 37 Table 2 Selected symptom names in Shāng Hán Lùn ...... 55 Table 3 English translations of “下利 xià lì” and “吐利 tǔ lì” ...... 55 Table 4 English translations of “头痛 tóu tòng” and “咽痛 yān tòng” ...... 56 Table 5 English translations of “口苦 kǒu kǔ” ...... 57 Table 6 English translations of “腹痛 fù tòng” ...... 58 Table 7 English translations of “发热 fā rè”...... 59 Table 8 English translations of “干呕 gān ǒu” ...... 60 Table 9 English translations of “烦躁 fán zào”...... 61 Table 10 English translations of “烦渴 fán kě”...... 62 Table 11 English translations of “恶寒 wù hán,” “恶风 wù fēng,” and “恶热 wù rè” ...... 64 Table 12 English translations of “腹满 fù mǎn” ...... 66 Table 13 English translations of “心烦 xīn fán” ...... 67 Table 14 English translations of “微热 wēi rè” ...... 68 Table 15 English translations of “大汗 dà hàn” ...... 68 Table 16 English translations of “懊憹 ào náo” ...... 70 Table 17 English translations of “呕逆 ǒu nì” ...... 70 Table 18 English translations of “郑声 zhèng shēng” ...... 71 Table 19 English translations of “眩冒 xuàn mào” ...... 72 Table 20 English translations of “喜忘 xǐ wàng” ...... 73 Table 21 English translations of “嗜卧 shì wò” ...... 73 Table 22 English translations of “无汗 wú hàn” ...... 75 Table 23 English translations of “厥逆 jué nì” ...... 75 Table 24 English translations of “短气 duǎn qì” ...... 76 Table 25 English translations of “下血 xià xuè” ...... 77 Table 26 Translation methods and strategies of symptomatic names ...... 78 Table 27 Comparison of symptomatic terms based on six translation principles ...... 79

viii Table 28 Names and translations of six meridian diseases ...... 86 Table 29 Definitions of selected disease names ...... 91 Table 30 English translations of “伤寒 shāng hán” ...... 91 Table 31 English translations of “中风 zhòng fēng” and “结胸 jié xiōng” ...... 93 Table 32 English translations of “风温 fēng wēn” and “温病 wēn bìng”...... 94 Table 33 English translations of “奔豚 bēn tún” ...... 95 Table 34 English translations of “谷疸 gǔ dǎn” ...... 96 Table 35 English translations of “藏厥 zàng jué” ...... 97 Table 36 English translations of “痈脓 yōng nóng” ...... 98 Table 37 Methods and strategies for translating disease names...... 100 Table 38 Comparison of disease terms using six translation principles ...... 101 Table 39 Results of TCM terminology translation methods ...... 104

ix ABBREVIATIONS

TCM Traditional Chinese Medicine

SL Source Language

TL Target Language

ST Source Text

TT Target Text

LA Linguistic Accuracy

AT Acceptability of Terms

SAT The Scientific Accuracy of Terms

LSC Lexical Structural Conciseness

LSS Lexical Structural Similarity

CT Cultural Transmission

x Chapter 1 Introduction

Under the guidance of Skopos theory and traditional Chinese medicine (TCM) translation principles, this study analyses different English versions of TCM symptoms and disease names in Shāng Hán Lùn, in an attempt to summarise target- reader oriented translation principles for TCM terminology. Suggestions for selection of translation strategies and methods for TCM terminology are made to promote the realisation of the communication goals of a target text (TT) and facilitate the international unification of TCM terms, thereby contributing to their international standardisation. In this chapter, the development background of TCM translation is introduced, literature involving the translation of TCM classics and terms is reviewed, and the contributions of this study are described. This chapter concludes with an overview of thesis structure.

1.1 Introduction to the development of translation of TCM

TCM has a long history. During the Qin and Han dynasties, TCM classic works including Huangdi Neijing (The Yellow Emperor's Inner Classic), Shennong Baicaojing (The Divine Farmer's Herb-Root Classic), and Shanghan Zabinglun (Treatise on Cold Pathogenic and Miscellaneous Diseases) were created. This established a medical concept system encapsulating the physiology, etiology and pathogenesis, diagnosis, treatment, prescriptions, and preservation of health, and formed a TCM terminology system, laying the foundation for the TCM theoretical system (Si & Cui, 2016).

TCM in nature is the accumulated experience of ancient Chinese people in fighting diseases in their daily lives. It was introduced to Europe by Arabs, but there were no direct medical exchanges between China and European countries until the middle of the 17th century (M. Fu, 2016). English translation of TCM can be dated to over 300 years ago, during which time many people have contributed to research on TCM translation. However, limited by varying translator competencies, the great time between when the original was created and when it was translated, and the great

1 disparities between China and the West in language, culture and medical science, overcoming Chinese and English language barriers and transcribing TCM terms into English with the same or similar meaning or value as the original is challenging (M. Fu, 2016).

TCM translation activities were dominated by spontaneous translation practices from the beginning and gradually developed into a situation where both practice and theory are emphasised. As a result of the improved English competence of Chinese people, TCM English translation activities have become increasingly detailed and extensive. With the publication of myriad Chinese–English dictionaries, English TCM works authored by scholars from other countries or regions have entered China, promoting debates about translation theory. This has led to gradual accumulation of new translation problems, expediting research on TCM translation theory and the international standardisation of TCM terminology translation (Hong, 2008). This section will review the background and development of the English translation of TCM classics, and collect the authoritative dictionaries or monographs on TCM translation standards in China and beyond.

1.1.1 Study on English translation of ancient Chinese medicine classics

Most historical works on English translation of TCM classics briefly review the history of TCM English translation when looking back at the external exchanges of TCM, exemplified by Huangdi Neijing, Classic of Difficult Issues, and Shāng Hán Lùn. Many scholars have engaged in the study of the English translation of Huangdi Neijing and Classic of Difficult Issues. In the 1950s, Chinese scholar Wen Huang, the dean of Sun Yat-sen University of Medical Sciences, translated some important chapters of Huangdi Neijing into English. Paul Unschuld also translated the chapter “Questions of Fundamental Nature” (Qiu, 2011).

From 1980 to 2020, six authoritative English versions of Shāng Hán Lùn were published by Chinese translators proficient in English and foreigners familiar with Chinese medicine. In style, some translations highlight the communicative function 2 and intelligibility of the TT, and others stress the retention of characteristics of the original text and conveying its connotation.

These six English versions are:

1) Treatise on Febrile Disease Caused by Cold With Modern Studies, the English version of Shāng Hán Lùn translated by Xiwen Luo, a researcher at the Chinese Academy of Social Sciences, published by New World Press in 1986. This version was republished in 1993, with an additional 500 ancient and modern medical cases; in 2007 by the New World Press in Chinese and English forms as one of Library of Chinese Classic series; and in 2016 by New World Press.

2) Shang Han Lun (On Cold Damage: Translation and Commentaries) translated by Mitchell, Feng Ye, and Nigel Wiseman, published by Paradigm Publications in 1999.

3) Introduction to Treatise on Exogenous Febrile Disease translated by Huang Hai and published by Shanghai University of Traditional Chinese Medicine Press in 2005.

4) Shang Han Lun Explained translated by Greta Young Jie De and published by Elsevier Australia in 2009.

5) Discussion of Cold Damage (Shang Han Lun): Commentaries and Clinical Applications authored by Guohui Liu and published by Singing Dragon in 2015.

6) On Cold Damage: Classical Chinese–Modern Chinese–English translated in English by Zhaoguo Li and in modern Chinese by Xiru Liu in 2017.

1.1.2 Summary of standardisation process of TCM terms

TCM, deeply rooted in China, is a unique theoretical medical system that has evolved over thousands of years. Many ideas in traditional Chinese culture have had an impact on development of TCM (Y. Wang & Zhao, 2017). For example, during the Warring States Period, radical social changes and blooming academic development that brought about Taoism, Confucianism, Buddhism, and other schools, provided a favourable social and cultural atmosphere that facilitated formation of the medical

3 theory system. At this time, ancient physicians began investigating the mystery of human life and relationships between man and nature, and attempted to refine medical experience into theory (Si & Cui, 2016). On the basis of medical practice and achievements in anatomy, ancient physicians combined natural sciences and ancient philosophies like yin and yang and five-element theory to establish theories of visceral manifestation and meridians to explain the physiology and pathology of the human body to guide the diagnosis, prevention, and treatment of diseases. Hence, the theoretical system of TCM was gradually established (Si & Cui, 2016).

As a unique theoretical system, TCM has two basic characteristics: holism and treatment based on syndrome differentiation (Si & Cui, 2016). Holism refers to deeming things as a whole, whose parts are inseparable. In TCM, the human body is considered to be an organic whole, and the parts are interconnected and inseparable. Physiologically, it is embodied in five Zang-organs as integration and body-spirit mutual dependence. The various functions of the human body coordinate and interact with each other. Pathologically, all parts of the human body are mutually affected.

In the process of understanding disease, TCM advocates to first observe the overall pathological reaction caused by local lesions and unify local pathological changes with the overall pathological reaction. For instance, liver fire, once occurred, may be transferred to the heart, leading to agitation and irritability. Such a unity of internal and external environments and the thought of considering the human body as a whole represent a holistic concept. Understanding and treating diseases based on syndrome differentiation is the basic principle of TCM (Si & Cui, 2016).

In Western medicine1 climate factors such as dryness and humidity are generally considered to be irrelevant in disease diagnosis. Western medical diagnosis emphasises characteristic pathological changes of diseases and relies on specific and accurate data as the basis for judgment. However, TCM regards climate as important

1 Doctors and other health care professionals (such as nurses, pharmacists, and therapists) use drugs, radiation or surgery to treat symptoms and diseases. Also known as homeopathic medicine, biomedicine, conventional medicine, mainstream medicine and orthodox medicine. (Institute, N. C., n.d.) 4 in disease diagnosis, because, for example, damp obstruction, fixed arthralgia, and other diseases are certainly associated with humidity, and dry weather often leads to external dryness. Therefore, TCM pays special attention to the identification and differentiation of subjective symptoms, carefully distinguishing the nature of pain, such as swelling, stabbing, stuffy, hidden, and aching pain, which are regarded as greatly significant for identifying the cold, heat, deficiency xu and excess shi of a disease (Zhu, 2005).

Since TCM is a unique theoretical system, many of its basic terms and concepts have no counterparts in English. Some TCM terms may appear to be common to Western medicine, but often contain disparate meanings, which increases the difficulty of TCM translation (J. Li & Hu, 2012). TCM terms are the basis and essence of TCM, so the key to the international standardisation of TCM translation lies in the international standardisation of TCM terminology translation (Jia & Zhao, 2016).

TCM translation can be traced back to the middle of the 17th century, with efforts for international standardisation of TCM terms beginning in the middle and late 19th century (X. Ye & Zhang, 2017). The publication of myriad TCM translation works in different versions and types, including TCM English-related textbooks and dictionaries, indicates initiation of the international standardisation of TCM terms. In 1965, the Ministry of Health of China began compiling the Essentials of Chinese Acupuncture—the first acupuncture training textbook compiled by the Chinese government. With increased application and spread of TCM knowledge, TCM English translation activities became more active, prompting domestic scholars to launch the compilation of the TCM English dictionaries (Jia & Zhao, 2016), such as the Chinese English Dictionary of TCM Vocabulary compiled by Zhufan Xie in 1980. Based on the first edition, he authored the Chinese–English Classified Dictionary of TCM in 1994 (X. Ye & Zhang, 2017). In the 1980s, the English translation of TCM outside of China focused on acupuncture. In 1984, the Western Pacific Regional Office of the World Health Organisation (WHO) organised the publication of Standard Acupuncture

Nomenclature, the first book concerning the international standard of the English translation of acupuncture. Subsequently, WHO organised members in other regions to revise the edition and published the Standard Acupuncture Point Names—Part 2 (Revised Edition) in 1989 (Jia & Zhao, 2016).

In the early 1990s, the increasing emergence of different TCM English translation works prompted translators to theoretically study TCM translation, leading to many articles and monographs on the translation of TCM terminology (X. Ye & Zhang, 2017). For instance, regarding translation of TCM terminology, Nigel Wiseman authored a widely used dictionary A Practical Dictionary of Chinese Medicine, first published by Paradigm Publications in 1994 and republished in 1998. The dictionary covered a wide range of TCM terms and built a TCM terminology system that has been adopted as the English standard by Paradigm Publications and Blue Poppy Press, two of the largest US traditional medicine publishers (X. Ye & Zhang, 2017).

Research on the theory of English translation of TCM terms reached a staged climax from the 1990s to the present. Several conferences on the international standardisation of TCM terms have been convened, in which an array of international standardisation programs of TCM terminology translation were completed, indicating a progression in the international standardisation of TCM terminology translation had been achieved (Jia & Zhao, 2016). In 2004, with support of the State Administration of Traditional Chinese Medicine of China, the English Translation of Common Terms in Chinese Medicine was published, which offered specific standards for Chinese medicine concepts, terminology requirements, the origin of Chinese characters, English grammar and expression, and comparison between Chinese and Western medicine concepts. The research results in this book are not only widely promoted in China, but were also adopted by WHO as one of the references for the formulation of the International Standard Terminologies on Traditional Medicine. In October 2004, the Conference on International Standardisation of TCM Terminology was held in Beijing, marking the official launch of the international standardisation project of Chinese Medical Terminology by WHO and confirming the position and role of China

6 in the research and implementation of international standardisation of TCM terms. On October 16, 2007, the WHO promulgated the WHO International Standard Terminologies on Traditional Medicine in The Western Pacific Region (ISTTCM), a new achievement in international cooperation on the international standardisation of TCM terms. Subsequently, while WHO boosts international standardisation of TCM terms, another TCM international academic organisation, the World Federation of Chinese Medicine Societies (WFCMS), also committed itself to this, formulating the International Standard Chinese—English Basic Nomenclature of Chinese Medicine (ISNTCM) that was unanimously approved at the general assembly meeting in April 2007 and published in 2008 (J. Li & Hu, 2012).

1.2 Introduction to Shāng Hán Lùn and its three English versions

As for TCM, there are four widely recognised classics: Huangdi Neijing, Shāng Hán Lùn, Synopsis of Prescriptions of the Golden Chamber, and Detailed Analysis of Epidemic Warm Diseases, included as teaching content of TCM classics in college and university textbooks (Hu, 2008).

Shāng Hán Lùn is the first medical classic in China with a comprehensive collection of treatment methods and prescriptions, combining theory and practice. It systematically reveals the rules of diagnosis and treatment of externally contracted heat diseases and miscellaneous diseases that cause internal damage, thereby laying the foundation for clinical medicine of TCM.

The Treatise on Febrile and Miscellaneous Diseases was written in the late Eastern Han Dynasty (200–219 AD), a period of chaos caused by continuous wars and widespread outbreak and prevalence of diseases. Zhongjing Zhang originally had a large family of more than 200, of which about half died of typhoid fever over a 10 year period, which made him determined to devote himself to medical research and writing medical books (especially Shāng Hán Lùn) to educate people. In Shāng Hán Lùn, he summarised medical achievements of the Qin and Han dynasties, the merits of other medical works, and he elaborated on his own rich experience in symptom

7 identification, making his book a TCM clinical classic covering pathology, symptom identification, treatment methods, prescriptions, and medicine preparation (X. Zhang & Liu, 2016).

Although the original Treatise on Febrile and Miscellaneous Diseases was lost in the chaos of war soon after completion, 100 years on, Shuhe Wang, an imperial physician in the Western Jin Dynasty, collected and organised the remaining typhoid fever part of the book and named it Shāng Hán Lùn. This was the first version of a book that was revised by Yi Lin, Qi Sun, Baoheng Gao, et al. from a medical bookstore in Song Dynasty, resulting in the currently popular Shāng Hán Lùn. Two versions of Shāng Hán Lùn are currently in circulation: 1) the Song Version, revised by Yi Lin et al. during the Zhiping period of the Song Dynasty, also lost, of which only a version reprinted by Kaimei Zhao in the 27th year of Wanli of the Ming Dynasty (1599 AD) remains; and 2) the Annotation version Shāng Hán Lùn Annotation, authored by Wuji Cheng in the 14th year of the Southern Song Dynasty (1144 AD) (X. Zhang & Liu, 2016).

1.2.1 Selection of Shāng Hán Lùn original texts

Following the loss of the original Shāng Hán Lùn, many medical practitioners have reorganised and modified it, producing different versions (X. Zhang & Liu, 2016). The version I refer to is a copy of the Shāng Hán Lùn Annotation in the “Online Library” of the Chinese Text Project website (http://ctext.org)2, comprising 10 volumes and 22 articles. From this I extract chapters 5 “Syndrome Differentiation for Taiyang Disease and Its Treatment” to 12 “Syndrome Differentiation for Jueyin Disease and Its Treatment,” which cover syndrome differentiation and treatment of six-meridian diseases, focussing on syndrome-differentiation of the six meridians.

2 Shanghan Lun (Sibu congkan chubian edition), reprinted in Sturgeon (2011), https://ctext.org/library.pl?if=gb&res=77419&remap=gb

1.2.2 Three English versions of Shāng Hán Lùn and their translators

Shang Han Lun (On Cold Damage): Translation and Commentaries, written and translated by Feng Ye, Nigel Wiseman, and Craig Mitchell, was published by Paradigm Publications in 1999. The main translator of this version is Nigel Wiseman, a scholar who has contributed greatly to spreading TCM in the West. Born in the UK in 1954, he is a well-known linguist and multilingual who is proficient in Spanish, German and Chinese. Granted a PhD in Complementary Health by the University of Exeter, in 1981, he immigrated to Taiwan and began teaching English and TCM at China Medical University and Chang Gung University (X. Ye & Zhang, 2017).

Xiwen Luo's Treatise on Febrile Disease Caused by Cold with Modern Studies was published by New World Press in 1986. The English version received widespread attention upon publication. It was republished in 1993. In 2007, to disseminate traditional Chinese culture to the world, and to comprehensively and systematically introduce Chinese cultural classics to the West, the series of Chinese–English books Library of Chinese Classics were published by New World Press, in which Luo’s version was republished as one of a series. The latest version of Treatise on Febrile Disease Caused by Cold was published by the New World Press in 2016. Xiwen Luo, born in 1945, is a researcher at the Institute of Philosophy of the Chinese Academy of Social Sciences, a national expert who has made outstanding contributions, and the gainer of special government allowances from the State Council. He is also the chief expert of the “Research on Traditional Chinese Medicine Classics and Their English Translation” project supported by the National Social Science Fund, the Chairperson of the Chinese Medicine and Philosophy Committee of the History of Chinese Philosophy Society, and an adviser to the research group of the “National Survey of Traditional Chinese Medicine and Ethnic Medicine,” Chinese Academy of Social Sciences. He is also an English translator of TCM classics. As early as 1972, he launched the translation of TCM classics under the guidance of an older generation of experts and scholars in TCM (“Introduction to Xiwen Luo,” 2013).

The Introduction to Treatise on Exogenous Febrile Disease translated by Hai Huang was published by the Shanghai University of Traditional Chinese Medicine Press in 2005. Hai Huang graduated from the Fujian University of Traditional Chinese Medicine with a Bachelors in 1986, and from Jiangxi University of Traditional Chinese Medicine with a Masters in Typhoid Fever in 1992. In 2005, he gained a PhD in Integrated Traditional Chinese and Western Medicine for Cardiovascular Disease by Fujian University of Traditional Chinese Medicine. In contrast to the former two translators, Huang is mainly engaged in clinical related work in TCM as a physician and professor (“Hai Huang,” 2016).

1.3 Research purposes and significance

Chinese classics, as the foundation and essence of TCM, are of great significance for the spread of TCM to the world. Previous studies have focussed on the English translation of Huangdi Neijing rather than Shāng Hán Lùn. Studies have compared the English versions of Huangdi Neijing from the perspective of Skopos theory.

Previous research on TCM terminology translation from Shāng Hán Lùn is generally based on the functional equivalence theory of Nida (Sheng, 2013), or Polysystem theory (Xi, 2012). Several studies have applied Skopos theory to explore the translation strategies of TCM terms. Translation Principles of Traditional Chinese Medicine Nomenclature—from Skopostheorie Perspective is a case in point, where translation principles of TCM nomenclature and translation methods of TCM nomenclature are discussed. Regarding translation principles for TCM nomenclature, the recommendation was made to use idiomatic words as often as possible to avoid Westernisation and retain traditional concepts, while underlining medical information over-literal translation. Regarding translation methods, it proposed transliteration, free translation, literal translation, and morpheme translation. Unfortunately it failed to systematically and logically combine translation principles and methods with the Skopos theory, and did not comment on the translation of TCM terms combined with principles of TCM translation (e.g., principles proposed by Li Zhaoguo).

Target readers of my study (this thesis) are students, practitioners, researchers and enthusiasts who learn TCM in English. My study focuses on translation of TCM terms from Shāng Hán Lùn based on Skopos theory. Research on application of TT communicative purposes and functions to TCM terminology translation is still exploratory. Hence, my research aims to explore the principles, strategies, and methods of English translation of TCM terms according to Skopos theory, to systematically and organically combine the cultural characteristics of TCM with the systematic properties of TCM terms. I expect to identify a balance between term translation standardisation and cultural differences, and between foreignisation and domestication. By studying different English versions of the symptoms and disease names in Shāng Hán Lùn, my study strives to analyse and discuss the translation principles and strategies of TCM terms from the perspective of Skopos theory, with an aim to make the translation of TCM terms more rational, standardised and scientific.

1.4 Thesis structure

Chapter 1 introduces the background of TCM terminology translation, reviews the development history of TCM classics and term translation activities, presents the creation background of Shāng Hán Lùn, the selection of the original text, and its three English versions, and finally outlines the structure of this thesis.

Chapter 2 reviews the literature on the international standardisation of TCM terms and debates on the translation strategies and methods for TCM terms.

Chapter 3 presents the concept of Skopos theory, elaborates the feasibility of its application in the English translation of TCM terms, and describes the principles of TCM terminology translation. Moreover, according to Skopos theory and TCM terminology translation principles, some target-reader oriented TCM terminology translation principles are summarised, and the research methods of this study are described.

Chapter 4 comprehensively analyses the translation examples of two-character symptoms and two-character disease names in Shāng Hán Lùn in combination with their three English versions.

Chapter 5 presents the main analysis and discussion, and explains study limitations.

Chapter 2 Literature Review

2.1 Research on the consistency and standardisation of traditional Chinese medicine terms

In recent decades, TCM has rapidly developed in many traditionally English-speaking countries. Some countries have even considered incorporating TCM into their medical system. TCM appears to have been increasingly accepted, wholly or partially, by more countries and regions. However, since TCM originates from China, its source language (SL) is also basically Chinese, and even ancient Chinese in some TCM classics. A single TCM term usually has different English translations, complicating academic research, clinical research, and various forms of communication of TCM (X. Ye & Zhang, 2017). In addition, TCM is an ancient medical system deeply rooted in Chinese traditional culture. TCM terms are the foundation of TCM theory, so their English translation will help English-speaking readers study TCM (Jia & Zhao, 2016).

TCM terminology translation is important to spread traditional Chinese culture to the world. Its standardisation plays a key role in popularising TCM theory (H. Jiang & Wu, 2019). However, translations are not consistent or standardised: for exampole, 心下急 xīn xià jí is translated into “distress below the heart” in the WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region, but “epigastric distress” in International Standard Chinese–English Basic Nomenclature of Chinese Medicine. Linguists and medical experts from around the world, in groups or individually, have endeavoured to establish a standardised English version of TCM terminology (X. Ye & Zhang, 2017), with some progress—for example, from 1978 to 1986, Ou Ming and his team wrote two dictionaries, Chinese– English Glossary of Common Terms in Traditional Chinese Medicine and Chinese– English Dictionary of Traditional Chinese Medicine, and in 2007, the WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region was published online by WHO in the Western Pacific Region (X. Ye & Zhang, 2017). However, so far, no internationally recognised standardised English version of

TCM terminology has been established (X. Ye & Zhang, 2017). In this section, I will first review the viewpoints of Chinese linguists and medical experts on standardising TCM terms, and then discuss their Western counterparts’ views. This will be followed by an analysis of any controversy and conclude with the necessity to unify and standardise TCM terms.

2.1.1 Research on the international standardisation of TCM terms by Chinese medical scientists and linguists

Zhufan Xie, born in China in 1924, studied Western medicine at the beginning of his medical education, before switching to major in TCM. In 1980, Xie wrote the Chinese English Dictionary of TCM Vocabulary, mainly used internally by Peking University. After 1994, he authored the Chinese–English Classified Dictionary of TCM based on his earlier version (X. Ye & Zhang, 2017). Xie (2003) believed that TCM was suffused with ancient Chinese wording and phrasing, esoteric ancient philosophical ideas, and cultural connotations, which brought about great challenges to the translation of TCM terminology. This also led to miscellaneous translations for a single TCM term by different translators, greatly hindering the correct understanding of TCM terms by Westerners. For this reason, unification and standardisation of the translation of TCM terminology is required to facilitate TCM teaching, practice, research and information exchange. Due to the efforts of TCM translation pioneers, there is no need to re-translate TCM terms one by one. What is needed is to conduct comparative studies using existing translations, and to identify widely accepted versions as standard translations (He, 2019).

Standardising TCM terms should create favourable conditions for development and spread of TCM. TCM boasts a unique theoretical system and thinking methodology and is characterised by many different terms and expressions that form a large number of endemic, vivid analogy descriptions, which pose more difficulties for the translation of TCM terms (Guan, 1995). In Discussion on the International Standardisation of Traditional Chinese Medicine Terminology, Guan (1995) stated to 14 address these problems the relations between TCM and Western medicine terms had to be disentangled, and connotations of terms peculiar to TCM fully understood and then expressed using suitable English words, to standardise TCM translation; ultimately, a national expert committee should standardise English translations of basic vocabulary commonly used in TCM, which Guan suggested was a problem that: 1) was in need of a solution, 2) that could not be solved overnight and could only be solved through a comprehensive solution based on thorough preparation, brainstorming, and extensive information collection; and 4) the task shall be mainly completed by personnel proficient in TCM and foreign languages.

Zhaoguo Li, born in China in 1961, pursued a PhD in translation studies of Chinese classical culture from the Shanghai University of Traditional Chinese Medicine. Since 1991 he has authored more than 100 papers and several books on the English translation of TCM, such as the Traditional Chinese Medicine Translation Skills published by People's Medical Publishing House in 1996—the first systematic theory work concerning TCM translation (X. Ye & Zhang, 2017). In Reflection on the International Standardisation of Traditional Chinese Medicine Terminology, Li defined terminology as “a set of specialised words or terms used in a specific subject, profession or sport.”

In TCM translation, many translators confuse TCM terminology with difficult sentences. A large portion of TCM’s daily expressions come from TCM classics. Classic quotes commonly used in daily expressions actually are not noun terms, but instead declarative or judgment sentences, for example, 脾主运化 pí zhǔ yùn huà (the spleen governs movement and transformation), 风为百病之长 fēng wéi bǎi bìng zhī zhǎng (wind is the leading factor in causing various diseases), and 百病皆因痰作祟 bǎi bìng jiē yīn tán zuò suì (a lot of disorders result from mischiefs of phlegm). From a grammatical point of view, these classic quotations are declarative sentences rather than noun terms (Li, 2008). Z. Li (1994) emphasised that for the translation of TCM terms, consistency should be maintained, but for the translation of sentences, there was no need to stretch on the Procrustean bed.

In his On the Concepts, Principles and Methods of International Standardisation of Traditional Chinese Medicine Terminology (Luo), Li highlighted the importance of internationally standardised TCM terminology translation. TCM is a medical system that originated in China and is rooted in Chinese traditional culture, because of which great disparities in theory and practice can exist with modern medicine. As such, TCM terms are difficult to find counterparts for in the languages of Western countries, complicating the international exchange of TCM. Li suggested that the problem of international standardisation of TCM nomenclature has long attracted the attention of the Chinese government and the WHO, who have proactively sought solutions. However, due to the differences in Chinese and Western medicines in language, culture and medical science, as well as discrepant understandings of standardised concepts, principles, and methods, the studies on international standardisation of TCM terms are fraught with difficulty.

Despite the uniqueness of TCM theory and practice and its incommensurability with modern medicine, the practical foundation of internationally standardising TCM nomenclature is increasingly enhanced by deepened exchanges between Chinese and Western medicines. Li mentioned that with constant communication and exchange Western scholars have developed a deeper understanding of TCM, and gradually addressed problems that once seemed unsolvable, with the example: today's Western readers no longer thoughtlessly consider beyond logic and above reason the notions that may be quite contrary to modern medicine like “the heart controls the mind.” Instead, they may naturally link them with Chinese culture and Chinese medicine theory. This should be credited to increased communication and development between China and the West in the field of Chinese medicine. At the same time, Chinese and Western translators are also gradually forming a more consistent view on the translation of basic TCM concepts such as Yin 阴 and Yang 阳, laying a foundation for cooperative studies on international standardisation of TCM terminology.

2.1.2 Research on international standardisation of TCM terms by Western medical scientists and linguists

A major problem encountered by Westerners in learning TCM is their inaccessibility to original TCM works. Most “TCM books” in the West are review articles about “traditional Chinese medicine.” Coupled with preconceived notions on how to constitute an effective scientific treatment, Westerners generally fail to develop a clear and correct understanding of TCM, which in turn affects Western translators’ objective reproduction of original texts (Wiseman & Zmiewski, 1989). The translation of TCM is a challenging task—particularly the handling of TCM terminology, which affects Westerners’ learning and understanding of Chinese medicine (Wiseman & Zmiewski, 1989). Paul Zmiewski and Nigel Wiseman (1989) argued that each discipline relies on standardised terminology to express its basic concepts and principles, so uniform nomenclature should be adopted in their translation. If different terms are used by translators to translate the same concept, it will confuse students. Further, if a translator is unaware of a problem and translates the same concept differently in different places, it will further confuse learners.

For any discipline, the standardisation and consistency of terminology are of uppermost importance. However, when it comes to the translation of TCM terminology, there has always been chaos (Wiseman & Zmiewski, 1989). Compared with Western medicine, TCM features a large proportion of ordinary language, which, to a certain extent, negatively affects the standardisation of Chinese medical terms and also complicates correct understanding and translation. Because TCM by and large studies the natural or social phenomena of daily life (e.g., gold, wood, water, fire, soil; yin, yang, cold, heat), its language is not unusual to ordinary Chinese people. The difference is that after introduction into the language system of TCM, those ordinary terms, from the connotation to the extension, have been closely integrated with the well-established theory of TCM and even vested with mysterious meaning. As a result, an average person generally fails to understand the meaning of those seemingly

17 common terms. Western medical terms are easier to be understood by laymen; for example, Streptococcus bacteria is a term that for common people is rarely used or accessed in their daily lives (Wiseman & Zmiewski, 1989).

Paul Zmiewski and Nigel Wiseman (1989) claimed that although English is a language full of productivity, for some TCM terms it is recommended to create new words by borrowing archaic words or unfamiliar words. Wiseman and Zmiewski (1989) believe that borrowing archaic words is preferable because they can improve the specialised level of terminology. For example, in many cases, 青 qīng in TCM means blue or green, especially when it is combined with the five elements3. However, for native English speakers, they tend to naturally associate green with a tree, and understand the 青 qīng in 面青 miàn qīng as “blue.” Therefore, 青 qīng associated with the five elements4 is translated into “green” while that in 面青 miàn qīng is translated into “blue,” and English-speaking readers will have difficulty associating blue with the five elements. Further, in English, green cannot be used to qualify complexion, nor blue a tree. Hence, Zmiewsk and Wiseman advocate for translating 青 qīng into “cyan.” In modern English, cyan has the dual meanings of blue and green, and is additionally an unfamiliar word that is fit to express the broad meaning contained in the TCM term.

Although English has a large number of ready-made words that can express subtle meanings, Chinese relies heavily on word combinations. For example, one word “theory” corresponds to the two Chinese characters “理论” lǐ lùn. Another case in point given by Zmiewski and Wiseman is “淡黄” dàn huáng, which, they think, should be translated into “pale yellow,” so as to reserve the connotation of the five elements contained in the original. The phrase is composed of two separate terms, “淡” dàn and “黄” huáng, so translating it into one word (“sallow”) loses its meaning in the five elements, even though the relevance of the two terms exists. Therefore, in

3 Metal, wood, water, fire, and earth, are held by the ancients to compose the physical universe and later used in TCM to explain various physiological and pathological phenomena (Jingwei Li, 2005). 4 The five elements correspond to five colours associated with diseases of the five organs: qing (cyan) the liver, hong (red) the heart, huang (yellow) the spleen, bai (white) the lung, and hei (black) the lung (Jingwei Li, 2005). 18 the translation of TCM terms, special attention must be paid to the terms of relevance and accuracy. TCM translators often reach a deadlock when directly translating a polysemous TCM term with professional terminology or in a paraphrased manner. To address this problem, Wiseman and Zmiewski believed the best way was to reduce use of English counterparts as much as possible, and to choose adaptable, highly abstract words to help target readers understand the connotation of TCM terms.

Qualitative terms are the property of a linguistic community. Therefore, when it comes to translating them they should be paraphrased according to context. However, if it is a technical term, it should be translated with a standardised counterpart (Wiseman & Zmiewski, 1989). Wiseman and Zmiewski (1989) identified several issues concerning the international standardisation of TCM terminology translation:

1. They regarded free translation to loyally convey the semantic meaning of terms to be difficult. For example, 熄风 xī fēng is a treatment for internal wind disease5 while 祛风 qū fēng is for external wind disease6, translated into “extinguishing wind” and “dispelling wind,” respectively. If the context is not clearly expressed the two translations will cause confusion. The translation of many TCM terms share this problem, so standardisation is still required.

2. Conditionally stipulated terms mainly refer to the 200 + words used to describe illness, pathological conditions, and treatment methods. For instance, 化 huà is usually translated into “transformation,” referring not only to the function of the spleen, but also a method of treating phlegmatic hygrosis and congestion. From this point of view, it seems that 化 huà can be translated into different versions, such as “transformation” to express the spleen's transport function, and “resolution” to underscore the removal of diseases and evils. While appearing reasonable, these translations actually lose the actual

connotation of the original semantic meaning. A more appropriate translation

5 Internal wind disease is not caused by external factors but by internal hepatic pathological changes (Jingwei Li, 2005). 6 External wind disease refers to the symptoms caused by external wind evils in nature (Jingwei Li, 2005). 19

requires the integrity of the original text’s semantics to be preserved.

3. Only by preserving the semantic relevance of TCM terms (as much as possible) can Western readers fully understand the culture and philosophy of TCM. In the end, maintaining consistency in terminology translation is conducive to the learning and research of TCM, in addition to facilitating lecturing TCM in English. Wiseman and Zmiewski (1989) believed that the failure to accurately identify technical terms resulted in incoherence and inconsistency of the Chinese language, causing misunderstanding and confusion. They advocated for establishing a terminology system similar to Chinese to enable English-speaking students to develop the same definition and connection of TCM terms as their Chinese peers.

Giovanni Maciocia was a visiting Associate Professor at Nanjing University of

Traditional Chinese Medicine. In the The Foundations of Chinese Medicine: A Comprehensive Text, Maciocia translated all TCM terms therein excluding the units of measurement like “yin,” “yang,” “qi,” and “cun.” As for the terms peculiar to TCM, he chose to capitalise the first letter of words, for example, “Blood” referred to an important substance in Chinese medicine, while “blood” referred to the blood flowing in blood vessels. He also applied the method of capitalising the initial letter of words to the pathological colour and shape of pulse quality and tongue body. Many teachers, himself included, preferred to use pinyin7, such as Yuan Qi (instead of Original Qi), especially when a term was first introduced. He also frequently used pinyin terms in the book, and pinyin to translate TCM terms at least once in each chapter, especially when a term was first introduced. His explanation for translating all TCM terms (with the exception of the aforementioned measurement units) was that a good English translation was more readable than Chinese terms with pinyin.

Transliteration may be the simplest option, but it is not an ideal one, because a single pinyin word can have more than one meaning, for example, jing, which may mean

7 A system for writing Mandarin in Roman letters instead of Chinese characters. Retrieved from https://dictionary.cambridge.org/dictionary/english/pinyin 20

“channels” (经), “shock” (惊), or “Essence” (精); and shen, which may mean either “Kidneys” (肾) or “Spirit” (神). Maciocia also believed that the greatest difficulty in translating TCM terms may be that a term often has different meanings in different contexts. For example, 厥 jué has a variety of meanings, including the state of fainting and loss of consciousness, ice-cold extremities, and a critical situation of urinary obstruction. Maciocia (2015) also asserted that (to his knowledge) most lecturers in the Western world generally preferred to use pinyin terms rather than English counterparts. Therefore, lecturers generally used more “Kidney-Jing” than “Kidney-Essence.” As for some terms like 治法 zhì fǎ, most lecturers favoured a pragmatic method, that is, translating it into “treatment principle” instead of “zhi fa”, but for other terms, transliteration may be completely adopted, like “Yuan Qi.” He held that the diversity of translation strategies may have a positive effect because each translator may highlight different aspects of a TCM term, enriching target reader understanding of a term. For example, 宗气 zōng qì was translated into “Gathering Qi” by Maciocia but into “Pectoral Qi” in the International Standard Chinese–English Basic Nomenclature of Chinese Medicine. Therefore, through different translation versions, readers can get exposure to different translators’ views and understandings of 宗气 zōng qì, but they cannot label these translations as “wrong.”

Unlike scholars who advocate for the international standardisation and consistency of TCM terms, Maciocia (2015) argued that attempts to strengthen the international standardisation of TCM terms may backfire and suppress healthy debate. He hoped that readers could benefit from the diversity of translation versions of TCM terms, and insisted there was no need for building an ossified, so-called “correct” nomenclature that encapsulated a corresponding translation for each TCM term—a practice and trend he considered to be a potentially dangerous, because such standardised, “approved” TCM terms inevitably resulted in students and practitioners missing out on the richness of Chinese and TCM ideological connotations, hence failing to get touch with the culture and philosophy of TCM. If each TCM term was given an authoritative, standardised translation, students would lose their motivation to explore

21 the meaning of Chinese terms that could only be sensed but not explained. Therefore, in his opinion, after comprehensive consideration of TCM characteristics and clinics, free translation combined with transliteration (where appropriate) may better help target readers grasp the spirit and essence of TCM (Maciocia, 2015).

2.1.3 Remarks

This section mainly discussed the viewpoints of researchers in China and Western countries on the international standardisation of TCM terminology translation.

The views of Chinese researchers represented by Zhufan Xie, Qisheng Guan and Zhaoguo Li, were first introduced, and this section concluded that these scholars have had a positive attitude towards standardisation. Xie (2003) thought that a confused situation caused by miscellaneous translations for a single TCM term went against target readers’ correct understanding of the original. Therefore, he advocated for the international standardisation of TCM terminology to facilitate the international promotion, research, and communication of TCM. Moreover, Xie (2003) also suggested to first collect the TCM terms as research objects from the published TCM books, including textbooks, monographs and dictionaries, and then select a suitable translation for each TCM term as the recommended standard translation. Guan also believed that standardising TCM terminology translation could provide favourable conditions for further development and spread of TCM. Zhaoguo Li underscored the great differences between China and Western countries in language, culture, and principles of medical science, as well as the absence of TCM counterparts in Western languages including English, which posed a great challenge to the international spread of TCM. For this reason, it is imperative that the English translation of TCM terminology is standardised.

The views of Western peers regarding this problem were discussed. Those of Paul Zmiewski and Nigel Wiseman supported standardisation while Giovanni Maciocia objected. In the opinion of the former two scholars, each subject needs standardised nomenclature to express its basic concepts and principles. Translating the same 22 concept with different words, from their point of view, increased the learners’ memory burden and thus affected their learning outcome. Accordingly, they supported international standardisation of TCM terminology translation, in favour of learning and TCM research. To the contrary, Maciocia believed that the attempts to standardise TCM terminology translation may suppress the positive debates about TCM translation, and that the advantages far outweighed the disadvantages. Readers could benefit from the diversity of English translations of TCM terms and draw inspiration from them. Therefore, he saw no need to establish a solidified and so-called “correct” nomenclature that offered an authoritative English translation for each TCM term. He considered it to be a potentially dangerous trend, because standardising the English translation of TCM terms may separate students and scholars from the richness of Chinese and TCM ideological connotations, thereby making them deviate from the essence of TCM concepts.

From my perspective, special attention should be given to the purpose of the translation of TCM terms, including target readers, promotion areas, and other goals, when this problem is considered. If the translation of TCM terms is used for teaching purposes, I agree with Giovanni Maciocia’s opinion that officially standardising the English version of TCM terms may discourage students from using their solutions to explore the meaning of Chinese terms, which goes against the spread of traditional Chinese culture. However, for other translation purposes, I think that a standardised and consistent English version of TCM terms is crucial if TCM is to be communicated in the West, especially in English-speaking countries, given that TCM terminology falls into the category of sci-tech terminology. Different English translations for a single TCM term by different translators will inevitably confuse readers and researchers. Therefore, I advocate for establishing an accurate, complete and comprehensive terminology system that incorporates an English translation for each TCM term, by which the essence of the TCM system can be more accurately and systematically transmitted to international TCM students and practitioners.

2.2 Research on the translation strategies and methods of C–E translations of traditional Chinese medicine (TCM) terminology

Translation involves both language and culture. It is no longer the transition of literal meanings in a traditional sense, but becomes trans-cultural communication behaviour. Cultural diversity introduces many difficulties for trans-cultural translation. In the process of translation, translators are faced with problems such as conveying the culture of the SL and overcoming the cultural barriers between SL and target language (TL) (H. Sun, 2011). Cultural factors influence and restrict the translation among different languages, so translation needs to overcome linguistic barriers and to consider cultural background also. In translation practice, it remains controversial when cultural factors are involved (L. Zhang, 2016).

In translation, translators are normally confronted with whether to be SL or TL centred. SL-centered translation involves being more faithful to the semantic meanings of the SL and author, while rendering an exotic style to the translation. TL- centered translation involves being more faithful to the culture and expression habits of the TL, rendering the translation more natural for the target reader (Xu & Zhang, 2002). Cultural differences in the process of translation demand a translation strategy.

Translation is a cross-lingual communication activity, of which the essence is the transmission of cross-cultural information. It is not only a process of language conversion but also a process of cultural transplantation and spread. Domestication and foreignisation shift translation from the linguistic level to the cultural level (W. Yang, 2010). Many concepts in TCM are closely related to traditional Chinese culture. Therefore, the translation of TCM terms also faces the cultural orientation problem between “domestication” and “foreignisation” and the selection of translation strategies.

In this section, I first introduce specific translation methods, such as literal translation, free translation, transliteration, and the Western medicine referenced method. I then elaborate on the concepts of foreignisation and domestication, and discuss their

24 application to the translation of TCM terms. In conclusion I summarise the contribution of these translation methods and strategies to the translation development of TCM terms.

2.2.1 Introduction to translation methods and strategies

The distinction between ‘word-for-word’ (i.e., ‘literal’) and ‘sense-for-sense’ (i.e., ‘free’) translation goes back to Cicero (106–43 BCE) and St Jerome (347–420 CE)

(Munday, 2016). Literal translation attaches great importance to the techniques of language processing, that is, how to maintain the form of source text (ST) while not distorting the meaning of the TT. Such a translation approach adheres to conveying the connotation of ST, and follows its linguistic form. To maximise the similarity of TT to ST in linguistic form, translators who favour literal translation tend to sacrifice the form elements of TT, even its intelligibility (F. Wang, 2014).

Free translation is based on the fact that different languages have distinct cultural connotations and expressions. When linguistic forms create challenges for translation, a free translation approach should be used to ensure the comprehensibility of the TT

(F. Wang, 2014). Those who prefer free translation are likely to pursue the elegance and comprehensibility of the TT at the expense of the linguistic form of the ST (F.

Wang, 2014). A case in point is Jerome, who backs free translation and opposes word- for-word translation, claiming that unduly following the form of the ST is prone to ridiculous translations that fail to clearly convey the meaning of the ST. Conversely, the sense-for-sense approach contributes to unequivocally expressing the meaning or content of ST (Munday, 2016).

Transliteration is a process of representing words from one language using the approximate phonetic or spelling equivalents of another language (Tiedemann &

Nabende, 2009). This approach attempts to completely transfer the conceptual meaning and cultural context in the SL to the TL, constructing corresponding concepts as well as a corresponding cultural context, with the aim of achieving the intact expression of meaning and culture. In particular, when some cultural words or 25 images in the SL have no counterparts in the TL while their rich connotation cannot be expressed in a concise manner, they are generally converted into the same or similar phonetic or spelling equivalents of the TL (Xiong, 2014). Xiong (2014) believed that transliteration helped to preserve the meanings of expression and cultural connotations peculiar to the SL, allowing target readers to experience the most authentic expression and culture of the TL. Transliteration may go against the style or manner of writing of the TL in an attempt to avoid cultural damage or misunderstanding to which literal translation is prone, or version prolixity caused by free translation.

Thanks to the simplicity of and easiness to remember pinyin, transliteration can ensure the conciseness of the translated terms or names to a large extent. Transliteration by pinyin (without tone marks) is particularly suited for Chinese words that refer to Chinese culture or have no English equivalent, and such an approach enables target readers to experience the alien quality of Chinese culture. Huang and Li (2004) deemed transliteration a non-mainstream translation approach. In their opinion, if transliteration played a leading role in translation, it inevitably increased the memory burden of target readers. Compared with free translation, transliteration only conveys the phonetics of the original and fails to clearly reveal its connotation. It is therefore hard to be memorised and has poor communicability. As such, it is unwise to extensively use this approach (Huang & Li, 2004).

Borrowing is defined as a type of direct translation in that elements of the ST are replaced by parallel TL elements. This process is considered to be the simplest type of translation because it merely involves converting a SL word into TT with no modification necessary. The reason for this transfer is usually that translators need to overcome some voids, strive to a particular stylistic effect, or to introduce some local colour into the TT. Borrowings or loan words often come to be so widely accepted in the TL that they cease to be perceived as foreign items (Shuttleworth, 2014).

Controversies over foreignisation and domestication can be viewed as the extension of the debate on “free translation” and “literal translation” (F. Wang, 2014). 26

Domestication and foreignisation are two different translation strategies used to provide language and cultural guidance. These strategies have long been the focus of debate in the translation community (Elnaili, 2014). The two concepts were first proposed by the American scholar Lawrence Venut in his translation studies book The Translator's Invisibility: A History of Translation in 1995. Before discussing the effectiveness of these two strategies, Venut first defined them. According to Venuti, domestication refers to “an ethnocentric reduction of the foreign text to target- language cultural values, bring the author back home, while foreignisation is an ethnodeviant pressure on those (cultural) values to register the linguistic and cultural difference of the foreign text, sending the reader abroad” (Venuti, 2003). In other words, foreignisation helps to retain the connotations of the original content, whereas domestication aims to improve a target reader’s understanding of the ST.

Foreignisation (possibly involving the calques of vocabulary and syntax) reflects the SL norms and reminds target readers they are dealing with translation, so the TT with foreignisation allows readers closer to the charm of foreign languages (Munday, 2016). Venuti considered the translation strategy of domestication departed from the ethnocentric ideology and literary norms behind it, for people centered on their own ethnicity, by leaving marks of TL culture on foreign texts and forcing the weaker culture to listen to the stronger one, hence the expression of cultural colonialism. He also proposed the concept of resistant translation, with the goal of developing one type of translation theory and practice to resist the trend of a dominant position of TL culture so as to highlight the differences of texts in terms of language and culture (Venuti, 2003). Venuti (2003) called for translators to “restrain the ethnocentric violence of translation,” by purposefully adopting an unsmooth translating style or that different from the TL habits, so as to highlight the foreign features of the ST, protect the ST from being controlled by the TL culture, and ultimately allow “the presence of the translator, more visible.”

Nida discarded the old words like “literal” and “free” and replaced them with “types of equivalence” (Munday, 2016). Unlike Venuti, who advocated for foreignisation,

Nida proposed formal equivalence and dynamic equivalence. The former is oriented to the ST structure, which plays an important role in determining accuracy and correctness. The most typical of such translations is “gloss translations,” sharing a similar structure with the ST but generally adding interpretive footnotes. Such translations are usually used in an academic or legal environment, allowing readers to get closer to the language and customs of the SL. The formal equivalence approach leads to literal translation, limiting the changes to the story or meaning of the original. However, for those with limited knowledge of the cultural background contained in the ST, it is merely a limited translation method that seems to remind people of the word-for-word (literal) translation (Watson, 2017). Dynamic Equivalence is defined as seeking the natural equivalent closest to SL information. Nida asserted that translation should follow the principle of naturalness of expression, and the behaviour patterns in SL should be assimilated into the cultural field that target readers are familiar with. Moreover, this translation concept does not emphasise that target readers should accept the behaviour patterns in the SL to understand the concept of source information. The reader-oriented approach considers the adjustment of grammar, lexicon, and cultural references to be essential for achieving naturalness (Munday, 2016).

The TT language should not show interference from the SL, and minimise the extraneousness set by the ST. The accuracy of a translation depends on producing the same effect in the target culture as the ST produces in the SL. Nida claimed that receptors of a translation should comprehend the TT to such an extent that they can understand how the original receptors must have understood (Venuti, 2018). This is contrary to Venuti’s view, that the extraneousness of the ST should be brought to the target reader to prevent them from indulging in cultural narcissism (Elnaili, 2014).

Nida’s advocacy of domesticating translation is explicitly grounded on a transcendental concept of humanity as an essence that remains unchanged over time. He pointed out that, as discovered by linguists and anthropologists, for humans, commonality is far greater than divergence, so that a basis for communication exists

28 even when the language and culture are distinct (Venuti, 2018). The key role of Nida is to develop word-to-word translation into the concept of formal and dynamic equivalence, which is essential for introducing reader orientation into translation theory (Munday, 2016).

Movement of the two cultural translation strategies, foreignisation and domestication, is depicted in Figure 1.

Domestication

Target Reader Writer

Foreignisation Figure 1 The movement of two translation strategies

Domestication Foreignisation

Free Literal Borrowing Transliteration translation translation

Figure 2 The relationship of four translation methods

In summary, these four translations methods, literal translation, free translation, transliteration and borrowing, all achieve their semantic and pragmatic value through changes in linguistic form or equivalence. Both literal translation and transliteration mainly preserve the meaning of the ST by following the form of the SL, while free translation and borrowing change the original form and content to eliminate the foreignness of the translation, thus improving its readability. From my point of view,

29 when it comes to cross-cultural translation, attention should be paid not merely to equivalence in linguistic form, but to the communicative function of the ST for target readers also. Foreignisation and domestication translation strategies allow translators to more systematically consider the pragmatic functions of the TT from a linguistic and cultural perspective. In Figure 2, the relationship between these four translation methods is summarised to discuss the pragmatic functions of the TT from the semantic and cultural background of the ST.

2.2.2 Research on domestication and foreignisation in English translation of traditional Chinese medicine terms

In the translation of TCM terms, translators often encounter various obstacles brought about by cultural differences. To solve these obstacles, domestication strategy may be considered. This strategy allows translators to search for the same or similar expressions in English according to the pragmatic meaning of TCM terms, regardless of their structure and syntax. Domestication translation strategy transforms the heterogeneous components of TCM culture into what target readers will understand in the Western medical system, so that the target reader can appreciate the similarities between cultures. Therefore, the translation under domestication strategy generally is easier for target readers to understand.

Zhang, in his paper Domestication and Foreignisation in the Translation of Traditional Chinese medical Terminology, listed three types of terms that should be translated with the domestication strategy.

1) Terms deeply rooted in Chinese culture, for which literal translation alone fails to express their original meaning, so interpretive translation is usually used (e.g., in ancient Chinese philosophy the “five internal organs” correspond to the “five elements,” specifically, the heart has fire, the lung metal, the liver wood, the spleen earth, and the kidney water. If the five elements in Chinese medicine are literally translated into metal, wood, water, fire, and earth,

confusion will occur. It is better to use a free translation strategy to translate them to lung, liver, kidney, heart, and spleen, to assist target reader understanding.

2) Culturally connotative words with counterparts with the same or similar “indicative meanings” in Western medicine, and TCM terms related to specific anatomies or medical symptoms that can be translated with corresponding counterparts in Western medicine. The direct use of English counterparts in Western medicine can improve the acceptability of translations. For example, the term 室女 shì nǚ in TCM corresponds to “virgin” in Western medicine, so it can be directly translated into “virgin”; 血室 xuè shì is a euphemism for womb, so the term “uterus” in Western medicine can be its translation.

3) Terms made up of metaphors concerning pathology and treatment. TCM contains many metaphors, most of which are the analogical reasoning based on ancient Chinese philosophy and other theories. Therefore, they are so abstract that a literal translation generally goes against the established cognitive world of Western readers, rendering them difficult to understand. A case in point is 金实不鸣 jīn shí bú míng, a term meaning the phenomenon of hoarseness or loss of sound caused by the obstruction of the lungs due to external evils8. Should it be literally translated into “solid metal bell cannot ring,” the translation preserves the language features of the original, but fails to clearly express the meaning of the original, showing little connection with the original meaning. If a free translation method is adopted, that is, translating it into “hoarseness or aphasia caused by asthenia of lung energy,” in spite of not preserving the form of the original, it clearly conveys the basic meaning contained in the metaphor. This translation better avoids cultural gaps and helps target readers understand the underlying meaning of the original.

8 Exterior evil is a general term for exogenous pathogenic factors, suggesting that the disease is developed inside but originates from outside. Traditionally, TCM has the six evils as its main contents in a narrow sense. The six evils, also known as six qi, include wind, cold, summer heat, humidity, dryness, and fire, corresponding to the climate changes during the year. In case of causing diseases, they are called six evils, or otherwise six qi (Jingwei Li, 2005). 31

TCM terms are characterised by conciseness in lexical structure, richness in meaning, and inclusion of traditional Chinese philosophy, such as yin and yang, and five elements. Coupled with the disparities between Chinese and Western cultures and medicines, it is hard for some TCM terms to find counterparts in Western medicine (L. Zhang, 2016). Therefore, although a domestication translation strategy can improve target reader acceptance of translations, domestication is not feasible in translating aforesaid terms. In this case, translators should consider using foreignisation, which can maintain the conciseness and richness in connotation of TCM terms, while reflecting the traits of a culture that make it different from another (L. Zhang, 2016). Appropriate use of pinyin helps to maintain the original style of TCM and more accurately convey the information contained in the original, thereby reducing the loss of information in the translation process and improving the translation quality (L. Zhang, 2016).

Two types of TCM term should be translated using the foreignisation strategy (L. Zhang (2016):

1) Terms that contain oriental philosophy and unique ways of thinking that are imbued with the cultural elements reflecting the social conditions, religious beliefs, and values of the Chinese culture. Because of this they have no counterparts in Western medicine, for example, qi, yin, and yang. qi in TCM is a concept from ancient Chinese philosophical ideas. It was a simple understanding that ancient Chinese had of natural phenomena. The notion of qi has two meanings, the subtle substances that make up the human body and maintain human life activities, and the functional activities of human organs, such as qi of the Five Viscera, qi of the Six Bowels, and qi of meridians and collaterals. If qi in TCM is translated into “vital energy,” “breath” or “air,” then such a translation obviously fails to express the rich connotation of the original, so it is more appropriate to directly use pinyin “qi.” Another example are the antonyms yin and yang from ancient Chinese philosophy. They originally indicated the side to the back of the sun and the side facing the sun,

respectively, but later extended to, for example, coldness and warmth in terms of climate, down and up, left and right, inside and outside (in terms of direction), and tranquility and agitation (in terms of motion state). Therefore, if translated into “shade” and “the sun,” their original meaning cannot be accurately expressed. Instead, transliterating them into “yin” and “yang,” respectively, retains their rich cultural connotation.

2) Terms that have no counterparts in Western medicine. For such terms, foreignisation is recommended to avoid cultural default and information loss. A case in point is the term “三焦” sān jiāo, a special 腑 fǔ that holds both the office of the sluices and manifests as the waterways, and summary of some of the body's functional systems also. It can be divided into upper, middle and lower parts, which mainly have the functions of reconciling various qi, dredging waterways, and transmitting nutrients. Therefore, it is inappropriate and inaccurate to translate it into “Triple energizer meridian” which only means “three places where energy is produced,” because this fails to fully take into account the characteristics of TCM culture. Hence, the recommended translation is “sanjiao,” which can better preserve the connotation of the term.

Shen (2011) advocated for using foreignisation as the translation strategy for TCM terms. Some scholars hold that foreignisation retains the original structure and conciseness of TCM terms, and fully conveys the underlying cultural connotation therein. Others have, however, have argued that translation using the foreignisation strategy is difficult for target readers to accept and thereby reduces readability.

TCM terms feature simplicity and ease to understand. However, many TCM terms are translated with low information density (lower than 0.5) and in a complicated way because: 1) of lexical gaps between TCM and Western medicine, translators usually have to add complementary words to maintain the integrity of the original meaning; and 2) Chinese is a language in which conjunctions are infrequently used, for example, causality is unusually visible (Shen, 2011). On the contrary, English is imbued with conjunctions. 33

To improve the comprehensibility of TCM terms, translators often must clarify the underlying logic in the terms, for example, translating 风寒咳嗽 fēng hán ké sòu into “cough due to wind and cold.” This seems to be inappropriate if the phrase is seen in isolation, but when incorporated into a sentence it will become prolix. Therefore, in translation, how to retain cultural information and keep the TT concise is the key to standardising the translation of TCM terminology (Shen, 2011).

A foreignisation-oriented strategy can bring about the fidelity or migration of translation and create special exoticism to target readers (Shen, 2011). Under the foreignisation strategy, three specific translation methods are available: literal translation (e.g.,金实不鸣 jīn shí bú míng as “excess metal failing to sound”), literal translation + free translation (e.g., 寒泄 hán xiè as “cold diarrhea”), and literal translation + transliteration (e.g., 补阳 bǔ yáng as “tonify yang”). These methods can reflect the pragmatic and semantic conciseness of TCM terms. Nevertheless, some scholars have argued that this translation strategy leads to a failure in the cognitive equivalence between the original and the translation, and increased difficulty in comprehension for target readers (Shen, 2011). Shen (2011) suggested that the translation guided by a foreignisation strategy cannot only faithfully convey the cultural connotation of TCM terms, but also retain their conciseness. Therefore, foreignisation is a practical and effective way to translate TCM terminology.

2.2.3 Research on methods of English translation of traditional Chinese medicine terms

TCM terminology embodies the unique theory of Chinese medicine. Only by starting with the background of the generation and development of these terms can the connotation and essence of TCM concepts and TCM theories truly be grasped. Therefore, translators should look at the selection of foreignisation and domestication from the perspective of the differences and idiosyncrasies of Chinese and Western cultures as much as possible.

A translators’ task is not just to pass the linguistic information of an original text to a target reader, but, more importantly, to convey cultural information contained in the TCM to them.

The loyalty of semantic meanings to TCM terms is the first factor to be considered in translation. The acceptability of target readers should also be taken into account. Many TCM terms have no counterpart in English, which suggests that the domestication strategy, which starts with the characteristics of the TL and the needs of target readers, and its main translation method is free translation, will play an important role in TCM term translation. To be specific, it is a translation method that aims to retain only the original content regardless of the forms of the original. Where transliteration or literal translation will lead to obscurity, incomprehension, or easiness to cause ambiguity or misunderstanding, free translation should be adopted.

In TCM translation, when a conflict between retaining original language forms and transmitting information exists, it is recommended to sacrifice the form and retain the content, rather than blindly emphasise the form at the cost of losing information. Therefore, translators are required to discard the shackles of the ancient Chinese language to transform the original in a manner that conforms to the lexico- grammatical features of the TL. This helps TL readers better understand TCM terminology. For example, 虚胀 xū zhàng refers to the syndrome of discomfort in the chest due to deficiency of qi, blood, and internal organs. If it is literally translated into “deficiency flatulence,” readers without TCM knowledge will find it difficult to understand its true meaning. In this case, it is necessary to abandon its semantic meaning and go deeper, so “flatulence due to yang-deficiency of spleen and kidney” may outperform the former (Z. Wang & Cheng, 2016).

The foreignisation translation strategy can retain traditional Chinese cultural elements more than the domestication strategy can, and therefore can better export TCM culture. Its main translation methods are transliteration and literal translation. Transliteration is a translation method based on the pronunciation of the SL, that is, searching for the same or similar pronunciation to the original in the TL as a 35 replacement. It is often used to translate some basic concepts and terms peculiar to TCM, by which the things reflected are generally unique to Chinese culture and have no counterparts in the TL culture, such as yin and yang. Appropriate use of transliteration can \promote the external communication and output of TCM culture.

The foreignisation translation method is applicable to the basic theoretical terms of TCM with Chinese traditional cultural concepts and special connotations. TCM and Western medicine are two different medical systems, but they both essentially study the physiological functions and pathological phenomena of the human body. Some TCM terms may have equivalent concepts in Western medicine. For example, 癫狂 diān kuáng in TCM is synonymous (by medical definition) with “psychosis” in Western medicine, so it can be literally translated as “psychosis.” Some Chinese medical terms can also be disassembled and literally translated into the counterparts of their disassembled parts in the TL—that is, to coin new expressions in the TL according to the combination rules of words. A case in point is the term “寒肿” hán zhǒng, in which “寒” hán and “肿” zhǒng are synonymous with “cold” and “edema,” respectively. As such, the term can be translated by combining the two words, i.e., “cold edema,” a new expression that Western medicine originally lacked. Since each word is not difficult to understand, translation by such coinage method not only retains the original cultural connotation of TCM terms, but also makes it easier for target readers to understand (Z. Wang & Cheng, 2016).

For the translation of any subject, literal translation, free translation, and transliteration are the most basic methods, and TCM translation is no exception. However, due to the abstruseness and profoundness of TCM language, these three conventional translation methods often seem to be less handy. For this reason, Zhaoguo Li experimented with some supplementary methods, including the Western medicine referenced method, morpheme translation method, and abbreviation method. In current practice these three methods are well suited to TCM translation, effectively solving some of the intractable problems in the translation of TCM terms. Z. Li (1997) elaborated on these three methods and their application scope (Table 1).

Table 1 Three methods and their application scope by Zhaoguo Li

Derivation Derivation refers to recombining meaningful language units like prefixes and suffixes to coin new words. The words coined by prefixes include prefabricate, defog, etc., while those coined by suffixes include consumerism, tubeless, etc. Compounding The morpheme translation method is not widely used because different languages generally have inconsistent morphological structures of semantic equivalents, especially in terms of grammatical morphemes. Most English morphemes cannot exist independently, but coexist with other words. Words composed of affixes, stems, or combination forms are called compounds. Medical English morphemes are mainly derived from Greek and Latin; for example, neurofibroma (神经纤维瘤 shén jīng xiān wéi liú) is composed of neuro (Greek)-fibro (Latin)-ma (Greek). Different languages demonstrate disparate combination specifications of morphemes. However, in TCM translation, this method has received increased attention from translators and is being applied to some TCM concepts or terms that contain unique connotations. A major benefit of using the morpheme translation method is that translations are concise and conform to the formation rules of medical English words, thereby contributing to their entry into the medical English vocabulary system. Although this method is not new, translators are generally not familiar with it due to its low use frequency. Blending Blending refers to combining the first part of a word and the last part of another to coin a new word. For example, smog, which is coined using the first part of “smoke” and the last part of “fog.” Shortening Shortening refers to removal of part of a word to make it simpler, such as shortening “fluenza” to “flu.” Functional shift Functional shift refers to shifting the part of speech a word belongs to as its grammatical use and function changes. This, in fact, creates a new word. For example, many nouns in English can be used as verbs. Back formation Back formation refers to English words that seem to be derived from a stem word because of the suffix, so the stem word is freed from the word into an independent word. For example, televise comes from television, destruct comes from destruction. Initial letters Initial letters method is a popular abbreviative word-formation method, for example acquired immune deficiency syndrome is abbreviated as AIDS. Acronyms Acronyms method is similar to initial letters method. Differences between them include the former being pronounced as a new word coined instead of as letters, and the words coined by acronyms are not necessarily capitalised. For example, laser, the acronym of ‘light amplification by stimulated emission of radiation’ is made up of small letters, because it is not considered an acronym.

2.2.4 Remarks

In Section 2.2.1, I presented differences between literal (word-for-word) and free (sense-for-sense) translation. As introduced, literal translation focused only on the handling of the linguistic problem, i.e., how to maintain the consistency of the SL and TL in lexical-grammatical features, while not deviating the meaning of the translation from the original as much as possible. Free translation lays priorities upon the comprehensibility of the TT. When language form hinders meaning expression, the translation method advocates sacrificing the pragmatic meaning of the SL to achieve the readability of the TT.

Transliteration was also introduced—a methodology that aims to completely convey the cultural concepts and context in the SL to recipients. Transliteration is especially fit for cases where specific cultural words and images in the SL cannot be expressed in a concise manner. This method helps to preserve the expression means and cultural connotation of the SL, delivering the most authentic information to recipients. Xiong (2014) believed that despite violating the writing style of the TL, transliteration can avoid the cultural damage or misunderstanding caused by literal translation, and avoid an excessively lengthy translation caused by free translation. This is because the lexical structure of pinyin is relatively simple. Huang and Li (2004) take issue with this view and claim that transliteration can only express the phonetic information of the original but will lose its connotation, thereby being less comprehensible to readers and increasing their memory burden. In my opinion, transliteration plays an important role with terms lacking counterparts in the SL or with strong traditional cultural or philosophical thoughts. For example, 功夫 gōng fū was transliterated into Kung fu— a translation widely accepted by English-speaking countries and regions. Nonetheless, this translation method should not be abused, or it will mislead reader understanding of the SL and increase memory burden.

Borrowing as a translation method was also introduced—a method which refers to replacing elements in the SL with those in the TL in a parallel manner. The translation

38 method is beneficial to readers’ understanding and acceptance. In my view, borrowing more likely achieves the equivalence or correspondence between SL and TL in language function rather than in language form, faithfully conveying the spirit of ST in a natural and smooth manner and striking a feeling or responsive chord in TT readers as it does in ST readers.

Two translation strategies—foreignisation and domestication—were also described. According to Venuti, foreignisation highlights and protects the external characteristics of the SL. In contrast, Nida emphasised dynamic equivalence, that is, the natural equivalence closest to the information of the SL; the purpose of translation is to assimilate the behavioural patterns in the SL into the cultural domain of target readers (Munday, 2016). Nida asserted that domestication is based on the transcendental concept of humans, that is, what unites us is greater than what divides us, so in the context of different languages and cultures, there needs to be a basis for communication (Venuti, 2018). According to their translation characteristics I classified these four translation methods into foreignisation (literal translation and transliteration) and domestication (free translation and borrowing) categories.

In section 2.2.2, I reviewed the application of domestication and foreignisation to the translation of TCM terms. L. Zhang (2016) proposed three types of TCM terms could be translated by the domestication strategy: 1) those rooted in Chinese traditional culture that could not literally be translated and required a free translation method; 2) those with counterparts in Western medicine; and 3) those that expressed pathology and treatment by metaphors. According to, L. Zhang, the two types of TCM terms could be translated by the foreignisation strategy: 1) those that contained unique oriental philosophy; and 2) those that were unique and had no counterparts in Western medicine, such as yin, yang, and qi. I then discussed Shen’s support for foreignisation, that this strategy both realises the loyalty of translation and reflects the rich connotations and conciseness of TCM terms.

Different opinions and suggestions of scholars regarding translation methods were reviewed. Z. Wang and Cheng (2016) pointed out that domestication strategy starts 39 with the linguistic characteristics of the TL and the needs of target readers, with the most commonly used translation method being free translation—one that expressed the intrinsic or essential meaning of the original text as much as possible by abandoning the expression forms of the original in semantic meaning. In contrast, the foreignisation strategy retains and exports as much traditional Chinese cultural elements as possible, with commonly used translation methods being transliteration and literal translation—the former based on pronunciation of the SL (specifically, to search for a replacement with the same or similar pronunciation in the TL to the original), and the latter a word-by-word, sentence-by-sentence translation method that strives to preserve both the content and form of the original. Three auxiliary methods proposed by Zhaoguo Li for TCM terms were also introduced: Western medicine referenced, morpheme translation, and abbreviation methods (Z. Li, 1997).

From my point of view, domestication and foreignisation contradict each other. They differ in their attitude towards preservation of cultural identity in meaning and form in language structure. I think it is necessary for domestication and foreignisation to coexist in TCM terminology translation. When a specific culture rooted in a different philosophy enters another culture, attention should be given to target readers in the selection of translation strategies, moving closer to them and conveying TCM terms with expressions that are in line with their language habits to increase translation acceptability. To not affect the accurate transmission of information, a foreignisation strategy is encouraged in the translation of TCM terms, so as to convey the underlying philosophy and cultural connotation contained in TCM to target readers. Main translation methods using the foreignisation strategy are transliteration and literal translation. In the translation of TCM terms, translators are required to take into account both the cultural characteristics of TCM and the rigor of TCM terms as a kind of sci- tech term. Therefore, the two translation strategies improve each other by mutually compensating for their individual deficiencies.

Chapter 3 Theoretical Framework and Analytical Methods

3.1 Introduction

In this chapter, theories involved in the thesis are briefly introduced to verify their feasibility. Guided by Skopos theory and integrated with Li Zhaoguo’s TCM terminology translation principles, I propose reader-oriented TCM terminology evaluation methods, which provide a new perspective for TCM terminology translation. This chapter also elaborates on the overall design of the thesis, specifically including the selection of the original text, three English versions, and why they were selected. In conclusion, the research topic of this thesis is identified, and the main research methods (and problems) are introduced.

3.2 Theoretical framework

In the history of translation studies, “equivalence” or “faithfulness” has long been used as the definitive criterion for judging the quality of a translation (Du, 2012). Du (2012) explained this translation evaluation criterion to be stereotyped and oversimplified, despite its positive role in guiding and standardising translation practice. A more descriptive approach would assist in identification and analysis of complex patterns in the use and distribution of linguistic devices when translating between distinct language and cultural systems.

Skopos theory attempts to provide a new perspective on such matters as the state of the ST and TT, the relationship between them, the definition of translation, the role of translators, and translation standards and strategies (Du, 2012). This thesis restricts the translation environment to various types of TCM terms in Shāng Hán Lùn. According to the functions of Skopos theory, this thesis is divided into a broad description of and preliminary solutions to specific translation problems. To clarify the purposes, principles, methods, terminology analysis and other key elements of TCM translation, I strive to separately analyse the symptoms and disease patterns in Shāng Hán Lùn, explore the strategies of TCM terminology translation under the

41 guidance of Skopos theory, and perfect the term translations that are ambiguous or controversial.

3.2.1 Basic concepts of Skopos theory

Skopos theory is a theory in translation developed in Germany in the late 1970s. It reflects a general shift in translation concepts from mainly linguistics to functional and sociocultural orientations (Wadensjö et al., 1998). Hans J. Vermeer was dissatisfied with the departure of applied translation theories from the reality and thus proposed the concept of Skopos theory. Vermeer claimed that translation studies should not rely solely on linguistics on the grounds that translation was not merely or even mainly a linguistic process, and linguistics failed to truly resolve the problems in translation. As such, he put forward the Skopos theory based on the theory of action (N. Zhang, 2004).

The communicative situation is the environment in which people interact with each other. Because communication is an interpersonal interaction, it involves multiple actions. Therefore, the theory of action can explain some aspects of translation. Action is a process that intentionally facilitates or prevent changes in the world. Therefore, action can be defined as an intentional “change or transition from one state to another” (Nord, 2014).

Skopos is a Greek word defined as “purpose.” According to Skopos theory (a theory that applies the Skopos concept to translation), the main principle that determines the course of translation is the purpose (skopos) of the overall translation behaviours. It suggests that any action is purposeful (Nord, 2014). Vermeer divided translation purposes into three categories: 1) the personal purpose of translators, such as translation as an income source; 2) the expected purposes of a TT, such as to instruct and educate target readers; and 3) the purposes of translation strategies or approaches (e.g., literal translation reveals the structural particularities of the SL).

When it comes to the term ‘skopos’ in Skopos theory, it falls into the third category (Nord, 2014)—the translation should perform the expected function for the anticipated recipients (N. Zhang, 2004).

Translation is not a process of transcoding, but instead a specific form of human behaviours. Like other human behaviours, translation has a purpose. Hence, before translation, the purpose of translation should be first clarified and defined. Skopos theory adopts a forward-looking attitude towards translation, as opposed to the retrospective attitude that focuses on the ST in some theories (Wadensjö et al., 1998). The theory offers a new perspective on the status of the ST, claiming that the ST is usually made for a scenario in the source culture, that is, it is oriented to the source culture. Simply transcoding the ST into the TT fails to acquire the purpose of the translation, whether or not its intended function is the same as that of the ST, unless “transcoding” is what the translation requires for (e.g., to make the TL readers understand the syntax of the ST, translate 功夫 to Kung Fu and 豆腐 to Tofu). What is more, Skopos theory believes that the purpose of translation may or even must be different from the purpose of the ST. The TT is a text with its own value and its potential use, so the consistency in function between the ST and TT is an exception rather than a common practice (N. Zhang, 2004).

As a general rule Vermeer assumed that the selection of translation methods and strategies depended on the anticipated purpose of the TT. Based on this assumption, he developed the three main rules of skopos, coherence, and fidelity (Wadensjö et al., 1998). The most important of these are the “skopos rules”—translation behaviours are determined by the purpose of the translation; purpose determines the reasonableness of the means adopted.

The Skopos rule can be interpreted as each text being produced for a specific purpose and therefore it should serve the purpose. Therefore, the ways for translation, interpretation, or writing should ensure the ST and TT play expected roles for readers and potential users. In addition, what translators should do is to produce a TT that is at

43 least meaningful to the TL readers, so the TT should conform to the standard of “intratextual coherence.” This means that the TT should be comprehensible for readers and meaningful in the target context and culture.

Another important rule of Skopos theory is the “coherence rule,” which stipulates that the TT should be consistent with the situation of TL readers. Moreover, since translation is to provide information based on the given information, it is expected to have a certain relationship with the corresponding ST. This relationship is called “intertextual coherence” or “fidelity,” also called “fidelity rule,” as a further principle. Similar to “skopos rules,” there should be intertextual coherence between the ST and TT, but its form depends on the translator's interpretation of the ST and the translation Skopos.

Possible intertextual coherence can be the greatest faithful imitation of the ST. In general, intertextual coherence is considered subject to intratextual coherence, and both are subject to skopos rules. If Skopos needs to change the functionality, the standard will no longer be the intertextual coherence of the ST, but the sufficiency and appropriateness of the Skopos. Furthermore, if Skopos does not require intratextual incoherence, intratextual incoherence will be no longer valid. It is noteworthy that the concept of Skopos applies not just to the entire text but to smaller units also (e.g., footnotes or citations) (Nord, 2014).

3.2.2 Applicability of Skopos theory to TCM term translation

TCM terms are unique, making TCM different from other natural sciences whose terms are generally derived from foreign countries, that is, unified Chinese translations of foreign terms (Si & Cui, 2016). TCM nouns and terms were typically formed in ancient times, with some extending over thousands of years, constituting a terminology system in TCM itself. TCM terms have the following features:

1) Historicality. Nouns and terms are mostly ancient Chinese. In many cases, a word contains the meaning of a phrase, for example 气 qì; or a short sentence

can be deemed as a phrase, for example 木克土 mù kè tǔ (wood restricting earth), 肺主气 fèi zhǔ qì (the lung governing qi), and 心开窍于舌 xīn kāi qiào yú shé (the tongue being the window of the heart).

2) Humanity. TCM is a discipline based on biology, combined with physics, chemistry, and mathematics, and mutually infiltrated with humanistic philosophy. Humanistic philosophy has exerted a profound influence on TCM, as illustrated by its nouns and terms, for example 阴阳 yīn yáng (yin and yang), 五行 wǔ xíng (five elements), and 母病及子 mǔ bìng jí zǐ (mother- organ disorder involving its child-organ), which contain strong traditional Chinese cultural connotations.

3) Qualitative description. 实喘 shí chuǎn (dyspnea of excess type), 虚喘 xū chuǎn (dyspnea of deficiency type). A quantitative description is rarely used.

4) Abstract concepts are expressed in concrete terms. For example, the five elements (wood, fire, earth, metal, and water): wood generates fire, fire generates earth, wood restricts earth, and fire restrains metal.

Therefore, the skopos of the original TCM terms in Chinese is to lay the foundation for the mastery over TCM theories by understanding and learning TCM terms.

TCM terms (e.g., symptom names and disease names) are important components of TCM theory, and contain a large number of Chinese-specific cultural elements that have no counterparts in a foreign language or cultural environment (J. Zhang & Li, 2014). Therefore, the cultural connotations contained in TCM terms tend to be difficult for foreign medical workers and readers to understand, challenging TCM term translation.

The translation of TCM terms is required for English-speaking readers to understand them, and to convey the cultural connotations contained therein, which cause great difficulties for translators (Z. Li & Liu, 1991). TCM terms are extremely rich and multi-dimensional in terms of names. For example, some diseases are named after the

45 six meridians9, in which yin and yang are ancient Chinese philosophical thoughts; some TCM terms contain such rhetorical methods as metaphors and personifications, and even combine the images in ancient Chinese myths. These complicated prescription names have challenged translators (Y. Ye, Zhao, & Zhou, 2019). As such, when it comes to the translation of TCM terms, Skopos theory should be adhered to as guidance, and optimal translation strategies and methods should be adopted to generate a TT that is scientific, preserves the unique TCM culture, and is comprehensible. Compared with other theories, Skopos theory takes into account the cultural environment, communicative purpose of translation, and target reader feelings, thereby breaking through the linguistic paradigm in translation. It also allows translators to choose translation strategies according to different language characteristics and communication purposes, thus better playing the communicative role of translation.

3.3 Principles of TCM terminology translation

Z. Li (1997) stated in his Traditional Chinese Medicine English Translation Techniques that the translation of TCM terms is the most confusing aspect of TCM translation, which has long attracted the attention of scholars internationally. He also acknowledged that TCM terminology translation is a complex issue, the solving of which required a complete set of procedures and systems covering theory and practice. Due to lack of government support, TCM translation has always lacked unified leadership and coordination, contributing to confusion in translation. Because of this, Z. Li (1997) proposed specific principles (Figure 3.1) for TCM terminology translation. These principles provide references for the translation of TCM terms.

9 The six meridians include three yangs, namely, 太阳 tài yáng, 阳明 yáng míng, and 少阳 shǎo yáng, and three yins, namely, 太阴 tài yīn, 少阴 shǎo yīn, and 厥阴 jué yīn, of which 阳 yáng and 阴 yīn actually refer to the human body's healthy qi. The term 六经 liù jīng “six meridians” is not seen in Zhang Zhongjing's Shāng Hán Lùn, and were first proposed and developed in the Song Dynasty, serving as the collective pronoun of three yangs and three yins. Since then, the concept has been widely used by doctors (Jinliang Yang, Ji, & Qi, 2019). 46

Translation of TCM terms should be natural and consistent with the TL. This requires translators to consider both the inherent characteristics of TCM and commonalities of natural sciences when Naturalness translating. As for TCM terms with counterparts in Western medicine, it is recommended that their translation adopts corresponding Western medicine terms, ensuring TT scientificity and naturalness.

Conciseness should be maintained in translation to ensure information density, in accordance with: 푛푢푚푏푒푟 표푓 푠푒푚푎푛푡푖푐 푢푛푖푡푠 ሺ푐표푛푡푒푛푡 푤표푟푑푠ሻ 푖푛 푎 푆푇 퐼푛푓표푟푚푎푡푖표푛 푑푒푛푠푖푡푦 = 푛푢푚푏푒푟 표푓 푠푒푚푎푛푡푖푐 푢푛푖푡푠 ሺ푐표푛푡푒푛푡 푤표푟푑푠ሻ 푖푛 푎 푇푇 Conciseness Information density can be divided into three levels: A (0.5), B (0.25), C (0.1). The optimal density is not lower than A. Words with density lower than level B should be modified, and those lower than level C should be avoided. The higher the information density of words, the less time taken to convey a unit of information to the receiver.

TCM is a medical system unique to the Chinese nation and boasts distinctive traditional Chinese Chinese characters. Although it is advocated to borrow Western medical terms, few TCM terms actually have national counterparts in Western medicine. The principle of Chinese national features is reflected in the features translation of the TCM terms that do not have corresponding counterparts.

The translation of TCM terms should have a similar lexical structure to the original, facilitating a two- way transmission of information. Back translatability has three advantages: 1) TCM translation is still poorly developed, the English level of TCM practitioners needs to be improved, there have been a limited number of international TCM practitioners, a TT that can be back-translated is helpful for the accurate transmission of information by translators, and helps TCM practitioners master TCM English Back faster and better. It is also beneficial for international TCM practitioners to acquire TCM theories and translatability effectively make business communication. 2) A TT that is back-translatable can accurately recover information in the ST, reducing information loss during translation. 3) Back translatability is conducive to improving the quality of translation and limiting indiscriminate translation.

This refers to prescribing the connotation of the translations of TCM terms so that they cannot be interpreted otherwise (the goal is to realise the equivalence in connotation between the original and the translation of TCM terms). Because few TCM terms have counterparts in English, the English translation of TCM terms is often beset by “meaning beyond words.” Hence, prescription may be imposed on the translation of TCM terms to ensure consistency in the connotation between the Prescription original and the translation, eliminating misunderstandings. TCM is a medical system unique to the Chinese nation and boasts distinctive traditional Chinese characters. Although it is advocated to borrow Western medical terms, few TCM terms actually have counterparts in Western medicine. The principle of Chinese national features is reflected in the translation of the TCM terms that do not have corresponding counterparts.

Figure 3 Principles of TCM terminology translation

3.4 An integrated approach to TCM terminology translation evaluation

Based on Skopos theory and with reference to Li Zhaoguo’s translation principles of TCM terms, I aim to explore TCM terminology translation strategies, and evaluate the translations of selected TCM terms.

The purpose (skopos) of translation determines the translation strategies adopted. Each TT is created for a specific purpose. Therefore, when translation strategies are selected, the TT should deliver its expected effect among target readers.

TCM translation is a type of scientific translation, the primary purpose of which is to convey ancient Chinese medical/scientific knowledge, rather than literary knowledge (Z. Li & Liu, 1991). A TT must meet the standard of intratextual coherence (a TT should be coherent, comprehensible by target readers, and meaningful in the TL culture and the communicative environment in which the TT is used). Therefore, translation of TCM terms should ensure accuracy and scientificity, avoid misunderstanding, and the TT should be acceptable and understandable for target readers.

TCM terms fall into a category of scientific terminology, so their translation should be concise to ensure information density, and accurately reproduce the ST information to reduce information damage during translation. The TT must deliver its meaning as medical terms in a communicative environment. The fidelity rule requires the original and translation to be intertextually coherent. Intertextual coherence has a similar meaning to fidelity to the original, while the degree and form of fidelity are determined by the purpose of the translation activity and the translator's understanding of the original. TCM terminology is a kind of professional, technical terminology, so accuracy and fidelity to the original are particularly important in translation.

There is always something in a language that reflects the distinguishing features of a culture, such as thoughts and concepts that lack counterparts in the language of other countries, as exemplified by “yin” and “yang” in TCM. Although such words

48 represent only a small proportion of the total vocabulary, their role is important because they reflect cultural characteristics. Therefore, under the premise of ensuring objectivity and accuracy, the TT should also strive to maintain the traditional characteristics of TCM to transmit Chinese culture to foreign readers. To improve the communication intention of translation, I have developed evaluation methods for TCM terminology translation guided by Skopos theory, combined with principles of TCM terminology translation (Figure 3.2).

The primary purpose of TCM terminology translation is to accurately convey the Linguistic accuracy medical knowledge it contains to target readers.

Acceptability of The translation of TCM terms should be coherent, so that target readers can terms understand them to a greater extent.

Scientific accuracy The translation of TCM terms should be scientific, so that TT can convey their of terms meanings as scientific and technological terms in a communicative environment.

Lexical structural The translation of TCM terms is required to guarantee the information density as conciseness much as possible and to make its structure concise.

Lexical structural The translation of TCM terms should ensure the TT is coherent and faithful to the similarity ST, and has as similar a structure to the ST as possible.

TCM is imbued with traditional Chinese culture and philosophy. Therefore, when Cultural it comes to the translation of TCM terms that carry strong traditional Chinese transmission cultural and philosophical connotations, special attention should be paid to convey such connotations to target readers.

Figure 4 Evaluation methods for TCM terminology translation

3.5 Analytical methods

3.5.1 Selection of the original text and its English versions

The original text studied in this research is a photocopy of the Shāng Hán Lùn Annotation authored by Wuji Cheng in the “Online Library” of the Chinese Text Project website (http://ctext.org). This text comprises 10 volumes and 22 articles. From this I have extracted chapters 5 (“Syndrome Differentiation for Taiyang Disease and Its Treatment”) to 12 (“Syndrome Differentiation for Jueyin Disease and Its Treatment”) as the research object.

The three selected English versions are:

1. Shang Han Lun (On Cold Damage): Translation and Commentaries, authored Feng Ye, Nigel Wiseman and Craig Mitchell, published by American Paradigm Publications in 1991. For simplicity, this version is hereinafter referred to as the ‘Wiseman’ version. 2. Treatise on Febrile Disease Caused by Cold translated by Xiwen Luo, published as one of the series of Chinese–English books Library of Chinese Classics in 2007. 3. Introduction to Treatise on Exogenous Febrile Disease translated by Hai Huang, published by the Shanghai University of Traditional Chinese Medicine Publishing House in 2005.

These three English versions were selected primarily because:

1) Translators have different backgrounds. All three are authorities in the field, and familiar with TCM background and culture; all three translations were published by American or Chinese authorised presses. Wiseman was a native English speaker engaged mainly in TCM translation and teaching. Luo was a native English speaker engaged mainly in English translation of TCM classics for the global spread of TCM. Huang was a professor at Fujiang University of Traditional Chinese Medicine, devoted to the clinical study of integrating Chinese and Western medicines; he was also a TCM doctor. 50

2) Translators had different translation styles. Wiseman’s version is original- oriented and strives to align the original with the TT in form. The Luo version made great changes to the form of the original, and preferred interpretative translation. The Huang version favoured preservation of TCM culture, and the foreignisation translation strategy. The contrast in these three translation styles lends itself to comparative study.

3) The three translations have the same translation scope. Each contains the main body parts of Shāng Hán Lùn, from chapters 5 to 12.

3.5.2 Collection methods of linguistic materials in Shāng Hán Lùn

A corpus-based approach is adopted in this research. The thesis research objects are the symptom and disease names clearly annotated or explained in Yangling Fu’s Revised Dictionary of Shāng Hán Lùn and contained in chapters 5 to 12.

To ensure the accuracy of collected materials, they are imported into AntConc software for manual searching (Anthony, 2019). After a term is confirmed to be studied, it, and the sentence in which it is included, are marked out in the original text. AntConc then tallies the number of occurrences. The term and number of occurrences are then recorded into a corpus (an Excel spreadsheet). The three English versions are then printed and scanned into pdf documents, which are converted into txt, from which the English versions of terms are located by CUC_ParaConc software (Cheng, 2019). Other TCM terms and their English versions are collected. Terms in the three English versions are then collected and arranged in order of original text, Huang, Wiseman, and Luo versions. The translation methods adopted in the English versions are compared and analysed and their translation strategies are summarised. Based on the Skopos theory and reader-oriented TCM terminology translation rules, each term in the three English versions is specifically analysed.

3.6 Research questions

1. What is the role of Skopos theory in the field of TCM terms translation?

2. Which translation method and strategy is more suitable for the translation of TCM terms in Shāng Hán Lùn?

3. What contribution can a Skopos theory-based translation strategy make to the international standardisation of TCM terms?

3.7 General remarks

This chapter confirms the applicability of Skopos theory to TCM terminology translation and develops a new perspective of TCM terminology translation—the reader-oriented TCM terminology translation principle, based on Skopos theory and principles of TCM terminology translation. Shāng Hán Lùn Annotation authored by Wuji Cheng is selected as the original text to be studied, and according to translator background, translation style, and content scope, the three English translations (Huang, Wiseman, and Luo) are selected for comparative analysis. According to the content of the three English versions, the symptom and disease names in chapters 5 to 12 of Shāng Hán Lùn are taken as research objects.

With the help of Dictionary of Research on Shāng Hán Lùn, symptom and disease names, and their three English versions, were identified and entered into a corpus. Term translation methods adopted in the three English versions are summarised, and translation strategies are summarised following comparative analysis of English versions using a corpus-based research method from the perspective of Skopos theory.

Chapter 4 Analysis and Discussion of TCM terms

4.1 Discussion on Chinese–English (C–E) translation of symptomatic terms

Symptoms are an essential basis for TCM diagnosis. Unlike Western medicine, TCM needs to extract disease or syndrome information through four standard methods of diagnosis—looking, asking and listening, smelling, and touching (for pulse-taking). Information collected using these four methods is referred to as “symptoms” or “syndromes,” including some objective indicators of subjective symptoms, physical signs, and disease manifestations (Ma & Li, 2010). The ultimate goal of TCM diagnosis is to differentiate symptoms of patients and diagnose the diseases they are suffering from, while the symptom information collected serves as the basis for such differentiation and diagnosis (Ma & Li, 2010).

“Pattern identification” biàn zhèng is a diagnostic thinking method of TCM, in which special attention is paid to the diagnostic significance of symptoms to pattern identification (Zhu, 2005).

“Syndrome” refers to all clinical manifestations, including symptoms and signs. Symptoms and signs are individual manifestations (not an internally connected group manifestation) occurring when the body has a lesion, and they are considered to be the main basis for disease type judgment and syndrome differentiation. They are the external representations rather than the essence of diseases (W. Liu & Zhu, 2007). In a narrow sense, symptoms are generally patients’ subjective feelings of discomfort or some pathological change, such as aversion to cold, dizziness, heaviness of the head, dimming of sights, tinnitus, palpitations, nausea, bloating, and waist and knee soreness. Hence, subjectivity is highlighted. Physical signs generally refer to the objective manifestations identified by a doctor by eye or aided by instrument, mainly including an enlarged square skull, depressed fontanels, yellow eyes, pale complexion, bluish tongue, tortuous sublingual collaterals, white tongue, weak and unsmooth pulse, abdominal distension, and low hemoglobin. Hence, objectivity is highlighted (W. Liu & Zhu, 2007). Symptoms and signs sometimes do not separate

53 completely. For example, some abnormal changes such as yellow skin, runny nose, cough, fever, and edema, can be both subjectively felt by the patient and objectively checked by the doctor. Therefore, they can be called either symptoms or signs, and the key to their categorisation depends on the acting subject (W. Liu & Zhu, 2007). Symptoms are the external manifestations of diseases and the main carrier of clinical diagnosis information. Therefore, standardising the C–E translation of TCM symptomatic terms promises to greatly facilitate its promotion and publicity.

In this study, I focus on two-character symptom terms. In chapters 5–12 of Shāng Hán Lùn, there are 125 symptomatic terms for double words, but among them some have the same or similar meanings, such as: “发热 fā rè” and “身热 shēn rè,” which both refer to the pathological increase in body temperature; “下血 xià xuè,” also called “便血 biàn xuè” and “清血 qīng xuè,” meaning bleeding from the anus; “心烦 xīn fán” and “发烦 fā fán,” both mean mental restlessness; “汗多 hàn duō,” “多汗 duō hàn” and “大汗 dà hàn,” having similar meanings related to excessive sweating. There are also some symptomatic terms with “微 wēi” as an adjective, such as “微热 wēi rè,” “微烦 wēi fán,” “微汗 wēi hàn,” “微喘 wēi chuǎn,” and “微利 wēi lì.” For comparison and analysis, I have built a corpus and screened the symptomatic terms that appear two or more times in the text, of which 27 were selected in total. As for the terms that are prefixed “微 wēi” as adjective and have a common or similar meaning, only one term that appears most frequently in chapters is selected as representative.

Table 2 presents the number of occurrences of symptom names through chapters 5–12 to explain the frequency of use of these collected words.

Table 2 Selected symptom names in Shāng Hán Lùn

Name Number(s) Name Number(s) Name Number(s)

发热 fā rè 71 下利 xià lì 56 恶寒 wù hán 51

腹满 fù mǎn 17 无汗 wú hàn 15 恶风 wù fēng 13

头痛 tóu tòng 12 心烦 xīn fán 11 微热 wēi rè 10

厥逆 jué nì 9 干呕 gān ǒu 9 烦躁 fán zào 8

咽痛 yān tòng 7 大汗 dà hàn 6 短气 duǎn qì 6

懊憹 ào náo 6 吐利 tǔ lì 4 下血 xià xuè 4

口苦 kǒu kǔ 3 恶热 wù rè 3 呕逆 ǒu nì 2

郑声 zhèng 2 眩冒 xuàn mào 2 嗜卧 shì wò 2 shēng

烦渴 fán kě 2 喜忘 xǐ wàng 2 腹痛 fù tòng 2

4.1.1 Analysis and discussion of the consistent translation of symptom names

The three translators adopted corresponding expressions in English to interpret partial symptomatic terms, and gave the same translations to terms including “下利 xià lì,” “吐利 tǔ lì,” “头痛 tóu tòng,” “咽痛 yān tòng,” “口苦 kǒu kǔ,” and “腹痛 fù tòng.

Table 3 English translations of “下利 xià lì” and “吐利 tǔ lì”

Symptom Huang Wiseman Luo name

下利 diarrhea diarrhea diarrhea

吐利 vomiting and diarrhea vomiting and diarrhea vomiting, and diarrhea

“下利 xià lì,” as interpreted in Shāng Hán Lùn Research Dictionary, is the collective name for dysentery and diarrhea; it also means the symptom of diarrhea, referred to as “利 lì” (Table 3). When translating the term, the three translators borrowed “diarrhea” from the Western medical terminology. Although “下利 xià lì” is composed of two Chinese characters, only one-word “diarrhea” is used in its translation. Judged from the principles of Lexical Structural Similarity (LSS) and Cultural Transmission (CT), it is also sufficient. For target readers, the translation “diarrhea” is not only concise but also easy to accept. “Diarrhea” is also a good choice as a technical term. “吐利 tǔ lì” can be split into “吐 tǔ” and “利 lì” in a coordinating relation, meaning vomiting accompanied by diarrhea. All three translators translated it into “vomiting and diarrhea.” Since “吐利 tǔ lì” omits the middle conjunction, the omitted “and” has to be supplemented. “Vomiting and diarrhea,” as a technical term, seems to be relatively complex in wording.

Unlike Western medicine terms, TCM terms are generally more concise in word formation. “吐利 tǔ lì” covers the two symptoms of “吐 tǔ” and “利 lì.” Although “vomiting and diarrhea” is inconcise, it (original lexical structure) conforms to the principle of LSS. The translation clearly expresses the original’s meaning, making it easy for target readers to understand, and it complies with principles of Linguistic Accuracy (LA) and Acceptability of Terms (AT), achieving the communicative goal of translation, to convey TCM and its culture and philosophy to target readers.

Table 4 English translations of “头痛 tóu tòng” and “咽痛 yān tòng”

Symptom Huang Wiseman Luo name

头痛 headache headache headache

咽痛 sore throat sore throat sore throat

Similarly, “头痛 tóu tòng” and “咽痛 yān tòng” were translated into “headache” and “sore throat,” respectively (Table 4). According to the English–Chinese Chinese– English Medical Dictionary, “头痛 tóu tòng” continues to be used as a Chinese term in modern medicine, and its translation is consistent with its Western medical counterpart, complying with principles of LA, AT, lexical structural conciseness (LSC), and the scientific accuracy of terms (SAT). “咽痛 yān tòng” was translated into “pharyngalgia” and “pharyngodynia,” while the phrase “sore throat” corresponds with the Chinese term “咽喉痛 yān hóu tòng.” “咽痛 yān tòng,” also known as “咽中痛 yān zhōng tòng” (Y. Fu, 2017), refers to pain in the pharyngeal cavity. Seen from the definition of “咽痛 yān tòng” in Chinese medicine, “sore throat” also complies with the principles of LA, AT, LSC and SAT. Although “headache” and “sore throat” fail to convey the traditional Chinese cultural meaning of TCM, these two Chinese terms are also used in modern medicine. Their corresponding translations are not only highly accepted but also accurately convey the meaning of the original, achieving the communicative goal of the translation.

Table 5 English translations of “口苦 kǒu kǔ”

Symptom Huang Wiseman Luo name

a bitter taste/bitterness bitter taste/bitterness in the 口苦 bitter taste in the mouth in mouth mouth

As for the term “口苦 kǒu kǔ,” all adopt an interpretive method and translate it into “bitter taste in the mouth” (Table 5). Y. Fu (2017) defined “口苦 kǒu kǔ” as patients’ self-feeling of bitter taste in the mouth, helping readers literally understand the meaning of “口苦 kǒu kǔ.” From the perspective of LA and AT, the translation is accurate and easy to understand. As a medical term, the wording structure of “bitter taste in the mouth” or “bitterness in the mouth” is inconcise, because the information density of bitter taste in the mouth is 0.4. As discussed in chapter 3, the information density of TCM translations should be no less than 0.5. The interpretive translation 57 also lacks scientificity. Hence, I suggest translating “口苦 kǒu kǔ” into “bitter taste,” which is not only acceptable to target readers, but also has a simple structure and guarantees accuracy.

Table 6 English translations of “腹痛 fù tòng”

Symptom Huang Wiseman Luo name

腹痛 abdominal pain abdominal pain abdominal pain

The World Health Organization. Regional Office for the Western (2007) interpreted “腹痛 fù tòng” as “pain in the region between the hypochondrium and pubic hairline,” while the three translators used the Western medical term “abdominal pain” (Table 6). “腹痛 fù tòng” is also translated into “abdominal pain,” and interpreted as a common clinical symptom, and the main reason prompting patients to visit hospital. Abdominal pain refers to acute or chronic, local or diffuse pain in the abdomen (Mosby's dictionary of medicine, nursing and health professions, 2019). From the principles of LA, AT, LSS and SAT, I think the translation into “abdominal pain” is accurate, scientific and natural, for it is intelligible in meaning and has a similar structure to the original. These translations show that TCM symptomatic terms are of partial consistency.

4.1.2 Analysis and discussion of the translation of symptom names with the same name in modern Western medicine

Combining the English–Chinese Chinese–English Medical Dictionary, some ancient TCM terms remain applicable in modern Western medicine, such as “发热 fā rè,” “干呕 gān ǒu,” “烦躁 fán zào,” and “烦渴 fán kě.”

Table 7 English translations of “发热 fā rè”

Symptom Huang Wiseman Luo name

发热 fever heat effusion fever

Huang Hai and Luo Xiwen translated “发热 fā rè” into “fever,” while Wiseman translated it into “heat effusion” (Table 7). According to the New Shāng Hán Lùn Research Dictionary, “发热 fā rè” refers to a pathological increase in body temperature, generally falling into exterior heat or interior heat. The former is the result of exterior evil10 on the skin surface and stagnation of 营 ying11 and 卫 wei12, more often accompanied by aversion to cold, as well as the symptoms like stiff neck, headache, and floating pulse. The latter is commonly seen in the meridians like 阳明 yáng míng13, 少阳 shǎo yáng14, 少阴 shǎo yīn15, and 厥阴 jué yīn16, as well as 坏病 deteriorated disease. The pyretic patients with sthenia syndrome are characterised by interior heat emitted outwardly, while those with deficiency syndrome are characterised by failure of yinqi playing its role under the condition of yangqi deficiency.

Although “发热 fā rè” is generally translated into “fever,” Wiseman insisted in literally translating it into “heat effusion” given that “发热 fā rè” includes both self-

10 Exterior evil is a general term for exogenous pathogenic factors, suggesting that a disease is developed inside but originates from outside. Traditionally, TCM has the six evils as its main contents in a narrow sense. The six evils, also known as six qi, include wind, cold, summer heat, humidity, dryness, and fire, corresponding to the climate changes during the year. In case of causing diseases, they are called six evils, or otherwise six qi (Jingwei Li, 2005). 11 Ying is a kind of yin qi that brings nutrition to the body (contrary to weiqi that belongs to yang). It usually coexists with blood, hence it is also known as “ying blood” (Jingwei Li, 2005). 12 Weiqi is a kind of yang qi that travels outside the passages and has a protective effect (Jingwei Li, 2005). 13 阳明 yáng míng, a meridian name, includes stomach meridian of foot-yangming and large intestine meridian of Hand-yangming (Jingwei Li, 2005). 14 少阳 shǎo yán, a meridian name, includes sanjiao meridian of hand-shaoyang and gallbladder meridian of foot- shaoyang (Jingwei Li, 2005). 15 少阴 shǎo yīn, a meridian name, includes heart meridian of hand-shaoyang and kidney meridian of foot- shaoyin(Jingwei Li, 2005) . 16 厥阴 jué yīn, a meridian name, includes pericardium meridian of hand-jueyin and liver meridian of foot-jueyin (Jingwei Li, 2005). 59 feeling of body heating and perceived increase in body temperature by touching. He also explained that a variety of diseases, external infection, and internal injuries may be accompanied by heat effusion. As for exogenous three-yang diseases, fever is the main manifestation of the conflict between right and evil, but does not mean it is certainly caused by heat evil. The main content of the Tai Yang Disease Section is to discuss the “fā rè” with Tai Yang exterior syndrome caused by cold evil. Different accompanying symptoms stand for different pathogeneses and disease positions of the right-evil conflict (Wiseman & Zmiewski, 1989).

In my opinion, “发热 fā rè” is an objective symptom of body temperature increase in general that can be felt by touch or measured, or may be a patient’s subjective feeling of body heating even when the measured body temperature is normal. Fever only means an increase in body temperature, and does not contain the self-feeling of body heat. “Fever” has a concise structure and ensures the scientificity as a Western medical term. Seen from the perspectives of LSC and SAT, it is slightly better than “heat effusion.” However, Wiseman's translation of “Heat fā rè” into heat effusion is more consistent with its connotation of exterior heat and interior heat contained in Shāng Hán Lùn than the other two translators’ “fever.” Seen from the perspectives of LA, TC, AT and SAT, “heat effusion” is superior to “fever.” “Heat effusion” both accurately conveys the original meaning of clinical definition, and introduces characteristics of TCM that differ from Western medicine, because 发热 fā rè is not defined in TCM as it is in modern medicine. The term in TCM covers the symptoms of exterior heat and interior heat, whose identification involves TCM culture.

Table 8 English translations of “干呕 gān ǒu”

Symptom Huang Wiseman Luo name

干呕 vomiting/nausea dry retching nausea

“干呕 gān ǒu” means loud vomiting but without, or with only a small amount of sputum being thrown up (Y. Fu, 2017). Both Huang and Luo used the word “nausea,” while Wiseman literally translated it into “dry retching” (Table 8). Nausea is more a feeling of vomiting, but does not always cause throwing up, a symptom commonly caused by seasickness, car sickness and the like, as well as early pregnancy, severe pain, emotional stress, gallbladder diseases, food poisoning, and various enteroviruses. “干呕 gān ǒu” in Shāng Hán Lùn refers to having the symptom of loud vomiting but without anything thrown up, or with only a small amount of sputum. As such, translating “干呕 gān ǒu” into “nausea” may confuse or express an incorrect concept to English readers with no experience with TCM, or who have a poor understanding of it, leading to misunderstanding. Moreover, it is translated into “dry vomiting” and “retching” in the English–Chinese Chinese–English Medical Dictionary. Although “nausea” is more concise in structure in “dry retching,” from the principle of LA, “nausea” is inconsistent with the original meaning, and fails to accurately express the meaning of “干呕 gān ǒu.” In short, “dry retching” not only guarantees the accuracy and structural consistency with the original, but it also expresses the symptom of the disease. Seen from the principles of LA, TC, AT, LSS, and SAT, “dry retching” outperforms “nausea.”

Table 9 English translations of “烦躁 fán zào”

Symptom Huang Wiseman Luo name

烦躁 restlessness vexation and agitation restlessness

With regard to the translation of “烦躁 fán zào,” both Huang and Luo adopted the word “restlessness,” while Wiseman literally turned it into “vexation and agitation” (Table 9). As Wiseman explained in his Shanghan Lun On Cold Damage, the terms “vexation,” “agitation,” and their combinations “agitation and vexation” and 61

“vexation and agitation,” all have different meanings when they occur in Shāng Hán Lùn. “Agitation” means the sense of subjective discomfort expressed outward through obvious abnormal movements, while “vexation” means an uneasiness felt in the heart area. When used in combination, as in “vexation and agitation,” it refers to subjective body heat and chest discomfort (vexation) and objective uneasiness of the extremities (agitation).

According to the New Shāng Hán Lùn Research Dictionary, “烦躁 fán zào” means inquietude in the heart and uneasiness of the hands and feet. Because of this, I consider that Wiseman’s vexation and agitation more clearly express the two levels of meaning of “烦躁 fán zào,” that is, mental anxiety and physical awkwardness, than does “restlessness” of the other two translators.

In summary, both translations are scientific. Although “restlessness” is more concise and easier for readers to accept, it is misleading. In terms of accuracy, “agitation and vexation” outperforms “restlessness,” and more importantly, it retains the uniqueness of “烦躁 fán zào” in TCM. Therefore, I think Wiseman's translation “agitation and vexation” is better than "restlessness."

Table 10 English translations of “烦渴 fán kě”

Symptom Huang Wiseman Luo name

烦渴 thirst and restlessness vexation and thirst restlessness and thirst

With regard to the term “烦渴 fán kě,” all three translators adopted a literal translation and similarly translated it into “thirst and restlessness,” “vexation and thirst,” and “restlessness and thirst” (Table 10). “烦渴 fán kě” can be divided into “烦 fán” and “渴 kě” in a coordinating relation, and all three translations cover the two symptoms of uneasiness and thirst. By looking up the English–Chinese Chinese– English Medical Dictionary, I found that “烦渴 fán kě” is translated into anadipsia,

62 dipsosis, and polydipsia. Anadipsia refers to extreme thirst, usually occurring during the manic phase of bipolar disorder. It is the result of dehydration caused by excessive sweat, electrolyte imbalance, persistent urination, and intense ruthless physical activities due to irritation (see also polydipsia). Dipsosis, also known as dipsesis, refers to extreme thirst, and craving for abnormal volumes of fluid.

All three translations convey the symptoms of the disease “烦渴 fán kě” in TCM. From the perspective of LA, all accurately deliver the meaning of the original and use “and” to connect the two nouns, indicating their coordinating relation. It is noteworthy that “vexation” outperforms “restlessness” in interpreting the symptom of “being perturbed.” From the perspective of LSS, both Luo and Wiseman followed the order of the original “烦 fán” (being perturbed) and “渴 kě” (feeling thirsty), so their translations are better than that of Huang. Because “烦渴 fán kě” contains the two symptoms of “烦 fán” (being perturbed) and “渴 kě” (feeling thirsty), presenting a great challenge to translators to ensure conciseness, I think it is prone to lead to a misunderstanding in readers. As far as communicating and remaining loyal to the semantic meaning of the translation, I think Wiseman’s translation outperforms those of Huang and Luo.

4.1.3 Analysis and discussion of the translation of symptom names with the word “恶 wù”

The symptomatic terms of “恶寒 wù hán,” “恶风 wù fēng” and “恶热 wù rè” share the character of “恶 wù” (Table 11). According to (World Health Organization. Regional Office for the Western, 2007), “恶寒 wù hán” refers to the “sensation of cold which cannot be relieved by warmth, also known as chills”; “恶风 wù fēng” refers to the “strong dislike of wind, also known as wind intolerance”; and “恶热 wù rè” refers to the “strong dislike of heat, also known as heat intolerance.” The New Shuāng Hán Lùn Research Dictionary interprets “恶寒 wù hán” as consciously afraid of cold, even without wind and cold, which cannot be alleviated by adding clothes and quilts. This shows that 恶 wù means “strong dislike” in both “恶风 wù fēng” and 63

“恶热 wù rè,” but “fear” in “恶寒 wù hán.”

Table 11 English translations of “恶寒 wù hán,” “恶风 wù fēng,” and “恶热 wù rè”

Symptom Huang Wiseman Luo name

恶寒 chill/aversion to cold aversion to cold chill

aversion to wind/a fear fearing wind/a fear of the 恶风 aversion to wind of the wind wind

恶热 a fear of heat aversion to heat a fear of heat

Luo borrowed the Western medical term “chill” for “恶寒 wù hán,” while literally translating “恶风 wù fēng” and “恶热 wù rè” into “fearing wind/a fear of the wind,” and “a fear of heat,” respectively. Wiseman used the literal translation method and translated them into “aversion to cold,” “aversion to wind,” and “aversion to heat,” respectively. Huang combined Western medical terms and literal translation and translated “恶风 wù fēng” into “chill/ aversion to cold,” but turned “恶风 wù fēng” and “恶热 wù rè” into “aversion to wind/a fear of the wind,” and “a fear of heat,” respectively, through a combination of free and literal translation (Table 11).

The Chinese term “恶寒 wù hán” is usually translated into “chill.” “Strictly speaking, it has a broader meaning, including both the trembling sense of coldness, and overall sensitivity to the influenza. So, we always regard it as ‘aversion to cold’” (Mitchell et al., 1999). Aversion is usually clearly defined as an obvious cold feeling even in the case of no external wind or coldness, which will not be weakened by the addition of extra clothes or a quilt. It usually contrasts with “aversion to wind” (“恶风 wù fēng”), indicating the coldness perceived when being exposed to the wind or airflow (Mitchell et al., 1999). Mitchell et al. (1999) also mentioned aversion to cold: “If we 64 accept the traditional definition in the Chinese medical literature, it is ‘inappropriate use of words.’” To be specific, “恶 wù” (aversion) suggests a reaction to external stimuli, while “寒 hán” means cold, so they are irrelevant according to their traditional definition.”

In my opinion, Wiseman translated all of “恶 wù” in “恶寒 wù hán,” “恶风 wù fēng,” and “和恶热 wù rè,” into “aversion to.” However, “恶 wù” in “恶寒 wù hán” means the conscious sensation of cold, so translating it into “aversion to” is inconsistent with the original meaning, while Luo’s “chill” more accurately expresses the discomfort of physical coldness. Huang’s translation combined the translations of the two translators. Although Huang's translation approach to the three symptomatic terms is more favourable to target readers, the combination of free and literal translation retains the cultural implication of TCM symptomatic terms while clarifying their hidden meanings. However, inconsistent translations may confuse target readers, even leading to deviations in the meaning of the two translations, such as “aversion to cold" and "chill.” As mentioned earlier, unlike the “恶 wù” in “恶寒 wù hán,” the “恶 wù” in “恶风 wù fēng” and “恶热”means “strong dislike.” My opinion is that “aversion to” is more consistent with the original meaning than is “a fear of/ fearing.”

From the perspective of LSC and LA, Luo’s translation of “恶寒 wù hán” outperforms those of Huang and Wiseman in terms of accuracy and conciseness. As for “恶风 wù fēng” and “恶热 wù rè,” Wiseman’s translation outperforms Huang’s and Luo’s in terms of accuracy and preservation of TCM culture. Translating “恶寒 wù hán” into “Chill,” “恶风 wù fēng” into “aversion to wind” and “恶热 wù rè” into “aversion to heat” better realises the goal of accurately introducing TCM terms with characteristics to foreign readers.

4.1.4 Analysis and discussion of partially consistent translation of symptom names

For the terms “腹满 fù mǎn,” “心烦 xīn fán,” “微热 wēi rè,” “大汗 dà hàn,” “懊憹 ào náo,” “呕逆 ǒu nì,” “郑声 zhèng shēng,” “眩冒 xuàn mào,” “喜忘 xǐ wàng,” and “嗜卧 shì wò,” translations of Huang and Luo are the same, but those of Wiseman differ.

Table 12 English translations of “腹满 fù mǎn”

Symptom Huang Wiseman Luo name

腹满 abdominal distention abdominal fullness abdominal distention

“腹满 fù mǎn” refers to the fullness of the abdomen and consequent discomfort, generally accompanied by swelling in appearance. Patients with “腹满 fù mǎn” will feel pain when their abdomen is pressed with the hand. If their abdomen is stiff and cannot be pressed, it is in repletion; or otherwise, it is in deficiency (Y. Fu, 2017). Both Huang and Luo adopted the free translation and translated this into “abdominal distention,” while Wiseman literally translated it into “abdominal fullness” (Table 12). The World Health Organization. Regional Office for the Western (2007) defines “腹满 fù mǎn” as “a subjective feeling of fullness in the abdomen without pronounced visible or palpable expansion,” which differs from the definition in the New Shuāng Hán Lùn Research Dictionary. L. Wang (2009) argued that “腹满 fù mǎn” represented the sense of fullness in the abdomen, yet with no visible symptoms in appearance. This disease was first described in 素问 Sù Wèn (Plain Conversation), 刺热篇 Chapter “Cì Rè” (Prickly Heat) and “六元正纪大论 Liù Yuán Zhèng Jì Dà Lùn” (Great Treatise on the Six Origins & Six Periods).

In my opinion, “abdominal fullness” better expresses the state of “腹满 fù mǎn” in general than does “abdominal distention,” which in fact is more aligned with “腹胀满 fù zhàng mǎn.” From the principles of LA and LSC, Wiseman’s translation is better than those of Huang and Luo.

Table 13 English translations of “心烦 xīn fán”

Symptom Huang Wiseman Luo name

annoyance 心烦 heart vexation restlessness/annoyance /restlessness

As for “心烦 xīn fán,” both Huang and Luo used the free translation method and translated it into “annoyance,” and “restlessness,” respectively, while Wiseman literally translated it into “heart vexation” (Table 13). It is defined as “a feeling of restlessness, heat, and oppression in the region of the heart” and translated into “vexation” (World Health Organization. Regional Office for the Western, 2007).

Huang and Luo’s translations stress the psychological and spiritual state of “心烦 xīn fán,” while Wiseman’s translation points out the specific organ that produces the restlessness, the heart. I think that Wiseman’s translation more specifically indicates the symptoms and places where symptoms occur, while the translations of Huang and Luo are more general and vague. According to the principles of LA and scientificity, Wiseman’s translation is better than Huang’s and Luo’s. According to principles of CT and LSS, Wiseman's semantic meaning is consistent with the original and completely retains the symptoms contained in “心烦 xīn fán.”

Table 14 English translations of “微热 wēi rè”

Symptom Huang Wiseman Luo name

微热 slight fever/light fever slight heat light fever

“微热 wēi rè” means slight fever and low fever (Y. Fu, 2017). Both Huang and Luo translated “微热 wēi rè” into “light fever,” and Wiseman literally translated it into “slight heat” (Table 14). Thus, both Huang and Luo used “fever” to express “热 rè,” while Wiseman turned it into “heat,” exemplified by “Heat fā rè.” Although Huang and Luo’s “fever” is easier than “heat” to accept and understand for target readers, I think Wiseman ’s translation is more accurate according to the description of the symptoms about “发热 fā rè.” This is because Wiseman ’s translation more accurately conveys the meaning of the original, which is more important for readers. From the perspective of the CT principle, “heat” retains symptom characteristics of surface heat and interior heat of “发热 fā rè” in TCM, which help readers better understand the symptoms unique to TCM.

Table 15 English translations of “大汗 dà hàn”

Symptom Huang Wiseman Luo name

大汗 profuse perspiration great sweating profuse perspiration

“大汗 dà hàn” means sweating heavily, and it is translated into “profuse perspiration” by both Huang and Luo, and “great sweating” by Wiseman (Table 15). “大 dà” in “大汗 dà hàn” is an adverb, indicating a large number or a wide range. In Chinese, “大 dà” may also be used as an adjective, meaning significant and important (Gudai Hanyu zidian, 2005). Both Huang and Luo used “profuse” to express the large

68 amount of sweat, while Wiseman chose the word “great,” which generally corresponds to “大 dà” in ancient Chinese. The cases in point include “大安殿 dà ān diàn” translated into “hall of Great Peace,” “大辩论 dà biàn lùn” into “great debates,” “大道理 dà dào lǐ” into “great principles,” “大方向 dà fāng xiàng” into “great direction,” and “大学 dà xué” into “the great learning” (Han Ying Zhongguo zhuan you ming cheng he shu yu jian ming ci dian = A concise Chinese-English dictionary of Chinese proper names and terms, 1994).

Although the “大 dà” in ancient Chinese is usually translated into “great,” I think that Wiseman’s literal translation of “大汗 dà hàn” into “great sweating” may mislead readers. This is because the “大 dà” in “大汗 dà hàn” means the large amount of sweat rather than its significance or importance. Therefore, Huang and Luo’s translation into “profuse perspiration” is closer to the original meaning of excessive sweating.

In summary, Wiseman's translation of “大 dà” into “great” outperforms Huang’s and Luo’s in terms of cultural preservation, and is more consistent with word formation of the original. The latter two translators’ translations are closer to the original meaning according to LA, and better accepted and easier to understand from the perspective of target readers. As such, Huang and Luo’s translations generally outperform Wiseman’s. However, “大汗 dà hàn” only contains one kind of symptom, so from the perspective of lexical structure, it seems to be a bit complicated to translate a TCM symptomatic name using the lexical structure of adjective + noun. Therefore, I think we can borrow a corresponding term from Western medicine to translate “大汗 dà hàn.”

As mentioned earlier, “大汗 dà hàn” refers to a state of excessive sweating like water flowing all over the body. Hence, it can be seen that “大 dà” in fact means “over/excessive,” so we can use the Western medical term “hyperhidrosis” to express the state of excessive sweating, improving the conciseness and scientificity of the translation (Mosby's dictionary of medicine, nursing and health professions, 2019).

Table 16 English translations of “懊憹 ào náo”

Symptom Huang Wiseman Luo name

restlessness and 懊憹 anguish restlessness and irritation irritation

“懊憹 ào náo” refers to the perceived burning sensation between the chest and diaphragm that makes patients sullen and helpless (Y. Fu, 2017). Both Huang and Luo translated it into “restlessness and irritation,” while Wiseman literally translated it into “anguish” (Table 16). The first two translators used two nouns, “restlessness” and “irritation,” to express the state of patients who were unable to relax and felt irritated and impatient. Wiseman used the noun “anguish” to express the serious mental or physical pain or torture suffered by patients (“Anguish” 2019). Since “懊憹 ào náo” contains the serious feelings of helplessness and chest distress, I think “anguish” can better reflect the state of serious mental and physical suffering.

In summary, Wiseman’s translation is superior to that of the other two translators’ in terms of accuracy, conciseness, and acceptance to readers. Therefore, I consider the translation of “懊憹 ào náo” into “anguish” appropriate.

Table 17 English translations of “呕逆 ǒu nì”

Symptom Huang Wiseman Luo name

呕逆 nausea/vomiting retching counterflow nausea

The term “呕逆 ǒu nì” that means the vomiting caused by reversed flow of qi was translated into “nausea/vomiting” by both Huang and Luo, but “retching counterflow” by Wiseman (Table 17). As mentioned earlier, “nausea” refers to a feeling of vomiting that does not certainly cause vomiting. Therefore, translating “呕逆 ǒu nì” into 70

“nausea” departs from its original meaning, for it is not just a disgusting state, but also suggests actual vomiting, while the word “vomiting” used by Huang and Luo, in spite of presenting the symptom of vomiting, ignores the reason for the vomiting, that is, it is caused by reversed flow of qi. Wiseman's translation differs in pointing out the symptom of vomiting, but also using the word “counterflow” to indicate the meaning of “逆 nì.”

In summary, from the perspective of LSC and AT, Huang’s and Luo’s translations are more concise and more acceptable to readers than Wiseman’s. The vomiting caused by the upward flow of qi includes two states of qi reverse and vomiting. Therefore, if it is translated by coinage with morphemes, I think the meanings are difficult to completely express. As such, in terms of accuracy, Wiseman’s translation is better than those of the other two. Translating “呕逆 ǒu nì” into “retching counterflow” better conveys the uniqueness of TCM to readers, and achieves the communicative goal of translation.

Table 18 English translations of “郑声 zhèng shēng”

Symptom Huang Wiseman Luo name

郑声 Zhengsheng muttering Zhengsheng

“郑声 zhèng shēng” means repeating words in a low faint voice. Both Luo and Huang adopted the transliteration, translating it into “Zhengsheng,” while Wiseman translated it as “muttering” (Table 18). Although transliteration can well retain the characteristics of TCM culture, target readers without a foundation in TCM will probably fail to understand translated terms readily (Yin, Ren, & Wang, 2015). According to the principles of AT and acceptability, Wiseman’s translation outperforms that of the two others. Considering the purpose of transmitting TCM culture, I think transliteration can better preserve the uniqueness of “郑声 zhèng

71 shēng” as a symptom name with TCM characteristics, and better retain its uniqueness. Therefore, Huang’s and Luo’s translation are considered better than Wiseman’s.

Table 19 English translations of “眩冒 xuàn mào”

Symptom Huang Wiseman Luo name

眩冒 dizziness veiling dizziness dizziness

“眩冒 xuàn mào” was translated into “dizziness” by both Huang and Luo, which is defined as the feeling of dizziness and rotation, or the inability to maintain a normal balance of standing or sitting, sometimes accompanied by dizziness, confusion, nausea and weakness. Wiseman translated it differently, into two nouns, “veiling dizziness.” According to the New Shuāng Hán Lùn Research Dictionary, “眩冒 xuàn mào” means the symptoms of feeling dizzy and blurring in vision (Y. Fu, 2017). “冒 mào” means a patient feels dizzy, as if the two eyes are obscured by something. Therefore, “眩 xuàn” and “冒 mào” are in coordinating relations. Veiling refers to a thin tulle fabric, generally used to make veils. “Dizziness” adopted by Huang and Luo expresses the feeling of rotation and loss of balance, but ignores the feeling that two eyes are blinded by objects. Wiseman’s translation accommodates the two states, so I think it more comprehensively expresses the true meaning of “眩冒 xuàn mào.”

In summary, Huang’s and Luo’s translations are more concise than Wiseman’s and have higher acceptability to the target readers, but the opposite is true in terms of accuracy. Based on principles of TC and LSS, Wiseman’s translation is also superior to those of the two others. As for translation of medical terms, the primary purpose is to accurately convey the meaning of the original and to avoid causing confusion to target readers, because an inaccurate or ambiguous translation may affect later study of TCM theory.

Table 20 English translations of “喜忘 xǐ wàng”

Symptom Huang Wiseman Luo name

喜忘 amnesia forgetfulness amnesia

“喜忘 xǐ wàng” has the same meaning/implication as “健忘 jiàn wàng” (Y. Fu, 2017), defined as “poor memory; tendency to forget matters, the same as amnesia” (World Health Organization. Regional Office for the Western, 2007). Both Huang and Luo borrowed the Western medical term “amnesia” to translate “喜忘 xǐ wàng.” “Amnesia” refers to memory loss caused by brain damage or severe emotional trauma (Mosby's dictionary of medicine, nursing and health professions, 2019), while Wiseman translated it into “forgetfulness” (Table 20). “Forgetfulness” is defined as the quality of often forgetting things (“Forgetfulness,” 2019). In terms of acceptability, all three versions could probably be understood by target readers since they borrow Western medical terms. However, I think it is better to translate “喜忘 xǐ wàng” into “amnesia,” for borrowing Western medical terminology is a way for Western readers to more quickly accept and understand TCM terms. Additionally, from scientific and natural perspectives, “amnesia” outperforms “forgetfulness.”

Table 21 English translations of “嗜卧 shì wò”

Symptom Huang Wiseman Luo name

嗜卧 like to lie in bed somnolence like to lie in bed

“嗜卧 shì wò” represents pathological sleepiness and drowsiness (Y. Fu, 2017). In addition, according to the World Health Organization. Regional Office for the Western (2007), it is defined as “excessive sleepiness night and day.” Both Luo and Huang

73 split the term into “嗜 shì” and “卧 wò,” with the former translated into “like to (do something)” and the latter into “lie in bed.” Literally, “卧 wò” does not indicate the place where a patient lies, but both translators specify on a bed. Wiseman used “somnolence” to express it, which has two meanings: the condition of being sleepy or drowsy, and tending to cause sleepiness (Table 21). Combining interpretations of the New Shāng Hán Lùn Research Dictionary and WHO international standard terminologies on traditional medicine in the Western Pacific Region, “somnolence,” I think, more accurately expresses the meaning of pathological sleepiness in “嗜卧 shì wò,” while the expression of “like to lie in bed” of Huang and Luo just signifies the fondness of lying in bed, failing to express the state of drowsiness and sleepiness, or explaining the reasons implied in the Chinese term. Therefore, TCM beginners may be confused about why patients like to lie in bed. Although the translations of Huang and Luo express the literal meaning of the original, their structure is long and therefore unsuitable as a TCM term.

In my opinion, the purpose of translating TCM terms is to convey the knowledge of TCM to target readers, rather than to pursue the equivalence of literal meaning between the translation and the original. Accordingly, the principles of accuracy and scientificity should be followed in translation. Wiseman’s translation borrows Western medical terms and is more accurate, scientific, and concise than those of Huang and Luo. Translating “嗜卧 shì wò” into “somnolence” is the better choice.

4.1.5 Analysis and discussion of the translation of inconsistent symptom names

Here I discuss symptomatic terms “无汗 wú hàn,” “厥逆 jué nì,” “短气 duǎn qì,” and “下血 xià xuè” that are translated differently in the three translations.

For “无汗 wú hàn,” all three translators use the free translation method. Huang translated it into “no sweating,” which is consistent with the original phrase structure of adj. + noun, Wiseman translated it into “absence of sweating” in a noun + prep. + noun phrase structure, while Luo adopted the prep. + noun structure and translated it

74 into “without perspiration” (Table 22). “无汗 wú hàn” means a patient is sweatless or has no sweat in the situations where they should sweat.

Table 22 English translations of “无汗 wú hàn”

Symptom Huang Wiseman Luo name

无汗 no sweating absence of sweating without perspiration

In my opinion, all three translations express the literal meaning of “无汗 wú hàn” in a very intuitive manner. However, in terms of phrase structure, Huang’s “no sweating” is more concise and clearer. In terms of acceptability, all three translations are possibly not hard for target readers to understand, because they are composed of phrases with simple words. All adopted phrases to translate “无汗 wú hàn.” In my view, this term only contains the symptom of no body sweating, so the Western medical term “anhidrosis” could be borrowed to express the state without sweating (Mosby's dictionary of medicine, nursing and health professions, 2019). This improves the conciseness and scientificity of the translation, so that target readers can more fully accept the information contained, achieving the communicative goal of translation.

Table 23 English translations of “厥逆 jué nì”

Symptom Huang Wiseman by Luo name

厥逆 coldness on limbs reverse-flow coldness on the extremities

“厥逆 jué nì” refers to the coldness of the hands and feet, with a similar meaning to “厥 jué,” “四逆 sì nì,” and “厥冷 jué lěng” (Y. Fu, 2017). Huang and Luo translated it into “coldness on limbs,” and “coldness on the extremities,” respectively, while 75

Wiseman literally translated it into “reverse-flow” (Table 23). Both Huang and Luo's translations express the symptomatic state of “厥逆 jué nì,” that is, cold extremities, while Wiseman’s translation of “reverse-flow,” although additionally explained as “cold in the extremities” in his book, fails to clearly convey its meaning and seems ambiguous. By referring to WHO international standard terminologies on traditional medicine in the Western Pacific Region, “厥逆 jué nì” can be interpreted as obvious coldness on the limbs below the knees or above the elbows, the same as cold extremities. Comparing these three translations, I believe Huang and Luo’s translations precisely convey the state of patients with “厥逆 jué nì,” while Wiseman's translation appears to be vague and ambiguous, for reverse-flow is more commonly used in chemical engineering science, exemplified by reverse flow reactors.

In summary, Huang’s and Luo’s translations are more accurate than Wiseman’s. However, both of their translations are composed of phrases, which are inconcise and inappropriate as medical terms. “厥逆 jué nì” is a symptom term peculiar to TCM, so transliteration may be better choice to preserve its uniqueness, but it is difficult for target readers to understand, even for Chinese speakers with no background knowledge of TCM. Therefore, considering the principles of conciseness and acceptability, I think it is better to translate it into “cold limbs.”

Table 24 English translations of “短气 duǎn qì”

Symptom Huang Wiseman Luo name

短气 shortage of breath shortness of breath short of breath

For “短气 duǎn qì,” all three translators resorted to prepositional phrases in translation, translating it into “shortage of breath,” “shortness of breath,” and “short of breath.” “短气 duǎn qì” means being out of breath and breathing in a non-continuous

76 manner. All three translations use “of” as a preposition to connect two nouns “shortage”/ “shortness”/ “short” and “breath” into a phrase (Table 24).

All translations accurately express the meaning of “短气 duǎn qì,” and are easy to understand. As a technical term, “短气 duǎn qì” only contains the state of shortness of breath, so the three translations lack conciseness and scientificity. For this reason, I hold that coinage with morphemes could be used to translate the term. “短 duǎn” means shortage/deficiency, whose corresponding combining form is “isch-” (Sheehan, 2000), while “气 qì” means “breath,” whose combining form is “-pnea” (Sheehan, 2000). Hence, we can create a new word, “ischpnea.” Morphological coinage can, in my view, improve the conciseness, acceptance, and scientificity of a translation, and guarantee its accuracy, thereby achieving the communicative goal of translation.

Table 25 English translations of “下血 xià xuè”

Symptom Huang Wiseman Luo name

下血 hematochezia blood descent stercorrhagia

“下血 xià xuè,” also called “便血 biàn xuè” or “清血 qīng xuè,” refers to bleeding from the anus, and the three translators translated it differently. To be specific, Huang cited the Western medical term “hematochezia,” which is defined as Frank (red) blood on or in the faeces, whether that be formed or not ("Hematochezia," 2016). Wiseman literally translated this into “blood descent.” Luo also borrowed a Western medical term and translated it into “stercorrhagia” (Table 25). “Rrhagia” in stercorrhagia refers to an abnormal or excessive flow or discharge and ‘‘sterco’’ refers to stools or faeces, so it is a problem of abnormal or excessive bowel movements (Lai, Yang, & Shan, 2004).

I hold that Huang and Luo borrowed Western medical terms with similar meaning, so their translations appear more professional, while Wiseman's “blood descent” just

77 indicates blood falling, without describing the fact that blood comes with the faeces.

Although Huang’s and Luo’s translations interpreted the meaning of the original well, I searched the term “stercorrhagia” used by Luo with Google and found only six results, suggesting that “stercorrhagia” is rarely used in practice. Therefore, in my opinion, Huanghai's “hematochezia” is betterchoice considering the acceptability of the translations.

4.1.6 Remarks

In this section, I aimed to compare the translations made by Huang, Wiseman, and Luo of TCM symptomatic terms selected from Shāng Hán Lùn. By comparatively analysing their English translations, I concluded that among the 27 TCM symptomatic terms selected, six were translated exactly the same, 17 were translated the same by two translators, and four were translated differently, accounting for 22%, 63% and 15% of the total number of translations, respectively. This analysis indicates that only 22% of selected TCM symptomatic terms had uniform English translations. Translation methods and strategies of symptom names adopted by the three translators are presented in Table 26.

Table 26 Translation methods and strategies of symptomatic names

Translator/ Methods & Strategies Huang Luo Wiseman Borrowing Western medical terms 11 6 12 Free translation 12 6 14 Literal translation 1 15 0 Transliteration 1 0 1 Combined literal translation and free 1 0 0 translation Combined Western medical term and 1 0 0 literal translation Domestication 23 12 26 Foreignisation 2 15 1 Combined domestication and 2 0 0 foreignisation

Both Huang and Luo preferred the domestication translation strategy, while Wiseman

78 preferred foreignisation. In terms of translation effect, although some TCM symptomatic terms have corresponding concepts and words in English, translating them following their original vocabulary structure and literal meaning may mislead target readers due to language and culture differences. Principles that exemplified terms satisfied are detailed in Table 27.

Table 27 Comparison of symptomatic terms based on six translation principles

Symptomatic terms Huang Wiseman Luo 下利 xià lì LA: √ LA: √ LA: √ 吐利 tǔ lì AT: √ AT: √ AT: √ 头痛 tóu tòng SAT: √ SAT: √ SAT: √ 咽痛 yān tòng LSC: √ LSC: √ LSC: √ 腹痛 fù tòng LSS: √ LSS: √ LSS: √ CT: ∕ CT: ∕ CT: ∕ 口苦 kǒu kǔ LA: √ LA: √ LA: √ AT: √ AT: √ AT: √ SAT: ∕ SAT: ∕ SAT: ∕ LSC: ∕ LSC: ∕ LSC: ∕ LSS: √ LSS: √ LSS: √ CT: ∕ CT: ∕ CT: ∕ 发热 fā rè 干呕 gān ǒu 烦躁 fán zào LA: ∕ LA: √ LA: ∕ 烦渴 fán kě AT: √ AT: √ AT: √ 微热 wēi rè SAT: ∕ SAT: √ SAT: ∕ 腹满 fù mǎn LSC: √ LSC: √ LSC: √ 心烦 xīn fá LSS: ∕ LSS: √ LSS: ∕ 呕逆 ǒu nì CT: ∕ CT: √ CT: ∕ 眩冒 xuàn mào 嗜卧 shì wò 恶寒 wù hán LA: ∕ LA: ∕ LA: √ AT: √ AT: √ AT: √ SAT: √ SAT: √ SAT: √ LSC: √ LSC: √ LSC: √ LSS: ∕ LSS: ∕ LSS: ∕ CT: ∕ CT: ∕ CT: ∕

Symptomatic terms Huang Wiseman Luo 恶风 wù fēng LA: ∕ LA: √ LA: ∕ 恶热 wù rè AT: √ AT: √ AT: √ SAT: √ SAT: √ SAT: √ LSC: ∕ LSC: √ LSC: ∕ LSS: ∕ LSS: √ LSS: ∕ CT: ∕ CT: √ CT: ∕ 大汗 dà hàn LA: √ LA: ∕ LA: √ 无汗 wú hàn AT: ∕ AT: ∕ AT: ∕ 厥逆 jué nì SAT: ∕ SAT: √ SAT: ∕ 短气 duǎn qì LSC: √ LSC: √ LSC: √ LSS: √ LSS: ∕ LSS: √ CT: ∕ CT: ∕ CT: ∕ 懊憹 ào náo LA: ∕ LA: √ LA: ∕ AT: √ AT: √ AT: √ SAT: ∕ SAT: √ SAT: ∕ LSC: √ LSC: √ LSC: √ LSS: ∕ LSS: √ LSS: ∕ CT: ∕ CT: ∕ CT: ∕ 郑声 zhèng shēng LA: √ LA: √ LA: √ AT: √ AT: √ AT: √ SAT: √ SAT: √ SAT: √ LSC: √ LSC: √ LSC: √ LSS: √ LSS: √ LSS: √ CT: √ CT: ∕ CT: √ 喜忘 xǐ wàng LA: √ LA: √ LA: √ AT: √ AT: √ AT: √ SAT: √ SAT: ∕ SAT: √ LSC: √ LSC: √ LSC: √ LSS: √ LSS: √ LSS: √ CT: ∕ CT: ∕ CT: ∕ 下血 xià xuè LA: √ LA: ∕ LA: √ AT: √ AT: ∕ AT: ∕ SAT: √ SAT: ∕ SAT: √ LSC: √ LSC: √ LSC: √ LSS: √ LSS: √ LSS: √ CT: ∕ CT: ∕ CT: ∕

In the translations of Huang, Wiseman and Luo, there are 19, 9 and 17 mistranslations, respectively. The reason for mistranslations by Huang and Luo may be because of their preference for free translation. Although this method helps improve the readability of a translation, inappropriate wording may lead to the

80 departure from the original meaning. A case in point is translating “干呕 gān ǒu” into “nausea.” The translation strategies of Wiseman are dominated by literal translation and supplemented by free translation, the translated terms are accurately conveying the original meaning on the whole. There are also individual TCM symptomatic terms unsatisfactorily translated in all these three translation versions, and these terms shall be translated with more matched words or using new translation methods.

4.2 Discussions on Chinese–English (C–E) translation of disease terms in Shāng Hán Lùn

Disease names are one of the most important sources of terms in Shāng Hán Lùn. The six chapters of Shāng Hán Lùn concerning the pulses, patterns, and treatments of “太阳病 tài yáng bìng,” “阳明病 yáng míng bìng,” “少阳病 shǎo yáng bìng,” “太阴病 tài yīn bìng,” and “少阴病 shǎo yīn bìng” record 76 names of disease patterns. From linguistic characteristics, these disease names inherit features of ancient Chinese languages characterised by simplistic structure and rich implication, and most display obvious differences between ancient and modern times, and between China and the West, so that even TCM scholars have to explore thoroughly to get their true meaning (Sheng, 2013).

Sheng (2013) summarised characteristics of disease names in Shāng Hán Lùn and classified them into: 1) similar names and implications to those in Western medicine, such as “痈脓 yōng nóng” and “衂 nǜ”17. This type of name is seldom seen in Shāng Hán Lùn; 2) Different names but similar implications to those in Western medicine. For example, “谷疸” gǔ dǎn is similar to one type of jaundice in Western medicine while “喉痹 hóu bì” is similar to sphagitis in Western medicine; 3) The same names but different implications with those in Western medicine. For example, “伤寒 shāng hán” had meanings in broad and narrow senses. The former refers to a general term of all exogenous diseases while the latter means the disease of exogenous cold; 4) Different names and implications from those in Western medicine. Most disease

17 衂 nǜ refers to bleeding from the nose, gums, skin, etc. that is not due to trauma (Fu, 2017). 81 names have this feature, and not only for Shāng Hán Lùn, but for the whole TCM. The names were named either by meridians, such as “太阳病 tài yáng bìng,” “阳明病” yáng míng bìng,” and “厥阴病 jué yīn bìng,” by etiology and pathogenesis, such as”结胸 jié xiōng,” by symptoms, such as “奔豚 bēn tún,” or by pathogenesis + symptom, such as “藏厥 zàng jué.” Others have no naming rules.

Here I select 15 of the 76 disease name for analysis, specifically six meridian disease names and 9 two-character disease names with different characteristics, as follows: “痈脓 yōng nóng” with a similar name and implication in Western medicine; “谷疸 gǔ dǎn” with a different name and similar implication in Western medicine; “伤寒 shāng hán” with the same name in Western medicine but a different implication, falling into the category of “温病 wēn bìng”—a kind of typhoid fever in a broad sense, and “中风 zhòng fēng”; “结胸 jié xiōng” named by etiology and pathogenesis; “藏厥 zàng jué” named by pathogenesis + symptom; “奔豚 bēn tún” named by symptoms and “风温 fēng wēn” named by dominant qi in four seasons.

The concept of six meridian diseases will be introduced, and I will discuss strategies for their translation adopted by Huang Hai, Negel Wiseman, and Luo Xiwen according to Skopos theory and TCM translation principles. Connotations of the nine disease names will be elaborated, and approaches and strategies for their translation adopted by the three translators will be discussed in combination with Skopos theory and integrated TCM translation principles. Finally, guidance on translation of TCM disease names will be proposed.

4.2.1 Introduction to names of the six meridian diseases

When studying Shāng Hán Lùn, we will inevitably encounter the two important concepts of “six meridian diseases” and “pattern identification of six meridian diseases.” In fact, these two concepts are the short names of the three-yin and three- yang diseases, and three-yin and three-yang pattern identification, respectively, coined by later generations. Names of the three-yin and three-yang diseases do not appear in

82 the original work written by Zhongjing Zhang, but are two later-proposed concepts (Jiang & Zhang, 2012). Hu (2008), the esteemed TCM classical prescription clinician and educator in modern China, held that the reason why treatment of diseases in TCM went with identification of pattern (the diagnostic method of TCM) instead of disease could not be separated from its developmental history. The development of TCM can be traced to ancient times (thousands of years ago) when there was neither an advanced scientific foundation nor fine instruments. Therefore, it was not possible to seek diagnosis and treatment like Western medicine based on pathological essence and pathogenic factors, but rather human natural intuition combined with human reaction to disease had to be relied upon for methods and experience. Through repeated practice, TCM promoted both an understanding of the medicinal effect and accuracy of prescription, and summarised common reaction rules for constantly changing diseases. On the basis of rules, various prescriptions were developed for the universal treatment of common diseases through experiments. Shāng Hán Lùn has evolved from the rules of “disease comes from yang” and “disease comes from yin.” The essence lies in the disease development process of yang’s transformation from sufficiency to deficiency (three yang) and then yin’s transformation from sufficiency to deficiency (three yin) (Hu, 2008).

Jinliang Yang et al. (2019) identified in their journal The Essence of Six Meridians and Six Meridian Diseases in Shāng Hán Lùn that the book actually described some acute infectious diseases caused by bacteria and viruses. According to the development of the diseases, their symptoms and treatments were summarised, and the concept of six meridian diseases was created in combination with the description of six meridians in Sù Wèn (Plain Conversation), Chapter “RèLùn” (On Heat), and the depth of the disease location (deep or shallow in the body). He also thought that the living standard in ancient China was low and the hygienic conditions were far behind modern times, so infectious diseases became frequent and common.

Based on clinical observations, Zhang Zhongjing summed up the various syndromes in exogenous fever development, and divided them into six stages: “太阳病 tài yáng bìng,” “阳明病 yáng míng bìng,” “少阳病 shǎo yáng bìng,” “太阴病 tài yīn bìng,” and “少阴病 shǎo yīn bìng,” according to the amount of yi qi and yang qi, degree of cold and fever identification, and location of pathogenic organs, in an attempt to discuss the main symptoms, pulses, treatment and nursing of the meridian diseases, and the progress of sequential transmission, reverse transmission and direct targeting (Jinliang Yang et al., 2019).

Yang (1982) at the Typhoid and Fever Teaching and Research Office of Tianjin University of Traditional Chinese Medicine identified in his journal Discussions on Essence of Six Meridians in Shāng Hán Lùn that the six meridian diseases in the book were pathological phenomena of visceral meridians in the development of exogenous diseases. No matter how complex and variable the clinical symptoms were, Yang summed up the pathological phenomena of a certain visceral meridian dysfunction into one meridian disease by following the rules of exogenous disease occurrence, development and evolution as well as the the theories of six meridians in the Internal Canon of Medicine (Nèijīng). The phenomena are categorised into six types: “太阳病 tài yáng bìng,” “阳明病 yáng míng bìng,” “少阳病 shǎo yáng bìng,” “太阴病 tài yīn bìng,” “少阴病 shǎo yīn bìng” and “厥阴病 jué yīn bìng.” These types are not isolated from one another, because the six meridians possess the physical foundation of visceral meridians. They have their respective physiological functions, and they also share intrinsic relations. Therefore, the dysfunction of visceral meridians influences and penetrates each other. Hence, the six meridians in Shāng Hán Lùn are the pathological changes of visceral meridians, which represent not only the six different types of diseases but also the different stages of disease development and evolution (Yang, 1982).

According to the Shāng Hán Lùn in Popular Language “太阳病 tài yáng bìng” occurs at the initial stage of the disease development, where an organism intends to excrete the pathogenic factors from the surface of the upper body in the form of 84 perspiration under the function of the cerebral cortex. Due to the limited body functions leading to failure of perspiration, hyperemia occurs in shallow blood capillaries or arteries, leading to increased body temperature as heat fails to be expelled from the body, producing a series of symptoms such as floating pulse, aching head and neck, and ultimately aversion to cold. For any disease, if there is such symptom, it will be named “太阳病 tài yáng bìng.” For the pathology of “阳明病 yáng míng bìng,” the organism drives the pathogenic factors into the intestines and stomach under the dominant function of the cerebral cortex and intends to expel them out through an excretion mechanism. Due to the mutual effects of pathogenic factors and organisms, as well as limited natural healing effect, constipation or stagnant diarrhea arises. The occurrence of “少阳病 shǎo yáng bìng” has two causes, namely transmission of “太阴病 tài yīn bìng,” and spontaneity. When an organism surrounds the pathogenic factors inside the pleuroperitoneal cavity, it relies on the functions of the respiratory tract, urinary system, and/or skin, to expel them. However, due to limited natural healing effects, they accumulate in these areas, leading to the inflammatory transmission in internal organs. “太阴病 tài yīn bìng”, “少阴病 shǎo yīn bìng,” and “厥阴病 jué yīn bìng” are all three yin diseases. “太阴病 tài yīn bìng” refers to gastrointestinal dysfunction leading to vomiting, anorexia, and stomach ache, because of decreased mutual interactions between healthy and pathogenic factors. “少阴病 shǎo yīn bìng” means that when the metabolic function decreases to a certain level, the syndrome and blood are weakened inside the body, with reactions including malnutrition, failure to self-maintain the cerebral cortex, and ultimately sleepiness. Just like other yin diseases, “厥阴病 jué yīn bìng” also has its root in the deficient cold. Only when the yin cold reaches the extreme does it push the deficient yang to rise, hence syndrome of the upper heat and lower cold. In terms of disease patterns, “少阴 shǎo yīn” means extreme deficiency while “厥阴 jué yīn” means extreme yin cold resembling yang, hence leading to fever syndrome.

4.2.2 Comparison of translations of six meridian disease names

Table 28 presents the “太阳病 tài yáng bìng,” “阳明病 yáng míng bìng,” “少阳病 shǎo yáng bìng,” “太阴病 tài yīn bìng,” “少阴病 shǎo yīn bìng,” and “厥阴病 jué yīn bìng” as well as their English translations by the three translators.

Table 28 Names and translations of six meridian diseases

Disease name Huang Wiseman Luo

The Taiyang (Initial Yang) 太阳病 Taiyang disease Greater yáng disease syndrome

The Yangming (Greater Yang) 阳明病 Yangming disease Yáng brightness disease syndrome

The Shaoyang (Lesser Yang) 少阳病 Shaoyang disease Lesser yáng disease syndrome

The Taiyin (Initial Yin) 太阴病 Taiyin disease Greater yīn disease syndrome

The Shaoyin (Lesser Yin) 少阴病 Shaoyin disease Lesser yīn disease syndrome

The Jueyin (Greater Yin) 厥阴病 Jueyin disease Reverting yīn disease syndrome

Regarding the translation method of the six meridian diseases, all three translators used transliteration for “阴阳 yīn yáng.” The linguistics of national conditions hold that some words and expressions will always reflect unique things, thoughts and concepts of a linguistic community, and therefore have no corresponding words in other languages, e.g., “阴阳 yīn yáng” in TCM (Niu, 2004). For this reason, translators tend to adopt transliteration when it comes to TCM terms that cannot be translated well by other means. As reported in Table 28, Huang adopted the combined method of transliteration + literal translation to translate “太阳 tài yáng,” “阳明 yáng míng,” “少阳 shǎo yáng,” “太阴 tài yīn,” and “少阴 shǎo yīn” into “Taiyang,” “Yangming,” “Shaoyang,” “Taiyin,” “Shaoyin,” and “Jueyin,” and “病 bìng” into

“disease.” Although the use of transliteration allows TL readers to better understand and appreciate the culture and background of the SL (Xiong, 2014), advocating the diversified trend of culture, special attention should be given to the differences between Chinese and Western cultures when it comes to translation, so as to correctly convey the connotation of the SL. For example, for “Taiyang disease,” “Taiyang” (太阳) also means “Sun” in Chinese, so TL readers might be confused or even misinterpret “太阳病 tài yáng bìng” if they lacked certain basic knowledge.

Wiseman combined literal translation + transliteration to translate “太阳病 tài yáng bìng” into “Greater yáng disease.” Similarly, “阳明病 yáng míng bìng,” “少阳病 shǎo yáng bìng,” “太阴病 tài yīn bìng,” and “少阴病 shǎo yīn bìng” were translated as “Yáng brightness disease,” “Lesser yáng disease,” “Greater yīn disease,” and “Lesser yīn disease,” respectively. For “厥阴病 jué yīn bìng,” Wiseman used the combination of free translation + transliteration to translate it into “Reverting yīn disease.” According to definition, “Revert” means “Return to (a previous state, practice, topic, etc.)” (Press, 2019).

Lü (2010) believes that the core cause of “厥阴病 jué yīn bìng” lies in the simultaneous occurrence of cold and heat. “厥阴 jué yīn” is the place where yin ends and yang generates, and it forms an integral part with “少阳 shǎo yáng,” characterised by converting evil into cold if the evil goes through the meridian from its yin channels, and into heat if the evil goes through the meridian from its yang channels. This leads to the simultaneous occurrence of cold and heat, and thus the disease. In short, a ‘hot liver and gall’ but ‘cold spleen and stomach’ is the main characteristic of pathological change in “厥阴 jué yīn” meridian.

Meng (1989) identified three characteristics of “厥阴病 jué yīn bìng”:

1) it is the most critical stage of exogenous fever;

2) “厥阴 jué yīn” is the extremity of “太阴 tài yīn” and “少阴 shǎo yīn,” heralding the end of yin and the generation of yang. In terms of symptoms, the

disease has both cold syncope syndrome and heat syncope syndrome, as exemplified by the aforesaid simultaneous occurrence of cold and heat, which is not the case in other five diseases;

3) symptoms of the disease are complicated and include dangerous signs before dying (apart from the mixed cold and heat), manifested as cold extremities.

Wiseman translated this into “Reverting yīn disease” possibly because of his efforts to express its cause, i.e., yin and yang disorders and alternating cold and heat. Of the six meridian diseases, Wiseman translated five of them using the literal translation + transliteration method, showing his preference for the foreignisation strategy, e.g., translating “太阳病 tài yáng bìng” into “Greater yáng disease.” He may have done so to follow translation principles of “faithfulness” and original-orientation, or to preserve the cultural characteristics of TCM.

Luo translated “太阳病 tài yáng bìng” and “太阴病 tài yīn bìng” by transliteration + free translation into “Taiyang” (Initial Yang) and “Taiyin” (Initial Yin), respectively. X. Zhang and Liu (2016) pointed out that “太阳病 tài yáng bìng” is the initial stage of the six meridian diseases, caused by the conflicts between good and evil that invade the human body, with the nature of the disease falling into yang and the place of the disease at the surface.

Luo translated “太阳 tài yáng” into “Initial yang.” Luo may have used this translation method to express the fact that the disease was the initial stage of the six meridian diseases, and place where the disease begins is still on the surface after evil invasion. In the same way, Luo interpreted “太阴 tài yīn” into “Initial Yin,” because the disease is the initial stage of the three yin diseases (short for “太阴病 tài yīn bìng” “少阴病 shǎo yīn bìng,” and “厥阴病 jué yīn bìng”) and “太阴病 tài yīn bìng” is generally caused by the failure of the treatment of yang disease, or the direct invasion of the evil of cold and dampness against “太阴 tài yīn,” or cold and dampness retardation as a result of weak spleen and stomach (Y. Fu, 2017). Therefore, Luo translated “太阴 tài yīn” into “Initial Yin” probably to express that “太阴病 tài

88 yīn bìng” is the beginning of the three yin diseases. As for translations of “阳明病 yáng míng bìng,” “少阳病 shǎo yáng bìng,” “少阴病 shǎo yīn bìng,” and “厥阴病 jué yīn bìng,” Luo adopted the method of transliteration + annotation. His annotations for “少阳病 shǎo yáng bìng” and “少阴病 shǎo yīn bìng” are the same in content as Wiseman’s, but differ in place adjustment—that is, Luo placed the annotation after the transliteration. Additionally, Luo literally translated “病 bìng” into “syndrome,” which in the Oxford dictionary means “the disease that is characterised by the concurrent occurrence of a group of signs, or by a group of related signs” (Press, 2019). As can be seen, Luo’s translation strategy tends to be one of foreignisation combined with domestication.

Luo's translation of “阳明病 yáng míng bìng” and “厥阴病 jué yīn bìng” is similar to Wiseman's (Table 28). Luo translated “阳明病 yáng míng bìng” into “The Yangming (Greater Yang) syndrome” and “厥阴病 jué yīn bìng” into “The Jueyin (Greater Yin) syndrome,” in which the “Greater yang” and “Greater Yin” correspond to Wiseman’s translations. Conflicts and ambiguities in the translation of these two TCM terms are apparent. In terms of translation methods, both Luo and Wiseman used literal translation. I think that Wiseman’s “Yáng brightness disease” more directly expresses the meanings of “阳 Yáng” and “明 brightness.”

In terms of linguistic accuracy and lexical structural similarity, Wiseman's translation outperforms Luo’s. In terms of vocabulary conciseness, Wiseman abandoned the annotation method, while Luo turned to transliteration combined with annotation, so Wiseman’s translation is more concise than Luo’s. Although annotations were added for the purpose of increasing comprehensibility, Luo’s translations of such TCM names as “阳明病 yáng míng bìng” and “厥阴病 jué yīn bìng” may mislead target readers and affect the communicative function of the TL. In short, Wiseman’s translation outperforms Luo’s.

Next, I summarise the analyses and discussions regarding the three translators’ translations in combination with Skopos theory and TCM translation principles. From

89 the perspective of lexical accuracy, Huang’s transliteration method and Wiseman’s literal translation method both avoid deviation of the translation from the original. From the perspective of acceptability, Luo’s annotation method can aid readers to understand the meaning of disease names. Although Huang’s transliteration better retains Chinese traditional culture, pinyin may be more difficult for beginners to understand.

Because the six meridian diseases are quite complicated, transliteration without proper annotation tends to affect reader comprehension. For instance, “taiyang” in “taiyang disease” literally means “sun,” so it is hard for readers to associate it with the true meaning that “taiyang disease” is the initial stage of all six meridian diseases. From the perspective of scientificity and conciseness of terminology translation, Luo’s translation has a lower information density and more complicated lexical structure than translations by the other two. The main purpose of the TT is to realise its communicative function for technical terms. In accordance with TCM translation principles, the structure of Wiseman’s translation is not only simple and easy-to- understand, but it also adopts a literal translation method, ensuring accuracy of the meaning conveyed to readers. In summary, Wiseman’s translation of the six meridian diseases outperforms translations of the other two translators.

4.2.3 Introduction to disease names

The term “伤寒 shāng hán” appeared 91 times from Chapters 5–12 in Shāng Hán Lùn (Treatise on Febrile Diseases), and the book is named after “伤寒 shāng hán” that covers a variety of exogenous fevers. According to Shāng Hán Lùn, most focuses on diseases and syndromes caused by the evil of cold, especially the broader meaning of “伤寒 shāng hán” that encapsulates a variety of exogenous diseases and miscellaneous diseases (Y. Fu, 2017). These nine disease names (Table 29) follow the characteristics of ancient Chinese, featuring a simple structure but profound meaning. Disease names of some have different meanings in ancient and modern Chinese. Here

I introduce these nine disease names by referring to the New Shāng Hán Lùn Research Dictionary edited by Yanling Fu.

Table 29 Definitions of selected disease names

Disease name New Shāng Hán Lùn Research Dictionary

伤寒 This is (broadly) a general term for all exogenous diseases, and more shāng hán concisely refers to diseases caused by perceived coldness from the outside.

中风 This refers to the syndrome of external contraction of wind cold evils. When zhòng fēng mentioned separately in Shāng Hán Lùn, it means the wind-stroke syndrome of Taiyang channel.

结胸 This refers to epigastric pain, mainly clinically manifested as perceived jié xiōng stiffness and fullness upon pressing. 奔豚 This is characterised by the main symptom that the patients can feel about air bēn tún up-rush from the lower abdomen to the chest.

风温 This features symptoms of scorching hot of the body, spontaneous sweating, fēng wēn perceived body weighting, drowsiness, large snoring, language difficulties, and floating yin and yang pluses. 谷疸 gǔ dǎn Also known as “谷瘅” (gǔ dān), a type of choleplania.

藏厥 This refers to the syndrome of cold extremities caused by severe deficiency of zàng jué visceral yang. This refers to disease caused by cold evil that invades the body in winter and 温病 hides in the skin but doesn’t give effect until spring. This disease is wēn bìng characterised by the initial clinical manifestations of fever, thirst, and absence of aversion to cold, and it is broadly one kind of “伤寒” (shāng hán). 痈脓 This refers to the carbuncle that has been purulent. yōng nóng

4.2.4 Comparative analysis of English translation of disease names in Shāng Hán Lùn

Following the introduction of the meanings of disease names in Table 29, I analyse the translation methods and strategies adopted by the three translators for each.

Table 30 English translations of “伤寒 shāng hán”

Disease name Huang Wiseman Luo

Febrile disease caused 伤寒 Shanghan syndrome Cold damage by Cold (shanghan)

For the translation of “伤寒 shāng hán,” the three translators used different methods. Huang Hai used a transliteration + literal translation method, first translating it into Chinese pinyin “Shanghan” and then adding the word “syndrome” to define it as a disease of typhoid fever. Wiseman adopted the literal translation method and translated it into “cold damage,” which directly expresses the meaning of the term (physical discomfort caused by cold). Luo adopted the method of free translation + transliteration annotation, that is, “febrile disease caused by cold” is first used to clarify the cause of the disease, and then pinyin “Shanghan” is annotated to it (Table 30).

From the perspectives of accuracy and acceptability, Wiseman’s and Luo’s translations of “伤寒 shāng hán” deliver a clearer expression. The former directly expresses that it is a disease caused by cold, while the latter gives a slightly more comprehensive explanation, pointing out that it is a fever disease caused by cold. Luo’s translation used its counterpart in Western medicine, that is, “febrile disease,” which is more scientific than the other two. In terms of LSS, both Huang and Wiseman adopted a structure basically consistent with the original. However, as for the translation of technical terms, one of the most important characteristics is conciseness. Luo’s translation has a low information density, which is inconsistent with expected communicative function which refers to transmit the translation of TCM terms to English-speaking readers. The other two translations outperform Luo’s in structural conciseness. From the perspective of CT, Huang’s translation preserves the characteristics of TCM culture. “伤寒 shāng hán” is the name of the disease that most appeared in the book, which was named after the disease and mostly focuses on the pathology, symptoms and treatment therapies of it.

In my opinion, transliteration helps retain the culture of the original, preserves the integrity and characteristics of TCM theory, and also contributes to cross-cultural communication. Therefore, I think transliterating it into “Shanghan” is not only good for target readers to remember the book named after the term, but that it also contributes to its international spread as a representative TCM term. 92

Table 31 English translations of “中风 zhòng fēng” and “结胸 jié xiōng”

Disease name Huang Wiseman Luo

Febrile disease caused by 中风 Zhong-feng syndrome Wind strike Wind

结胸 Jiexiong syndrome Chest bind A blocked-up chest

Huang translated “中风” zhòng fēng and “结胸” jié xiōng into “Zhong-feng syndrome” and “Jiexiong syndrome,” respectively, using a transliteration + literal translation method (Table 31). As previously defined, “中风” zhòng fēng is a disease caused by the wind evil from the outside (Y. Fu, 2017). “结胸” jié xiōng is a morbid state caused by the retention of pathogens in the chest and abdomen (such as hot or cold, accompanied by stagnant water, sputum or foods), usually manifested as local stiffness, fullness and pressing pain and same as chest contraction (World Health Organization. Regional Office for the Western, 2007). Wiseman translated “中风” zhòng fēng into “wind strike” using a combination of literal translation and free translation. Literally speaking, “strike” suggests the essence of the disease, while “wind” highlights TCM’s understanding of the cause of the disease, thereby preserving the guidance role of TCM theory.

As for “结胸” jié xiōng, Wiseman literally translated it into “chest bind,” making clear the constraint of the chest caused by pathogens. Luo continued to adopt the free translation method and translated them into “febrile disease caused by Wind” and “a blocked-up chest,” respectively (Table 31). “Febrile disease caused by Wind” accurately clarifies that the disease is a kind of fever due to wind-evil. “A blocked-up chest” accurately expresses the fact that it is a disease caused by chest blockage. I think that Wiseman’s translation conforms more with the structure and connotation of the original terms, and is more concise and clear than the other two translations. In terms of accuracy, all three translations accurately express the connotation of the original. Comparatively speaking, Luo’s free translation and Wiseman’s literal translation are easier to be understood by target readers, thereby showing higher 93 acceptability than transliteration. Huang and Wiseman’s translations basically conform to the lexical structure of the original, hence they are superior to Luo’s translation.

Although Luo’s translation accurately and comprehensively delivers the meaning of the above two diseases, it has a long structure and therefore is not as concise as the other two. The primary purpose of TCM term translation is to realise their communicative function on the premise of comprehensibility. Therefore, Wiseman’s “Wind strike” and “Chest bind” have a concise structure that is similar to the original and more importantly, accurately express the meaning of the original to readers.

Table 32 English translations of “风温 fēng wēn” and “温病 wēn bìng”

Disease name Huang Wiseman Luo Acute febrile disease Fengwen (wind-warm 风温 Wind warmth caused by Wind syndrome) (Fengwen)

Acute febrile disease 温病 Wenbing (warm-disease) Warm disease (Wenbing)

“风温 fēng wēn” refers to the warm disease caused by the wind-warm evil, while “温病 wēn bìng,” refers to the general term of exogenous fevers caused by warm evil, accompanied by the main symptom of fever (World Health Organization. Regional Office for the Western, 2007). As for “风温 fēng wēn” and “温病 wēn bìng,” Huang turned to the method of transliteration + literal translation, and translated them into “Fengwen (wind-warm syndrome)” and “Wenbing (warm-disease),” respectively, while Wiseman literally translated them into “Wind warmth” and “Warm disease.” Using the combined method of free translation and transliteration annotation, Luo translated them into “Acute febrile disease caused by Wind (Fengwen)” and “Acute febrile disease (Wenbing),” respectively (Table 32). All three translations, whether in literal translation method, transliteration method, or free translation method, accurately express the meaning of the original. The former two present the literal meaning of the SL, while the latter interprets its implications.

From the perspective of AT, I think that Luo’s translation more comprehensively expresses the original meaning and contains more rich connotations than the other two, so that readers show higher acceptance. Nevertheless, as for medical terms, such a translation seems to have low information density. Wiseman’s translation has the same structure as the original, and is more concise than the other two, thereby promoting the associative memory of readers. Therefore, in general, Wiseman’s literal translation outperforms the other two, retaining the cultural heritage of TCM terms, possessing a concise and clear lexical structure, better realising the communicative function of the translation as medical terms.

Table 33 English translations of “奔豚 bēn tún”

Disease name Huang Wiseman Luo

奔豚 Running-pig syndrome Running piglet Bentun

“奔 bēn” in “奔豚 bēn tún” means rushing and running, while “豚 tún” literally means piglet. When the disease occurs, the patient feels that there are currents of air rushing up and down like running piglets, causing them great pains, hence the name. The disease is named after the characteristics of its symptom (Zhi, 2006). “奔豚 bēn tún” presents the symptoms of a disease with metaphor. In terms of accuracy, Huang and Wiseman translated the term into “running-pig syndrome” and “running piglet,” respectively, changing the meaning of the original to some extent (Table 33). Maybe they wanted to inform the TL readers of the main symptoms of the disease through metaphor. However, seen from the perspectives of AT, LSC, and CT, due to lack of rich knowledge of the disease, readers may be confused and find it difficult to associate “running piglets” with the disease.

The use of the pig as a TCM term also lacks scientificity. Luo resorted to transliteration and translated “奔豚” into “bentun” (Table 33). Transliteration not only makes the structure of the TT more concise but also transfers the unique concepts of TCM to target readers well. However, it may cause difficulties in comprehension to

95 target readers who lack the foundation of TCM theory and culture. Since “奔豚 bēn tún” uses a metaphorical method to display the syndrome characteristics of the disease, literal translation and transliteration fail to accurately convey information to the target readers, thereby affecting the expected communicative function. As such, I prefer to use free translation and translate the term into “sensation of gas rushing.” Although the structure of the translation has low information density as a technical term, it is acceptable given the complicated situation that “奔豚 bēn tún” includes a metaphor while is named after a disease syndrome. This translation not only accurately expresses the meaning of the original, but is also easier for target readers to understand than the previous three translations, better achieving expected communicative purposes.

Table 34 English translations of “谷疸 gǔ dǎn”

Disease name Huang Wiseman Luo

谷疸(谷瘅） Jaundice Grain jaundice Gudan

“谷疸 gǔ dǎn” is a kind of yellow jaundice, named by Zhang Zhongjing according to its pathology. Literally, the incidence of the disease is associated with “谷 gǔ” which means cereals. “谷疸 gǔ dǎn” got its name according to its causes and symptoms, suggesting that its incidence is closely related to diet (Guo, 2006). In the Jīn Kuì Yào Luè (Synopsis of Golden Chamber), Zhang Zhongjing divided jaundice into “黄疸 huáng dǎn” (yellow jaundice), “谷疸 gǔ dǎn,” “酒疸 jiǔ dǎn” (alcoholic jaundice), “女劳疸 nǚ láo dǎn” (jaundice due to sexual intemperance), and “黑疸 hēi dǎn” (black jaundice) (M. Liu et al., 2019).

For “谷疸 gǔ dǎn,” Luo transliterated it into “gudan,” Huang borrowed the Western medical term “jaundice” to express it, and Wiseman translated it into “grain jaundice” (Table 34). In terms of simplicity, Huang and Luo’s translations are superior to Wiseman’s. Both Huang and Wiseman borrowed Western medical terms, showing higher comprehensibility, AT and SAT than Luo’s translation. Huang’s translation, in

96 spite of being concise and simple, is too general, failing to distinguish “谷疸 gǔ dǎn” from four other categories, thereby departing from the original. The “grain” in Wiseman's translation “grain jaundice” clearly points out the key of the original.

From the perspective of accuracy for technical terms, Wiseman's translation has higher accuracy than Huang’s. In my view, the former not only accurately expresses the meaning of the original, but it is also simpler and more intuitive, with the original structure taken into account. Therefore, Wiseman’s translation accurately conveys the meaning of the original to target readers. Compared with the other two translations, “grain jaundice” better achieves the communicative purposes of the TT.

Table 35 English translations of “藏厥 zàng jué”

Disease name Huang Wiseman Luo

Coldness on the 藏厥(脏厥) Visceral Jue Visceral reversal extremities of the Viscera

“藏厥 zàng jué,” also called “脏厥 zàng jué” (Mitchell et al., 1999), refers to the symptom of cold extremities caused by the visceral yang deficiency (Y. Fu, 2017). Using the method of literal translation + transliteration, Huang translated it into “visceral jue,” in which “visceral” as an adjective expresses the pathological location. Wiseman combined literal translation and free translation and translated it into “visceral reversal,” in which “reversal,” even though highlighting the pathogenesis of qi-movement disturbance, fails to express the symptom of cold extremities (Table 35).

The “厥 jué” of “藏厥 zàng jué” means the coldness of the hands and feet, but the term “reversal” only expresses the pathogenesis of the disease; it does not clarify the symptom of cold extremities, which may cause target reader misunderstanding. Therefore, his translation does not fully express the original meaning of the term. Luo adopted the method of free translation and translated it into “coldness on the extremities of the viscera.” His translation has low information density despite accurately expressing the original meaning, so I think it is unsuitable as a medical term. In terms of accuracy, Huang and Luo’s translations accurately express the 97 semantic meaning of the original. Luo’s free translation enjoys higher acceptability than the other two translations, but appears to have lower information density, because its information density is approximatly 0.3 (the best information density in translation of TCM terms is 0.5). Therefore, in terms of lexical structure, Wiseman’s and Huang’s translations are more concise in structure and therefore more suitable to be used as a technical term.

I think that Huang’s use of the transliteration method to translate “厥 jué,” a distinctive TCM word, into “jue” does a good job preserving the traditional cultural characteristics of TCM, avoiding ambiguity due to misinterpretation of the original. Translating “藏厥 zàng jué” into “Visceral Jue” better conforms to the translation principles of TCM terminology and more accurately conveys the original meaning.

Table 36 English translations of “痈脓 yōng nóng”

Disease name Huang Wiseman Luo

A syndrome with ulcer Suppurating welling- A syndrome with ulcer and 痈脓 and pus abscess pus

“痈 yōng” refers to a purulent disease caused by the accumulation of pathogenic toxin against qi and blood; it can be divided into internal and external types according to the depth of diseased regions below the body surface. Various pathogenic factors represented by cold evils invade the human body, causing blood stasis, disharmony between 营 ying and 卫 wei, and meridian obstruction, hence swollen welling- abscess. In case of poor resistance of the body to the disease and failure to control pathogenic factors in a timely manner, it may be further reduced to heat evil, leading to blood stasis and flesh rotting and ultimately causing “痈脓 yōng nóng.” Modern clinical medicine has depicted the pathogenesis and signs of its progression from general infection to systemic infection and sepsis, and ultimately to multiple organ failure syndromes (MSOF) or death. The infection mentioned here covers internal “痈 yōng” and external “痈 yōng” (Wu, 2019).

As for “痈脓 yōng nóng,” both Huang and Luo adopted free translation and translated it into “a syndrome with ulcer and pus,” while Wiseman freely translated it into “suppurating welling-abscess.” “Suppurating” in “Suppurating welling-abscess,” i.e., the present participle of suppurate, refers to the yellow viscous liquid formed or dispersed due to infection (“Suppurating,” 2019). “Welling” in “welling-abscess” means an intrusion slowly appearing on or below the surface of something (“Well,” 2019). “Abscess” refers to the pus (i.e., viscous yellow liquid) contained in the pain or swelling areas on or in the body (“Abscess,” 2019). Therefore, the general meaning of the phrase is that the human body experienced the symptom of swelling accompanied by an abscess on or below its surface. As mentioned above, “痈脓 yōng nóng” highlights “swelling” and “pus,” instead of the symptoms of ulcers. The “ulcer and pus” in the translation of Huang and Luo, even though covering the symptom of sepsis, stresses on the boundary-like or volcanic vent-like lesions of the skin or mucous membrane caused by some inflammations, infections or malignant processes. However, they only emphasised the symptom of “脓 nóng,” ignoring other key information about “痈 yōng.” Therefore, with regard to accuracy, Wiseman’s translation contains more accurate symptom information, fully expressing the symptoms of the disease in these two aspects.

All three translations were composed of phrases. Since “痈脓 yōng nóng” can be divided into external “痈 yōng” and internal “痈 yōng,” and is a complicated disease, an excessively concise translation may miss some key information contained and lead to reader misconception. Therefore, I believe the translation in phrases allows target readers to clearly understand the symptoms of the disease. The three translations adopt different Western medical counterparts, including “ulcer,” “pus” and “abscess,” ensuring their scientific accuracy.

4.3 Summary

The primary purpose of translation is to accurately pass the meaning of the original to target readers, enabling them to understand and receive medical and cultural

99 information in the TL. I hold Wiseman’s “suppurating welling-abscess” to be more consistent with TCM translation principles, and to better achieve the expected communicative purposes as a TCM term.

I mainly analyse and discuss the translation methods adopted by Huang Hai, Negel Wiseman, and Luo Xiwen for the disease names selected from Shāng Hán Lùn. Through comparative analysis of 15 Chinese TCM disease names and their translations made by three translators, I found no identical translation of names; for only one name was the translation made by two translators the same. Therefore, 0%, 7% and 93% of the total disease names were identically translated by all, by two translators, and differently translated by each translator, respectively. Translation methods and strategies for these disease names adopted by the three translators are shown in Table 37.

Table 37 Methods and strategies for translating disease names

Method & Strategy Huang Luo Wiseman Borrowing Western medical 1 0 0 terms Free translation 2 4 1 Literal translation 0 0 6 Transliteration 0 2 0 Combined literal & free 0 0 2 translation Combined literal & transliteration 12 2 5 Combined Western medical term 0 0 0 & literal translation Combined free translation & 0 7 1 transliteration Domestication 3 4 1 Foreignisation 12 4 11 Combined domestication & 0 7 3 foreignisation

Huang and Wiseman preferred to use foreignisation strategy, while Luo preferred to use a combined strategy of foreignisation and domestication. However, where the original contains rich information, the application of the free translation method may

100 lower information density of the translation, so it is not perfect as an international translation standard of TCM terms. The number of mistranslations made by Huang, Wiseman, and Luo is 3, 2, and 4, respectively. Huang and Luo probably mistranslated because of their use of the free translation method, which does not correctly express the meaning of the original. Although the free translation method assists TL readers to better understand meaning, it tends to depart from the original meaning—for example, translating “谷疸 gǔ dǎn” into “Jaundice” renders is easy for TL readers to confuse it with “黄疸 huáng dǎn.” Wiseman’s translation method is dominated by a combination of literal translation and transliteration, supplemented with free translation, which can accurately convey the original meaning.

By comparing the three translation versions, it can be concluded that 1, 12, and 0 translations made by Huang, Wiseman and Luo, respectively, are more consistent with Skopos theory and TCM translation principles, and more favourable to the realisation of their communicative purposes. Individual disease names are also unsatisfactorily translated in each translation, and these names shall be translated with more matched words or using new translation methods.

Principles the exemplified terms have satisfied are presented in Table 38.

Table 38 Comparison of disease terms using six translation principles

Disease term Huang Wiseman Luo 太阳病 tài yáng bìng LA: √ LA: √ LA: √ 少阳病 shǎo yáng bìn AT: ∕ AT: √ AT: √ 太阴病 tài yīn bìng SAT: ∕ SAT: √ SAT: ∕ 少阴病 shǎo yīn bìng LSC: √ LSC: √ LSC: ∕ LSS: √ LSS: √ LSS: √ CT: √ CT: √ CT: √ 厥阴病 jué yīn bìn LA: √ LA: √ LA: ∕ 阳明病 yáng míng bìng AT: ∕ AT: √ AT: ∕ SAT: √ SAT: √ SAT: ∕ LSC: √ LSC: √ LSC: ∕ LSS: √ LSS: √ LSS: ∕ CT: √ CT: √ CT: ∕

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Disease term Huang Wiseman Luo 伤寒 shāng hán LA: √ LA: √ LA: √ AT: ∕ AT: √ AT: √ SAT: √ SAT: √ SAT: √ LSC: √ LSC: √ LSC: ∕ LSS: √ LSS: √ LSS: ∕ CT: √ CT: √ CT: ∕ 中风 zhòng fēng LA: √ LA: √ LA: √ 结胸 jié xiōng AT: ∕ AT: √ AT: √ SAT: √ SAT: √ SAT: √ LSC: √ LSC: √ LSC: ∕ LSS: √ LSS: √ LSS: ∕ CT: √ CT: √ CT: ∕ 风温 fēng wēn LA: √ LA: √ LA: √ 温病 wēn bìng AT: √ AT: √ AT: √ SAT: ∕ SAT: √ SAT: ∕ LSC: ∕ LSC: √ LSC: ∕ LSS: √ LSS: √ LSS: ∕ CT: √ CT: √ CT: ∕ 奔豚 bēn tún LA: ∕ LA: ∕ LA: √ AT: ∕ AT: ∕ AT: √ SAT: ∕ SAT: ∕ SAT: √ LSC: √ LSC: √ LSC: √ LSS: √ LSS: √ LSS: √ CT: ∕ CT: ∕ CT: √ 谷疸 gǔ dǎn LA: ∕ LA: √ LA: √ AT: √ AT: √ AT: ∕ SAT: √ SAT: √ SAT: √ LSC: √ LSC: √ LSC: √ LSS: ∕ LSS: √ LSS: √ CT: ∕ CT: √ CT: √ 藏厥 zàng jué LA: √ LA: ∕ LA: √ AT: √ AT: ∕ AT: √ SAT: √ SAT: √ SAT: ∕ LSC: √ LSC: √ LSC: ∕ LSS: √ LSS: √ LSS: √ CT: √ CT: ∕ CT: ∕ 痈脓 yōng nóng LA: ∕ LA: √ LA: ∕ AT: √ AT: √ AT: √ SAT: √ SAT: √ SAT: √ LSC: ∕ LSC: √ LSC: ∕ LSS: ∕ LSS: √ LSS: ∕ CT: ∕ CT: √ CT: ∕

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Chapter 5 Conclusion

In this thesis, chapter 1 introduced the development background of the English translation of TCM terminology and presented reasons for selecting the original version of Shāng Hán Lùn and its three English versions. Chapter 2 reviewed the current status of standardisation on TCM terminology translation and relevant debates on the translation methods and strategies of TCM terminology. Chapter 3 presented the concept of Skopos theory, demonstrated the feasibility of applying it to TCM terminology translation, and described the principles of TCM terminology translation. Additionally, based on Skopos theory and TCM terminology translation principles, the target-reader oriented TCM terminology translation method was proposed to provide guidance for the international standardisation of TCM terminology translation. In chapter 4 the three English versions of symptoms and disease names in Shāng Hán Lùn were analysed under the guidance of Skopos theory and TCM translation principles. Here in chapter 5 the major findings of this study are summarised, the three translators’ selection of domestication and foreignisation translation strategies (from the perspective of reader-oriented communicative action) are explored, and main limitations of this study and final conclusions are presented.

5.1 Major Findings

To bridge a research gap, this study mainly examined the: 1) role of Skopos theory in the field of TCM terms translation; 2) more suitable translation methods and strategies for translation of TCM terms in Shāng Hán Lùn; and 3) contribution of Skopos theory-based translation strategy to the international standardisation of TCM terms.

Three English versions were selected: 1) Introduction to Treatise on Exogenous Febrile Disease translated by Hai Huang in 2005; 2) Shang Han Lun (On Cold Damage): Translation and Commentaries mainly translated by Nigel Wiseman in 1999; and 3) Treatise on Febrile Disease Caused by Cold translated by Xiwen Luo in 2007. The English versions of the selected two-character symptom and disease names are analysed from the perspective of Skopos theory.

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As analysed in previous chapters, Skopos theory plays an excellent role in guiding the translation of TCM terms. Given that TCM terms fall into the category of sci-tech terminology, to promote the international standardisation of TCM terms, the feasibility of applying Skopos theory to TCM terminology translation is explored in Chapter 3. According to Skopos theory, translation is a purposeful human action that no longer pursues the rigid correspondence of the ST to the TT. The advantage of Skopos theory is that it allows translators to flexibly select translation methods while taking into account the differences between Chinese and Western cultural environments. My study demonstrates that to achieve reader-oriented communicative actions, translators of TCM terms are entitled to select the most suitable translation methods and strategies based on Skopos theory to more rigorously and accurately convey the meaning of the original to target readers while preserving Chinese traditional culture and philosophy.

Analysis in chapter 4 reveals differences between the three translators in the selection of translation methods and strategies when translating Shāng Hán Lùn. In Chapters 5– 12 of Shāng Hán Lùn there are 125 two-character symptom names and 76 disease names, of which 27 two-character symptom names and 15 disease names with representativeness are selected as the research objects in this study. Based on chapter 4 statistics, TCM terminology translation methods are presented in Table 39.

Table 39 Results of TCM terminology translation methods

Term Huang Wiseman Luo

Borrowing Western medical terms 12 6 12 Free translation method 14 7 18 Literal translation method 1 21 0 Transliteration 1 0 2 Combined free & literal translation methods 1 2 0 Combined borrowing Western medical terms & literal 1 0 1 translation method Combined free translation method & transliteration 0 1 7 Combined transliteration & literal translation method 12 5 2

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Previous chapters have presented statistics on the number of times domestication and foreignisation have been used by each translator. Huang applied domestication on 26 occasions, foreignisation 14 times, and a combination of domestication and foreignisation twice; Wiseman used domestication 13 times, foreignisation 26 times, and a combination of domestication and foreignisation three times; and Luo used domestication 30 times, foreignisation twice, and a combination of domestication and foreignisation 10 times. Hence, it can be seen that both Huang and Luo preferred to use domestication, while Wiseman preferred foreignisation.

In chapter 4 the three English versions of the 42 TCM terms selected are separately evaluated under the guidance of Skopos theory and TCM translation principles (Fig. 3). The numbers of mistranslations made by Huang, Wiseman, and Luo were 22, 11, and 21, respectively. It would appear that the foreignisation translation strategy was more suitable for TCM terminology translation. However, in my opinion, translators should be flexible and adopt different translation strategies for different TCM terms. TCM terms do not just fall into a sci-tech terminology, but they also contain unique connotations of traditional Chinese culture and philosophy.

To promote the global spread of TCM knowledge, different translation strategies should be selected according to characteristics of the original language. For TCM terms that have counterparts in English, a domestication strategy should be used, which is expected to ensure the rigor and accuracy of the translation while facilitating the acceptance and understanding of target readers. As for the TCM terms with strong Chinese traditional culture and unique philosophical connotations, a foreignisation strategy is recommended. For example, 阴 yīn and 阳 yáng is better to be translated into “yin” and “yang,” 气 qì into “qi,” and 厥 jué into “jue.” As for TCM terms composed of multiple morphemes, the morpheme translation method may be used.

For example, 短气 duǎn qì, a term consisting of an adjective 短 duǎn and a symptomatic name 气 qì, should be translated into ischpnea using the morpheme method rather than using a literal or a free translation method, to avoid verbosity.

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As discussed in chapter 2, there is no consensus on the translation of TCM terminology, and a unified standard is yet to be developed. Additionally, there is very little literature on the subject. These problems both restrict the development of Chinese medicine in the world, and cause difficulties and confusion in the understanding of TCM culture among foreign scholars and readers. Through the study of the three English versions of Shāng Hán Lùn, it is herein demonstrated that the translation methods and strategies selected from a reader-oriented perspective under the theoretical guidance of Skopos theory and TCM translation principles can guarantee the accuracy, scientificity, uniqueness, and standardisation of TCM terminology translation, and contribute to the realisation of the communicative intention of spreading TCM knowledge to the world.

5.2 Limitations of this study

Limitations include the author’s initial inexperience, and inadequacy of research material. This study selects representative two-character symptoms and disease names in Shāng Hán Lùn as research objects, but excludes symptom and disease names consisting of a single or more than two characters, which may lead to insufficiency and incomprehension of research data.

The Wiseman version selected for study contains many notes on the clause of Shāng Hán Lùn, but in the Huang and Luo versions, there are none. For simplicity of sample collection and comparison, more attention is given to comparative analysis of translations than to notes in the Wiseman version. Notes are also not discussed in summaries of translator translation strategies (in the actual translation activities, it is necessary to refer to the notes).

Skopos theory has played an important role in translation studies, introducing a new perspective for translation study development. It allows translators to abandon pursuit of simple SL and TL equivalence at the language level. Nonetheless, it is worth noting that Skopos theory may cause precarious translation evaluation standards. The theory asserts the evaluation criterion of a translation is if it sufficiently satisfies the purpose

106 of the translation activity, which may disregard that a translation targets multiple types of reader and must meet more than one purpose. For example, in translating TCM terms, the application of the domestication translation strategy, in spite of improving the acceptability of the TL, will inevitably lead to loss of Chinese traditional cultural and philosophical connotations contained in TCM terms. Moreover, the theory may lead to translators ignoring the richness in the original meaning and the versatility of the TT. In the end, the criterion of whether a translation has successfully met its purpose contains many uncertain factors, for in some cases it is difficult to judge if a translation has sufficiently satisfied its goal(s).

5.3 Suggestions for future research

With regard to TCM classics, apart from the well-known Huangdi Neijing, Shāng Hán Lùn, and Synopsis of Prescriptions of the Golden Chamber, there are many other classics that are of great guiding significance and research value for modern Chinese medicine, such as, Shennong's Root and Herbal Classic, Classic of Difficult Issues, Prescriptions Worth a Thousand Pieces of Gold for Emergencies, Fu Qingzhu's Obstetrics and Gynecology, and Compendium of Materia Medica. These (representative) TCM classics are rich in various types of medical terms that merit study. The scope of my study is limited to the English translation of some two- character symptoms and disease names in Shāng Hán Lùn. Subsequent research could examine single- or three-or-more-character TCM terms in various TCM classics.

Application of Skopos theory to TCM terminology translation is still exploratory, with many limitations and shortcomings to be solved. For example, when translating or critiquing translation standards using Skopos theory it is difficult to meet the needs of multiple types of TT or target reader. Furthermore, the foremost goal of Skopos theory is the purpose of translation (Du, 2012). However, the undue pursuit for translation purposes may lead translators to omit or abandon the rich and diversified connotations contained in a TT. Therefore, when translating TCM terms or evaluating TCM terminology translation, attention should be paid to whether a translation can fully

107 satisfy the needs of the spread of TCM terms to the word, and if it can comprehensively convey the unique medical and philosophical ideas contained in TCM terms to target readers.

Compared with traditional translation theories, this research shows that Skopos theory has made considerable contributions in terms of text type, relationship between original and translated texts, participants of translation activities, and the handling of cultural factors in translation. It provides a new perspective on translation studies. However, in practice, it may lead to limitations and deficiencies in translation evaluation standards. Therefore, attention should be paid to its scope of use in actual translation activities, so as to better play its role in guiding them.

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BIBLIOGRAPHY

Abscess. (2019). Cambridge Dictionary. Retrieved from https://dictionary.cambridge.org/dictionary/english/abscess?q=Abscess Anguish. (2019). Cambridge Dictionary. Retrieved from https://dictionary.cambridge.org/dictionary/english/anguish?q=Anguish Anthony, L. (2019). AntConc (Version 3.5.8) [Computer Software]. Retrieved from https://www.laurenceanthony.net/software Cheng, N. (2019). CUC_Paraconc (Version V3.0). Beijing: Communication University of China. Du, X. (2012). A brief introduction of Skopos theory. Theory and Practice in Language Studies, 2189– 2193. Elnaili, S. (2014). Domestication and foreignization strategies in translating Sinbad of the Arabian Nights. (PhD thesis) Louisiana State University, Baton Rouge, LA. Retrieved from https://digitalcommons.lsu.edu/cgi/viewcontent.cgi?article=4012&context=gradschool_disse rtations Forgetfulness. (2019). Cambridge Dictionary. Retrieved from https://dictionary.cambridge.org/dictionary/english/forgetfulness?q=Forgetfulness Fu, M. (2016). Zhongyi yingyishi shuli yu cunzaiwenti yanjiu [English translation of traditional Chinese medicine: A historical carding and problems researching]. (PhD thesis). Heilongjiang University Of Chinese Medicine, Available from the Chinese National Knowledge Infrastructure (CNKI) Fu, Y. (2017). Xinxiu Shanghanlun yanjiu dacidian [New Shāng Hán Lùn research dictionary]. Beijing: Zhongguo zhongyiyao chubanshe [China Press of Traditional Chinese Medicine]. Guan, Q. (1995). Zhongyi mingci shuyu yingwen fanyi biaozhunhua wenti tantao [Discussion on the international standardization of traditional Chinese medicine terminology]. Tianjin zhongyi xueyuan xuebao [Journal of Tianjin University of Traditional Chinese Medicine](04), 41–42. Gudai Hanyu zidian. (2005). (Beijing di 1 ban. ed.). Beijing Shi: Shang wu yin shu guan guo ji you xian gong si. Guo, W. (2006). gudan bing zhengzhi yuanliu yanjiu [Research on treatment and origin of jaundice in 'Synopsis of Prescriptions of the Golden Chamber']. (Masters thesis) Hubei zhongyi xueyuan [Hubei University of Chinese Medicine], Available from the Chinese National Knowledge Infrastructure (CNKI) Hai Huang. (2016). Fujian University of Traditional Chinese Medicine, College of Traditional Chinese Medicine. Retrieved from https://zy.fjtcm.edu.cn/zyxy/sssds20140401162120/20160529/73187.html Han Ying Zhongguo zhuan you ming cheng he shu yu jian ming ci dian = A concise Chinese–English dictionary of Chinese proper names and terms. (1994). (Di 1 ban. ed.). Beijing: Beijing da xue chu ban she. He, Y. (2019). Xie Zhufan zhongyi mingci shuyu yingyi biaozhunhua fanyi sixiang chutan [A preliminary study of Zhufan Xie's thoughts on standard nomenclature of traditional Chinese medicine]. Overseas English(15), 138–139. Hong, M. (2008). Jin 30 nian zhongyi mingci shuyu yingyi biaozhunhua de licheng [Standardization history of English terms of Chinese medicine in last 30 years] (PhD thesis) China Academy of Chinese Medical Sciences, Available from the Chinese National Knowledge Infrastructure

109

(CNKI) Hu, X. (2008). tongsu jianghua [Shāng Hán Lùn in popular language]. Beijing: Zhongguo zhongyiyao chubanshe [China Press of Traditional Chinese Medicine]. Huang, Z., & Li, Y. (2004). Kexue fanyixue [Translation Studies in Science]. Beijing: China Translation & Publishing Corporation. Institute, N. C. (n.d.). NCI Dictionaries. Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/western-medicine Introduction to Xiwen Luo. (2013). Chinese Academy of Social Sciences. Retrieved from http://cass.cssn.cn/xuebuweiyuan/rongyuxuebuweiyuan/lxw/ Jia, J., & Zhao, H. (2016). Zhongyi shuyu yingyi biaozhun de yanjiu xianzhuang [Research status of English translation standard of TCM Terms]. Journal of Clinical Medical(54), 10859–10860. Jiang, H., & Wu, J. (2019). Zhongyi shuyu yingyi de biaozhunhua [International standardization of traditional Chinese medicine terminology] Zhongguo keji fanyi [Chinese Science & Technology Translations Journal](01), 5–8. Jiang, Y. a., & Zhang, Q. (2012). 'liujing' zhi mingshi [The concept and essence of "Six Channels" in 'Treatise on Febrile Diseases']. Global Traditional Chinese Medicine(12), 932– 935. Lai, X., Yang, Y., & Shan, X. (2004). The investigation of euphorbiaceous medicinal plants in Southern China. Economic Botany, 58, S307–S320. Li, J. (2005). Dictionary of traditional Chinese medicine. Beijing: People's Medical Publishing Houses. Li, J., & Hu, J. (2012). Research review on the standard English terminologies of TCM Science & Technology Information(15), 24–25. Li, Z. (1994). Guanyu zhongyi mingci shuyu yingyi biaozhunhua de sikao [Reflections on the standardization of traditional Chinese medicine terminology]. Zhongguo zhongxiyi jiehe zazhi [Chinese Journal of Integrative Medicine](03), 144. Li, Z. (1997). Zhongyi yingyu fanyi jiqiao [Traditional Chinese medicine English translation techniques ]. Beijing: Renmin weisheng chubanshe [People's Medical Publishing House]. Li, Z. (2008). Lun zhongyi mingci shuyu yingyi guoji biaozhunhua de gainian, yuanze yu fangfa [On the concepts, principles and methods of international standardization of traditional Chinese medicine terminology]. Chinese Translators Journal(04), 63–70, 96. Li, Z. (2008). Zhongguo jiben mingci shuyu yingyi guoji biaozhunhua yanjiu [International standard Chinese–English basic nomenclature of Chinese medicine]. Beijing: People's Medical Publishing House. Li, Z., & Liu, X. (1991). Lun zhongyi fanyi de yuanze [On the principles of traditional Chinese medicine translation]. Chinese Translators Journal(3), 43–47. Li, Z., & Liu, X. (2017). On cold damage: Classical Chinese–modern Chinese–English. Shanghai: Shanghai sanlian shudian. Liu, G., & McCann, H. (2015). Discussion of cold damage (Shang Han Lun): Commentaries and clinical applications: Jessica Kingsley Publishers. Liu, M., Zhang, B., Zhu, X., Zhang, T., Gan, G., & Zhang, C. (2019). View on clinical experiences of Zhang Zhongjing about syndrome differentiation and treatment on jaundice. Chinese Archives of Traditional Chinese Medicine, 1–9. Liu, W., & Zhu, W. (2007). Zhongyi zhengzhuang guifanhua ruoganwenti de sikao [Reflections on some problems about the standardization of TCM symptoms]. Journal of Traditional Chinese

110

Medicine(06), 555–556. Lü, L. (2010). jueyin bing shiyi [Discussion on the jue yin disease on febrile disease]. Jiangxi zhongyi xueyuan xuebao [Journal of Jiangxi University of TCM](01), 33–34. Luo, X. (2007). Treatise on febrile caused by cold (Shang Han Lun) / Library of Chinese Classics (Chinese–English) Beijing: New World Press. Luo, X. (2016). Treatise on febrile disease caused by cold. Beijing: New World Press. Ma, L., & Li, J. (2010). Zhengming biaozhunhua de yiyi yu fangfa [Significance and methods of standardizing symptom names]. Liaoning zhongyi zazhi [Liaoning Journal of Traditional Chinese Medicine](07), 1264–1265. Maciocia, G. (2015). The foundations of Chinese medicine: A comprehensive text. Retrieved from http://public.ebookcentral.proquest.com/choice/publicfullrecord.aspx?p=2072089 Meng, Q. (1989). Di shi jiang jueyin bing zhengzhi [Lecture 10 treatment of jue yin disease]. Zhonguo shequ yishi [Chinese Community Doctors](08), 38–40. Mitchell, C., Feng, Y., & Wiseman, N. (1999). Shang Han Lun: On cold damage, translation & commentaries. Boulder: Paradigm Publications. Mosby's dictionary of medicine, nursing and health professions. (2019). ([Revisted 3rd Australia/New Zealand edition]. ed.). Place of publication not identified: Elsevier. Munday, J. (2016). Introducing translation studies: Theories and applications (Fourth edition. ed.). Milton Park, Abingdon, Oxon: Routledge. Niu, C. (2004). Ming buzheng yan bushun, yan bushun ze shi bucheng-tantan zhongguo minci shuyu yinyi de yanze wenti [Principles for English translation of the terms in traditional Chinese medicine]. Journal of Integrative Medicine(06), 474–476. Nord, C. (2014). Translating as a purposeful activity: Functionalist approaches explained. London: Routledge. pinyin. (2019). Cambridge Dictionary. Retrieved from https://dictionary.cambridge.org/dictionary/english/pinyin Press, O. U. (2019). Revert. Lexico.com. Retrieved from https://www.lexico.com/definition/revert Press, O. U. (2019). Syndrome. Lexico.com. Retrieved from https://www.lexico.com/definition/syndrome Qiu, L. (2011). Zhongyi guji yingyi shishi yanjiu zongshu [A general review of research on historical facts of English translation of ancient traditional Chinese medicine books]. Journal of Chinese Integrative Medicine(04), 459–464. Sheehan, M. (2000). Word parts dictionary: Standard and reverse listings of prefixes, suffixes, roots and combining forms. Jefferson, N.C: McFarland. Shen, Y.-H. (2011). Foreignization in the translation of traditional Chinese medicine terminologies and its cognitive theoretical basis. Zhong xi yi jie he xue bao [Journal of Chinese Integrative Medicine] 9(3), 337–340. doi:10.3736/jcim20110317 Sheng, J. (2013). Ji yu naida gongneng duideng lilun de bingzhengming yingyi yanjiu [On translation of the disease and syndrome terms in treatise on cold damage (Shang Han Lun) from the Perspective of Nida’s Functional Equivalence Theory]. (Masters thesis) Nanjing University of Traditional Chinese Medicine, Available from the Chinese National Knowledge Infrastructure (CNKI) Shuttleworth, M. (2014). Dictionary of translation studies: Taylor & Francis.

111

Si, F., & Cui, S. (2016). Zhongyi lilun jichu [Theoretical basis of traditional Chinese medicine]. Zhengzhou: Henan kexue jishu chubanshe [Henan Science and Technology Press]. Strate, L.L. (2016). Hematochezia. In M. B. Wallace, B. A Aquel, Lindor K. D., Devault K. R. (Eds.), Practical Gastroenterology and Hepatology Board Review Toolkit (pp. 237–240). Oxford, UK: John Wiley & Sons, Ltd. Sturgeon, D. (2011). Chinese text project. Retrieved from http://ctext.org Sun, H. (2011). On cultural differences and translation methods. Journal of Language Teaching and Research, 2(1), 160–163. doi:10.4304/jltr.2.1.160-163 Sun, Y. (2007). Translation principles of traditional Chinese medicine nomenclature—from Skopostheorie Perspective. (Masters thesis). University of South China, Available from the Chinese National Knowledge Infrastructure (CNKI) Suppurating. (2019). Cambridge dictionary. Retrieved from https://dictionary.cambridge.org/dictionary/english/suppurate?q=Suppurating Tiedemann, J., & Nabende, P. (2009). Translating transliterations. International Journal of Computing and ICT Research, 3, 33–41. Venuti, L. (1995). The translator's invisibility: A history of translation: Routledge. Venuti, L. (2003). The translator's invisibility: A history of translation: Taylor & Francis. Venuti, L. (2018). The translator's invisibility: A history of translation (Third edition. ed.). New York: Routledge. Wadensjö, C., Baker, M., Malmkjær, K., Saldanha, G., Anderman, G., & Wollin, L. (1998). Routledge encyclopedia of translation studies: Routledge. Wang, F. (2014). An approach to domestication and foreignization from the angle of cultural factors translation. Theory and Practice in Language Studies, 4(11), 2423–2427. doi:10.4304/tpls.4.11.2423-2427 Wang, L. (2009). The research of common symptoms of abdominal normative. (Masters thesis). Shandong University Of Traditional Chinese Medicine, Available from the Chinese National Knowledge Infrastructure (CNKI) Wang, X., & Zhang, Y. (2008). English–Chinese Chinese–English Medical Dictionary. Beijing: Foreign Language Teaching and Research Press. Wang, Y., & Zhao, X. (2017). Zhongguo chuantong wenhua dui zhongyi de yingxiang tanxi [An analysis of the impact of Chinese traditional culture on traditional Chinese medicine]. Asia-Pacific Traditional Medicine(22), 12–14. Wang, Z., & Cheng, Y. (2016). Cong yihua yu guihua kan zhongyi shuyu [Traditional Chinese medicine terminology from the perspectives of foreignisation and domestication]. Zhongyiyao xinxi [Information on Traditional Chinese Medicine](04), 71–73. Watson, M. (2017). Translation studies: Shifts in domestication and foreignisation in translating Japanese Manga and Anime (Part One). Memoirs Of Kagoshima Junshin Junior College, 47, 129–137. Well. (2019). Cambridge University Press. https://dictionary.cambridge.org/dictionary/english/well?q=Welling Wiseman, N., & Zmiewski, P. (1989). Rectifying the names: Suggestions for standardizing Chinese medical terminology. In P. U. Unschuld (Ed.), Approaches to traditional Chinese medical literature: Proceedings of an international symposium on translation methodologies and terminologies (pp. 55–66). Dordrecht ; Boston: Kluwer Academic Publishers.

112

World Health Organization. Regional Office for the Western Pacific. (2007). WHO international standard terminologies on traditional medicine in the Western Pacific Region: Manila : WHO Regional Office for the Western Pacific. Wu, J. (2019). yongnong bianzhi tantao [The exploration of treating carbuncle pus in the synopsis of the golden chamber]. Journal of Nanjing University of Traditional Chinese Medicine(04), 376–378. Xi, F. (2012). A comparative study of the English translation of Shanghanlun in terms of polysystem theory. (PhD thesis). Nanjing University Of Chinese Medicine, Available from the Chinese National Knowledge Infrastructure (CNKI) Xie, Z. (2003). On the standard nomenclature of traditional Chinese medicine. Beijing: Foreign Languages Press. Xiong, X. (2014). Yinyi lilun yiji yinyi chansheng de beijing [Transliteration theory and its background]. Chinese Science & Technology Translators Journal, 27(01), 39–41,+27. Xu, J., & Zhang, R. (2002). Foreignization and domestication: An examination from the perspective of cross-cultural translation. Chinese Translators Journal(05), 38–41. Yang, J. (1982). liujing shizhi de tantao [Discussion on the essence of six channels in treatise on febrile diseases]. Tianjin zhongyi xueyuan xuebao [Journal of Tianjin University of Traditional Chinese Medicine](00), 6–11. Yang, J., Ji, R., & Qi, W. (2019). de liujing shizhi yu liujing bing [The essence of the six meridians and six-menstrual disease in Shanghanlun]. Acta Chinese Medicine, 34(01), 35–38. Yang, W. (2010). Brief study on domestication and foreignization in translation. Journal of Language Teaching and Research, 1(1), 77–80. doi:10.4304/jltr.1.1.77–80 Ye, X., & Zhang, H. (2017). A history of standardization in the English translation of traditional Chinese medicine terminology. Journal of Integrative Medicine, 15(5), 344–350. doi:10.1016/S2095- 4964(17)60357-1 Ye, Y., Zhao, H., & Zhou, E. (2019). On translation of TCM formulas in Shanghanlun from perspective of Skopos theory—Based on Luo Xiwen version and Niger Wiseman version. Modern Linguistics, 7(2), 93–99. Yin, Y., Ren, B., & Wang, D. (2015). Guihua yu yihua zai zhongyi shuyu yingyi zhong de yingyong [Application of domestication and foreignization in TCM terminology translation]. Journal of Wenzhou Medical University(12), 935–938. Zhang, J., & Li, K. (2014). Zaiyi zhongyi shuyu de yingyi jiyu fanyi mudilun de shijiao [Rediscussion on translation strategies for traditional Chinese medicine terminology: From the perspective of Skopos theory]. Science & Technology Vision(32), 69+130. Zhang, L. (2016). Zhongyi shuyu fanyi zhong de guihua yu yihua [Domestication and foreignisation in the translation of traditional Chinese medical terminology]. Shenyang gongcheng xueyuan xuebao (shehui kexue ban) [Journal of Shenyang Institute of Engineering (Social Sciences)](04), 527–531. Zhang, N. (2004). Mudilun piping [Skopos criticism]. In Zhongxi yixue piping [Chinese and Western Translation Criticism] (pp. 111). Beijing: Tsinghua daxue chubanshe [Tsinghua University Press]. Zhang, X., & Liu, D. (2016). Shanghan Lun baihua jie [Shāng Hán Lùn in the Vernacular]. Beijing: Zhongguo yiyao keji chubanshe [China Medical Science and Technology Press]. Zhang, Z. (1993). Treatise on febrile diseases caused by cold with 500 cases: A classic of traditional

113

Chinese medicine with ancient and contemporary case studies (1st ed.). Beijing, China: New World Press. Zhang, Z. (2009). Shang Han Lun explained: A guided tour of an ancient classic text written by Zhang Zhong Jing in 200AD and its modern clinical applications. Sydney, N.S.W: Elsevier Churchill Livingstone. Zhang, Z. a., Luo, X., Shi, J., & Ren, Y. (1986). Treatise on febrile diseases caused by cold: A classic of traditional Chinese medicine (Shanghan Lun) / by Zhang Zhongjing, translated by Luo Xiwen, translation revised by Shi Jizhao, introduction by Ren Yingqiu (First edition). Beijing, China: New World Press. Zhi, Y. (2006). bentunqi bing zhengzhi yuanliu yanjiu [A Study of the treatment and origin of in Jinkuiyaolue]. (Masters thesis) Beijing University of Chinese Medicine, Available from the Chinese National Knowledge Infrastructure (CNKI) Zhu, W. (2005). Lun zhongyi zhengzhuang de guifan yanjiu [Research on the standardization of TCM symptoms]. Zhongyi zazhi [Journal of Traditional Chinese Medicine](09), 649–651. Zhu, J. (2006). Standardization of terms of traditional Chinese medicine (TCM) and modernization and internationalization of TCM. China Journal of Traditional Chinese Medicine and Pharmacy(01), 6–8.

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APPENDICES

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Appendix 1 Selected symptoms in Shāng Hán Lùn and their English translations

Symptom Huang Wiseman Luo name 发热 fever heat effusion fever fā rè 下利 diarrhea diarrhea diarrhea xià lì 恶寒 chill/ aversion to cold aversion to cold chill wù hán 腹满 abdominal distention abdominal fullness abdominal distention fù mǎn 无汗 no sweating absence of sweating without perspiration wú hàn 吐利 vomiting and diarrhea vomiting and diarrhea vomiting, and diarrhea tǔ lì 恶风 aversion to wind/a fear of fearing wind/a fear of the aversion to wind wù fēng the wind wind 头痛 headache headache headache tóu tòng 心烦 annoyance/restlessness heart vexation restlessness/annoyance xīn fán 微热 slight fever/light fever slight heat light fever wēi rè 厥逆 coldness on limbs reverse-flow coldness on the extremities jué nì 干呕 vomiting/nausea dry retching nausea gān ǒu 烦躁 restlessness vexation and agitation restlessness fán zào 咽痛 sore throat sore throat sore throat yān tòng 大汗 profuse perspiration great sweating profuse perspiration dà hàn 短气 shortage of breath shortness of breath short of breath duǎn qì 懊憹 restlessness and irritation anguish restlessness and irritation ào náo 下血 hematochezia blood descent stercorrhagia xià xuè 口苦 a bitter taste/bitterness in bitter taste/bitterness in the bitter taste in the mouth kǒu kǔ mouth mouth 恶热 a fear of heat aversion to heat a fear of heat wù rè

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呕逆 nausea/vomiting retching counterflow nausea ǒu nì 郑声 Zhengsheng muttering Zhengsheng zhèng shēng 眩冒 dizziness veiling dizziness dizziness xuàn mào 烦渴 thirst and restlessness vexation and thirst restlessness and thirst fán kě 嗜卧 like to lie in bed somnolence like to lie in bed shì wò 喜忘 amnesia forgetfulness amnesia xǐ wàng 腹痛 abdominal pain abdominal pain abdominal pain fù tòng

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Appendix 2 Selected diseases in Shāng Hán Lùn and their English translations

Disease name Huang Wiseman Luo

太阳病 Greater yáng The Taiyang (Initial Yang) Taiyang disease tài yáng bìng disease syndrome

阳明病 Yangming Yáng brightness The Yangming (Greater Yang) yáng míng bìng disease disease syndrome

少阳病 Shaoyang The Shaoyang (Lesser Yang) Lesser yáng disease shǎo yáng bìng disease syndrome

太阴病 Taiyin disease Greater yīn disease The Taiyin (Initial Yin) syndrome tài yīn bìng

少阴病 Shaoyin disease Lesser yīn disease The Shaoyin (Lesser Yin) syndrome shǎo yīn bìng

厥阴病 Reverting yīn Jueyin disease The Jueyin (Greater Yin) syndrome jué yīn bìng disease

伤寒 Shanghan Febrile disease caused by Cold Cold damage shāng hán syndrome (shanghan)

中风 Zhong-feng Wind strike Febrile disease caused by Wind zhòng fēng syndrome

结胸 Jiexiong Chest bind A blocked-up chest jié xiōng syndrome

奔豚 Running-pig Running piglet Bentun bēn tún syndrome

风温 Fengwen (wind- Acute febrile disease caused by Wind warmth fēng wēn warm Wind (Fengwen) syndrome) 痈脓 A syndrome Suppurating welling- A syndrome with ulcer and pus yōng nóng with ulcer and abscess pus 谷疸 Grain jaundice (谷 Jaundice Gudan gǔ dǎn 瘅）

藏厥 Coldness on the extremities of the Visceral Jue Visceral reversal zàng jué Viscera(脏厥)

温病 Wenbing (warm- Warm disease Acute febrile disease (Wenbing) wēn bìng disease)

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