General Background: Asian medicine began to take root in the United States after President Nixon visited China in 1970 and observed an appendectomy being performed using Acupuncture anesthesia. This news shocked the American people and veterinarians were the first to utilize acupuncture as a method of analgesia. Quickly after Nixon’s visit to China, the State of Nevada and the State of California both began to license acupuncturists in the mid-1970’s, and a few state-approved acupuncture schools were established. Due to the scarcity of English acupuncture literature, schools were forced to use English textbooks from China, which were insufficient. However, since then, an increasing number of books on Asian medicine have been written in English and some translations of medical classics have been also published.

About 15 years ago, Bob Flaws and Honora Wolfe of Blue Poppy Press hosted a small, private brainstorming workshop in Colorado, where this “terminology and translation debate” began, and the Consortium for Oriental Medical Publishers (COMP) was formed. Hitherto, our profession at the national level has failed to discuss this important issue. After calling this to the attention of the AAOM, its leadership agreed to sponsor a panel discussion on the subject and asked six experts to be panelists. Each of the six panelists was to write a position paper on the “terminology and translation” prior to the debate.
Miki Shima, OMD, LAc
from “Asian Medical Nomenclature Debates Position Paper

Nomenclature and the study of naming objects and ideas are at the core of the medical professional life. They dictate the procedures of medical culture. The descriptions, names and classifications of disease entities are directly tied to the beliefs of the culture within which the medical services are provided. However, there is the risk that professional language can be used politically to exclude and mystify outsiders, holding power over the public (Said, 1996). Take for instance the bombardier who uses the term ‘target acquisition’ instead of ‘bombing a tank.’ There are further risks if the goal of glossary standardization is achieved through dominance including alienation, fragmentation and conflict. The current push for a standardized terminology creates clarity for learners and a reduced level of confusion for accurate translational processes. But it also poses risk. The use of political power to mandate standardized translation can create alienation, fragmentation and conflict within our profession. That said, a standardized professional language permits professionals to self-identify, this is part of what creates the boundary between who is and is not in a profession. William Morris, OMD, MSEd

A Chinese word or phrase can have an evolutionary process. The best interpretation of their original meanings should and could be a big debate even for some already commonly accepted terminologies used today. It’s almost inevitable that different interpretations from the original language of Chinese will be brought into existence using English translations. If the terminology is in the Chinese language, the Chinese characters and phrases used in TCM will not change that much. Yet, after thousands of years of evolution, people’s understanding and interpretation of their meanings will almost never be the same. On one hand, the debate on the meaning of the language won’t affect the language itself in Chinese. On the other hand, the situation is very different in English. Once someone comes up with a different interpretation of a word, the translation will have to be changed to reflect this new understanding. In other words, how a translator understands terminology will affect how the terminology will evolve in the destined language.
Master Xiaotian Shen, OMD, LAc
from "An Extra Thought about Nomenclature of Eight Extraordinary Channels"

Over the last fifteen years or so there has been a great deal of discussion related to the proper way of transmitting Chinese medicine to the West, with a specific emphasis on translation methodology. We are a group of practitioners of Chinese medicine who are native English speakers and who have varying degrees of experience translating Chinese medical texts for a variety of forums. We represent a broad spectrum of translation approaches that includes extensive direct experience with all of the major positions being advocated. Our individual views on the transmission of Chinese medical texts to the West are by no means monolithic, and in some cases they are almost diametrically opposed. In this paper we will define the areas in which we all agree. We will present the basic operating principles that we all work with in the hopes of helping to define a common ground for all approaches to Chinese medical translation. Although our individual application of these essential premises will inevitably vary among us, they are the principles that ultimately determine the course of our decision-making in specific situations.
Dan Bensky, DO; Jason Blalack, LAc ; Charles Chace, DiplAc, DiplCH; Craig Mitchell, MSTCM, LAc
from "Toward a Working Methodology for Translating Chinese Medicine"

Because a name is used to identify or define, if the thing defined changes significantly, or if the context within which that thing is used changes, then it may become necessary for its name to change as well. One key to successful naming, however, is an agreement of usage so there can be a basis for sharing knowledge and for true understanding between individuals and groups.

Traditional Chinese Medicine, Zhong Yi, is changing, as it has been for millennia. The myriad pages of its rich story have provided us with oracle bone divination, the emergence of classical medicine, significant growth in herbal knowledge, acupuncture and moxibustion during the Tang, Song and Ming dynasties, decay and the threat of abolition under Manchurian rule, revival and modernization in 20th century China, and an increasing international presence in contemporary healthcare. Indeed, the medicine has always been changing. So what is more significant now in the nomenclature debate is not that the medicine is changing, but rather that its moderns contexts are changing. Consequently, to find the most suitable name for this medicine it will be essential to consider the modern context in which it now exists.
Adam Burke PhD, MPH, LAc
from “The Naming of a Medicine”

Several circumstances must be considered when addressing the problems surrounding the translation of Chinese medical texts. These are the fact that Chinese medicine has been a text based practice since antiquity, that distinctive authorial conceits informed the production of classical Chinese texts, that the processes of engaging classical texts from the linguistic perspective of different historical periods present specific problems of their own, and that the contemporary production of marketing of texts both in China and the English speaking world are distinctively and historically determined. Translation of classical and modern Chinese medical texts into English has, in the last 20 years, set the stage for an often heated and generally lively discussion. This debate has crystallized over the question of the choice to use denotative / functional translations that use a standardized terminology that is freely available to readers in the form of a glossary versus the use of connotative translations where terminology is more loosely glossed, and where the text is interpreted by the author for his/her perception of the audience that is being addressed.
Marnae Ergil, MA, MS, LAc, Dipl. OM (NCCAOM) and Kevin Ergil, MA, MS, LAc, Dipl. OM (NCCAOM)
from: “Issues Surrounding the Translation of Chinese Medical Texts into English”.

The Problem… Over the last 800 years, but especially during the last 30 or more years, the English language terminology of acupuncture and Chinese medicine has grown up in an unplanned, haphazard way. Practitioners, teachers, students, authors, and translators have been left to their own devices to adopt or create whatever terms they like regardless of their linguistic accuracy and faithfulness to the medicine as described and expressed in Chinese. This has led to a veritable Tower of Babel within the study and practice of Chinese medicine in the West in general and in North America in particular. Based on my 25 years experience as a teacher, writer, and translator of Chinese medicine, the single greatest impediment to the learning and skillful practice of Chinese medicine in the West as it was created and is practiced in China is the lack of a linguistically accurate, standard English language translational terminology for this medicine. This problem is highlighted by the fact that such a linguistically accurate, standard English language Chinese medical terminology has existed for more than 20 years. Unfortunately, because there is no equivalent of Latin and Greek academic terms in Chinese, all too few Western students and practitioners of Chinese medicine have understood that this medicine does, in fact, have a standard professional terminology. Nevertheless, this is most definitely the case.
Bob Flaws, DiplAc, DiplCH, FNAAOM, RegAc [UK]
from "Arguments for the Adoption of a Standard Translational Terminology In the Study & Practice of Chinese Medicine In the English-speaking World"

"We do not need an arbitrary standard, something imposed from “on high.” Neither do we need a hidden standard, something that closes primary markets to investment and development. We need an open standard that encourages competition and development."

Standardization is a concept that is greatly misunderstood. People tend to think of a standard as a set of rules that everyone is forced to apply. People also tend to think that standardization of the English terminology of Chinese medicine means choosing one equivalent for each Chinese term, and forcing everyone use that term. Western practitioners are resistant to the idea of standardization—of terminology or anything else—because they fear that it goes against what they consider to be the “spirit of Chinese medicine,” which is individual and holistic. They see standardization is limiting their freedom of choice. I would like to show you that in the real world, standardization does not mean a single set of rules imposed by a single authority. The actual practice is quite different. In many cases standardization is the existence of multiple implementations that are carefully interfaced with each other. It does not limit personal preferences. In fact, an “Open Standard” gives individuals a maximum freedom of choice.
Robert L. Felt
from "The Role of Standards in the Transmission of Chinese Medical Information"

"The true spirit of the Chinese language is to use simple terms when explaining complex subjects."

There has been significant interest by the English speaking traditional Chinese medicine (TCM) community as to which English words to use for Chinese medical terms. The Chinese medical language is very precise, and will have different words for similar concepts, such as boost, assist, nourish, or tonify. These differences are quite important to the well-trained practitioner, ultimately indicating which particular herb is required for therapy. For example, various herbs may affect qi in the following ways: tonify, support, secure, consume, descend, rectify, absorb, break, normalize, harmonize, warm, move, increase or correct. All of these terms are represented by different Chinese characters, and may indicate the need for a specific type of medicinal herb. … First is my agreement that there should be some basic consensus on English language translations of TCM terms in the hopes of creating a solid front and foundation for students and practitioners. Second is a desire to be in step with the mainstream trends promoted by the Western TCM publishing houses.
Jake Paul Fratkin, OMD, LAc, DiplAc, DiplCH
from "ASIAN MEDICAL NOMENCLATURE DEBATE Position Paper"

In teaching courses on Chinese herbal medicine, focusing on prescriptions, materia medica, and classics such as the Shang Hán Lùn, it became apparent that there was much confusion in most students over much of the material being taught. The many inaccuracies in translation led to distortions in understanding the subject, and allowed misconceptions to flourish as gaps in understanding were filled by inappropriate biomedical and alternative medical substitutions. Even though most translators aimed at “transparency,” i.e., a simple, easy-to-read approach, the end result was often a poor transmission of core concepts. This contributed to poor communication between practitioners, students and teachers alike. While each person in our field has valuable perspectives and original insights that should be shared with others, several authors were not careful to differentiate between original ideas and source materials in their textbooks. Several of these textbooks became the basis of TCM college programs, and ultimately state and national board exams and certifications.

An Open Standard is, in my opinion, the best choice. Attempts at an open standard in publication were an essential part of the foundation of COMP. (Council of Oriental Medical Publishers), but COMP was perhaps an idea before its time. An Open Standard doesn’t require rigid conformity to specific term sets, but does encourage an accountable, source-based approach to translation. That source is primarily the Chinese language, specifically technical Chinese medical language encoded in voluminous dictionaries derived from thousands of medical texts over two thousand years of history.
Z'ev Rosenberg, LAc, OMD
from "Asian Medical Nomenclature Debates Position Paper: A Personal Perspective from a Professor of Herbal Medicine"