當(dāng)中醫(yī)遇到西醫(yī)

林巍

原 文

[1] 中醫(yī)萌芽于周朝，以春秋戰(zhàn)國時(shí)期的《黃帝內(nèi)經(jīng)》為標(biāo)志，已有兩千余年歷史，治病救人、除疾養(yǎng)生，承擔(dān)國醫(yī)使命，但是近代以后受到了西醫(yī)的沖擊。

[2] 西方的科學(xué)醫(yī)學(xué)，自19世紀(jì)后飛速發(fā)展，特別是在化學(xué)與微生物領(lǐng)域，確立了獨(dú)立的科學(xué)體系。清朝末期，隨著“西學(xué)東漸”的潮流，中國迎來了“賽先生”，當(dāng)然也包括其寵兒——西醫(yī)。

譯 文

[1] Traditional Chinese Medicine （TCM）， originating in the Zhou Dynasty and symbolized by the Inner Canon of the Yellow Emperor in the Spring and Autumn Period（770—476 BC）， has been saving lives and curing diseases as well as preserving peoples health as the“national medicine” for the past two thousand years or so. However， it was challenged by Western Medicine （WM） when it entered modern times.

[2] Scientific medicine in the West has developed rapidly since the 19th century， especially in the field of chemistry and microbiology as individual disciplines. At the end of the Qing Dynasty （1636—1912）， with the trend of “Western culture emerging in the East，” China received Mr. Sai （the initial syllable of “science” in translated Chinese） and its favorite son—WM.

譯 注

[1]中的“萌芽于周朝，以春秋戰(zhàn)國時(shí)期的《黃帝內(nèi)經(jīng)》為標(biāo)志”在譯文中可用動名詞originating和過去分詞短語symbolized by處理成定語，以求簡潔，便于表達(dá)。

[2]中“確立了獨(dú)立的科學(xué)體系”，原文是動賓結(jié)構(gòu)，譯文里為表述方便，不妨譯為介詞短語as individual disciplines；關(guān)于“西學(xué)東漸”，有多種譯法，如the eastward transmission of western sciences、western learning introduced into China、eastward spread of western culture等，這里作了些變通。

原 文

[3] 中西醫(yī)結(jié)交的典型事例，是對于天花的防治。天花，作為古老的烈性傳染病，死亡率高達(dá)90%。在中國，古人發(fā)現(xiàn)若一個人得過天花，此生便不會再得，于是根據(jù)“以毒攻毒”的原理，發(fā)明了人痘接種術(shù)，即通過接種人痘來預(yù)防“痘瘡”。但由于技術(shù)不夠成熟，這一做法風(fēng)險(xiǎn)很大。

[4] 中國的“接種人痘”西傳到歐洲，英國的皇家學(xué)會對此作了改進(jìn)，由英國醫(yī)生詹納發(fā)明了接種牛痘預(yù)防天花的新方法，然后又傳回了中國。所以，牛痘接種術(shù)的傳入，真正顯示了西方醫(yī)療技術(shù)在中國的實(shí)力，由此奠定了西醫(yī)進(jìn)入中國的基礎(chǔ)。

[5] 在19世紀(jì)下半葉之前，面對蓬勃而來的西醫(yī)，應(yīng)當(dāng)說中醫(yī)還是蠻有自信的。如著名中醫(yī)王清任在1830年出版了《醫(yī)林改錯》，比照西醫(yī)的解剖圖式，糾正了中醫(yī)里的許多錯誤。

[6] 英國傳教醫(yī)生本杰明·霍布森來華，于1851年出版了《全體新論》等詳細(xì)論述醫(yī)學(xué)的著作，有計(jì)劃地把西醫(yī)臨床醫(yī)學(xué)帶入了中國知識界，從而使中醫(yī)感受到了挑戰(zhàn)。

譯 文

[3] A typical case in merging TCM and WM was the prevention and treatment of smallpox， a virulent infectious disease with a mortality rate of up to 90%. In ancient China， people found that if a person had had smallpox， he or she wouldnt get it again. Based on the idea of “curing a poisoned patient with poison，” a method of “human variolation” was invented to prevent the disease by vaccination. However， it was very risky due to the immature techniques.

[4] When the Chinese way of preventive variolation was introduced to the West， the Royal Society improved the method and the new vaccination invented by Dr. Jenner was reintroduced to China. In this way， vaccination proved an advantage of WM， laying the groundwork for it to expand in China.

[5] Before the second half of the 19th Century， in the face of vigorous WM， it should be said that TCM was quite confident. A well-known Chinese doctor， Wang Qingren， for example， published a book entitled Corrections to TCM in 1830， rectifying many traditional mistakes according to the anatomical schema of WM.

[6] The British missionary doctor Benjamin Hobson came to China and published his book Treatise on Physiology in 1851， among many others in later years， systematically planting the seed of western clinical medicine into the soil of the Chinese intelligentsia， and posing a serious challenge to TCM.

譯 注

[3]中，“中西醫(yī)結(jié)交”不是“中西醫(yī)結(jié)合”，不宜譯成 the combination of TCM and WM，而是兩種醫(yī)學(xué)第一次在中國相遇、共同治愈一種疾病，故可用in merging… prevention and treatment of…句式。

[4]中的“中國的‘接種人痘”，因上文已作了明確闡釋，在譯文里可簡化為preventive variolation；“實(shí)力”，一般譯成strength、power等，此處就其具體療效可譯為an advantage。

[ 5 ]中“蓬勃而來”，似可用prosperously/flourishingly/exuberantly developed等，此處作了相應(yīng)的變通。

[6]“使中醫(yī)感受到了挑戰(zhàn)”是被動語句，譯文轉(zhuǎn)換為主動句posing a serious challenge to TCM。

原 文

[7] 起初，中醫(yī)試圖“匯通”西醫(yī)。如，唐宗海主張擷取西醫(yī)中有用的部分，摻入中醫(yī)便可；朱沛文在對比研究中醫(yī)的經(jīng)絡(luò)系統(tǒng)與西醫(yī)的循環(huán)系統(tǒng)之后得出結(jié)論：醫(yī)學(xué)中屬于“形”的范圍，應(yīng)以西醫(yī)為準(zhǔn)（“從洋”），而屬于“理”的范圍，應(yīng)以中醫(yī)為準(zhǔn)（“從華”），顯然受到洋務(wù)運(yùn)動中“中學(xué)為體、西學(xué)為用”思想的指導(dǎo)。之后，又有惲鐵樵、張錫純等人的具體醫(yī)學(xué)實(shí)踐。

[8] 中醫(yī)面臨真正的危機(jī)，是在1895年甲午戰(zhàn)敗之后。嚴(yán)復(fù)發(fā)表《論世變之亟》，力言過去那種“增新不變舊”的洋務(wù)運(yùn)動改革不能成功；鄭觀應(yīng)出版《盛世危言》，批評傳統(tǒng)學(xué)術(shù)，贊揚(yáng)西方科技；梁啟超發(fā)表《變法通議》。這些社會壓力終于促使清政府在1905年取消了科舉取士制度，象征著傳統(tǒng)經(jīng)學(xué)的全面崩潰，也使中醫(yī)失去了固有國學(xué)支撐的優(yōu)勢。

譯 文

[7] Initially， TCM tried to incorporate WM. For example， Tang Zonghai advocated infusing the useful part of WM into TCM； Zhu Peiwen， after comparing the meridian system of TCM and the circulatory system of WM， concluded that in treating external diseases one should rely on WMs techniques， while in dealing with internal illnesses， TCMs philosophy ought to prevail， which was clearly influenced by the idea of the Westernization Movement—“Applying Western technologies guided by Chinese philosophy.” Consequently， Yun Tieqiao， Zhang Xichun and others practiced medicine in that way.

[8] The first real crisis TCM encountered was after the SinoJapanese War of 1894—1895， when Yan Fu published his book entitled An Urgent Transformation of Our Time， pointing out that the failure of the reform simply “added something new to the old” under the name of the Westernization Movement. Zheng Guanying published his Warnings in a Prosperous Time， criticizing traditional Chinese learning and praising Western technologies. Liang Qichao also published his On Reform. Under various social pressures， the Qing government finally abolished the Imperial Examination System in 1905， symbolizing the collapse of traditional Confucian studies， which were the backbone of TCM.

譯 注

[7]中的“匯通”是文言文的用法，相當(dāng)于現(xiàn)代漢語的“結(jié)合”“融匯”等，可用combine、integrate、blend等，此處用了incorporate，其本義為make into a whole or make part of a whole，筆者以為更恰當(dāng)。同時(shí)，將“‘形（的范圍）”理解為external diseases，將“‘理（的范圍）”譯為 internal illnesses，不完全對等，是一種意譯。“中學(xué)為體、西學(xué)為用”可有多種翻譯，如Chinese learning for the basic conduct of life and the Western knowledge for dealing with practical affairs、Chinese learning as the fundamentals and Western learning as techniques等，這里作了較大的變通。

[ 8 ]中的“洋務(wù)運(yùn)動”還可譯為Self-Streng thening Movement、Westernization Drive等。“使……失去了……的優(yōu)勢”，一般以否定形式譯成making it lose its advantage，但此處順其意，譯為which were the backbone of…。

原 文

[9] 1914年，《中西醫(yī)學(xué)報(bào)》發(fā)表了《中醫(yī)救亡芻言》：“自戊戌（1898）新政，新學(xué)漸露萌芽，迄至近世，民智勃起，科學(xué)昌明，而中西醫(yī)學(xué)之優(yōu)劣，判若天淵，昭然若揭。于是謀改良者有人，謀會通者有人，興醫(yī)報(bào)立醫(yī)會者有人，皇皇汲汲，不可終日”。這頗為形象地概括了當(dāng)時(shí)中醫(yī)界的狀態(tài)。

[10] 之后，又有留日歸國醫(yī)生余巖掀起的中西醫(yī)的論爭，力促政府“廢舊醫(yī)，行新醫(yī)”，認(rèn)為“舊醫(yī)一日不除，民眾思想一日不變，新醫(yī)事業(yè)一日不向上，衛(wèi)生行政一日不能進(jìn)展”，從而給了中醫(yī)沉重一擊。

[11] 自20世紀(jì)20年代之后，西醫(yī)在中國得到了迅速發(fā)展，其間得益于西方生理學(xué)、病理學(xué)、免疫學(xué)、遺傳學(xué)、生物化學(xué)等學(xué)科的創(chuàng)建與突破。特別是自然科學(xué)研究與臨床醫(yī)學(xué)相結(jié)合，令科學(xué)醫(yī)學(xué)發(fā)揮出顯著的療效。至上世紀(jì)70年代，中國的西醫(yī)人數(shù)終于超過了中醫(yī)人數(shù)。

譯 文

[9] An article entitled On Saving TCM appeared in the Academic Journal of TCM-WM in 1914， vividly presenting the situation then：“Since the proposed reform in 1898， new learning from the West has sprouted and people have been enlightened in recent years. With the thriving of science， the advantages and disadvantages of the two medicines have been clearly revealed. People are in a constant state of anxiety now： Some seek reform， some engage in social intercourse， some publish medical journals and set up medical associations…”

[10] This was followed by an overseas returnee， Dr. Yu Yan， stirring up the controversy between TCM and WM. He urged the government to abandon TCM and adopt WM， believing that if TCM was not deserted and peoples old ways of thinking remained， the new medical era and health administration would not make any progress. It was a severe blow to TCM.

[11] Since the 1920s， WM has developed rapidly in China， benefiting from many emerging breakthroughs in disciplines in the West， such as physiology， pathology， immunology， genetics， biochemistry and so on. The combination of physical scientific research and clinical medicine， in particular， has produced remarkable curative effects. In the 1970s， the number of doctors in WM finally surpassed those practicing TCM.

譯 注

[9]中，將“這頗為形象地概括了當(dāng)時(shí)中醫(yī)界的狀態(tài)”提前譯出，以在表述上更為緊湊。

[10]中，對于“舊醫(yī)一日不除，民眾思想一日不變，新醫(yī)事業(yè)一日不向上，衛(wèi)生行政一日不能進(jìn)展”，首先，將直接引語改為間接引語；其次，此處并未逐句譯出，而是將其含義綜合，如將四個“一日”概括在was not、would not…之中，同時(shí)將“新醫(yī)事業(yè)……，……衛(wèi)生行政”合并在一句中等。

[11]中，這里的“創(chuàng)建”未必總是establish、set up、create等，而是與“突破”相關(guān)聯(lián)，合譯為emerging breakthroughs in…；此處的“中醫(yī)人數(shù)”不是簡單的 the number of TCM practitioners，而是指the people who practice TCM，故用了those practicing TCM，以更切其意。