A Study to View International Standard Terminology from the English Translation of Terms Related to Tongue Proper in an Original Foreign Work

LI Yuan-yuan (李媛媛), WANG Lei (王 蕾), GUO Rui (郭 睿), WANG Yi-qin (王憶勤),HU Liang-liang (胡亮亮), YAN Hai-xia (燕海霞)

Shanghai Key Laboratory of Health Identification and Assessment, School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

Correspondence to: Yan Hai-xia, Associate Professor, Postgraduate Supervisor, Tel: 021-51322286, E-mail:hjy2012ok@163.com.

Supported by: Shanghai Traditional Chinese Medicine Standardization Cultivation Project (NO.ZY3-GJHZ-1-1001-11);Shanghai Science and Technology Commission Special Technical Standard Project (NO.14DZ0500400)

ABSTRACT By analyzing the original foreign work Tongue Diagnosis in Chinese Medicine and taking it as a reference, this paper made a comparative study on the word-formation patterns, translation methods along with the translations of specific terms of tongue proper, such as tongue colors, forms of tongue, motilities of tongue and sublingual veins in International Standard Chinese-English Basic Nomenclature of Chinese Medicineand WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region. From a cross-cultural perspective, this paper emphasized the significance of the standardization of traditional Chinese medicine (TCM) terminology, and analyzed the merits and demerits of the English translations of TCM terms related to tongue proper from 2 different books, so as to provide references for the standardization of TCM terminology.

KEYWORDS Tongue proper; Terminology; English translation; International standards

Throughout history, many scholars have pointed out that medical knowledge and resources have been transformed between cultures in contact with each other. In the process of communication,especially for the traditional Chinese medicine (TCM),there are always some mixed or chaotic factors,leading to the failure of cultural communication or even misunderstanding. With the spread of TCM worldwide, the standardized translation of TCM terminology is the first step for TCM to enter the world. The normalization and standardization of English translation of TCM terms have become a hot research trend[1]. Accurate and faithful translation is the foundation of TCM translation.

It has been more than 300 years since TCM began to be translated into English with historical records. During this period, many scholars have been devoted to the study of TCM translation and have made fruitful achievements[2]. Standardization of TCM terminology is a significant part of international standardization of TCM. The publication ofInternational Standard Chinese-English Basic Nomenclature of Chinese Medicine[3](hereinafter referred to as "standard 1") andWHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region[4](hereinafter referred to as "standard 2") in 2007 marked the beginning of international cooperation in the compilation of standardized English translation of TCM terms.

However, the translation of the same entry in different standards or the same standard is still diverse, making it difficult for TCM with a unique cultural system to accurately spread worldwide. The features of tongue manifestation in TCM are various,and the inspection of tongue proper is an important part of tongue inspection, which plays a significant role in clinical practice to accurately diagnose the rising and falling of vital qi and pathogen, distinguish the nature of pathogen, analyze the location of disease, and predict the tendency of disease. By reading the translation of terms related to tongue proper in the bookTongue Diagnosis in Chinese Medicine[5](hereinafter referred to as "original version"), the author figured out the differences between the 2 standards and the original version from a cross-cultural perspective. Through analyzing and comparing the terms related to tongue proper in the 3 works, we hope to find problems in the English translation process, and propose solutions to standardize and internationalize the translation of terminology in tongue inspection, aiming to provide a basis for the standardization of TCM terminology.

ENTRY SELECTION

Through the research on the terminology associated with tongue inspection in standard 1,standard 2 and the original version, a total of 23 terms related to tongue proper were selected,including pale red tongue, pale tongue, red tongue,crimson tongue, purple tongue, blue tongue,enlarged tongue, teeth-marked tongue, swollen tongue, thin tongue, red dotted-thorny tongue,prickly tongue, fissured tongue, limp wilting tongue,stiff tongue, deviated tongue, trembling tongue,protruding and waggling tongue, shortened tongue,curled tongue and retracted testicle, Shezong,paralytic tongue, sublingual vein, which basically contained tongue color, form of tongue, motility of tongue and sublingual vein in tongue proper inspection. The similarities and differences between the 2 standards and the original version were compared and analyzed. See table 1 for details.

COMPARISON AND ANALYSIS

Through the comparison, it was found that in standard 1 and 2, the Chinese word-formation patterns were "adjectives concerning tongue manifestation" + "tongue", and their English translation methods were corresponding to the Chinese patterns. The original version directly used adjectives describing features of tongue manifestation.

Conventionalization is the basic law of language development[6]. "Convention" means that the name or social habits of things are often determinedor formed by people through long-term social practice. After 2002, World Federation of Chinese Medicine Societies (WFCMS) and the World Health Organization Western Pacific Region (WHOWPR)have successively incorporated "convention" into the principles of translation of TCM terminology[7].

Table 1. Comparison of Common Translations of Tongue Proper

The conventional power of social language is very great, in a sense, it can change the direction of the development of a word. Therefore, when translating, translators should adopt some longused, widely-applied and habitual terms with unaffected communicative functions[8]. The English translations of 9 terms related to tongue proper in 3 books, such as pale tongue, red tongue, purple tongue, blue tongue, enlarged tongue, teeth-marked tongue, thin tongue, stiff tongue, and deviated tongue were identical and could be used according to the principle of convention.

YAN Fu, a great translator, once put forward the comprehensive translation standard of "faithfulness,expressiveness and elegance", which was recognized and respected by the translation circle.For a long period of time, it has played a positive role in promoting the translation work in China.

Generally speaking, the translation of TCM terms must adhere to 4 principles[9]: first, it must maintain the cultural characteristics of TCM terms and concepts; second, it must unify the literariness and modern scientific nature of TCM language; third,it must clarify the multiple semantics of TCM terms;fourth, it must adhere to the informatization translation of TCM terms. Therefore, the author thought that the base of TCM translation is faithfulness,also means standardized. So as to facilitate the development of TCM English translation and international communication, the author compared the 2 standards and the original version, analyzed and discussed other terms in addition to the unified translations mentioned above. (The relevant English and corresponding Chinese definitions below without special noting are quoted fromOxford Advanced English-Chinese Dictionary(6th Edition)[10])

Tongue Color

The different tongue colors of the 2 standards and the original version are pale red tongue and crimson tongue. The manifestation of pale red tongue is characterized by pale red and moist tongue. It mainly reflects a physiological state with sufficient heart blood and exuberant stomach qi. Red is the color of blood whose bright luster embodies the bloom of stomach qi.The book concerning the principles of tongue coatingwrote: "Pale red tongue color is the manifestation of healthy people... Red represents heart qi while light reflects stomach qi." Pale red tongue is the tongue manifestation of healthy people. If it is seen in a patient, whose illness is mild. Its translations in standard 1, 2 and the original version are respectively "light red tongue", "pale red tongue", "pale and red". "Light"means pale in color, such as "light blue eyes". "Pale"means light in color, containing a lot of white.

The lightness in TCM is that blood color is not so red, which means blood color is not the same as red. The original version choose "pale and red" as the translation. "And" indicates that the 2 components are considered to be in a parallel relationship, and juxtaposing the 2 adjectives is not easy for readers to understand. "The translation of TCM terms should not be a rigid 1-to-1 model,but a dynamic combination of words[11]." In other words, the translation of words should not be carried out independently, and the translators should take the concept and meaning of collocation into consideration. Translation and segmentation of words should be carried out according to TCM connotation[12]. Therefore, the translations in original work and standard 1 are not appropriate, and the translation "pale red tongue" in standard 2 is correct.

The manifestation of crimson tongue is characterized by a darker color than the red tongue.There are 3 reasons for the further development of the crimson tongue from the red tongue. First, qi and blood both ablaze due to the pathogenic heat over, so the blood in tongue's network of vessel is exuberant. Second, in the external contracted diseases, heat enters nutrient-blood, which causes pachemia and consumption of nutrient yin. And blood heat floods the tongue. Third, in miscellaneous internal damage diseases, due to yin deficiency with effulgent fire, the deficiency fire will flame upward the tongue vein, so the darker the color, the more serious the heat pathogen.

The standard 1 and 2 share the same translation: "crimson tongue", and that in original version is "dark red". "Crimson" means dark red in colour. "Dark red" means to go 1 step further on the basis of "red". This translation adopts the method of literal translation, whose illustration is to translate as close as possible to the original content and form within the range allowed by the grammatical ability of the target language[13]. The method can be understood easily.

However, the characteristics of TCM language are concentrated, concise and profoundly philosophical, so the original translation version is not in line with this feature. The translation of a language should not only conform to the characteristics of the native language, but also focuses on the style and habits of the foreign language. Therefore, "crimson tongue" is the appropriate translation, which is adopted in standard 1 and 2.

Form of Tongue

The different translations concerning form of tongue in standard 1, 2 and original version are enlarged tongue, red dotted-thorny tongue and cracked tongue. The feature of enlarged tongue is that the tongue body is larger and thicker than the normal one, and the extended tongue is full of mouth with pale tongue color and can be accompanied by teeth marks. The tongue is slippery. The formation of enlarged tongue is due to yang deficiency of the spleen and kidney and the delivery of body fluids was impaired. As a result, the water-dampness is stagnant in the body. "enlarged tongue" is the translation of the term in standard 1 and standard 2.

There is no translation of enlarged tongue in the original version, and the related translation is"swollen" , and "a swollen tongue is distended and larger than normal 1". Its clinical significance is yang deficiency or there is dampness in the body. This interpretation is similar to the clinical significance of enlarged tongue. But the translation "swollen"should correspond to the swollen tongue. The swollen tongue refers to the tumid tongue body with which patients cannot even close the mouth. The tongue color is bright red or hyacinthine. In severe cases, you can't retract your tougue into mouth.It means the heart and spleen dominated by heat exuberance, the exogenous heat and dampness.

As for the enlarged tongue and swollen tongue,the former is a manifestation of deficiency syndrome,while the latter is excess syndrome. We should avoid confusing the 2. Therefore, the translation of enlarged tongue is still based on standard 1 and standard 2.

The manifestation of prickly tongue and dottedthorny tongue is as follows: The dots refer to the red or purple-red star points protruding from the tongue.Spines refer to the fungiform papillae that are enlarged and raised, and form a spike, shaped like a thorn. So it is called dotted-thorny tongue.

Standard 1 and 2 have common translation of the 2 terms and they are respectively "spotted tongue" and "prickly tongue", while the original version has no separate statements of the 2, whose related interpretation is "score-covered", meaning that the sores or ulcers cover the tongue. The literal translation method adopted by standard 1 and standard 2 needs to be combined with certain conditions and occasions, otherwise it is easy to cause misunderstandings among readers. If the translation of standard 1 and 2 does not consider the context, it will lead to misunderstanding. In the original version, the translation completely deviates from the feature and meaning of the dotted-thorny tongue's manifestation. In clinical practice, the dots and spines are similar and can be seen together.

So the translation "red dotted-thorny tongue"is more appropriate. It not only accords with the characteristics of classification according to manifestation, but also fits the language characteristics of relevance. The similar research has also suggested that this translation is suitable[14].

The manifestation of the cracked tongue is characterized by cracks of various shapes on the tongue surface. There is no tongue coating in the cracks. Both standard 1 and standard 2 translate the term as "fissured tongue". The translation in the original version is "cracked". "Fissured" means a long deep crack in something. "Cracked" refers to rimous. The formation of cracked tongue is on account of the deficiency of essence and blood,consumption of fluid due to intense heat, blood deficiency conducing less nourishment in the tongue. All these factors can cause the tongue nipple to shrink or the tissue to rupture and crack.All of the above translations can express the TCM connotation of cracked tongue.

Tongue Motility

The different translations of tongue motility in the 2 standards and the original version contain limp wilting tongue, trembling tongue, protruding and waggling tongue, shortened tongue, curled tongue and retracted testicle, Shezong and paralytic tongue.

The manifestation of the limp wilting tongue is that the tongue body is weak and cannot flex and rotate at will. Its translations in the 2 standards and the original version 1 are respectively flaccid tongue(1), limp wilting tongue(2) and flaccid."Flaccid" means soft and weak; not firm and hard."Limp" refers to a lack of strength or energy; The explanation of "wilting" is that if a plant or flower wilts, or something wilts it, it bends towards the ground because of the heat or a lack of water.Flaccid：soft and weak; not firm and hard，limp wilting：limp-lacking strength or energy，wiltingif a plant or flower whilts, or sth wilts it, it bends towards the ground because of the heat or a lack of water. The reason for a "flaccid" state cannot be differentiated, while the translation "limp wilting tongue" is in line with the term's TCM connotation,which is a state of weakness and insanity caused by the deficiency of qi and blood. Therefore, the translation in standard 2 should be adopted.

The manifestation of the trembling tongue is characterized by the trembling of the tongue body, which cannot be autonomously controlled.The mild symptom manifested as slightly trembling when patients extend their tongues; while in the severe conditions, the patients' tongue body keeps trembling even they are tight-lipped. Both standards translate the term as "trembling tongue" and the original version as "quivering". "Trembling" is a feeling of movement or sound of trembling, e.g. "a tremble of fear"; "she tried to control the trembling in her legs". "Quivering" means to shake slightly or to make a slight movement. "Quivering" refers to a slight tremor, which can only partially express the symptom. Therefore, the translation in standard 1 and standard 2 is more appropriate.

The manifestation of protruding tongue is that the tongue extends beyond the mouth and cannot be retracted. The symptom of repeatedly extending the tongue or licking around the lips is called waggling tongue. The translation "protruding" is consistent in the 2 standards and the difference lies in the word"waggling". The respective translations in standard 1,standard 2 and the original version are "protruding and waggling tongue"; "protruded agitated tongue";"moving". "Waggling" means to make something move with short movements from side to side or up and down. "Agitated" is showed in your behavior that you are anxious and nervous. "Moving" is to change position or make somebody/something change position in a way that can be seen, hear or felt, e.g."Don't move: stay perfectly still". "Waggling tongue"is used to describe the state of extended tongue to swing around. "Agitated" mostly refers to anxiety,excitement, and unease of people's emotions;and "moving" refers to the movement of positions.Accordingly, the translation of standard 1 is more appropriate.

The manifestation of shortened tongue is that the tongue body is short, tightly-contracted,and cannot extend. The shortened tongue and limp wilting tongue can always be seen together clinically. Its translations in standard 1, standard 2 and the original version are respectively"shortened tongue", "contracted tongue" and "short"."Shortened" means to make something shorter. The illustration of "Contracted" is to make something become less or smaller. "Short" is used to measure or cover a small length or distance, or a smaller length or distance than usual. The word "contracted"in standard 2 refers to narrowness in space, while the word "short" in the original version refers to length. Both of them cannot precisely illustrate the intension of the term, which is characterized by short and tightly-contracted. So the applicable translation should be "shortened tongue" in standard 1. The symptoms of TCM are relative in measurement, and the description language used is relatively vague. In addition, metaphors and analogies are often applied to describe and define their clinical manifestations.These factors all cause the ambiguity of the definition of connotation and extension of TCM symptoms[15-16]. Therefore, it is easy to transform the generalized TCM symptoms into Western medicine symptoms with quantitative indicators and cause deviations in the degree of ideology[17].

The definition of curled tongue and retracted testicle in standard 2 is "the tongue body is curled and contracted and meanwhile the testicle is retracted, which indicates a high severity of illness."In the original version, this term is translated as"rolled". "Rolled" refers to a long piece of paper,cloth, film, etc. This term not only includes the symptom of curled tongue but also of retracted testicle. So the translation in the 2 standards is the suitable selection. The terms and concepts of TCM are often changed according to different contexts or collocations[18]. Because a considerable part of the professional terminology of TCM is directly derived from daily life language, its concept is often the original meaning or extended meaning and metaphorical meaning of the original word. Getting familiar with the word semantics and related cultural information of the 2 languages (target language and source language) in translation, the intertextual relationship and interactive relationship of the translated text is pretty important[19].

The standard 2 defines Shezong as "extended tongue body cannot retract", which is consistent with standard 2. The original version translate the term as"long". The meaning of "Protracted" is lasting longer than expected or longer than usual. Shezong in TCM is an ill condition manifested as a patient lacking the capability to retract the extended tongue. The above 2 translations are just literal translations, and they cannot express the connotation of Shezong at all. It is recommended to use Chinese Pinyin "Shezong",which not only maintains the cultural characteristics of the terminology of TCM, but also can be accepted by foreigners.

The manifestation of paralytic tongue is that the tongue cannot feel anything or move. The definition in standard 2 is "the tongue body is numb and not flexible at all". The translation in standard 1,standard 2 and the original version are respectively"paralytic tongue", "paralyzed tongue" and "numb"."Paralytic" means that the suffering from paralysis makes sb unable to move. "Paralyzed" means to be affected or subject to with paralysis. "Numb"is unable to feel, think or react in the normal way,e.g. "he felt numb with shock". Paralytic tongue in TCM refers to the numbness of the tongue and the inability to move. It is caused by internal stirring of liver wind which is due to blood deficiency."Paralyzed tongue" is an acceptable translation."Paralytic" and "Numb" cannot reflect the ability of the tongue to feel or move. Therefore, the English translation of Standard 1 is more appropriate.

Sublingual Vein

The sublingual veins are large longitudinal veins on both sides of the lingual frenulum of normal people.The definition of standard 2 is "the veins on both sides of the lingual frenulum". The respective translations in standard 1, standard 2 and the original version are"sublingual vein", "sublingual collateral vessels" and"underside of the tongue". "vein" refers to any of the tubes that carry blood from all parts of the body to the heart. Collateral vessels: "collateral" is connected with something else, but in addition to it and less important."Vessels" is a tube that carries blood through the body of a person or an animal or liquid through the parts of a plant. The translation in the original version refers to a wider range. The tissues under the tongue not only refers to the sublingual vein, but also includes tissues such as the tongue gland and lingual frenulum. The term only refers to the large veins under the tongue.The translations in both standard 1 and standard 2 are acceptable.

CONCLUSION

The three subjects involved in translation(the author, the translator and the reader) may be influenced by distinct cultural traditions and live in different times or regions. Translation is also a kind of activity across time and space, which is an exchange and communication between 2 cultures whose social backgrounds and cultural traditions are quite different.The terminology of tongue inspection of TCM is inherently abstruse and difficult to understand, and the translation methods are flexible and varied. If the terminology of TCM is not translated in a standard way, its actual connotation of the original concept cannot be fully expressed. Even if transplanted to foreign countries, it will be the heterogeneous seeds, which is not conducive to the communication between TCM and modern science and hindering the faster and better introduction of TCM to the world. By comparing the relevant terms of tongue proper in the 2 standards with those in the original workTongue Diagnosis in Chinese Medicine, the translations in the 2 standards are slightly different, but the expression of relevant terms in the original version is quite different from the culture of Chinese Medicine, which indicates that TCM terms have not been transplanted to the world accurately, let al1 fully. Let us more clearly understand that there is still a great deal of work to be d1 to improve the standardized translation of TCM terms. For example, the inspection of tongue proper also includes the tongue spirit, such as the lustrous tongue and the withered tongue, which are not covered in the three books, and it is necessary to supplement and improve them in the future. In addition to the tongue proper related terms, the standardization of terms concerning TCM disease patterns are waiting to be done.