AAOM terminology conference review

[Guest guest]

AAOM notes

 

The AAOM must be commended for bringing our community together to

address the issue of Chinese medical terminology. As medical

information worldwide is increasingly moving towards a digital age,

standards of expression in East Asian medicine are being addressed by

a variety of organizations, including the World Health Organization

(WHO), the World Federation of Societies (WFCMS), and

China's State Administration of Traditional (SATCM).

As the first US-based organization to address this issue, the AAOM

has done a great service to the profession by stimulating discussion

on this important topic. By bringing together the advice of American

experts in the field, the AAOM is spearheading the task of identifying

trends in English terminology use in the United States. Identifying

these trends allows the AAOM to offer vital representation for the

profession to larger organizations such as the WHO, which seeks to

establish international standards in Chinese medical terminology.

 

This letter is essentially a review of my personal impressions of the

meeting as a member of the audience. While it is impossible for me to

encapsulate the depth of the presenters' speeches in a few brief

sentences, I hope that my take-home impressions may offer a general

overview of the meeting for those who were unable to attend.

 

Before I begin, I would like to briefly introduce myself so that my

comments may be assessed in accordance with my experiences and

personal limitations. My observations of the meeting are nothing

other than personal observations, and I hope that they convey an

accurate representation of the views of the various presenters. I

flew in from Taiwan 2 days before the conference and drove through the

night from LA in order to attend; I apologize if my memory is a bit

imperfect on any issues, it is due to travel fatigue and not ill intent.

 

I am a graduate of the Pacific College of Oriental Medicine, with a

prior background in undergraduate study of Chinese language, history,

and cultural studies. I have lived for the past three years in

Taiwan, where I have studied Chinese medical translation with Nigel

Wiseman and Feng Ye while completing an extended clinical internship

in the Chinese medicine department of Chang Gung Memorial Hospital.

With regards to translation and terminology, my experience is

primarily centered upon my work experience as a translator and editor

for the US-based Paradigm Publications and the Beijing-based People's

Medical Publishing House (PMPH, Renmin Weisheng Chubanshe). During my

stay in Beijing, I assisted PMPH with training and recruitment of

translators and was frequently involved in discussions with local

experts and staff about translation styles and the English terminology

of Chinese medicine. In Beijing, I attended the foundational

terminology meeting of the World Federation of

Societies (WFCMS), in which foremost experts from the PRC and foreign

experts such as Nigel Wiseman and Paul Unschuld discussed issues of

terminology. While I am a member of the WFCMS' terminology committee,

it is a largely honorific position that is of less practical

importance than my daily experience with translation and editing of

Chinese medical texts. Having studied Chinese for only ten years, I

lack the depth of experience of the field's leaders, but I am

nevertheless reasonably well-informed about a wide range of issues

relating to translation theory and term choices.

 

Any review of the conference should naturally begin with my sincere

gratitude towards Miki Shima and Will Morris, the people who made this

timely discussion on nomenclature a reality. In my opinion, Will

Morris, the president of the AAOM, has truly demonstrated his

commitment to the profession by initiating one of the most important

efforts towards the advancement of the field ever undertaken by a

professional CM organization. I left the meeting vowing to join the

AAOM as soon as I move back to the USA, and I certainly now perceive

the AAOM to be at the forefront of all our professional organizations

as a result of their efforts.

 

As a key organizer in the event, Miki Shima selected a balanced group

of professionals with diverse perspectives to facilitate debate,

discussion, and unity within the field. I left with a strong

impression that Miki is very dedicated to resolving differences

between different members of the field and is keen to create a unified

and open system of terminology that will allow for enhanced

correlation of concepts throughout the English literature. He seems

to greatly value pluralism, which is seen by his desire to create an

integrated and inclusive database of existing terminology.

 

Following an introduction by Will Morris and Miki Shima, Jeannie Kang

took the podium to offer the group a brief report on her interactions

with the WHO and their meetings in Seoul regarding standardized

English terminology. Her presentation was eloquent and she struck me

as an extremely intelligent individual. She seems to be an ideal

representative for our community within a large organization like the

WHO, which must constantly balance multiple agendas across many member

states and medical styles. According to Ms. Kang, the WHO is already

planning to incorporate Chinese diagnostic codes into its

international classification of disease codes. Her report was a

reminder that term standardization is an important and widely

recognized issue internationally, and the increasing reliance on

technology makes professional standards in terminology essential in an

age of paperless hospitals and searchable databases of medical studies.

 

Although the topics of Miki Shima and Jeannie Kang were not oriented

towards terminological issues related to their native Japanese or

Korean medical traditions, their insightful presentations left me

thinking about how crucially the Western field needs more input from

the Japanese and Korean communities, especially in terms of

terminology and the enhanced transmission of information that comes

with it. While my personal experience with East Asian medicine is

nearly entirely based on my interactions within the Chinese world, I

have a strong opinion that increased insight from our Japanese and

Korean colleagues is a much-needed element in our profession's growth.

Indeed, I feel that one of the areas most deeply lacking in the

discussions on terminology in the US is adequate representation from

Korean and Japanese traditions; thus far very little material has been

developed in English to illuminate the differences in terminology and

other characteristics of Korean and Japanese styles of East Asian

medicine. Miki and Chip Chace briefly touched upon some examples of

different nuances of terms within the Japanese literature, and this

type of material would be a fascinating area for further development.

 

One interesting point that Ms. Kang touched upon in passing was that

the WHO is particularly concerned with Evidence-Based Medicine (EBM).

I was personally surprised that the issue of biomedical interface

terms for EBM was hardly discussed at the AAOM meeting, whereas it was

one of the most fundamental issues faced at the meetings of the WFCMS

and the WHO. The differing needs of practitioners in an integrated or

biomedical environment versus practitioners practicing more purely

traditional medicine has a tremendous impact on the terminology

chosen. In some circles, traditional medicine is regarded as less

clinically important than integrated medicine, and

biomedically-oriented term choices are typically favored in such

communities. By contrast, individuals seeking terminology appropriate

for classical texts or texts devoted purely to traditional medicine

tend to favor term choices that reference the original source concept

versus a possible biomedical correlate. In light of these different

needs and different attitudes, some groups (such as the WFCMS) seek to

establish biomedical interface terms for conditions that correspond

closely with a given biomedical pathology, whereas a source-based

translation may be chosen for traditional or historical works to

preserve the original concept. An example of this can be seen in the

following principle established at the WFCMS' terminology in Beijing

in 2006:

 

" If the Chinese term closely corresponds to a specific Western medical

term, it is acceptable to use multiple terms, i.e., & #39118; & #28779; & #30524;

wind-fire

eye (acute conjunctivitis). However, it is preferable to keep terms

to a minimum, with no more than two equivalents for a given Chinese

term. While biomedical interface terms may be chosen to supplement

traditional medical terms, the following points should be observed: a)

If the concept is identical and no specialized knowledge or equipment

is required for understanding the Chinese term, a single equivalent

may be used (examples include dysentery, diarrhea, and malaria). b)

If the concept is essentially the same but modern knowledge or

equipment is required to understand the biomedical phrase, a

biomedical interface term should be chosen for scientific works, while

a term that preserves the original meaning of the Chinese concept

should be used for historical or traditional works (ex. wind-fire eye

vs. acute conjunctivitis). "

 

Next was a well-balanced presentation by Chip Chace. Like Craig

Mitchell (who presented later), Chip is a very qualified translator

who has worked with both Dan Bensky and Nigel Wiseman. Thus, the

experience of Chip and Craig offers a relatively balanced perspective

and an interesting angle of insight. Chip emphasized that he

initially developed a strong mastery of Chinese medical Chinese based

upon the systematic approach developed by Wiseman. In later years, he

has gradually expanded, and he emphasized the need for constant

questioning of his assumptions, even in words and concepts that he

thinks he has mastered. He emphasized the importance of a strong and

systematic base, and also emphasized the importance of not rigidly

adhering to ideas and being open to different interpretations. He

indicated that he noticed the need to continually refine his notions

about a variety of terms, especially as his work expands into new

areas such as Japanese acupuncture where the terms may have different

connotations.

 

Marnae Ergil followed with an extremely informative presentation on

translation styles and the impact of terminology on the educational

level of future practitioners. In my personal opinion, Marnae offered

perhaps the most moving and resource-rich presentation of the morning

panel. She emphasized the effect of different translation styles in

terms of their impact on concept detail and accuracy, and drew

attention to the crucial issue of identifying who our target audience

is and what needs are required for this community. She drew attention

to the fact that our core textbooks cannot be written as simplified

materials oriented towards a lay audience with average adult literacy;

rather we must recognize that the target audience of these texts is a

specialist audience that has a clinical need to rely on professional,

advanced materials as the basis for the responsible practice of

medicine. In a detailed and insightful manner, Marnae pointed out a

variety of ways in which the clinical potential of the field is

limited by texts that use excessive simplification, biomedicalization,

and other distortions of Chinese medical concepts. She also pointed

out that many students in the field are quite capable of rising up to

higher standards of clinical reasoning if they are given access to

material that is taught at a level appropriate for aspiring medical

professionals.

 

Following Marnae Ergil was Bob Felt, the publisher of Paradigm

Publications and arguably one of the main people responsible for

initiating the discussion of terminology in the Western community. By

publishing the Practical Dictionary of and other key

works by Nigel Wiseman, the range of literature produced by Bob Felt

is truly the reason that the Western field has matured to the point of

having nomenclature debates in the first place. The impact of Nigel

Wiseman's foundational work was underscored by the first slide in

Bob's presentation, which contained an image of an empty chair. The

empty chair represented the absence of Nigel at the AAOM meeting,

despite the fact that the entire discussion of terminology in the West

was largely initiated by his creation of a standardized English

terminology for use as a basis for discussion and as source of

reference for translators. In addition to introducing the Western

world to the importance of terminological accuracy, the work of Nigel

Wiseman and his colleague Feng Ye has provided the only comprehensive

tool available to native English speakers who wish to learn advanced

Chinese medical Chinese; this is arguably one of the greatest

contributions to the field ever made by a single group of individuals.

Indeed, the focus of praise or criticism underlying nearly all the

papers and presentations of the other panelists primarily revolved

around their work, so the empty chair depicted in Bob Felt's

Powerpoint served as a reminder that the AAOM's meeting on terminology

was missing the foremost Western expert on the subject, in fact, the

very man whose work helped propel the profession to its current level

of academic maturity such that the debate could even take place to

begin with.

 

Bob Felt reinforced the notion that standards are in no way limiting

to the field, and emphasized his view that the field should embrace an

open standard that is unrestrictive and freely available. One of the

most common misperceptions of the issue of standard terminology is

that such standards would imply mandatory use of certain terms or

limit writers' expression in some way. Quite to the contrary, term

standards offer tremendous freedom for deviation by individual writers

and in no way are intended to reduce the accuracy or flexibility of

translations; rather, there are extensive guidelines already in place

to allow deviations for the specific preferences of writers or for the

specific nuances of terms in different historical periods. Such

deviations are a natural part of an accountable translation system.

In such a way, all users can have the benefit of a systematic and

accurate approach like Wiseman's, without having to use any words that

some perceive as overly meticulous or uncommon (most people who

dislike Wiseman's work actually just dislike some of the individual

terms chosen, not the overall methodology and approach).

 

After addressing widespread misconceptions about term standards (such

as an irrational fear of their mandatory imposition), Bob brought our

attention to some of the most important but least discussed factors

limiting progress in terminology across the profession- money and

power. As a bookseller, Bob recognizes that the primary sector of the

CM book market is the textbook market for the examinations. Because

all students must pass their exams and all colleges base their

curriculum around the exams, the terminology used in the exams

actually creates the de facto standard of term use. Thus, the central

textbooks that are required by the exams essentially create the term

standards. Within this is a powerful financial incentive to resist

changes in terminology, owing to the largely consolidated power held

by the parties that benefit financially from the current status quo.

Thus, Bob's recommendation was that for terminology to progress and

impact the field in any meaningful way, the issue of terminology must

be addressed by the exam committees. Publication of approved and

correlated terminology lists by the exam committees would allow the

exams to be opened up to increased market competition. Currently, all

the influence is held by a few key players in the market that may

stand to benefit financially by the exclusion of other terminologies,

thereby controlling the primary sector of profit in the textbook

industry and limiting the field's ability to progress and incorporate

the higher educational standards that could be achieved by increased

differentiation of clinically important concepts in Chinese medicine.

 

Following up on Bob Felt's presentation was a presentation by Bob

Flaws. Bob (Flaws) articulated a number of important points, notably

the need for increased numbers of Western translators to develop the

range of English literature available. His presentation called

attention to the fact that many schools do not adequately emphasize

the importance of language, and too few students elect to pursue

Chinese medical Chinese. These factors limit the range of new

knowledge that enters the field and ultimately puts a ceiling on our

development as a profession. He emphasized the need for transmitting

technically accurate concepts in Chinese medicine for the simple point

that it makes the educational process more clear and enhances the

clinical potential of practitioners. A common theme with several of

the morning presenters, including Bob Flaws, was the notion that

higher standards of terminology is not a peripheral academic concern

but rather is a fundamental clinical issue.

 

The next presenter was Dan Bensky. Dan appears to place less

importance on establishing standard forms of expression and rather

emphasizes a wider variety of expression based on context. He rather

humbly pointed out that the more experience he has, the more he

realizes that the exact static meaning of a particular concept is

sometimes difficult to pin down. I agree with him on some level,

because the more I learn, the more I realize how little I know.

Chinese medicine and language is humbling and some lines are nebulous

in meaning. What I gathered overall from Dan and later Craig Mitchell

was that they tend to promote the idea that diversity in the English

expression of Chinese medicine helps to flesh out concepts and

provides more interpretations than a single term standard could.

 

The podium then came to Jake Fratkin. In my opinion, Jake's

presentation unfortunately represented a dramatic departure from the

well-researched presentations of the other panelists. His

presentation was riddled with errors that strongly suggested a lack of

basic competence on the topic, and while I do not wish to offer an

extended criticism, I suppose that I am somewhat obliged to justify my

rather harsh review of his presentation by providing details.

However, since I was overwhelmingly impressed with the meeting as a

whole, I do not wish to interrupt the flow of my informal conference

review to pick apart the details of his presentation. Therefore, I

have added on a few comments about Mr. Fratkin's presentation at the

end of my review of the conference. Interested readers can then

continue, while those not wishing to be bothered by a detail-oriented

critique can skip it. Suffice to say that Jake and I have one thing

in common and one great difference of opinion: our common ground is

that we both have a variety of individual terms in PD terminology that

we don't like to use, despite our overall appreciation of the

structure and scope of the PD; our difference is that we seem to have

dramatically different standards in terms of what constitutes an

acceptably well-researched position paper for a professional

conference and have dramatically different opinions on what

constitutes expertise in the subject of Chinese medical Chinese.

 

While I may be mixing up the order, I think that Jake was followed by

Xiao Tian Shen, a Chinese medical practitioner and teacher in the US.

Originally from Sichuan, he struck me as a remarkably intelligent man

with a deep understanding of Chinese medicine. His spoken English was

absolutely beautiful, and he offered a number of valuable insights on

the importance of technology and the challenge of finding perfect

correlative concepts when translating between Chinese and English. I

particularly liked his example of the conceptual differences between

the words for " box " in Chinese and English; in Chinese, the word can

only be used for a three-dimensional container, whereas in English it

can be either a container or a two-dimensional box that you put a mark

in on a piece of paper. He touched upon the fact that language

evolves naturally, and noted that phrases deeply imbedded in popular

use tend to become standard forms of expression despite the existence

of a standard word that is actually more accurate or official. In the

Chinese language, this can be seen with the words for many computer

products, including computers themselves, which have official Chinese

names that are actually less commonly used in colloquial speech than

other popular terms or abbreviations. Implied in his speech was the

need to recognize terms in popular use that, while perhaps less

precise than an official term, have attained a distinct identity

within the community and deserve to be placed on correlative term

lists (unless they represent frank errors, I presume).

 

If I haven't completely botched the order of panelists by this point,

I believe that the podium next came to . Z'ev is the

chair of PCOM's herbal medicine department and is one of the few

practitioners and educators in the field of Chinese medicine who has

been going strong for over 25 years. Because he has seen so many

students and has watched the CM knowledge base of Westerners evolve

over time, Z'ev has a number of insights that are extremely valuable.

Z'ev has instilled in many generations of students a love of endless

study; in particular, he values language study greatly and has clearly

noticed that Chinese language acquisition has helped his students to

access tremendous knowledge beyond the limitations of the English

literature. As an educator, he has also witnessed a dramatic change

in the quality of student knowledge over the past 25 years. He

believes that one of the greatest factors in improved student

comprehension of clinical concepts was the release of the Practical

Dictionary of , which has become an indispensable text

in his classes. Truly the increased emphasis on investigating

concepts and the increased range of reliable translations has

transformed the potential of the field.

 

Dr. Ding, a representative of the NCCAOM, was the next panelist. She

had a great presentation and attitude, and her words revealed that the

NCCAOM is truly responsive to the needs of the profession. In

speaking with both her and Bryn Clarke of the NCCAOM, I was struck by

the fact that the NCCAOM truly cares about the profession and is

dedicated to continually advancing their exam system so that it best

serves the community. With regard to terminology, it appears that the

NCCAOM is highly responsive to the recommendations of expert panels

such as the one assembled by the AAOM, and they appear quite willing

to adopt improved standards in terminology according to such

recommendations. In this way, the NCCAOM has shown that they are a

neutral, unbiased organization that simply seeks to stay at the

forefront of developments in the community. Commendable.

 

Next up was Craig Mitchell. As the dean and a language instructor at

SIOM, Craig has a unique position of being an educator in the only

school that mandates study of Chinese language. Craig emphasized that

students who are exposed to Chinese language throughout their study

have an advantage conceptually, clinically, and academically, with

wider access to source materials and less dependence on English

expression for their ideas of CM. He took the angle that a diverse

number of renderings for given terms expands the students' concept of

the meaning of the word more than a single standard achieves, and

emphasized that learning to cope with a certain amount of chaos was

beneficial for these students because it rounded out their impressions

of English connotations, while their Chinese knowledge allowed them to

maintain a link to the Chinese source concept itself. In this way,

the English terminology becomes a moot point because the default

concept is studied in Chinese and is not dependent on the English

correspondence. Someone asked whether this same " chaos " is as

beneficial for monolingual students at large schools who lack the

basis of Chinese to fall back upon, an interesting question that was

rather politely deflected. Regardless of whether the SIOM students'

experience is applicable to the wider student body, it is apparent

that the approach that is taken at SIOM is a step above and is a boon

to the profession. Craig pointed out one of the best single lines of

the conference: " Imagine what would happen to the profession if all

students graduated with the ability to approach Chinese literature. "

Indeed, if more than one small school produced bilingual graduates,

the entire profession would rapidly transform by the influx of new

knowledge that would be available.

 

Overall, I was very impressed with the quality of the presentations

and I am deeply grateful that the AAOM has allowed this dialogue to

move forward. To show my support for the AAOM's endeavors in

addressing this valuable issue, I have two contributions: 1) I will be

joining the AAOM so that I can contribute financially to their efforts

(and I will encourage my colleagues to join), and 2) I am attaching a

sample of first draft charts that compare the prominent English

terminologies in use. By assessing the three main term bases

available in English (by Wiseman and Feng, Xie Zhu-Fan, and Eastland

Press), I have assembled a variety of files. One file matches all the

known matches between Xie's terms and Wiseman & Feng's terms (this

file also highlights matching terms that can be found in the Eastland

list). One file matches all the known matches between Wiseman & Feng

and Eastland only (i.e., terms not matched to Xie's list). One file

matches correspondence terms found in all three lists. Finally, one

file illustrates the number of terms found only in Wiseman's list

(terms not matched in the other lists); this file is an astounding 750

pages.

 

Because the lists were matched by computer, there are a number of

known errors. Certain terms may not have been matched due to

formatting issues, and there are around 300 Eastland terms missing

because matches were not found in the general database for them. Some

of the matches (particularly comparing the PD and EP) are incomplete

from the PD side, due to a limitation in the computer processing that

caused only one PD definition to appear for a given term. In other

words, these comparative lists represent only the first draft effort

of a unified term bank, and the list will require numerous minor

corrections and additions. While imperfect in many ways, these term

lists may be the greatest digital comparison available in the English

world, and are thus a valuable building block for future developments

and discussions.

 

Personally, I think that the AAOM should appoint a panel of experts

(largely consisting of the experts present at the recent meeting, with

perhaps the inclusion of Wiseman himself) to provide peer review and

be responsible for the maintenance of a unified term database.

Database files could be maintained by the group, and members of the

general community (particularly experts in particular terms or

historical periods) could make various suggestions on terms inside an

additional field for feedback. Feedback and reasons for particular

term selections could be maintained in the database, and the panel of

experts could review new terms and suggestions for inclusion. Yearly

meetings could refine the database, fill in its gaps, and make

informed additions and modifications as required. The evolution of

terminology is a natural process that cannot be dictated by a given

committee, but the committee could support an open system that allows

the English terminology to develop naturally with rigor, peer review,

and diverse input.

 

Thus concludes my review of the conference. I would like to thank and

congratulate all those who made it possible. Keep up the good work!!!!!

 

The comparative term files have been uploaded to the " files " section

of CHA.

 

Eric Brand

 

 

 

Note:

 

I realize that I was a bit direct with my criticism of Mr. Fratkin in

the paragraphs above, and I want to elucidate the reasons for my

criticism since it is simply a professional criticism and not a

personal attack in any way. However, I found Mr. Fratkin's

presentation to be quite unprofessional and it is worth addressing.

If you don't care about such details, stop reading now.

 

After making preliminary comments praising the translations coming out

of mainland China, Jake emphasized that the English literature already

available is more than enough for the clinical needs of the Western

community. Having personally worked on translations in China, I am

familiar with the methodology commonly used for many of the PRC

publications, and I must respectfully disagree with Jake's assessment

of the Chinese publications. Many English texts translated in the PRC

are done by grad students or volunteers with minimal knowledge of

translation theory or methodology, and the term lists used often have

little basis in the nomenclature actually used in Western countries.

Most of the translators have never traveled abroad and nearly all of

them have never even heard Chinese medicine discussed in English.

Word-by-word translation is done based on dubiously-composed term

lists, and the copy editing is frequently done either by local

Westerners with little to no knowledge of Chinese medicine, or is

farmed out to India by larger companies with more advanced

infrastructures for cost control. Frequently, unreasonable deadlines

and mismanaged committee decisions propel the books to print before

any truly qualified Western reviewers can evaluate the text for its

accuracy or methodological integrity. While the situation is

improving as the Chinese begin to recognize the importance of working

in teams with qualified Westerners (and also start to implement more

widely-used term standards), many of the smaller publishers are still

not putting out the quality of material that the field needs. But

this side note has nothing to do with my disappointment in Mr.

Fratkin's presentation.

 

Jake was a vocal critic of a number of Wiseman's term choices, and

offered a number of examples of terms that he found particularly

offensive. I also have preferences that occasionally differ from

Wiseman's, and a good healthy critique is a very useful basis for

dialogue. However, Jake's critique was hard to take seriously because

he had dozens upon dozens of mistakes; he ascribed so many terms to

Wiseman that Wiseman never uses that the critique appeared sloppy, as

though the critique was made without actually reviewing the topic of

criticism. Personally, I doubt that he was deliberately

misrepresenting Mr. Wiseman's term choices in an effort to malign his

terminology; rather, I think that Jake simply prepared a

well-intentioned but stunningly poorly researched piece of work.

Despite having months to prepare and a supposed 20 years worth of

experience translating Chinese medical works, he assembled a list of

exemplary terms that was filled with errors so pervasive that I am

amazed he presented it in public. After making an effort to identify

155 terms to exemplify the differences between his translations

(informed by 20 years of " clinical experience " ) and those of Mr.

Wiseman, he managed to make gross errors on over 60 of the terms that

he isolated; in other words, misrepresentations or basic language

mistakes accounted for well over a third of the document. Despite the

widespread free publication of Wiseman's entire term set, Jake not

only failed to accurately transcribe dozens of examples of Wiseman's

terminology, he also managed to make countless blunders that

illustrated a profound lack of understanding of Chinese language and

terminology. He listed numerous " terms " that could not be found in

China's largest Chinese medical Chinese dictionaries (which contain

over 30,000 technical terms), as well as many extremely basic phrases

that contain such fundamental errors that the reader can only conclude

that the document was prepared by someone lacking in anything beyond

an extremely rudimentary knowledge of the Chinese language. The very

selection of terms was characteristic of a list selected by someone

with minimal knowledge of Chinese medical Chinese, as the selection

appeared to be a hodge-podge lacking in any fundamental structure or

basic utility, with randomly interspersed biomedical terms that are

completely irrelevant to the discussion of Chinese medical terminology.

 

One would think that his hand-picked 12 " most egregious Wiseman terms "

found in the main paper and presentation would at least represent some

valid criticisms and room for improvement, but out of these 12

carefully selected terms, 5 very obvious errors (covering both

erroneous attribution to Wiseman and mistakes in the fundamental

Chinese source terms) made a mockery out of the critique. For

example, in the 12 hand-picked examples, we find the phrase qian xu

huo ascribed to Wiseman as " subdues frenetic vacuity fire. " To begin

with, the phrase qian xu huo is not a standard term in widespread use

in the literature; it cannot be found in a Chinese medical dictionary

with over 30,000 terms. Furthermore, the word Wiseman translates as

" frenetic " is absent in the phrase, so even if the phrase existed,

Wiseman would theoretically translate it " subdues vacuity fire, " not

" subdues frenetic vacuity fire. " Given the fact that Nigel has a

widely available free term list with 30,000 of his term choices, and

Chinese sources have their own lists of over 30,000 terms, there

should be little reason to pull misrepresented theoretical examples

out of thin air for the sake of argument. Also on the short list of

12 terms was the attribution of sheng jin to Nigel as " engenders

humors, " whereas Jake's translation was " engenders fluids. " However,

Nigel translates ye (the thick fluid) as " humor, " jin (the thin fluid)

as " liquid, " and the combination jin ye as " fluids. " This type of

misrepresentation shows a remarkably superficial investigation of

Nigel's term set. Also on the same 12 term list, Fratkin lists the

phrase yin xu huo wang dong; anyone with even a basic knowledge of

Chinese medical Chinese will recognize that the 5 character phrase is

non-standard (and is not found in CM dictionaries). The basic phrase

is just the first four characters (which Fratkin again manages to

bungle with a misrepresentation of Nigel's translation). These

errors, along with the inclusion of Western medical terms in the term

list (such as jiang suan), makes one truly question whether Fratkin

actually has the ability to read Chinese literature in the first

place. His repeated misattributions to Wiseman over very basic terms

like luo (Wiseman=network vessels), which Fratkin attributes to

Wiseman as " connections, " makes one wonder if Fratkin even spends much

time reading the English literature. I mean, sure, we all have seen

" network vessels " and " collaterals, " but has anyone ever seen any

writer use the word " connections " for those channels?

 

As if the outright misrepresentation and astounding abundance of

mistakes was not enough, Mr. Fratkin claimed that his translations

represented clinically important improvements on Wiseman's terms

gained through Mr. Fratkin's 20 years of clinical experience. Such

" clinical " translations include recommending changing Wiseman's

translation of jin from " sinew " to " tendon. " Despite the fact that

Mr. Fratkin has studied Chinese medicine since before I was in

preschool, I had identified this mistranslation as a clinical issue

before I even graduated from my basic education at PCOM. I originally

encountered this difference in conceptual anatomy while working as an

apprentice at a Chinese herbal pharmacy; the old Chinese boss was

teaching me tuina techniques and he described the jin as essentially

ropy tissues, the part that can be " plucked, " including things that

are clearly muscle bellies in Western anatomy, such as the upper

trapezius and SCM muscles. Later, I pursued the definition of jin

with Nigel Wiseman and at the terminology meetings with Wang Kui of

the WFCMS, along with a variety of doctors in top academic positions

in both Taiwan and China. Unanimously, the experts and Chinese

medical dictionaries agree that jin is a concept that is clinically

distinct from tendons (it overlaps with ligaments, tendons, and

fascia, as well as certain muscle bellies such as the SCM).

Therefore, I do not understand why Mr. Fratkin is trying to

demonstrate the " clinical " superiority of the word " tendon " when it

obscures the fundamental nature of the category of tissue related to

the liver. This is an issue in Chinese medicine with vast clinical

implications, and it is precisely this type of distortion of concepts

that standards in Chinese medical terminology seek to eliminate. The

exact problem that plagues our field is people walking around with 20

years of misconceptions that are promulgated until they become

accepted as fact.

 

Another " clinical " criticism of the PD terminology offered by Mr.

Fratkin is the suggestion to change the word " panting " for the Chinese

word chuan. Mr. Fratkin suggests the word " wheezing " instead, but the

list of terms is so haphazard that it offers no suggestion for the

chuan's commonly-paired word xiao; which is translated by Wiseman as

" wheezing. " In fact, it is xiao, not chuan that is associated with

sound. It is one thing to dislike Wiseman's term choices out of

colloquial preferences, but to suggest that alternatives such as these

represent more " clinically useful " or accurate translations is an

altogether different matter. So Jake and I have our differences in

terms of what we think the profession needs, I suppose…

 

Eric

[Guest guest]

Great post Eric, Thanks for filling us in. It was a

very interesting read.

Gariel Fuentes

--- Eric Brand <smilinglotus wrote:

 

> AAOM notes

>

> The AAOM must be commended for bringing our

> community together to

> address the issue of Chinese medical terminology.

> As medical

> information worldwide is increasingly moving towards

> a digital age,

> standards of expression in East Asian medicine are

> being addressed by

> a variety of organizations, including the World

> Health Organization

> (WHO), the World Federation of

> Societies (WFCMS), and

> China's State Administration of Traditional Chinese

> Medicine (SATCM).

> As the first US-based organization to address this

> issue, the AAOM

> has done a great service to the profession by

> stimulating discussion

> on this important topic. By bringing together the

> advice of American

> experts in the field, the AAOM is spearheading the

> task of identifying

> trends in English terminology use in the United

> States. Identifying

> these trends allows the AAOM to offer vital

> representation for the

> profession to larger organizations such as the WHO,

> which seeks to

> establish international standards in Chinese medical

> terminology.

>

> This letter is essentially a review of my personal

> impressions of the

> meeting as a member of the audience. While it is

> impossible for me to

> encapsulate the depth of the presenters' speeches in

> a few brief

> sentences, I hope that my take-home impressions may

> offer a general

> overview of the meeting for those who were unable to

> attend.

>

> Before I begin, I would like to briefly introduce

> myself so that my

> comments may be assessed in accordance with my

> experiences and

> personal limitations. My observations of the

> meeting are nothing

> other than personal observations, and I hope that

> they convey an

> accurate representation of the views of the various

> presenters. I

> flew in from Taiwan 2 days before the conference and

> drove through the

> night from LA in order to attend; I apologize if my

> memory is a bit

> imperfect on any issues, it is due to travel fatigue

> and not ill intent.

>

> I am a graduate of the Pacific College of Oriental

> Medicine, with a

> prior background in undergraduate study of Chinese

> language, history,

> and cultural studies. I have lived for the past

> three years in

> Taiwan, where I have studied Chinese medical

> translation with Nigel

> Wiseman and Feng Ye while completing an extended

> clinical internship

> in the Chinese medicine department of Chang Gung

> Memorial Hospital.

> With regards to translation and terminology, my

> experience is

> primarily centered upon my work experience as a

> translator and editor

> for the US-based Paradigm Publications and the

> Beijing-based People's

> Medical Publishing House (PMPH, Renmin Weisheng

> Chubanshe). During my

> stay in Beijing, I assisted PMPH with training and

> recruitment of

> translators and was frequently involved in

> discussions with local

> experts and staff about translation styles and the

> English terminology

> of Chinese medicine. In Beijing, I attended the

> foundational

> terminology meeting of the World Federation of

>

> Societies (WFCMS), in which foremost experts from

> the PRC and foreign

> experts such as Nigel Wiseman and Paul Unschuld

> discussed issues of

> terminology. While I am a member of the WFCMS'

> terminology committee,

> it is a largely honorific position that is of less

> practical

> importance than my daily experience with translation

> and editing of

> Chinese medical texts. Having studied Chinese for

> only ten years, I

> lack the depth of experience of the field's leaders,

> but I am

> nevertheless reasonably well-informed about a wide

> range of issues

> relating to translation theory and term choices.

>

> Any review of the conference should naturally begin

> with my sincere

> gratitude towards Miki Shima and Will Morris, the

> people who made this

> timely discussion on nomenclature a reality. In my

> opinion, Will

> Morris, the president of the AAOM, has truly

> demonstrated his

> commitment to the profession by initiating one of

> the most important

> efforts towards the advancement of the field ever

> undertaken by a

> professional CM organization. I left the meeting

> vowing to join the

> AAOM as soon as I move back to the USA, and I

> certainly now perceive

> the AAOM to be at the forefront of all our

> professional organizations

> as a result of their efforts.

>

> As a key organizer in the event, Miki Shima selected

> a balanced group

> of professionals with diverse perspectives to

> facilitate debate,

> discussion, and unity within the field. I left with

> a strong

> impression that Miki is very dedicated to resolving

> differences

> between different members of the field and is keen

> to create a unified

> and open system of terminology that will allow for

> enhanced

> correlation of concepts throughout the English

> literature. He seems

> to greatly value pluralism, which is seen by his

> desire to create an

> integrated and inclusive database of existing

> terminology.

>

> Following an introduction by Will Morris and Miki

> Shima, Jeannie Kang

> took the podium to offer the group a brief report on

> her interactions

> with the WHO and their meetings in Seoul regarding

> standardized

> English terminology. Her presentation was eloquent

> and she struck me

> as an extremely intelligent individual. She seems

> to be an ideal

> representative for our community within a large

> organization like the

> WHO, which must constantly balance multiple agendas

> across many member

> states and medical styles. According to Ms. Kang,

> the WHO is already

> planning to incorporate Chinese diagnostic codes

> into its

> international classification of disease codes. Her

> report was a

> reminder that term standardization is an important

> and widely

> recognized issue internationally, and the increasing

> reliance on

> technology makes professional standards in

> terminology essential in an

> age of paperless hospitals and searchable databases

> of medical studies.

>

> Although the topics of Miki Shima and Jeannie Kang

> were not oriented

> towards terminological issues related to their

> native Japanese or

> Korean medical traditions, their insightful

> presentations left me

> thinking about how crucially the Western field needs

> more input from

> the Japanese and Korean communities, especially in

> terms of

> terminology and the enhanced transmission of

> information that comes

> with it. While my personal experience with East

> Asian medicine is

> nearly entirely based on my interactions within the

> Chinese world, I

> have a strong opinion that increased insight from

> our Japanese and

> Korean colleagues is a much-needed element in our

> profession's growth.

> Indeed, I feel that one of the areas most deeply

> lacking in the

> discussions on terminology in the US is adequate

> representation from

>

=== message truncated ===

 

 

 

 

______________________________\

____

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[Guest guest]

Eric,

 

Thanks for taking the time to compile this very thoughtful report. I

think it is well balanced and accurate based on my own experience at

this meeting.

 

Bob

 

, " Eric Brand "

<smilinglotus wrote:

>

> AAOM notes

>

> The AAOM must be commended for bringing our community together to

> address the issue of Chinese medical terminology. As medical

> information worldwide is increasingly moving towards a digital age,

> standards of expression in East Asian medicine are being addressed by

> a variety of organizations, including the World Health Organization

> (WHO), the World Federation of Societies (WFCMS), and

> China's State Administration of Traditional (SATCM).

> As the first US-based organization to address this issue, the AAOM

> has done a great service to the profession by stimulating discussion

> on this important topic. By bringing together the advice of American

> experts in the field, the AAOM is spearheading the task of identifying

> trends in English terminology use in the United States. Identifying

> these trends allows the AAOM to offer vital representation for the

> profession to larger organizations such as the WHO, which seeks to

> establish international standards in Chinese medical terminology.

>

> This letter is essentially a review of my personal impressions of the

> meeting as a member of the audience. While it is impossible for me to

> encapsulate the depth of the presenters' speeches in a few brief

> sentences, I hope that my take-home impressions may offer a general

> overview of the meeting for those who were unable to attend.

>

> Before I begin, I would like to briefly introduce myself so that my

> comments may be assessed in accordance with my experiences and

> personal limitations. My observations of the meeting are nothing

> other than personal observations, and I hope that they convey an

> accurate representation of the views of the various presenters. I

> flew in from Taiwan 2 days before the conference and drove through the

> night from LA in order to attend; I apologize if my memory is a bit

> imperfect on any issues, it is due to travel fatigue and not ill intent.

>

> I am a graduate of the Pacific College of Oriental Medicine, with a

> prior background in undergraduate study of Chinese language, history,

> and cultural studies. I have lived for the past three years in

> Taiwan, where I have studied Chinese medical translation with Nigel

> Wiseman and Feng Ye while completing an extended clinical internship

> in the Chinese medicine department of Chang Gung Memorial Hospital.

> With regards to translation and terminology, my experience is

> primarily centered upon my work experience as a translator and editor

> for the US-based Paradigm Publications and the Beijing-based People's

> Medical Publishing House (PMPH, Renmin Weisheng Chubanshe). During my

> stay in Beijing, I assisted PMPH with training and recruitment of

> translators and was frequently involved in discussions with local

> experts and staff about translation styles and the English terminology

> of Chinese medicine. In Beijing, I attended the foundational

> terminology meeting of the World Federation of

> Societies (WFCMS), in which foremost experts from the PRC and foreign

> experts such as Nigel Wiseman and Paul Unschuld discussed issues of

> terminology. While I am a member of the WFCMS' terminology committee,

> it is a largely honorific position that is of less practical

> importance than my daily experience with translation and editing of

> Chinese medical texts. Having studied Chinese for only ten years, I

> lack the depth of experience of the field's leaders, but I am

> nevertheless reasonably well-informed about a wide range of issues

> relating to translation theory and term choices.

>

> Any review of the conference should naturally begin with my sincere

> gratitude towards Miki Shima and Will Morris, the people who made this

> timely discussion on nomenclature a reality. In my opinion, Will

> Morris, the president of the AAOM, has truly demonstrated his

> commitment to the profession by initiating one of the most important

> efforts towards the advancement of the field ever undertaken by a

> professional CM organization. I left the meeting vowing to join the

> AAOM as soon as I move back to the USA, and I certainly now perceive

> the AAOM to be at the forefront of all our professional organizations

> as a result of their efforts.

>

> As a key organizer in the event, Miki Shima selected a balanced group

> of professionals with diverse perspectives to facilitate debate,

> discussion, and unity within the field. I left with a strong

> impression that Miki is very dedicated to resolving differences

> between different members of the field and is keen to create a unified

> and open system of terminology that will allow for enhanced

> correlation of concepts throughout the English literature. He seems

> to greatly value pluralism, which is seen by his desire to create an

> integrated and inclusive database of existing terminology.

>

> Following an introduction by Will Morris and Miki Shima, Jeannie Kang

> took the podium to offer the group a brief report on her interactions

> with the WHO and their meetings in Seoul regarding standardized

> English terminology. Her presentation was eloquent and she struck me

> as an extremely intelligent individual. She seems to be an ideal

> representative for our community within a large organization like the

> WHO, which must constantly balance multiple agendas across many member

> states and medical styles. According to Ms. Kang, the WHO is already

> planning to incorporate Chinese diagnostic codes into its

> international classification of disease codes. Her report was a

> reminder that term standardization is an important and widely

> recognized issue internationally, and the increasing reliance on

> technology makes professional standards in terminology essential in an

> age of paperless hospitals and searchable databases of medical

studies.

>

> Although the topics of Miki Shima and Jeannie Kang were not oriented

> towards terminological issues related to their native Japanese or

> Korean medical traditions, their insightful presentations left me

> thinking about how crucially the Western field needs more input from

> the Japanese and Korean communities, especially in terms of

> terminology and the enhanced transmission of information that comes

> with it. While my personal experience with East Asian medicine is

> nearly entirely based on my interactions within the Chinese world, I

> have a strong opinion that increased insight from our Japanese and

> Korean colleagues is a much-needed element in our profession's growth.

> Indeed, I feel that one of the areas most deeply lacking in the

> discussions on terminology in the US is adequate representation from

> Korean and Japanese traditions; thus far very little material has been

> developed in English to illuminate the differences in terminology and

> other characteristics of Korean and Japanese styles of East Asian

> medicine. Miki and Chip Chace briefly touched upon some examples of

> different nuances of terms within the Japanese literature, and this

> type of material would be a fascinating area for further development.

>

> One interesting point that Ms. Kang touched upon in passing was that

> the WHO is particularly concerned with Evidence-Based Medicine (EBM).

> I was personally surprised that the issue of biomedical interface

> terms for EBM was hardly discussed at the AAOM meeting, whereas it was

> one of the most fundamental issues faced at the meetings of the WFCMS

> and the WHO. The differing needs of practitioners in an integrated or

> biomedical environment versus practitioners practicing more purely

> traditional medicine has a tremendous impact on the terminology

> chosen. In some circles, traditional medicine is regarded as less

> clinically important than integrated medicine, and

> biomedically-oriented term choices are typically favored in such

> communities. By contrast, individuals seeking terminology appropriate

> for classical texts or texts devoted purely to traditional medicine

> tend to favor term choices that reference the original source concept

> versus a possible biomedical correlate. In light of these different

> needs and different attitudes, some groups (such as the WFCMS) seek to

> establish biomedical interface terms for conditions that correspond

> closely with a given biomedical pathology, whereas a source-based

> translation may be chosen for traditional or historical works to

> preserve the original concept. An example of this can be seen in the

> following principle established at the WFCMS' terminology in Beijing

> in 2006:

>

> " If the Chinese term closely corresponds to a specific Western medical

> term, it is acceptable to use multiple terms, i.e.,

& #39118; & #28779; & #30524; wind-fire

> eye (acute conjunctivitis). However, it is preferable to keep terms

> to a minimum, with no more than two equivalents for a given Chinese

> term. While biomedical interface terms may be chosen to supplement

> traditional medical terms, the following points should be observed: a)

> If the concept is identical and no specialized knowledge or equipment

> is required for understanding the Chinese term, a single equivalent

> may be used (examples include dysentery, diarrhea, and malaria). b)

> If the concept is essentially the same but modern knowledge or

> equipment is required to understand the biomedical phrase, a

> biomedical interface term should be chosen for scientific works, while

> a term that preserves the original meaning of the Chinese concept

> should be used for historical or traditional works (ex. wind-fire eye

> vs. acute conjunctivitis). "

>

> Next was a well-balanced presentation by Chip Chace. Like Craig

> Mitchell (who presented later), Chip is a very qualified translator

> who has worked with both Dan Bensky and Nigel Wiseman. Thus, the

> experience of Chip and Craig offers a relatively balanced perspective

> and an interesting angle of insight. Chip emphasized that he

> initially developed a strong mastery of Chinese medical Chinese based

> upon the systematic approach developed by Wiseman. In later years, he

> has gradually expanded, and he emphasized the need for constant

> questioning of his assumptions, even in words and concepts that he

> thinks he has mastered. He emphasized the importance of a strong and

> systematic base, and also emphasized the importance of not rigidly

> adhering to ideas and being open to different interpretations. He

> indicated that he noticed the need to continually refine his notions

> about a variety of terms, especially as his work expands into new

> areas such as Japanese acupuncture where the terms may have different

> connotations.

>

> Marnae Ergil followed with an extremely informative presentation on

> translation styles and the impact of terminology on the educational

> level of future practitioners. In my personal opinion, Marnae offered

> perhaps the most moving and resource-rich presentation of the morning

> panel. She emphasized the effect of different translation styles in

> terms of their impact on concept detail and accuracy, and drew

> attention to the crucial issue of identifying who our target audience

> is and what needs are required for this community. She drew attention

> to the fact that our core textbooks cannot be written as simplified

> materials oriented towards a lay audience with average adult literacy;

> rather we must recognize that the target audience of these texts is a

> specialist audience that has a clinical need to rely on professional,

> advanced materials as the basis for the responsible practice of

> medicine. In a detailed and insightful manner, Marnae pointed out a

> variety of ways in which the clinical potential of the field is

> limited by texts that use excessive simplification, biomedicalization,

> and other distortions of Chinese medical concepts. She also pointed

> out that many students in the field are quite capable of rising up to

> higher standards of clinical reasoning if they are given access to

> material that is taught at a level appropriate for aspiring medical

> professionals.

>

> Following Marnae Ergil was Bob Felt, the publisher of Paradigm

> Publications and arguably one of the main people responsible for

> initiating the discussion of terminology in the Western community. By

> publishing the Practical Dictionary of and other key

> works by Nigel Wiseman, the range of literature produced by Bob Felt

> is truly the reason that the Western field has matured to the point of

> having nomenclature debates in the first place. The impact of Nigel

> Wiseman's foundational work was underscored by the first slide in

> Bob's presentation, which contained an image of an empty chair. The

> empty chair represented the absence of Nigel at the AAOM meeting,

> despite the fact that the entire discussion of terminology in the West

> was largely initiated by his creation of a standardized English

> terminology for use as a basis for discussion and as source of

> reference for translators. In addition to introducing the Western

> world to the importance of terminological accuracy, the work of Nigel

> Wiseman and his colleague Feng Ye has provided the only comprehensive

> tool available to native English speakers who wish to learn advanced

> Chinese medical Chinese; this is arguably one of the greatest

> contributions to the field ever made by a single group of individuals.

> Indeed, the focus of praise or criticism underlying nearly all the

> papers and presentations of the other panelists primarily revolved

> around their work, so the empty chair depicted in Bob Felt's

> Powerpoint served as a reminder that the AAOM's meeting on terminology

> was missing the foremost Western expert on the subject, in fact, the

> very man whose work helped propel the profession to its current level

> of academic maturity such that the debate could even take place to

> begin with.

>

> Bob Felt reinforced the notion that standards are in no way limiting

> to the field, and emphasized his view that the field should embrace an

> open standard that is unrestrictive and freely available. One of the

> most common misperceptions of the issue of standard terminology is

> that such standards would imply mandatory use of certain terms or

> limit writers' expression in some way. Quite to the contrary, term

> standards offer tremendous freedom for deviation by individual writers

> and in no way are intended to reduce the accuracy or flexibility of

> translations; rather, there are extensive guidelines already in place

> to allow deviations for the specific preferences of writers or for the

> specific nuances of terms in different historical periods. Such

> deviations are a natural part of an accountable translation system.

> In such a way, all users can have the benefit of a systematic and

> accurate approach like Wiseman's, without having to use any words that

> some perceive as overly meticulous or uncommon (most people who

> dislike Wiseman's work actually just dislike some of the individual

> terms chosen, not the overall methodology and approach).

>

> After addressing widespread misconceptions about term standards (such

> as an irrational fear of their mandatory imposition), Bob brought our

> attention to some of the most important but least discussed factors

> limiting progress in terminology across the profession- money and

> power. As a bookseller, Bob recognizes that the primary sector of the

> CM book market is the textbook market for the examinations. Because

> all students must pass their exams and all colleges base their

> curriculum around the exams, the terminology used in the exams

> actually creates the de facto standard of term use. Thus, the central

> textbooks that are required by the exams essentially create the term

> standards. Within this is a powerful financial incentive to resist

> changes in terminology, owing to the largely consolidated power held

> by the parties that benefit financially from the current status quo.

> Thus, Bob's recommendation was that for terminology to progress and

> impact the field in any meaningful way, the issue of terminology must

> be addressed by the exam committees. Publication of approved and

> correlated terminology lists by the exam committees would allow the

> exams to be opened up to increased market competition. Currently, all

> the influence is held by a few key players in the market that may

> stand to benefit financially by the exclusion of other terminologies,

> thereby controlling the primary sector of profit in the textbook

> industry and limiting the field's ability to progress and incorporate

> the higher educational standards that could be achieved by increased

> differentiation of clinically important concepts in Chinese medicine.

>

> Following up on Bob Felt's presentation was a presentation by Bob

> Flaws. Bob (Flaws) articulated a number of important points, notably

> the need for increased numbers of Western translators to develop the

> range of English literature available. His presentation called

> attention to the fact that many schools do not adequately emphasize

> the importance of language, and too few students elect to pursue

> Chinese medical Chinese. These factors limit the range of new

> knowledge that enters the field and ultimately puts a ceiling on our

> development as a profession. He emphasized the need for transmitting

> technically accurate concepts in Chinese medicine for the simple point

> that it makes the educational process more clear and enhances the

> clinical potential of practitioners. A common theme with several of

> the morning presenters, including Bob Flaws, was the notion that

> higher standards of terminology is not a peripheral academic concern

> but rather is a fundamental clinical issue.

>

> The next presenter was Dan Bensky. Dan appears to place less

> importance on establishing standard forms of expression and rather

> emphasizes a wider variety of expression based on context. He rather

> humbly pointed out that the more experience he has, the more he

> realizes that the exact static meaning of a particular concept is

> sometimes difficult to pin down. I agree with him on some level,

> because the more I learn, the more I realize how little I know.

> Chinese medicine and language is humbling and some lines are nebulous

> in meaning. What I gathered overall from Dan and later Craig Mitchell

> was that they tend to promote the idea that diversity in the English

> expression of Chinese medicine helps to flesh out concepts and

> provides more interpretations than a single term standard could.

>

> The podium then came to Jake Fratkin. In my opinion, Jake's

> presentation unfortunately represented a dramatic departure from the

> well-researched presentations of the other panelists. His

> presentation was riddled with errors that strongly suggested a lack of

> basic competence on the topic, and while I do not wish to offer an

> extended criticism, I suppose that I am somewhat obliged to justify my

> rather harsh review of his presentation by providing details.

> However, since I was overwhelmingly impressed with the meeting as a

> whole, I do not wish to interrupt the flow of my informal conference

> review to pick apart the details of his presentation. Therefore, I

> have added on a few comments about Mr. Fratkin's presentation at the

> end of my review of the conference. Interested readers can then

> continue, while those not wishing to be bothered by a detail-oriented

> critique can skip it. Suffice to say that Jake and I have one thing

> in common and one great difference of opinion: our common ground is

> that we both have a variety of individual terms in PD terminology that

> we don't like to use, despite our overall appreciation of the

> structure and scope of the PD; our difference is that we seem to have

> dramatically different standards in terms of what constitutes an

> acceptably well-researched position paper for a professional

> conference and have dramatically different opinions on what

> constitutes expertise in the subject of Chinese medical Chinese.

>

> While I may be mixing up the order, I think that Jake was followed by

> Xiao Tian Shen, a Chinese medical practitioner and teacher in the US.

> Originally from Sichuan, he struck me as a remarkably intelligent man

> with a deep understanding of Chinese medicine. His spoken English was

> absolutely beautiful, and he offered a number of valuable insights on

> the importance of technology and the challenge of finding perfect

> correlative concepts when translating between Chinese and English. I

> particularly liked his example of the conceptual differences between

> the words for " box " in Chinese and English; in Chinese, the word can

> only be used for a three-dimensional container, whereas in English it

> can be either a container or a two-dimensional box that you put a mark

> in on a piece of paper. He touched upon the fact that language

> evolves naturally, and noted that phrases deeply imbedded in popular

> use tend to become standard forms of expression despite the existence

> of a standard word that is actually more accurate or official. In the

> Chinese language, this can be seen with the words for many computer

> products, including computers themselves, which have official Chinese

> names that are actually less commonly used in colloquial speech than

> other popular terms or abbreviations. Implied in his speech was the

> need to recognize terms in popular use that, while perhaps less

> precise than an official term, have attained a distinct identity

> within the community and deserve to be placed on correlative term

> lists (unless they represent frank errors, I presume).

>

> If I haven't completely botched the order of panelists by this point,

> I believe that the podium next came to . Z'ev is the

> chair of PCOM's herbal medicine department and is one of the few

> practitioners and educators in the field of Chinese medicine who has

> been going strong for over 25 years. Because he has seen so many

> students and has watched the CM knowledge base of Westerners evolve

> over time, Z'ev has a number of insights that are extremely valuable.

> Z'ev has instilled in many generations of students a love of endless

> study; in particular, he values language study greatly and has clearly

> noticed that Chinese language acquisition has helped his students to

> access tremendous knowledge beyond the limitations of the English

> literature. As an educator, he has also witnessed a dramatic change

> in the quality of student knowledge over the past 25 years. He

> believes that one of the greatest factors in improved student

> comprehension of clinical concepts was the release of the Practical

> Dictionary of , which has become an indispensable text

> in his classes. Truly the increased emphasis on investigating

> concepts and the increased range of reliable translations has

> transformed the potential of the field.

>

> Dr. Ding, a representative of the NCCAOM, was the next panelist. She

> had a great presentation and attitude, and her words revealed that the

> NCCAOM is truly responsive to the needs of the profession. In

> speaking with both her and Bryn Clarke of the NCCAOM, I was struck by

> the fact that the NCCAOM truly cares about the profession and is

> dedicated to continually advancing their exam system so that it best

> serves the community. With regard to terminology, it appears that the

> NCCAOM is highly responsive to the recommendations of expert panels

> such as the one assembled by the AAOM, and they appear quite willing

> to adopt improved standards in terminology according to such

> recommendations. In this way, the NCCAOM has shown that they are a

> neutral, unbiased organization that simply seeks to stay at the

> forefront of developments in the community. Commendable.

>

> Next up was Craig Mitchell. As the dean and a language instructor at

> SIOM, Craig has a unique position of being an educator in the only

> school that mandates study of Chinese language. Craig emphasized that

> students who are exposed to Chinese language throughout their study

> have an advantage conceptually, clinically, and academically, with

> wider access to source materials and less dependence on English

> expression for their ideas of CM. He took the angle that a diverse

> number of renderings for given terms expands the students' concept of

> the meaning of the word more than a single standard achieves, and

> emphasized that learning to cope with a certain amount of chaos was

> beneficial for these students because it rounded out their impressions

> of English connotations, while their Chinese knowledge allowed them to

> maintain a link to the Chinese source concept itself. In this way,

> the English terminology becomes a moot point because the default

> concept is studied in Chinese and is not dependent on the English

> correspondence. Someone asked whether this same " chaos " is as

> beneficial for monolingual students at large schools who lack the

> basis of Chinese to fall back upon, an interesting question that was

> rather politely deflected. Regardless of whether the SIOM students'

> experience is applicable to the wider student body, it is apparent

> that the approach that is taken at SIOM is a step above and is a boon

> to the profession. Craig pointed out one of the best single lines of

> the conference: " Imagine what would happen to the profession if all

> students graduated with the ability to approach Chinese literature. "

> Indeed, if more than one small school produced bilingual graduates,

> the entire profession would rapidly transform by the influx of new

> knowledge that would be available.

>

> Overall, I was very impressed with the quality of the presentations

> and I am deeply grateful that the AAOM has allowed this dialogue to

> move forward. To show my support for the AAOM's endeavors in

> addressing this valuable issue, I have two contributions: 1) I will be

> joining the AAOM so that I can contribute financially to their efforts

> (and I will encourage my colleagues to join), and 2) I am attaching a

> sample of first draft charts that compare the prominent English

> terminologies in use. By assessing the three main term bases

> available in English (by Wiseman and Feng, Xie Zhu-Fan, and Eastland

> Press), I have assembled a variety of files. One file matches all the

> known matches between Xie's terms and Wiseman & Feng's terms (this

> file also highlights matching terms that can be found in the Eastland

> list). One file matches all the known matches between Wiseman & Feng

> and Eastland only (i.e., terms not matched to Xie's list). One file

> matches correspondence terms found in all three lists. Finally, one

> file illustrates the number of terms found only in Wiseman's list

> (terms not matched in the other lists); this file is an astounding 750

> pages.

>

> Because the lists were matched by computer, there are a number of

> known errors. Certain terms may not have been matched due to

> formatting issues, and there are around 300 Eastland terms missing

> because matches were not found in the general database for them. Some

> of the matches (particularly comparing the PD and EP) are incomplete

> from the PD side, due to a limitation in the computer processing that

> caused only one PD definition to appear for a given term. In other

> words, these comparative lists represent only the first draft effort

> of a unified term bank, and the list will require numerous minor

> corrections and additions. While imperfect in many ways, these term

> lists may be the greatest digital comparison available in the English

> world, and are thus a valuable building block for future developments

> and discussions.

>

> Personally, I think that the AAOM should appoint a panel of experts

> (largely consisting of the experts present at the recent meeting, with

> perhaps the inclusion of Wiseman himself) to provide peer review and

> be responsible for the maintenance of a unified term database.

> Database files could be maintained by the group, and members of the

> general community (particularly experts in particular terms or

> historical periods) could make various suggestions on terms inside an

> additional field for feedback. Feedback and reasons for particular

> term selections could be maintained in the database, and the panel of

> experts could review new terms and suggestions for inclusion. Yearly

> meetings could refine the database, fill in its gaps, and make

> informed additions and modifications as required. The evolution of

> terminology is a natural process that cannot be dictated by a given

> committee, but the committee could support an open system that allows

> the English terminology to develop naturally with rigor, peer review,

> and diverse input.

>

> Thus concludes my review of the conference. I would like to thank and

> congratulate all those who made it possible. Keep up the good work!!!!!

>

> The comparative term files have been uploaded to the " files " section

> of CHA.

>

> Eric Brand

>

>

>

> Note:

>

> I realize that I was a bit direct with my criticism of Mr. Fratkin in

> the paragraphs above, and I want to elucidate the reasons for my

> criticism since it is simply a professional criticism and not a

> personal attack in any way. However, I found Mr. Fratkin's

> presentation to be quite unprofessional and it is worth addressing.

> If you don't care about such details, stop reading now.

>

> After making preliminary comments praising the translations coming out

> of mainland China, Jake emphasized that the English literature already

> available is more than enough for the clinical needs of the Western

> community. Having personally worked on translations in China, I am

> familiar with the methodology commonly used for many of the PRC

> publications, and I must respectfully disagree with Jake's assessment

> of the Chinese publications. Many English texts translated in the PRC

> are done by grad students or volunteers with minimal knowledge of

> translation theory or methodology, and the term lists used often have

> little basis in the nomenclature actually used in Western countries.

> Most of the translators have never traveled abroad and nearly all of

> them have never even heard Chinese medicine discussed in English.

> Word-by-word translation is done based on dubiously-composed term

> lists, and the copy editing is frequently done either by local

> Westerners with little to no knowledge of Chinese medicine, or is

> farmed out to India by larger companies with more advanced

> infrastructures for cost control. Frequently, unreasonable deadlines

> and mismanaged committee decisions propel the books to print before

> any truly qualified Western reviewers can evaluate the text for its

> accuracy or methodological integrity. While the situation is

> improving as the Chinese begin to recognize the importance of working

> in teams with qualified Westerners (and also start to implement more

> widely-used term standards), many of the smaller publishers are still

> not putting out the quality of material that the field needs. But

> this side note has nothing to do with my disappointment in Mr.

> Fratkin's presentation.

>

> Jake was a vocal critic of a number of Wiseman's term choices, and

> offered a number of examples of terms that he found particularly

> offensive. I also have preferences that occasionally differ from

> Wiseman's, and a good healthy critique is a very useful basis for

> dialogue. However, Jake's critique was hard to take seriously because

> he had dozens upon dozens of mistakes; he ascribed so many terms to

> Wiseman that Wiseman never uses that the critique appeared sloppy, as

> though the critique was made without actually reviewing the topic of

> criticism. Personally, I doubt that he was deliberately

> misrepresenting Mr. Wiseman's term choices in an effort to malign his

> terminology; rather, I think that Jake simply prepared a

> well-intentioned but stunningly poorly researched piece of work.

> Despite having months to prepare and a supposed 20 years worth of

> experience translating Chinese medical works, he assembled a list of

> exemplary terms that was filled with errors so pervasive that I am

> amazed he presented it in public. After making an effort to identify

> 155 terms to exemplify the differences between his translations

> (informed by 20 years of " clinical experience " ) and those of Mr.

> Wiseman, he managed to make gross errors on over 60 of the terms that

> he isolated; in other words, misrepresentations or basic language

> mistakes accounted for well over a third of the document. Despite the

> widespread free publication of Wiseman's entire term set, Jake not

> only failed to accurately transcribe dozens of examples of Wiseman's

> terminology, he also managed to make countless blunders that

> illustrated a profound lack of understanding of Chinese language and

> terminology. He listed numerous " terms " that could not be found in

> China's largest Chinese medical Chinese dictionaries (which contain

> over 30,000 technical terms), as well as many extremely basic phrases

> that contain such fundamental errors that the reader can only conclude

> that the document was prepared by someone lacking in anything beyond

> an extremely rudimentary knowledge of the Chinese language. The very

> selection of terms was characteristic of a list selected by someone

> with minimal knowledge of Chinese medical Chinese, as the selection

> appeared to be a hodge-podge lacking in any fundamental structure or

> basic utility, with randomly interspersed biomedical terms that are

> completely irrelevant to the discussion of Chinese medical

terminology.

>

> One would think that his hand-picked 12 " most egregious Wiseman terms "

> found in the main paper and presentation would at least represent some

> valid criticisms and room for improvement, but out of these 12

> carefully selected terms, 5 very obvious errors (covering both

> erroneous attribution to Wiseman and mistakes in the fundamental

> Chinese source terms) made a mockery out of the critique. For

> example, in the 12 hand-picked examples, we find the phrase qian xu

> huo ascribed to Wiseman as " subdues frenetic vacuity fire. " To begin

> with, the phrase qian xu huo is not a standard term in widespread use

> in the literature; it cannot be found in a Chinese medical dictionary

> with over 30,000 terms. Furthermore, the word Wiseman translates as

> " frenetic " is absent in the phrase, so even if the phrase existed,

> Wiseman would theoretically translate it " subdues vacuity fire, " not

> " subdues frenetic vacuity fire. " Given the fact that Nigel has a

> widely available free term list with 30,000 of his term choices, and

> Chinese sources have their own lists of over 30,000 terms, there

> should be little reason to pull misrepresented theoretical examples

> out of thin air for the sake of argument. Also on the short list of

> 12 terms was the attribution of sheng jin to Nigel as " engenders

> humors, " whereas Jake's translation was " engenders fluids. " However,

> Nigel translates ye (the thick fluid) as " humor, " jin (the thin fluid)

> as " liquid, " and the combination jin ye as " fluids. " This type of

> misrepresentation shows a remarkably superficial investigation of

> Nigel's term set. Also on the same 12 term list, Fratkin lists the

> phrase yin xu huo wang dong; anyone with even a basic knowledge of

> Chinese medical Chinese will recognize that the 5 character phrase is

> non-standard (and is not found in CM dictionaries). The basic phrase

> is just the first four characters (which Fratkin again manages to

> bungle with a misrepresentation of Nigel's translation). These

> errors, along with the inclusion of Western medical terms in the term

> list (such as jiang suan), makes one truly question whether Fratkin

> actually has the ability to read Chinese literature in the first

> place. His repeated misattributions to Wiseman over very basic terms

> like luo (Wiseman=network vessels), which Fratkin attributes to

> Wiseman as " connections, " makes one wonder if Fratkin even spends much

> time reading the English literature. I mean, sure, we all have seen

> " network vessels " and " collaterals, " but has anyone ever seen any

> writer use the word " connections " for those channels?

>

> As if the outright misrepresentation and astounding abundance of

> mistakes was not enough, Mr. Fratkin claimed that his translations

> represented clinically important improvements on Wiseman's terms

> gained through Mr. Fratkin's 20 years of clinical experience. Such

> " clinical " translations include recommending changing Wiseman's

> translation of jin from " sinew " to " tendon. " Despite the fact that

> Mr. Fratkin has studied Chinese medicine since before I was in

> preschool, I had identified this mistranslation as a clinical issue

> before I even graduated from my basic education at PCOM. I originally

> encountered this difference in conceptual anatomy while working as an

> apprentice at a Chinese herbal pharmacy; the old Chinese boss was

> teaching me tuina techniques and he described the jin as essentially

> ropy tissues, the part that can be " plucked, " including things that

> are clearly muscle bellies in Western anatomy, such as the upper

> trapezius and SCM muscles. Later, I pursued the definition of jin

> with Nigel Wiseman and at the terminology meetings with Wang Kui of

> the WFCMS, along with a variety of doctors in top academic positions

> in both Taiwan and China. Unanimously, the experts and Chinese

> medical dictionaries agree that jin is a concept that is clinically

> distinct from tendons (it overlaps with ligaments, tendons, and

> fascia, as well as certain muscle bellies such as the SCM).

> Therefore, I do not understand why Mr. Fratkin is trying to

> demonstrate the " clinical " superiority of the word " tendon " when it

> obscures the fundamental nature of the category of tissue related to

> the liver. This is an issue in Chinese medicine with vast clinical

> implications, and it is precisely this type of distortion of concepts

> that standards in Chinese medical terminology seek to eliminate. The

> exact problem that plagues our field is people walking around with 20

> years of misconceptions that are promulgated until they become

> accepted as fact.

>

> Another " clinical " criticism of the PD terminology offered by Mr.

> Fratkin is the suggestion to change the word " panting " for the Chinese

> word chuan. Mr. Fratkin suggests the word " wheezing " instead, but the

> list of terms is so haphazard that it offers no suggestion for the

> chuan's commonly-paired word xiao; which is translated by Wiseman as

> " wheezing. " In fact, it is xiao, not chuan that is associated with

> sound. It is one thing to dislike Wiseman's term choices out of

> colloquial preferences, but to suggest that alternatives such as these

> represent more " clinically useful " or accurate translations is an

> altogether different matter. So Jake and I have our differences in

> terms of what we think the profession needs, I suppose…

>

> Eric

>

[Guest guest]

Being the representative of the AAOM to the WFCMS and an elected Vice

President there, I think it is safe to say that both organizations strongly

support

the advances we are making in terminology development. Since I am not presently

on the board of the AAOM, I cannot speak for them other than to say that I

think that Will Morris has shown foresight and an almost uncommon academic

common sense in providing the venue for this exchange, and hopefully, for

further

similar exchanges.

 

I know my US collegues in the WFCMS, Angela Tu and Xiao Ming Tian, were with

me in strongly supporting the WFCMS in working to help develop this exchange.

It was our thought that the development of a clear and common understanding of

nomenclature and the scientific interactions it may bring to our field of

medicine would similar to how Conventional Medicine has looked at developing a

more comprehensive knowledge of basic sciences, looking deeper into an

understanding of how their science worked. The availability of historical

archives as

well as rapid communication of modern research is an important step in the

development of Chinese/Oriental Medicine in the world, and to have a common

discussive and diagnostic language with everyone on the same page is considered

to

be of utmost importance to the entire WFCMS structure.

 

Thank you, Eric, for your clear reports on this topic and thank you Will, for

your inspirational foresight on developing this discussion, both in print and

at the conference.

 

David Molony

Vice Chair, WFCMS