On standardization of Chinese medical nomenclature
First, let me start by saying that I am not wholly familiar with the nomenclature debates. I have read the most recent articles, had discussions with a few professionals and thought about it for about 6 months. This by no means qualifies me as an expert on the subject! I wanted to report about my AAAOM conference experience, and Wiseman’s talk on Chinese medical translation was the first, and most interesting, talk I attended. I did not attend the debates on the prior day because I had midterms. I hope to further familiarize myself with the full breadth of the debate and as I learn more I will write more about it. I do most earnestly request that if you have an opinion or further information on this topic that you reply in the comments so we can have an open discussion. It’s too important an issue to ignore.
My first impression: Wiseman is composed, entirely rational and of impeccable intellectual achievement, also clearly passionate. The talk itself was frankly a bit of a marathon - four hours with no breaks. For an NCNM student used to my breaks every hour on the hour, it was a challenge. :D Kidding - but not really. I came to the talk with my mind completely open and ready to learn.
The bulk of the talk:
Wiseman started out by discussing the general way that transmission of knowledge and artifacts from one culture to another happens. It was an interesting preamble and the general point seemed to be that transmission happens most easily from a culture with high influence to cultures with less influence. He moved on to discuss the way that Western medicine was transmitted to China as a comparative model to analyze how Chinese medicine has been transmitted to the West. In general, I took a few things from this portion of the lecture. First, Western medicine was easily transmitted to China because the West had/has great cultural influence thus Chinese people tended to know Western languages and were generally open to Western ideas. Second, Chinese medicine transmission has suffered in the West because of the absence of these things. Third, and less overt in Wiseman’s actual words, Chinese medicine transmission to the Western world has been negatively impacted by the extremely high influence of Western concepts in the realm of medicine. In other words, when the medicine is transmitted, there is a greater tendency to put everything in explicitly Western CONCEPTS, not just Western LANGUAGE. Does that make sense?
He then moved on to the center of the lecture. In short, Wiseman believes that Chinese medical terminology should be standardized and that the standard terminology should be as literal as possible, with few exceptions. He seemed to be arguing largely against people who use biomedical translations for Chinese terms - for instance using “conjunctivitis” when translating the characters for “wind-fire-eye.” 风火目 (pardon if I don’t have those characters correct, I don’t have a text with that in it right in front of me). I am entirely behind the thrust of Wiseman’s argument on this point. Not only is it simply annoying when book authors do this, as opposed to providing a list of POSSIBLE correspondences, it’s also flatly irresponsible. Most of the biomedical approximations are just that, approximations, and often do not include important information that the Chinese term possesses.
In general, the lack of term standardization can be extremely confusing for people, particularly when Chinese characters are not available for a given concept. Wiseman pointed out several situations in which certain translations were not only merely confusing but actually misleading. I have to say that I am frankly confused by people’s resistance to standardization, particularly when that standardization is literal. If the standardization were clearly ideological (such as using all biomedical concepts) I could understand the resistance. Some have expressed concern that the standardization would prevent them from being able to express their unique understanding of a particular concept or text. However, the standardization would not mean that you couldn’t continue to explain to students or colleagues your understanding of a term, even when it differs from the standard. In fact, it would provide a convenient place to start that conversation.
My thoughts: I think the ideal situation is that everyone learns Chinese well, including Classical grammatical structures, before starting study or at least while they are learning the medicine. With this standard in place, the Chinese can be used and we avoid the problem of terminology at least for the educational environment. Whether we would still want to translate for the benefit of the general public and whether it would still be best to standardize in that situation is up for debate and largely unimportant.
But people aren’t going to learn Chinese, so this is simply impractical. Would it be fair to have this as a requirement for Chinese medical education in English speaking countries? I don’t know. I haven’t learned Chinese in the way I should have - but I’m working on it and I hope to have basic mastery within the next few years. Travel to China will certainly help me in this quest. I think regardless of its fairness or unfairness, it’s just not going to happen. Short of having people learn Chinese as a mandatory step in the Chinese medical educational process, a standard nomenclature seems best. It will help people communicate with one other and streamline the learning process for students. I’m looking forward to hearing your comments.
Eric
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Tags: Character, chinese-language, chinese-medicine, nigel-wiseman, nomenclature-debates, translation, translation-problemsRelated posts
If you’re not memorizing, you’re not paying attention
Note: I’m working on write-ups of the AAAOM conference in Portland. I’m writing something about Nigel Wiseman’s talk on Chinese medical translation and my general support for his ideas. I’m also writing about the national student organization meetings and my renewed optimism and excitement concerning the viability of our profession in the US. I’d also like to talk about a few new companies I had contact with and discuss issues around purity and quality of Chinese herbs.
I was just reading an article in the latest National Geographic magazine about memory. It is an interesting article as a whole, but more importantly it really got me thinking about the role of memorization in education. The article talks about the times before easily available printed material, when most everything had to be memorized if it was to be accessed at some future date. One sentence in particular really struck me - it’s actually a quote from the author of The Book of Memory: A Study of Memory in Medieval Culture 
“In a world of few books, and those mostly in communal libraries, one’s education had to be remembered, for one could never depend on having continuing access to specific material.” (Mary Carruthers, in National Geographic Magazine, November 2007)
It is my understanding that to this day, memorization of texts is still a valued (and even expected) component of Chinese medical education in China. All of my professors that learned the medicine mostly or entirely in China can recite maddening amounts of text verbatim from many classical texts. Additionally, they have memorized uncountable phrases, rhymes and poems used as mnemonic devices for various types of information. It’s amazing, quite frankly. We’ve had a few conversations in classes about this subject. One generalization I’ve heard is that for the Chinese, memorizing the material is primary and you are not expected to form opinions about it until you’ve had it in your memory for some time. The idea, I think, is that having the information coded in your head allows you to make connections between that text or information and other texts you are reading as well as between the texts and your clinical experiences. If you don’t have that information ready at hand - er, mind - then you’re not going to be able to make those connections as easily if at all.
There’s a serious amount of resistance to this notion among most US-based Chinese medicine and acupuncture students I am acquainted with. Most of us know that we need to memorize things in order to pass tests - but few people seem to see solid memorization of material (and continued renewal of that memorized material to keep it solid) as a foundational aspect of their educational program. The first year of study at my school doesn’t involve much memorization. It’s mostly about acquainting students with the cultural and philosophical foundations of the medicine, while getting their feet wet with basic Western and Chinese medicine concepts. There are few tests of one’s mental rigor, though lots of great intellectual growth takes place regardless. The second year, then, is a rude awakening for most students. It’s then that we take points, herbs, Chinese pathology and more Western medicine. Nearly all the classes have testing, and one professor in particular is notorious for his frequent (very frequent) testing and exacting standards. Many students fail his first midterm.
People underestimate the amount of information they will need to memorize VERBATIM. Many of them complain about what they see as “rote” memorization, they fail to see the value of this kind of learning for their future career. These folks and, I think, American culture in general puts a much stronger value on analysis of information and the formation of opinions and judgments. In my school in particular, I think folks tend to have a pretty philosophical frame of mind and thus are constantly trying to see patterns and interconnections among the various pieces of information. Education in some way is seen as a creative pursuit.
In my experience, it is only information that I have thoroughly committed to memory that is actually useful to me in the higher order creative activities I’m describing. The absolute base for this process is simple memorization. Information must be placed in the memory and repeatedly accessed until it becomes as familiar as all of the television commercial jingles we all undoubtedly have memorized. You might object, saying that you cannot retain material that doesn’t have relevance, material that doesn’t MEAN anything to you, yet. It’s true that it is difficult to commit something to memory that you have no context for, it is NOT true for any of us that this material we are studying has no context in our experience. While you may not know much about, say, 茯苓（Fu Ling, poria) with a little effort you can most certainly associate it with aspects of your experience. By studying a little about the applications of the herb you can help relate it to your life, perhaps with a time that you suffered from excess dampness. Also, there are numerous memorization techniques that help you build an infrastructure in which you can place any amount of seemingly meaningless information. When you do this, and do it well, it will begin to seep into your entire being and you will begin to understand.
I’d like to write a couple more articles about this, focusing on different memory techniques and resources that are available to help increase memory. Until then, I’d like to hear your thoughts on memorization in Chinese medicine. What role has it played in your education?
Tags: academics, Acupuncture, chinese-herb, chinese-herbs, cultural-differences, education, exams, memorization, students, study, study-methods, studyingRelated posts
A new (awesome) online community for Chinese medicine students and practitioners
Hey everyone. As you may know, I’m a huge proponent of the expansion of use of Internet tools by Chinese medicine practitioners and students. I feel that the potential to exchange information, build relationships and organize political and social action is simply too great to ignore. Add this to the fact that much of the information you can find on the Internet is anything but - to use Abdallah’s term in a comment on a recent blog post about the integration of Western medicine and ancient Chinese medicine - rigorous. In fact, most of it is intended to steer clients towards over-the-counter products that may or may not be right for their condition. Much of the rest is repetitive and pedantic.
My most earnest desire is to see thriving communities mediated by the Internet, involving people with diverse approaches and experiences from all over the world talking about the theory, practice and social/political development of this medicine. I don’t think this can be a substitute for “real life” relationship building, learning in a classroom environment (or, preferably, within a Master-Student relationship) or careful clinical practice. I simply see it as one more immensely powerful tool in our effort to understand nature, the human body and ancient Chinese medicine.
This site is my small effort to contribute to that and every day I learn a little more about how to make my dream become reality. Imagine my happy surprise, then, when I found another site already well developed that operates in the same spirit and adds many features that my small site cannot hope to offer at this time. Enter rootdown.us - an incredible new online community for Chinese medicine. When you visit the site, be sure to sign up for an account and add some personal information as well as a photo. I feel this helps to increase the “community” feel of the site. You can also build networks of friends as you can do at various social media sites. Only this time, the social connections are relevant to our passion - Chinese medicine.
Some of my favorite features of the site? Aside from the awesomeness of the individuals behind it? It’s community aspect is definitely part. The theoretical and clinical information database is built by the community. For instance, you can add indications and clinical applications to particular herbs, points or formulas. People can then comment on your addition. You can vote herbs and points “up” and “down” depending on their clinical effectiveness. There are forums that are growing in complexity and popularity. These features and more help to create a feeling of a real community with a powerful function of increasing the understanding of Chinese medicine for all.
The database is another incredible feature. You will find detailed descriptions and explanations for nearly every formula, herb and point available. Chinese, pinyin and English are all included - which I love. The information is also interconnected - if you head over to a formula, say Gui Zhi Tang , you can click on an individual herb to be taken to its page. The amount of information available is just going to grow as the community does - go and add some information today! I have been informed that soon each herb will come with pictures of the growing herb and the dried version - an invaluable resource as I think most of you will recognize immediately.
This site is a great resource for both students and practitioners. Students can quickly look up a formula and investigate its properties and individual herbs. They can participate in forum discussions and network with professionals and fellow students all over. Practitioners can see how others are using formulas, add their voices to the various discussions and network with people they might not have otherwise met.
The site is expanding at a healthy clip - there are a number of new features coming. There is also a form on every page on the site allowing you to send feedback, and the developers are very responsive. I am so excited about this site that I’ve asked to be involved in any way I can. I’m hoping in particular to increase the amount of information available from Classical sources, perhaps even Classical text translations? I’ve started by adding information to the herbal database and I’m looking forward to participating in many forum conversations. I hope I’ll see you there - be sure to add me as a buddy. :)
Eric
Tags: chinese-medicine, professional-development, TechnologyRelated posts
A quick question about language
My first ever formulas midterm with Arnaud Versluys is fast approaching. Thus, most of my time is devoted to studying for it. Oh, and of course the other midterms between here and there. Last night at my clinic shift, an interesting conversation was started about language and I’ve been thinking about it ever since. One person indicated that they preferred to refer to Chinese herbal medicine as botanical medicine because of negative connotations with the former (the word hippie was bandied about, I’m afraid). Others did not share this opinion. I’ve had other conversations about how to represent the medicine in advertising and conversation with lay people and other healthcare practitioners.
There are legal restrictions on what we as Chinese medicine practitioners can call ourselves - but what language do you use to describe yourself as a practitioner, or what language do you prefer to use when referring to other practitioners? How do you talk about herbalism? Acupuncture? Do you call yourself an acupuncturist even when that isn’t all that you do? Why or why not?
As I begin to build my business strategy and think about how I want to discuss what I will be doing with others - these questions become more and more pertinent. I’d love to hear your thoughts in the comments.
Eric
Tags: Acupuncture, chinese-herb, chinese-medicine, language, professional-developmentRelated posts
Blog Action Day 2007 : Is Chinese medicine environmentally friendly?
Today is Blog Action Day - one day where many writers come together to blog about a single topic to increase our total impact. This year, the topic is the environment - something near and dear to my heart. In this article, I’d like to suggest that Chinese medicine can easily be a strong part of the solution to our growing environmental problems while also mentioning one area in which Chinese medicine practitioners need to advocate for more ecologically friendly practices.
Balance is as balance does (or vice versa)
One of the most powerful features of Chinese medicine is its ability to bring us into closer harmony with the natural world. In fact, all of the Classics talk about the importance of people’s closeness to and concordance with the processes of Earth. QiBo and Huangdi, some of Chinese medicine’s founding fathers, repeatedly lament the lack of people’s ability to live within nature’s boundaries and point to it as a major cause of disease as well as treatment resistance. Now it could easily become (and in some ways has become) a watered down forceless statement to say that Chinese medicine can bring you into harmony with nature - what does that really mean and why does it matter from an ecological perspective?
Being in balance means simply this - your body is in a physiological state whereby there are no extreme states. No intense cravings, no wildly oscillating emotions, nothing like that. You can sleep. You can smile. When you eat normal food, your guts don’t hurt. You don’t go into sneezing fits at the merest whiff of cat dander. There may be pain, sure, there may be problems of varying kinds - but the body is generally in balance around these points and things are moving in a more or less effortless fashion. When some adverse condition arises, your body is able to respond appropriately.
It is my assertion here that this state of balance, whatever it looks like for a particular individual, produces generally balanced behavior. Balanced behavior is less likely to be destructive in a number of ways. So much of what goes on from an environmental damage perspective comes from people’s unordered responses to life. Think about vices, for instance. So many of these (tobacco, alcohol, coffee) are intensively farmed with the accompanying herbicides and pesticides. Also, a body in balance may be more likely to ask for things that are generally good for it - such as fresh air, long walks and clean water. I know that when I’m the least in balance, I’m least likely to care whether I am drinking filtered water or eating organic food. It just doesn’t matter to me. Maybe I’m the only one.
Ecological medicine
Chinese medicine is generally ecologically friendly. Our equipment needs are minor, we don’t require huge research facilities that use a variety of toxic chemicals to operate. Because many Chinese medicine practitioners are likely to be following the principles set out in the classics, they may be more likely to pay attention to the way their products are produced and the way the electricity for their offices is generated. This is, of course, not always the case and probably less so outside of the Western world. Chinese medicine also doesn’t ask people to consume synthetic drugs, the production of which puts a heavy environmental load on the planet.
But what about herbs? If you’ve thought about it even for a little while, you’ve likely been concerned about the ecological impact of Chinese herbs. I know I have and I’d like to address a couple of the most obvious problems here.
Herbs frequently travel long distances, increasing our dependence on fossil fuels : what to do?
The vast majority of Chinese herbs are produced in Asian countries. If you do not live in an Asian country, it follows that these substance are going to have to be transported to your place of practice. The travel may be considerable and of course this means reliance on significant amounts of fossil fuels. There are a number of things Chinese herbalists can do to reduce their impact. Probably the easiest and most effective behavior is to research the herbs you are procuring from grower to distributor. Where do they come from? How are they transported? Can you find a distributor close by so you can use alternative transportation to get them? Can you find a supply line with a minimal number of links? Can you find a supply line that includes companies that have an ecological frame of mind? This will, of course, require some research - but it will be well spent.
Another possibility is to grow some of your own herbs or form growers coops in your local area. This is energy intensive and there is some question as to the energetic quality of the resulting materials, but I think it is at least something to consider. Going a step further, some people have suggested that instead of using the Chinese species of herbs we should do the research required to find local correlates to all of the herbs. These folks argue that the herbs will be more likely to resonate with our own physiology and the disease patterns we present if they are local. I am not convinced that this is the case and I am by no means sure that we are energetically sensitive enough to discover the Wei and Qi of herbs in an accurate manner today.
Chinese herbs are commonly produced using lots of chemicals in China : what to do?
Simply demand organic, or at least pesticide and herbicide free herbs. This is a very similar tactic as has worked with the organic foods movement. Simply know where your consumables are coming from and how they are grown and when the practices are ecologically damaging, demand better. Only buy from companies/distributors that support best practices - and when that is not possible, communicate your desires to the people you are working with. Finding chemical free herbs is not only good for the environment, but it’s great for your patients and will do a lot to alleviate their fears about taking products produced in China.
There may be other positive and negative environmental impacts of Chinese medicine, but these are the ones I think of most frequently. I’d like to hear what others think on these and related topics - please add your voice in the comments.
Eric
Tags: balance, chinese-herb, chinese-herbs, environment, environmentalism, herbs
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