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English Translation of TCM
Journal of Chinese Integrative Medicine: Volume 10, 2012   Issue 2
Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Defense, Qi, Nutrient and Blood Pattern Identification/Syndrome Differentiation (Part 2)
Zhao-guo Li (College of Foreign Languages, Shanghai Normal University, Shanghai 200234, China E-mail: zhooushi@163.com)

Received December 9, 2011; accepted December 12, 2011; published online February 15, 2012.
Full-text LinkOut at PubMed. Journal title in PubMed: Zhong Xi Yi Jie He Xue Bao.

基金项目: 国家社会科学基金资助项目(No. 08BYY009); 国家中医药管理局资助项目(No. ZYYS20090010-2); 国家质量监督检验检疫总局资助项目(No. 200910263)
Correspondence: Zhao-guo Li, MD, Professor; E-mail: zhooushi@163.com; Blog: zhooushi.blog.163.com

  

     邪伏膜原证pattern/syndrome of pathogen hidden in the pleurodiaphragmatic interspace: a pattern/syndrome marked by episodes of chills and fever at fixed hours, severe headache and generalized pain, distension and oppression in the chest and hypochondriac regions, vomiting of phlegmatic substance, and white powdered coating of the tongue
     To translate膜原as “pleurodiaphragmatic interspace” in the WPRO Standard[1] seems quite specific and easy to understand. But in Chinese philosophy, a term or a concept is usually quite abstruse, involving many things that appear unrelated to each other on the surface. That is why膜原was transliterated as “moyuan” in the past because it is not something as simple and concrete as skin or hair. The idea of膜原was first mentioned in the chapter of “Discussion on Pain” in Suwen (Plain Conversation), suggesting that “pathogenic cold is retained between the intestines and stomach and below膜原”. But the specific location of膜原was not mentioned.
     In explaining the idea of膜原, Wang Bing, a scholar in the Tang Dynasty said that “膜refers to the region between the diaphragm while原refers to the space between the heart and the diaphragm”. A Japanese scholar said in the chapter of “Textual Research on Moyuan” in his book entitled Appendices of Medical Literature that “moyuan refers to the membranous part of the diaphragm that is attached to the seventh thoracic vertebra”, which is a quite clear and specific description about the location of膜原. However, such a concrete description is somewhat subjective according to the theory of TCM.
     With the development of TCM, the connotation of膜原was further enriched and became more complicated. In syndrome differentiation concerning warm diseases, for instance, 膜原refers to the part between the exterior and interior. In the book Synopsis on Pestilence, for example, it says that “the pathogenic factors are not far away from the exterior region and is quite near the stomach…, the pathogenic factors are retained in the region between the meridians and stomach, that is why the syndrome caused is known as half interior and half exterior syndrome”.
     气分湿热证qi aspect dampness-heat pattern/syndrome: a pattern/syndrome arising when pathogenic dampness-heat invades qi aspect, marked by unsurfaced fever, oppression in the chest and distension in the abdomen, jaundice, cumbersome limbs, nausea and vomiting, reddened tongue with yellow slimy coating and rapid slippery pulse
     In the WFCMS Standard[2], 气分湿热证is translated as “syndrome/pattern of dampness-heat in qi aspect”, similar to that in the WPRO Standard. The common clinical manifestations of this syndrome/pattern also include yellow urine and soft rapid pulse. In the definition, the expression “unsurfaced fever” may be the translation of the Chinese term身热不扬which means mild fever; the expression “cumbersome limbs” may be the translation of the Chinese term肢体困倦which means tiredness of the limbs, often translated as “lassitude of limbs” in the current translation practice.
     湿热郁阻气机证pattern/syndrome of dampness-heat obstructing qi movement: a pattern/syndrome arising when the dampness-heat pathogen obstructs qi movements, marked by fever, lassitude, aching limbs, thoracic oppression and abdominal distension, nausea, vomiting, reddish urine, and white slimy or slimy turbid tongue coating
     The so-called湿热郁阻气机证means pattern/syndrome of dampness-heat stagnating and obstructing qi movement. In this term, 郁阻describes two interrelated pathological changes, namely, stagnation and obstruction, in which郁 (stagnation) is the cause while阻 (obstruction) is the result. To translate it as “pattern/syndrome of dampness-heat obstructing qi movement”, the cause郁 (stagnation) seems to be inadequately expressed.
     湿重于热证pattern/syndrome of dampness predominating over heat: a pattern/syndrome marked by unsurfaced fever, thirst without appreciable intake of fluid, heavy feeling of the head and cumbersome limbs, impaired urination, diarrhea, reddened tongue with yellowish slimy coating, and slightly rapid and slippery pulse
     This syndrome/pattern is caused by dampness and heat stagnation in which pathogenic dampness outweighs pathogenic heat. In the definition, the expression “thirst without appreciable intake of fluid” seems to be the translation of the Chinese term渴不多饮which is often simply rendered as “thirst without much drinking of water”; the expression “impaired urination” seems to be the translation of the Chinese term小便不利which is often translated as “difficult urination” or “inhibited urination”.
     热重于湿证pattern/syndrome of heat predominating over dampness: a pattern/syndrome marked by fever, thirst, reddened face and eyes, cumbersome limbs and head, ungratifying loose bowels, short voidings of little urine, reddened tongue with yellow slimy coating and rapid slippery pulse
     This syndrome/pattern is caused by dampness and heat stagnation in which pathogenic heat outweighs pathogenic dampness. The common clinical manifestations still include inhibited defecation and urination. In the definition, the expression “ungratifying loose bowels” may be the translation of the Chinese term便溏不爽which simply means inhibited sloppy stool; the expression “short voidings of little urine” may be the translation of the Chinese term小便短赤which actually means scanty reddish urine.
     湿热浸淫证spreading dampness-heat pattern/syndrome: a pattern/syndrome marked by redness, swelling, itching, ulceration and exudation of the eyelid, ears, nose, mouth angle, fingers or toes
     In the WFCMS Standard[2], 湿热浸淫证is translated as “syndrome/pattern of dampness-heat immersion”. The so-called湿热浸淫in Chinese means extensive spreading of dampness-heat. Thus to render浸淫as “spreading” seems more expressive and vivid than “immersion”.
     暑兼寒湿证pattern/syndrome of summerheat with cold-dampness: a pattern/syndrome arising when a combination of summerheat and cold-dampness attacks the exterior of the body, marked by headache, fever, aversion to cold, absence of sweating, epigastric oppression, irritable disposition and thin slimy tongue coating
     In the WFCMS Standard[2], 暑兼寒湿证is translated as “syndrome/pattern of combined sumerheat and cold-dampness”. In this term, the Chinese character兼means to be mingled with, which is rendered as “combined” in the WFCMS Standard[2] while as “with” in the WPRO Standard[1], both of which are clear in meaning. Comparatively speaking, “combined” seems to be more expressive as indicated by the explanation in the definition. In the definition, the expression “absence of sweating” obviously is the translation of the Chinese term无汗which is often simply translated as “no sweating” or “anhidrosis”.
     暑湿困阻中焦证pattern/syndrome of summerheat dampness encumbering the middle energizer: a pattern/syndrome arising when a combination of summerheat and dampness harasses the spleen and stomach, marked by intense fever, persistent thirst, profuse sweating, short voidings of urine, epigastric stuffiness, heaviness of the body and large surging pulse
     In the term暑湿困阻中焦证, the character困means “encumber” while the character阻means “obstruct” or “block”. In the WPRO Standard[1], 困 and阻in this term are collectively rendered as “encumber”, appearing understandable. In the WFCMS Standard[2], these two Chinese characters are collectively rendered as “retention”, which seems unclear in meaning. In the definition, the expression “persistent thirst” may be the translation of the Chinese term渴而不解which means that the patient frequently feels thirsty; the expression “large surging pulse” may be the translation of the Chinese term脉洪大which is also frequently rendered as “large and full pulse”.
     暑热证summerheat-heat pattern/syndrome: a pattern/syndrome of summerheat marked by fever, thirst, listlessness, shortness of breath, irritable disposition, dizziness, sweating, short voidings of yellow urine, reddened tongue with dry yellow coating and large surging pulse
     This syndrome/pattern is caused by invasion of summerheat that causes a series of clinical pathological changes as listed above. In the definition, “irritable disposition” is certainly the translation of the Chinese term易怒which means easiness to lose temper and thus is often simply rendered as “irritability”.
     暑湿证summerheat and dampness pattern/syndrome: a pattern/syndrome caused by a combination of summerheat and dampness, marked by fever, vexation, sensation of pressure in the chest, nausea syndrome and vomiting, reddened tongue with yellow slimy coating, and rapid slippery pulse
     This syndrome/pattern is caused by invasion of summerheat and dampness that causes a series of clinical pathological changes as listed above. In the definition, “vexation” may be the translation of the Chinese term心烦which is also frequently rendered as “dysphoria” or “listlessness”; “sensation of pressure in the chest” seems to be the translation of the Chinese term胸闷which means oppression or distress in the chest, and thus frequently rendered as “chest oppression” or “chest distress”. Besides, the word “syndrome” in “nausea syndrome” seems unnecessary and thus should be deleted.
     暑入阳明证pattern/syndrome of summerheat entering yang brightness: a pattern/syndrome attributed to exuberant summerheat that enters yang brightness, namely, the qi aspect, marked by intense fever, profuse sweating, irritable disposition, headache with dizziness, reddened face, coarse breathing, thirst, dry teeth, yellow dry tongue coating, large surging pulse or large surging hollow pulse
     In the term暑入阳明证, the Chinese expression阳明is traditionally transliterated as “yangming” which is now used worldwide, thus to retranslate it as “yang brightness” seems quite unnecessary. In the definition, “coarse breathing” seems to be literal translation of the Chinese term气粗which means hoarseness in breathing. To literally translate the Chinese character粗as “coarse” seems still in need of careful consideration. The expression “large surging hollow pulse” appears illogical. In TCM, if the pulse is “surging”, it must be “full” and cannot be “hollow”.
     暑伤津气证pattern/syndrome of summerheat damaging fluid and qi: a pattern/syndrome caused by summerheat which consumes qi and damages fluids, and manifested by fever with sweating, strong thirst, irritable disposition, flushed face, listlessness, lack of strength, shortness of breath, short voidings of deep-colored urine, redden tongue with dry yellow coating and large floating weak pulse
     This syndrome/pattern is caused by summer-heat that invades the body and consumes qi and body fluid. The clinical manifestations also include thirst with polydipsia, mental fatigue and scanty yellow urine. In the definition, “short voidings of deep-colored urine” is unclear in meaning. Perhaps it is the translation of the Chinese term小便短黄which means scanty yellowish urine.
     暑热动风证pattern/syndrome of summerheat-heat stirring wind: a pattern/syndrome of summerheat marked by high fever, loss of consciousness, convulsion, opisthotonos and trismus
     This syndrome/pattern is caused by excessive summer-heat which stirs liver wind. In暑热动风证, the Chinese character动is also translated as “disturb” in the current translation practice.
     暑闭气机证pattern/syndrome of summerheat blocking qi movement: a pattern/syndrome of summerheat marked by sudden fainting, fever without much sweating, reversal cold of limbs, dyspnea, lockjaw, or nausea, vomiting and abdominal pain
     The so-called暑闭气机证refers to apoplexy caused by summerheat which obstructs qi movement. In the definition, “fever without much sweating” seems to be the translation of the Chinese term身热少汗which literally means feverish body with little sweating, also frequently translated as “fever with scanty sweating”; reversal cold of limbs” may be the translation of the Chinese term四肢厥逆which means coldness of the limbs due to reverse flow of qi, and thus frequently rendered as “coldness of limbs”.

  
References
1. World Health Organization Western Pacific Region. WHO international standard terminologies on traditional medicine in the Western Pacific Region. 2007.
2. Li ZJ. International standard Chinese-English basic nomenclature of Chinese medicine.Beijing: People’s Medical Publishing House. 2008. Chinese-English.
  
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