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Nigel Wiseman Replies
182
Clinical Acupuncture and Oriental Medicine
NIGEL WISEMAN REPLIES As to the problems of transmission, I agree wholeheartedly with Dr Stephen Cowan when he says it is futile to expect a university course in Chinese medical terminology to illuminate the complex semantic and metaphorical nuances of the ancient Chinese language. After 20 years translating Chinese medical literature, I do not expect to see a Chinese medical curriculum in the near future that will enable people to read Chinese texts with ease. If it were that easy, I would put myself out of my translator’s job by simply writing language textbooks. Cowan suggests that I do not understand the true source of Chinese medical knowledge and that I do not understand the mechanisms of knowledge transmission. But Cowan may misunderstand what I mean by ‘source.’ This source is not any particular work, or any particular historical strand of Chinese medical thought; it is the accumulated corpus of knowledge in Chinese texts, the tradition of Chinese medicine to which students in China are gradually introduced in their studies. This corpus of knowledge represents the clinical experience of generations of physicians in China. It is a general familiarity with this corpus of knowledge that provides physicians in China with the basis for
developing their own personal clinical experience. This corpus of knowledge defines what they look for and what questions they ask. Personal experience that lays all past experience aside is an attempt to reinvent the wheel. It is important to point out that in Between Heaven and Earth Beinfield and Korngold are not giving us their opinion of the meaning of various received texts of the ancient literary tradition. They are writing as authorities on the subject of Chinese medicine, a huge corpus of knowledge and literature in a language they do not read. They are effectively creating their own form of Chinese medicine without a full appreciation of the traditions of Chinese medicine. The ambiguities of language are of secondary importance to the very critical point that people wishing to contribute to a subject should be broadly familiar with its literature. They, as many others, appear to believe that what is available in English enables them to make authoritative judgments on the subject. Cowan’s arguments on these issues seem to be based on his assertion that I underestimate the ambiguity of language. Cowan explains his point about the source of knowledge by a comparison of three different translations of Lao Zi. He discusses the
Clinical Acupuncture and Oriental Medicine (2001) 2, 180–184 © 2001 Harcourt Publishers Ltd
Correspondence
problem of authenticity in terms of dates at which the original texts appeared, showing his awareness of one problem that scholars of Daoism face. He concludes that the variability of received texts of Lao Zi mean that ‘the more voices we can hear on a subject, the closer we get to understanding it.’ On the question of Chinese medicine, he therefore argues that in view of the ambiguity of language, the practitioner is a better source than the written word. This argument is fraught with problems. For example, many of the differences in the English texts he discusses are due not to differences in the Chinese sources, but simply to differences in translation. To gain a deeper understanding of Daoism in all its forms, any Westerner ultimately has to discard English translations and delve into the Chinese. It would be impossible to write comprehensively about, study or understand the historical development of Daoist texts and, hence, Daoist thought on the basis of English translations alone. Of course, anyone is entitled to write about how they understand Daoism, but when we wish to discuss the original content of Daoist texts (which are incontestably the starting point of Daoism), we must go to the Chinese texts. These early texts are written in terse style, and are extremely ambiguous. Such texts cannot simply be translated, since no translation can provide a mirror image of the Chinese text. Translations of such texts must be supported by detailed notes that clarify the translator’s full understanding of the original. More to the point, however, is the fact that Chinese medical texts for the most part cannot be compared with Lao Zi. Early Chinese medical texts contain ambiguities, indeed, but these are rarely of the same magnitude as those found in philosophical texts. Chinese medical texts are mostly technical texts characterized by a technical vocabulary. As I have pointed out before, this is not an interpretation on my part, but a fact attested by the large number of Chinese medical dictionaries. Chinese medical texts and Chinese medical terminology are not as unequivocal as modern Western medical texts, which by convention do not allow any scope for variable interpretation. Chinese medical terms are extensively and consistently used by individual writers to mean one specific thing, and many terms have been used by different writers in the same sense over periods of centuries. Citing the fact that some of these terms have had different meanings, Cowan concludes that standardization is not possible, a conclusion which notably is not shared by experts in China (see page 168 for a progress report on current efforts to standardize Chinese medical terminology in China).
183
I suspect that Cowan has no or minimal knowledge of Chinese. But it seems to me that it is this point of misunderstanding that allows him to jump to the conclusion that because language is ambiguous, we can leave its problems aside and let clinical experience be the judge of what is right and wrong. This conclusion is hasty. There is no such thing as clinical experience independent of theoretical knowledge. Even in the most pragmatic, symptomatic healing system clinical experience is defined by non-clinical or pre-clinical ideas. Clinical experience in treating a certain condition is dependent upon conceptions of the condition we are trying to treat that may not be informed wholly by our clinical experience, if at all. In the case of Chinese medicine, the corpus of knowledge on which modern practice in China is based spans more than 2,000 years. Only a fraction of this corpus is available to Westerners who do not read Chinese. My point is simply that if we inculcate in every student’s mind the notion that Chinese medicine comes from China and that the greater part of Chinese medical knowledge available is in Chinese, we will encourage awareness of a very useful option in the study of Chinese medicine. If one in ten students vigorously pursued language study to gain access to the primary literature, we would have one in ten students who had a deeper understanding of Chinese medicine and who was potentially a translator. This would also encourage students to prefer literature translated from primary sources using an English terminology that is pegged to the Chinese, further enhancing the fidelity of the Western adaptation of Chinese medicine to its ancestral roots. In short, notions of Chinese will help to orient students toward the source of Chinese medical knowledge, which is the heritage both possessed and transmitted by the Chinese. Cowan adduces the Lao Zi not only as an example of textual problems, but also because, like Beinfield and Korngold, he espouses the philosophy Daoism. Daoism has had a great influence on the development of Chinese medicine, but not always in ways that Westerners would immediately understand. As Paul Unschuld has explained, Daoism exerted a preference for medicinal therapy over acupuncture, and encouraged the search for lifeprolonging medicinals. In the West, the principle feature of Daoism that attracts people is that it offers an escape from the rigidity of convention. In China, that kind of freedom tends to be seen as complementary to discipline, not as an alternative. A master calligrapher, for example, is one who has practiced characters over and over and over again in different styles. To excel he has to ‘let go’ and go with the
Clinical Acupuncture and Oriental Medicine (2001) 2, 180–184 © 2001 Harcourt Publishers Ltd
184
Clinical Acupuncture and Oriental Medicine
flow of his own accumulated experience in calligraphy. This certainly does not mean that he does not have to learn different styles of characters and practice. When we are learning about Chinese medicine, we still have to have a broad command of
the experience of China’s clinicians before we start letting go. Cowan’s point is that because language is ambiguous, let’s just dispense with its problems and find our own way. This is not the Chinese approach.
Clinical Acupuncture and Oriental Medicine (2001) 2, 180–184 © 2001 Harcourt Publishers Ltd
Clinical Acupuncture and Oriental Medicine
NIGEL WISEMAN REPLIES As to the problems of transmission, I agree wholeheartedly with Dr Stephen Cowan when he says it is futile to expect a university course in Chinese medical terminology to illuminate the complex semantic and metaphorical nuances of the ancient Chinese language. After 20 years translating Chinese medical literature, I do not expect to see a Chinese medical curriculum in the near future that will enable people to read Chinese texts with ease. If it were that easy, I would put myself out of my translator’s job by simply writing language textbooks. Cowan suggests that I do not understand the true source of Chinese medical knowledge and that I do not understand the mechanisms of knowledge transmission. But Cowan may misunderstand what I mean by ‘source.’ This source is not any particular work, or any particular historical strand of Chinese medical thought; it is the accumulated corpus of knowledge in Chinese texts, the tradition of Chinese medicine to which students in China are gradually introduced in their studies. This corpus of knowledge represents the clinical experience of generations of physicians in China. It is a general familiarity with this corpus of knowledge that provides physicians in China with the basis for
developing their own personal clinical experience. This corpus of knowledge defines what they look for and what questions they ask. Personal experience that lays all past experience aside is an attempt to reinvent the wheel. It is important to point out that in Between Heaven and Earth Beinfield and Korngold are not giving us their opinion of the meaning of various received texts of the ancient literary tradition. They are writing as authorities on the subject of Chinese medicine, a huge corpus of knowledge and literature in a language they do not read. They are effectively creating their own form of Chinese medicine without a full appreciation of the traditions of Chinese medicine. The ambiguities of language are of secondary importance to the very critical point that people wishing to contribute to a subject should be broadly familiar with its literature. They, as many others, appear to believe that what is available in English enables them to make authoritative judgments on the subject. Cowan’s arguments on these issues seem to be based on his assertion that I underestimate the ambiguity of language. Cowan explains his point about the source of knowledge by a comparison of three different translations of Lao Zi. He discusses the
Clinical Acupuncture and Oriental Medicine (2001) 2, 180–184 © 2001 Harcourt Publishers Ltd
Correspondence
problem of authenticity in terms of dates at which the original texts appeared, showing his awareness of one problem that scholars of Daoism face. He concludes that the variability of received texts of Lao Zi mean that ‘the more voices we can hear on a subject, the closer we get to understanding it.’ On the question of Chinese medicine, he therefore argues that in view of the ambiguity of language, the practitioner is a better source than the written word. This argument is fraught with problems. For example, many of the differences in the English texts he discusses are due not to differences in the Chinese sources, but simply to differences in translation. To gain a deeper understanding of Daoism in all its forms, any Westerner ultimately has to discard English translations and delve into the Chinese. It would be impossible to write comprehensively about, study or understand the historical development of Daoist texts and, hence, Daoist thought on the basis of English translations alone. Of course, anyone is entitled to write about how they understand Daoism, but when we wish to discuss the original content of Daoist texts (which are incontestably the starting point of Daoism), we must go to the Chinese texts. These early texts are written in terse style, and are extremely ambiguous. Such texts cannot simply be translated, since no translation can provide a mirror image of the Chinese text. Translations of such texts must be supported by detailed notes that clarify the translator’s full understanding of the original. More to the point, however, is the fact that Chinese medical texts for the most part cannot be compared with Lao Zi. Early Chinese medical texts contain ambiguities, indeed, but these are rarely of the same magnitude as those found in philosophical texts. Chinese medical texts are mostly technical texts characterized by a technical vocabulary. As I have pointed out before, this is not an interpretation on my part, but a fact attested by the large number of Chinese medical dictionaries. Chinese medical texts and Chinese medical terminology are not as unequivocal as modern Western medical texts, which by convention do not allow any scope for variable interpretation. Chinese medical terms are extensively and consistently used by individual writers to mean one specific thing, and many terms have been used by different writers in the same sense over periods of centuries. Citing the fact that some of these terms have had different meanings, Cowan concludes that standardization is not possible, a conclusion which notably is not shared by experts in China (see page 168 for a progress report on current efforts to standardize Chinese medical terminology in China).
183
I suspect that Cowan has no or minimal knowledge of Chinese. But it seems to me that it is this point of misunderstanding that allows him to jump to the conclusion that because language is ambiguous, we can leave its problems aside and let clinical experience be the judge of what is right and wrong. This conclusion is hasty. There is no such thing as clinical experience independent of theoretical knowledge. Even in the most pragmatic, symptomatic healing system clinical experience is defined by non-clinical or pre-clinical ideas. Clinical experience in treating a certain condition is dependent upon conceptions of the condition we are trying to treat that may not be informed wholly by our clinical experience, if at all. In the case of Chinese medicine, the corpus of knowledge on which modern practice in China is based spans more than 2,000 years. Only a fraction of this corpus is available to Westerners who do not read Chinese. My point is simply that if we inculcate in every student’s mind the notion that Chinese medicine comes from China and that the greater part of Chinese medical knowledge available is in Chinese, we will encourage awareness of a very useful option in the study of Chinese medicine. If one in ten students vigorously pursued language study to gain access to the primary literature, we would have one in ten students who had a deeper understanding of Chinese medicine and who was potentially a translator. This would also encourage students to prefer literature translated from primary sources using an English terminology that is pegged to the Chinese, further enhancing the fidelity of the Western adaptation of Chinese medicine to its ancestral roots. In short, notions of Chinese will help to orient students toward the source of Chinese medical knowledge, which is the heritage both possessed and transmitted by the Chinese. Cowan adduces the Lao Zi not only as an example of textual problems, but also because, like Beinfield and Korngold, he espouses the philosophy Daoism. Daoism has had a great influence on the development of Chinese medicine, but not always in ways that Westerners would immediately understand. As Paul Unschuld has explained, Daoism exerted a preference for medicinal therapy over acupuncture, and encouraged the search for lifeprolonging medicinals. In the West, the principle feature of Daoism that attracts people is that it offers an escape from the rigidity of convention. In China, that kind of freedom tends to be seen as complementary to discipline, not as an alternative. A master calligrapher, for example, is one who has practiced characters over and over and over again in different styles. To excel he has to ‘let go’ and go with the
Clinical Acupuncture and Oriental Medicine (2001) 2, 180–184 © 2001 Harcourt Publishers Ltd
184
Clinical Acupuncture and Oriental Medicine
flow of his own accumulated experience in calligraphy. This certainly does not mean that he does not have to learn different styles of characters and practice. When we are learning about Chinese medicine, we still have to have a broad command of
the experience of China’s clinicians before we start letting go. Cowan’s point is that because language is ambiguous, let’s just dispense with its problems and find our own way. This is not the Chinese approach.
Clinical Acupuncture and Oriental Medicine (2001) 2, 180–184 © 2001 Harcourt Publishers Ltd