Comments on Nomenclature in Traditional Chinese Medicine

by Kexin Bao, L.Ac.

Correctly naming a discipline can directly portray the object of study, clearly pointing out its essence, and presaging its future development. Carefully naming an independent discipline may provide the breakthrough necessary to establish its independence. Given the importance of nomenclature, the terminology being applied to the various branches of traditional Chinese medicine (T.C.M.) is disconcerting. Current usage of such terms as "Chinese medicine", "oriental medicine", "herb", "herbology" or "herbal medicine" and "acupuncture" in my view are improper. These terms are discussed in the present article for the purpose of defining their meaning more precisely.

1.  Regarding "Chinese Medicine"

The traditional medicine of China is the classical medicine of China and is distinguishable from modern Chinese medicine. T.C.M. is a medical science guided by traditional Chinese medical theories, and includes natural product medication, acupuncture, moxibustion, massage, plaster, steam bath, etc. as modalities in the treatment and prevention of disease.

T.C.M. is called "zhong yi xue" (phonetic transcription of Chinese character, the same below) in Chinese. The Chinese characters "zhong yi xue" and "zhong hua yi xue" both translate literally into the English words "Chinese medicine". However, to refer to T.C.M. as "Chinese medicine" has two shortcomings. First, "Chinese medicine" fails to convey the rich "tradition" associated with T.C.M.; and second, this translation leads to confusion by not distinguishing between T.C.M. and modern Chinese medicine. Examples of the confusion associated with the global term "Chinese medicine" include the following. Currently, some books and journals published in English include "Chinese medicine" in their titles; however, are concerned only with T.C.M. On the other hand, another journal titled "Chinese Medical Journal" is concerned only with modern Chinese medicine. Although the above titles "Chinese medicine" suggest that they contain similar material, the material in fact is quite different. In addition, some institutions with the name "Chinese medicine" in fact are concerned only with T.C.M., not modern Chinese medicine. Finally, an organization named "Chinese Medical Association" is a society involved only with modern medicine in China. The subject material of "Chinese medicine" as used above differs so extensively that T.C.M. and modern Chinese medicine must have a distinguished nomenclature.

Medicine in the broadest sense should include both modern medicine and traditional medicine. However, the term, "medicine" typically refers only to modern medicine. The word "traditional" is often used to distinguish traditional medicine from (modern) medicine. For these reasons, "zhong yi xue" should be translated into English according to its precise definition, "traditional Chinese medicine". This translation conveys both the traditional and the Chinese aspects of the discipline, and distinguishes it from modern Chinese medicine.

2. Regarding "Oriental Medicine"

Another vague, ambiguous term is "oriental medicine". "Oriental medicine" in English publications is usually synonymous with traditional medicine of China, Japan, Korea, Vietnam etc. Actually, all of these disciplines are various branches of T.C.M. which according to relevant literature originated in China. Moreover, in Japanese, traditional medicine is called "Han Fang", which translates into T.C.M.

The term "oriental medicine" probably originated to distinguish it from western "occidental medicine". "Occidental medicine" is usually associated with modern medicine since it originated in the West. Although the "oriental" or "occidental" qualifier may be convenient in dialogue to emphasize the origin of particular aspects of medicine, such use is detrimental because of its ambiguity.

The use of the "oriental" qualifier has at least two shortcomings: it fails to express its original meaning of traditional medicine in China, and it is also fails to recognize the existence of modern medicine in the East.

The use of the "occidental" qualifier bears the same kind of shortcomings. It does not convey the difference between occidental traditional medicine and (modern) medicine. If medicine were referred to as "occidental medicine" as currently is done with "oriental medicine", differentiation of modern and classical Western medicine such as Hippocratic medicine in 6-4 centuries B.C. or American Indian folk medicine would be compromised. Though the classical medicine in the west has gradually withered away, it existed in history and needs to be distinguished just as traditional Chinese medicine needs to be distinguished from modern Chinese medicine.

Difference in the nature of medicine in the west and the east has been dissolving for a long time. Currently only differences in tradition and degree of development distinguish the two.With time, the disparity in development between western and eastern medicine will become smaller and smaller, leaving only tradition as a distinction.

Since the essence of "oriental medicine" is traditional Chinese medicine, its true colors of T.C.M. should be restored.

To name disciplines of medicine by using the "oriental" or the "occidental" qualifier can not directly portray the object of study, clearly point out its essence, presage its future prospects of growth. Neither differentiates traditional medicine and modern medicine in either the West or the East.
If the word "oriental" is necessary to precede traditional medicine in the east, it can only be named traditional oriental medicine to differentiate (modern) medicine in the East. This reason is the same as that the naming of T.C.M. is differentiated with (modern) medicine in China.

3. Regarding "Herb", "Herbology" or "Herbal Medicine"

Traditional Chinese materia medica (T.C.M.M.) is a branch of T.C.M., which studies the theory and application of medication based on theories of T.C.M.

Traditional Chinese materia medica differs extensively from herbal medicine. The relationship between the two is somewhat akin to the difference between folk medicine and natural product pharmacy in the U.S. It is improper to use T.C.M.M. synonymously with the terms herbology or herbal medicine. In China T.C.M.M. is an officially recognized branch of T.C.M. with standardized medication procedures documented in the state pharmacopoeia or equivalent books. Herbal medicine, however, is folk medicine, and is not officially recognized in the state pharmacopoeia. The two procedures are much different with T.C.M.M. having a systematic theory as guidance for its practice while the latter is employed entirely without theory.

In T.C.M.M. medicines are derived mainly from plants, but animals and minerals provide additional sources. The materials are prepared and refined using well established procedures. The English phrase herbal medicine generally refers to folk medicine, and in most cases the crude herb or crude extract is used. Animal products and minerals are generally not included in definitions of herbal medicine.

For the above reasons, to translate Chinese word "zhong yiao"--T.C.M.M. into herb, herbology or herbal medicine is improper on either the basis of the definition of T.C.M.M. or the English meaning of the word herb.

4. Regarding "Acupuncture"

The Science of acupuncture and moxibustion is a branch of T.C.M. which prevents and treats diseases by puncturing specific points on the body with needles, or the burning or warming of the points by applying heat via ignited moxa wool or roll. These procedures are important external therapies of T.C.M.

The term acupuncture is derived from the Latin words acus, which means surgical needle, and punctura, which means to puncture. Moxibustion can be defined as the burning, warming, fumigating, or placing hot compressions on certain points for the treatment or prevention of diseases. The two therapies are commonly applied in combination, and are also typically used as compound word acupuncture-moxibustion (acu-moxibustion--Chinese sound "zhen jiu", which literally means "needling-moxibustion").

In the literal sense, acupuncture refers to a method of needling (i.e. Chinese words "zhen ci") or a therapy of needling (i.e., Chinese words "zhen ci liao fa"); however, science of acupuncture and moxibustion is also a discipline (i.e., Chinese words "zhen jiu xue"), a branch of T.C.M. When using the term "acupuncture" we should make clear whether we are referring to its meaning as a method, a therapy or a scientific discipline. Use of the term "acupuncture" without distinguishing among these three meanings leads to a confusion that could be eliminated by restricting and refining the use of the term. In this light, I am proposing that when using "acupuncture" to refer to the discipline, we should use the term "acupunctology" (i.e., "acupuncture" plus "-ology"). This term should become the standard through international scientific meetings. It is assumed that acupunctology in the broad ense could cover moxibustion and such similar therapies in the same field.

In summary, the present paper suggests that the current use of "Chinese medicine", "oriental medicine", "herb", "herbology" or "herbal medicine" and "acupuncture" as terms representing disciplines of T.C.M and its branches is either improper or indistinct. Without more attention to concisely defining these terms, many individuals consider that T.C.M.M. is a folk herbology, and acupuncture as only a therapeutic method. Under such conditions T.C.M. is demoted to folk medicine; the science of T.C.M.M. to herbology or herbal medicine; the doctor of T.C.M. to herbalist; the science, acupunctology to the therapy acupuncture; and the acupunctologist to the acupuncturist. The present paper is a call to recognize T.C.M.M. and acupuncture as scientific branches of T.C.M. with appropriate translations to reflect their scientific nature and separate them from folk therapies.

Acknowledgement: The author wish to thank Dr. Lawrence D. Middaugh for his helpful comments on the original manuscript and Ms. Marilyn Ruotolo for typing the manuscript.