by Eric Brand

When we first study Chinese medicine, we need to establish a number of baseline theories early on. Many of the foundational theories covered in Chinese Medicine 101 come from the Huang Di Nei Jing, such as channel theory, five phase associations, visceral manifestation, and the functions of the various organs. These basic concepts are important throughout our study of Chinese medicine, so it is imperative that we build our foundation by starting with accurate translations and concepts.

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At present, there are a number of fundamental theories that are often misunderstood in the Western TCM community, and in many instances the misunderstanding is rooted in an error of translation. The existence of these errors is understandable, since the pioneering early-generation of American TCM practitioners typically had few English books available, and the few good teachers that were around often had a limited ability to communicate in English. Complicating matters, Chinese medicine is fundamentally difficult to translate into natural English, because it contains a number of concepts that lack a precise English equivalent. After a generation or two of Western practice, some translation errors have come to be accepted as normal, and this leads to poor concept acquisition in new generations of students.

Problems in translation have major clinical implications. In some situations, a perfect translation can be found, but in other situations one must learn a new concept when no single equivalent English word exists. Take the problem of zhi, which is stored by the kidney. This is generally translated as will, but the Chinese concept of zhi is more accurately described as a combination of mind, will, and memory. Mind, will, and memory are totally separate things in English, but the Chinese concept has characteristics of each. There is no English word that combines these three concepts, so there is no one ideal English translation for zhi.

Most sources agree that will and mind are the best translations for zhi. According to my teacher Feng Ye, the character zhi that was originally in the Nei Jing was written the same as will, but later historical writers explain the meaning of this zhi by using another word (also pronounced zhi) that contains a “yan” radical on the left. This explanation reinforces the connection of the zhi with the mind and memory, and indeed many of the signs of waning kidney essence that are seen clinically relate to decline in mental function and memory.

The links between the zhi and the mind and memory are well-elucidated in works like Wiseman and Feng's Practical Dictionary of Chinese Medicine, as well as in the Chinese resources that the Practical Dictionary is based on. As it relates to will, my teacher Yuan Wang once explained the kidney's zhi relatively succintly by saying that: "it could be compared to one's desire to live, to do things; when old people no longer have drive and ambition to pursue their interests, this decline is what the concept of zhi means in terms of will."

Thus, the Chinese concept of zhi is elusive to a single translation because no single word like will, mind, or memory can completely encapsulate it. But the important thing is that the Western student understands that zhi is a concept with characteristics and applications of all three of these English words, will, mind, and memory. Too often, students simply learn it as “will,” so they then take the English concept of will and take it once step further, and go on to write about willpower. The next thing you know, we have all these articles about the kidney and willpower, etc., and suddenly people that are hooked on cigarettes are somehow “kidney deficient” because they can’t stop smoking. This is totally taking the original Chinese concept and running with it!

We may not have one word that fits better than “will” to describe the zhi, but the concept of zhi is much bigger than the English concept of will. We should recognize that grandpa’s waning memory and luster for life reflects a decline in kidney essence, we shouldn’t start forming new theories about willpower simply because English has no perfect translation for the Chinese concept and “will” is the only word we hear.

Liver Governs the Tendons?

In the example of “zhi” above, there is not really an inherent mistranslation present. Instead, the wider concept is missed because no one English word can fully encapsulate it. By contrast, the translation of the word jin as “tendon” represents a true error in translation, and it is one that has permeated the Western TCM community. Here we have a major body tissue that is widely misunderstood by virtue of imprecise translation.

Jin tissue is governed by the liver, and it is associated with agility, flexibility, and strength. In pathology, the contractions seen in epilepsy are associated with contraction of the jin, and hypertonicity of the sinews is widely treated with methods that involve liver-wood. The texture of jin tissue is stringy and ropy. If you look at red meat, the gristle and white tissue surrounding and joining the red part is all described as jin. In Tui Na, any ropy tissue that you can grab and “pluck” is generally associated with jin.

In biomedicine, tendons attach muscle to bone. This is much narrower in scope than the Chinese tissue type. Chinese medical dictionaries often describe jin as encompassing tendons, ligaments, and connective tissue, though in fact many muscle bellies are also categorized as jin tissue. Examples include ropy muscles like the SCM on the neck or the aptly-named gracilis muscle, which just happens to traverse the liver channel area. The upper trapezius muscle is also quite ropy and is described as jin tissue in Tui Na; this region is coincidentally associated with the gallbladder (wood).

Chinese medicine divides the body’s tissues differently than biomedicine, and we must endeavor to understand Chinese medicine on its own terms. The translations of sinew (jin) and flesh (rou) are far more accurate than the words tendon and muscle. When people hear that the liver governs the tendons and the spleen governs the muscles, their understanding often ends right there. In actuality, the liver governs the tendons, ligaments, connective tissue, and ropy muscle bellies, while the spleen governs the thick, meaty, fleshy part of the body. This has major implications for the treatment of our patients, since understanding how the body’s tissues are grouped is essential for proper diagnosis.

In my opinion, it is essential to study Chinese medicine as it actually is, without trying to fit it into our own cultural box. There is plenty of room to bring our own culture’s contributions to Chinese medicine after we learn the foundation well, but at the moment the foundation of many students remains somewhat shaky. Having more accurate, consistent, and professional terminology would do wonders for future generations of students. I’ve already witnessed a major transformation in the students at the Pacific College of Oriental Medicine, simply because so many teachers there pay attention to issues like proper expression and terminology. It takes time and education to correct ingrained habits like the use of the word “tendon” to describe the tissue of the liver, but our patients will thank us for taking the time to learn TCM concepts correctly.