Category: English

Articles written in English

Interface

Before a practitioner can start treating people, s/he must first find out what is wrong – as far as that is possible at all. Naturally there are many ways to do that and I am not going into the details of examination techniques. However, I am under the impression, that the Chinese with their intellectual world domination in this area have inspired many westerners in believing and practicing something that is usually “handled” (please observe the expression; there will be a few more instances of this kind of illuminating terms below) a little differently in Japan.

Since I have not had the opportunity to observe things directly in mainland China, reading through (Chinese influenced) reports, research material etc., or also material from China, I am also under the impression, that the authors gather information by taking the pulse, inspecting the tongue and some other bits of information to draw their conclusions based on the classifications the Chinese love so much and/or select the points for their treatment based on the theoretical instructions found in textbooks or the classics. It is of course laudable to know the textbooks and classics, but personally I very much doubt, they can tell you anything about any real patient. Just like the description of “pneumonia” in a textbook of medicine gives you an averaged, generalized model, but not the particular situation you encounter in patient “xxx”.

Although not all Japanese practitioners adhere to the practice I attempt to put into the words I chose below and which a patient of mine once has called “poking around”, I prefer it and believe a substantial number of other (Japanese) practitioners could offer the world here something, that may not really make the EBM enthusiasts happy, but provides a sometimes very enlightening “close encounter of the Japanese kind“.


Interface is a term usually used in relation to computer and machine technology. But I would like to express a few ideas pertaining to (physical) treatment, in particular acupuncture treatment, and borrow this expression for this particular purpose.

In the medical world it is common sense, that individual life forms, including single-celled microorganisms, plants, animals and man, have a body surface that forms the interface of this particular individual with the environment. Yet, in contrast to man-made devices, which are usually one out of a more or less large number of identical devices manufactured at a specific site with identical specifications, these life forms are always UNIQUE. Not one of these many “devices” (let’s call them units below) exactly matches any other unit, even if they are of the same species, like for example “man”.

Each individual unit is slightly different. For that reason the interface between the unit and the environment at any given moment in time is subject to a unique, highly specific set of parameters influencing both the unit and its environment. And because the specifications for each unit are unique, the interaction between the particular unit and the environment occurring at their common interface – in man the skin – also is subject to unique changes. That means, that no other unit would react in exactly the same way to a given, reproducible parameter/influence, like temperature or pressure.

In computer technology the status of the various devices and their respective hard- and software can be checked and a “digital output” of the relevant data prepared. In medicine, here I refer in particular to acupuncture, “running diagnostics” is also largely a “digital” process, because the practitioner uses his/her fingers = digits to literally READ information from the body surface of people/patients. But in contrast to this process in computer technology the diagnostic process in acupuncture exceeds the unidimensional digital level and becomes a “sensual” holistic process, in that it includes visual (inspection), audio (hearing, listening) and chemical (smell, but only RARELY taste) parameters.

In relation to the “EBM frenzy” currently almost everybody is looking for “reproducible, digital readouts” of this information: like temperature, pressure, electrical resistance etc. However, to the best of my knowledge, even if there are devices under development that may be able to test and measure some of these parameters like pressure, which would be essential for examining the pulse, these devices are still very far from reliably and meaningfully measuring the parameters they are designed for. The human touch still exceeds their capabilities.

Even if there were devices that would satisfactorily measure ONE particular parameter, a human (erratic as that may be!) practitioner would still integrate all the different modalities of into one whole (“holistic“) picture quite different from what any machine would produce. In addition, the practitioner him/herself too is a unique unit, which produces naturally a unique and not completely reproducible output. THAT is for all scientifically/technically inclined researchers believing in the holiness of EBM a horrible concept.

Now, the interface used for data collection, namely the two layers of the skin of both patient and practitioner approaching and in most instances also coming into contact with each other, are not unlike a telephone. (This is a metaphor I like to use, when I try to explain the situation to my patients and refer here only to palpation.)

On the “one hand” (please note THIS expression) the practitioner moves with his/her hand(s) over the body of the patient to collect = read the data written on the patient’s body surface. Although most patients are not really aware of them, for a practitioner with a little clinical experience there is a lot of information to read there, that will tell him/her about the past, present and future state/development(s) of the examinee. This is like listening to that person talking on the other end of a telephone.

During the treatment on the “other hand“, for which the hands do not even have to be lifted off the body = cut the connection, the same hand(s) of the practitioner provides some input for the system “patient”. That is then like responding to the person on the other end of the telephone line.

Modern telecommunication technology uses wired networks, where cables are used to connect different devices, and wireless networks using electromagnetic waves and fields. In medicine nothing substantially has changed in the technological setup of the wired and wireless networks (only our understanding of their functioning is growing) since their inception = billions of years ago. Practitioners use the hardware components for the wired networks, like nerves, muscles, bones etc. in order to receive/transmit physical stimuli/information = like nerve impulses traveling along nerves, or moxibustion induced chemical changes/substances propagated via the chemical transport system “blood”. For the wireless networks practitioners tap into energies and information in and also propagated along LAN channels that work without having their own hardware, in the field of acupuncture these are often referred to as meridians or also channels (note the similarity).

Actually, I have been called for help in my capacity as an acupuncturist via mail. However, as I said above, both patient and practitioner are unique individual units with their own unique specifications and therefore without exactly predictable reactions (to interventions). Thus, helping people over long distances is usually not working very well, because I as a practitioner have to do almost completely without data readouts from the malfunctioning unit (person). Therefore the attempts are in most cases bound to be unsuccessful.

The advice would be: get a piece of real “first-hand” human touch experience up close …… again those expressions …

Painful acupressure …

 This is UNACCEPTABLE!

The nails cut into the flesh!!
The other day I was asked to “evaluate” a DVD to determine, whether its translation and eventually publication in Japan is worthwhile.
While I was watching the DVD, featuring three professional therapists (all university graduates), I noted that ALL of them kept rings, watches etc. on their respective hands and at least two of the three had finger nails clearly extending beyond the finger cups.
Probably I am very old-fashioned, but I learned “in school” – this in itself does not mean anything – that professionals are not supposed (I think even prohibited by (Japanese) law) to have rings, watches … anything metal … on their hands during the treatment. Personally I am very much in favor of this idea and NEVER have anything metal or otherwise hard on/at my hands.
Again, when I was looking for some stuff and found on Wikipedia a picture of an acupuncture practitioner (see link). This clearly shows very long fingernails and even a mark on skin, where those finger nails have pressed into the flesh (of the patient/model).

Acupressure


http://upload.wikimedia.org/wikipedia/commons/0/05/Acupuncture_point_Hegu_%28LI_4%29.jpg

This is UNACCEPTABLE!
The practitioner is hurting the patient.
Since Hippocrate’s time “Primum non nocere (first, do no harm)” is known to have utmost priority in all forms of treatment!!!

Avian influenza / COVID

以下に日本語 / 英語 / ドイツ語を並記します。

Below I list an old article of mine in Japanese / English / German about avian influenza and my personal view of the virtues of moxibustion treatment. I believe, this also applies to the current COVID pandemic.

以下のリンクをたどれば更なる情報がある。
These links lead to more information.
Die folgenden Links führen zu Seiten mit weiterführenden Informationen.

http://www.cdc.gov/flu/avian/outbreaks/current.htm
http://www.who.int/csr/disease/avian_influenza/updates/en/index.html
http://www.shanghai.cn.emb-japan.go.jp/tori/index.html
http://www.wpro.who.int/health_topics/avian_influenza/

鳥インフルエンザ
 再び人類が顕微鏡でないと見えないほど小さな敵の攻撃に曝されている。その危険は決して侮ることが出来ないが,慌ててしまうと矢張り見えるものが見えなくなる。
 現時点では「特効薬」がないそうだ。鳥インフルエンザヴィールス自体も刻々と変化しつづけている。もし「特異的な」治療法がないようでしたら、数千年の実績を誇るべき治療法を一度視野に入れても損はないでしょう。
 お灸は「非特異的に」人間の免疫機能を活性させる事は、疑問を持てずほどはっきりと証明されているようだ。ならば、病気になるまで待って、それから果たして安全かどうかが不明な薬剤を投与することは余り賢くないと思う。そして現在市販されている新薬以外、商売の極めて上手の中国人はそれなりに高価な「特異的に効く漢方薬」を発売するのも時間の問題と予想する。SARSの時もそうでしたから。
 ならば、是非安価であって、それぞれ個人で自宅に実行出来るお灸をお奨めしたい。商売にはならないが、国民の健康が心配であれば、この方法を思い出してもらいたい。

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Avian influenza
Again, mankind faces the threat of an enemy so small, that it can be seen only under the microscope. The danger of this disease definitely cannot be taken lightly, but panicking in the face of this threat will only impair cool judgement.
Currently there appears to be no “specific drug” to treat this disease. And the virus itself continously changes. If that is so, it may be a good idea at looking at available treatment forms that can look back on a tradition of several thousand years of successful treatment: moxibustion.
That moxibustion “non-specifically” activates the human immune function has by now be verified beyond doubt. So, waiting to get sick and then be treated with drugs of possibly questionable safety and efficacy, does not seem very wise to me. And in addition to the already commercially available modern drugs, I have no doubt that the Chinese with their wonderful capitalistic sense of business will shortly announce the successful development and marketing of a (probably not inexpensive) Chinese medicine specifically effective for this disease. I remember that this was the case with the SARS epidemic too.
Well, why not try the extremely cheap moxa therapy, that can be performed by anybody at home? This will certainly NOT generate any business, but if someone has an earnest interest in the health of the people, this is a therapy that deserves to be called to mind!

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Vogelgrippe
Wieder einmal sieht sich die Menschheit der Bedrohung durch einen Feind ausgesetzt der so klein ist, dass man ihn nur unter dem Mikroskop erkennen kann. Und obwohl die Gefahr beim besten Willen nicht leicht genommen werden darf, Aufregung im Angesicht dieser Gefahr kann das Urteilsvermögen beeinträchtigen.
Derzeit gibt es offenbar kein “spezifisch wirksames” Wundermittel gegen diese Krankheit. Außerdem ist der Virus in der Lage sich selbst ständig zu verändern und weiterentwickeln. Wenn dem so ist, könnte es durchaus eine gute Idee sein, sich auf Therapieformen zu beziehen, die auf eine mehrere Jahrtausende überstreckende Tradition wirksamer Behandlung zurückblicken können: zum Beispiel die Moxibustion.
Das die Moxibustion die menschliche Immunfunktion “nicht-spezifisch” stimuliert, ist inzwischen über jeden Zweifel erhaben nachgewiesen worden. Jetzt darauf warten, dass man krank wird, um sich dann mit modernen Medikamenten behandeln zu lassen, deren Sicherheit und Wirksamkeit nicht unbedingt erwiesen ist, scheint mir persönlich keine sehr weise Entscheidung zu sein. Außerdem würde es mich nicht wundern, wenn neben den bereits kommerziell erhältlichen modernen Medikamenten die Chinesen mit ihrem wunderbar kapitalistischen Sinn fürs Geschäft in Kürze mit einer “neu entwickelten und hochspezifisch wirksamen” (vermutlich auch nicht sehr billigen) chinesiche Medizin auf den Markt bringen. Ich kann mich daran erinnern, dass dies bei der SARS Epedemie auch so war.
Nun, warum dann nicht einmal die extrem billige und dabei gleichzeitig von Jedermann zu Hause durchführbare Moxibustion ausprobieren? Dies wird mit Sicherheit NICHT geschäftlich interessant sein, aber für Alle, die ernsthaft um die Gesundheit der Menschen besorgt sind, ist dies eine Therapieform, die einmal in Erwägung gezogen werden sollte!

Translator as “Bookfinder”

In the not so distant past the military used scouts, sometimes also called “pathfinders” (Merriam Webster: path.find.er n (1840): one that discovers a way; esp: one that explores untraversed regions to mark out a new route — path.find.ing n or adj.), to find their way through unknown territory. Literally, these were people that could find a path not visible to anybody else. During a recent conference on translation, a certain question appeared in several different sessions: what actually is the job and/or function of a translator?

The answer to this question appears on first sight to be simple and obvious, but many of the attending translators and agencies presented widely varying definitions and concepts. This motivated me to write this little article and express an idea, I had for quite a while now. I.e., translators should also (or maybe even predominantly) be “bookfinders” in analogy to the above mentioned pathfinders. Below I will try to explain why.

I have been a translator for about 30 years and during this time spent nearly 100% of my working time with activities, involving the rendition of a certain meaning expressed in one language into another. Sometimes, in particular when the source text is of rather poor quality and/or ambiguous, this also involves a more less significant portion of text interpretation and re-writing. Nevertheless, the basic idea is always the same: change A into B. Very few, if any, people I happened to work with over the years have ever questioned or even challenged this view. This is simply considered to be the job and function of a translator.

Yet, if you are a translator for any specialized field, have a professional interest in extending your horizons, conduct a little research in your own or maybe even other fields of expertise, then you will certainly do some reading.

This puts the translator in a unique position. He/she is not only capable of professionally handling and evaluating two or more languages, but will be reading reference books on certain topics in these languages. Sometimes there are equivalents or even translations of certain valuable references, but most often not. Under these circumstances the translator can evaluate several books that might be worth translating from both linguistic and technical points of view.

I believe that a look at the currently available selection of translated books shows clearly, that the choices are definitely not always “professional”. They are made by publishers based on information and recommendations of sometimes questionable origin and mainly commercial considerations. This provides the general population with a selection of translated books influenced by a possibly biased and – naturally – profit orientated choice made by publishers. But this could also mean, that the average person has access only to a rather distorted view of the world.

Today, the internet offers access to the so-called information highway carrying more information with an incredibly short turnover time than anybody could ever handle. Yet, fast access to a terrifying amount of information could also block the view for the more distinct, practical, comprehensive and interesting information a book can provide. After all, reading should also be fun.

While access to the information highway may often prove to be very helpful, who would like to live in a house with the front door opening right onto the highway? Personally, I prefer the quiet small back roads. This is, where books come in. It takes much longer to publish a book than to publish and update a web site. Naturally, books are always somewhat “behind their time”, but that does not reduce their value.

For example, I am a native German living in Japan. I know of literally “uncountable” translations of German literature, science books etc. available in Japanese bookstores. Yet, whenever I visit Germany and wander through large bookstores, I can find at best a handful of Japanese books translated into German. A very illustrative little episode happened, when I visited the annual Tokyo International Book Fair a few years ago. There I asked a German publisher if they might be interested in the publication of translated Japanese books. The representative at that booth said: “No, why should we? Publisher XXX already has published two books.” This is hardly representative for a nation that publishes around ten thousand new books every year!

Thus, in spite of the omnipresent information highway and Japan being a superpower with a major impact on the world economy, intellectually it still remains largely uncharted territory (a sort of a black hole) for the people of other countries, because there is so little tangible (books that you can take in the hand in contrast to virtual material on the internet) information about it available. I firmly believe that the same situation also applies to quite a number of other countries.

Now, here is a field, in which translators could offer a real contribution to international understanding: selecting and recommending books worth of translation. The translator who recommends certain books might even do the entire translation. In many cases this would be not only be advantageous for the translator, but also the translation itself and thus the reader.

瞬間移動の練習中

治療院に座って本を読んでいる状態から瞬間移動に「旅立った」瞬間。姿はまだ見えているが、既に半分消えているが、体を透き通て体の後ろにあるものが見える。
もう少し修行すると宇宙を旅出来るかなあ・・・

Teleportation practice

Sitting in my practice reading a book I am practicing teleportation. On this picture I have already started to leave, but while my figure is still visible, so are the things that were located behind my back.
With another 200 years of practice I hope to be able to do interstellar travel ….

(There is nice, rather old science fiction novel about this, called “Tiger! Tiger!”)

Politeness in the digital age

I am registered in many sites pertaining to translation and interpretation. From one related to interpretation I got the following message in the afternoon. The job would have to be done the next day.

“New message from XXX XXX via interpreters.travel
Automotive world 2019 , tokyo big sight
January 17 (10:00 – 18:00)”

That is all. No “please” or “are you available”, “could you help us out” … nothing.
Just “Tomorrow. Be there!”
Naturally, I reclined the “job offer”.
Is this the style of American, Chinese, Russian or other mafia like people.
Or is this now considered to be the “new standard” of politeness in the digital age?

Breathing

Everybody does it – 24 hours a day – no big deal. 

YES, big deal! 

Breathing is essential to life. This is common knowledge. You can survive (only survive, not live) for almost 2 months without food, something like 7-10 days without water, but the brain tissue starts dying 3 minutes after oxygen supply has been interrupted. So, breathing is required for survival and everybody does it throughout life, without any interruption. What can be so special about that? 

Special is, that ALL healthy babies do it right, but only VERY FEW adults seem to capable of maintaining this skill. If you don’t think that this applies to you, well give it a (simple) try. 

Go some place where you (and some noise) won’t bother ordinary people (who might otherwise call the police and try to commit you to a lunatic hospital) and scream. Yes, that’s right: scream. With all the power you have and as long as you can do it. Most people I know will be very lucky, if they can keep screaming at the top of their voices for 10-15 minutes. After that your voice will start “fading”, because you get hoarse and later you may not be able to talk properly for days. 

THAT would be “normal” for most educated, civilized people. 

My eldest son, when he was about 6 months old, once managed to scream for a full 5 hours – with no apparent trouble. Neither during the screaming nor afterwards. Why? Because he was breathing correctly (which the mother did not like at all at the time!)

 Correct breathing would be the so-called abdominal breathing. Deep and slow, having your belly expand and retract. Textbooks on physiology give the normal respiratory rate (the number of inhalation and exhalation per minute) as 12-15 cycles, meaning a cycle of inhalation and exhalation takes 4-5 seconds. 

Personally I believe that is too fast. 

Too fast, excessive breathing may lead to “hyperventilation syndrome”, a condition were the victim may drop to the ground with uncontrollable spasms – like an epileptic. But these victims don’t have any brain lesions, they simply exhale too much carbon dioxide. This happens frequently in young girls that keep screaming during a rock concert. 

I advise my patients to attempt achieving a respiratory of 10, meaning 6 seconds per cycle. That may be far longer than you expect, when you try doing that while watching a clock. 

The deep breathing both provides you with more air than you would obtain during fast and shallow breathing and it reduces the amount of carbon dioxide you are venting into the air. That in turn raises the concentration of CO2 dissolved in the blood. And THAT has about the same effect as a mild tranquilizer! Here is reason why most meditating people appear to be so cool. 

So, if you are upset, anxious, cannot sleep etc. – try to slow your breathing as far as possible. 

Naturally, according to oriental thoughts correct breathing also provides your body with energy and power. The power that allows karate specialists to smash bricks and a tea master to prepare a cup of delicious tea. 

But this is something, I will write about next time.

1-Point Advice

Low Back Pain

  • Almost everybody will suffer once in his/her life time from low back pain.
  • The only bones supporting the center of your body are the vertebrae.
  • Thus, support of the “low back” is provided mainly by muscles around your waist.
  • Use your body to train those muscles.
  • The simplest way is walking.
  • Use the stairs instead of escalators and walk to the station instead of taking the bus.
  • The there is one acupoint known to tune your muscles.
  • The “Yang Mount Spring” (G34) laterally below the knee.
  • Regularly stimulate this point – like regular tooth brushing, using your fingers or objects with rounded head.
  • More information will come up in the scheduled frequent updates of this page.

“True” or “authentic” acupuncture

Well, this is a very much discussed topic. Although there is a serious lack in research into the scientific basis of acupuncture, an not insignificant number of studies have been performed, trying to verify the efficacy of acupuncture. For that purpose one thing that always pops up is the distinction between “true” and “sham” acupuncture. Like the distinction between the real drug and a placebo in clinical trials. Apart from the fact, that the design of pharmaceutical clinical trials cannot really be applied to research into acupuncture, the concepts of “true” and “sham” acupuncture present a problem, I believe.
Naturally, performing “sham” acupuncture, not considering the ethical implications of “knowingly deceiving” the patient, is always difficult to realize technically. But the real problem is not the “sham” acupuncture – it is the “true” acupuncture.
The Chinese try to make everybody on earth believe, that their way is the only “authentic” = “true” form of acupuncture. Yet, it uses needles almost as think as sharp-pencil mines, that are inserted “free hand”. This requires some REAL (!) skill to do it in such a way, that it is NOT painful.
I have tried a lot of different brands of needles, but by now come to the conclusion, that “Made in China” represents a very low manufacturing quality. Needling with needles “Made in China” is almost inevitably painful. I tried that myself. And on top of that, the assertion is, that unless you do not elicit the so-called “de-qi” feeling, which is according to definitions by most physiologists a kind of pain, the acupuncture will not be effective.
MOST of my patients, including myself, do NOT like the pain called “de-qi”, or “tokki”, as it is called in Japan. Thus, one type of pain coupled with another type of pain (from the technically poor needles) causes the patient CONSIDERABLE dyscomfort! In fact, and I have been told so by people who underwent such treatment in Germany or the USA, the dyscomfort is so intense, that even though the patients received money from the government, in order to participate in a study designed to show the efficacy of acpuncture, they rather choose to drop out of that study. It was just too painful. And the treatment had been delivered by professionals with something like +20 years clinical experience!
If the treatment is something like a medieval torture, so that patients break into cold sweat even before the third or fourth treatment session and therefore leave the study, the obtained results can hardly verify the value of acupuncture treatment.
Using Japanese needles, technically superior, which are much thinner and inserted with the help of a tube, so that there is usually no pain or dyscomfort whatsoever, “Japanese style” acupuncture treatments still relieves many of the patient’s symptoms – without pain or dyscomfort. Usually my patients leave with much improved symtoms and a feeling of satisfaction.

I think, the world should know about this! And put the true acupuncture into perspective.

With all due deference, but …

he entire human race uses “language”, with the exception of the comparatively few people suffering from some sort of impairment, as a matter of course. Although there are differences regarding region/land and historical time, people in a specific location and at a specific time take the use of their “native” language for communication with other people of the same time and region for granted. While there are differences among different languages in the way how certain things/concepts are handled, the basic idea of conveying information between people is probably everywhere the same. 

To quote from the Wikipedia(1):
“(language as) A tool for communication
Yet another definition defines language as a system of communication that enables humans to cooperate. This definition stresses the social functions of language and the fact that humans use it to express themselves, and to manipulate things in the world.”


Again from the Wikipedia, pertaining to communication(2):
“Human communication
Human spoken and written languages can be described as a system of symbols (sometimes known as lexemes) and the grammars (rules) by which the symbols are manipulated. The word “language” is also used to refer to common properties of languages. Language learning is normal in human childhood. Most human languages use patterns of sound or gesture for symbols which enable communication with others around them.”


Problems arise, when people of one specific region try to communicate with people in or from other regions. These problems arise already during communication related to common things like food, housing, directions etc., occasionally even among speakers of different dialects of the same language, but become much more complex in areas of high specialization. Oriental medicine is one such area. Even if one assumes, that the people who try to study and/or communicate about oriental medicine are already experts in their field, communication of specific concepts using different languages may represent a very challenging task. Assuming that there is a wealth of valuable information, which I will define for the sake of this discussion as information originating in Japan, this is and remains of very little use. That is because it is (encrypted) in Japanese, which mainly precludes access to it by most people of the world and information becomes only then really useful, if it is made available/accessible. 

I am not a scholar and do not speak on behalf of any particular group of people or organization, but would like to formulate a few of my personal concepts related to this topic. In particular I would like to focus on aspects of the Japanese language, how it seems to be currently handled and understood in this field of learning and what potential future students of oriental medicine might expect or would like to see.
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As stated above, language is used to convey concepts among people. This is an extremely simplified statement, but since I do not want to/can delve into all the complexities of research into language, communication and information exchange, I would appreciate, if you will permit me to leave it standing as it is. 

The Japanese language is quite different from both English or other European languages and other oriental languages like Chinese. It does not use articles, rarely distinguishes between plural and singular and handles nouns and verbs differently from the way this is done in English for example(5). This may contribute to the impression, that Japanese is complicated and so difficult to learn, that most foreigners are not expected to have much success. Yet, Japanese is a highly developed, delicate and elegant language. Examples of highly refined typical Japanese literature like the “Genji Monogatari” for example, even though they use the writing system imported from China, antedate comparable works sometimes almost by centuries. 

Yet, the Japanese people themselves seem to suffer from an inferiority complex about their language precisely because it seems to be so difficult and inaccessible. In a very illuminating book written by the linguist Suzuki Takao “The World of the Closed Language Japanese”(8) the author points out, that Japanese is actually one of the top 10 most spoken languages of the world. In his book he cited Japanese to be on rank 6, but while the rank has dropped to “9”(6) since its publication 30 years ago, it still remains among the most frequently, widely spoken languages of the world. There is nothing to be ashamed (shame is also a concept of special cultural significance in Japan) of. Rather on the contrary: I firmly believe that Japanese people should take more pride in their language and their achievements, which are largely expressed through this language. This in turn suggests, that materials explaining these achievements should be made assessible to the world through translation. 

However, because of their fear, that other people/languages may be superior to their own and in conjunction with the aggressive promotion of a “standard TCM terminology” by the Chinese through the WHO(7), the Japanese have adopted a quite restrained behavior of promoting/displaying their own concepts and practice of oriental medicine through the use of Chinese dominated language. The result is an almost unbearable mixture of expressions, circumscriptions etc. that make even comparatively simple ideas almost unintelligible for many students of the matter throughout the world. I will try to illustrate with a few examples.

Occasionally I translate Japanese articles meant for magazines etc. that have the purpose of promoting the Japanese concepts pertaining to the use of Chinese herbal medicine, called Kampo, as well as research into acupuncture and oriental medicine in a wider sense. 

Yet, while the use of Chinese herbal medicines in the Japanese way = Kampo should be considered an original Japanese application, editors sometimes/often cling to the Chinese form of an alphabetical notation of the relevant terms. For example, certain editors follow the recommendations by an authoritative academic (Japanese) society for the research into Kampo medicine and thus demand from me, that I write the name for prescriptions as ONE word, appearing in third place after English and Chinese like:
* Cassia Twig and Tuckahoe Pill plus Coix Seed 
* Gui-Zhi-Fu-Ling-Wan-Liao-Jia-Yi-Yi-Ren
* keishibukuryoganryokayokuinin

Here I can understand the use of an English translation. That certainly facilitates access to this information. The Chinese notation at least shows the breaks between individual characters, facilitating search in dictionaries and possibly also provides clues about the pronunciation. While the Japanese … (12)

The above shown Japanese “word” has 29 (!) characters. There are even longer ones, like for example “yokukansankachinpihangegotokishakuyakusan” with no less than 41 characters. And, while the English and Chinese terms are treated as proper nouns and thus capitalized, in the example above the Japanese term appears only in lower letters, as if it were no proper noun.

I once asked a scholar about the necessity of expressing the Japanese terms as single words. The answer was, it would be very difficult to decide where to put any possible breaks. Again, I have great difficulties in believing, that the current approach will facilitate the declared purpose(9) of disseminating relevant information. 
For example, one could easily break down the expression for the prescription called “Keishikaryukotsuboreito” in the following way:
* Keishi = drug name
* Ka = processing instruction
* Ryukotsu borei = names of TWO drugs
* To = drug form.

Not even Japanese persons would consider Keishikaryukotsuboreito” to be ONE word, even if it is ONE name. For a Japanese person the term becomes immediately intelligible by looking at its elements, in particular since the Japanese know the associated Chinese characters for this term. This latter information and the underlying structure is presumably NOT available to many possible students of the material, unless they have previously acquired a considerable knowledge of the Japanese language, and thus makes comprehension very difficult, it not impossible. This includes also the difficulties encountered during attempts of looking up the term in dictionaries, that are newly created by this notation.

When I showed terms like “ryokeijutsukantogotokishakuyakusan” to Japanese people and asked them to read that for me, ALL were struggling very hard or could not figure it out at all, although they could read, naturally, the term when it is written in Chinese characters.

A little search about the use of long words in the English language showed, that the longest non-coined and nontechnical word is “Antidisestablishmentarianism” with 28 characters and the longest word in Shakespeare’s works is “Honorificabilitudinitatibus” with 27 characters(4). So, for any “reasonable” discussion words of less than 20 characters should be suitable/comprehensible. “yokukansankachinpihangegotokishakuyakusan” (41 characters) is simply incomprehensible. The use of notations like “Thisisalonggreenhouseattheroadside” or “Lelangageestunsystme de signesidentifis permettantunecommunication entreune ouplusieursentits” would NOT help any learner of English of French respectively. Further, I believe that MOST people will have difficulties pronouncing the English word “Supercalifragilisticexpialidocious” with 34 letters, that was in the song with the same title in the Disney musical film Mary Poppins(10), without any practice. 

Following the same argument, I think it would help both foreign students as well as ultimately also the Japanese practitioners, if terms related to acupuncture like “Seppi”, “Hinai Shin” etc. were left in Japanese and maybe provided with a descriptive English translation. In a similar fashion the technical terms related to Judo or other forms of martial arts are used WITHOUT translation. If the provision of such word pairs is too difficult to integrate into every text, it should be no problem at all to set up a frequently updated online database with the relevant terms.

After all, anyone who starts learning a certain subject, here oriental medicine, or a particular language, here Japanese, WILL have to refer to dictionaries and other reference materials. In this respect, with all due deference, I am under the impression that the highly educated scholars who have apparently been working on the above mentioned standard terminology or are representatives of the academic societies that strive to study oriental medicine and disseminate the relevant information, may have lost touch with basic problems learners have to face. In particular regarding the use of terminology, I firmly believe that the currently used Japanese approach is wrong.

Let’s consider the use of dictionariess for an attempt to find out more about “keigairengyoto” = Jing-Jie-Lian-Qiao-Tang.
If you use a Chinese-English dictionary that provides alphabetized entries, you will know, that you are looking at a term consisting of 5 characters and can look up each according to its reading. However, there are naturally a large number of characters reading “Jing” and in ordinary language most probably no combination like “Jing-Jie”. For that purpose you need a special dictionary.

The Japanese is worse, much worse. Here you are offered only ONE term. Even if the learner suspects, that this term consists for more than one character, HOW should this learner look for the relevant characters? The term could be split like:
*   ke iga iren gyo to
*   kei gairen gyoto
*   keiga iren gyoto
*   keigai rengyo to etc.
That gives the student many possible dictionary entries to look up – a largely futile effort. 

For anyone who does not know the language (Japanese), all of the listed divisions are equally possible. Depending on how the individual terms/characters are listed in the particular dictionary, this may render a search almost impossible. If the particular dictionary does NOT provide alphabetized notations, most foreign readers are denied access to this information right from the start. I have experienced this myself many times. Unfortunately, to my knowledge there are, with one little exception(11), no proper dictionaries that would help foreign students getting access to the required information. The shortest, and only, way would always require the combined use of several Chinese-English, Chinese character, Japanese-English dictionaries. Occasionally more than one of each type.

Apart from the standard dictionaries there are a number of special dictionaries for oriental, in this context mostly Chinese medicine. Sometimes the tycoons in the field publishing those dictionaries then argue about who has the “right” translation, which will invariably be different from what is found in dictionaries published in China and among the latter ones again, each gives something different and here the English rendition itself more often than not appears to be rather dubious. What the WHO has published recently as the “agreed upon standard terminology” still feels in many instances not right, at least to me. And, naturally, that terminology assumes that everything must be based on Chinese concepts. 

Since people are basically dealing with “Chinese medicine”, this consensus is of course not wrong, but what happened to the Japanese view and all those aspects special to Japan? The basic concepts of acupuncture and herbal medicine have been brought to Japan about 1,500 years ago and over centuries after that through books and by practitioners. Yet, that is a long enough period for some original, independent developments to take place. Take for example the use of guiding tubes for acupuncture: a purely Japanese invention. In conjunction with the cultural differences, climatic and geographic differences and not least the mentality of the people this period of 1,500 years of development has led, I believe, to the establishment of conceptional systems and practical applications that are clearly distinct from the Chinese form ? even though many Japanese practitioners strongly assert, that they are practicing CHINESE medicine. 

In spite of the thus historically formed system of a typical Japanese approach to oriental medicine, the insistence of the people in charge to NOT make this information publicly known, or to choose deliberately expressions/notations that are/will be incomprehensible for many/most non-Japanese persons, is a waste of very valuable resources. 

I do hope, and possible can help to stimulate the process to adopt a more enlightening approach to the “dissemination of information”, so that the mountains of intellectual treasures currently hidden behind the veils of the Japanese language can be more easily assessed by the people of the world.



References:
(1) http://en.wikipedia.org/wiki/Language
(2) http://en.wikipedia.org/wiki/Communication
(3) http://en.wikipedia.org/wiki/Information
(4) http://en.wikipedia.org/wiki/Longest_word_in_English 
(5) An Introduction to Japanese Syntax, Grammar & Language
    by Michiel Kamermans; grammar.nihongoresources.com
    http://grammar.nihongoresources.com/doku.php
    http://www.thejapanshop.com/
(6) http://en.wikipedia.org/wiki/List_of_languages_by_number_of_native_speakers
http://www.photius.com/rankings/languages2.html
(7) WHOIST
WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region
(8) 鈴木孝夫: 閉ざされた言語・日本語の世界 (Suzuki Takao “The World of the Closed Language Japanese”)

(9) From the JSOM HP:
“Objective:
The intention of the society is to hold research presentations and seek communication, tie-up and promotion concerning oriental medicine and contribute to the progress and dissemination of oriental medicine, and thus contributing to the development of scientific culture.”
(10) http://en.wikipedia.org/wiki/Supercalifragilisticexpialidocious 
(11) Japanese-English Dictionary of Oriental Medicine; written and compiled by JONG-CHOL CYONG M.D. & Ph.D.; Oriental Medicine Research Center of the Kitasato Institute, Tokyo; ISEISHA

(12) Comment pertaining to: “WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region”:
* In this dictionary the items are listed in the order “Code ? Term ? Chinese ? Definition/Description”. “Term” represents the column with the English terms and “Chinese” lists the corresponding Chinese terms ONLY in Chinese characters. That means, users cannot search the dictionary according to reading/pronunciation of Chinese terms and MUST know, what they are looking for in English. Or else they have to read through entire sections of the book.
* The only section, that provides “pronunciation” is the one listing classical medical texts. However, this too looks to users who are NOT very familiar with the different involved languages like a deliberate attempt at making things as incomprehensible as possible:
Chinese: 素問玄機原病式 = Suwenxuanjiyuanbingshi
“Suwen” may be known well enough, but xu-an-ji or xuan-ji?
Japanese: 百腹圖説 Hyakufukuzusetsu
Should it be “pronounced” Hyakufu kuzu setsu or Hya kufu ku zusetsu?
萬安方 Man’ampo ? the approstrophe is almost a relief and very helpful!!!
Korean: 鄕藥救急方 Hyangyakgoogeupbang ? I have no idea at all how this is supposed to be pronounced!
Vietnamese: 保嬰良方 Bao Anh luong phuong ? even though I do not know how to pronounce that, I can clearly infer, that the term is made of 4 characters and look up their respective meaning, if I have Vietnamese dictionary (with alphabetical notation).

Even if the above are ‘single terms’, I am convinced that native speakers of the respective language pronounce these terms with certain intonational structure, revealing the listener clues to the makeup of the relevant terms. Without these clues, in the above example the apostrophe shows the listener/reader, that there is a break after “Man” and the term is not read Manam Po. Considering that even native speaker among themselves use these intonational structures, imagine what will happen, if someone who does not know the proper pronunciation of the relevant languages tries to read those terms / pronounce them / use them during communication with other practitioners.