Translating Ancient Chinese Wisdom into Medicine for Today

Q&A Forum

Q&A Forum for Imperial Mentorship members

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Shouldn't 脾 be identified with the Pancreas instead of the Spleen?


My question is, Why is 脾 almost universally translated as "spleen"? The functions attributed to 脾 are much closer to those of the pancreas. I'm curious to know whether you have any insight into early Chinese-to-English medical translations and why "spleen" might have been chosen and maintained.

My answer (admittedly just a start but perhaps we can get a discussion going below):

This is a really interesting question that nobody has asked me before and honestly, I don't have the perfect long answer or resource to send you to since it just never occurred to me. You are not the first person to have made this assertion, though, and it is also something that contemporary Chinese scholars have argued, such as this blog (if you can read Chinese), which argues that Chinese medicine misidentified 脾 with the organ we call spleen a long time ago:

I need to start with the disclaimer that I myself am not a biomedical doctor and do not have a biomedical education. I see medicine and the human body through the lens of the knowledge I have gained from studying the classical texts, obviously also influenced by the culture I grew up in and my training in medical anthropology and ethnomedicine. So I know way more about 脾 than I do about the biomedical understanding of the spleen and pancreas. Frankly, the biomedical concept of the pancreas is not something I have ever worried about because its Chinese equivalent (see below) is not an important topic in the medical classics. It would certainly be fun to dig deeper but for now, perhaps what I have to say below will at least explain to you why the vast majority of contemporary Western practitioners and scholars of Chinese medicine translate 脾 as “spleen.”

Based on historical Chinese organ drawings and explanations of 脾, we can deduce that the identity between the entity called 脾 in the Chinese classics and the anatomical organ that we call "spleen" in English is something that was established long ago and generally taken for granted. I know that the Chinese 脾 has a much richer role and broader function than the biomedical understanding of the spleen, but that is not really something that concerns me as a scholar of classical Chinese medicine. Biomedicine misses a lot of things about female reproduction, blood, uterus, kidney etc etc, which is more of my specialty, so it is not surprising to me that the CM understanding of 脾 is far greater than the biomedical one. And I have also heard people explain the role of 脾 as a combination of the spleen and pancreas, so that might be a compromise that you can live with.

The issue you raise about the Chinese concept of an organ not matching with the modern biomedical understanding of the same organ is not limited to the 脾/spleen situation. In terms of the marrow, kidneys, heart and all the other organs, they all have functions that do not match up exactly with the biomedical understanding of them. To emphasize this difference between the biomedical understanding and the Chinese medicine understanding of a certain organ, the German scholar Manfred Porkert refused to translate 肝 as "liver" but rendered it as "orbis hepaticus" and advocated and translated zàng 臟 as "Funktionskreis" (functional entity) or "Orbis". Some medical historians still use capital letters for this same reason, to alert the reader that the English word is different in a CM context than the popular English understanding of the term. I don't do that because historically and in different cultures, the Western concepts of "heart" or "liver" etc. have also changed dramatically so the word "heart" can refer to much more than the narrow biomedical meaning, depending on context, time, usage, and individual author's intention, even in English and other Western languages. I just assume, at least for the books I am currently writing or have written in the past, that my Western readers are trained in Chinese medicine and therefore know that when I talk about the spleen, or blood, or the kidney, it implies all the functions and relationships that we associate with these terms in Chinese medicine.

In Chinese, there is a different word to translate the English term "pancreas": 胰. I don't know how old that term is and when it was firmly associated with the Western notion of “pancreas,” but I did find this term in the Kangxi dictionary (published in 1716), so it clearly predates any serious influence of biomedicine on Chinese medicine and was not an invented term created in response to a biomedical word that the Chinese had no equivalent for. In the Kangxi dictionary, the character 胰 is explained as the flesh adhering to the spine. In my dictionary of "traditional" Chinese medicine 中醫大辭典, the term 胰 is explained as "kidney fat," with the Bencao Gangmu (completed in 1578) cited as reference. According to Li Shizhen, “it is also called kidney fat. Growing between the two kidneys, it looks like fat but is not, and looks like flesh but is not. It is located in the place of the Mingmen and source of the Sanjiao and is more in obese people and less in skinny people.”

If you want to get really nerdy, you can read this lengthy explanation by Nigel Wiseman on the topic of translation and the art of matching Chinese technical medical terms to English words.

I hope this answer at least gives you some ideas. Thanks for a fun little research project (:

And now I invite all of you members of this forum to comment if you wish…

Sabine Wilms10 Comments