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The American Translators Association Scholarly Monograph Series is published

periodically by John Benjamins Publishing Company. Since contributions are
solicited by the Editors, prospective contributors are urged to query the Managing
Editor or Theme Editor before submission. The theme and editor for volume XI
is Language Management, Robert Sprung.
Back volumes of the ATA Series may be ordered from John Benjamins Publish­
ing Company Amsterdam (P.O. Box 75577, 1070 AN Amsterdam, The Nether­
lands) or Philadelphia (P.O. Box 27519, Philadelphia PA 19118-0519, USA).
Volume I (Translation Excellence, edited by Marilyn Gaddis Rose), Volume III
(Translation and Interpreter Training and Foreign Language Pedagogy, edited
by Peter W. Krawutschke) and Volume IV (Interpreting-Yesterday, Today and
Tomorrow, guest editors: David and Margareta Bowen) are out of print. The
following volumes are available:

Volume II Technology as Translation Strategy, Guest editor: Muriel

Vasconcelles, Washington, D.C.
Volume V Translation: Theory and Practice. Tension and Interdependence.
Guest editor: Mildred L. Larson, Summer Institute of Linguistics (Dallas,
Volume VI Scientific and Technical Translation. Guest editors: Sue Ellen and
Leland D. Wright, Jr., Kent State University.
Volume VII Professional Issues for Translators and Interpreters. Guest editor:
Deanna L. Hammond, Washington D.C.
Volume VIII Translation and the Law. Guest editor: Marshall Morris, Puerto
Rico, Rio Piedras.
Volume IX The Changing Scene in World Languages. Issues and challenges.
Guest editor: Marian B. Labrum, Brigham Young University, Utah.

Managing Editor: Françoise Massardier-Kenney, Kent State University (Kent,

Ohio). Editorial Advisory Board: Marilyn Gaddis Rose (Binghamton University
NY); Deanna L. Hammond (t); Peter W. Krawutschke, Western Michigan
University (Kalamazoo); Marian Labrum, Brigham Young University (Provo,
Utah); Marshall Morris, University of Puerto Rico (Rio Piedras, P.R.) and Sue
Ellen Wright, Institute for Applied Linguistics, Kent State University (Kent,
and Medicine

Volume X 1998


Henry Fischbach


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American Translators Association Series


Volume X 1998


Series Editor's Foreword


Guest Editor's Preface




Breaking the Greco-Roman Mold in Medical Writing:

The Many Languages of 20th Century Medicine

A Contribution to the History of Medical Translation in Japan


Some Thoughts on the Spanish Language in Medicine


The Language of Medicine:

A Comparative Ministudy of English and French


Who Makes a Better Medical Translator: The Medically Knowledgeable

Linguist or the Linguistically Knowledgeable Medical Professional?
A Physician's Perspective
Training in Medical Translation with Emphasis on German

Student Assessment by Medical Specialists



The Pragmatics of Medical Translation:

A Strategy for Cooperative Advantage

Translating and Formatting Medical Texts for Patients with Low

Literacy Skills

Right In the Middle of It All: The US National Institutes of Health

Translation Unit—An Interview with Unit Head, Ted Crump

On-line Medical Terminology


Contributors 163

ATA Corporate Members (1998) 167

ATA Institutional Members (1998) 175

ATA Officers and Board of Directors (1998) 177

Recipients of the Alexander Gode Medal 177

ATA Past Presidents 179

Subject Index 181

Author Index 189

Series Editor's Foreword

This tenth volume of the American Translators Association Scholarly

Monograph series, guest-edited by Henry Fischbach, reaffirms the ATA's
commitment both to reflect on the practice of American translators and to
encourage the dissemination of a systematic body of knowledge as it relates to
specific kinds of translation practices. As the international demand for
specialized translated material increases at an astonishing rate, and as new
methods of research for translation become available, this scholarly series must
provide a forum where new resources and methods can be presented and
assessed, where current practices can be analyzed and improved, and
consequently where effective translator training methods can be articulated.
The content of the ATA Series volumes must mirror the complex interaction
of the varied needs of translation practitioners, clients, scholars and trainers, and
attest to the increased professionalization of the translation field. The integration
of theoretical and practical reflection is challenging but necessary: without
systematic study, practice can only be an unreflecting production whose success
cannot be predicted, let alone repeated; without engagement with practice, theory
cannot advance the field of translation. Thus, this volume on translation and
medicine alternates between theoretical and practical issues: from the structure of
medical language to relations with clients; from the descriptions of teaching
practices to the assessment of new resources and their impact on medical
translation research; from discussions of the applicability of translation theories
to scientific material to factors such as patient literacy levels.
As we approach the twenty-first century, the exponential increase in
international communications and the surge of globalization in the business
world will lead translators to play a larger and more visible role, and will require
increased systematic training of specialized translators, which in turn will mean
that the ATA Scholarly Series will be a crucial link between different translation
Guest Editor's Preface

The contributors to this volume on "Translation and Medicine" in the

ATA's Scholarly Monograph Series address several broad aspects of medical
translation, from the cultural/historic framework of the language of medicine to
pragmatic considerations of register and terminology. Their articles do not
represent a comprehensive cross-section of the field—how could they, given the
wide scope of the subject? Rather, they highlight some of the contributions
translation has made to medical science and focus on certain questions raised by
those who escort the advances of medicine across language and cultural barriers
as well as those who are training the next generation of medical translators.
For ease of consultation, this volume has been divided into three sections.
Section 1 covers some Historical and Cultural Aspects that have characterized
the language of medicine in Japan and Western Europe, with special emphasis
on French and Spanish; Section 2 opens some vistas on The Medical
Translator in Training with two specific university-level programs, one in
Switzerland and the other in Spain, as well as an in-depth analysis of who
makes the better medical translator: the medically knowledgeable linguist or the
linguistically knowledgeable medical professional; and Section 3 looks at
several facets of The Medical Translator at Work, with discussions of the
translator-client relationship and the art of audience-specific translating, an
insider's view of the Translation Unit of the National Institutes of Health, and a
detailed study of on-line medical terminology resources.
All the contributors, including those who train medical translators in the
academic world, are accomplished professional translators in the commercial
world as well, fully aware of the problems involved in the translation process. If
medical communicators are not to betray the same commitment of the very
authors they are asked to translate—primum non nocere—we need to
acknowledge and correct certain problems which most of the contributors to this
monograph draw to our attention: differences in scientific terminology, deceptive
lexical equivalence, misconceived readership level, out-of-focus translator
training, misjudged translation expectations, etc.
The editor has long maintained that medical translation may well be the most
universal and oldest form of scientific translation because of the ubiquitousness
of human anatomy and physiology (after all, the human body is much the same
2  Editor's Preface

everywhere), the long, venerable and well-documented history of medicine, and

the hitherto uniform character of the language of medicine, at least in the West.
At the dawn of recorded medical literature in the Western world, the writings of
Hippocrates (often considered the "Father of Medicine") and Galen of
Pergamum implanted Greek as the language of medicine, nourishing several
generations of medical translators into Arabic and Hebrew. There is ample
evidence that Greek medicine was transplanted to Rome by physician-translators
such as Asclepaides. By the 2nd century, Latin supplemented (and gradually
supplanted) Greek as the language of medicine, although the latter remained the
language of instruction for medical students until late in the 3rd century. In the
7th century, with the rise of Islam and the establishment of flourishing medical
schools in Damascus and Baghdad, where the Caliph Al-Mansur had also
established a school of translators, Arabic assumed a major role in medicine.
Writing about that period, the noted medical historian and translator Dr. Marti-
Ibanez observes that "never in history have translators played as important a part
as they did." The voluminous writings of the Persian physicians Rhazes and
Avicenna and of the brilliant period of Arab medicine in Spain (nurtured by the
Toledo School of Translators) between the 10th and 13th centuries were then
made accessible to Christian Europe by translation into Latin. With the humanist
revival of Greek in the Renaissance, that language regained its codominant role
with Latin in medical terminology.
The predominant core of Latin and Greek in the language of medicine over
the past two millennia is now changing, as Leon McMorrow documents. He
traces the course of medical writing from the Greek tradition of Hippocrates at
the end of the 5th century B.C. to Galen and the Roman Empire in the early 3rd
century A.D., when Greek research dominated the Southern European and
Middle Eastern medical worlds, to Medieval Europe (1200-1500 A.D.), which
saw a second wave of translations directly from the Greek. He shows how the
Greco-Roman mold changed as the Hippocratic humoral theory of disease gave
way to the so-called naturalist method and modern science, chronicling the
linguistic contributions to medical translation by Muslim, Jewish, and Christian
scholars at the great Western European medical schools of Salerno, Montpellier,
Bologna, Padua, Toledo, and Paris.1 He points out the "quasi-uniformity" of
medical terminology among the Western European languages, including
eponyms, acronyms, trade names, and abbreviations. The references he cites
contain many interesting historical footnotes, e.g., that the early professors of
medicine in the Middle Ages were clerics, that celibacy was required for medical
men at the University of Paris until 1452, that medieval medicine was centered
in libraries rather than laboratories or hospitals, that surgery became the province
of barbers and quacks, and that pharmaceutical Latin was taught and practiced
until the 1950s. McMorrow concludes with several highly useful suggestions
for medical translators, many of which are echoed by some of the other authors.

Henri van Hoof offers an interesting complement to McMorrow's Western

perspective by outlining the contributions of various cultures and their languages
to Japanese medicine. The process began in the 3rd century with the Chinese,
whose substantial influence continued over the centuries with the importation of
Chinese medical manuscripts; their Japanese translation did not appear until the
14th century. Chinese medicine maintained its predominant position in Japan
even while Japanese interest in Western techniques, particularly surgery, grew
after the arrival of the Portuguese in 1542, surviving several decades of
xenophobia. The next century saw the waxing influence of the Dutch, including
that of surgeon-interpreters trained by the Dutch India Company, and in the early
1700s, when Dutch medical books began to be imported, translation was given
considerable impetus. The European influence broadened in the early 19th
century with the first translations of medical manuscripts from German and
English, which accelerated during the push for Westernization embarked upon
during the Meiji period (1867-1912). The author concludes by comparing the
Japanese historical example to that of Western medicine where translation played
a similarly pivotal role in the diffusion of scientific knowledge.
Jack Segura retraces the venerable history of Spanish medical writing since
the days of the famous Toledo School of Translators when the "Romance"
language, at least in Spain, was an intermediate form between vulgar Latin, the
plebeian speech of Rome, and what was to become Castilian Spanish. Segura
recalls the great medical contributions of Santiago Ramon y Cajal (Nobel Prize
winner in neuroanatomy), Gregorio Maranon (endocrinology), Miguel Serveto
(pulmonary circulation), Andres Laguna (the first to describe the ileocecal
valve), Gaspar Casal (who identified the "illness of the rose," later known as
pellagra), Bernardo Houssay (Nobel Prize winner in biology), and the
Barraquer brothers (ophthalmology)—all of whom wrote in Spanish. He then
describes the medical translation challenges facing Spanish translators today,
writing for over 300 million readers of Spanish, which will be the third most
widely spoken language in the third millennium (40 million speakers in the
United States alone), after Mandarin and English. The author decries the reliance
of translators on English-Spanish medical dictionaries that often contain too
many direct translations rather than the actual terminology used in the target
language. To remedy this, he recommends assiduous reading of Spanish
medical literature, attention to the nuances of the Dictionary of the Spanish
Academy, and reference to Glosas, a quarterly bulletin of the American
Academy of the Spanish Language which he edits and which is devoted to
exposing "false friends" and a host of pervasive Anglicisms.
In a parallel contribution, Henri van Hoof provides a valuable comparative
approach to English and French medical translation which, in the opinion of the
editor, is largely—albeit selectively—applicable to Spanish, French, Italian,
Portuguese, and to some extent German as well. The author's ministudy
deplores the deceptive lack of consistency in a field of science that is so firmly
4  Editor's Preface

embedded—if increasingly less so, as Leon McMorrow shows—in Greco-Latin

lexicographic foundations. He provides a wealth of French <> English examples
to reveal the unnerving permutations in spelling, prefixation, suffixation, and
eponymic naming2 of anatomical and disease terms that can make a perfectly
"correct" translation so imperfectly suited to the professional reader, especially if
the translation is intended for publication. He points out that a major difference
between scientific French and scientific English, particularly in the language of
medicine, is "the former's partiality for the learned word where the latter often
prefers the descriptive term from common speech." One wonders whether the
declining use of Greek and Latin in English medical writing may not also be due
in large measure to the fact that these two languages have largely disappeared
from the high-school curriculum. He shows how the hybrid nature of some
compounds terms can present stumbling blocks in the process of translation
when Greek roots of English terms turn Latin in their French equivalents, and
conversely, when Greek suffixes are grafted onto Latin roots in some
languages, and Latin suffixes onto Greek roots in others. The lesson to be
drawn from his examples is that medical terminology in various languages,
although rooted in the same Greco-Latin core, does not always offer a one-to-
one correspondence and often presents a choice of doublets, both terms being
understandable yet only one being consecrated.
Whether the experienced professional linguist with extensive knowledge of
medicine (however acquired) will be able to prepare a better medical translation
than the medical student or medical professional with a background in foreign
language (however acquired) is a question that has long preoccupied not only
educators like Hannelore Lee-Jahnke and Maria Gonzalez Davies who are
engaged in training medical translators, but also theorists of translation science
and practicing translators pursuing a business career in medical translation. The
question is not academic since there will always be more medical translations
than physicians are able or willing to undertake and much of the work will
perforce be performed by non-physicians.
In her contribution to this perennial question, Maria O'Neill, a physician-
turned-translator with a strong linguistic background, presents valuable insights
from both perspectives, exploring this topic by quoting the responses to a
personal survey, conducted by word of mouth, mail, and posting on the
Internet, of individuals and translation bureaus involved in medical translation in
the United States and abroad. Important points learned were that respondents
regularly contact medical professionals to clarify ambiguous statements,
nonstandard abbreviations, and woolly writing in the original, since even a
slight mistranslation has the potential for causing serious consequences. O'Neill
reports on how medically knowledgeable linguists gain their expertise and check
on register because, like any technical field, the "medical profession (particularly
clinical medicine) is full of jargon and idiosyncratic phrases." Half the medical

translators responding to the survey mentioned the Internet, specifically

MEDLINE, as a source of medical terminology. Medical translators, she feels,
must assume the responsibility for turning out work that is clear, accurate and
written in the appropriate register. Conversely, since writing is usually not part
of the medical-school curriculum, reliance on the scientist's technical
terminology alone is not enough to communicate in a readable, intelligible
manner if writing skills are wanting. Most translators agree that there is no
substitute for a thorough knowledge of the source language and linguistic
proficiency in the target language as a prerequisite for an accurate translation.
Many independent translators are unaware of the gaps in their medical
knowledge and that is why they and translation bureaus, most of which virtually
never receive a translation that does not contain some type of error, should
institute quality control through a team approach. She concludes that good
medical translation can be crafted by both medical professionals and medically
knowledgeable linguists. "A love of language, an ear for style, a willingness to
pursue arcane terminology and caring enough to get it exactly right are the keys
to true success."
Hannelore Lee-Jahnke and Maria Gonzalez Davies, who train medical
translators in the academic world in Switzerland and Spain, respectively, have
$sked themselves the same question in connection with German and Spanish and
have developed innovative teaching methods.
Hannelore Lee-Jahnke notes that the venerable history of medical
translation and its practical importance today, coupled with the fascination
medicine has always held for all cultures, create powerful incentives for would-
be translators. Two categories of people are likely to become competent medical
translators: those with a medical background who understand the subject matter
but initially lack the translation techniques, and any good translator genuinely
interested in medicine who must acquire the specialized knowledge. Since
medical students and physicians usually do not seek instruction in translation, it
is the latter group that is the main focus of her article. Among the major
approaches applicable to scientific texts, she singles out the "skopos theory,"
according to which any translation must first of all serve the objective of the
original text, no matter how that goal is approached: the text should be translated
in a "receiver-specific" way. In this respect, she agrees with Veronica Albin that
not only the sociocultural differences must be taken into account, but also the
different levels of knowledge of the target audience. In training medical
translation students, the three major concerns addressed are the different text
structure of the source and target languages, the languages of special purposes
(LSPs), and the specific domain. To excel, students are urged to undertake
extensive parallel reading in both languages and be wary of misleading
eponyms, aware of pitfalls, guided by bilingual textbooks, shown how to access
databanks, etc. In conclusion, she proposes that training models bridge theory
and practice.
6  Editor's Preface

Maria Gonzalez Davies has assessed undergraduate medical translation

students in an experiment at the Facultat de Traduccio i Interpretacio in
Barcelona. The four-month experiment consisted in putting the translation
student in touch with the requirements of potential clients—with the course
instructor acting as counselor, but not problem-solver. The students' medical
translations were assessed for acceptability, not only by the instructor but also
by a medical specialist. The author describes the project, which sought to
answer the following questions: 1. Is it possible to align university programs
and professional needs? 2. How good are third-year students in producing a text
for specialized (i.e., medical) publication? 3. How aware are subject specialists
with no knowledge of pedagogy programs or translation problems? 4. In which
direction should teaching go? The course design focused on the following
issues, which the author examines in some detail: research skills, technical
writing skills, building of background knowledge, awareness of the translation
process, and assessment of the final product by subject specialists. The results
should be of interest to those who teach medical translation. Among the author's
conclusions, which are quite independent of the language pairs involved, were
that greater emphasis should be given to improving research skills and coherence
in technical writing; that students must be mindful of the subjectivity element in
text assessment; and that the subject specialists be alerted to the problems
involved in translation and the need to collaborate with the medical translator.
In what she terms "a strategy of cooperative advantage," Barbara Reeves-
Ellington proposes a translator-client relationship that will clarify beforehand the
expectations of both with regard to every translation situation. She identifies the
questions that need to be answered before any translation is undertaken, namely:
What is expected of a translation? By whom? What should authors expect from
the translation of their work? What should clients expect when they commission
a translation? What should readers expect when they read it? What should a
translator expect when sitting down to do it? Who sets the standards? Who
makes the rules? Who faces the consequences? She rightfully points out that it is
not possible for a translator to meet the specifications for a translation without
knowing what they are. It is therefore the translator's responsibility to ascertain
them from the client before proceeding, because only thus can an effective
translation strategy be adopted. Both the translator and client will then
understand why the translation has been requested, for whom it is intended, and
how it is to be done. Like all translators, medical translators are "cultural
mediators," and they are apt to work with many genres of medical texts:
biomedical papers, toxicology and clinical reports, New Drug Applications, case
reports, patient consent forms, expert opinions, official regulations governing
drug manufacturing and clinical research, package inserts, and patient education
brochures—each with its own style and presentation requirements. Given the
complexity of their work, translators need to do more than "microediting," i.e.,

simply translate the source text, verify that the technical terms are correct and
ensure that grammar, punctuation, spelling, and word usage are appropriate.
They also have to do enough "macroediting" to ensure cohesiveness and flow of
information that will correspond to the client's and reader's expectations.
Some of these same points are made by Veronica Albin in the specific case
of translations intended for an audience with low literacy skills. She explores an
aspect of medical translation that is often neglected by professional translators:
writing for the reader with a low level of understanding. She emphasizes the
distinct difference between translating for the scientist and translating for the
general public. In both cases accuracy is paramount, but the register of the
language used will differ widely. This applies particularly to instructional
medical texts, patient guides, and manuals. She cites studies which reveal that
patients with low literacy skills lack the ability to understand subject-specific
terminology or to analyze instructions, then proceeds to enumerate ways of
matching the difficulty of the medical communication to the patient's literacy
level—all calculated to enhance the readability of the message. Some would
maintain that this is not the responsibility of the translator, but the author
convincingly maintains that it should be—of course in consonance with the
client ordering the translation. Merely replacing technical terminology with lay
terms does not suffice because the latter often are not standardized and may have
more than one meaning. Such common nontechnical expressions as "use
sparingly," take "as soon as you wake up" or "first thing in the morning" can
mean different things to different people. The medical translator's output should
be, in her words, "culturally accessible."
Sally Robertson's interview with Ted Crump, head of the U.S. National
Institutes of Health's Translation Unit, offers an interesting glimpse into that
Government center of medical translation, as seen by a veteran medical
translator. The interviewer elicited insights on how the unit operates, the variety
of documents it translates, and the problems it is called upon to solve. Although
the interview is partly a personal narrative of how he became a medical
translator, the mentors he has had, and the changes he has seen over time, it
includes sidelights of the operation he has headed for 17 years. Here is a candid
look at how the unit serves NIH scientists, occasionally by providing them with
oral sight translations, and how its two resident translators interact with them in
contributing to the cross-fertilization of leading-edge technologies and trial drugs
culled from the foreign literature. Crump recalls anecdotal events with political
undertones that required the staff to provide translation services under
demanding deadline constraints. He discusses the various terminology resources
the Translation Unit relies on, including personal glossaries and occasional
consultation with the Institute's scientists, and lists its in-house dictionary
holdings, many of which he implies are in urgent need of updating—a problem
shared by all translators who have specialized private dictionary libraries. Like
other authors in this monograph, he shares his views on what makes a good
8  Editor's Preface

medical translator. Some of these may surprise you, in the light of the opinions
expressed by other contributors on this subject.
Clove Lynch details 13 on-line medical terminology resources of paramount
lexical interest to the medical translator. Because medical information is
constantly expanding worldwide, quick access to current language, subject, and
usage-specific terminology is crucial. In the past, the most reliable resources
were research or industry journals, conference proceedings, and interaction with
subject experts. Regrettably, access to these channels of information is not
within the reach of all language professionals, therefore creating the need for
what Lynch calls "an accessible, non-static resource that provides high-quality
information in a timely manner...the World Wide Web." Some Internet sites
have on-line consumable and/or downloadable resources, such as glossaries,
articles, databases, and on-line documents. In his overview of the content and
quality of WWW medical information Websites, Lynch lists their URLs with
special emphasis on the links to other resources. Among the 13 sites he reviews
The World Health Organization's Technical Terminology Service;
EURODICAUTOM, hosted by ECHO, which offers on-line keyword searches
by source/target language and domain and supports 10 source/target languages;
and Medscape, which the author describes as a medical information warehouse.
The latter offers free access to the National Library of Medicine's MEDLINE
and other databases, considered to be the "...largest biomedical resource library
in the world." MEDLINE (also accessible via HealthGate) offers translated
abstracts of articles from a broad range of medical journals, which can be
ordered online. Lynch concludes that these sites represent a small percentage of
WWW resources currently available to medical translators and that their number
is growing.
The scope of this monograph is not as broad as one might wish or as the
editor would have liked. Those most knowledgeable about the subject are busy
professionals who are often unable to find the time to ponder their thoughts and
communicate them to us. We are therefore indebted to those who did, even
though, engaged as they are, they somehow made the time to share their
knowledge with us.


1. Also see Fischbach, Henry: "Translation, the Great Pollinator of Science: A Brief
Flashback on Medical Translation." Scientific and Technical Translation. Sue Ellen Wright
and Leland D. Wright, Jr., ed., Kent State University. ATA Scholarly Monograph Series VI,
1993, pp. 89-100.
2. In the author's enlightening article in Meta (Vol. 32, No. 1, March 1986), in which
he creates an impressive classification of medical eponyms, he quotes Dr. A. Sliosberg, for
many years the Information Director of a major French pharmaceutical company, in the French
translators* journal Traduire as follows: "L'habitude d'accoler un iponyme a une hi, a une

maladie, a un symptome ou a une unite est fort ancienne; on a ainsi perpetue la memoire de
ceux qui ont contribue a la science ou a I'art de guerir, et c'est justice."


Fischbach, Henry. 1986. "Some Anatomical and Physiological Aspects of

Medical Translation." Meta. 31: 16-21.
Marti-Ibanez, Felix (Ed.). 1962. The Epic of Medicine. Clarkson N. Potter, Inc. 87.


The editor is greatly indebted to Jeanne De Tar and Christine Hicks for their
invaluable support and assistance in preparing this monograph.
Section 1:
Historical and Cultural Aspects of Medical
Breaking the Greco-Roman Mold in
Medical Writing: The Many Languages
of 20th Century Medicine


Unlike most technical fields of translation, medicine has had a very long
history of writing; it almost rivals the written tradition of law. The tendency to
record medical findings as something precious and deserving of being preserved
for others is not confined to any one major region of the world. All the great
civilizations—Indian, Chinese, Middle Eastern, European—had organized
medical practitioner systems that produced records of medical research. 1
Sometimes medical observations were combined with religious or magical
explanations; sometimes the interest was almost solely in medicinal herbs. The
distinctly scientific method that characterizes modern medicine in Europe and the
Americas is traceable to a Greek civilization (500-30 B.C.) that succeeded in
passing on its tradition first to the Roman Empire (100 B.C-400 A.D.) and
then to Medieval Europe (1200–1500 A.D.). In the process it created the core of
the contemporary Western medical writing system.
Why would one language area adopt the language of another, creating local
linguistic turmoil and even strife, as we see today in France? It is axiomatic that
dominance in knowledge, customs or technology has major repercussions upon
language relationships. What is seen as superior tends to flow into what is seen
as inferior; one may view the process in terms of either push (imposition) or pull
(borrowing). Whoever leads the field gets to create the words that capture the
emerging concepts and products.
In the last 30 years of the twentieth century English has been rapidly
exported from and imported into many languages through the dominant role of
the U.S. in computer science and technology as well as medical technology. Our
current boom in translation in the U.S. is a direct consequence of U.S.
leadership in some technical fields. Italian did likewise for the language of
music, and French for food preparation and diplomacy. The pull factor—or
need—seems more logical. It is often quicker and easier for other linguistic areas
to borrow the foreign terminology along with the science, behavior, or product
than to mine their own languages for suitable expressions. Nativism in language
14  Breaking the Greco-Roman Mold in Medical Writing

development is probably a pipe dream, if history is any guide (see Dirckx, pg.
105); the same seems to be true in scientific languages.
While Greek and Latin undoubtedly set the character of medical writing for
over 2,000 years, the reasons seem to have been circumstantial rather than
prescriptive, social and political rather than linguistic or technological. Now the
trend is turning back to the dominance model. Changes in medical knowledge
and language have overtaken changes in political and social context during the
past 200 years. A major change in medical terminology is well under way, one
that will not wipe out the classical heritage, but enfold it with many layers of
heterogenous material.
One of the most common questions asked of me at translator conferences is:
how does one go about becoming a medical translator/interpreter? The answer:
learn the language of medicine. It is a demanding task and there are several
possible acceptable levels of competency, depending on long-range goals. One
may wish to be a physician- or nurse-translator or a multilingual medical records
expert, attaining the most desirable level of competency for the client or
translation user. One might rather combine a translation career with that of
practitioner of a lower level of medicine and learn medical language suitable for
paramedics, technicians, aides, etc. Or one may desire simply to be a translator
with a special interest in medicine and acquire enough skill to be able to
understand and translate medical documents accurately. It is important to
conquer the field of medical language as efficiently as possible in line with one's
goal. This paper is directed to that end. If one understands the key structures of
medical language and the direction it is currently taking, success in one's studies
is much more likely to be realized. Just as medical dictionaries have to decide
what to delete from past editions as no longer useful and what to add from the
maelstrom of current research language, the translator has to decide what is
worth understanding and memorizing out of the large mass of materials. It is
critically important not to become archaic, which is the death rattle of a language

The Greco-Latin Mold

Greek and Latin are still the core of scientific terminology and the basis for
medical language studies. Luckily, the number of student aids for learning
medical Greco-Latin terms has increased as general knowledge of these
languages has declined in the secondary schools and universities of Western
Europe and America. 2 The 2,000-year contribution of Greece and Rome to
Western medical science has also been richly documented (e.g., Garrison 1929;
Ackerknecht 1955; Bender and Thorn 1961; Crombie 1967; Stenn 1967); we
need to highlight only the dynamic push-pull factors that influenced the linguistic

For approximately 600 years (between Hippocrates at the end of the 5th
century B.C. and Galen who died in the early 3rd century A.D.), Greek medical
research and writing dominated the Southern European and Middle Eastern
medical worlds. Within the supporting framework of the empires of Alexander
the Great and his successors (325-30 B.C.), Rome (130 B.C-475 A.D.) and
Byzantium (330-650 A.D.), Greek physicians were able to develop and
propagate a radically new approach to medicine, on one hand avoiding the heavy
religious-magical orientation of their predecessors and contemporaries and, on
the other, focusing on the exact description of anatomy and disease, the so-
called naturalist method. They benefitted considerably from the logical scientific
orientation of contemporary Greek scholarship so that they were able to
construct a system of medical knowledge and therapy. But, like their colleagues
in astronomy and physics, they sometimes let philosophical theory run ahead of
evidence, as with the Hippocratic humoral theory of disease. Yet, with the crude
diagnostic tools available, progress in medical knowledge and exposition was
remarkable. And it was recorded.
Writing was one of the accepted techniques of the Greek scholars in
communicating ideas; in an imperial world with scattered centers of learning—
Smyrna, Corinth, Alexandria, Ephesus—it was as understandable as the
frequent travel required to keep up with new knowledge. It was also the
preferred method of passing on esteemed knowledge across generations and
cultures. After the absorption of Greece by the Roman Empire and the
conversion of the Eastern Roman Empire into the Byzantine Empire, Greek
physicians still maintained their prestige—and their technical language. Their
centers of medical learning shifted from Greece to Western Asia and Egypt but
they brought their manuscripts with them. Teaching and research in Greek
continued for centuries until political events—mainly the Arab/Muslim
conquest—wiped out Greek civilization. But the corpus of Greek medical
teaching had been progressively translated into the local languages of the Eastern
Roman and Byzantine Empires—Syriac, Arabic, Farsi, Hebrew and possibly
lesser languages; only a small part of it, however, was translated and used in the
West by Latin-speaking physicians, as far as we know. 3 Galen (130-200
A.D.), the most widely known of the Greek traveling medical scholars, was also
the most prolific and this enshrined his influence. His extensive writings4 were
unknown in the West until translated between 1000 A.D. and 1200 A.D. from
Arabic to Latin by Muslim, Jewish, and Christian scholars in the new Western
European universities and medical schools at Salerno, Montpellier, Bologna,
Padua, Toledo, and Paris.5 Ackerknecht summarizes:
16  Breaking the Greco-Roman Mold in Medical Writing

"It was by way of a long detour through the Near East and North Africa that Greek
medical lore returned to Western culture, the Arabs acting as intermediaries. The two
outstanding translators of classical material from Arabic into Latin were Constantinus
Africanus (1020-1087), who worked at Salerno and at the cloister of Monte Cassino,
and Gerard of Cremona (1140-1187), who worked in Toledo. It is noteworthy that
both translators resided on the Arab-Christian frontier. It was no coincidence that
Salerno, the first famous medical center of the Middle Ages, was close to Arab Sicily
and the first medically outstanding medieval university, Montpellier, was situated in
southern France, near the Spanish border." Ackerknecht, pg. 84; see also Bender, pg.
71, Dirckx, pg. 57.

The Arabic language, unlike Arabic science, held no attraction for anti-
Muslim Western Europe, and its contribution to the language of medicine is
relatively small (Crombie, pg. 35 gives examples; see also Dirckx, pp. 68-69).
But it was seen as the pathway to the Greek scientific system until a second
wave of more accurate translations, directly from the Greek manuscripts,
occurred in the later medieval period, 1250-1500.6 Arabic then lost its place in
Western medical history; it might have been otherwise had the Arab researchers
created a whole new systematic body of medical writing. Galen's authority
dominated Western medical thought for several centuries, almost to the point of
medical sainthood, until some courageous researchers with improved tools
decided to review the evidence and correct some of his major findings. That day
also marked the beginning of new research leaders and new languages of
Classical Latin as a medical language is available to us only in early
translations from Greek or the compilations of a few writers: Celsus, Pliny the
Elder, Scribonius Largus; it never attained any status as a medium of medical
scholarship and was practically unknown until the renaissance of classical
studies circa 1500. Medieval Latin—variously called postclassical or Late
Latin—was the medium of study and communication at the great city
universities of Italy, France, Holland, Germany, Spain, and England. 7 It
accepted Greek and Arabic medical terminology very quickly and simply by
transliteration or overlay with Latin prefixes and suffixes and minor root
changes latinized the result.8
Latin had a life of about 800 years in academic medicine (1000-1800). It
was progressively influenced, however, by the needs of communication with
medical students, patients and those physicians without university education, of
whom there were many in Medieval Europe; apprenticeship was still the main
track in education for the professions and trades.9 Cheaper printing methods
and popular education were rapidly speeding up mass communication; personal
libraries were being formed by the rich (Getz 1982, pp. 436-437). National
cultures also replaced the "united states of Europe." By 1800, Latin as a
teaching and writing medium had practically come to an end, except in
ecclesiastical institutions. 10 In spite of the resurgence of local languages,

however, the similarity of all medical languages in Western Europe was left
intact, since they retained their common Greco-Latin terminological core.

Paradox of Twin Languages:

Anglo-Saxon and Norman English

One of the brighter sides of the Dark Ages in Western Europe (500-1000)
was the opportunity opened up for the renewal of suppressed older languages
or the development of new ones by the demise of the Roman Empire.
Languages develop in isolation, as anthropologists found out a hundred years
ago in Papua-New Guinea (with more than 700 languages in a small, extremely
mountainous area). But they also develop by contact, as seen in some political
conquests. Britain was a laboratory for both methods. The former Celtic
inhabitants were exterminated or exiled in the 5th and 6th centuries by the
waves of Angle and Saxon invaders from regions today within the boundaries
of Germany, Denmark, and the Netherlands. During two to three centuries of
isolation and local conflict, the new inhabitants settled upon one dialect as a
lingua franca (Wessex or West Saxon) but called it Englisc as well as referring
to the country as England (Angle-land) after the majority Angle component of
the population (Dirckx, pg. 4). By the late 9th century an Old English literature
existed, best known through the Anglo-Saxon Chronicle. Translation of Latin
works written by the educated class, who were mostly clerics, began, e.g., the
Venerable Bede's The Ecclesiastical History of the English People, which is the
main source of historical data for the period.
On the European continent the Gallic Latin of France developed in isolation
into Old French, the first written record of which is the Oath of Strasbourg (842
A.D.). At the end of the 9th century, France suffered an invasion of the
Normandy region by Scandinavian explorers and colonists. These Norsemen
adopted French, and, when they conquered Britain in 1066, they brought along
French and used it continually for 200 years. Since they were the ruling class,
they were imitated, and the British elite created Norman English, a side-by-side
amalgam of Anglo-Saxon English and French which is the basis of modern
English; we have in fact inherited English-French doublets and are constantly
involved in a conscious or (mostly) unconscious choice between them when we
speak or write.
Local popular medical languages had always existed in the oral tradition in
the regions absorbed into the Roman Empire. When it collapsed, little education
or tradition of writing or translation continued except in Western Asia. Latin
remained the sole resource for written technical expression in Western Europe,
and this was confined to the church schools. It was only in the late Middle Ages
that education and publication resources were sufficiently developed for people
to write down local medical lore in their own vernacular. In England, Latin and
18  Breaking the Greco-Roman Mold in Medical Writing

the vernacular Middle English were equally acceptable for medical

communications even among physicians, although Latin still retained priority in
the universities.11
The need to choose among English medical styles goes back to Middle
English. On one hand an Anglo-Saxon medical terminology existed for basic
anatomy, physiology and many diseases: words such as head, skull, brain,
nose, ear, mouth, tongue, throat, neck, arm, hand, chest, breast, flank, leg,
foot, toe, skin, blood, bone, fat, disease (dis-ease), cough, ache, sore, wound,
pox, scurvy, harelip, chilblain. These are very recognizable as mostly single-
syllable, hard-sounding, sometimes compounded words that betray their
Germanic origin. On the other hand, French—the descendant of Gallic Latin—
was already being absorbed by the educated elite, and Latin—the language of
the scholarly Renaissance—was affecting Britain equally with continental
Europe. What was a medical writer or translator to do?
A fine example of a decision to go with Anglo-Saxon style occurred around
1450. Gilbertus Anglicus had written the first major medical treatise in England
two centuries earlier; he participated in the renaissance of Greek medicine and
professed the "humoral" theory of medicine of Hippocrates. Gilbert wrote his
Compendium medicinae in Latin and an unknown translator produced a
translation, probably toward the middle of the 15th century, that is remarkable
for its preference for Anglo-Saxon medical terminology, although not devoid of
the common French influence on the vernacular of the time. An excerpt bears
close analysis:


Calide discrasie sine humoris vitio: signa sunt arsura et punctura sub dextro
ypocondrio, lingue et palati siccitas, sitis continua, urina intensa rubea vel subrubea
vel ultra quandoque obumbrata cum spuma crocea, citrinitas faciei, et color viridis
aut emulus, habitudinis extenuatio et maxime causa prolongata; frigida prosunt,
calida obsunt; frequens ventris constipatio, et egestionis paucitas, et fastidium, et
sompnus brevis. Semperque in somnis os habent apertum. Adest nausea, fastidium,
et in augmento oculorum, et facies infectio, et ycteritia, et tunc sequitur universalis
pruritus et scabies...

Middle English translation:

Distempering of the lyver that commeth of hete hath thes tokenes: brennying and
pricking vndir the right side, drienes of the tunge and of the roof of the mouthe,
continuel thrist, the vryn is of an hie colour, the face is citryn and otherwhiles grene.
Colde thingis comforten him and hote thingis noien him. He is ofte costif, and whan
he shetith, it is but litil. He volateth his mete, and slepith but litil. And whan he
slepith, he holdeth his mouth open. And otherwhilis, his visage and his yghen ben
infecte with a yelewe colour. And then he hath a grete ycching ouer al the bodi and a
(Getz 1982, pg. 439)

A modern English reworking of the spelling and punctuation would give:

Distempering of the liver that comes of heat has these tokens: burning and pricking
under the right side; dryness of the tongue and of the roof of the mouth; continual
thirst; the urine is of a high colour; the face is citrine and at other times green. Cold
things comfort him and hot things annoy him. He is often costif, and when he shits,
it is but little. He volates his meat, and sleeps but little. And when he sleeps, he
holds his mouth open. And at other times, his visage and his eyes are infected with a
yellow colour. And then he has a great itching over all the body and a scab.

While generally very literal and accurate, the translation also reflects the
contemporary tradition of selective translation of the text; there are several
omissions and transpositions. The translator, however, used only medical Latin
loan words that filled in gaps or were more precise than the Anglo-Saxon
vernacular: urine, citrin (lemon-colored), costif (constipation), infecte(d).
What other choice did he have? Possibly only the latinized English that came
from Norman French. By 1500, many Greco-Latin words had already been
transformed into Norman or Middle English and would have been widely used
by the educated English elite; examples visible in the ME translation above
(c. 1450) are face, visage, volate, colour, distemper, continual, annoy, scab.
Direct Latin/Greek borrowing in medicine may have come later. In the
18-19th centuries wild enthusiasm for "classical" word formations and grammar
swept the English cultural elite, including scientists and physicians. Medical
English came to resemble the Latin texts used by the academics. If we were to
retranslate the Gilbertus Anglicus excerpt above in an 18-19th century style and
restore the omitted Latin text, it would read somewhat as follows:

Calorific dyscrasias without humoral deficiency have the following signs: ardor or
puncture beneath the right hypochondrium, lingual and palatal siccation, continual
thirst, intense ruber or rubescent urine occasionally umbrated with crocean spume,
facial citrination and a virid or similar colour, corporeal extenuation of prolonged
duration. Cold ameliorates while heat is prejudicial to him; frequent ventral
constipation and paucity in evacuation, fastidium, insomnia. His mouth is always
open when he sleeps. There is presence of nausea, fastidium, ocular dilatation, facial
infection and icterus, which is followed by universal pruritus and scabies...

Almost all of the terms used here are available in English medical dictionaries of
1860-80 vintage; many are now obsolete but several are still included in our
current standard medical dictionaries. Language assimilation is often too
complex to reduce to logical or systematic processes. This is also true of medical
terminology today: while some new coinages are deliberate imitations of Greek
or Latin, 12 many are standard English terms of French, Latin or Greek
provenance dating back to the Middle Ages and require no professional
knowledge of their linguistic history, merely of their current precise meaning.
The historical dynamics of our current medical language, then, have been
interesting. Greek jumped ahead of the rest of the world as the bearer of new
medical knowledge. Latin, the language of the invaders, did not suppress or
20  Breaking the Greco-Roman Mold in Medical Writing

overwhelm medical Greek and initially absorbed very little of it. Arabic did
overwhelm it but absorbed it. When the Latin-speaking Western European elite
realized that there was à Greek-Arabic medical system available to fill their void,
they had "rush translations" done from the contemporary Arabic by teams of
scholars, whose names have been recorded (Crombie I, pg. 34) and then more
leisurely and accurate translations directly from the ancient Greek. The
vernacular speakers of the former Roman Empire also had a void to fill, and
they borrowed heavily from Latin while it still existed as a medium of scientific
communication. Today, Greek and Latin have declined in scientific usefulness;
they no longer carry clout as initiator languages to be a push factor. Do they still
represent a pull factor and for whom? For researchers? For communicators—
medical writers and translators? The answer for research is clear: they are dead.
What about communication?

Greco-Latin Medical Terms

The basics of Greek/Latin medical terminology can be learned in a period of

a few weeks, using the commercially available aids.2 Patwell's Fundamentals of
Medical Etymology in the preface to Dorland 1994 provides an outline. A
relatively small core of key pathological, anatomical and physiological terms is
vastly increased by the use of prefixes, suffixes and compounds. The Table
below exemplifies a number of common Greek and Latin terms and their
modern cognates or derivatives; sometimes the Greek and Latin traditions
overlap. The terms are a sample from words beginning with la in an English
standard medical dictionary (Dorland 1994); the linguistic pathway is
chronologically followed: Greek-Latin-English. German and Italian equivalents
are shown for reference, to indicate general borrowing by Western medicine
from the same sources.

Greek Latin English German Italian

labium/-a labium/-a Labium labio-

- labilis labile labil labile
- labrum labrum - labbro
labyrinthos labyrinthus labyrinth Labyrinth labirinto
- laceratio laceration Laceratio lacerazione
- lacuna lacuna Lacuna lacuna
lac, lactatio lactic, lactation Lactat, Lactation latte, lattazione
lalia lallatio lalo- (cf. laliatry) Lalo- lalo-
lama lamina lamina Lamina lamina
lampas lampas lampas - -
- lancea lance lancieren (Fr) lanceolato (deriv.)
lapara - laparo- Laparo- laparo-
- lana+oleum lanolin, lanum Lanolin lanolina
- larva (ghost, mask) larva, larvate Larve, larvatus larva, larvale

Greek Latin English German Italian

larynx (-g) _ larynx (g-) Larynx (g-) laringe

- latens (latent-) latent latent latente
latus, later- latus, later- Latus, later- lato, later-
latex latex Latex lattice
ladanon* laudanum* laudanum Laudanum laudano
lavare lavage (Fr) Lavage (Fr) lavaggio
laxativus** laxative Laxans, Laxativum lassativo

* Dirckx finds a Greek origin (Dirckx, pg. 63), others Latin.

**In Classical Latin it meant "loose, lax"; in Late Latin it also meant "purgative."

Sometimes parallel Greek and Latin derivatives survived, resulting in at least

partial synonyms in the modern languages, for example:

Greek -Latin English German Italian

chromo-metron chromometer Chromometer cromometro

- colori-metrum colorimeter - colorimetro

angeion - angiogram Angioblastom angiogramma

vas vasal Vasodilatation vasale

kardia _ cardiac kardial cardiaco

- cor, cord- cor, (pre)cordial Cor, (prä)kordial cuore, (pre)cordiale

The existence of such quasi-uniformity in terminology across Western

European languages is a communications wonder. If it could account for all
medical terms, translation would scarcely be needed. This was a Middle Ages
reality but it didn't last. The only area where the Greco-Latin tradition of medical
terminology continues unabated is the lists of anatomical terms called the
Nomina Anatomica12 and to a lesser extent the Index nominum genericorum
(plantarum) and the International Code of Nomenclature of Bacteria. Medical
research has not stopped, but rather accelerated enormously. The great
physicians of the past were also mathematicians, biologists, astronomers,
physicists and chemists ("Renaissance men") and borrowed terms from those
sciences. Today, medical research moves forward also through the brains of
people who are specialists in the natural, mathematical and biological sciences,
even if they have no medical degrees. The language they use for communication
is that of the scientific field they represent: engineering, biology, chemistry,
physics, mathematics, and their subfields. Sometimes they use modern
derivatives of old Greek and Latin words, especially in combining forms such
as stereo-, mono-, poly-, multi-, with no concern for etymological purity, but
they also use eponyms very heavily and occasionally acronyms, such as laser.
Their language also appears eventually in a growing stream in medical
22  Breaking the Greco-Roman Mold in Medical Writing

The preface to one popular comprehensive medical dictionary states: "As

always, the vocabulary has been reviewed, with obsolete terms being discarded,
new terms being added, and the remainder thoroughly revised. These changes
have been made across the entire spectrum of specialties and have affected tens
of thousands of entries throughout the entire book" (Dorland 1994, v); the dust
jacket of the volume claims 7500 new entries. The etymology of these discards
and additions bears examination—is there any discernible pattern in the
vocabulary changes? Where are the losses sustained? What sources are behind
the additions?
A random sample of approximately 1,000 words was taken from Dorland
1994 and matched with Dorland 1988; this group included only words
commencing with la. Subgroups were quite obvious, since the etymology is
given: Latin, Greek, standard English terms; the remainder consisted of
eponyms, acronyms and trade names. Some lines of division are indeed
fundamentally inexact because of overlap between technical Greek and Latin
loan words and "naturalized" loan words; for example, is labor classifiable as a
technical Latin loan word (related to childbirth) or as a standard English term of
Latin descent? (It is treated as a standard word, since it is the only word in
popular use in this context; standard words are those used equally by laymen
and scientists.) The changes over time in relative subgroups appeared as

Dorland 1994 Dorland 1988

Total basal entries/clusters13 90/786 96/ 801

Greek: 12/150 15/158
Latin: 39/392 41/ 403
Standard English: 14 39/244 41/ 239
Eponyms, Trademarks: 227 252

Total Entries: 1103 1149

Note: The preponderance of Latin and English terms is due to a large number of clusters
with lac, lamina, law, layer.

The lexicographers deleted 3 Greek-based basal entries and added none; 2 basal
entries of Latin origin were deleted, and none added; standard English and
eponyms registered a net loss of 2 basal entries. The net losses in the clusters
included both deletions and additions in each category; overall there were 56
deletions and 47 additions. A term-by-term analysis—too detailed to record
here—shows where the deletions and additions occurred. The lexicographers
eliminated several variant spellings, 2 German words, 29 eponyms under the
entry law, many of the subentries under lac, some types of lamp, and several
plant, insect and microbial terms. They added a large number of subentries
under lac, lamp, laser and latency. It becomes quite obvious in term-by-term
analysis where new terms are coming from: microbiology and biochemistry for

the lac group, neurology for the latency group, and physics and engineering for
the lamp and laser group. There was no apparent pattern to the deletions (except
for the deletions under law), reflecting merely the editors' choices.
To avoid the possibility of chance in this selection and to see how
characteristic the changes are over a 20-year period, I also examined the entries
under cha (with heavy presence of Greek loan words because of the Greek letter
chi) and mo in the last three major editions of Dorland—1974, 1988, and
1994—the first being the "most extensively revised edition to be published" up
to that date (Dorland 1974, v)-using exactly the same basal entry/cluster
concepts. The results are as follows:

Dorland 1994 Dorland 1988 Dorland 1974

cha mo cha mo cha mo
Total basal entries/clusters13 32/81 84/476 27/86 80/451 35/100 80/ 514
Greek: 9/9 8/255 9/10 6/234 10/ 17 7/253
Latin: 5/9 43/132 5/10 38/138 7/ 9 36/ 174
Standard English:14 18/63 33/89 13/68 36/79 18/74 37/ 87
Eponyms, Trademarks: 34 90 42 88 49 85
Total Entries: 147 650 156 619 184 679

Again, term-by-term analysis is more interesting than the net gains and
losses recorded above. A few basal terms or combining forms in Greek and
Latin sometimes generated great clusters of terms, such as mono- , morph-,
monster and moto(r)- out of all proportion to other terms—mono- alone created
over 200 terms in Greek. 15 Standard English too, while usually consistent in
averages, could sometimes load an important term with clusters of associates:
chain, chamber, molecule, movement. This process has held steady over 20
years; such basal words have obviously become established as scientific terms
and are likely to grow. Eponyms are very numerous. They are deleted/added in
about equal numbers from edition to edition. They represent generational
progress in science: only those researchers who made major contributions
survive the lexicographer's scalpel. Likewise, anglicized terms are closely allied
to progress in science and technology and sifted accordingly; some are deleted as
the concept or product they represent fades in importance, while others with
lasting value remain.
Finally, to obtain a 19th-20th century contrast, I compared Dorland 1994
with Dunglison-Stedman 1903.

Dorland 1994 Dunglison-Stedman 1903

cha mo cha 
Total basal entries/clusters 32/81 84/476 58/132 126/552
Greek: 9/9 8/255 16/51 10/166
Latin: 5/9 43/132 9/32 56/321
Standard English:14 18/63 33/ 89 33/49 60/65
Eponyms, Trademarks: 34 90 39 75

Total Entries: 147 650 229" 753

24  Breaking the Greco-Roman Mold in Medical Writing

Significant results were found: in 1903, Greek had 45 entries under chamae-
and 125 under mono; it lost almost all of the chamae- entries (only 4 in 1994),
while by 1994 the entries under mono- had increased to 222—and the selection
is very different. In general, hundreds of botanical terms (the medicinal herbs of
the day) were pruned regardless of etymology; old anatomical and disease names
were dropped, e,g, chaffbone, chancebone, mockknees, moth freckle, and
morulus. The whole section of approximately 200 terms clustered under morbus
in Latin shrank to 4; all 20 terms for botanicals, diseases and cures related to
mountain disappeared entirely. Surviving eponyms refer mostly to anatomists
and pathologists such as Morgagni and Charcot; trade names took the place of
"famous name" medicines or equipment: Dr. Morton's fluid, Dunglison's
mixture, Whirling's chair.


After observing the changing picture of medical English from the 15th to the
20th century and the last 100 years of medical dictionary entries, the overriding
impression one obtains is—to use a metaphor—of a river with fast moving
water and a large tree being washed downstream, sometimes rapidly, sometimes
slowly as it snags on the bottom and holds momentarily, losing pieces and
picking up flotsam as it goes. The Greco-Latin corpus of medical terminology is
the tree, always there but moving along erratically; the churning water is the
standard English, eponyms, trade names and other detritus picked up along the
course of time. How the tree moves and changes is unpredictable.
The medical translator must enter that stream at the same point as others in
the field today, whether practitioners or researchers. Knowing what is coming
downriver from the past, no matter how impressive the sight, is just one tool in
the translator's kit; knowing the current mix of standard English from all
scientific and technological sources, including new eponyms, acronyms,
abbreviations and trade names is just as important, because that is what others
are already observing in addition to the Greco-Latin heritage.


1. Do not throw out old dictionaries; keep them at least 20 years, because there
is no correspondence between the speed of terminological change from
country to country. I notice that my modern Italian medical dictionaries
(monolingual and bilingual) still include many of the terms no longer used in
English. You may have to use the archaic English word to get to the modern

2. Use the Greco-Latin heritage as a bridge between vernacular terms that are
hard to define exactly. For example, if a German report states that the patient
was "O-beinig" and your bilingual dictionaries do not include it, go to a
monolingual German medical dictionary and it will tell you it means genu
varum (Latin). Now check your English monolingual dictionary under genu
varum and you will find: "Known also as bowleg." The Latin was a bridge
between the two vernacular terms, which is what you want to use in this
context: O-beinig = bowlegged. Guessing from "-" to "bow-" would have
been risky.
3. Take as many opportunities as you can find to study the basic terminology
of biomedicine: biochemistry, cell and molecular biology, immunology and
bioengineering. These are the chief sources for the flood of new terms
entering the medical dictionaries. It is beyond the scope of this paper to
analyze the flow in detail; it is a worthwhile task, however, to consult some
textbooks and/or journals representative of these fields and then look at
some articles occurring in major medical journals like the New England
Journal of Medicine, American Journal of Cardiology or Diabetes.
4. It is also beyond the scope of this paper to discuss "medical writing style" as
well as vocabulary. Although there is no absolute entity called "medical
style"—even the American Medical Association 1989 bypasses the issue in
its manual—there are some expected elements: a certain degree of
impersonality, avoidance of prolixity, exact description, somewhat fixed
methods of reporting and hypothesizing. Subgroups within the medical
profession may have particular stylistic requirements for their
documentation, such as drug warnings, drug package inserts and clinical
trial reports.


1. Encyclopedia Britannica 1984. Bender and Thorn 1961.

2. Among the many available may be mentioned: Agard 1937; Skinner 1961;
McCulloch 1962; Lea 1975; Peterson 1980; Ehrlich 1988; Smith et al. 1991; Frenay and
Mahoney 1993.
3. Crombie I, pp. 10-11: "The scientific inheritance of the Latin West ... was limited
almost exclusively to fragments of Greco-Roman learning such as had been preserved in the
compilations of the Latin encyclopedists. The Romans themselves had made hardly any
original contributions to science. The emphasis of their education was upon oratory. But some
of them were sufficiently interested in trying to understand the world of nature to make careful
compilations of the learning and observations of Greek scholars. One of the most influential of
these compilations, which survived throughout the early Middle Ages as a textbook, was the
Natural History of Pliny (23-79 A.D.)." See also Dirckx, pg. 46.
4. Estimated to number about 200 pieces; not all may have been written by him but by
later imitators, and it is possible that not all his own contributions have survived human and
natural disasters.
5. Crombie I, pp. 223-224.
6. Crombie I, pg. 35 provides a well-focused picture of the dilemmas of early medical
translators: "The earliest known Latin-Arabic glossary is contained in a Spanish manuscript
26  Breaking the Greco-Roman Mold in Medical Writing

dating, perhaps, from the 13th century, but the work of translating Greek and Arabic texts was
severely hampered by the difficulty of mastering the languages involved, the intricacy of the
subject matter, and the complicated technical terminology. The translations were often literal,
and often words whose meanings were imperfectly understood were simply transliterated from
their Arabic or Hebrew form. Many of these words have survived down to the present day as,
for example, alkali, zircon, alembic (the upper part of a distilling vessel), sherbet, camphor,
borax, elixir, talc, the stars Aldbaran, Altair and Betelgeuse, nadir, zenith, azure, zero, cipher,
algebra, algorism, lute, rebeck, artichoke, coffee, jasmine, saffron and tarnxacum. Such new
words went to enrich the vocabulary of medieval Latin, but it is not surprising that these literal
translations sprinkled with strange words provoked complaints from other scholars. Many of
the translations were revised in the 13th century either with a better knowledge of Arabic or
directly from the Greek." Dirckx calls it "Latinized Arabic" (Dirckx, pg. 46).
7. Ackerknecht wryly notes that the earliest professors of medicine in these universities
were clerics, and that "as a matter of fact, celibacy for medical men at the University of Paris
was required until 1452" (Ackerknecht, pg. 85). Since the Church also frowned upon surgery—
Ecclesia abhorret a sanguine—"medieval medicine was centered, not in laboratories or
hospitals, but in libraries" and surgery became the province of barbers and quacks
(Ackerknecht, pg. 88).
8. Late Latin has been collected in dictionary form by Latham 1965. Dirckx
pp. 43-56 provides the most recent and best starting point for examining the contribution of
both Classical and Late Latin to medical language.
9. Medieval trade/professional groups such as the Society of Surgeon Barbers in London
and its equivalent in Paris used the vernacular in their communications (Bender, pp. 108-108).
In Italy, where surgery was permitted in the universities, Latin was the language of surgery
until the 18th and 19th centuries.
10. Somewhat surprisingly, Germany remained a center for academic use of Latin well
into the 19th century, resembling Italy and Spain. The last major use of medical Latin in
English-speaking countries was in pharmaceuticals—pharmaceutical Latin was taught and
practiced until the 1950s (Dirckx, pg. 50).
11. Getz 1982 discusses these issues at length. An excellent example of mixed
Latin/English medical writing in 1616 is the lecture notes of William Harvey (Bender and
Thorn 1961, pg. 117).
12. The most systematic continuing use of medical Greek and Latin is in the official
Nomina Anatomica (anatomical terms, abbreviated NA), a standardized list of anatomical terms
initiated by the International Anatomical Nomenclature Committee appointed by the Fifth
International Congress of Anatomists, Oxford 1950 and edited and expanded every 5-10 years
13. Basal entries are 'root' words—not compounds, derivatives or repetitions of other
words already present, e.g. laminar, laminography, laminectomy are not basal entries, but
lamina is. Accretion entries are the collections of compounds, derivatives or repetitions
surrounding major entries.
14. Standard English includes scientific terms from any field except anatomy, physiology,
pathology, biology, botany, and zoology, which traditionally use at least some Greek- or
Latin-based terms in their classifications.
15. One big loser among Latin clusters was morbus: it shrank from approximately 150
subentries in 1903 to 24 in 1974, and to 2 in 1988.

Ackerknecht, Erwin H. 1982. A Short History of Medicine. Revised Edition.
Baltimore: Johns Hopkins University Press.
Agard, Walter R. 1937. Medical Greek and Latin at a Glance. 2nd edition, N e w
York: P.B. Hoeber.
LEON M C M O R R O W  27

American Medical Association 1989. Manual of Style. 8th ed. Baltimore: Williams
and Wilkins.
Bender, George A. and Thorn, Robert A. 1961. Great Moments in Medicine.
Detroit: Parke-Davis.
Crombie, A.C. 1967. Medieval and Early Modern Science. 2 vols. Cambridge:
Harvard University Press.
Dirckx, John 1983. The Language of Medicine. 2nd ed. New York: Praeger.
Dorland 1974. Borland's Illustrated Medical Dictionary. 25th ed. Philadelphia:
W.B. Saunders Co.
Dorland 1988. Borland's Illustrated Medical Bictionary. 27th ed. Philadelphia:
W.B. Saunders Co.
Dorland 1994. Borland's Illustrated Medical Bictionary. 28th ed. Philadelphia:
W.B. Saunders Co.
Ehrlich, Ann 1988. Medical Terminology for the Health Professions. New York:
Delmar Publishers Inc.
Encyclopedia Britannica 1984. 15th ed. "Medicine, History of." Macropedia,
Vol. 11: 823. London.
Frenay, Agnes C. and Mahoney, Rose M. 1993. Understanding Medical
Terminology. 9th ed. Dubuque IA: Wm.  Brown Publishers.
Garrison, Fielding H. 1966. Introduction to the History of Medicine. 4th ed.
Philadelphia: W.B. Saunders Co.
Getz Faye Marie 1982. Gilbertus Anglicus Anglicized. "Medical History." 26:
Lea, James 1975. Terminology and Communication Skills in the Health Sciences.
Teston VA: Reston Publishing Co.
McCulloch, James A. 1962. A Medical Greek and Latin Workbook. Springfield IL:
Charles  Thomas.
Poynter, Frederick N. and Kenneth D. Keele 1961. A Short History of Medicine.
London: Mills & Boon.
Skinner, Henry A. 1961. The Origin of Medical Terms. Baltimore: Williams and
Smith, Genevieve L., Davis, Phyllis E. and Dennerll, Jean T. 1991. Medical
Terminology. A Programmed Text. 6th ed. New York: Delmar Publishers Inc.
Stenn, Frederick ed. 1967. The Growth of Medicine. Springfield IL: Charles 
A Contribution to the History of
Medical Translation in Japan

Although the ancient chronicles of Japan (Kojiki, 712; Nihongi, 720)

contain a few medical chapters and tell about two gods (Onamuchi No Kami,
Sukuna Hikina No Kami) regarded as pioneers of the art of healing in ancient
times, the history of Japanese medicine actually only started when cultural
relationships with China developed in the 3rd century. From then on, it went
through successive periods of foreign influences—Chinese, Portuguese, Dutch,
and other European languages—which carried with them distinctive problems of

The Chinese Influence

The first Chinese medical manuscripts were imported during the reign of
emperor Ojin (270-310). Wani, a Korean scholar, introduced the Chinese
ideographic writing and taught prince Wakairatsuko the fundamentals of Materia
Medica (Pen-ts'ao) in 285. Korea played a major role in the transmission of
Chinese medicine into Japan: the first foreign physician ever to treat a mikado
(414) was Korean-born Kim Mu, and the first Korean medical treatises reached
Japan in 459.
In 552, under emperor Kimmei (508-571), Buddhism found its way to
Japan and became the source of education and medical organization. Bonzes
were often active physicians, and in 561 a total of 164 Chinese medical books
were imported. Japanese youths were sent to China to study medicine (603-
608) until in 702 when a medical academy was established in Japan. The
medical classics of the time were Chinese works easily recognizable in their
Japanese adaptations: So- (ex Su-wen, first part of the Nei-king), Shin-kyô
(ex Tchen-king, a treatise on acupuncture), Shin-nô honzô (ex Chen-nong pen-
ts'ao, Materia Medica), Senkin-hô (ex Ts'ien-king fang, A Thousand
Prescriptions of High Value), etc.
In the Nara period (710-784), medicine was very much influenced by
Buddhism. The Chinese bonze Kan-Jin, who came to Japan in 763, studied
medicinal plants and taught both Buddhism and Chinese medicine. Sinophilia
30  Λ Contribution to the History of Medical Translaton in Japan

culminated during the Heian period (794-1185) and resulted in the compilation
of the first Chinese-Japanese glossaries by Hukae Ozin in his Honzô wamyô
(898-900) and Minamoto No-Shitago in his Wamyô-rui jushô (929). Although
many medical books were still imported from China, Japan was beginning to
gain a footing and soon Japanese treatises came into existence, such as Yakkei
taiso (800, a collection of 254 drugs) by Wake Hiroyô, Daido-ruiju-ho (806-
810, a collection of prescriptions) by Izumo Hirosada and Abe Manao, which
seems to be a local adaptation of the Chinese Tang Pen-ts'ao (660), Kinran-ho
(868, a handbook of medicine written at the emperor's command by Sugawara
Minetsugu and a team of 21 scholars), Honzo-wamyô (901-922, Materia
Medica) by Tamba Yasuyori, etc.
Chinese was still the language of most publications, but among the more
important books a few were already written in Japanese. The main work of the
Kamakura period (1192-1333) was a treatise on clinical medicine, Mannan-ho
(1314), by Kajiwara Shôzen, that mirrors the Song's classic San-yin ki-yi,
ping-tcheng fang luen (1174). Other major works of the period were the
textbooks of pharmacy (Honzô shi-kiyô-shô) and medicine (Idansho) by
Koremune Tomotoshi and the handbook of internal medicine (Zôfu-shôrui-shô)
by Tamba Yukinaga.
After the fall of Kamakura (1333), a period of civil war set in and lasted for
sixty years, ending in the victory of the Ashikaga dynasty which initiated the
Muromachi period (1338-1573). The Chinese influence was still tangible. The
Buddhist priest and physician Yurin translated many Chinese medical texts and
compiled the writings of his foregoers in his Yurin Fukuden-ho (1362-1367).
Other famous physicians of the time were Manase Dôsan (1507-1594), a
supporter of classical Chinese medicine, who wrote a short handbook of
practical medicine (Kiteiki shu) and Nagata Tokuhon, an opponent of the
classical school. In 1528, Isho-taizen, an encyclopedia by Asai Sozui, was the
first medical book printed in Japan. This momentous event was soon to be
overshadowed by an even more epoch-making development, i.e. the discovery
of Japan by the Portuguese.

The Portuguese Influence

In 1542, the first contacts of Japan with the Western world materialized
when Portuguese trading ships reached the islands of Kyushu and Tanegashima.
They were soon followed by missionaries who rapidly succeeded in converting
large numbers of Japanese to Christianity, including daimyos (feudal lords).
One of these, Otomo Sôrin, founded a hospital at Funai (now Ôita) in 1556 and
commissioned a Portuguese Jesuit, Luis de Almeida (1525-1583), to run it.
Almeida, the first European physician known in Japan, had come to the Far East
at the age of twenty-four to earn a living as both a trader and a doctor. He stayed

in Japan until his death, practising and teaching medicine and surgery at Funai.
European medicine became very popular and gave rise to a Japanese school of
surgery, illustrated by such works as Namban geka shô (Surgery of the
Southern Barbarians) ascribed to Sawano Chuan (Japanese name of ex-Jesuit
Cristovao Ferreira), Namban ryû-geka (Precis of Portuguese Surgery) by Handa
Ju-an of Nagasaki, etc., Nishi Kichibei was a medical interpreter in the service
of the Portuguese since official talks with the government were conducted in
Portuguese, which would remain the lingua franca in the region until the end of
the 17th century.
In the meantime, the Azuchi-Momomaya period (1574-1600) had ushered in
a time of civil wars and religious dissent. Persecution of the Christians started in
1585 and ended with the expulsion of the Jesuits in 1597. Although the medical
sciences owed much of their progress to the contributions of the Portuguese,
Chinese medicine remained the foundation of Japanese therapy, and in 1592 the
Chao-hing pen-ts'ao (Materia Medica of the Chao-hin era, ca. 1159) compiled
by Wang Ki-sien was translated into Japanese under the title Shôkô-kôtei-keishi
shôrui-bikiû-honzô. The ban on foreigners was maintained under the early Edo
or Tokugawa period (1603-1867), culminating in the massacre at the
Portuguese embassy in 1640. Only the Chinese, considered the paragons of
classical medicine, and after 1641 the Dutch, regarded as the messengers of
Western science, were now tolerated in Japan.

The Dutch Influence

Dutch traders set foot on the island of Hirado in 1609, where they
established a factory that was transferred to the artificial island of Deshima,
facing Nagasaki, in 1641. Although Portuguese was still the language used in
official contacts, the Dutch often resorted to Chinese in order to be more easily
understood. About 1678, the language problem became so acute that the
Japanese government decided to set up a school for interpreters. The Dutch India
Company also trained its own interpreters, who, as their education progressed,
were taught medicine as well. Eminent surgeons of the Company who
participated in the project were Schamberger (arrived 1643), Hoffmann (1650),
Katz (1661), Danner (1663), Palm (1666), Ten Rhyne (1673), and others. The
more gifted students sometimes created their own medical schools, founding
whole dynasties of physician-interpreters—the Narabayashis, the Nishis, the
Yoshios, etc.—some of whom also became well known as translators. Unlike
the Portuguese era, the period of Dutch influence was indeed to be very
productive in the field of translation.
In the early Edo period, however, translations from Chinese were still
common, such as the abridged version of Li Che-Tchen's Pen-Ts'ao kang-mu
(1590, Materia Medica) under the title Tashi-kihen (1612) by the renowned
32  A Contribution to the History of Medical Translaton in Japan

physician Hayashi Dôshun, or the complete version of the same work, Zuga
wago honzô kômoku (1698), by Hanbei Nagamura. While they discovered a
Western anatomy and surgery unknown to them, the Japanese retained their
admiration for Chinese medicine in other fields, especially in its materia medica
where the influence of Li Che-Tchen was considerable. Yet, in 1654, Mukai
Genshô published his Kômoryâ-geka-hiyô, probably the first translation from
the Dutch, a surgical manuscript by Johan Mestruans.
When the importation of Dutch medical books was authorized in 1720,
translation took off on a much larger scale. A few years before, in 1706,
Narabayashi Chinzan (1643-1711), a student of Willem Hoffmann, had already
revealed the French surgeon Ambroise Paré's work La Méthode curative des
plaies (1545) by translating it from a 1649 Dutch version—presumably an
offspring of the Ghent physician Carel Batten's De chirurgie ende alle de Opera,
ofte Werchen van Mr. Ambroise Paré (1595)—and publishing it under the title
Oranda geka sôden. This work was retranslated in 1735 by Nishi Gentetsu, who
corrected Narabayashi, and again in 1769 by Irako Kohaku.
In 1739, Aoki Konyô (1698-1769), the court librarian, and Noro Genjô
(1693-1761), the court physician, were ordered by the shogun to learn Dutch. A
few years later, Noro translated a treatise on pharmacology (1742-1748) of
unknown European origin. In 1745, Nishi, Yoshio and other interpreters were
allowed to read and possess Dutch books. Yoshio Kôgyû (?-1800), a student of
the Swedish botanist Carl Thunberg, who had reached Japan in 1776, translated
many scientific works and became the head of the Yoshio-ryu medical school,
where Noro Genjô, Maeno Ryôtaku (1723-1803), Ôtsuki Gentaku (1757-
1827) and others received their educations. Maeno, physician to the daimio of
Nakatsu, had attended in 1729 the Dutch classes organized by Aoki and Noro,
went to Nagasaki in 1770 to improve his knowledge and returned to Edo with a
dictionary and some medical books, including a Dutch version of the German
Johann Kulmus' Tabulae anatomicae (1732). With his colleagues Sugita
Gempaku (1733-1817), Katsuragawa Hoshu (1751-1808) and Nakagawa Jun-
an (1739-1786), he embarked on the translation of the Gerardus Dicten version
Ontleedkundige tafereelen (1734), a task which took them four years. It was
written in Japanese script, but Sugita transcribed it into Chinese characters and
published the first edition in 1773 under the title Kaitai shin-shô (New handbook
of anatomy). In 1771, Nakagawa, another student of Thunberg's, had obtained
from the Dutch in Edo copies of Kulmus' Tabulae and Gaspar Bartholin's
Anatomica nova to translate and compare them with the Chinese classics. Oranda
zenku naigai bungôzu (published 1772) is a translation of the German Johann
Remmelin's anatomical Kleiner Welt-Spiegel prepared by the Nagasaki
interpreter Motoki Ryôi (1628-1697) from a 1667 Dutch version by Justus
Ôtsuki Gentaku, the best pupil of the German Hermann Retzke, who later
headed the Nagasaki Office for Translation of Foreign Books (1811), not only

translated the German Lorenz Heister's surgical work as Yo-I-shin-shô (1792),

but also published Rangaku kaitei (1783), the very first Dutch work on grammar
written in Japanese. That same year, the first monograph on the Dutch language
was authored by Hiraga Gennai (1729-1779), who also revised the Kulmus
translation under the title Jutei kaitai shin-shô (1788), while Inamura Sanpaku
(1759-1811) compiled the first Dutch-Japanese dictionary along the lines of
François Halma's Woordenboek der Nederduitsche en Fransche taaien (1710).
In 1793, Udagawa Genzui (1755-1797) translated Johannes de Gorter's
compendium of medicine Gezuiverde Geneeskunst (1744), which appeared for
the first time under the title Naika sen-yo (Digest of Internal Medicine). The
manifest interest of medical circles for Dutch works did not stop the production
of translations from the Chinese, another example being the treatise on forensic
medicine Munben-roku-jutsu (1736) translated by Kawai Naohisa from similar
Chinese originals.

The Change to a European Influence

The Dutch influence lasted until the early 19th century, when the Japanese
discovered that many of the recent medical works were actually Dutch
translations of German originals. From then on, a broader European influence
prevailed, and translators began to explore German and English medical
Yet translations from the Dutch continued unabated. Ypei yakusei (1818) is
Aochi Rinsô's translation of Adolphe Ypey's Handboek der Materia Medica; it is
the first Japanese translation of a Western treatise of materia medica. Oranda-
yaku-kyô (1828), another book on the subject, was adapted from the writings of
A. Ypey, H. J. van Houte, J. Arnemann and Chr. J. Nieuwenhuis by Udagawa
Genshin (1769-1834), who also published Rasen gigi zenshô, a translation of
the Swede Nils Rosen von Ronsenstein's treatise on pediatrics via a 1776
German version, Anweisung zur Kenntnis der Kinderkrankheiten. In 1831,
Adachi Chôshun (?-1836) translated, under the title Ihô kenki, a treatise on
internal medicine by the German Anton Stoerck. In 1832, the first adaptation of
a textbook of physiology, Igen-shuyo, appeared under the signature of Takano
Choei (1804-1850), a collaborator of Philipp von Siebold at the Nagasaki
school of medicine founded by the latter. Itô Gemboku, another physician of the
Nagasaki school and cofounder of the Edo Academy of European medicine,
translated the German Christoph Bischoff's treatise on internal medicine under
the title Iryo-seishi (1835). More translations on internal medicine followed: Seii
chiyô, from the Dutchman Gerard van Swieten's book, by Uno Ransui;
Mambyo chijun, from the Dutchman Herman Boerhaave's treatise, by Tsuboi
Seiken; Tissot Naiko shô, from the Swiss André Tissot's work, by Ema Ryûen,
and others. In 1855, Hirose Genkyô translated Anthelme Richerand's Nouveaux
34  A Contribution to the History of Medical Translaton in Japan

éléments de physiologie (1802) under the title Riserando jinshin kyurisho. One
year later, Hayashi Dôkai, who was later to organize the 2nd Japanese Congress
of Medicine (1893), published his Water-yakusei-ron (1856), a translation of the
Dutchman J.A. van de Water's pharmacology handbook.
In 1857, Nagasaki welcomed the arrival of J.L.C. Pompe van Meerdervoort
(1829-1908), the first professor formally invited by the Japanese government to
establish the official and public teaching of Western medicine and surgery. In his
memoirs (Vijf jaren in Japan, 1857-63), he stressed the difficulties of the
language barrier: the students did not know the first word of Western anatomical
vocabulary and the interpreters of the Dutch school were not yet quite up to the
arduous task of scientific translation. Pompe's Lessons of Special Surgery was
translated as Geka-kakuron by Matsumoto Ryôjun (?-1907).
The need for basic language tools probably accounts for the adaptations, in
1857, of the English surgeon William Cheselden's Anatomical Tables (1730)
and Osteographia (1733) via Benjamin Hobson's Chinese version Ts'iuan-t'i
sin-luen (1851) by Miyake Gonsai under the title Zentai shin-ron. As a rule, the
Japanese adapters were not satisfied with a mere translation; they went so far as
to compile some sort of digest of what seemed to be most assimilable from the
various authors. That is also how Ogata Koan (1810-1863), founder of the
Osaka Dutch School of Medicine, adapted the German Christian Hufeland's
Enchiridion medicum (1838) via H. Hageman's Dutch version Handleiding tot
de geneeskundige praktijk (1838), publishing it under the title Fu-si kei-ken i-
kun. Ogata, who later became president of the Academy of European Medicine,
had formerly translated Hufeland's treatise on general pathology, Byori tsûron
(1847). In 1859, Ryôkaku Shingû published Geyô hôfu, tanpô hen, an
adaptation of the Austrian Joseph von Plenck's Drugs Used in Surgery;
Plenck's Medical Compendium had already been translated before by Yoshio
Eiho (1785-1831). In 1887, Kuga Kokimei signed a translation of the Manuel
du chirurgien d'armée (1792) by the French surgeon Baron Pierre-François
Notwithstanding the overall European influence, translations from the
Chinese were not completely forgotten. A Chinese work on external pathology,
published in 1693 and imported in 1732, was translated into Japanese by
Narabayashi Soken, an interpreter and vaccinator associated with the German
physician Otto Mohnike (who introduced the stethoscope to Japan) at Nagasaki
between 1848 and 1854.
Conversely, Japanese books began to be translated into European languages.
Kagawa Genetsu's San-ron (1768), a treatise on parturition and obstetrics, was
translated into Dutch by Miwa Junzo in 1825, into German by Ph. von Siebold
in 1865, and into French by Charpentier in 1879. Beschreiving van het naaide
steken en moxa branden (published 1827) is the adaptation of a book on
acupuncture and moxas by the Dutchman Isaac Titsingh (1745-1812), who
wrote under the dictation of a Japanese interpreter.

The advent of the Meiji period (1867-1912), when the Tokugawa shogunate
was overthrown by emperor Mutsu Hito, ushered in sweeping religious, social
and cultural changes. To complete the westernization, a vast program of
scientific translations from the major foreign languages was initiated. Yet, the
traditional bonds with China were not entirely severed, and Chinese books that
conveyed new ideas and concepts were accepted and translated. During the short
Taishô period (1912-1926), Japan participated in World War I and confirmed
the conservative traits inherited from the Meiji era. Medicine, however, though
under German influence, gained its autonomy and the Association of Japanese
Physicians was recognized by the government in 1923. The interest in Chinese
and European medicine remained vivid, as illustrated by Ochiai Taizô's Chinese-
European-Japanese Medical Dictionary.
The onset of the Shôwa period coincided with emperor Hirohito's access to
the throne in 1926. The influence of German medicine, enhanced by the dispatch
of many German professors to Japan and of Japanese students to Germany, was
later checked by the defeat of the Axis Powers in World War Π. Soon Japanese
medicine shook off its complexes about Western medicine, and foreign teachers
were replaced by nationals. To help solve basic terminology problems, the
Japanese Society of Anatomy published a Japanese-Latin nomenclature,
Kaibogaku Yogo—Nomina anatomica japonica (1963). Medical translation
developed in every direction, as evidenced by the constantly increasing number
of specialized dictionaries in a variety of languages: Petit dictionnaire des termes
techniques de médecine (French-Japanese, 1933) by Ohya Zensetsu, Concise
Medical Dictionary (English-Japanese, 1948) by Kusarna Yoshio, Kleines
medizinisches Wörterbuch (German-Latin-Japanese, 1952) by Hirose Wataru et
al., Dictionary of Symptomatology (Japanese-English, 1955) by Watanabe
Yoshitaka, Dictionary of Surgical and Orthopedic Terms (Japanese-German-
English-Latin, 1957) by Menjo Matsutoshi, Medical Terminology in
Dermatology and Urology (English-German-Latin-Japanese, 1961) by H.
Yokoyama, New Pocket Psychiatric Dictionary (English-French-German-Latin-
Japanese, 1966) by S. Yoshioka, Dictionary of Internal Medicine (Japanese-
English-French-German-Latin, 1975) by Y. Aoyagi, etc.


The saga of medical translation in Japan is a fine example of translation's

contribution to the dissemination of knowledge. It parallels the adventure of
Greek medical science, with which the Western world became acquainted only
through a succcession of translation processes, first into Syriac by the Nestorian
school of Jundisapur (5th c ) , then into Arabic by the Baghdad Bayt alhikma
(House of Wisdom, 8th-9th c ) , and finally into Latin by the Toledo translators
36  A Contribution to the History of Medical Translaton in Japan

(12th c.) paving the way for the major European vernaculars. As the saying
goes: History repeats itself.

R E F E R E N C E S (Selection)

Ardouin, L. 1884. Aperçu sur l'histoire de la médecine au Japon, Paris: Berger-

Aston, W.G. 1924. Nihongi, Chronicles of Japan from the earliest times to A.D.
697, London: Kegan Paul.
Fujii, J. (transi. H.K. Colton & K.E. Colton) 1958. Outline of Japanese History in
the Meiji Era, Tokyo: Obunsha.
Fujikawa, Y. 1925. The Outline of the Medical History of Japan, Tokyo: Dai roku-
kai kyokuto nettai igakukai.
Fujikawa, Y. 1934. Japanese Medicine, translated from the German by J. Ruhrah,
New York: Hoeber.
Goodman, G.K. 1867. The Dutch Impact on Japan, 1640-1853, Leiden: Brill.
Huard, P. & Z. Ohya. 1962. La médecine japonaise avant l'ère Meiji, Symposium
Ciba, X, 1.
Huard, P. & M. Wong. 1969. La médecine chinoise, Paris: P.U.F.
Huard, P. & M. Wong. 1967. La médecine des Chinois, Paris: Hachette.
Huard, P. & M. Wong. 1959. La médecine chinoise au cours des siècles, Paris:
Huard, P., Z. Ohya & M. Wong. 1974. La médecine japonaise des origines à nos
jours, Paris: Dacosta.
Kleiweg de Zwaan, J.P. 1917. Völkerkundliches und Geschichtliches über die
Heilkunde der Chinesen und Japaner mit besonderer Berücksichtigung
holländischer Einflüsse, Haarlem: Stam.
Levy, R. 1961. Ennin. Journal d'un voyageur en Chine au IXe siècle. Traduction
et introduction, Paris: Albin Michel.
Mosig, A. & G. Schramm. 1955. Die Arzneipflanzen und der Drogenschatz
Chinas, Berlin: de Gruyter.
Nagaoka, H. 1905. Histoire des relations du Japon avec l'Europe aux XVIe et
XVIIe siècles, Paris: Jouve.
Pompe van Meerdervoort, J.L.C. 1867. Vijf jaren in Japan 1857-63, Leiden: Brill.
Shibata, M. & M. Sibata. 1969. Kojiki. Chronique des choses anciennes.
Introduction, traduction intégrale et notes, Paris: Maison-neuve et Larose.
Toussaint, Fr. 1969. Histoire du Japon, Paris: Fayard.
Wallnöfer, H. & A.v. Rottauscher. 1959. Der goldene Schatz der chinesischen
Medizin, Stuttgart: Schuler.
Wong, M. 1968. L'Histoire de la médecine sous les Song, Bruxelles: Institut de
Some Thoughts on the Spanish
Language in Medicine

Since long before it became a full-fledged modern language, Spanish has

been associated with medicine. From the 2nd to the 7th centuries, Spain, like
Italy, was under the control of the Visigoths, a hardy Germanic tribe
("Barbarians from the North") that had swooped down and defeated the Roman
legions gone soft.
Under St. Isidore of Seville (570-636), and earlier (311-383) with bishop
Ulfilas (Wulfila), translation was first attempted from Latin into Visigoth. Soon,
however, the Visigoths abandoned their own language in favor of Latin. Along
with classic Latin, a new form known as vulgar Latin began slowly to emerge—
born and developed mostly in Rome, and not in the provinces, as some people
seem to think. This vulgar form was to give rise to a number of Romance
languages, such as Spanish, French, Italian, Portuguese, Catalan and
Rumanian. Although the term "Romance" is usually equated with these
languages, in Spain, at least, Romance was actually an intermediate form
between vulgar Latin and Castilian Spanish. It should also be noted that classic
Latin was the language of the Christian church, and that it continued to rule the
world of literature well into the 17th century. Some of the greatest writers of the
times—Erasmus, Juan Luis Vives, Francis Bacon, John Milton, Spinoza,
Leibnitz and Newton—wrote in Latin.
The Romance phase coincided with the invasion of Spain by the Moors (718
A.D.). These Arab armies brought with them a treasure-trove of medical and
scientific knowledge from ancient India, Persia, Egypt, Greece and Syria,
gleaned from translations done at their Baghdad House of Wisdom (8th and 9th
centuries A.D.). The Arabs, who in the 7th century embraced Islam, had no
prose literature of their own, only poetry. As Garcia Yebra and Menéndez Pidal
have pointed out, with the Koran, which itself owed much to the Old and New
Testaments, the Arabs launched a series of far-reaching translations,
interpretations and commentaries of works by Aristotle, Plato, Archimedes,
Hippocrates, Euclid, and many of the outstanding philosophers and scientists of
ancient Greece. They also translated into Arabic the Septuagint, a version of the
Bible which had originally been translated from Hebrew into Greek, for the
38  Some Thoughts on the Spanish Language in Medicine

benefit, curiously enough, of dispersed Jews, who had forgotten their ancestral
The Arabs had also brought with them literary tales and fiction conveyed
from ancient India and Persia through various intermediary languages and
reworked into thoroughly Arabic versions. Among these were the Arabian
Nights (Alf-Layhla wa Laylah), and the Fables of Bidpai (Kalila wa-Dimna)
which, together with translations of the Bible, were to play a key role in
European literature. In England, King Alfred the Great (849-901) had already
planned the translation into English of all books in Latin he deemed essential to
the education of his subjects. An early translation of the Greek Bible into Latin
was the version known as the Vulgate, completed by St. Jerome, the patron
saint of translators, in about 384 A.D. This translation, and subsequent ones
based on it, was to help English become a literary language. The German
translation of the Bible by Luther signaled the beginning of modern German.
Similarly, Spanish, French, and Italian translations appeared.
While many of these later efforts showed a literary bent, two centuries after
the arrival of the Moors in Spain, a world-famous School of Translators was
started at Toledo by Archbishop Raimundus (1125-1152), with the stated
purpose of mining the treasures of ancient science and technology brought by
the Arabs. By a process described below, works not only on ancient and Greek
medicine, but also on philosophy, astronomy, mathematics, botany, and
alchemy were translated and drawn into the mainstream of European thought. To
accomplish this, Raimundus surrounded himself with some of the best medical,
philosophical and legal minds in Europe, including many outstanding Arabs and
Jews from Spain and elsewhere. Among his contemporaries and collaborators
were Abenzoar and Aberroes, both Hispanic-Arab physicians, philosophers and
theologians, who became leading authorities on Aristotle and his works;
Avicenna, also a physician, philosopher, mathematician, and author of the
Canon, a medical textbook read and studied in medical schools up to the 18th
century, and of nearly 100 other books on medicine; and last, but not least,
Maimonides, a Spanish Jewish philosopher whose work influenced Albertus
Magnus, St. Thomas Aquinas and, later, Spinoza.
The procedure used for translating medical, scientific and philosophical
texts, was as follows: A Jew who knew both Hebrew and Arabic first translated
orally from these two languages into Spanish Romance, the precursor of what
later became Castilian Spanish. The Romance version was then translated into
Latin by a Christian, to be disseminated throughout Europe. Among the
translators who worked at Toledo were Spaniards, Gascons, Frenchmen,
Italians, Englishmen and Germans.
The undertaking started by Archbishop Raimundus at Toledo was followed
and improved upon by King Alfonso the Wise (1252-1284), who also gathered
around him the best minds of his time. King Alfonso was not content to have the
great works of antiquity translated into Romance and Latin. He now wanted

Romance to be discarded in favor of Castilian Spanish. He promoted the first

Spanish (and European) translation of the Kalila wa-Dimna. Alfonso also wrote
outstanding treatises on medicine, mathematics, history, law and navigation (the
famous Alfonsine astronomical tables, which amended and expanded on some
of the theories put forth by Ptolemy). In addition, he supervised most of the
translations from Arabic crafted during his reign. He even created the job of
editor {emendador) and exercised it continually to ensure that his translators used
"straight Spanish," not Romance.
Curiously, the Arabs, in these translations, left some gaps in their
knowledge of medicine and added some new tricks of their own. Because of the
Islamic prohibition of showing images of the human body, or of dissected
anatomy, very little was said about surgery, or for that matter about painting. On
the other hand, because of their long sufferings in the Arabian deserts, where
sand storms were almost a daily menace, they developed great expertise in
ophthalmology, a specialty later inherited by Spanish physicians, who have
preserved that tradition and today are among the world's foremost specialists in
eye diseases.

The Literary Tradition in Spanish Physicians

We mentioned that the great Arab and Hebrew physicians were also
mathematicians, philosophers, and writers. Spanish and Latin-American doctors
share with them this tradition. Indeed, many Spanish-speaking physicians,
whether well-known or working in near-anonymity, are often frustrated writers.
Santiago Ramon y Cajal, the Spanish Nobel Prize winner in Neuroanatomy
(1906), wrote beautifully about his discoveries, as well as about ethics and
philosophy. One of Spain's greatest novelists of recent times, Pίο Baroja, finally
abandoned medicine to devote himself fully to writing. (Baroja was
Hemingway's mentor, by the latter's own acknowledgment). Another great
physician, Dr. Gregorio Maranón, has written not only on endocrinology, his
specialty, but on sexology, the arts, and insanity, and has produced
psychobiographies of famous Spanish personalities. A further example of a
physician-philosopher-writer is the Cuban Dr. José Varela Zequeira (1854-
1939), who left us a diaphanous and colorful description of Cuban life and
politics in the 19th and early 20th centuries, as well as penetrating essays about
the human brain and instincts.
In the 15th century, Spain discovered and colonized the New World. There
followed a number of signal achievements in the fields of medicine, astronomy,
mathematics, navigation, botany, and mining technology. In medicine, Miguel
Servet discovered the pulmonary circulation; Andrés Laguna first described the
ileocecal valve; chinchona (quinine) was discovered by Spaniards in Peru as a
remedy against malaria; and Gaspar Casal identified the "illness of the rose"
40  Some Thoughts on the Spanish Language in Medicine

(later known as pellagra). Interestingly, quite a number of these discoveries

were first reported in Spanish and then translated into English and other
European languages, only to be retranslated into Spanish in recent times by
people who apparently were not aware of the original discoverers.
The 17th and 18th centuries witnessed the Golden Age of Spanish literature,
with figures like Miguel de Cervantes, author of Don Quixote; the playwright
Lope de Vega (often compared to Shakespeare); the satirical writer Quevedo
(also a translator); and the poet Góngora.
In more recent times, there has been a revival of interest in the role of
Spanish-speaking physicians and writers. As already mentioned, a Nobel prize
went to the Spaniard Santiago Ramon y Cajal for his work on neurons; Nobel
Prizes were also awarded to the Argentine physiologist Bernardo Houssay
(1947) for his biological discoveries and to the Spanish-born American
biochemist Severo Ochoa (1959, co-discoverer of the mechanisms of DNA and
RNA). Other famous Spanish-speaking physicians are the Barraquer brothers
and Dr. Castroviejo (ophthalmologists) from Spain; the Argentinians Domingo
Liotta and René Favaloro (who pioneered heart bypass surgery); and the
Mexican Ignacio Chavez, who collaborated with Wiener in his research on
cybernetics; as well as the Cuban Carlos Finlay, who laid the groundwork for
discovery of the transmission of yellow fever by a mosquito.
The purpose in singling out these prestigious names—there are many more
we have not mentioned—is to reassure some doubting Spanish translators that
their language is not underdeveloped. Spanish-speaking doctors, scientists and
writers have never had any difficulty in communicating their findings on their
specialty subjects, or, for that matter, on any subject, whether it be medical,
scientific, technical, theological, philosophical, ethical, or legal.

Where Spanish Stands Today Versus English

Like many other European and Asian languages, Spanish is today somewhat
behind the times with respect to the plethora of English terminology being
created every day. According to a July 24, 1995, article in US News and World
Report, about 25,000 new English words are coined every year, of which 4%
make it into the dictionaries. But the catching up with English goes on
continually, by either finding adequate Spanish words, borrowing from English,
or Hispanicizing English terms (sometimes poorly, as reflected in Spanglish).
English and Spanish are emerging as the languages of the third millennium.
English is, quantitatively, the second most widely spoken language in the world,
following Mandarin; Spanish is third, with well over 300 million speakers. It is
projected that by the year 2025, Spanish will be spoken in the United States
alone by more than 40 million people, thus ranking the U.S. second (after
Mexico, and well ahead of Spain) in terms of the number of Spanish speakers.

How is English Transferred into Spanish?

Every year, some 8,000 books, in addition to piles of other printed

materials, are translated into Spanish. Most of these translations relate to the
field of medicine and to other scientific or technical subjects. Some are quite
good, while others admittedly leave much to be desired, either because they
were done under great pressure or because the translators involved were not
always up to the task. The challenges facing Spanish translators in the United
States are many. Earlier generations of translators were immigrants, not well
grounded in their own language, let alone English. Many in the later generations
are also immigrants, but tend to be better prepared, have a college or university
education, and may even be professionals—doctors, architects, or writers. But a
core remains of less well-prepared people who, upon coming into contact with
English, have mistakenly reached the conclusion that because, in their view,
anything goes in English, the same should apply to Spanish. Thus, little
attention is paid to grammar, syntax, spelling, style, etc. The lack of any visible
authority in the English language to rule over propriety—as opposed to the role
played in Spanish by the Spanish Academy—has misled some people into
believing that no such thing as a standard English exists. A closer study of the
many excellent American dictionaries and grammars, and above all, style
manuals, would no doubt quickly disabuse them of their views. In the end, a
good translator needs to do more than learn the two languages; he or she must
learn them well and, above all, must love them. Without such love,
understanding the peculiarities, similarities, and differences between the two
languages is next to impossible. Without such love, translation becomes a
tedious chore.
Speaking of dictionaries, particularly scientific and medical dictionaries, they
are both a help and a hindrance to the translator. They help up to a point, as far
as they go, which is never far enough nowadays; they hinder when they force
the professional translator to waste time in fruitless searches. No dictionary can
be totally up to date—even those that now appear on the Internet. By the time
they are translated into Spanish, many of the terms have already lost their reason
for being, have changed or been discarded. With regard to Spanish medical
dictionaries, many are translated directly from English, and these frequently do
not take into account the actual terminology used in the target language. In other
words, they include only American or British entries. Often, the target language
uses a different term for a particular item or process, and this, of course, is not
reflected in the translated dictionaries. A couple of cases in point: radioscopia,
antibiograma. These appear in monolingual Spanish dictionaries, but not in the
translated American dictionaries, which prefer the more usual terms
"fluoroscopy" and "antibiotic sensitivity test." This has led many translators to
use the English approaches (fluoroscopia, prueba de sensibilidad a los
42  Some Thoughts on the Spanish Language in Medicine

antibióticos), because they are not aware that commonly used Spanish
counterparts exist.
Again, some American-produced dictionaries do not seem to be aware of the
many "false friends" and inverted terms that they introduce. In the following
examples, the English term (bold) and its meaning are given first, then > the
Spanish false friend (italic) and its meaning > followed by the correct or more
usual Spanish term (underscored): abatement (reduction) > abatimiento
(depression) > disminución. alivio: bizarre (strange) > bizarr (courageous,
generous) > extrano, estrambótico: condition (a disease or disease state,
frequently temporary) > condición (a permanent quality or state) > enfermedad,
estado; deprivation (lack of something) > deprivación (does not exist in
Spanish) > privación: generic name (non-proprietary name) > nombre
genèrico (genèrico would properly be applied in Spanish to a drug of the same
class or gender, which might or might not be proprietary) > denominación
comun  no registrada: Physiopathologic (relating to both physiology and
pathology or disease), > fisiopatológico > patofisilógico: photomicrography (a
picture of a microscopic object) > fotomicrografia > microfotografia: pesticide
(kills pests) > pesticida > (peste has other unsavory meanings) > plaguicida:
renosvascular (affecting the vessels of the kidneys, or both the vessels and the
kidneys) > renovascular > vasculorrenal is preferred. Thus, if a translator looks
up the usual Spanish term in an American-produced dictionary, he/she may not
find it.

How Can the Translator Keep Up?

Ideally, to keep up with his or her native language, today's translator must
not only read on a continuous basis—literature, newspapers, magazines—but
must also listen to radio, watch TV, surf the Internet, and frequently visit one's
country of origin. Whether we like it or not, the media have become the modern
models and teachers of language for a large portion of the population; sometimes
with dire results, as in the case of Spanglish.
What is one to do when faced with a new term that does not appear in any
dictionary or reference source? My practice, for many years, has been to give the
new term an appropriate Spanish equivalent, sometimes by drawing from similar
terminology lurking in memory or from books. This is followed by the English
term in parentheses, so that the source term will not be misconstrued. The
Spanish term is then used throughout the translation. In this manner, one can
communicate clearly and immediately what the original word conveys, and if
other people do not care for the term offered, they can always create a new one.
Either the one offered or theirs may prevail. More likely, the final arbiter, often
capricious, will be usage by people in their own countries. In the meantime, the
translator has succeeded in fulfilling an immediate need, in an unequivocal

fashion. I was greatly surprised, in researching this article, to find out that King
Alfonso the Wise, back in the 13th Century, used precisely this same method in
translating unknown medical and scientific terms from Arabic, Hebrew, and
Greek. As I have also mentioned, he instituted the function of editor, and I
cannot emphasize enough the need we all have of being competently edited.

Knowing Your Subject Matter

Medical translation, and scientific/technical translation in general, requires

more than a sound knowledge of both languages and the use of specialized
dictionaries. These, obviously, are basic prerequisites. But beyond that, the
translator must have at least a rudimentary knowledge of the subjects he is
In a way, medicine is easier to write about or translate than other scientific
and technical subjects, because much of its terminology is based on Latin and
Greek words, prefixes and suffixes. But as we have seen above, here and there
we come across some semantic pitfalls. Aside from terminology, a great deal of
specific English usage in medical and surgical procedures requires a parallel
knowledge of how these things are said in other languages. This means that the
translator must read these same subjects and terms in the target language (in
textbooks, journals, papers, etc.) and compare them with the source language.
One other aid I have found to be invaluable. At times, we translators like to
complain that there are no real sources of information about certain medical
procedures or terminology in the target language. This is obviously specious.
Often what I cannot find in Spanish I usually find in French or Italian—or even
Portuguese—all of them Romance languages whose thought patterns and
inventive processes are similar. My reference dictionary for medicine is
Gladstone's English-French, which hardly ever fails me, pointing the way to
how I can say what I need to say in Spanish. Earlier I had found that French and
Italian were also excellent guides for translating English technical words like
push-pull (en contrafase), flip-flop (circuito bie stable, basculador), scanning
(tomografía, imaginología, exploratión), and throughput (rendimiento neto). In
the case of "scanner," the Spanish Academy has already Hispanicized it to
escáner, though only with reference to the original medical CT scanners. Usage
in Spain has now expanded the meaning of escáner to encompass other than
medical applications, including the scanners used in supermarkets to read bar
codes (also known as lectores ópticos—optical readers).
44  Some Thoughts on the Spanish Language in Medicine

Giving Back Some Gifts

As one matures in the profession and looks back at what has modestly been
achieved, it becomes clear that it is time to return some of the gifts received to
the new generations of translators. I agreed to teach a translation course on Life
Sciences—a fancy name for what used to be known as natural sciences and
more commonly biology—at New York University. This was an opportunity to
put into teaching practice all—or much—of what I had learned in my medical
translation experience. I was fortunate to be given a free hand in developing the
syllabus for the 12-week evening course, given twice a year.
I began the course by telling my students that it was not enough to learn
what a particular part of the body is called. If one wishes to translate accurately
and convey in Spanish the style of the original English, it is necessary also to
know the body's structure, its various functions, and how doctors look at it and
refer to it in their daily conversations and reports. My students were already
translators, some quite advanced in years and experience, who now wanted to
be able to translate medical subjects. I taught them a little basic biology, enough
to refresh their memories of what they had learned in school or else to become
acquainted with the rudiments of this science. Every time an English term was
mentioned, it was accompanied by its Spanish term and vice versa.
In addition to the core subjects of cells, tissues, organs, and systems, we
delved into the various types of microscopes that are used to see cells and their
components, as well as other investigational and diagnostic tools—like
computed tomography (CT), magnetic resonance imaging (MRI), positron-
emission tomography (PET) and single-photon emission computed SPECT
scanners. Medical translation, while deeply involved with anatomy and function,
also deals on an ongoing basis with diseased, malfunctioning and
nonfunctioning body components. This led the course directly into drug
treatment—the major type of therapy today, besides surgery—and to the nature
of the various drugs available, how they are studied, approved, labeled,
marketed, all matters the medical translator will have to deal with. Following is
an outline of the course:

1. The structure of cells, tissues, organs and body systems, including cell
components or organelles, types of tissues, main body systems (nervous,
muscular, cardiovascular, digestive, etc.).
2. How all these elements and parts function. The underlying processes at
the atomic and molecular levels; biochemical reactions (bonds and valences),
metabolism, cell respiration, glycolysis, the Krebs cycle, hydrogen and electron
transport, oxidation and reduction, the power-supplying role of ATP; salts,
acids and bases, hydrolysis, buffers, body gases.
3. Abnormal structure was approached from the genetic and environmental
aspects—all the way from cell division to mutations, excessive or insufficient

chromosomes, abnormal DNA sequences, bad RNA transcription, all possibly

leading to malformation and disease.
4. Having detailed the structural and functional basics and problems, we
went on to therapy, concentrating on drug treatment. We reviewed the basic
pharmacology—pharmacokinetics, pharmacodynamics—and how drugs are
administered (orally, by various types of injections, and even by pulmonary
absorption of gases). The importance of drug absorption, bioavailability (how
much of the drug reaches the target tissue) and biotransformation (how drugs
give rise to metabolites, some of them quite dangerous). Finally, there is the end
process of drug excretion—renal (urinary), biliary (fecal), sweating, saliva, and
5. In approaching medical translation, the most frequent requirements have
to do with medical articles and papers, package inserts, investigational new drug
applications (IND's) and new drug applications (NDA's). Samples of these
were reviewed in class. IND's are necessary before a drug company is allowed
to experiment with a new drug intended for market. DNA's are required before
clinical tests start. Experimental testing usually starts with the selection of a
particular molecule, among many, that holds some promise as a therapeutic
agent. At this stage, the drug mostly should show some efficacy and lack of
toxicity. To find out, these type of studies are conducted in laboratory animals.
When experimental tests have been successfully completed, clinical tests can
begin (with the FDA's permission). Clinical tests are conducted on selected
humans under highly controlled conditions, and they are promptly terminated if
any strong toxicity, not found in the experimental animals, now emerges during
the tests. In addition to drug action, the effects on different types of populations
(older patients, younger patients, male or female, children) may be studied.
Tests are usually done first on a small number of patients, then on wider groups
and finally on large samples involving hundreds or thousands of participants.
Tests used include single- and double-blind, randomized or open studies, and
their results are evaluated by means of statistical analysis, in which the placebo
effect, patient compliance, tolerance, cross-tolerance and other factors are taken
into account. Finally, in some countries, Government regulations require a drug
company to continue to monitor effectiveness and safety, particularly the latter,
after the drug has reached the market, as the toxicity of some drugs does not
become apparent until they have been used by millions of human beings.
6. As a drug progresses through experimental and clinical tests to
launching, it acquires different names and labels that are important to the
manufacturer, the FDA and the translator. While under investigation, the drug
usually has a chemical and a structural name, the nature of which is sometimes
hidden from rival eyes and ears by the use of an in-house code name. All drugs
under testing or already approved also have a generic or non-proprietary name
(like nifedipine), the use of which is recommended for all medical
communications. If the manufacturer has been successful in patenting the drug,
46  Some Thoughts on the Spanish Language in Medicine

he may then use a proprietary or a registered trade name, such as Procardia or

Adalat. Before a drug is approved for marketing, the FDA will require the
manufacturer to use only approved labeling, which sets the tone for claims he is
allowed to make in his literature, package inserts, labels, etc. Again, these
intricate aspects were discussed during the course.
7. On a very practical level, no medical translation course can begin to be
complete without dealing with the interactions between patient and doctor and
between patient and hospital, including emergency room requirements and
procedures, admission, physical examination, history, therapy, discharge, etc.
This, in itself, requires a considerable amount of time and terminology, which
we tried to break down into sections, each given at the very beginning of each
8. Supporting subjects and materials, such as statistics, correct and
incorrect grammar and terms, samples of medical literature, how and where to
obtain medical information (books, magazines, journals, databases), frequent
quizzes on subject understanding and on appropriate terminology, as well as
mid-term and final tests were included as part of the course.

After about five years of teaching the course, I decided to withdraw because
two other projects required my time and attention: an English-Spanish/Spanish-
English pocket dictionary for a Spanish publisher and, as a member of the
American Academy of the Spanish Language and chairman of its Translation
Commission, editing a quarterly bulletin called Glosas a publication that seeks to
clarify all types of obscure points of usage and grammar. It is intended
particularly for people who work with Spanish in public forums—schools,
universities, radio, TV, and so on. In addition, the bulletin includes a couple of
pages of Spanish terms culled from the official Dictionary of the Spanish
Academy, with their English equivalents. These are modern or special terms
selected for their timeliness and need. Because these pages also include medical
terms, Glosas is a helpful resource for medical translators. It is almost axiomatic
that many people consult a dictionary only when they need to find a term, but
otherwise often remain oblivious to the specific content of dictionaries, and as a
result miss a lot of new words. Glosas also has a section on new English terms
(medical, computer, technical) and suggested Spanish equivalents. Another very
useful section deals with "false friends"—words that are written the same or
almost the same way in Spanish and English but have different meanings (we
have dealt with a few earlier). Finally, it includes a list of expressions with the
prepositions they normally require. This is very important because the use of
prepositions is perhaps what most distinguishes one language from another, and
what allows one to pinpoint right away if a person is really fluent in a language
or is still trying to conquer its finer points.

A Word in Closing

Finally, some reflections engendered by all those years as a practicing

translator. When I started, translation was relatively easier than it is today.
People learned by doing and by seeing how others did it. There were no schools
that taught you how to translate. The pace was different, too. One would do a
translation, put it in the mail, and forget it until it was paid for. Today, one is
less of a translator and more of a communicator, who needs to handle not only a
computer, but also forever-changing software, floppies, e-mail, faxes, the
Internet, the World Wide Web, and so on.
A newly revived science of linguistics has emerged in recent years, no doubt
spurred by the perceived need to develop automatic translation by computers.
First, it is necessary for linguists to figure out how languages are structured,
what their common features and differences are, and where and how possible
solutions are to be found. Though great strides have been made in gaining a
better understanding of what makes languages work, with parsers and other
tools being added to the linguist's armamentarium, the fact remains that
automatic translation is still a long way from solving the basic problems of
communication, and its usefulness is mostly confined to a narrow field—
repetitive, predefined, and search jobs.


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Ortega y Gasset, José. 1916. "Ideas sobre Ρίο Baroja," in El Espectador, I as cited
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The Language of Medicine: A Comparative
Ministudy of English and French

The language of medicine, whether English or French, rests on a

fundamentally learned terminology made up of formants (roots, prefixes,
suffixes) drawn from Greek and Latin. Hence, it is commonly believed that a
translator who enjoyed a classical training in the exacting disciplines of these
seminal languages will readily identify and understand any medical term by
going back to its etymology. Of course, the fact of knowing that brachy (from
brakhys) means short, ectomy (from ektome) excision, phobia (from phobos)
aversion, rrhea (from rhein) flow, etc., may make things easier, but on the
whole the little regard shown by the language of medicine for the rules of
etymology and the laws of word-building will rather be misleading. One
building process that would have been unthinkable in the classical period is the
combined use of Greek and Latin components, whereas the language of
medicine flaunts scores of such hybrids (adipolysis/adipolyse,
hemoglobin/hémoglobine, claustrophobia/claustrophobie, etc.). This is true for
both French and English, but translating these and other terms from one
language into the other brings to light a number offindingsthat should make the
translator aware of a deceptive lack of consistency: changes in spelling
(leukocyte/leucocyte, nematocide/nématicide, etc.), changes in prefixes
(superinfection/surinfection, subduction/infraduction, etc.), parallel forms
(morbific/morbifique, morbigène, etc.), root switches from Greek to Latin and
vice versa (oophoritis/ ovarite, cerebrospinal/céphalo-rachidien, etc.).
The Greco-Latin foundations of its terminology are but one feature of the
language of medicine, which in both English and French displays a peculiar
liking for synonyms, eponyms and abbreviations. Since these often differ in
English and French, they simply add to the difficulties of the translation process.
And so do a number of features specific to each language, such as the propensity
of English for the descriptive term drawn from everyday speech as compared to
the preference of French for the learned term, or the tendency of English to use
ordinary words in a medical sense.
The purpose of this study is to help the translator find his way among these
many and varied intricacies.
50  The Language of Medicine: English and French

Roots and Stems

The problems related to the translation of Greek and Latin roots or stems
arise from (1) differences in spelling, (2) possible parallel forms, and (3)
switches from Greek to Latin and vice versa.

Differences in spelling

Transliteration of Greek and Latin letters has not always resulted in the same
spellings in English and French. Vowels, for one thing, offer the following
examples: ameba/amibe (ex amoibe), adipocere/adipocire (ex cera),
fungicide/fongicide (ex fungus), cheiromegaly/chiromégalie (ex kheiros),
glucosuria/glycosurie (ex glukus), neuroglia/névroglie (ex neuron), etc.; the
same is true of consonants: hypochondria/hypocondrie (ex khondros),
leukemia/leucémie (ex leukos), kinesiology/cinésiologie (ex kinesis),
hemorrhage/hémorragie (ex rhegnynai), ophthalmology/ophtalmologie (ex
ophthalmos), etc.
Not only has transliteration followed different paths, but it also does not
seem to respect definite rules. For instance, most terms derived from the Greek
khondros (cartilage) adopt the spelling ch in both English and French
(chondmlgia/chondralgie, chondromaiacia/chondromalacie, etc.), but in French
hypocondrie (hypochondria) coexists with hypochondrodysplasie
(hypochondrodysplasia). Whereas derivatives of the Greek kinesis (movement)
are commonly spelled ki in English (kinesalgia, kinetosis, etc.) and ci in French
(cinépathie, cinétose, etc.), the latter language offers exceptions like kinéscopie,
kinésisme, etc., next to the doublets acinésielakinésie,
cinésithérapie/kinésithérapie and the like. Similarly, derivatives of the Greek
neuron (nerve) are normally written eu in both English (neurology,
neurasthenia, etc.) and French {neurologie, neurasthénie, etc.), yet in many
cases the latter requires the spelling év (nemalgia/névralgie, neuritis/névrite,
/névrome, neuvosis/névrose) and in others it offers a choice between
doublets: neurectomy/neurectomie, nevrectomie, neurotomy/neurotomie,
névrotomie, neurodermitis/neurodermite, névrodermite. Although such doublets
are sometimes perfectly interchangeable, it would be dangerous to generalize: the
couple neuropathie/névropathie is not. Neuropathie is the generic name given to
all nerve diseases; névropathie usually defines a condition of general weakness
of the central nervous system considered mainly from the viewpoint of the
psychic functions and is then a synonym of neurasthenie. In the couple
neurologielnévrologie, the latter term relates to the part of the anatomy that deals
with the nervous system, while the former describes the study of the diseases of
that system, even if some authors use it in connection with its anatomy or

Parallel forms

The above examples show that French spelling doublets of an English term
may easily lead to mistranslation. A similar pitfall threatens when English and
French have several terms for one and the same thing. They are not always
synonyms like céphalodynie, céphalalgie and céphalée are for "cephalodynia"
and "cephalalgia." Thus, to translate the English "ptosis" (Greek for drop, fall),
French has ptosis and ptôse. The terms are not interchangeable: the latter
describes a downward displacement of an organ and serves to form such words
as gastroptose (gastroptosis), néphroptose (nephroptosis), blépharoptose
(blepharoptosis), etc.; the former applies specifically to a drop of the upper
eyelid and is therefore synonymous with blépharoptose.
To describe the condition resulting from excessive endocrine secretion,
English indiscriminately uses "hypercrinemia," "hypercrinia," or
"hypercrinism," for which French can offer only hypercrinémie and hypercrinie.
But in French these two terms cover entirely different notions: the former is used
to describe an increased blood level of internal secretion products; the latter
stands for an increased secretion whether or not attended by a change in the
quality of that secretion.

Switches between Greek and Latin roots

The hybrid nature of certain terms, as alluded to above, can become even
more palpable in the process of translation when Greek roots of English terms
turn Latin in their French equivalents, and conversely.
Let us start with some Greek roots. In "oophoralgia," "oophorectomy,"
"oophoritis," "oophoropexy," etc., French regularly substitutes the Latin
ovari(o) for the Greek oophor(o) to build ovarialgie, ovariectomie, ovarite,
ovariopexie, etc., while also keeping the Greek forms oophoralgie,
oophorectomie, etc. Similarly, it replaces the Greek proct(o) with the Latin
rect(o) in "proctitis," "proctocele," "proctoplasty," etc., to form rectite,
rectocèle, rectoplastie, etc.; but it keeps proct(o) in proctologie and proctectomie.
The Greek trachel(o) in English terms often gives way to the Latin cervic(o) in
French, as in trachelodynia/cervicodynie, trachelopexy/ cervicopexie,
trachelotomy/cervicotomie, etc., but is retained in trachélorraphie
(trachelorrhaphy), trachéloptose (tracheloptosis) and others. In French again, the
Latin cœc(o) duplicates the Greek typhl(o) in many doublets such as cœcoptose,
typhloptose (typhloptosis), cœcopexie, typhlopexie (typhlopexy), caœcostomie,
typhlostomie (typhlostomy), but not so in typhlatonie, typhlocolite,
typhlomégalie, which are the sole equivalents for the English "typhlatonia,"
"typhlocolits," and "typhlomegaly."
Latin roots are subject to the same phenomenon. In a few cases, the
cerebr(o) of English terms changes to the Greek cephal(o) in French:
52  The Language of Medicine: English and French

"cerebrospinal" to céphalo-rachidien or encéphal(o), as in

cerebropathy/cérébropathie, encephalopathie, cerebromalacia/cérébromalacie,
encéphalomalacie. Except in lienal and liénite (not in common use), French
systematically substitutes the Greek splen(o) for the Latin lien(o) of English
terms: lienectomy/splenectomies 1ienography/splénographie, lienopathy/
splénopathie, etc. More rarely, the Latin pelvi(o) switches to the Greek pyel(o):
pelvilithotomy/pyélolithotomie, pelvioplasty/pelvioplastie, pyéloplastie. In the
few English terms derived from the Latin semen, French regularly turns to the
Greek sperma: semenology/spermatologie, semenuria/spermaturie. Similarly, it
replaces the Latin test with the Greek orch(i,d) in testalgia/orchialgie,
testectomy/orchidectomie, testitis/orchite, etc. The Latin root ven(e,o) used in
many English terms often changes into the Greek phleb(o) in their French
equivalents: venesuture/phléborraphie, venogram/phlébogramme,
venosclerosis/phlébosclérose, sometimes in coexistence with the vein(o) form:
venectasis/phlébectasie, veinectasie, venectomy/phlébectomie, veinectomie,
venotomy/phlébotomiey veinotomie. In the same way, French often uses the
Greek metr(o) or hyster(o) instead of, or concurrently with, the Latin uter(o) of
the English terms: uteralgia/métralgie, utéralgie, uterectomy/hystérectomie,
uteroscope/hystéroscope, utéroscope, uterotomy/métrotomie, hystérotomie,
utérotomie. The Latin viscer(o) may turn to the Greek splanchn(o) in the French
doublets splanchnoptose, viscéroptose (visceroptosis), splanchnomégalie,
viscéromégalie (visceromegaly), splanchnotrope, viscérotrope (viscerotropic).
And the list could be further extended with ovo and recto for which French
either keeps the Latin forms or substitutes the Greek oo and procto, respectively:
ovocyte oocyte (ovocyte), ovogenèese, oogenèse (ovogenesis), rectoclyse,
proctoclyse (rectoclysis), rectophobie, proctophobie (rectophobia), rectoscopie,
proctoscopic (rectoscopy), etc.

At first sight it would seem that translating a Greek or Latin prefix is the
easiest thing in the world. Should it not logically remain unchanged in both
English and French? However, reality is not that simple. Indeed, the fact that the
English "subfebrile" matches the French subfébrile does not mean that the Latin
prefix sub- in English terms will automatically generate the same form in their
French equivalents. To mention just a few examples, "subpituitarism" becomes
hypopituitarisme, "subcutaneous" becomes sous-cutané, "subclinical" becomes
infraclinique. Similarly, the fact that the Greek prefix hyper- remains unchanged
in a whole series of English and French terms (hypertension/ hypertension,
hypertrophy/hypertrophie, etc.) does not exclude a variety of translations in
many others, such as poly- in hyperdontia/polydontie, super- in

hyperinvolution/superinvolution, sur- in hyperalimentation/suralimentation,

pleo- in hypercytosis/pléocytosee, etc.
Hence, the main difficulty in translating prefixes will arise from the fact that
English and French do not use them in the same way, and from the multiple
forms they are apt to generate from one language to the other. In addition to the
examples of sub- and hyper- mentioned above, a few others deserve some
attention. The Latin circum- in English terms may remain unaltered in French
(circumduction/circumduction), but is also subject to transliteration
( c i r c u m c i s i o n / c i r c o n c i s i o n ) or replacement by the Greek peri-
(circumcorneal/péricornéen). Also the Greek dis- may remain unchanged in
many French terms (dissection/dissection, dislocation/dislocation) or,
conversely, take the Latin form des- (disintoxication/désintoxication), or even be
replaced by another Greek prefix (disariiculation/désarticulation, exarticulation).
Whereas most English terms built with hypo- will keep this Greek prefix in
French when it stands for a deficiency (hypoglycemia/ hypoglycémie,
hypogonadismlhypogonadisme, etc.), they swap it for the Latin prefixes infra-,
sub- or the French sous- when it describes a topographically lower position
(hypoglossal/infra-lingual, sublingual; hypodiaphragmatic/sous-
diaphragmatique); but there are exceptions like hypodermic/hypodermique,
sous-cutané in the latter case or hyporeflexia/hyporéflexie, subréflectivité in the
former. Contrariwise, the Latin infra- in English terms may need to be
translated—besides infra-, of course (infraorbital/infraorbitaire)—by sous-
(infrasicmal/sous-sternal) or sub- (intrapsychic/subconscient). Similarly, the
Latin intra- of English terms may in French keep the form intra- (intramuscular/
intramusculaire) or adopt the formper- (intraoperative/peropératoire).
The French doublets parallergie, coallergie for "parallergy"; paracystite,
extracystite for "paracystitis"; paranéphrite, périnéphrite for "paranephritis";
paramètre, mésomètre for "parametrium"; paraméningocoque, pseudo-
méningocoque for "parameningococcus," etc., show that the Greek prefix para-
of English terms may undergo chameleon-like changes to co-, extra-, peri-,
meso- or pseudo-; more rarely even to dys- (parareflexial/dysréflexie) or juxta-
(parametrial/juxta-utérin). The Latin super- which forms a great many English
terms is another adept at metamorphosis when Gallicized: hyper- as in
superflexion/hyperflexion, sur- as in superinfection/ surinfection, sus- as in
supcracromial/sus-acromial, or supra- as in superselective/ suprasélectif,
hypersélectif supersélectif

Medical suffixation is second to none of the other word-building processes
when it comes to hybridization. Greek suffixes like -genous, -itis, and -orna are
frequently associated with Latin roots: morbigenous/morbigène,
54  The Language of Medicine: English and French

cellulitis/celiulite, fibromai/fibrome,etc., while Latin suffixes like -ic or -ism are

unreservedly grafted onto Greek stems: aortic/aortique, labyrinthic/
labyrinthique, thyroidism/thyroïdisme, hypnotism/hypnotisme, etc. Since this
anarchy is peculiar to both English and French, the actual translation problems
will not arise at this level. They will rather lurk in the adjectival endings. One
may think that endings as simple as -al, -ary, -ic, -ive will be solved by mere
calques. Habitual reading of medical literature offers abundant proof to the
To take only the English ending -al, this may keep the ending -al
(cervical/cervical) or adopt a dozen different forms in French: -aire
(dental/dentaire), -atif (germinal/germinati/), -e (portai/porte), -é (sacral/sacré),
-éal (subungual/subunguéal), -eux (anginal/ angineux), -ien (carpai/ carpien),
-ifère (seminal/séminifère), -in (palatal/ palatin), -ique (meatal/méatiqué), -ulaire
(appendical/ appendiculaire). It will therefore be necessary to select the form that
suits the context. "Larval epilepsy" will require épilepsie larvée, whereas "larval
disease" calls for affection larvaire. "Mental condition" can, of course, only be
rendered by état mental (since it is derived from mens, mentis, "mind"), but the
English "mental artery" is the French artère mentonnière (because it is rooted in
mento, "chin"), even though artère sous-mentale and ganglions sous-mentaux
translate "submental artery" and "submental lymph nodes," respectively.
"Seminal cells" will call for cellules séminales, but "seminal ducts" for conduits
séminifères; "germinal cells" for cellules germinales, but "germinal spot" for
tache germinative.
The ending -ar may variously generate the French forms -aire
(alveolar/alvéolaire), -é (fascicular/fasciculé), -eux (cerebellar/cérébelleux), -ien
(condylar/condylien), -éen (cochlear/cochléen, cochléaire). The existence of
multiple French forms for the English adjective ending -ar does not mean they
are interchangeable. For instance, "trochlear fossa" stands for fossette
trochléaire, but "trochlear process" must be translated by apophyse trochléenne',
and though it is true that "cochlear nerve" translates as nerf cochléen it is also
called branche cochléaire du nerf auditif. For the sibling ending -ary, French
offers -arien (coronary/coronarien), -aire (mammary/mammaire), and -eux
(biliary/bilieux). Some English terms generate doublets in French:
coronary/coronaire, coronarien, biliary/biliaire, bilieux, urinary/urinaire,
urineux, etc., but these twin forms have different meanings. While "urinary
tract" and "urinary calculus" actually stand for appareil urinaire and calcul
urinaire, "urinary fever" and "urinary abscess" must be rendered by fièvre
urineuse and abcès urineux; similarly, while "biliary calculus" and "biliary
fistula" are correctly translated by calcul biliaire and fistule biliaire, "biliary
fever" calls for fièvre bilieuse; and while "coronary artery" is equivalent to artère
coronaire, "coronary insufficiency" is properly translated as insuffisance

The ending -ial may lead to the French forms -ial (facial/facial), -aire
(hypophysial/hypophysaire), -iaque (cardial/cardiaque), -iel (arterial/artériel),
-ien (bacterial/bactérien), -ique (bronchial/bronchique). In English the adjective
"cardial" usually relates to the cardia (upper orifice of the stomach), whereas the
French cardiaque applies to both the cardia and the heart; yet, in the compounds
"myocardial," "endocardial," etc., it is synonymous with cardiac (relating to the
heart) and then becomes cardique (myocardique, endocardique, etc.). For the
English ending -ian, French substitutes -ien (genian/genien), -ier
(subclavian/sous-clavier), -ique (ovarian/ovarique). In the case of "ovarian,"
French translates "ovarian cycle" by cycle ovarien, but will prefer kyste ovarique
for "ovarian cyst."
For the ending -ic, the possibilities in French are again manifold: -ique
(aortic/aortique), -aire (embryonic/embryonnaire), -e (normochromic/
normochrome), -iaque (manic/maniaque), -ie (epidemic/épidémie), -idien
(allantoic/allantoïdien), -ien (trochanteric/trochantérien), -in (masseteric/
massétérin). Where two French forms exist for an English term, such as
trochantérien/trochantérique for "trochanteric" or épidémie/épidémique for
"epidemic," one should be careful to use them appropriately. For instance,
"trochanteric line of femur" is to be translated by ligne intertrochantérique
antérieure, but "tendinotrochanteric ligament" calls for ligament
tendinotrochantérien. In the case of "epidemic," the point is to avoid confusion
between the noun (épidémie) and the adjective (épidémique), for which English
has only one word. Contrariwise, French has only maniaque to render both the
English noun (maniac) and adjective (manic). Similarly, the French suffix -cide
is used for both the noun (e.g., un bactéricide) and the adjective (e.g., un effet
bactéricide), while English discriminates between -cide (bactericide, n.) and
-cidal (bactericidal, adj.).
As to the suffix -oid, the French forms -oïde and -oïdien are often found side
by side: chéloide, chéloïdien for "cheloid," sigmoide, sigmoïdien for "sigmoid,"
thyroïde, thyroïdien for "thyroid," etc. While there is no doubt about the
substantival character of the first (cheloide, hypertrophic scar; sigmoide, fourth
portion of colon; thyroid, endocrine gland) both forms are used indiscriminately
as adjectives: sigmoid flexure/anse sigmoide and sigmoid valves/valvules
sigmoïdes, but sigmoid arteries/artéras sigmoïdiennes; thyroid gland/glande
thyroïde and thyroid cartilage/cartilage thyroïde, but thyroid artery/artère
thyroïdienne', coracoid process/apophyse coracoïde, but coracoid
notch/échancrure coracoïdienne; choroid plexus/plexus choroïde, but choroid
fissure/scissure choroïdienne, etc. The same suffix -oid may further generate the
forms -ien (condyloid canal/canal condylien) and -oidal (sphenoid process/
apophyse sphénoidale).
Another possible cause of confusion is the ending -ory, which in French
may take on the forms -oire (respiratory/respiratoire), -eur (excretory/
excréteur), -if (olfactory/olfactif), -itif (sensory/sensitif), -oriel (sensory/
56  The Language of Medicine: English and French

sensoriel). Here again, the existence of parallel forms will raise the question of
an adequate choice. Indeed, while "sensory nerve" may be rendered by either
nerf sensitif or nerf sensoriel, "sensory neuron" admits only neurone sensitif,
"sensory system" and "sensory center" are translated by appareil sensoriel and
centre sensoriel, but "sensory nucleus" (of trigeminal nerve) and "sensory nerve
endings" call for noyau sensitif (du trijumeau) and terminaisons sensitives,
respectively. A similar ambiguity exists for the pairs excrétoire, excréteur
(excretory) and sécrétoire, sécréteur (secretory): an "excretory canal" is called
canal excréteur, but "excretory organ" is rendered by organe excrétoire; a
"secretory capillary" is called canalicule sécréteur, but "secretory neurosis" is
translated by névrose sécrétoire.


Medical terminology offers perhaps the best example of synonym

proliferation. Countless notions, indeed, go under several names which are
basically equivalent but differ according to whether they derive from anatomical,
pathogenic, toponymic, historical, or simply descriptive considerations.
"Heine-Medin disease"/maladie de Heine-Medin* is the historical name given
to a disease affecting the gray substance of the spinal cord, also known clinically
as "infantile spinal paralysis"/paralysie spinale infantile or anatomically as "acute
anterior poliomyelitis"/poliomyélite antérieure aiguë, for which English has the
additional synonyms "acute atrophic paralysis," "anterior spinal paralysis,"
"epidemic infantile paralysis," "spinal paralytic poliomyelitis," etc. Similarly,
"ulcerative colitis"/colite ulcéreuse is the term for chronic inflammation and
ulceration of the colon and rectum, which English also calls "chronic ulcerative
colitis," "idiopathic ulcerative colitis," or "colitis gravis," while French knows it
as colite crypto génétique, colite suppurante, rectocolite hémorragique (et
purulente), rectocolite muco-hémorragique, and rectocolite ulcéro-hémorragique.
While the above two examples show that the synonym mania is common to
English and French, the synonyms in either language do not necessarily coincide
numerically or formally. Another instance is "rheumatoid arthritis," also called
"atrophic arthritis," "chronic infectious arthritis," and "proliferative arthritis,"
which the French physician knows mainly by the name of polyarthrite chronique
évolutive, next to the synonyms polyarthrite déformante, rhumatisme chronique
déformant, and polyarthrite rhumatoïde. As to the "rheumatic fever" of the
English, with its synonyms "acute articular rheumatism," "inflammatory
rheumatism," "(acute) rheumatic arthritis," and "polyarthritis rheumatica," its
usual French equivalent is rhumatisme articulaire aigu, next to the synonyms
fièvre rhumatismale, polyarthrite aiguë fébrile, syndrome post-streptococcique,

* For eponyms: see next page.


and maladie de Bouillaud. Now, the term "Bouillaud's disease" may also be
familiar to English-speaking physicians, but it stands for "bacterial (or infective
or infectious) endocarditis." This shows that formal coincidence will not guard
against possible mistranslations.
Not only the names of diseases but also anatomical, physiological, and
technical terms are likely to have several synonyms. What both English and
French know as "pileus ventriculi" becomes bulbe duodénal for the latter and
"duodenal bulb" for the former, also known as "duodenal cap," "pyloric cap,"
and "bishop's cap" in English. Functional synonyms such as "forced expiratory
volume in the first second" and "timed vital capacity" have their French
equivalents in volume expiratoire maximum seconde, débit expiratoire maximum
seconde, and capacité pulmonaire utilisable à Vejfort. The technique designated
in both languages by the terms radioiomy/radiotomie, stratigraphy/stratigraphie,
and, more commonly, tomography/tomographic is further known in English by
the expressions "analytical roentgenography," "body section
roentogenography," "sectional radiography," "laminography," "planigraphy,"
and "vertigraphy"—some of which are, of course, obsolete or obsolescent.

Eponyms—terms adapted from the names of famous physicians or
scientists—are nothing less than an amplification of the synonym phenomenon.
Just like synonyms, they come in very large numbers and do not always tally in
French and English.
There are two types of eponyms, depending on whether the proper noun has
given rise to a common noun (paikinsonism/parkinsonisme) or has been kept as
a proper noun to describe a disease (Down's syndrome/syndrome de Down), an
anatomical notion (islets of Langerhans/ilots de Langerhans), a procedure
(Billroth's gastrectomy/opération de Billroth), a device (Foley catheter/sonde de
Foley), etc. The latter type can be further divided into simple eponyms
(Cushing's syndrome/syndrome de Cushing) and compound eponyms (Koch-
Weeks bacillus/bille de Koch-Weeks, Wolff-Parkinson-White
syndrome/syndrome de Wolff-Parkinson-White).
Translation problems can even start with common noun eponyms, as the
form they adopt in one language is not infallibly the same in the other. What
English calls "Basedow's disease" is known in French as basedowisme; for the
English "Kupffer cell sarcoma," French offers endothélioma kupjférien and
kupjférome; "fallopian pregnancy" becomes grossesse tubaire (no eponym in
French), etc.; contrariwise, "trigeminal impression" (no eponym in English) is
rendered by fossette gassérienne. "Teslaization" is a term that describes the
therapeutic use of high frequency currents developed by Nikola Tesla, a Serbo-
American electricial engineer; it is the translator's business to know that it should
58  The Language of Medicine: English and French

be translated as darsonvalisation, for a similar method discovered by the French

physicist d'Arsonval.
Proper noun eponyms only make things worse, first because of their
number, but also because in the matter of translation they obey no rules at all.
An English eponymic term may quite well have a non-eponymic French
equivalent (Broadbent's apoplexy/inondation ventriculaire) or vice versa
(osteochondrolysis/maladie de König)', or an English epony m may correspond to
another eponym in French (Pott's asthma/asthma thymique de Kopp); or the
eponym may be the same in both languages but be associated with different
nouns to describe the same notion (Corrigan's sign/pouls de Corrigan). Or
again, more treacherously, the same eponym in French and English may apply
to different notions. In the pair "Paget's disease"/maladie de Paget, for instance,
the equivalence is completely deceptive: the English term refers to "osteitis
deformans" and its true French eponymic equivalent is maladie osseuse de
Paget, while the French maladie de Paget ought to be translated as "Paget's
disease of the nipple." Similarly, the eponym "Recklinghausen's disease,"
which in English covers both "neurofibromatosis" and "osteitis fibrocystica,"
will be rendered by maladie de Recklinghausen in the first case and by maladie
osseuse de Recklinghausen in the second.
The puzzle becomes even more intricate when several eponyms are used to
describe a disease, a technique, etc. Such is the case of "exophthalmic goiter,"
called "Basedow's disease"/maladie de Basedow, which in English has the
synonyms "Graves' disease," "Marsh's disease," "Flajani's disease," "Parry's
disease," etc.; such also is the case of "partial gastrectomy," a procedure known
in French as opération de Finsterer or opération de Hofmeister, which English
calls "Hofmeister-Finsterer operation" or "Billroth's operation II" (not to be
confused with "Billroth's operation I," which in French is called opération de

Every scientific jargon tends to coin its own abbreviations, and so does the
language of medicine. This may be justified by a disinclination to repeat at length
such longish terms as "progressive systemic sclerosis," "systemic lupus
erythematosus," "human growth hormone," "serological test for syphilis," and
the like, for which the English-speaking physician may prefer to use the
abbreviations PSS, SLE, HGH and STS, respectively, that he knows to be
understood by everyone in the profession. Where it comes to turning them into
French, the translator ought to know that PSS and STS have no equivalent
abbreviations for sclérodermie généralisée and sérodiagnostic de la syphilis, that
SLE corresponds to LED (lupus érythémateux disséminé) and that HGH is
naturalized into French unchanged. Similarly, a French writer may prefer to

replace polyarthrite chronique évolutive, concentration inhibitrice minimale and

other such terms by their respective abbreviations PCE, CIM, etc., for which the
English equivalents would be RA (rheumatoid arthritis), MIC (minimum
inhibitory concentration), etc. It is obvious that dealing with abbreviations is no
job for the amateur medical translator.
Quite a number of abbreviations should normally cause no problem, either
because they are the same in both languages (ECG, electrocardiogram/
électrocardiogramme; BSP, Bromsulphalein, bromosulfonephtaléine; etc.) or
because they stand for terms so fundamental that even a formal change from
English into French will not prevent recognition (CNS, central nervous
system/SNC, système nerveux central; CSF, cerebrospinal fluid/LCR, liquide
céphalo-rachidien; SR, sedimentation rate/VS, vitesse de sédimentation; etc.).
But even at this stage confusion is possible, for several quite different terms
may hide behind the same abbreviation: SR stands not only for "sedimentation
rate" but also, among others, for "sex ratio" and "sinus rhythm"; similarly, MS
is a stand-in for "mitral stenosis," "multiple sclerosis," and "muscle strength."
The same goes for French, where DAV abbreviates différence artério-veineuse
(arteriovenous difference) and dissociation auriculo-ventriculaire (AVD,
atrioventricular dissociation), SIDA stands for syndrome immuno-déficitaire
acquis (AIDS, acquired immunodeficiency syndrome) and présentation sacro-
iliaque droite antérieure (RSA, right sacro-anterior position; SDA, sacro-dextra
anterior position), etc.
Contrary to this particular type of polysemy, synonymous abbreviations may
shorten the various names of one and the same notion: in English, FFA (free
fatty acids), NEFA or NFA (non esterified fatty acids) and UFA (unesterified
fatty acids); HSV (herpes simplex virus) and HVH (herpes virus hominis), etc.;
in French, CPUE (capacité pulmonaire utilisable à Vejfort), DEMS (débit
expiratoire maximum seconde) and VEMS (volume expiratoire maximum
seconde/FEV1 or "forced expiratory volume in one second"), etc.
Very often French simply adopts the English abbreviations. Corticotropin is
probably better known by the abbreviation ACTH (from the English
"adrenocorticotropic hormone") than by its full French name; so is LSD for
lysergide (from the English "lysergic acid diethylamide"), etc. In a number of
cases, the French form exists side by side with the English: DNA/ADN
(deoxyribonucleic acid/acide désoxyribonucléique), GOT/TGO (glutamic
oxalacetic transaminase/transaminase glutamique oxaloacétique), etc. Less
frequently, English borrows French abbreviations like BCG for "Calmette-
Guérin bacillus" (bacille de Calmette-Guérin), OMCA for "acute catarrhal otitis
media" (otite moyenne catarrhale aiguë), etc.
60  The Language of Medicine: English and French

Everyday English vs. Learned French

A major difference between scientific French and scientific English is the
former's partiality for the learned word where the latter often prefers the
descriptive term drawn from common speech. This is particularly true where the
language of medicine is concerned.
For many learned terms which are the only possibility in French, English
has a synonym in everyday speech: coagulation, clotting/coagulation; glycemia,
blood sugar (level)/glycémie; trismus, lockjaw/trismus; myopia, short-
sightedness/myopie; cicatrization, scarring/cicatrisation, etc. When French has a
synonym for the English common term, it is mostly a learned term as well:
hesperanopia, twilight blindness/hespéranopie, amblyopic crépusculaire;
xeroderma, paper skin/xérodermie, astéatose cutanée; anarthria, jumbled
speech/anarthrie, aphasie motrice sous-corticale, etc.
Consequently, one should not be surprised by the many non-learned terms
found in English medical texts. They may be easier to understand, being less
esoteric, but caution is imperative in translating them. Indeed, even in those
cases where French has a common-speech equivalent it is likely to clash with the
overall learned tone expected from a French medical text. Take the English pairs
itch/pruritus and bleeding/hemorrhage, for instance, for which French
respectively offers démangeaison/prurit and saignement/hémorragie: at first sight
they seem quite harmless. Yet, it would be ludicrous to translate "winter itch" by
démangeaison hivernale, since the correct term is prurit hivernal; similarly, while
it is possible to render "nosebleed" by saignement de nez, never will you see
saignement intestinal massif for "massive intestinal bleeding," but rather
hémorragie intestinale massive.
Even adjectives are more learned in French than in English: taste
buds/papilles gustatives, jaw jerk/réflexe massétérin, one-egg twins/jumeaux
univitellins, sweat gland/glande sudoripare, twin pregnancy/grossesse
gémellaire, etc. The adjectival use of nouns is a standard feature of English,
even when true adjectives can be formed by suffixation: "pigment granules," "fat
embolism," "bile ducts," "lymph nodes," etc., although the adjectives
"pigmentary," "fatty," "biliary," "lymphatic," etc., do exist. But the two forms
cannot always be substituted for one another, like in "biliary ducts" for "bile
ducts." For instance, while the French granules pigmentaires refers to "pigment
granules," épithélium pigmentaire becomes "pigmentary epithelium"; while
embolie graisseuse is rendered by "fat embolism," surcharge graisseuse du foie
becomes "fatty liver"; while ganglion lymphatique matches "lymph node," and
vaisseau lymphatique becomes "lymphatic vessel."
Also, when English uses a true adjective, it prefers one less learned than in
French: bald tongue/langue dépapillée, chalky gont/goutte tophacée, fat-splitting
enzyme/ferment lipolytique, boring pain/douleur térébrante, etc. The same goes
for compound adjectives, of which there are a great many in medical

terminology: eyeball heart reflex/réflexe culo-cardiaque, blood-brain

barrier/barrière hémato-encéphalique, end-to-side anastomous/anastomose
termino-latérale, etc.

Everyday English vs. Medical Meaning

Every language offers examples of words taken from common speech
whose basic meaning is extended to new (and sometimes imaginative) uses in
technical and scientific jargon. This is especially true of medical English,
because of the reason illustrated above. Translating such words in their
specialized sense is not always that obvious. "Approach," "course,"
"discharge," "history," "early," "late," and "tender" are just a few such terms.
With regard to "approach," the French calque approche is to be avoided at all
costs. Where it means "how a problem is dealt with" (e.g., dosage reductions
are possible by an adequate "approach"), possible equivalents are ligne de
conduite and rationale de traitement (as in une rationale de traitement appropriée
permet de réduire la posologie); where the route of a surgical act is concerned
(e.g., hysterectomy can be performed by an abdominal "approach"), the correct
solutions are voie d'abord or simply voie (as in Vhystérectomie peut se pratiquer
par la voie abdominale). "Course" describes either the developmental stage of a
disease (e.g., the postoperative "course" was uneventful), in which case it is
translated by cours or évolution (as in I'évolution post-opératoire fut sans
histoires), or a series of therapeutic procedures (e.g., the patient was given a
"course" of injections), when it is rendered by série or cure (as in le patient a
reçu une série de piqûres). "Discharge" has two meanings which command
distinctive translations: one refers to the evacuation of liquid matter from a part
of the body (e.g., the patient presented with profuse nasal "discharge"), in
which case it is translated by écoulement, or better by the scientific term ending
in -rrhée (e.g., le patient présentait un écoulement nasal abondant/une rhinorrhée
abondante)', the other refers to the act of leaving the hospital (e.g., at the time of
"discharge" his ECG was normal) and is then simply translated by sortie
(d'hôpital) (e.g., à sa sortie d'hôpital, son ECG était normal). In medical
practice, "history" is the term used to designate the patient's condition prior to
his or her visit to a doctor or admission to a hospital. It has three French
equivalents: anamnese (e.g., a correct diagnosis requires a carefully taken
"history"/un diagnostic correct exige une anamnese détaillée), antécédents (e.g.,
the patient had no allergic "history"/le patient n'avait pas d'antécédents
allergiques), and passé (e.g., a past "history" of gastric ulcer complicated the
treatment/un passé d'ulcère gastrique a compliqué le traitement).
The adjective "early" will require three different translations as well,
depending on whether it refers to a period before the usual time (e.g., "early"
diagnosis of carcinoma is essential), in which case it will be précoce (e.g., un
62  The Language of Medicine: English and French

diagnostic précoce du cancer est essentiel); or to a nearby period (e.g., the

"early" results of the operation are good), in which case it will be immédiat
(e.g., les suites immédiates de l'opération sont bonnes); or to a first occurrence
(e.g., the treatment of "early" breast cancer is still controversial), in which case
it will be primaire (le traitement du cancer primaire du sein reste un sujet de
controverse). Similarly, translating the adjective "late" will require a judicious
choice between two possible solutions, depending on whether it refers to an
indefinite time in the future (e.g., the "late" results of heart transplantation are
unpredictable), in which case it will be éloigné (e.g., les suites éloignées de la
transplantation cardiaque sont imprévisibles); or to a belated occurrence (e.g.,
bone lesions are a "late" complication of brucellosis), in which case it will be
tardif (e.g., les lésions osseuses sont une complication tardive de la brucellose).
As to "tender" and "tenderness," their very familiarity is perhaps the most
treacherous pitfall; they have nothing to do with affection or softness, so the
French calques tendre and tendresse would be utterly off the mark. Particularly
in a sentence like: "the lymph glands were enlarged, firm and tender," where
"firm" and "tender" seem to be a contradiction in terms. The actual meaning
involved is that of a painful feeling of some part of the body when touched. The
French translation for the above sentence would therefore read: les ganglions
étaient gonflés, durs et douloureux au palper. And, consequently, the sentence:
"there was tenderness in the periumbilical region" (nothing to do with petting,
mind you!) would become: la région péri-ombilicale était sensible/douloureuse à
la pression.

A Word in Conclusion

What kind of conclusion is there to be drawn from this brief comparative

study of the English and French medical languages? First of all, that the practice
of medical translation—like that of any other type of scientific translation, for
that matter—does not dispense with a sound knowledge of the problems of
translation in general. Only too often, would-be translators are heard to declare:
"Not for me the subtleties of literary translation. At least scientific translation is
only a matter of terminology, and there the dictionaries provide the answers."
This is a gross misconception that begs the linguistic implications of the
translation process. In addition, it unduly magnifies the "life-saving" power of
dictionaries, which in the hands of the uninitiated may be "life-threatening." The
experienced translator knows that dictionaries always lag behind and often fail to
solve the immediate problem, especially in the field of medicine, where progress
develops at a fast pace. Hence, the translator has to be his or her own
lexicographer, and this implies constant and intensive reading of the medical
literature in both languages.

REFERENCES (Selection)



Bonvalot, M. 1982. Le Vocabulaire médical de base : étude par l'étymologic

Paris: O.I.P.
Chevalier, J. 1983. Précis de terminologie médicale. Paris: Maloine.
Conseil des Organisations internationales des sciences. 1967. Terminologie et
lexicographie médicales. Paris: Masson.
Sournia, J.-CH. 1974. Langage médical moderne. Paris: Hachette.


Allan, F.D. & J.B. Christensen. 1966. The Language of Medicine. Washington
(D.C.): Sigma Press.
Bernthal, P.G. & J.D. Spiller. 1981. Understanding the Language of Medicine.
Oxford University Press.
Dirckx, J.H. 1976. The Language of Medicine. New York: Harper & Row.
Edmonson, F.W. 1965. Medical Terminology. New York: Putnam.
Field, D.J. & J.B. Harrison. 1968. Anatomical Terms, their Origin and Derivation.
Cambridge: Heffer.
Gordon, B.L. et al. 1966. Current Medical Terminology. Chicago: American
Medical Association.
Jaeger', E.C. 1953. A Source-Book of Medical Terms. Springfield (I11.): Thomas.
MacLean, J. 1980. English in. Focus. English in Basic Medical Science. Oxford
University Press.
McCullogh, J.A. 1962. A Medical Greek and Latin Wordbook. Springfield (I11.):
Paddock, M.J. 1955. Basic Medical Terms and Techniques Simplified. Chicago:
Am. Technol. Society.
Roberts, R. 1966. Medical Terms, their Origin and Construction. London:
Schmidt, J.E. 1969. Structural Units of Medical and Biological Terms. Springfield
(I11.): Thomas.
Schmidt, J.E. Revision, A Medical Word Finder. 1958. Springfield (I11.): Thomas.
Skinner, H.A. 1961. The Origin of Medical Terms. Baltimore: Williams & Wilkins.
Smith, G.L. & P.E. Davis. 1967. Medical Terminology, a Programmed Text. New
York: Wiley.
Spilman, M. 1949. Medical Greek and Latin. Ann Arbor: Edwards Bros. Inc.
Strand, H.R. 1968. An Illustrated Guide to Medical Terminology. Baltimore:
Williams & Wilkins.
64  The Language of Medicine: English and French



Blacque-Bélair, A. 1981. Dictionnaire médical clinique, pharmacologique and

thérapeutique. Paris: Maloine.
Garnier, M. & V. Delamare. 1985. Dictionnaire des termes techniques de
médecine. Paris: Maloine.
Hamburger, J. 1969. Petite encyclopédie médicale. Paris: Flammarion.
Manuila, A. et al. 1970-75. Dictionnaire français de médecine et de biologie.
Paris: Masson.


Agnew, L.R.C, et al. 1985. Dorland's Illustrated Medical Dictionary. Philadelphia:

W.B. Saunders.
Brown, J.A.C. 1971. Pears Medical Encyclopedia. London: Pelham Books.
MacNalty, A.S. 1965. Butterworth's Medical Dictionary. London: Butterworth.
Miller, B.F. & Cl. Brackman Keane. 1983. Encyclopedia and Dictionary of
Medicine, Nursing and Allied Health. Philadelphia: W.B. Saunders.
Parr, J.A. & R.A. Young. 1965. Concise Medical Encyclopaedia. Amsterdam:
Riley, P.A. & P.J. Cunningham. 1966. The Faber Pocket Medical Dictionary.
London: Faber & Faber.
Stedman, T.L. 1982. Stedman's Medical Dictionary. Baltimore: Williams &
Taber, C.W. et al. 1965. Taber's Cyclopaedic Medical Dictionary. Oxford:
Blackwell Scientific Publ..
Thomson, W.A.R. 1982. Black's Medical Dictionary. Totowa (N.J.): Barnes &
Walton, J. et al. 1986. The Oxford Companion to Medicine. Oxford University


Chaumuzeau, J.P. et al. 1975. Dictionnaire de médecine Flammarion. Paris:

Delamare, J. & T. 1986. Dictionnaire français-ang lais/anglais-français des termes
techniques de médecine. Paris: Maloine.
Fontaine, R. 1978. Médecine/Medicine. Ottawa: Bureau des Traductions.
Gladstone, W.J. 1984. Dictionnaire anglais-français des sciences médicales et
paramédicales. Paris: Maloine.
Lépine, P. & P.R. Peacock. 1984. Dictionnaire français-anglais/anglais-français
des termes médicaux et biologiques. Paris: Flammarion.

Moisan, D. 1983. Lexique élémentaire français-ang lais/anglais-français à l'usage

des médecins. Québec: O.L.F.
Veillon, E. & A. Nobel. 1977. Dictionnaire médical-Medical Dictionary. Huber:
Section 2:
The Medical Translator in Training
Who Makes a Better Medical Translator: The
Medically Knowledgeable Linguist or the
Linguistically Knowledgeable Medical
Professional? A Physician's Perspective

Since there always will be more medical translations than can be handled
by the relatively few physicians who translate, medical translation will perforce
be done by non-physicians. And if, as Woody Allen proposes, "80% of success
is just showing up," then I suppose the linguists win this contest hands down!
But can the linguists do an adequate job (or perhaps even a more satisfactory one
than physicians themselves)?

"Physician" vs. "Medical Professional"

As a physician-turned-translator with a strong linguistic background

(language and translation studies at the university level, as well as overseas
residence and work for several years), I was intrigued by the issues inherent in
the title question originally proposed to me, which pitted the "medically
knowledgeable linguist" against the "linguistically knowledgeable physician."
The first issue that occurred to me was whether or not one could substitute
"medical professional" for "physician" in the title: I would argue yes (so I made
the substitution!). The curricula for most medical and para-medical fields include
the same core courses: biology, chemistry, biochemistry, organic chemistry,
anatomy, physiology, pharmacology, etc., such that physicians, nurses,
dentists, physician's assistants, and paramedics all have the same basic
knowledge. From that starting point, individuals will develop greater in-depth
knowledge of their particular fields, of course, with paramedics being better
versed in emergency terminology than physicians specializing in pathology, for
example. However, for the purposes of this article, I submit that all medical
professionals learn the language of medicine during their education and training
(although they also become proficient in the "dialect" of their specific fields).
70  Who Makes a Better Medical Translator?

The Language of Medicine

What is this "language of medicine" and why is it so important? Like any

field, the medical profession (particularly clinical medicine) is full of jargon and
idiosyncratic phrases which sound unusual, to say the least, in the context of
everyday speech or writing. For example, physicians routinely say, "the patient
complains of such-and-such" and "the patient's chief complaint is," which may
sound like we are calling the patient a whiner. However, this phrase has no such
connotation in the medical world (at least not overtly—an in-depth discussion in
that regard would be interesting, but is beyond the scope of this article!) and
simply means that these are the problems that the patient "presented with" (med-
speak for "came in with" or "consulted for").
The temptation may be great to change or omit these often awkward-
sounding phrases, but they are so much a part of the professional language that
the translator who does so is actually making a radical change in the register of
the text; and to medical ears, the text becomes jarring and sounds "less
professional" without these familiar phrases. Not only does this make it more
difficult for the medical professional end-user to quickly grasp the substance of
the communication, but I believe it also has the undesirable effect of
undermining the scientific credibility of the article or text (even if only
subliminally). For an in-depth discussion on the language of clinical medicine
(American English), there is a wonderful book titled Doctors' Stories: The
Narrative Structure of Medical Knowledge, by Kathryn Montgomery Hunter,
which details the process of communication in the medical profession and the
conventions of both the oral and written forms.1
In addition to the above-mentioned jargon and idiosyncratic phrases, there
are also very specific medical terms which have been developed over the
centuries in order to describe a disease situation, medication or dosage so
precisely that someone who is only reading or hearing the description
understands exactly what is meant. Furthermore, there is often an entire body of
implicit knowledge underlying the actual written words. Barbara Thomas, a
physician-translator in Spain, says, "I run into situations all the time in which
there is so much implicit knowledge behind the words. For instance, steps or
conditions in an operation—a physician knows what is involved because her
anatomic knowledge allows her to form a complete mental picture of the
operation from a brief description; there's no way that a non-physician translator
can understand the implicit information. Generally speaking, the non-physician
isn't aware of it at all."
A slight mistranslation can lead the reader down the wrong path in terms of
conclusions, and although the reader will generally at some point realize a
mistake was made, it may be difficult for him or her to backtrack and determine
what the correction should be. Given the huge amount of reading that most
medical professionals undertake in order to keep up with current practice, a

poorly translated article (even if the errors are only minor ones) may be so
frustrating to read that it will end up being passed over. This does a grave
disservice to medical and pharmaceutical researchers all over the world, who
rely on the sharing of such information in order to receive recognition for their
work as well as to spark new avenues of inquiry or steer them away from clearly
fruitless ones. Worse yet, inaccuracies in medical translations have the potential
for causing serious clinical consequences, depending on the sort of material
being translated (i.e., pharmaceutical package inserts, medical guidelines for lay
persons, etc.).
I mention all this just to make the case that one might well believe that only
medical professionals themselves could successfully navigate these linguistic
shoals and turn out accurate, professional-sounding work. Even physicians who
translate have difficulty consistently maintaining an appropriate register and must
verify specific terminology. However, the fact of the matter is that there are
relatively few medical professionals doing translation work, and the vast
majority of medical translation is being done by linguists who have developed
some degree of medical knowledge. How are they able to do this and are they
turning out credible work?

A Survey of Medical Translators

In order to explore this topic, I devised a survey for medical translators and
one for translation bureaus as well, addressing some of the issues that I felt were
pertinent. I posted both surveys on the Internet LISTSERV Lantra-L (the
"Language and Translation" LISTSERV, a forum for translators and interpreters
and anyone interested in related topics2) and also sent them directly to
individuals and translation bureaus I had previously identified as being involved
in at least some medical translation work. (The comments I received from bureau
owners will be discussed in "The Translation Bureau Point of View," below.)
Of the 65 surveys sent to specific individuals, I received 36 responses; two
of those individuals did not consider themselves to be medical translators and
were eliminated from the results. In addition, I received four responses from the
general posting on Lantra-L, for a total of 38 usable surveys.
Of this number, only three identified themselves as "linguistically
knowledgeable medical professionals" (an RN, a medical student and a
translator with a "BA in medicine"), although I myself would reclassify two
others into that category, based on their professional history (RN's, one of
whom practiced six years, the other 19 years). Thus there were five medical
professionals and 33 linguists who responded to the survey.
Particularly interesting to me were the ways in which the "medically
knowledgeable linguists" gained their expertise:
72  Who Makes a Better Medical Translator?

- Studied medicine or took medical courses - 5

- Have worked or are working in some position related to the medical
profession (secretary in hospital, work for pharmaceutical company, etc.)
- Translation courses with medical emphasis - 6
- Close relative is a medical professional -11
- Have access to medical professionals - 25
- Personal illness that led to a lot of medical research and contact with
medical professionals - 6
- None of the above - 6
(Note: The numbers add up to more than 33 because many people mentioned
more than one source of information.)

In general, concern and caution were expressed by almost all of the

respondents in terms of wanting to "get it right." Most of the linguist
respondents regularly contact medical professionals regarding sticky points in
their translations or for a check on register. Overall, half of the medical
translators who responded to the survey mentioned the Internet as a source of
medical terminology; and I was pleased to see that many specifically mentioned
MEDLINE, which is at the top of my list of useful resources for medical
translation (discussed in more detail below).
In my experience and from the responses to the survey, the editing of
medical translations appears to be a hit-or-miss proposition: most respondents
reported that their work is edited only some of the time or not at all, and, if
edited, it was not always done by a medical professional. Clearly, translators
themselves must assume the responsibility for turning out medical translations
that are clear, accurate and written in an appropriate register.

On the Other Hand...

Thus far I have looked at the question from the point of view of the medical
professional. Lest I seem to be ignoring the language side of things in favor of
the scientist's terminology, let me hasten to reassure you that I am only too
aware of the need for a strong linguistic base from which to proceed for any
translation work, medical or not! The issue of what makes a good translator
tends to be hotly debated among those in the profession, but from discussions
both virtual and real, it appears fair to say that most translators agree that in
order to translate well, there is no substitute for a thorough knowledge of the
target language (which, many go on to say, should be one's native language). At
the very least, such linguistic proficiency is a necessary, though perhaps not
sufficient, prerequisite for a good translation.

Writing is not usually part of the core medical school curriculum, although
scientific writing courses are available on most medical school campuses. This
general lack of writing skill has been noted by Jo Ann Cahn, a Paris-based
medical translator and editor who undertakes extensive revisions of writing (in
English) by French physicians for publication in peer-reviewed medical journals:
"I think a professional translator (by which I mean to imply, with good writing
skills) with medical knowledge is probably better than a dilettante doctor with
some linguistics knowledge. Although there are obviously translators who write
badly, in general their livelihood depends partly on their writing ability, in
contrast to that of physicians. Many physicians, even those writing in their
mother tongue, need heavy editing; translators, one would hope, require only a
light hand. Most medical journals provide neither, as far as I can see. If
translated articles (especially in English) are to fulfill their primary purpose of
providing useful scientific information to physicians throughout the world, they
need content but they also need concise, clear communication. I think that is
most likely to come from professional translators."
And Barbara Thomas, MD, who has coordinated projects using physician
translators in Spain, concedes: "Sometimes physicians have weak writing skills.
For instance, a physician with no theoretical training in medical writing is much
more likely to use an anglicism than a non-physician." Which brings us to
another issue: the hegemony of English in the scientific world.
The problem of professionals who have received much of their education
and training in a language which is not their native one is emphasized by Jussara
Simoes, a translator in Brazil: "In my country, for example, there is this
misguided idea that the person who speaks, understands and/or writes in a
foreign language can be a translator. So we see thousands of engineers, doctors,
lawyers, etc., translating in their 'areas of specialization.' Well, there's no doubt
that the technocrats are specialized in their areas, but the big question is: do they
have a solid background in Portuguese? It is far more important than their great
expertise in the foreign language. There is one sine qua non requisite to
translation: excellent knowledge of the mother tongue. If they have an excellent
knowledge of Portuguese, they'll be able to convey the foreign ideas in a
readable, intelligible manner in the mother tongue. If they have the poor notions
of Portuguese that the majority of our technocrats have, they'll write those
'Frankenstein' texts they do. And, just to make things worse, they will insist
that they are 'excellent translators'... Nobody cares about Portuguese in our
universities. When you go to the University in Brazil, it seems the language
spoken there is English and only English." Manuel Delgado, a translator in
Portugal, agrees: "Physicians themselves tend not to know their own mother
tongue: few are linguistically inclined and most prefer to use chic foreign terms,
such as 'sling-and-cuff' instead of the well-established Portuguese word
74  Who Makes a Better Medical Translator?

This problem likely extends around the globe. Josh Wallace, a Canadian
medical translator, remarks, "There are only two or three bureaus specializing in
medical translation in Montréal. One told me the way in which doctors are
educated in Quebec is at the root of the problem. Most educational materials are
in English, so they have trouble writing in French. This leads to inconsistent use
when producing reports, since they don't know their medical French very well."
And Maria Teresa Cattaneo, an Italian medical translator, says, "In Italy doctors
tend to use a very peculiar language. They use a lot of English words, partly
because most medical texts are in English (and therefore quite a few words,
especially the new ones, are not translated) and partly to 'show off'. So it is not
always easy to pick what one should actually use."
Barbara Thomas adds, "[Physicians] also may have weak translation skills. I
usually find that physicians are very good at the technical concepts, but often trip
up with the simplest things." Because their expertise tends to be narrowly
scientific, medical professionals may indeed be confounded by relatively simple
items that would not daunt linguists, with their greater breadth of cultural
knowledge. One example from my personal experience occurred while
translating from French to English and involved the word amiénoise in the
phrase, Cette étude amiénoise... I could not find this term anywhere, and had
almost resigned myself to bluffing with information gleaned from the context
(something along the lines of "this poorly conducted study"), when I decided to
post a query to Lantra-L. Fortunately, an answer soon appeared: "from the city
of Amiens." Ah, of course—what could be simpler? Thus I was saved from
erroneously maligning the study in question. (In my defense, may I mention that
the author in question had previously cited close to a hundred studies without
once mentioning where the study was from? There is an axiom in medicine,
which, it has occurred to me, could apply equally to translation: "If you don't
think of it, you can't diagnose [translate] it.") If medical professionals are
scrupulously honest and humble enough to admit what they don't know, this
kind of error can generally be avoided—but that's a big " i f (especially in regard
to physicians)!

The Translation Bureau Point of View

As I formulated my questions for bureau owners (and/or employees), I

hypothesized that medical professionals would likely be less computer- and
modem-savvy than their linguist counterparts, and that they might have difficulty
treating translation deadlines with the same respect as a starting time in the
operating room. Barbara Thomas, who has worked with many physician-
translators in Spain, reports: "Although most younger physicians are computer
literate, there are still a lot of physicians who don't know how to type or use a
word processor. Many working physicians can only spare a few hours a day for

translation, which makes it very hard to schedule jobs, although those who
regularly do translation work are more reliable."
However, most bureau respondents did not mention these shortcomings of
specialist translators, focusing instead on the need for teamwork in the
translation process. Michael Grant, who heads a translation bureau in the Czech
Republic, says, "The more technical a document is, the more likely I will be to
assign it to a specialist, but I will also be prepared to edit the ensuing translation
for style."
Mary O'Neill, president of a U.S.-based translation bureau that handles a
high volume of medical and biomedical work, comments, "I would be really
hard put to choose between a qualified linguist and a qualified physician,
because if they both are qualified, theoretically they should be able to do the
same job. I do think we should place a lot of stress on technical qualifications,
however, because linguistic skills are the base and technical skills are the
superstructure and it is much harder to find the superstructure. Finding qualified
technical translators is a much harder challenge than finding good customers.
Translator training should be at the graduate level and should build on a four-
year program of technical skills."
She continues, "However, most independent translators are unaware of the
gaps in their technical knowledge and are frequently tempted to 'wing it.' We
virtually never receive a translation that does not contain some type of error, and
that is why we feel in-house quality control and a team approach is the key to
excellence in documentation."
Barbara Thomas, MD, agrees with the team approach, for a slightly different
reason: "I also think that after any translation is proofed there should be a sign-
off step by the translator on the proofing process. It helps to educate the
translator, and it also keeps the proofreader from replacing terminology that
'sounds odd' or isn't consistent with previous work (which may have been
incorrect) with erroneous terms."
Alessandra Caberlotto, a translator and bureau owner in Italy, comments on
editing medical texts: "Sometimes even a doctor is not enough. My sister is a
nephrologist and once I asked her to check a text where some neurological
problem was addressed. She stopped and said, 'I'm sorry, but here I'd better
ask a colleague of mine; after university I studied another five years to become
an expert on human kidneys, not on the human brain.'"
Henry Fischbach, a medical translator and translation bureau owner in the
U.S. with over forty-five years' experience in working with medical
professionals, notes that they approach medical translation somewhat differently
than linguists do: "They do not suffer fools gladly (rightfully so) and have a
very low tolerance level for the logorrhea of non-English medical professionals.
Some foreign writers tend to be unduly discursive and historical beyond any
reasonable need to underpin the essential message. Medical professionals native
to English tend to come to the point fast and, when translating, often tend to 'cut
76  Who Makes a Better Medical Translator?

through' what they consider to be non-essential information, i.e., to edit and

condense. But translation clients want their foreign texts translated in full,
without editing, however judicious, by the translator. Unless the medical
professionals are very self-disciplined on that score, I have found their
translations to be more of an abstract than a verbatim translation."
In summary, it appears that either a medical professional or a medically
knowledgeable linguist can do a good job with a medical translation; but given
the relative strengths and weaknesses of both sides, the ideal situation would be
for the medical professional who translates to be edited by a linguist, and the
linguist translating medical work to be edited by a medical professional.
However, this happens all too infrequently in the real world, due to cost and
time constraints. So, given the reality, is there any way that credible-sounding,
accurate medical translation can be done?

How to Fake It: A Modus Operandi That Works

Doug Robinson, a translator and the author of several works on the

translation process, as well as an occasional translator of medical texts, replied
succinctly to the question as to how he developed his medical register: "Faking
it, mostly." Upon reflection, it occurred to me that this is, in fact, what we all do
in translation—we assume the guise of the author and pretend that we are the
neurologist or the gastroenterologist or the engineer who wrote the text. And
even if we're lucky enough to be translating a text that happens to be in our
particular specialty, we're still "faking it" in a certain sense, in that we must
consciously adopt the writing style and conventions that are appropriate to the
subject matter and target audience. So how does one fake it convincingly?
Research is the key to success in medical translation, in my opinion.
Medicine is so highly compartmentalized that, for example, my background in
surgery and emergency medicine offers little help when I'm faced with a
dermatology translation. So research is crucial, even for a physician doing
medical translations. And when I do my research, I'm looking both for
terminology and for style (how the terms are used by native-target-language
specialists in the field).
I start a translation assignment by using whatever textbooks I have on hand
and skimming relevant chapters on the topic, although such textbook
information is usually very general compared to the specificity of the articles that
I translate. (The Merck Manual, which is also available in Spanish, French,
Italian, and German, is a useful, concise medical reference for those who don't
have textbooks available.) More helpful are the articles by native-target-language
physicians which are referenced at end of the article I'm translating, especially
review articles on the subject. Jo Ann Cahn reports, "I read at least two and
usually more of the articles written by a native-target-language physician in the

reference list of the article I am working on. If it's a new subject for me, I do
substantial additional research and hope that it will eventually pay off."
Reading such articles helps one to begin to get a feel for the language and
style of the specialty. Patrick Lafferty, who teaches in Georgetown University's
translation and interpretation program and frequently translates public health
texts into English, comments: "In medical translation, as for any translation, I
read materials written by native English writers in that field as I am doing the
translation. Style is not something we learn as a fact and file away; it is
something we emulate through exposure. Access to an excellent medical library
helps greatly."
Even without physical access to a medical library, one can access an
enormous collection of medical writing on MEDLINE via the Internet.3
MEDLINE is an electronic database of abstracts of medical journal articles from
1966 to the present, and is the single most valuable resource for medical
translation work into English, in my experience. I use it constantly while
translating, to check on the spelling of drug names, and for terminology and
usage that I'm not sure of. Sometimes I even check on certain things that I think
I do know (particularly when I'm answering a question for someone on Lantra-
L, where my response will be read by 900+ of my fellow translators), and I
occasionally find that what I thought I knew is not necessarily correct! Even
though MEDLINE contains only abstracts and not the full text of the articles, I
find that it suffices for my purposes about 90% of the time while translating. I
should mention that when I am verifying terminology and usage, I make sure
that I am looking at "native-English" abstracts, or even specifically U.S.-English
abstracts, by noting the institution at which the work was done. There are,
unfortunately, some poorly translated abstracts on MEDLINE which may lead
the unwary translator astray.
MEDLINE can be useful even when you don't know what you're looking
for (although I admit that this type of search might be trickier for non-medical
professionals to undertake). When I'm blocked and just can't think of the correct
English term, I sometimes search for a "translationese" version of the term. This
will often yield several translated abstracts (containing the incorrect term); and I
can then scroll down to the MeSH Subject Headings section (which contains
MEDLINE key words), and I will sometimes be able to find the correct English
version of the term I'm blocked on. Another approach that occasionally works is
to search for the foreign term itself, since the original titles of translated abstracts
are sometimes given and may contain the term; I have hit pay dirt using that
method a few times.
I have not yet mentioned the scourge of technical translation: the poorly
written source text. As we all know, source texts are not without error, and who
among us has not wasted time searching for a term that turned out to be a typo in
the original? MEDLINE can come to the rescue in this type of situation, too.
Here is an example of such a search that I carried out recently: A query was
78  Who Makes a Better Medical Translator?

posted on Lantra-L regarding "propyl anesthesia" in the context of an "inferior

alveolar nerve block." The translator wanted help on translating "propyl
anesthesia" into Spanish. I had never heard of "propyl anesthesia," but (given
my past experience) searched for it anyway: no hits. Someone else on Lantra-L
had suggested that the term might be "propylene anesthesia," so I searched for
that as well, to no avail. Having no idea what the term really should be, I
searched for "inferior alveolar nerve block" (31 hits) and then "anesthesia"
(44,191 hits) and then combined the two categories (13 hits). As luck would
have it, the very first abstract gave me the answer: "...compared with the
[inferior alveolar nerve] block, the incidence of successful pulpai anesthesia (80
reading) was significantly greater..."4 [italics mine]. Clearly, "propyl" was a
typographical error, perhaps a transcription error by someone listening to a
dictated operative summary.
Abbreviations and acronyms are further sources of aggravation for the
medical translator since they are liberally sprinkled throughout most medical
texts, often without any explanation; in addition, they may or may not actually
belong to the source language (e.g., in the body of an article in French, one may
find English acronyms being used). One can search for abbreviations and
acronyms on MEDLINE or on the World Wide Web (a good option for
languages other than English; see below), but one must exercise caution in
assigning a particular meaning to an abbreviation within a given context, since
some abbreviations have a myriad of possible meanings.
Key-word searching as described above for MEDLINE can also be done on
the World Wide Web (WWW), of course, using search engines such as Alta
Vista and Metacrawler. An advantage of the WWW is that one can search in
languages other than English. With experience, search techniques become
refined so as to reduce the total number of "hits" while increasing the odds that
any responses obtained are relevant to the topic at hand. Susan Larsson, a very
busy Swedish-to-English translator who regularly deals with medical topics,
swears by this method and often provides Web site addresses for specialty
topics (sometimes in languages she doesn't even know!) on Lantra-L.
I recently had the opportunity to try out some search engines myself (I used
problematic terms from past translations as key words), and was amazed at the
results I was able to generate virtually instantaneously—so much so that I will
be upgrading my Internet account in the very near future in order to take full
advantage of these resources. Despite my enthusiasm, however, there is one
caveat I feel I should issue pertaining to the reliability of information obtained on
the WWW. MEDLINE, as a database of abstracts from peer-reviewed medical
journal articles, is a nearly impeccable resource for medical translators. In
contrast, information gleaned from the WWW does not necessarily pass through
any editing process; therefore one must carefully scrutinize each source for
reliability and attempt to verify the information from other sources as well.

Another approach to problems of terminology and style is the use of text

corpora and concordancing. Michael and Ingrid Friedbichler of the University of
Innsbruck in Austria report, "Over and above the standard procedures and
resources commonly used for settling terminological problems or questions of
register-appropriate language, we rely heavily on cross-referencing in our
computer-held domain-specific text corpora with the help of concordancing
software." Essentially, this involves the use of electronic texts (corpora) which
can be searched using KWIC (key-word-in-context) concordancers which
"make it possible to instantly check the occurrence, frequency, and context of
any given word or string of words in any corpus available." They point out that
more and more medical journals are offering full-text year-end CD-ROMs, and
the use of concordancing software in conjunction with such CD-ROMs holds the
promise of enhancing both the productivity and quality of medical translation.
More information about this approach to translation can be found at <http://
While working on a medical translation, input from acquaintances in the
medical profession can be helpful, but it is often difficult to contact these busy
professionals. Accessing fellow translators is somewhat easier now that there
are LISTSERVs such as Lantra-L and on-line forums such as FLEFO on
CompuServe, and posting a query can yield fruitful results in short order.
However, as noted above regarding the World Wide Web, some responses are
more authoritative than others; and on-line answers to terminology questions
should be confirmed by other sources, if at all possible.
It may be noticed that I have not mentioned dictionaries at all in my modus
operandi. When asked about resources, several respondents to the survey
commented that available bilingual medical dictionaries—not to speak of
multilingual ones—are largely useless. I tend to agree, since many seem to
consist largely of cognate-type translations which ignore real usage in current
practice. Although there are some good medical dictionaries and encyclopedias
available, recommendations for specific monolingual or bilingual resources are
unfortunately beyond the scope of this article.
Once a translation is completed with the help of all these research methods,
there is still no substitute for good editing as an integral part of the translation
process. As mentioned previously, having your work edited by a professional in
the specialty (or, conversely, by a linguist if you are the specialty professional
translator) is the ideal solution, though by all accounts not often the most
feasible one in the real world of cost containment and deadlines.
In any case, don't forget to ask for feedback from the client or bureau! Most
bureaus, whether or not they consult with the original translator during the
editing process, are quite willing to provide a final version of the document.
This works to everyone's advantage, since translators can thus be made aware
of not only any errors (and, conversely, correct any injudicious "corrections")
but also the stylistic preferences of their clients, enabling them to tailor their
80  Who Makes a Better Medical Translator?

future work accordingly (thereby reducing the amount of editing required on

future assignments).
In addition to all of the above, experience counts. As Neil Inglis, a staff
translator at the International Monetary Fund, has put it, "Mature judgment,
carefully acquired and reflected upon, is often the finest guide of all. Learn from
your own past ordeals and mistakes, and don't forget that in the final analysis,
you alone are accountable. The acid test for translators is less the sprawl of their
library than the breadth of their own problem-solving talents when their library
fails them. In practice, this means an ability to craft meaningful compromises
and to close in on ideal renderings through a process of successive
approximations, over time."5


Good medical translation can be done by both medical professionals and

medically knowledgeable linguists; but in both cases (Woody Allen
notwithstanding), a love of language, an ear for style, a willingness to pursue
arcane terminology and caring enough to get it exactly right are the keys to true

1. Hunter, K.M. 1991. Doctors' Stories: The Narrative Structure of Medical Knowledge.
Princeton University Press: Princeton, New Jersey.
2. To become a member of the Lantra-L mailing list, send a message to <listserv@
segate.sunet.se> (no subject line necessary) with <subscribe lantra-1 Firstname Lastname> as
the message. Warning: you may receive as many as 200 messages in a single day!
3. MEDLINE can now be accessed free of charge at the National Library of Medicine:
4. Childers, M. et al. 1996. "Anesthetic efficacy of the periodontal ligament injection
after an inferior alveolar nerve block." Journal of Endodontics 22(6): 317-20.
5. Inglis, Neil. 1997. "The Italian Language: Finance and Economics." The ATA
Chronicle, 26(8): 24-25.
Training in Medical Translation
with Emphasis on German

Medical translation today is a defined, separate field of study both for

historical reasons and because it represents a big share of the market.
Alluding to the historical importance of medical translation, Henri Van Hoof
(1993: 1-2) had this to say:

"Avec la traduction religieuse, la traduction médicale est probablement

une des branches les plus anciennes de l'activité traduisante: les
souffrances de l'âme et du corps ont toujours été au centre des
préoccupations de l'homme. Le plus ancien des documents serait le
Corpus Hippocraticum, une compilation des enseignements d'Hippocrate
faite au IIè siècle avant notre ère par des médecins grecs d'Alexandrie."

The other major study, conducted by Henry Fischbach (1986), gave the
following assessment in Some anatomical and physiological aspects of medical

"Medical translation is the most universal and oldest field of scientific

translation because of the homogeneous ubiquity of the human body (the
same in Montreal, Mombasa and Manila) and the venerable history of

We may also recall certain medical translations dating from the 8th century
called Basler Rezepte, which may be regarded as early vulgarizations of medical
texts because the Latin texts were not translated entirely but explained and
annotated (Lee-Jahnke 1996: 7).
The ancient history and the recent practical importance of medical translation,
combined with the fascination medicine has always held in all cultures, are
powerful incentives for would-be translators.
The second factor why this subject is worthy of discussion is that medical
translation has always been of major importance in the field of translation
because a large number of texts are being translated and hence it represents a big
share of the market.
82  Training in Medical Translation with Emphasis on German

This brings us to the question: Who is likely to become a competent medical

translator? By and large, two categories of people: those with a medical
background—medical students and physicians; and, secondly any good
translator genuinely interested in medicine. The first category understands the
subject matter but lacks the translation techniques. The second must acquire the
specialized knowledge and should be in touch with the medical community to
obtain essential feedback.
As this article is based largely on my personal teaching experience, I would
like to note that I almost exclusively teach the second category of translators at
the university level. Doctors or medical students usually do not demand
instruction in translation or, if they do, this will be dispensed with at the
postgraduate level. ·

Preliminary Knowledge

To start with, future professional translators should be taught, in general

terms, the major translation theories applicable to scientific texts. The text-
typology by Susanne Göpferich (1992) where scientific text types are
categorized is most helpful. Another theory applicable to medicine is the
"skopos" theory developed by Reiss & Vermeer (1991: 96), which implies that
any translation must first of all serve the objective of the original text, no matter
how that goal is approached. We learn here that the text should be translated in a
receiver-specific way. Hence it is not only a different language or culture which
has to be taken into consideration, but also the different degree/level of
knowledge of the recipient.
This indicates that there may be several skopoi (Greek for goal, target, aim)
for one and the same text—thereby requiring a hierarchical arrangement. Thus it
cannot be ruled out that the aim of the target text differs from the aim of the
original source text (Reiss and Vermeer 1991: 103). For Reiss and Vermeer, it is
the recipient who must be the primary consideration. But aside from this, one
must bear in mind the type of text, the species and the different conventions of
the target text.
As far as the contents are concerned, we must differentiate between non-
socioculturally defined information valid for all languages and cultural
backgrounds and socioculturally determined information of interest only to
certain cultural circles or which has a different content in different cultural
circles. On the language level, we differentiate between conventions which are
not linked to the species of the text and conventions which facilitate text
It must be made clear that scientific texts have to be defined as specimens of
pragmatic, semantic and syntactic superstructures which, on the basis of

corresponding text-external and text-internal features, can be assigned to

conventional text genres whose patterns and communicative norms have evolved
traditionally in the course of professional communication. Hence it is essential to
point out at the very outset of the training what the targets are, what difficulties
have to be overcome, and what training models have to be used to link theory
and practice.
The main purpose of the professor is to train students in such a way that they
will be able to excel in their chosen fields. To achieve this, it is necessary to
focus on three goals during the training:

1. The text structure in the different languages—in the present case, we

shall postulate German as the source language to be discussed.
2. The languages of special purposes (LSPs).
3. The special domain.

Re 1. The structure of a German medical text is rather complex compared to

an English medical text. It is still heavily loaded with Latin and Greek
terminology. On the other hand, it may come as a surprise that a number of
terms translated into German from Latin or Greek have become the specific
German medical terminology, while retaining their every-day usage. But it is
also true, that many English words have been adopted and are rather common in
German scientific writing as well as in many other languages.
Text structure as such is often very complex and hence a major difficulty for
the translator unfamiliar with the specific field at hand. Therefore, reading and
re-reading of the source text is required. In addition to exercises using short
texts of diverse subject matter, we recommend a number of textbooks1 that exist
in both English and German in order to enable the student, through parallel
reading, to explore this particular difficulty. During this exercise students are
astonished that the target and source text often differ a great deal in length2—a
point which has been well developed by Christine Durieux (1990) and which
may be illustrated by the following example:

Physiologic principles
In unicellular organisms, all vital processes occur in a single cell. As the
evolution of multicellular organisms has progressed, various cell groups
have taken over particular functions. In higher animals and humans, the
specialized cell groups include a gastrointestinal system to digest and
absorb food, a respiratory system to take up O 2 and eliminate CO 2 , a
urinary system to remove wastes, a cardiovascular system to distribute
food, O 2 , and the products of metabolism, a reproductive system for
perpetuating the species, and nervous and endocrine systems to
coordinate and integrate the functions of the other systems (Ganong
1977: 1).
84  Training in Medical Translation with Emphasis on German

Physiologische Grundlagen
Bei Einzellern spielen sich alle vitalen Prozesse in einer einzigen Zelle ab.
Mit Fortschreiten der Evolution mehrzelliger Organismen kam es zur
Übernahme besonderer Teilfunktionen durch verschiedene Zellgruppen.
Bei höheren Stufen der Tiere und beim Menschen sind insbesondere
folgende spezialisierte Zellgruppen wichtig: Gastrointestinales System
(Verdauung und Resorption der Nahrungsstoffe), Respirationssystem
(02-Aufnahme und C02-Abgabe), Harnbereitungssystem (Abgabe von
Abfallstoffen), cardio-vasculäres System (Verteilung von
Nahrungsstoffen, O2 und Stoffwechselprodukten), Reproduktionssystem
(Erhaltung der Art) und schliesslich Nerven- und endokrines System
(Koordinierung und Integration von Funktionen der anderen Systeme)
(Ganong and Auerswald 1974: 3).

Re 2. The LSPs do, of course, include terminology as well as idiomatic and

idiolectic particularities. The student needs to be made familiar with the special
lexica of the German medical text, needs to be fully aware of false friends which
might occur due to similar affixes and suffixes in the two languages, and needs
to be careful with eponyms. We shall examine the specific difficulties of
eponyms later.
A second particularity of the LSPs is the enunciation of the medical terms,
the particular way in which they are used and which may be due partly to the
source language (SL), but also to poor handling of the text by the author of the
source text (ST).
Taking the example of a scientific research paper, LSPs may be illustrated on
the five levels normally used in such reports:

a) Topic
b) Introduction
c) Material and Methods
d) Results and Discussion
e) Summary/Conclusion

Re 3. It is essential to acquire a basic medical knowledge applicable to all

areas of medicine and then to proceed to the specific subject required by the
translator. This training will involve intensive documentation, not only in print
but also on line. In teaching, certain points should be taken into consideration:
the linkage between language and subject-matter knowledge as well as the
information transfer which must be adjusted to try to encourage and stimulate the
creativity of the students so that they will increase their responsibilities and,
when necessary, seek expert advice.

Let us now highlight the major difficulties in medical translation, suggest
optimal solutions on how to tackle them, and by so doing combine theory and
The necessary knowledge of the subject matter may be acquired through
reading the pertinent reference material. This material is not difficult to obtain, as
it is available in all university libraries and often on the Internet.


In many cases, medical terms derive their origins from Greek and Latin, a
fact which is explained by the history of medicine. The physician in Ancient
Greece or Rome communicated with his community in his native language. The
medieval physician, for his part, used Latin as a means of international
communication. And Latin has thus remained the language of medicine well into
the 18th century. Later on, there were some attempts to vulgarize texts, but by
and large Latin remained the standard of the professional elite. This is even more
acutely the case in the German-speaking countries.
Obviously, this is not of any help to modern translators, who are rather
likely to be awed by this terminology if they are not familiar with Latin or
Greek. Therefore we tend to approach the medical terminology problem by
subdividing such terms into prefixes, suffixes and roots, by analyzing them and
thus becoming familiar with their meanings.

A few examples of common Greek and Latin prefixes and suffixes:

Prefix Suffix
a- absence of -algia pain
brady- slow -ectasia dilatation
dys- difficult, painful, abnormal -ectomy excision
hyper- above normal -ernia blood
hypo- below normal -itis inflammation
poly- several -ome tumor
tachy- rapid -osis disease process

Once we split the whole term into its components, we can readily grasp the
meaning. For instance, when "hypoglycemia" is broken down into its
components, hypo = below normal; glyc = sugar; and ernia = blood; we
understand that the term indicates an insufficient blood sugar level.
It is definitely productive to give students a few exercises at the very
beginning of the training in order to enable them to gain a better understanding
86  Training in Medical Translation with Emphasis on German

of the subject matter. Such exercises should be undertaken each time a new
subject matter is dealt with.
As medical translation is based on specialized cognitive knowledge which
only the specialist has, and since its main purpose is to provide information, we
must be aware that medical writing does not escape the fact that there are unclear
borderline areas that often make understanding difficult (Amal Jammal 1990 ).
One of the possibilities of overcoming the hurdle of terminology is to learn
by doing. But that is not all: We need solid documentation on which we can
rely, in the form of mono- and bilingual dictionaries3 which may help in certain
cases. Here, the word "certain" is critical because, as mentioned above, terms
which belong to borderline areas can not be easily identified by such a
procedure. The neophyte translator has to realize that the basic meaning which a
word is given in the dictionary is not necessarily the same as the meaning it will
have in the context at hand. Therefore, we strongly recommend that the learner
perform the exercises described by Jean Delisle (1993: 80-81).
But we must bear in mind that scientific dictionaries are all too soon out of
date. They often need revision the very moment they are published. Therefore,
other material has to be collected, such as glossaries from companies,
specialized articles from the medical press, 4 research reports, and medical
textbooks that may be available in several languages. I would like to mention
several of them which have always been very useful in my translation courses:

Ganong, Physiology. English, French, German, Italian and other

language versions.
Harrison, Principles of Internal Medicine. English, German, and French
The Merck Manual, Merck & Co. German, Italian, French and Spanish
Tables Ciba Geigy. English, French, German, Italian versions.

Databanks are of major interest for the student and should be made available
in any medical translation training program. Internal company glossaries are
very useful if they contain definitions which help technical understanding and
provide subject-related examples.


Another obvious difficulty confronting the medical translator are acronyms,

which occur very frequently and can have different meanings depending on the
specialty involved. They also can be author-specific. How to handle this
problem? Here too, specialized books5 may help. Or else the author should have
explained at the beginning of the text the meaning of the acronym. If the term is

not explained—as is too often the case—one should, wherever possible, make
an effort to contact the author to find out what is meant. The author usually
follows the so-called IMRAD scheme,6 used chiefly in the United States but also
more and more frequently in the German medical press (Ylönen 1993: 84). Once
the translator has understood the acronym by expanding it, the corresponding
acronym needs to be tracked down in the target language.

Medical eponyms

According to the typology established by Van Hoof (1993),7 a difference is

made between the kind where the name has been banalized, e.g., parkinsonism,
and where it has remained intact, e.g., Broca's amnesia. On the other hand, Van
Hoof (1993) names three categories and distinguishes among:

1) identical eponyms in both source text and target text;

2) different eponyms in source text and target text;
3) absence of an eponym in one or the other language.

This particular problem requires, of course, extensive research; once the

student has been acquainted with all the possibilities of documentation and
possibly addresses of competent specialists, the advice to follow is: Check and
check again. In medicine, a proper name should never be taken for granted.
Similarly, the names of pharmaceutical products can present problems, for
they often differ from one country to another. But here the problem is more
obvious and usually all the relevant documentation is supplied together with the
text to be translated. The student, moreover, has to be acquainted with the lists
of medications of the different countries,8 a valuable source of terminology.

Predominance of English

English is predominantly used in medical texts, especially in newer

techniques like nuclear magnetic resonance (NMR). Many would consider it a
major mistake to translate terms like "spin" or "compliance," for example. And if
we look at a glossary of NMR9 terminology we would be astonished at the
number of English terms that are being used in other languages, such as German
or French. Definitions and examples of context, instead of translations, clarify
the terms and thus contribute to a clearer target text.

Medical phraseology

The difficulties in medical phraseology are determined most of the time by

extralinguistic factors. Thus, medical reports differ considerably when written
by a German doctor or by a colleague in England, the United States, or
88  Training in Medical Translation with Emphasis on German

Australia. Certain style patterns are not to be translated at all, a pitfall which
occurs quite frequently. Take, for example, the following phrases:

"Do not stop or change dosage without consulting your doctor."

"Die Dosierung is ohne ärztliche Beratung weder zu unterbrechen noch


By extralinguistic patterns we refer to the nature or purpose of the text to be

translated: study, commercial brochure, manual, etc. Translation trainees should
be aware that terminology is closely related to the phraseology of the medical
jargon, which can be learned best by reading the medical literature and
discussing the subject with specialists.
Linked to phraseology are the oft-criticized redundancies in medical writing.
What should the translator do in such cases? Depending on the author and the
type of text, a translation may improve the original text but this presupposes
perfect knowledge of the subject matter and style. The student must know that
the core purpose of specialized medical texts consists in an exact description and
classification of concrete phenomena: objectives, changes, analytical processes,
measures to be taken, methods, causes and effects (Schefe 1981: 362).

Types of Texts to be Translated

The variety is extensive, and ranges from publicity—institutional or

noninstitutional—in which case lay terminology should be used, to formal
treatises, not to mention medical reports, registration files for medication,
clinical studies, articles for the specialized press, medical abstracts, etc. As far as
publicity is concerned, the aspiring translator must learn to respect the differing
deontological ethics that prevail in various countries.

Training Models to Bridge Theory and Practice

Not so long ago, training for a professional career in translation consisted

mainly of learning directly from experienced translators and trying to find out,
through a dangerous process of trial and error, what made the difference
between a good and a poor translation. The precepts of Cicero, St. Jerome,
Martin Luther, Georges Mounin, Jean Delisle, Henri Van Hoof, and others were
perhaps duly quoted, but not systematically taught.
At present, students receive a solid theoretical education on which they can
build their practical experience. They must learn at an early stage how to perform

their work under very often tight deadline conditions—in other words, how to
work under pressure.
Standards, too, have changed recently—by which I do not mean standards
of accuracy in translation; about that, there can be no compromise. But for
certain types of texts, considerations of good style are increasingly on the
decline. Translators are expected to transmit information quickly. Unless a
translation is for publication in a book or in one of the more prestigious journals,
there may be no opportunity—or time—to polish it. Another important change in
medical translation over the past few years is that it has simply become more and
more difficult due to the proliferation of scientific knowledge, with texts ranging
widely, and sometimes simultaneously, over complicated fields, like
immunology, biotechnology, and genetic engineering.
Translator training has to include all of these aspects. Classroom teaching
should be supplemented by scheduling internships in pharmaceutical companies
or hospitals, working in teams with experts in order to go over a text before and
after translation, and organizing workshops at an interdisciplinary level to
improve subject knowledge.
Traditional translation activities in the classroom usually involve the
production of texts aimed at a single and particularly biased reader—the teacher.
The artificiality of this situation may lead to a lack of motivation in producing
texts that would appeal to other potential readers. The kind of feedback provided
by the instructor also influences the student's performance, as it must
concentrate on adequacy of the target text compared to the source text. To
counteract this teacher-centered practice, an experiment has been carried out
which transferred the role of reader from teachers to students (Pagano 1994).
I would like to mention a workshop on nuclear magnetic resonance (NMR)
which we organized at the University of Geneva, and which was intended as
postgraduate training for translators. Invited as speakers were a medical doctor,
a physicist and a biologist who each described NMR applications in their
particular field. As preparation for this workshop, we established a glossary in
cooperation with experts in different European countries and also with the NMR
expert at the World Health Organization (WHO) which has its headquarters in
Geneva. This glossary, established by translators with the help of experts, has
become a useful aid in translation of NMR texts and has been approved by the
Eurospin Group in Brussels, leading scientists in this field:
Despite the difficulties I have mentioned, it seems to me that with the
incredibly rapid advances in medical science and the increasing ease with which
such information can be accessed, medical translation has become more
promising than ever as a translation specialization.
90  Training in Medical Translation with Emphasis on German


1. See Textbooks in the reference section.

2. In the language combination English-German, this certainly does not make a big
difference in the number of words but in the length of the text.
3. Some are listed under Monolingual Medical Dictionaries in the reference secion.
4. In Switzerland there are a few bilingual journals which are very useful for this
5. Ursula Spranger, Rolf Heister, MD, Sandoz AG, and Albrecht Schertel, among many
6. IMRAD = Introduction, Materials or Methods, Results and Discussion.
7. Also see Van Hoof's contribution to this Monograph.—Editor.
8. Switzerland offers the Schweizerisches Arzneimittelkompendium in three languages
and now also in a nonscientific version.
9. Parallèles No. 13.

Delisle, Jean. 1984. Analyse du discours comme méthode de traduction. Ottawa:
Editions de l'Université d'Ottawa.
Delisle, Jean. 1993. "La traduction raisonnée. Manuel d'initiation à la traduction
professionnelle anglais-français." Collection Pédagogie de la traduction.
Ottawa: Les Presses de l'Université d'Ottawa.
Durieux, Christine. 1990. "Le foisonnement en traduction technique d'anglais en
français." Meta XXXV, 1:55-60.
Fischbach, Henry. 1986. "Some anatomical and physiological aspects of medical
translation. Lexical equivalence, ubiquitous references and universality of
subject minimize misunderstanding and maximize transfer of meaning." Meta
XXXI, 1:16-21.
Göpferich, Susanne. 1995. "A Pragmatic Classification of LSP Texts in Science
and Technology." Target 7(2):305-326.
Heister, Rolf. 1985. Lexikon medizinisch-wissenschaftlicher Abkürzungen.
Stuttgart, New York: F.K. Schattauer Verlag.
Jammal, Amal. 1990. "L'étude des langues des spécialités médicales: un
scialytique sur un champ opératoire," Meta XXXV, 1:50-54.
Lee-Jahnke, Hannelore. 1996. "La traduction médicale." Traduire 1(7):7-12.
Lexikon medizinischer Abkürzungen. 1991. Nürnberg: Sandoz AG.
Nord, Christiane. 1991. "Scopos, Loyalty and Translational Conventions," Target
Pagano, Adriana. 1994. "Decentering translation in the classroom: an
experiment." In: Studies in translatology, 2.
Reiss, Katharina, and Vermeer, Hans J. 1991. Grundlagen einer allgemeinen
Translationstheorie. H. Altmann 2. Edition Linguistische Arbeiten 147.
Tübingen: Max Niemeyer.

Schefe, Peter. 1981. Zur Funktionalität der Wissenschaftssprache - Am Beispiel der

Medizin. Wissenschaftssprache. Bungarten, Theo. Munich: Wilhelm Fink, 356-
Schertel, Albrecht. 1984. Abbreviations in Medicine. 3rd. Edition. Basel: S. Karger
Spranger, U. 1990. Abkürzungen in der Medizin und ihren Randgebieten,
Stuttgart: Gustav Fischer.
Van Hoof, Henri. 1993. "Histoire de la traduction médicale en occident." ILL
19, 1-2.
Van Hoof, Henri. 1986. "Les éponymes médicaux: Essai de classification." Meta
XXXI, 1, 59-84
Ylönen, Sabine. 1993. Stilwandel in wissenschaftlichen Artikeln der Medizin. Zur
Entwicklung der Textsorte, "Originalarbeiten" in der Deutschen
Medizinischen Wochenschrift von 1884 bis 1989. Fachtextpragmatik.
Schröder, Hartmut, Tübingen: Gunter Narr, 81-98.

Textbooks in both English and German

Ganong, W.F. 1974. Physiologie, Springer.

Harrison, 1989. Prinzipien der Inneren Medizin. Vollständige Übersetzung der 11.
Auflage von Harrison's Principles of Internal Medicine. Publisher of the
German edition: Straub, P.W. Vol. 1, Basel: Schwabe & Co. AG.
Ciba Geigy. 1960. Wissenschaftliche Tabellen. Geigy AG: Basel.
Feneis, Heinz. 1988. Anatomisches Bildwörterbuch der internationalen
Nomenklatur. 6. Aufl. Stuttgart, New York: Thieme Verlag.

German Monolingual Medical dictionaries

de Gruyter, Walter. 1994. Ρschyrembel, Klinisches Wörterbuch. 257th revised

edition. Berlin, New York.
Reallexikon der Medizin. 1972. Muenchen, Urban & Schwarzenberg.
Roche Lexikon Medizin. 1994. München, Wien, Baltimore: Hoffmann-La Roche
AG & Urban & Schwarzenberg.
Thiele Handlexikon der Medizin. 1982. Studienausgabe. 2 Bd. Muenchen, Wien,
Baltimore: Urban & Schwarzenberg.
Student Assessment by Medical Specialists:
An Experiment in Relating the Undergraduate to
the Professional World in the Teaching of Medical
Translation in Spain


The gap between the university learning environment and the

professional world may be narrowed if students of specialized translation
expand their world to include that of the field specialist.
I would like to present an experiment carried out with my medical translation
students in the academic year 1995/96. The main aim was to put the students in
direct contact with the demands of potential clients, as well as to make them
directly responsible for their work with the instructor acting as counselor, but
not as problem-solver: The students had to hand in a translation to be assessed
for acceptance, not only by the instructor but also by medical specialists.


Several published articles on scientific and technical translation and on

translation pedagogy emphasize the need for a collaboration between the
translator and the field specialist.1 To my knowledge, however, there is no
available literature on experimental research in this area at the undergraduate
level. Therefore, I outlined an experimental project to help find some answers to
four main questions:

1. Is it possible to more closely align university programs and professional

2. How good are third-year translation students at producing a text for a
specialized publication?
3. How aware are field specialists having no connection with university
programs of the translation problems involved?
94  Student Assessment by Medical Specialists

4. In which direction should our teaching go? What are we preparing our
students for? Where do the main problems lie: in the language, in the
background knowledge, in the curriculum design, or in a combination of all

The Course Design

The research was carried out in a four-month course on medical translation at

the Facultat de Traducció i Interpretació (Vic, Barcelona).2 Fourteen third-year
students with no previous experience in translating this kind of text participated
in the project. The course was designed around five main issues:3

1. Research skills
2. Technical writing skills
3. The building of background knowledge
4. Awareness of the translation process
5. Assessment of the final product by field specialists

Re 1 : Following the pedagogical principle of counseling on savoir faire

rather than on savoir, research skills became a crucial point in the syllabus. The
students were made aware of the difference among literature resources (mono-
and bilingual, specialized and non-specialized dictionaries, encyclopedias,
parallel texts, etc.), software resources (CD-ROM, Internet, etc.), and human
resources (field experts). In line with Gile's consultancy (Gile 1995: 146) or
Maier and Massardier-Kenney's collaboration (1992: 155), asking medical
specialists for advice became a common strategy used by the students.
Re 2: Technical writing skills were implemented mainly through the use of
parallel texts4 to create an awareness of the metalanguage of scientific texts from
two points of view:

a) specialized language, i.e., terminology, phraseology, and neologisms,

taking into account the three levels of language proposed by Newmark
(1988: 153): academic, professional, and popular;

b) text typology, concentrating on discursive modalities, style, cohesion

and coherence.

Re 3: As to the building of background knowledge, motivating the students

to follow scientific and technological findings and reports in the mass media as a
basic component of their future professional lives became another main feature
of the syllabus. The students were divided into groups, each of which would be
responsible for following press releases on their assigned topic (pneumology,

psychiatry, or medical discoveries as reported in the mass media) and presenting

them to the rest of the class by means of a dossier and oral presentation. These
included a glossary of specific terminology extracted from their press clippings
(TV documentaries or radio programs were also considered), encyclopedia
research on the basic content of their topic, press releases or tapescripts when
relevant, and annotated bibliography (which newspapers included sections on
medicine and on which days, a list of specialized and non-specialized journals
on their topics, etc.).
Re 4: Explicit teaching methods, where the syllabus is designed so that
explanations and activities which focus on a chosen issue are included clearly
and frequently, were used to teach the translation strategies5 they used in their
translations, emphasizing those which are relevant to medical translation.6 Most
of the work revolved around finding adequate solutions to problems posed by
the two aspects of scientific metalanguage mentioned above. Besides
participating in class discussion, the students were required to hand in a control
sheet with each of their translations which included the problem in the source
language (SL), the strategy they used to solve it, and the final text in the target
language (TL) presented in three columns so as to aid visualization.7 This helped
both the students and the instructor to become aware of the translation process.
The students stated that this enabled them to systematize their knowledge, justify
their solutions, and approach the text with more confidence. From the teaching
angle, it helped to clarify the learning stages of the students and favored
reflective teaching.
Finally, Re 5: two of their final products were assessed by field specialists.
All other course assignments were assessed by the instructor.

Assessment by Field Specialists8

Two texts were selected from two of the three fields which the students were
working on. Here, I shall use as references only purely medical texts. They
were authentic, i.e., not specially prepared or graded for the students, recent
(not more than two years since their publication), written by and intended for
specialists. The first text was "Haemoptysis: CT or Bronchoscopy?" in
European Respiratory Topics, 1994, a 500-word summary of an article
accompanied by editorial comments and a table.
The second text was "Existence of Hyperventilation in Panic Disorder With
and Without Agoraphobia, GAD, and the Normals: Implications for the
Cognitive Theory of Panic in Journal of Anxiety Disorders," 1993, the 500-
word introduction to an article including an abstract.9
The first text was to be handed in 6 weeks after the beginning of the course,
and the second, 6 weeks later. The students were told that each translated text
would be assessed by two field specialists as well as by the instructor so that the
96  Student Assessment by Medical Specialists

coincidence and non-coincidence of criteria between the field specialists

(potential future clients) and the instructor (trainer of future professional
translators) could be detected, which may help find answers to the pedagogical
questions in goal 4 above.
The field specialists had the source text and were given an assessment sheet
(see Fig. 1). The students received the complete assessment sheet along with
their translations once these had been checked by the specialists and the
instructor, so they were aware of the whole process and of the outcome of the
specialist's and instructor's assessments.



• Specific terminology 12 34 5
• Non-medical terminology 12 34 5
• Syntax/grammar 12 34 5
• Cohesion and coherence 12 34 5
• Transmission of source message 12 34 5
• References, format 12 34 5
• Student's comments (if applicable) 12 34 5


1. Acceptable translation
2. Acceptable, but can be improved
3. Unacceptable translation


• Rating given to the translation in the general classification

Fig. 1 : Assessment sheet.

Text 1


The students' translations presented similar lexical and conceptual problems. 10

Those problems which were corrected by the field specialists more than 3 times
were considered significant. Both specialists agreed in subdividing Specific
terminology (point 1 in the assessment sheet) into academic vocabulary and
professional vocabulary. It was agreed that academic vocabulary would be
defined as "transferred Latin and Greek words associated with academic papers"
and professional vocabulary would be defined as "formal terms used by experts"

(Newmark 1988: 153). As this subdivision is consistent with Newmark's (see

above), it was kept and referred to in class discussions to create an awareness of
the difference, but not when recording the students' errors. Here are some
examples of significant mistranslations:


Source text Examples of student's Specialist's

mistranslations translations

Fiberoptic broncoscopia fibroóptica fibrobroncoscopia

bronchoscopy broncoscopia por fibra óptica

chest roentgenogram roentgenograma de radiografía de tórax

roenplacanograma de tórax


central airways vías respiratorias vías respiratorias

altas/hiliares centrales

operators cirujanos especialistas


Source text Examples of student's Specialist's

mistranslations translations

guidelines bases directrices/líneas pautas

de conducta/instrucciones

thorough profunda investigación/ investigación

investigation reconocimiento completa/minuciosa

As to the other points in section A, the results were the following:

SYNTAX/GRAMMAR : 15 significant corrections, mostly by the instructor.

COHESION/COHERENCE: 23 significant corrections, mostly by the



REFERENCES/FORMAT: 15 corrections.
98  Student Assessment by Medical Specialists

As to the total assessment, specialist Β (SB) gave consistently lower grades

than specialist A (SA). They both agreed in giving the highest overall score to
specific terminology and the lowest to references/format (see Table 1). On the
other hand, the instructor (I) gave lower grades for syntax and grammar, for
cohesion and coherence, and for references and format. A non-final Hierarchical
Cluster Analysis, which helps to establish homogeneous groups to allow for the
classification of apparently heterogeneous groups, seems to point to the fact that
the specialists rate syntax and grammar, and non-medical terminology together
on a lower scale, whereas the instructor also tends to rate these same issues
together, but on a higher scale.

Table 1: Scoring on section A.


Total score
min. max. Specialist A Specialist Β Course Instructor
• Specific terminology 12 34 5 49 46 47

• Non-medical terminology 12 34 5 48 43 50

• Syntax/grammar 12 34 5 45 43 41

• Cohesion and coherence 12 34 5 45 43 39

• Transmission of
source message 12 34 5 43 42 44

• References, format 12 34 5 38 38 39

• Student's comments
(if applicable) 12 34 5 8 8 8

To carry out the statistical analysis, the last parameter (student's comments)
has been excluded because only 2 students offered any comments. A
comparative study of the average score by each specialist and the instructor
revealed nonsignificant differences according to the Kruskal-Wallis test: I =
18.64 (SD 4.94); SA = 19.21 (SD 4.89); SB = 18.36 (SD 4.20), SD
corresponding to the standard deviation.


Both specialists and the instructor were in agreement on this point: they
accepted four translations, suggested that six would be acceptable if revised, and
rejected four. Although SB did not rank one student's translation (St4) as
acceptable, the score given did not differ by more than 2 points, so the lack of
agreement was low. More than 2 points' difference can be observed in the score
given to only one student (St7) and, in this case, specialist A and the instructor

differed by exactly 2 points (see Table 2). However, although specialist Β and
the instructor differed by more than 2 points in the scoring, they did so by only
1 position in the overall classification. A Concordance Analysis was used to
measure the agreement rate achieved by the subjects involved in the assessment
stage of the experiment and the average score. The result, as indicated by the
Kappa Index in which +1 corresponds to total concordance and - 1 to
concordance inversion, was acceptable: SA/I = 0.85; SB/I = 0.71;
SA/SB = 0.85.

Table 2: Results of assessment sheets.

Students Specialist A (SA) Specialist Β (SB) Course instructor (I)

St1 27 1 1 27 1 1 26 1 1
St2 22 1 2 22 1 3 24 1 3
St3 22 1 3 24 1 2 24 1 2
St4 23 1 4 22 2 5 22 1 4
St5 18 2 5 21 2 6 21 2 6
St6 20 2 6 20 2 7 20 2 7
St7 19 2 7 25 1 4 21 2 5
St8 19 2 δ 22 2 8 20 2 8
St9 16 2 9 16 2 9 18 2 10
St10 17 2 10 18 2 10 19 2 9
St11 14 3 11 15 3 11 14 3 11
Stl2 14 3 12 14 3 13 12 3 12
Stl3 13 3 13 12 3 12 12 3 13
Stl4 13 3 14 10 3 14 10 3 14


This section refers to the classification of the students' translations according

to the performance of the class group. Although the specialists and the instructor
do not agree in 10 cases, the disagreement cannot be considered significant as it
does not exceed 1 position, except in a single case (St7) (see Table 2).

Specialists' Comments

A semi-structured interview with the two specialists followed their

assessments. In the case of both, they attached paramount importance to the
correct translation of the specialized terminology above any other feature, and
were less strict in their marking of these criteria because they considered it the
most difficult part of the translation. They regarded syntax and grammar the least
relevant points and also, to a lesser degree, cohesion and coherence. From the
point of view of pedagogical versus professional expectations, it seems relevant
that the instructor should detect and correct more mistakes related to these points
than the specialists. This seems to underline the general idea that what is relevant
100  Student Assessment by Medical Specialists

in scientific and technical translation is the specialized terminology, references

and format or conventions of presentation, and the transmission of the source-
language message. Neither specialist considered syntax, grammar, cohesion and
coherence to be crucial criteria. Interestingly enough, it was with regard to these
latter aspects that the students came across more problems.
A conservative view of translation could be appreciated in written
observations such as "not literal enough" or "too free—keep to the original text."
Both specialists took a positive approach to the need for translation and
competent translators so that doctors could, in their words, "keep up with new
developments" and because of the "growing communications in the field."


1. The percentage of coincidence between the specialists' and the instructor's

assessments is high, as is the coincidence in the criteria which were given the
highest and lowest marks in the linguistic and textual assessment (A). Overall, it
seems the course design was adequate.
2. Differences can be observed in the actual grades. These, however, are
consistent for each marker, but different when they are compared. This brings
us to the ongoing debate of subjectivity in the traditional numerical way of
3. There is a high coincidence regarding the degrees of acceptability (B) and
general rating (C). This suggests that we should consider including these
parameters in our class assignment grading.
4. The areas which needed more pedagogical work to improve the students'
performances became clearly and usefully defined: More emphasis was assigned
during the rest of the course and in future curriculum design of scientific
translation courses to: (a) improving research skills and the use of parallel texts
to check on referencing and conventions of presentation, and (b) improving
syntax, grammar, and cohesion and coherence in technical writing skills.
5. The students were made aware of the subjectivity element in text
assessment, which had two outcomes: On the one hand, they realized the
importance of achieving professional standards when submitting a text and, on
the other, they realized that the client may not always "be right" and that they
have therightto discuss and defend their own work.
6. From the point of view of the specialists, to judge by their comments, the
experience was also positive for them in that they themselves were made more
aware of the problems involved in translation and of the need to collaborate with
the translator.
7. This was a pilot experimental research project: A wider population sample
should be studied and more experimental research is needed in this area. Above

all, this research should be shared and compared if it is to be improved upon and
become meaningful in various contexts.


1. For different suggestions, see Wright and Wright (1993: 1) (cf. also Balliu (1994: 16),
Gallardo et al. (1992: 158), Gile (1995: 146), Hervey, Higgins and Haywood (1995: 155-9),
and Maier and Massardier-Kenney (1993: 155). Snell-Hornby talks about the double
supervision of a thesis when the topic is specialized translation (Dollerup and Loddegaard 1992:
2. My colleague Eva Espasa followed a similar outline with her students using texts on
Environmental Studies.
3. The first two issues are proposed by Maier and Massardier-Kenney in their pedagogical
model for graduate specialized translation training (Wright and Wright 1993: 151).
4. For a thorough discussion on the use of parallel texts, see Gile (1995: 141).
5. Strategy here was understood to be a non-automatic solution to a translation problem.
6. This part of the research was carried out thanks to a grant awarded by the Universitat
Rovira i Virgili (Tarragona, Spain) - 96 78C Ajuts a la Recerca-96.
7. Compare Gile's separation principle (1995:117)andproblem reports (1995: 123-4).
8. I would like to thank Drs. Josep E. Boada and Jordi Dorca for their collaboration, as
well as Dr. Luis Garcia for his help with the statistical analysis.
9. The results and conclusions derived from this second text are now being processed. They
have not been included here for reasons of both time and space.
10. From Hervey, Higgins, Haywood (1995: 154).
11. Notice that numerical scoring and general rating within the group do not always
coincide. When asked about this, the specialists responded that they had classified in accordance
with the importance of the aspects which had been well solved (e.g., a good grade in cohesion
was not considered as positive as a good grade in specific terminology).


Balliu, Christian. 1994. "L'enseignement de la traduction médicale: pour une

nouvelle pragmatique". In Meta XXXIX, 1: 15-25.
Dollerup, Cay and Loddegaard, Anne (eds). 1992. Teaching Translating and
Interpreting. Amsterdam and Philadelphia: Benjamins.
Gallardo, Natividad, Mayoral, Roberto and Kelly, Dorothy. 1992. "Reflexiones
sobre la traducción científico-técnica." In Sendebar, 3: 185-191.
Gile. 1995. Basic Concepts and Models for Interpreter and Translator Training.
Amsterdam and Philadelphia: Benjamins.
Hervey, Sandor, Higgins, Ian and Haywood, Louise. 1995. Thinking Spanish
Translation. Andover and New York: Routledge.
Kiraly, Donald. 1995. Pathways to Translation. Pedagogy and Process. Kent and
London: Kent State University Press.
Maier, Carol and Massardier-Kenney, Françoise. 1993. In S.E. Wright and L.
Wright (eds). Scientific and Technical Translation. (ATA Scholarly
Monograph Series VI). Amsterdam and Philadelphia: Benjamins, 151-161.
Munjack, Dennis, Brown, Richard Α., and McDowell, Diane. E. 1993. "Existence
of Hyperventilation in Panic Disorder With and Without Agoraphobia, GAD,
102  Student Assessment by Medical Specialists

and the Normals: Implications for the Cognitive Theory of Panic in Journal of
Anxiety Disorders." In C. G. Last and M. Hersen (eds). Journal of Anxiety
Disorders, vol 7. New York and Oxford: Pergamon Press, 37-48.
Newmark. 1988. A Textbook of Translation. London: Prentice Hall.
Snell-Hornby, Mary. 1992."The Professional Translator of Tomorrow: Language
Specialist or All-Round Expert?" In C. Dollerup and A. Loddegaard (eds).
1992. Teaching Translating and Interpreting. Amsterdam and Philadelphia:
Benjamins, 9-22.
Wright, Sue Ellen and Wright, Leland (eds). 1993. Scientific and Technical
Translation. (ATA Scholarly Monograph Series VI). Amsterdam and
Philadelphia: Benjamins.
Yernault, J.C. 1994. "Haemoptysis: CT or Bronchoscopy?" In European
Respiratory Topic, vol. 1: 16.
Section 3:
The Medical Translator at Work
The Pragmatics of Medical Translation:
A Strategy for Cooperative Advantage


When the first English translation of Ernest Lasègue's classic text De

l'anorexie hystérique was published in 1873, several important passages were
missing. One of the omissions involved a crucial diagnostic clue (Vandereycken
and van Deth, 1990). The American title of Wilhelm Röntgen's seminal work
Über eine neue Art von Strahlen was rendered as On a new kind of rays
(Rutkow 1993), which at best might be considered a less-than-optimum
translation, even for 1896. Though these examples are a hundred years old, the
problems they pose remain challenges for twenty-first century translators.
Although the consequences of the act of translating cannot always be
foreseen, it should be obvious that unexplained omissions may cause
considerable damage to a physician's reputation, not to mention a patient's
health. It could be argued that poor use of English in the translation of a title
neither hinders understanding nor harms the diffusion of scientific knowledge.
A recent study published by Fernando Navarro and Jeffrey Barnes (1996)
suggests otherwise, however.
These translators looked at the English translations of Spanish titles of 292
papers published in Medicina Clínica and found 458 errors in 225 (77%) of the
292 titles. Differences in meaning between the original Spanish and the English
translation were found in 100 titles (34%). In addition, 72 titles contained
orthographical, lexical, or grammatical mistakes without distortion of meaning.
Approximately one-third of the lexical and grammatical errors were caused by
Spanish interference.
The authors were surprised by their findings, stating that the comparison had
"yielded much worse results than had been expected." To highlight the potential
consequences of errors in title translation, they show how errors may be
reproduced when they are incorporated as key words in international indices
such as Current Contents, thereby hindering millions of people searching
databases around the world.
Equally direct repercussions of the translation process have been reported by
J. Wetlesen, a member of a regional Committee on Research Ethics in Norway
106  The Pragmatics of Medical Translation

(1989). He has questioned the official Norwegian translation of the Declaration

of Helsinki, calling for a revision. In his opinion, the translation presents the
document as a set of rules rather than guidelines. Apparent discrepancies in the
translation have caused confusion among committee members and affected
outside expectations of their work (Wetlesen 1989).

Expectations of Translation

Expectations are key in the world of translation. Navarro and Barnes found
translation errors "worse than expected." Wetlesen is concerned about "outside
expectations" of his committee's work. What is expected of a translation? By
whom? What should authors expect from the translation of their work, even if
only a title is translated? What should clients expect when they commission a
translation? What should readers expect when they settle down to read? What
should a translator expect when sitting down to work? Who sets the standards?
Who makes the rules? Who faces the consequences?
Matt Hammond (1995) recently described a situation in which a company
refused to pay a translator because the translation "did not resemble the source
text closely enough." In the ensuing court case, the translator's lawyer argued
that a translation could only be judged "by comparison with the specifications set
for it." But what or who determines the specifications? How are they agreed
upon? Who needs to know what they are? What responsibility should the
translator shoulder for determining them?
It is impossible for a translator to meet the specifications of a translation
without knowing what they are. At the very least, the translator needs to know
why and for whom the translation has been commissioned. The source of this
information has to be the client; yet, all too frequently, the client contact cannot
supply the information. When asking about the purpose of the translation of a
scientific article, the translator will often be told "Oh, someone in the research
department wants to know what it says."
Some translators are loathe to ask too many questions of a client with regard
to assignments. My aim in writing this paper is to encourage such questioning.
Only by establishing the specifications for a translation can a translator analyze
the translation situation and adopt an effective translation strategy. If the
translator has to educate the client in this endeavor, so be it. The opportunity
should be grasped with both hands. At the same time, the translator should learn
as much as possible about the client's business. As a result both translator and
client will understand why the translation has been requested, for whom it is
intended, and how it needs to be done. Both the client and the translator will
benefit. This is the concept of cooperative advantage (Reeves-Ellington 1993)
applied to translation.

Pursuing Cooperative Advantage

with the Translation Situation

Much good advice has been given to translators regarding the need to obtain
contracts in writing to cover the structural, financial, and legal aspects of an
agreement to work for hire (for example, Jane Maier 1994). To the best of my
knowledge, however, the translation situation is not usually covered in these
agreements. It should be.

Get it in writing

In the medical field, as in all other spheres, translation is a function of the

translation situation. Key players in the translation situation are the party
commissioning the translation, the translator's client (who may or may not be
the commissioner), the author of the source text (who may be the client), and the
intended audience. Medical translators can be of greatest service to their clients if
they understand the relationships of the players and ascertain the information
they need to map out the translation situation at the very outset of each new
project. Some clients may not have the information. Indeed, some may not
understand the need for it. It is part of the translator's job to explain the need,
discuss any questions with the client, and confirm the answers in writing.
A written agreement on the translation situation can be included in an overall
contract if such a contract is needed for each assignment. On the other hand, if a
translator has a general contract covering all work for hire done for a client, then
each new assignment can be covered by a brief addendum describing the
translation situation and any elements specific to that particular assignment. By
coming to an agreement on the translation situation, the translator is not merely
simplifying the work process, not merely doing a better job, not merely
obtaining some protection against potential criticism, but is providing mutually
agreed upon added value, involving the client and other key players in the
translation situation to cooperative advantage.

The translator's responsibility

It is clear that the translator should take on this responsibility. It was

presumably a translator's decisions that led to the discrepancies that had such
far-reaching consequences for the Norwegian ethics committee, evidence
enough that the process of translation involves more than exchanging words in
one linguistic system for another, more than an appreciation for lexis, grammar,
and register.
The translator must, in fact, be a cultural mediator and must inhabit the
spaces between cultures and communities. The translator must have a full
understanding of the context of the source text: its function and purpose; its what
108  The Pragmatics of Medical Translation

and why (Vermeer's skopos 1990: 94); and its environment, that is, the culture
and communities (audiences) that sustain it and the expectations of those
communities (Toury's polysystem 1981), which applies to pragmatic as well as
literary texts. Similar information must then be obtained about the context and
environment of the projected target text. This will make it possible to devise a
strategy that will help the translator negotiate the hazards of the translation
process and produce a translation that meets its function and purpose while
minimizing opportunities for confusion, misunderstanding, and unintended
social or political repercussions.

The textual-contextual approach

The textual-contextual approach to translation has become well established in

recent years (Snell-Hornby 1988; Hatim & Mason 1990; Nord 1991; Neubert &
Shreve 1992). Neubert and Shreve's (1992: 69) approach is based on Richard
de Beaugrande and William Dressler's (1981) seven standards of textuality as
they apply to any text: intention, acceptability, coherence, cohesion, and
intertextuality, with the needs of situation and communication "informativity"
kept in the foreground at all times. For the purposes of my discussion, I shall
use Neubert and Shreve's coinages of "situationality," "intentionality," and
"acceptability" as the defining variables of the translation situation.
"Situationality" locates the text in a discrete sociocultural context in real time and
place. "Intentionality" refers to the impact of the author's intentions with regard
to text and audience (that is, productive intent versus receptive intent).
"Acceptability" refers to readers' expectations with regard to textual
conventions. The variables of the translation situation may or may not be
congruent for the source and target texts. My comments are directed to
translation into English.

Genres in Medical Translation

Assessment of the translation situation and the use of textual analysis can be
applied to any genre of medical text. Among the many genres a medical
translator is likely to work in, the most common include biomedical papers,
clinical reports for New Drug Applications, case reports, patient consent forms,
expert opinions, official regulations governing drug manufacturing and clinical
research, package inserts, and patient education brochures. In my experience,
biomedical papers are the daily fare of most independent medical translators. It is
in the area of journal publication of this genre that the medical translator can use
the lever of cooperative advantage to the fullest extent.

The biomedical paper: translation f or publication

Everyone learned in high school the basic format of the scientific paper:
introduction, materials and methods, results, and discussion. It may surprise
many translators to know, therefore, that many scientists, particularly
physicians, do not follow this format as perhaps they should. Even when they
get the headings correct, some authors include appropriate information in an
inappropriate section; for example, they incorporate arguments from the
discussion section in the introduction. Moreover, the basic format excludes
important elements, specifically the title, abstract, and conclusion, to which the
translator needs to pay special attention. Given the nature of our on-line culture
and the importance of databases such as MEDLINE, the title and abstract are the
only part of a biomedical paper that many scientists will read. They must contain
clear, concise, relevant information.
Most journals publish "instructions for authors" to encourage scientists to
follow a general framework when writing papers; however, such instructions
differ from journal to journal, particularly as regards references. Moreover,
authors frequently disregard instructions and thus waste time for journal staff,
reviewers, translators and the authors themselves, all of whom become involved
in additional editing. In several attempts to remedy this, various groups of
clinical investigators, biostatisticians, and editors have joined together to make
the requirements for biomedical reports more consistent and complete
(International Committee of Medical Journal Editors, 1993; the Working Group
on Recommendations for Reporting of Clinical Trials, 1994; The Standards of
Reporting Trials Group, 1994).
Most recently, the Asilomar Working Group (1996) has combined all
previous attempts at standardization to provide an inclusive checklist of
information that should be included in biomedical papers. They suggest it be
used by clinical investigators, journal editors, and peer reviewers to ensure
consistent, complete, and useful reporting of clinical findings. I suggest that it
also be used by medical translators.
Given the complexity of clinical reporting, translators are not doing their job
if they simply translate the source text, verify that all technical and medical terms
are correct, and perform enough microediting to ensure that grammar,
punctuation, spelling, and word usage are appropriate. If translators want to
help clients achieve the goal of publication, they must take greater responsibility
for the translated text. They have to do enough macroediting to ensure that the
text is cohesive and that content, organization, and flow of information
correspond to readers' expectations. Where feasible, translators also have to
point out to the foreign-language author where the source text fails to meet the
demands of the Asilomar checklist so that any gaps can befilled.Most medical
texts written by American scientists and physicians in English are improved by
professional medical writers and editors prior to publication. To my mind, it is
110  The Pragmatics of Medical Translation

unthinkable that a medical translator should not also improve the organization of
a medical text in translation if it is to be published. It is simply inappropriate for
a translator to justify a sloppy English text on the basis of a sloppy German text,
unless—and this is an important caveat—the client of the translation specifically
requests, perhaps for legal reasons, that a text remain "unimproved." Here
again, it is essential for the translator to know the purpose of the translation.
As part of the discussions on the translation situation, the translator should
ascertain the journal to which the author intends to submit the paper, and
perhaps help in the selection, so that "instructions for authors" can be followed
from the outset. Before beginning the translation, the translator should review
the paper to determine whether and where the source text fails to meet the
demands of the Asilomar checklist. In cases of inconsistencies between the
Asilomar checklist and the specific journal instructions, the latter should be
Thus, when the translator confirms the translation situation for a biomedical
paper that the client intends to publish, situationality, intentionality, and
acceptability all come together in the targeted journal and the Asilomar checklist.
In providing this additional service, the translator is truly adding value to the
product and gaining cooperative advantage for the client.
Once alerted to any gaps, the author can collect the necessary information or
rewrite inadequate sections while the translator continues to work. If the author
has been invited to make a contribution to a special issue of a journal and is
working against a deadline, this obviously saves time. As the translator works
through the text, discrepancies may come to light, for example, inconsistent use
of terminology, misreferences from text to figures or references that are missing.
Such minor problems are more easily remedied when collected in a list of
translator's notes to be appended to the translated text.
Added value does not stop with the biomedical paper. Whatever genre the
translator works in, the translation situation and product specifications must be
clarified. Take, for example, a package insert. If, in thinking of American
conventions and patient expectations, a translator produces a translation of a
foreign-language package insert to meet those expectations, client expectations
may not be met. It would serve no purpose to reorganize a foreign-language
package insert if the purpose of the person who commissioned its translation
was to determine how the source text differed from an American text in
information content and organization.

The biomedical paper: translation "for information only"

A translator may be lulled into apathy by translating papers "for information

only." The knowledge that a translation will not be published is no reason not to
pursue an agreement with the client on the translation situation.

I was recently asked to provide a rough translation of an article for

informational purposes. My client contact, a translation coordinator in a large
corporation, told me not to translate the title and abstract because they were
already in English.
Now, I am always wary of people who want rough translations and expect
to save a few dollars on abstracts. Moreover, Röntgen's title is a constant
reminder to me of the importance of titles. In response, I explained that, if
extracts from the translation were likely to be published, the final text should be
polished, not rough. Moreover, since the fee for the translation would be based
on the number of words in the final text, a rough translation was likely to be
more expensive than a properly checked and edited text. My contact easily
agreed with the logic of this position.
In an effort to ascertain some of the information for the translation situation,
I asked who had commissioned the translation and why. Apparently, a junior
research scientist had asked for the translation, but my contact did not know
why. I explained the reason for my question, and my contact agreed to call me
back with the information.
In the meantime, the text arrived. The title, a literal translation of the original
title read "The language in which cells communicate." This is how the abstract

The problem for the cells' communication in the organism, as well as for
the language they use in the process of communication is discussed in the
article. This problem is not exhausted with the cyclic mononucleotids.
The abundant information is a reason to accept that such a function may
be fulfilled by the inositol phosphate, the growing factor, some
aminoacids, etc. To unveil the secrets of nature, at the basis of which is the
communication between cells and the system for their management, will
undoubtedly take us closer to the understanding of this divine secret, as
well as to the possibilities to use it in man's favour.

This was certainly the English language, but it was language devoid of
meaning. Poor syntax, bad grammar, and inappropriate register combined to
create problems of cohesion and coherence. British orthography might offend
some Americans' sense of propriety. The abstract had presumably been written
by the author of the foreign-language text or by someone for whom English was
a second language. The full article appeared in a popular scientific journal which
provided an English abstract for articles appearing in each edition but no abstract
in the source language.
Although the translation would not be published in a journai, the intended
audience (which I had yet to ascertain) had the right to expect clear English. The
readers should not have to work hard to get their information. Leaving this
abstract as it was would serve no one any purpose: the intended audience would
scarcely be able to understand it, the original author would lose some standing
112  The Pragmatics of Medical Translation

among an English-reading public, and I would surely not gain in reputation (not
the least of my considerations).
A telephone call to my contact clarified the situation. She had not actually
read the abstract, acknowledged that it was unacceptable, and agreed that I
should create a new abstract after translating the full text of the article. She also
informed me that the junior research scientist who had requested the translation
was writing a newsletter article for non-specialists focusing on the subject of cell
communication. I was now in a reasonable position to confirm the translation
situation, which I confirmed to my client by fax, as follows:

The source text deals with the subject of cell communication. Written by a
senior research scientist, it was intended as a popular scientific article for
an educated general audience. Typical of the periphrastic style of
Bulgarian researchers, the text occasionally lacks coherence and
cohesion. The translated text will be used by a scientist as the basis for a
newsletter article whose audience might be readers of Scientific American.
Structure, flow of information and style should conform to expected
English usage in a newsletter. As an example of the latter, I suggest a title
change from "the language in which cells communicate" to either "the
language of cells," "cell communication," or "cell talk." The abstract,
which does not conform to expected English usage, will be rewritten.

The cooperative advantage of this approach soon took on tangible results.

After receiving the translation, the scientist sent me a copy of the newsletter and
asked if I would be willing in the future to abstract relevant information for the
newsletter rather than translate whole texts. This is a clear example of
cooperative advantage ensuing from the translation situation by which everyone
benefits. I benefited by obtaining a new type of work; the client by saving
money; the scientist by saving time.

The Translator-Client Relationship

Of the several key players in the translation situation, the medical translator
frequently has access only to the client contact, who may be an in-house
translator, a bureau owner, a hospital librarian, a research scholar, or a product
manager. In an ideal world, in-house translators and bureau owners appreciate
the translator's need for information and usually do their own homework to
provide that information before they call an independent translator to take on an
For several years I had the distinct pleasure of working for a client who not
only understood the language and content of the texts he sent to me for
translation, but also knew why he wanted them translated. He would often ask
me not to translate but to rewrite the original text, explaining the purpose and
intended audience. He could intelligently discuss the end product and request
changes. And he paid a time-based fee.

intended audience. He could intelligently discuss the end product and request
changes. And he paid a time-based fee.
In a less than ideal world, the medical translator may be dealing with a client
who not only has no understanding of the language or content of the text to be
translated, but no knowledge of the business of translation. In this case, the
translator brings added value to the service by trying to understand the client's
business and educating him or her about translation.
The idea that the translator should "do what the client says" without asking
some pertinent questions is ridiculous. Not only is it bad practice that may lead
to sloppy work habits, it is also likely to lead to poor client relationships as the
client realizes that he or she is not satisfied with the translator's output. After all,
the translator has been hired as a consultant in intercultural communication.
Translators are business partners, not subordinates. It is their job to understand
the client's business as well as their own. Only then can the best professional
advice be offered. If the client chooses not to listen to that advice on a consistent
basis, the work relationship might require reconsideration.
Confirmation of the translation situation in writing not only helps avoid
miscommunication, it may also help the client to refine the purpose of the
translation. Very often, the translator's client contact may not know why the
translation has been commissioned. If the contact is unwilling or unable to get
answers to the translator's questions, and if the translator has no direct access to
the commissioner, the translation situation must still be considered, and the
translator must still analyze the source text situation, consider various options
for the target text, and set arbitrary specifications for the function, purpose and
intended audience of the target text. The translator then has a basis for a strategy.
Once the client receives a copy of the translation situation, he or she can pursue
it with the commissioner.
Choices in translation are dictated by the translation situation. In the final
analysis, a translator offers advice within a given context. Once a translation is
completed according to its initial specifications, it can always be used at some
later date for different purposes. The translator cannot be criticized at that later
date for failing to meet changed product specifications. The translator's work
can be better defended if a copy of the original specifications is retained as proof
that they were agreed to by the client contact.

According to Gadamer, "every translation, even the so-called literal
reproduction, is a sort of interpretation" (Gadamer 1989: 32). Determination of
the translation situation and textual analysis will not eliminate a certain element
of subjectivity in translation, but it lays the groundwork on which the translation
can proceed.
114  The Pragmatics of Medical Translation

When the translator outlines the translation situation in writing to the client,
three things are achieved: 1) the client is given the opportunity to accept or
reconsider expectations; 2) the translator's own strategy for translation is
clarified; 3) the product specifications against which the translation can be
judged are confirmed. If, at some later point, either the client or the
commissioner seeks to criticize the translation, the criticism can be handled
within the framework of the agreed upon translation situation.


The Asilomar Working Group on Recommendations for Reporting of Clinical

Trials in the Biomedical Literature. 1996. "Checklist of information for
inclusion in reports of clinical trials." Annals of Internal Medicine, 124(8):
de Beaugrande Robert and Wolfgang Dressier. 1981. Introduction to Text
Linguistics. London and New York: Longman.
Gadamer, Hans-Georg. 1989. "Text and Interpretation." [Translated by Dennis J.
Schmidt and Richard Palmer]. In Diane Michelfelder and Richard Palmer
(eds), Dialogue and Deconstruction. The Gadamer-Derrida Encounter.
Albany, SUNY Press, 21-51.
Hammond, Matt. 1995. "A new wind of quality from Europe: Implications of the
court case cited by Holz-Manttari for the U.S. Translation Industry." In
Morris & Marshall (eds), Translation and the Law. (ATA Scholarly
Monograph Series VIII). Amsterdam and Philadelphia: Benjamins, 233-245.
Hatim, Basil B. and Ian Mason. 1990. Discourse and the Translator. London:
International Committee of Medical Journal Editors. 1993. "Uniform
requirements for manuscripts submitted to biomedical journals." Journal of
the American Medical Association, 269: 2282-2286.
Maier, Jane. 1994. "Getting it in writing: The key to problem-free business
relationships." In Deanna L. Hammond (ed), Professional Issues for
Translators and Interpreters. (ATA Scholarly Monograph Series VII).
Amsterdam and Philadelphia: Benjamins, 35-46.
Navarro, Fernando A. and Jeffrey Barnes. 1996. Traduction de titulos al inglés en
Medicina Clinica: calidad e influencia del castellano. Medicina Clínica,
106(8): 298-303.
Neubert, Albrecht and Gregory M. Shreve. 1992. Translation as Text. Kent, Ohio:
The Kent State University Press.
Nord, Christiane. 1991. Text Analysis in Translation. Amsterdam: Editions Rodopi
Reeves-Ellington, Richard. 1993. "Using cultural skills for cooperative advantage
in Japan." Human Organization, 52(2): 203-215.
Rutkow, Ira M. 1993. "How American surgeons introduced radiology into U.S.
medicine." American Journal of Surgery, 165: 252-257.

Snell-Hornby, Mary. 1988. Translation Studies. An Integrated Approach.

Amsterdam: John Benjamins Publishing Company.
The Standards of Reporting Trials Group. 1994. "A proposal for structured
reporting of randomized controlled trials." Journal of the American Medical
Association, 272: 1926-1931.
Toury, Gideon. 1981. "Translated Literature: System, Norm, Performance.
Toward a Target-Text-Oriented Approach to Literary Translation." Poetics
Today, 2(4): 9-27.
Vandereycken, Walter and Ron van Deth. 1990. "A tribute to Lasègue's
description of anorexia nervosa (1873), with completion of its English
translation." British Journal of Psychiatry, 157: 902-908.
Vermeer, Hans J. 1990. Skopos und Trans lationsauftrag-Aufsätze. Heidelberg:
Translatorisches Handeln: 94.
Wetlesen, J. 1989. "The Helsinki Declaration: A misleading Norwegian
translation?" (in Norwegian). Tidsskr Nor Laegeforen, 109(11): 1179-80.
Working Group on Recommendations for Reporting of Clinical Trials in the
Biomedical Literature. 1994. "Call for comments on a proposal to improve
reporting of clinical trials in the biomedical literature." Annals of Internal
Medicine, 121(11): 894-895.
Translating and Formatting Medical Texts for
Patients with Low Literacy Skills

The best scientific writing, with its penchant for objectivity, systematic
investigation, and exact measurement, is indeed outstanding. Translating
medical documents intended for other experts, or knowledgeable non-experts,
requires the translator to have a sound base of medical knowledge and familiarity
with the target language's medical stylistics. The translator must be able to
mimic the tone of the original document and render it precisely into the target
language. Unfortunately, medical translators are presented not only with the best
scientific writing, but also with quite a bit of the worst: general-use documents
intended for the patient population at large.
Nowhere is the confrontation between scientific and everyday language more
apparent than in documents intended for the general public. Health-care
providers, in an effort to save time and assist patients, produce instructional
medical texts in-house, sometimes without any real written communication
skills. When non-writers write instructional texts, essential background
information and procedural steps may be omitted because they seem obvious to
the author; data may be reduced to such an extent that the information is rendered
incomprehensible to the lay person; technical terms may be left undefined or, in
an effort to reach patients who are not highly literate, substituted with jargon or
imprecise lay terms. As a result, countless hours are wasted every year at both
ends of the writing/reading communication continuum producing documents
which fail to convey information.
Despite the fact that many medical professionals are aware that patients do
not comply with medical instructions any better than before they are made
available in written form, non-functional English instructional texts are often not
taken out of circulation. Thus, they eventually land (like a ton of bricks!) on a
translator's desk. Given that non-English-speaking patients are generally
perceived to have lower literacy skills than the average American patient, and
with full knowledge that English-speaking patients are not complying with the
instructions, translators are often asked to simplify the texts they receive.
With a brick-load of non-functional source language (SL) instructions sitting
on his or her desk, the translator is left with the challenge of creating a target
language (TL) document that is effective. The translator's formidable task is to
118  Translating and Formatting for Low Literacy Patients

construct a text that is intelligible and, especially when translating for a low
literacy level, accessible. Most translators are good masons; they work with
poorly built SL instructions and attempt to render them more intelligibly in the
TL. However, intelligibility does not entail accessibility. The master builder, in
contrast to the mason, builds instructional texts that are technically accurate, and
written at a targeted legibility (typographic accessibility) and readability
(linguistic accessibility) level.

Illiteracy in Perspective

Illiteracy is a disability that cannot be defined along racial, ethnic, national

origin, or socioeconomic lines. The Literacy Volunteers of America (LVA) state
that forty-four million American adults (Ryan, 1997), or approximately 20
percent of the adult American population, have been labeled functionally illiterate
(generally interpreted as having reading skills below the fifth-grade level). What
is equally disturbing is that another 39 percent are only marginally competent
(Doak & Doak, 1985).
Since pain, anxiety, medications, age, and cultural differences all play a role
in the level of patient understanding (Doak & Doak, 1985; Crystal, 1991), all
hospital-patient and physician-patient communications—whether intended for
the literate or low-literate patient—should be written in simplified form.
Since they realized that even highly literate patients have trouble
understanding written instructions due to anxiety, pain, or medications, the
Doaks set about to assess the match between the literacy requirements of
available health instructions and the literacy abilities of patients. These studies
were undertaken in the United States Public Health Service Hospital in Norfolk,
Virginia, and included patient education materials ranging from the patient Bill of
Rights to the most explicit diet instructions. According to these studies, a tenth-
grade reading level was required for understanding the available texts. In
addition, although the majority of the patients in the sample stated that they were
high school graduates, on the average, the word recognition tests they took
placed their literacy abilities at about the seventh-grade level. This finding was
confirmed by the LVA 1996 report which showed that one person out of every
10 who graduates from high school cannot read his or her diploma.
These studies, along with others, such as the Diabetes Control Project,
South Carolina Department of Health and Environmental Control (1980-1981),
and Northcut's national Adult Performance Level study (1984), made it quite
clear that there is a gross mismatch between the difficulty of the existing medical
instructional materials and patient literacy levels (Doak & Doak, 1985). If we put
the results in perspective, it means that some of these adults are not aware that
the average body temperature is 98.6 degrees Fahrenheit, cannot address an
envelope properly, comprehend a simple road map, or order from a menu.

While an eighth-grade reading level is required to follow the instructions on a

frozen TV-dinner package, the average aspirin-bottle label requires tenth-grade
reading skills.
Furthermore, the data gathered from these studies reveal that patients with
low literacy skills do not have the ability to understand subject-specific
terminology, to analyze instructions, or to cull key information pertaining to a
behavior expected of them—nor, for that matter, can they apply the problem-
solving skills for drawing inferences and conclusions from experience. In
addition, the unskilled or temporarily handicapped reader may not be able to
navigate through a document in order to integrate information supplied in the
form of footnotes, endnotes, warnings, captions, legends, illustrations, or other
cross-referenced material (Rubens,1992;Doak & Doak, 1985).


When we are asked to simplify an instructional text in translation, few of us

know that simplification is neither subjective nor a haphazard process. We may
be tempted to mimic the original document and limit our input to substituting lay
terms for technical ones. After all, difficult terminology is what gives us our
daily headaches. Those of us who have been trained as editors may have a
deeper understanding of simplification, by being able to detect superfluous,
extraneous, or insufficient information; lack of parallelism; or, even worse,
ambiguities and inconsistencies; and many other problems in the SL text which
would make it difficult to read, let alone understand. But overall, the elements of
simplification are poorly understood by the vast majority of translators.
As we will see in the following sections, the formatt of a document plays an
important role in transmitting information clearly and efficiently; it is a key
element of simplification. Unfortunately, even when the translator has been
asked to simplify a text, the client who has made the request may not realize the
crucial role formatting plays. As a result, many medical instructional texts, such
as brochures, patient guides and manuals will often be DTP'd (subjected to
desk-top publishing) without consulting the translator. In these cases, all a
translator can do is inform the client that there are better and simpler ways of
conveying the information provided and hope that the client heeds the advice.
Nonetheless, the vast majority of medical instructional texts will not be
subjected to desk-top publishing. These documents will be facsimiles of the
translator's finished work. It is with this type of assignment that the translator
can truly make a difference in the process of communication. Let us consider
legibility and readability, the key concepts for understanding simplification.
120  Translating and Formatting for Low Literacy Patients


Legibility, in its strictest sense, applies to the visual aspects of text on a

page. In order to make a text easy to read, we must manipulate typographical
variables—such as paper size, type and size of font, spacing between letters and
words, hyphenation, contrast, blank spaces, and margins—to help the reader
navigate through the page without getting lost.

Typographical Variables

As Hartley (1988) eloquently states, instructional texts are typographically

far more complex than a novel. Key words often have to be made to stand out
from the remaining text; lists have to be numbered, bulleted, or check-boxed;
and texts may contain lines, fill-in-the-blank spaces, illustrations, numerical
quantities, and the like. Nonetheless, this necessary variation is not an artistic
license. Typography should enhance understanding, not distract from it.1 To
enhance legibility, my best advice is to leave the font cartridges and clip-art CD-
ROMs in the drawer.


Serifed fonts, such as Times Roman, Garamond, and C o u r i e r , are

easier to read than non-serifed fonts such as Arial. Avoid using fancy fonts
which tilt and curve with a spirit that would make Magellan proud. Brush script
is a case in point. Words set at an angle from the horizontal and reverse lettering,
that is, white characters on a black background, also limit legibility of text and
graphic aids. If it is necessary to stress key words, use bold or underline.
While, according to Hartley, the use of italics for highlighting terms has not
been sufficiently studied to determine its suitability in aiding poor readers, the
Doaks recommend that italics be used sparingly, if at all. ALL CAPS are
acceptable for titles, but should be avoided in sentences. People with low
literacy skills read longer sentences more accurately when they can rely on the
cues given by upper and lowercase letters.


As we know, a line of text may be made to extend from the left margin to the
right margin, creating an even right-hand edge. This is called full justification. In
order to accomplish this, the computer automatically adjusts spaces between
words to make the line of text fit evenly on the page. Poor readers have a more
difficult time connecting words when the spaces between them are visibly
unequal. Short sentences of centered text are acceptable, but should be kept at a

minimum. In simplified texts, it is best to eschew justification in order to avoid

stretching words and the spaces between them.


For simplified texts, turn off the automatic hyphenation feature on your
word-processing program. Poor readers are often unable to read words that have
been cut at the end of a line, and have trouble reading lines which begin with an
incomplete word.
If a text will be DTP'd by others, the translator should instruct them to turn
off the English or SL hyphenation feature in their computers. Otherwise, not
only will the final TL text be hyphenated and hamper poor readers, but the
words will be divided according to the SL rules.

Lists, Bullets, and Numbers

An instruction sheet should contain lists parallel in style and form. Lists are
useful tools for organizing tasks. It is much easier to scan a vertical list of
instructions than a horizontal one. When it is important for the reader to scan a
list quickly to retrieve an item, or to remember each item, use a vertical list. Use
bullets when you want the items on a list to stand out. Use numbers where the
order follows a prescribed sequence or hierarchy, in contrast to other lists where
the order may be arbitrary (Tarutz, 1992). Parallelism in style means that all
items in a list have the same grammatical construction. As a general rule, all
items should be either phrases or complete sentences, not mixed. Every item
should begin with the same part of speech and be in the same form. Patients
with low literacy skills read better when lists start with nouns which serve as
key words:

Medicine - Take 2 tablets of (your medicine) with breakfast.

Blood sugar - Put a drop of blood on the test strip to measure the blood
Telephone - Call the nurse after you measure your blood sugar.

Asterisks, Footnotes, and Endnotes

Poor readers cannot efficiently piece together information from different

parts of a document. Thus, even if you must repeat the information several
times, avoid using this type of marker or notation.
122  Translating and Formatting for Low Literacy Patients


Readability, simply stated, refers to the amount of effort required on the part
of a reader to understand a given text. By manipulating the verbal aspects of a
text, such as terminology, verb tenses, or sentence length, a writer can aid poor
readers. The first legibility studies, conducted in the 1920s, allowed
investigators to pinpoint the verbal aspects which made texts easier or more
difficult to read. The degree of legibility depended on linguistic aspects which
were objective and measurable. The first attempt to develop a valid and reliable
instrument to assess the readability of materials in English was completed by
Spaulding in 1951 (Crawford, 1984). Since then, more than 40 different
procedures have been developed (Cassany, 1995) for other languages as well—
based largely on the English-text studies conducted in the United States. Table 1
illustrates some of the most common verbal aspects measured by these
instruments, and Table 2 presents some of the important elements of simplified

Table 1. Instruments which measure readability

Item Measured Measurement System

Length of terms Number of syllables per word.

Number of syllables in 100 running
Due to linguistic differences, the tests words.
for Spanish accept longer words than
the tests for English when considering

Length of sentences Number of words per sentence.

Number of syllables per sentence.
For most measuring systems, a
sentence is any string of words
punctuated by a period, an
exclamation point, or a question mark.

Basic vocabulary Number of terms which do not belong

to a basic vocabulary.
A frequently used instrument for
English is the Wide Range
Achievement Test (WRAT). See
Suggested Reading List.

Table 2. Readability2


Text that is easy to read and INCLUDES CERTAIN ITEMS AND\

Short, simple words Long, complex words

Short sentences Long sentences

Parallelism Lack of parallelism

Concrete language Abstract language

Text markers (such as transitional Referenced material (such as endnotes,

phrases), which permit the reader to footnotes, superscripts, captions,
anticipate what is to come etc.)

Repetitions as reinforcement No reinforcement

Vertical lists; numbered when sequence Horizontal lists

is important, bulleted, or otherwise

Alphabetical lists (when appropriate) Non-alphabetical lists

Logical placement of the verb Complicated syntax

Simple verb tenses (imperative mood, Complicated verb tenses (subjunctive,

past, present, and simple future) compound tenses)

Active voice Passive voice

Plain Language Campaigns

The anxiety generated over special uses of language (the language of the
courts, government, medicine, business, computers, etc.) is most markedly seen
in the campaigns to promote "plain writing," notably the Plain English
campaigns in Britain and the United States. The campaigners argue that stilted
language should be replaced by clearer forms of expression.
124  Translating and Formatting for Low Literacy Patients

Simplified English

One approach to solving the dilemma of communication between two or

more linguistic groups has been to develop vocabularies and rules of grammar
for controlled subsets of Standard English. These are called Basic English,
Fundamental English, or Simplified English. Simplified English is defined as a
subset of Standard English intended for scientific or technical communications
(Rubens, 1992). The goal of this approach is to have non-native readers
understand the English material, so companies, agencies, and institutions can
avoid the problems of finding qualified translators, delaying publication, and
incurring additional production costs.
Writing in Simplified English is an excellent solution when communicating
with scientists or technicians who are non-native speakers, yet share a
knowledge base (whether expert or non-expert) and are competent enough to
follow straightforward English instructions. The best scientific writing transfers
ideas in a clear manner through the use of simple grammar, verb tenses, and
consistent terminology (Mathews, 1996), which is precisely what Simplified
English accomplishes. Because of this, the Simplified English subset and its
Spanish counterpart, known as espanol llano (Cassany, 1996), should be the
master style for all technical communication, regardless of the language
competence of the readers.

Handling Medical and Technical Terminology

in Simplified Texts

The inexperienced translator will try to make the text less difficult by getting
rid of technical terminology. Unfortunately, lay terms often have more than one
meaning and are not standardized. Because of this, they may confuse the patient.
For example, a morning-shift interpreter at one of the Texas medical center
hospitals where I freelanced explained the term "catheter" as a sonda; the person
who covered her during lunch called it a tripita; the afternoon interpreter used
the term tubo; and the Spanish-speaking nurse who prepped the patient in the
cardiac catheterization lab called it a espagueti. By the time the actual procedure
was about to be carried out, the patient asked me if they were going to stick him
four times in all. Imagine the confusion that ensues when a patient not only has a
catheter in his body, but also an IV, a nasogastric tube, a chest tube, and a
Foley—and every document he reads aad every person he comes into contact
with uses a different term to refer to them. In order to foster communication and
understanding, arm the patient (and the interpreter, in case the document will be
sight-translated) with a simple glossary at the head of the page.

There are at least three good reasons for familiarizing patients with technical

• They have only one meaning

• They are standardized
• They enhance caregiver/patient communication during continued clinical

Handling Non-Technical Terminology

in Simplified Texts

Common non-technical language can easily be a source of confusion, even

for good readers. In 1979, Wile studied common non-technical language to
determine congruence between physicians and patients on words or phrases
such as "going home soon" and "if you have a reaction." Agreement was very
low, even among the physicians (Doak & Doak, 1985). In one pharmaceutical
survey carried out in the U.K., the term "use sparingly" was found to be
misunderstood by 33 percent of the patients in the sample (Crystal, 1991).
Colors, for example, are extremely subjective. If a mother is instructed to call
the pediatrician if the baby turns "yellow," just how yellow is yellow enough to
call the doctor? Should the translator encounter this type of instruction, contact
the author or health-care providers and ask them to explain what yellow means,
then include the most accurate description or analogy you can find in the target
language. A case in point is the variety of Spanish equivalents for the color
Create a limited vocabulary for any simplified language technique. Such a
listing is not simply an approved word list; each word must have only one
meaning. When a word in the instructions has a different meaning than the one
understood by the patient, it is called "masking." During my days as an
interpreter, I once had to reassure a worried father-to-be that, despite what was
stated on the On The Day Your Baby Is Born instruction sheet, his wife was not
really going to give birth "on the floor." Some frequently used nouns which
create "masking" problems are stools, formula, bottom, top, push fluids, and
servings. Verbs can also "mask" meanings. In the following example from a
California clinic, the verb to take has four different connotations:

• Take your medicine as soon as you wake up

• Take your urine sample first thing in the morning
• Call the nurse so she can take your urine sample
• Take your blood pressure before breakfast
126  Translating and Formatting for Low Literacy Patients

In addition, consider the terms "as soon as you wake up" and "first thing in the
morning." Which one would you do first?
Another excellent example is offered by Fischbach (1961) regarding the
injudicious placement of adverbs which will tend to obscure meaning. In his
sentence: "The first patient took this medication the next day," the placement of
the adverb "only" within the sentence dictates the meaning:

Cultural Accessibility

The final aspect a translator will need to consider when working on

simplified texts is to render them culturally accessible. A translator should not
give instructions which make reference to behaviors which are culturally
determined. For example, do not instruct a new mother from Bolivia to hold her
baby to her breast as if she were holding on to a football right before a tackle, or
tell a man from Yemen to use a jigger to measure his cyclosporin. In addition,
signs, symbols, acronyms, abbreviations, and initialisms do not always
resemble their referents. In other words, anyone can kick a ball between two
poles, but it will only be a goal to those who know the rules of soccer.
Certain term sequences are also culturally determined. On-Off, True-False,
and Yes-No are a case in point. When the sequence does not match the
language/society patterns, the reader is easily confused. Let's look at the
following example from an instructional video script for pediatric patients with

Mark your answer with an X on the answer sheet where it says No or Yes.
Here is a practice question.
Some children do not like bananas.
Some children do like bananas.
Do you like bananas? Mark No, or Yes.3

The culturally determined sequence in English is Yes-No. This instruction

requires that the child invert the "natural" sequence to No-Yes. When a writer
fails to use the appropriate sequence for the language, he or she invites an
automatic wrong answer in the "correct" Yes-No order, which can render the
survey, instrument, or instruction invalid, useless, and even dangerous.
Frequently, the English term sequence is different from the TL sequence. Some
examples commonly found in instructional texts which must be reversed when
translating into Spanish are True-False - falso-verdadero; back and forth - ida
y vuelta; soap and water - agua y jabón; and hot and cold -frío y caliente.


Simplification is poorly understood by nurses, doctors, writers, and

translators alike. Although their words may sometimes fail them, when hospital
personnel tell the translator: "You know, use Tex-Mex Spanish... something
more or less at the sixth-grade level," they are not really asking him or her to use
non-standard Spanish for uneducated Latin Americans. What they mean to say is
that the instructional TL texts should be modified, in language and in form, in
order to improve their legibility and readability. If the TL text is simplified in
accordance with the recommendations presented in this article, the patients will
find it easier to comply with the instructions. Although I have concentrated on
the translation of medical instructional texts, the techniques which I presented
have broad applicability to other forms of technical instructions—from how to
use electrical appliances to safety rules in the workplace. I hope this article has
shed some light on the rigorous process of simplification, and has provided the
translator with sufficient information to be able to put it into practice, if duly
authorized by the client.


1. See Hartley (1988, Chapters 3 & 9) for a complete description of typographical

variables in instructional texts.
2. See Rubens (1992, Chapter 8) for a complete description of science and technical
writing for non-native English speakers; and Hartley (1988, Chapter 6) for a complete
description on writing simplified instructional texts.
3. Partners in Asthma Management. Revised Narration for Case Finding Instrument.
University of Texas School of Public Health, 1996.
128  Translating and Formatting for Low Literacy Patients


Duffy, T. Waller, R. (Eds.) 1985. Designing Usable Texts. Orlando, Florida:

Academic Press.
Fry, E. 1968. "A Readability Formula That Saves Time." The Journal of Reading
11(7): 513-516, 575-578.
.1977. "Fry's Readability Graph: Clarifications, Validity, and Extension to
Level 17." The Journal of Reading 21(3): 242-252.
. 1969. "The Readability Graph Validated at Primary Levels." The
Reading Teacher 22: 534-538.
Garcia, W.F. 1977. Assessing Readability for Spanish as a Second Language: The
Fry Graph and Cloze procedure. Unpublished doctoral dissertation, Teacher's
College, Columbia University.
Gilliam, B., Peña, S.C. and Mountain, L. 1980. "The Fry Applied to Spanish
Readability." The Reading Teacher 33(4): 426-430.
.1984. "Eighty Ways of Improving Instructional Text." IEEE Transactions
of Professional Communication, PC-4, 1.
Rodríguez-Trujillo, N. 1980. "Determinación de la comprensibilidad de
materiales de lectura por medio de variables lingüísticas." Lectura y Vida 1:
Spaulding, S. 1956. "A Spanish Readability Formula." The Modem Language
Journal 40(8): 433-441.
.1951. "Two Formulas for Estimating the Reading Difficulty of Spanish."
Educational Research Bulletin 30(5): 117-124.
Thonis, E.W. 1976. Literacy for America's Spanish-Speaking Children. Newark,
Delaware: International Reading Association.
Vari-Cartier, P. 1981. "Development and Validation of a New Instrument to
Assess the Readability of Spanish Prose." The Modern Language Journal
65(2): 141-148.
Wide Range Achievement Test (WRAT): Jastak Association, Inc., 1526 Gilpin Ave.,
Wilmington, Delaware, 1986.
Wright, SE. 1993. "Stylistic Considerations in Scientific and Technical
Translation," Scientific and Technical Translation. (ATA Scholarly
Monograph Series). Amsterdam and Philadelphia: Benjamins.

Alley, M. 1987. The Craft of Scientific Writing. Englewood Cliffs, NJ: Prentice
Cassany, D. 1996. La cocina de la escritura. Barcelona: Anagrama.
Crawford, A. 1984. A Spanish Language Fry-Type Readability Procedure:
Elementary Level. Los Angeles: California State University.
Crystal, D. 1991 (ed). "Language for Special Purposes." The Cambridge
Encyclopedia of Language. Cambridge: Cambridge University Press.
Doak, C , Doak, L. and Root, J. 1985 Teaching Patients with Low Literacy Skills.
Philadelphia: J.B. Lippincott Company.

Fischbach, H. 1961. "What the Translation Client Should Know or How Not to
Write for Foreign Publication." Montreal: Journal des Traducteurs, Oct.-Dec.
Hartley, J. 1988. Designing Instructional Text. New York: Nichols.
Mathews, J., Bowen, J., Mathews, R. 1996. Successful Scientific Writing. NY:
Cambridge University Press.
Rubens, P. 1992 (ed) Science and Technical Writing. New York: Henry Holt.
Ryan, M. 1997. "Join the Incredible Reading Rally." The Houston Chronicle
Parade, Jan 5, page 4.
Tarutz, J. 1992. Technical Editing. Reading, MA: Addison-Wesley.
Right In the Middle of It All: The US National
Institutes of Health Translation Unit—An Interview
with Unit Head, Ted Crump


Most of the translations commissioned by researchers at the National

Institutes of Health (NIH) are performed by the staff or contractors of the NIH
Translation Unit, tucked away discreetly in a hallway at the back of the NIH
Library on the sprawling NIH campus in Bethesda, Maryland.
The Translation Unit has been headed for the past fifteen years by Ted
Crump. This conversation, which took place in Crump's office in April 1997,
explores his experiences as head of translations at NIH. He explains how the
Unit operates, the variety of documents it translates and the uses to which these
translations are put. He tells readers what dictionaries, reference books and other
resources are most useful to him in his work.
Crump shares his ideas on how to get started in medical translating and his
opinions on what makes a good medical translator. He relates how he found his
way to the field of medical translation and what changes he has seen since his
career began.

Robertson: How did you first get into translating?

Crump: I was enrolled in a Ph.D. program in Russian literature at Bryn Mawr

College in Pennsylvania. I saw an ad in the Philadelphia Inquirer for a
translator/abstracter at Biosis, the Biosciences Information Service in
Philadelphia. They publish Biological Abstracts. It called for someone who
knew Russian and German and had a scientific background. I thought, "Well,
that sounds like me except I don't have a scientific background," but I went in
and interviewed for the job and, to my astonishment and trepidation, got it.
I started working at Biosis in 1976 as a translator/abstracter. What we did
was read the foreign article and write a half-page abstract in English. We also
did indexing. This was very good training for me. I had to scramble to figure
out how to find terminology. With abstracts, you don't have to translate every
132  Right In the Middle of it All—AnInterview with Ted Crump

single word. If there's something you just can't solve, you can work around it.
It's good training for reading through something to get the gist of it.
While I was at Biosis, I heard through the ATA grapevine about an opening
for a translator at NIH. I applied for the job and was accepted. I moved to the
Washington area and came to work in February of 1980. I've been here ever

Robertson: What course has your career taken since you came to NIH?

Crump: When I came here, Paul DePorte had been the only translator in the
Translation Unit for several months. He was glad to see me because I could do
German and Russian, leaving him to work with Romance languages, which he
preferred. Paul retired a couple of years later, and Shari Lama joined the Unit,
taking over the Romance languages, which she continues to do as we speak.
We used to have a library technician assigned to the Unit for clerical support,
but this position was eliminated with the general downsizing of the library, and
so for about the past ten years the clerical functions, such as record keeping,
making photocopies, logging in and tracking of translations, have been divided
among the staff translators and clerical staff of the Administrative Office.

Robertson: Is the Translation Unit fairly autonomous?

Crump: We report to the Chief of the Library, but handle our own day-to-day
management. Our work is easy to quantify by means of our monthly statistics
and work trends, and we always enclose a quality control questionnaire to our
patrons in order to receive their comments about quality of the product. These
statistics and returned questionnaires are provided to the Chief so that she can
monitor our progress.

Robertson: Who are your clients?

Crump: Anybody who has an NIH library card can avail himself of our
services. Some of our clients are scientists working here or at various branches
of NIH outside Bethesda; some are administrators.

Robertson: From the outside, being a translator at NIH looks very impressive.
I imagine you being at the very center of medical innovation. Do you feel that
way? Is it exciting? Do you feel you're contributing to important medical

Crump: Yes, I do. One does get the feeling of being in the middle of things.
Especially when the scientists come in and they're all excited about what they're
investigating. They'll tell you all about it, and I try my best to understand what

they're talking about. I like interacting with the scientists who come here.
They're the cream of the crop from all over the world.
Part of the reward of working here is you feel like you're a part of
something and that you're helping, contributing to it. A lot of it is leading-edge
technologies and cures.
I've worked on a lot of things that have to do with trial drugs. I've translated
material on genetic engineering, which is about as exciting as anything,
especially when they tell me what they've done, how they're going about trying
to solve the problems and how close they are to the solution.
We don't search the foreign literature looking for likely candidates for
translation; our business is strictly walk-in. The scientists will usually run a
Medline search on their topic of interest, and if this turns up articles published in
foreign languages, they obtain the articles and bring them in for translation.
Sometimes researchers elsewhere will be in the lead in particular areas,
sometimes the NIH scientists just want to add additional data to their own, for
example, to get results on a greater number of cases.
Another thing we do is old, classic papers. For example, I've done many of
the old German researchers: Friedrich von Recklinghausen and Rudolf Virchow,
Robert Koch and Paul Ehrlich, Alois Alzheimer, Carl Westphal. The scientists
like to consult those original papers, the original case histories and descriptions
of the diseases.
Often scientists will go chasing down the wrong gopher hole because
somebody has incorrectly cited another scientist from twenty years before and
the error has been perpetuated for generations because no one went back to the
original paper. The original paper said one thing, but somebody else got the
wrong notion. Sometimes when we translate the original paper, the scientist
says, "So this is what the original actually said. We've been on the wrong track
for a long time now."
One thing that has always struck me over seventeen years is that research
will sometimes lie there for twenty, thirty, even fifty years or more, before
anybody moves it ahead. You get a 1920 paper and you think, "This has got to
be old hat; this can't be of any interest to anybody," when actually nobody in the
meantime has moved forward from what that researcher was specifically doing.
About a year ago, I translated a couple of articles on yeast, ca. 1906, and the
translations were posted on the Internet. The scientist who requested the
translation declared, "That's all we know about this particular yeast and nobody
has ever gone back to it in the meantime."

Robertson: Do many of your translations end up being published?

Crump: I've had a few publications. The Westphal paper on agoraphobia was
published in the Journal of Anxiety Disorders and case histories from von
Recklinghausen's book were published in Advances in Neurology.
134  Right In the Middle of it All—An Interview with Ted Crump

Robertson: How much of your translating is actually research-related?

Crump: When I first came to work here, the lion's share of the work consisted
of published research articles in foreign journals. However, in recent years we
have been called upon to translate increasing numbers of personal documents to
support the appointments of foreign visiting fellows to NIH. These documents
now make up a majority in numbers of requests, although the research papers
still account for the majority of words translated.

Robertson: Why do you think this is so?

Crump: It's largely because the researchers have discovered us. I don't know
how they got their personal documents translated before. A few years ago, a
survey found that only 25% of NIH staff knew that the Translation Unit existed.
Now we are more visible. For one thing, the library has its own Webpage and
translation services are listed on it. We even have a hot link to the translation
request form, so researchers can download the form and fill it out. The Unit is
also listed on NIH library handouts. Finally, word of mouth has also had an
effect. The Russian visiting fellows, in particular, have learned that this service
is available, and now they are pouring through the door.

Robertson: Besides German, what other languages do you and Shari do in-

Crump: I also do Russian, French, Serbian, Croatian, Polish, Latin, Dutch,

Ukrainian and Czech to English. Shari does Spanish, French and Italian to
English. We tend not to translate into a foreign language, except for short texts
that we can have reviewed by a native.
A lot of times, the scientists will say they don't have enough money in their
budgets to contract a job out. So, to try to save the scientists money, we do as
much work as we can in-house and contract out as little as possible.

Robertson: What kind of work do you contract out?

Crump: We contract out almost all of the into-foreign work, and into-English
work from any languages neither Shari nor I can handle, plus overflow when
we're too busy and there's a pressing deadline. The quality of the outside
translations has been a problem. We've had a hard time finding good outside
translators, especially into the foreign languages. Most of the jobs we have sent
out are protocols into Spanish and French.

Robertson: Does the Unit contract work to individual freelance translators?


Crump: Almost never. The work is contracted on the basis of blanket purchase
agreements (BPAs). In order to keep a BPA alive, we have to give a contractor a
certain minimum amount of work per year, and it's hard to maintain more than a
couple of BPAs because we don't contract out enough. Our procurement people
like to see $5,000 a year from a particular vendor in order to justify the
maintenance cost. Otherwise, from their standpoint, it's not economic to
maintain that BPA.
Among the outside providers with which we have BPAs is the referral
service of The Translators and Interpreters Guild. If a translator wants to do
work for NIH, he or she should contact the Guild.

Robertson: What changes have taken place in your work here over the past
seventeen years?

Crump: A lot of the changes have been in the area of technology. When I first
came to work here, we had manual typewriters. Then we got electric
typewriters. If I made a typo, I would just skip and start the word all over again,
and then when I got to the bottom of the page, I'd roll the sheet out and knock
out those partial words with White-Out. I found that was faster than any other
way. The only problem was that the final product looked kind of funny with all
those holes in it. Finally, we got correcting typewriters, and later machines with
memory, which were a kind of primitive word processor. Then we finally got
IBM computers. This was followed by scanners to allow us to import graphics
into the layout, page layout software for laying out the text to look like the
original and allow keying in English inside the graphics, and finally laser
printers to give us high-quality camera-ready copy.
Before the advent of computers, we did a lot of dictating onto cassettes. This
was a highly productive technique from the standpoint of amassing large
numbers of words translated, but then the poor scientists would have to sit and
listen to them, or have their secretaries transcribe them. But I wasn't terribly
keen on such recording; for one thing, it would be very aggravating if someone
else later requested the same article that had been taped, and it was a matter of
doing it over or trying to obtain a copy from the first requestor, who perhaps
had left NIH in the meantime, or had discarded the tape once he had listened to
We also used to do a lot of oral or sight translations, where someone would
come in and hand us an article and want it translated. That is a real exercise,
especially in German where you have to scan the unbelievably long sentence,
pinpoint the verb, put it into context and rearrange it in English syntax, all on the
fly. I tend to discourage it now. If the scientist is in a real hurry, we'll go
through the article and pick out the conclusions. Sometimes they'll want to
know how many patients were involved in a protocol and how was it broken
136  Right In the Middle of it All—An Interview with Ted Crump

down, what drugs were used, what the dosages were. You can go through the
article and pick that out, or read the legends of the graphics to them, and then
send them on their way. This suits their purposes for the moment, and this can
be followed up with a full-dress written translation as time permits.

Robertson: What are some of the most exciting moments in NIH translation

Crump: A few come to mind. One time there was a patient on the operating table
in the Clinical Center whose medical records from Germany had not yet been
translated. These arrived when the patient was already on the table, and were
rushed down to us. The runner would wait in the doorway and take each page
up to the OR as soon as it was completed.
On another occasion, one of the NIH scientists was going to meet with the
Deputy Director of NIH about setting up a program to study ethics in medicine,
particularly with respect to Nazi medicine. With two hours notice, he handed me
some ten pages of German with details about how German doctors and the SS
had collaborated in the murder of Poles and Jews and how some of the cadavers
came to be used by Eduard Pernkopf in his Atlas of Topographic and Applied
Human Anatomy. I still had a couple of pages to go when the scientist arrived at
my door and began pawing the carpet, interspersed by calls to the Deputy
Director postponing the meeting for another five minutes.
In 1992, scores of Russians died in an outbreak of anthrax in the city of
Sverdlovsk. The Russian authorities claimed that the victims had succumbed
from eating contaminated meat, but the unusual nature of the outbreak raised
suspicions in Western circles. Wind patterns and rumors of germ warfare
research implicated a laboratory several miles upwind. But the Russians
maintained that anthrax could not be spread through the respiratory pathway. As
their authority, they cited the classic study by S. M. Derizhanov in 1935.
Western officials were frustrated by not having access to Derizhanov, then the
National Library of Medicine came up with the only copy available outside
Russia, and I received a phone call to translate it immediately, if not sooner. It
ran 58 pages, single-spaced, so in order that my other work would not suffer, I
did it mostly on my own time. It turned out that, contrary to what the Russians
were now claiming, Derizhanov had documented cases of transmission of
anthrax through the respiratory pathway. Western scientists later visited a
laboratory upwind of Sverdlovsk and confirmed that a release of airborne spores
had occurred.
Then there was the time when some officials from the National Cancer
Institute were going to meet in New York with Premier Kravchuk from Ukraine
to sign a protocol. The English version of the protocol had to be translated into
Ukrainian for the signing. As frequently happens, we only were given two days
to accomplish it. We faxed it to a vendor, and received an acceptable translation

back in time, but the requestor rejected the formatting as being unacceptable to
hand to the Premier of Ukraine. I said, "No problem. I think I've got Ukrainian
at home on my Macintosh computer. I'll take this home and reformat it for you."
This was about noon on Friday. The requestor replied, "I have to catch a plane
at noon on Saturday; I'll come by and pick it up at your house." It turned out I
didn't actually have Ukrainian characters; I had to make them up with my
Macintosh. Twenty-two hysterical hours later, the scientist was standing over
me as I urged on my ancient computer to put the finishing touches on the

Robertson: You have two walls full of dictionaries in your office, outside your
door is the NIH library, and the National Library of Medicine is within walking
distance. With that embarrassment of riches, what resources do you find most
valuable to you in your work?

Crump: Indexes are our favorite resources. I learned how to use indexes when I
was working at Biosis. Take the index they produce as part of Biological
Abstracts, for example. In the subject part, you can look up terms that you can't
find in your dictionaries, and you can get them in context. Sometimes you can
solve a linguistic problem just by finding it in the right context. Also, you can
confirm spelling and usage.
I'll show you an example. I had to solve the Russian term svechenie po
Fal'ku. Svechenie can mean illumination, lighting, luminescence, luminosity,
phosphorescence—a lot of different things; it also means fluorescence. So the
problem was: which is it? po Fal'ku means "according to Falk." I looked up
Falk in the subject section of the ΒA Index and found "Falk's fluorescence
method," so I knew that in this context svechenie was fluorescence. That's how
you can use an index as a dictionary. And this term was solved in a matter of
When I came here, I discovered the Science Citation Index which is even
better. The library has it from 1955 to the present. It has a source part, a citation
part and a Permuterm subject part. If you run into X's method as modified by Y,
you can go to the citation part and look up X and see that Y cited his original
paper, maybe 40 years later, so the chances are he modified his method, and
there you go.
Another advantage we used to have here was having subscriptions to many
foreign journals. Now we only have a few left. As the budget tightens, the
journals consulted less often have had to be cut, and naturally the foreign
journals are less frequently consulted. This problem is compounded by rising
prices, particularly of the foreign journals. It used to be that we were able to
trace the work of a particular scientist through different articles in different
journals. Sometimes he would use the same abbreviation or talk about the same
138  Right In the Middle of it All—An Interview with Ted Crump

thing somewhere else, or we would get a reference to somebody else who'd

been studying the same thing, but now we are less able to do that.
However, the biggest news of the past year has been the Internet. Let me
give you a quick demo. I had this German abbreviation to solve: GrFG. I use a
program called Dogpile, which combines all the search engines. You just key in
what you want, in this case GrFG. We know it has to do with a student who got
a grant from a university in North Rhine-Westphalia. After about a minute, it
comes back with 26 hits. Number 22 gives us the expansion. GrFG is the
Graduiertenförderungsgesetz of North Rhine-Westphalia. Is that incredible or
what? This is a tool that any translator who is miles away from a good library
can use.

Robertson: It's starting to sound like dictionaries are a dispensable tool around
here. Do you ever use dictionaries?

Crump: Yes, of course. I haven't had the time over the past five or six years to
update them, so mine are getting kind of obsolete now. Shari has a more up-to-
date collection of dictionaries in the Romance languages. I'll show you some of
my favorites, and you can get a list of Shari's favorites from her to include in the
I am in the best shape for German. My Russian collection is not all that
great, although I've got pretty good representation of what is available; there's
just not that much available. I have a lot of stuff in Polish, but nothing up to
date, except for this Russian-Polish one, Podrçczny Stownik Polsko-Rosyjski
by Stypuľa and Kowalowa. I'm in sad shape when it comes to Serbo-Croatian. I
don't have a modern, up-to-date technical dictionary. I've asked Yugoslav
scientists to bring me something back, but they say they couldn't find anything
to bring me.
This 3-volume set, Encyclopedic Dictionary of Medical Terms, is invaluable,
but it's from 1982-84, so it's really getting old. I get a lot of calls from
translators when they can't solve a term. Sometimes I can help, sometimes I
can't. But a lot of times I can help with this particular encyclopedia, and it's very
Dictionaries I particularly like for German are: Werner Bunjes, Wörterbuch
der Medizin und Pharmazeutik; Jürgen Nöhring, Wörterbuch Medizin, which is
a good supplement to Bunjes; and Roche Lexikon Medizin. I like the
Grosswörterbuch Wirtschaftsenglisch by Hamblock and Wessels for financial
terms. For chemistry, I mostly use Helmut Gross, Fachwörterbuch Chemie und
chemische Technik, but I also use Patterson's German-English Dictionary for
Chemists. It's small, but it's got some things Gross doesn't have. And
everybody needs the 6-volume Römpp Chemie Lexicon.

I can show you my favorite dictionary. This is the new Walther, Technik
und angewandte Wissenschaften, which I've already worn out. It was published
in 1993 and it's in Fetzen (German for "tatters") already.
Lang's German-English Dictionary of Terms Used in Medicine from1932is
pretty good, believe it or not. This baby has saved my bacon a lot of times.
Some of the terms listed have dropped out of use, but when I translate those old
papers, it comes in handy. The same goes for the old Brockhaus encyclopedia
from 1960. They were going to throw it away and I said, "Don't you dare!"
Then there's Foster's 4-volume Encyclopedic Medical Dictionary from
1892. It's got German, French, English and Latin. I hesitate to even touch it,
because every time I get near it, a piece falls off onto the floor, but it's good.
The common medical dictionary for Russian is Eliseenkov, which was
published in 1975. We really need an update or a better one. You wouldn't be
able to do much without it, but it could stand some improvement. The Russian-
English Medical Dictionary and Phrasebook, edited by Petrov, Chupyatova and
Corn, kind of supplements it.
I guess the last dictionary I bought was Callaham's Russian-English
Dictionary of Science and Technology. That is an excellent dictionary. I also
have the Dictionary of Science and Technology, Russian to English, by G.
Chakalov. This dictionary has been criticized for its abundant typos and sloppy
printing, but it is very comprehensive, and one will put up with poor production
for the sake of a desperately sought term.
Then there's Macura, Elsevier's Russian-English Dictionary, four volumes.
It's a good general encyclopedic dictionary, but it's pretty expensive.
A couple of other good Russian references are Eugene and Vera Carpovich's
Science and Engineering Dictionary and Jim Shipp's Russian-English Dictionary
ofAbbreviations & Initialisms.

Robertson: What's this monster you're using to elevate your typing stand? Do
you still use it as a dictionary too?

Crump: That's Webster's Second International Dictionary. Yes, I use it all the
time. It's got a lot of Latin terms and many odds and ends that the third edition
doesn't have. There are a lot of foreign terms right in there as headwords. It's
just an amazing dictionary. They went downhill with the third edition, in my

Robertson: Have you developed your own glossaries over the years?

Crump: Yes, I've got German, for example, divided into three different files
because they're getting so big. Unlike some translators, I can't remember every
word I ever looked up. And I hate to look up a word twice, so every time I look
140  Right In the Middle of it All—An Interview with Ted Crump

up a word, even if it's just a general word, I'll put it in the glossary. I don't
always solve the problem, so I've got some question marks in there, too.
At the end of the glossary files, I keep a translator's diary. I indicate in the
diary how I went about finding things. Lately I've been getting a lot of hits with
the Internet, so that information is in the diary.
In addition to the diary, I have a section which is kind of a catch-all, just
odds and ends, including translator humor. For example, I coined the term
"adverborrhea" for the German habit of stringing adverbs together, and I
recorded here the best example I ever saw: Auch dies findet sich regelmassig
beim erwachsenen Menschen als Eigentiimlichkeiten der beiden Zentren (sonst
nur noch ebenfalls ziemlich regelmässig, doch entsprechend spärlicher im
Striatum). (You can just see the little professor, peering over the lectern through
his coke-bottle glasses, with one finger straight in the air and spit flying into the
second row.) I also saw a bad case of conjunctionitis: Da doch nun aber auch...

Robertson: Are you able to use the scientists who work here as a resource for
medical terminology?

Crump: It's funny. You'd think that would be a great resource, but it's not. We
tend to find that if we can't figure it out, they can't either. It's really amazing.
Once in a while they can. I once went from Russian to Russian with some
abbreviations that none of them could solve until I happened upon a volunteer in
one of the labs who had worked in the same field from which the abbreviations
had originated. Russian abbreviations are the worst single problem that I have.
The Russians themselves don't always know what they mean. I always beat on
them about their abbreviations, but they come right back and say the Americans
are just as bad.

Robertson: If trained physicians aren't that much help with terminology, how
important do you think it is for translators to have a medical background before
they start doing medical translating?

Crump: I don't think they need to have any medical background, but I think
they need to know how to find what they need to find. That's kind of the gist of
my whole spiel about using the indexes. When I was working at Biosis, it was a
kind of training for coming here, like a launching pad, because I was able to
know at least superficially what the areas were and where to find the
I don't think it's necessary that I understand the underlying principles behind
the science. Sometimes I'm doing an oral translation for a scientist and we get to
the conclusions and the scientist says, "How do they reach that conclusion from
what you've just said?" I say, "Hey, I don't know, I'm just translating." Or I've

had scientists say, "What do you think that means?" and I reply, "Don't ask
You have to know enough science to resolve any ambiguities in the
language, but I think a superficial acquaintance is good enough to do it. The
important thing with medicine, as I imagine with any other scientific field, is
realizing when you don't know something and being honest about it, and
chasing it down, not just glossing over it. If you can't ultimately solve a
problem—and there are problems that you can never solve and there's nobody
on God's green earth who can help you—then you just have to tag it as
I remember when I first started to work here, I used to pursue a term or an
abbreviation for days. Work would back up, but I would just be determined that
I was going to solve it, and I would have scientists coming over here from all
over NIH, sitting down and trying to figure it out with me, but we couldn't, so
eventually I had to back off from that.

Robertson: Do you have other advice for newcomers trying to get into medical

Crump: Get into indexing and abstracting first. There used to be a lot of
companies farming out abstracting work. The National Library of Medicine had
a string of indexers. Biosis used to farm out a lot of abstracting work. That's
one way to become familiar with the terminology.
The main thing for would-be medical translators is that you need more than
just a copy of Dorland's or any other standard medical dictionary. You need to
be near a library or at least have. Internet access, and the Internet is not always
going to help you. Sometimes it will leave you high and dry. Be near a library
and know how to run down information. The main thing is to be near indexes
and journals, because indexes together with journals are the best source of
terms. If you can catch an American scientist working on the same problem as
the foreign scientist whose article you are translating, you can see the terms he
uses and begin to start cross-referencing. Many times you will see that there are
no linguistic connections between the terms used by the American and the
foreign scientist for the same concept.

Robertson: What are the most common mistakes you see medical translators

Crump: The biggest thing is not being alert. Here's a classic case. We had
contracted out the translation of a Russian paper and I was reviewing it. The
Russian author had said that he administered 160 mg of cyclophosphamide per
os, which in Russian is vnutr', and the translator had rendered it as
"intravenously," which is vnutrivenno. In a lapse of concentration, he had
142  Right In the Middle of it All—An Interview with Ted Crump

mistaken per os for I.V., so if the recipient of the translation had followed the
advice and administered the drug intravenously, he would have killed his
patient. Fortunately, I caught it.
Another problem is bad usage, mushy usage—almost colloquial. It's
surprising to see translators using this register. Perhaps they don't know how to
run down the specific term and settle for the generic. If it's not some general
term they can find in a general dictionary, they don't know where to go from
there. Or lack of subject area knowledge will make them pick out the wrong
choice from several given in a technical dictionary. Most of the corrections we
make are of this nature: abbreviations, specific names of apparatus, tests and the

Robertson: What role has ATA played in your professional life?

Crump: I didn't get active in ATA until I came to the Washington area. In fact,
right after I moved here from Philadelphia, on March 1, 1980, was when we
had the meeting to organize the National Capital Area Chapter of ATA. Deanna
Hammond, Marilyn Daly, Bill Cramer, Stewart Colten, Eric McMillan, Denise
Tschiaperas, Gerald Geiger, Albin Drzewianowski (whose name took three men
and a boy to pronounce), Alicia Edwards, Ed Bourgoin, Walter Haller—to name
a few—were all there, and we organized the local chapter.
Early on, I volunteered to take over the chapter newsletter and I named it
Capital Translator (CT)—a pun—and came up with the logo and the format. I
started the CT in the fall of 1980 and I ran it until 1987, when I took over as
editor of the ATA Chronicle. I got elected to the ATA board of directors in 1983
and was on the board for one term. I was editor of the Chronicle for 23 months,
was dormant for a year or two and then took over the CT again for about three

Robertson: You're also well-known for your language-related cartoons, are

you not?

Crump: Yes, after I gave up the Chronicle, I started "Great Moments in

Languages," a series of cartoons which got syndicated to various translator
publications. One of these days, I'll start cranking them out again because I've
got a lot of ideas.
Another extracurricular activity of mine was writing a book called
Translations in the Federal Government 1985. It was a 19-agency survey of in-
house and contract work. It was self-published in 1985 and is now out of print;
however, I have agreed to collaborate with the Interagency Language
Roundtable on a revised and expanded version.

Robertson: Did you have any mentors who helped you at the beginning or
who were particularly inspirational?

Crump: Olga Karkalas was a great inspiration. She was my supervisor at

Biosis, and she's the one who told me about this job. She is such a
professional. She's so good, she's so thorough, so accurate, so conscientious.
She really was a role model—I think the best role model I've ever had in
translation. She's a very fine person.
Paul DePorte was too. When I first came here, he would critique my
translations, particularly with respect to style and usage.
Apropos of that, I'll point out Morris Fishbein's book Medical Writing: the
Technique and the Art. It's invaluable, and it also makes very good reading.
I think the main problem with many of us is avoiding "translationese" when
faced with short deadlines. We don't have the luxury of putting a translation
aside for a few days and then going back and revising it. We have to produce
final copy the first time through. But the scientists are mainly interested in
accuracy and will put up with less-than-polished phrasing if the proper terms are

Robertson: Aside from "translationese" and budget cuts, what other problems
and frustrations have you encountered while working at NIH?

Crump: A few years ago, I had a lot of trouble with carpal tunnel syndrome. I
wore a splint for a while, but after several months of naproxan plus vitamin B-6,
it improved. I also lowered my keyboard, which helps.

Robertson: Are you happy this is what you ended up doing for a career?

Crump: Yes, I'm quite happy with it. I had originally intended to become a
professor of Russian literature, but got involved in translation instead and have
never regretted it.


The author is very grateful to Ted Crump and Shari Lama of the NIH Translation Unit for
compiling the bibliographic information on their most useful reference works.
144  Right In the Middle of it All—An Interview with Ted Crump

German and Slavic References

Boyd, J.H. and Crump, T. 1991. "Westphal's Agoraphobia." Journal of Anxiety

Disorders 5(1): 77-86.
Bunjes, W.E. 1981. Wörterbuch der Medizin und Pharmazeutik, 3rd edition.
Stuttgart: Thieme.
Callaham, L., Newman, P.E. and Callaham, J.R. 1996. Callaham's Russian-English
Dictionary of Science and Technology. New York: John Wiley & Sons.
Carpovich, Eugene A. and Vera V. 1988. Science and Engineering Dictionary,
Russian-English. Mt. Vernon, Maine: Technical Dictionaries Co.
Chakalov, G. 1993. Elsevier's Dictionary of Science and Technology, Russian to
English. New York: Elsevier.
Condoyannis, G. (ed.) 1992. Patterson's German-English Dictionary for Chemists,
4th edition. New York: John Wiley & Sons.
Crump, T. 1981. Translation of case reports from Über die multiplen Fibrome der
Haut und ihre Beziehung zu den multiplen Neuromen by F. von
Recklinghausen. Advances in Neurology 29: 259-275.
Dorland's Illustrated Medical Dictionary. 28th edition. 1994. Philadelphia: W.B.
Saunders Co.
Eliseenkov, Yu.B. 1975. Russian-English Medical Dictionary. Moscow: Russkii
Falbe, J. and Regitz, M. (eds.) 1992. Römpp Chemie Lexicon, 9th edition, 6 vols.
New York: Thieme.
Fishbein, M. 1948. Medical Writing: the Technique and the Art. Philadelphia:
Foster, F.P. 1892. Encyclopedic Medical Dictionary (German, French, English and
Latin). New York: Appleton.
Gross, H. 1992. Fachwörterbuch Chemie und chemische Technik, 4th edition.
Berlin, Paris: Alexandre Hatier.
Der Grosse Brockhaus. 1960. Wiesbaden: F.A. Brockhaus.
Hamblock, D. and Wessels, D. 1989. Grosswörterbuch Wirtschaftsenglisch.
Düsseldorf: Cornelsen-Girardet.
Macura, P. 1990. Elsevier's Russian-English Dictionary, 4 vols. New York:
Meyers, M.K. (ed.) 1932. Lang's German-English Dictionary of Terms Used in
Medicine and the Allied Sciences with their Pronunciation. Philadelphia:
Nöhring, J. 1987. Wörterbuch Medizin. Thun, Frankfurt: Harri Deutsch.
Petrov, V.I., Chupyatova, V.S. and Corn, S.I. (eds.) 1983. Russian-English Medical
Dictionary and Phrasebook. Moscow: Russkii Yazyk.
Petrovskii, B.V. (ed.) 1982-84. Entsiklopedicheskii slovar' meditsinskikh terminov
[Encyclopedic Dictionary of Medical Terms], 3 vols. Moskow: Sovetskaya

Roche Lexikon Medizin, 2nd edition. 1984. Munich, Vienna, Baltimore: Urban &
Shipp, J. 1982. Russian-English Dictionary of Abbreviations & Initialisms.
Philadelphia: Translation Research Institute.
Styputa and Kowalowa. 1989. Podreczny Stownik Polsko-Rosyjski, Russian-
Polish. Warsaw/Moscow: Wiedza Powszechna/Russkii Yazyk.
Walther, R. 1993. Technik und angewandte Wissenschaften, Deutsch-Englisch.
Berlin: Alexandre Hatier.

Romance Language References


Dictionnaire de Médecine Flammarion, 5th edition. 1994. Paris: Médecine-

Sciences Flammarion.
Gladstone, William J. 1990. English-French Dictionary of Medical and
Paramedical Sciences. 3rd edition. Quebec: Edisem.
Mansion, J.E. 1972. Harrap's New Standard French and English Dictionary. New
York: Charles Scriber's Sons.
Manuila, Α., Manuila, L., Nicole, M. and Lambert, H. 1970. Dictionnaire Français
de Médecine et de Biologie (4 volumes). Paris: Masson & Cie.
Termium on CD-ROM. 1995. Ottawa: Public Works and Government Services.
Vocabulary of Cell Engineering/Vocabulaire du génie cellulaire Vol. I: Cell
Structure. Terminology Bulletin 211. 1992. Ottawa: Canada Communications
Vocabulary of Genetic Engineering/Vocabulaire du génie génétique.
Terminology Bulletin 200. 1990. Ottawa: Canada Communications Group.
Vocabulary of Medical Signs and Symptoms/Vocabulaire du sémiologie médicale.
Terminology Bulletin 199. 1990. Ottawa: Canada Communications Group.


Bussi, L. and Cognazzo, M.T. 1983. Nuovo Dizionario Inglese Italiano delle
Scienze Mediche. Edizioni Minerva Medica.
Chiampo, L. 1993. 77 Gould Chiampo Dizionario Enciclopedico de Medicina
Inglese-Italiano/Italiano-Liglese. New York: McGraw-Hill.
Manuale Merck di Diagnosi e Terapia. 1st Italian edition. 1984. Rome: Edizioni
Scientifiche Internazionali.
Petrelli, M.L. 1992. Dizionario Medico Italiano-Inglese/Inglese-Italiano.
Florence: Casa Editrice Le Lettere.
146  Right In the Middle of it All—An Interview with Ted Crump


Albin, V.S. and Coggins, M.T. 1994. Bilingual Glossary for Medical and
Healthcare Translators: Oncology, Hematology & Radiotherapy. English-
Spanish/Spanish-English. Houston: PCM Translation Resources.
Braier, L. 1980. Diccionario Enciclopedico de Medicina JIMS, 4th edition.
Barcelona: Editorial JIMS.
Diccionario de Ciencias Médicas, 8th edition. 1988. Buenos Aires: Libreria "El
Ateneo" Editorial.
Diccionario Medicohiologico University. 1966. Editorial Interamericana, S.A.
El Manual Merck, 7th edition. 1986. Nueva Editorial Interamericana, S.A. de C.V.,
Garrido Juan, A. 1979. Diccionario Ingles-Espanol para Medicos y Estudiantes de
Medicina, 2nd edition. Barcelona: Editorial Pediátrica.
McElroy, O.H., and Grabb, L.L. 1996. Spanish-English/English-Spanish Medical
Dictionary, 2nd edition. New York: Little, Brown and Co.
Stedman's Diccionario de Ciencias Médicas, 25th edition. 1993. Buenos Aires:
Editorial Medica Panamericana.
Torres, R. 1995. Diccionario de Terminos Médicos, 8th edition, revised. Houston:
Gulf Publishing Co.
On-line Medical Terminology Resources

Internet-based resources for medical translators and translation-oriented
medical terminologists are cost-effective, abundant and unique. Resources
include Web-served glossaries, databases and on-line documents, in a range of
source and target languages. The inherent structure of Web authoring facilitates
concept-based organization and research. Quality of available resources must be
evaluated on a site-by-site basis, as content varies.
Medical information management depends on access to a constantly evolving
reference environment. As new technology, procedures and preparations are
developed to meet the needs of medical science, medical information users at all
levels must have access to this data with a certain degree of specificity, as well
as strategies and procedures to manage it. Improved information dissemination,
retrieval and usability are fundamental goals in the development of these
procedures, and hypermedia technology has emerged as an effective medium to
achieve these goals.
Medical translation and terminology work involve the transfer of meaning at
the conceptual level and its representation at the lexical level. It is at the
divergence of conceptual and representative structures that terminological
research begins. While all translation activity involves the task of mapping
meaning coherently between an "abstract logical structure" and a linguistic
expression (Shreve 1992: 98), the language of medicine more often describes
rather than defines "...incompletely understood natural phenomena" (Rothwell et
al. 1994: 695). Conceptual definition and organization are therefore fundamental
to the transfer of meaning-based information at the linguistic level in medical
science, yet most multilingual medical resources are either subtly or markedly
deficient in concept-based representation of vocabularies.1
Medical terminology worldwide shares a certain conceptual uniformity, yet
for the hundreds of thousands of concepts in medical science and industry that
exist around the world, there are multiple standards for mapping specific terms
to concepts, few of which are adhered to in an "unmodified format" (ICH 1996:
4). Additionally, medical terminology displays a rich variety of field and
regional usage, and multilingual representation must also be specific (if not
148  On-line Medical Terminology Resources

standardized) in order to be accurate. This is true of many scientific and technical

fields, and efforts to standardize terminological guidelines and principles
internationally is a recognized priority (Felber 1984: 48).
The medical informatics community is meeting the challenges of modeling,
representing and exchanging concept-based information electronically, in an
effort to standardize and eventually harmonize medical vocabularies
internationally. The goal of this effort is to facilitate the exchange of medical data
between healthcare practitioners for the benefit of healthcare recipients.2 In
meeting the needs of cross-cultural technical communication, medical translators
and terminologists are similarly called upon to provide the end users of their
work with accurate and well-documented material. However, medical translation
and terminology work are as deadline-driven as the rest of the healthcare
industry, and generally must rely on existing language resources and informants
rather than devoting time to the development of more appropriate, translation-
oriented resources.
Unfortunately, many multilingual resources and subject experts prove
inconsistent as resources in translation and terminology research, and are not
completely reliable unless supporting information (definitions, sources, etc.) is
provided. While there is arguably no single optimal medical terminology
resource, there are clearly characteristics that define the effectiveness and
reliability of available resources. As medical information is not static, language
resources must consequently be dynamic. Medical reference works published
before the discovery or approval of important substances or procedures are
useful for the core information that they provide, however they become as dated
as world atlases during times of political upheaval.
The most reliable conventional resources for the medical terminologist and
translator have been journals of significant research or industry associations,
conference proceedings and frequent interaction with subject experts.
Unfortunately, access to these channels of information simultaneously is not
within the reach of all language professionals involved in medical translation and
terminology work, therefore creating the need for an accessible, non-static
resource that provides high-quality information in a timely manner. Enter: the
World Wide Web (WWW).3

Medical Information on the Net

Access to medical terminology resources via the Internet, including
multilingual as well as monolingual resources, offers the advantages of
immediate availability, cost-effectiveness, interactivity4 and powerful search
capabilities, coupled with the disadvantages (in some cases) of poor or sparse
content, unreliability of sources and disorganization. While a singular resource
in itself, the Web can generally be viewed as another location for medical

terminology information that is certainly available elsewhere, and not as an

exclusive medium for otherwise unavailable resources. Most university medical
libraries are replete with the necessary resources to carry out high-quality
terminology work. However, when quality resources are found on the Internet,
the benefits to the user are many. Namely, if a resource is well-maintained,
information is updated more regularly than in published hard copy or removable
media (CD-ROM, etc.). Additionally, what some users would consider the
primary advantage of Web-served information is instant access via hyperlinks
and search engines to related resources, allowing for greater coverage of
information in a shorter period of time. When looking for specific term
information, particularly information dealing with new or evolving areas in
medical science, the capability to perform world-wide searches through libraries,
established terminology services and even smaller, lower profile terminology
collections—all from a personal computer—is a tremendous advantage.
Most medical information on the Internet is not directed at translation and
translation-oriented terminology professionals, but rather at students, patients
and physicians. Also, the content and utility of particular WWW medical
information sites must be measured against the goals of the providers.
Generally, as with other fields with a presence on the Internet, content is still
second to presentation. Purveyors of medical information have taken advantage
of the inherent structure and appeal of hypermedia to reach a very select group of
information consumers, i.e. those with Internet access and the ability to navigate
the growing body of information available.
Some providers are motivated to reach these consumers by a genuine desire
to distribute information for educational and informative purposes. Others use
the Web for name recognition and the chance to increase exposure for new or
existing products and services. Some providers employ a design methodology to
ensure that the content of their site is well organized, whereas others will focus
more on visual appeal than substance. Some sites require subscriptions to
special services before making them available, thereby defining the quality of
resources by their exclusivity. However, if medical information providers do not
charge for Web-served resources, this is not sufficient reason to conclude that
there is limited value to their offerings. Conversely, fee-based resources are not
necessarily guaranteed to provide better quality, speed or availability.

Site Characteristics

Some medical information sites have actual, on-line-consultable and/or

downloadable resources, such as glossaries, articles and databases, while others
offer a mix of immediate resources and links. Fortunately, the job of weeding
out good resources from poor, compiling links to the good ones and regularly
checking and updating these links has been undertaken by a number of medical
150  On-line Medical Terminology Resources

information Web authors. These "virtual libraries" of links provide the

beginning of an infrastructure that each medical information user will need to
create in order to use the Web effectively.
To present an overview of the content and quality of WWW medical
information authoring, thirteen Websites are reviewed below, each with its URL
and an overview of its content and links. Special emphasis is placed on links, as
they greatly enhance the content of sites by building the unique "conceptual
structure" that makes the Internet so conducive to terminological research
(Bergeron and Bailin 1997: 124). This list is by no means exhaustive, but rather
representative of the kind and quality of WWW resources available to medical
translators and terminologists.

Site Review
1. World Health Organization (WHO) PLL ONUNE
http://www. who. ch/programmes/pll/cat/cat_resources. html#who

This site is administered by the WHO Technical Terminology Service, in the

Division of Publishing, Language and Library Services (PLL). As a resource for
terminologists, translators and other information specialists, the site is one of the
more formal and coherent presentations of information in this domain that can be
found. A 1,100-word mission statement provides a historical and scientific
backdrop for medical terminology activity and raises the issues of urgency,
organization, harmonization, standardization, multidisciplinarity and technology
in the field. Five domains of WHO program-related terminology records are
available through WHOTERM, a database containing the "the institutional
memory of terms and concepts used, proposed and recommended in WHO
literature" (WHO 1997). All records contain definitions, some providing
keyword translations (French and Spanish). Numerous associative links to other
translation-oriented on-line terminology resources are offered on the Technical
Terminology Service main page, and a Customer Service link offers a technical
term query service. Here, questions about international public-health terms, as
well as comments, etc., can be directly submitted via e-mail to the Technical
Terminology Service.
The PLL ONLINE site also offers a link to the Computer-assisted
Translation and Terminology Unit (CTT) in the WHO Office of Language
Services. This group is dedicated to the research and deployment of effective
translation memory strategies for the organization and offers a small collection of
downloadable resources, including short glossaries (French-English or French-
English-Spanish) in ASCII format, as well as actual translation memories and
aligned documents.


One of the various Web-served databases hosted by ECHO5 as a service of

the I*m Europe Information Market, this WWW gateway to EURODICAUTOM
offers on-line keyword searches by source/target language and domain. The site
was piloted at the beginning of 1997 (Pastor 1997), and while the majority of
the term records it offers pertain to EU government activities and technical
vocabulary, queries can be made in the domain of medicine. Records typically
deliver the search term by subject, as well as related keywords elsewhere in the
database that include the term under the same subject. The site features an
intuitive interface and rapid search capabilities. Ten source/target languages are
currently supported.
152  On-line Medical Terminology Resources

3. Terminology Collection: TERM-ONLINE


This site is maintained by Anita Nuopponen in the Department of

Communication Studies at the University of Vaasa, Finland. In addition to a
search table of terminology resources spanning over 40 domains, the site
features a Terminology Forum with information on current research and
researchers, terminology organizations and programs by country, terminology
service providers, terminology events, and a terminology LISTSERV.6 Each
domain contains links to on-line consumable terminology collections elsewhere
on the WWW, acting as a clearinghouse for most of the major term resources
that can be found.

Links to medical resources are abundant, with additional links under the
domains of pharmacology and biology. The following list of medical
information links from TERM-ONLINE describes the scope of resources
generally available in this domain and offers a perspective on the utility of this
kind of site.7 This list includes some resources reviewed in more detail in this
article (indicated by *):
• English, Dutch, French, German, Italian, Spanish, Portuguese and Danish:
Multilingual Glossary of technical and popular medical terms in nine European
Languages (http://allserv.rug.ac.be/-rvdstich/eugloss/welcome.html)*
• English: Medical Dictionary (www.medicinenet.com/MAINMENU/Glossary/
• English: Glossary of health communication terms (http://www.emerson.edu/
• English: Kaiser Permanenten Medical Glossary (http://www.scl.ncal.
• English: Glossary of Oncology Terms (http://www.cheshire-med.com/
• English: Glossary of Medical Specialties (http://www.mmchs.org/
• English: Glossary of Medical. Statistical and Clinical Research Terminology
• English: GMHC Treatment Issues AIDS Medical Glossary
• English: Managed Care Glossary (http://www.bcm.tmc.edu/ama-mss/
• English: Medical Glossary Related to Alzheimer's Disease (http://
• English - French: Diagnostic et évaluation de l'autisme (http://w.refer.fr/
• Finnish - Swedish: Finsk-svensk ordlista over halsotermer (http://
• Finnish - Swedish: Finsk-svensk ordlista over halsotermer 2 (http://
• Spanish - French: La législation de l'interruption volontaire de grossesse
• English (interface): On-line Medical Reference System: Bibliography of
Printed Medical Dictionaries (http://www.kumc.edu/service/dykes/refassist/
• English-French-Spanish: WHO Terminology Information System
(WHOTERM) (http://www.who.ch/programmes/pll/ter/ter index.html)*
• German, English (interface): Internet Medical Terminology Resources -
Medizinische Terminologie Ressourcen im Internet by Josef Ingenerf
154  On-line Medical Terminology Resources

4. Managed Care Glossary

http://www. bcm. tmc.edu/ama-mss/glossary. html

An example of a Web-served term resource with a narrow scope yet very

useful information is the Managed Care Glossary. In English only, this site
offers immediate consultation of English health-care administration terminology
with complete definitions. Records were compiled from various sources and are
maintained by the Texas Medical Association.

5. Dr. Schueler's Health Informatics online Dictionary


An example of a well-organized, highly effective delivery format for medical

terminology, this site offers a definition-based English-language medical
glossary. Designed and maintained by Dr. Schueler's Health Informatics
(DSHI), specialists in computer-based medical informatics tools for physicians
and patients, the glossary is clearly designed for ease of use with a focus on
high-quality content. The glossary features cross-linked definitions in a multiple-
frame window, allowing for the display of two definitions simultaneously.
Many links to other Internet-accessible medical information sites are given.

© 1996, Dr. Schueler's Health Informatics, Inc. All rights reserved.


6. HealthGate
http://www. healthgate. com/HealthGate/home. html

HealthGate provides access to a vast amount of medical information with a

very navigable and well organized interface. MEDLINE and other NATIONAL
consulted at no charge but with the presence of advertising links. HealthGate
also offers fee-based, advertisement-free access through its MedGate service to
these and other databases, including EMBASE* (biomedical journal service),
and PsycINFO (an index of over 1,300 journals and reports on psychology and
relatedfieldscovering 25 languages).

Reprinted with permission. Copyright 1997, HealthGate Data Corp.

Links to other information resources are also available, namely MedWeb

Electronic Publications (http://www.gen.emory.edu/MEDWEB/keyword/
electronic_publications.html), sponsored by the Emory University Health
Sciences Center Library, with over 8,000 links to electronically-available
medical information resources around the world.
156  On-line Medical Terminology Resources

http://www. ipoline. com/~guoli/home/index. htm

A private effort on the part of author Guo Li, MD, Ph.D., INFOMEDICAL
features a Dictionary of Online Medical Resources (English only), a Dictionary
of Information for Patients and Support Groups (English), and an English-
Chinese Dictionary of Medical Terms. The Dictionary of Information for
Patients is topic-based and alphabetically organized, with a collection of links to
related sites. The Dictionary of Online Medical Resources is also organized
alphabetically and includes definitions and links to pertinent contextual or related
terminological information elsewhere on the Internet. The EnglishoChinese
dictionary is bi-directional and indexed alphabetically in English and pinyin
(phonetic) Chinese, offering headword translations based on the author's
research. Here records are displayed in Simplified Chinese and supplemented by
pinyin equivalents.

8. Merck Publications

The Merck Manual can be consulted on-line at this site, by direct keyword
search or by linking to a particular section, with the same extensive coverage of
diseases, disorders, symptoms and procedures found in the print edition.
Additionally, companies offering fee-based access to the Merck Index are listed.
The Merck Index is an encyclopedia of chemical substances, compounds, drugs
and various products.
A Japanese edition of the Merck Manual can also be consulted online
at http://www.msd-japan.com/!!sqMbH3013sqMbH3013/msdj6.htm. No other
translated editions were available on-line at the time this overview was written.

9. Multilingual Glossary of technical and popular medical terms in nine

European Languages

This site is the culmination of a project commissioned by the European

Community, directed by the Heymans Institute of Pharmacology of the
University of Gent, and managed by the Department of Applied Linguistics at
Mercator College. The goal of the project was to produce a seed databases of
multilingual medical terminology for WWW distribution, focusing on
terminology from and for product packaging inserts in German, English,
French, Spanish, Italian, Portuguese, Danish, Dutch and Greek. The only
language of the nine that cannot be consulted on-line is Greek, records for which
can be retrieved via ftp.8 Records can be browsed by language or concept and
are organized in paired lists of popular and scientific terms. A quick search
window allows for rapid keyword searches (in any of the eight on-line
languages) of the 1,830 records in the database, which can be viewed in
dictionary format with descriptions, or in glossary format with translator notes
and comments. The collection can also be consulted by concept and language,
with all language entries for the 1,830 concepts represented on a single page.
Delivery formats are linked, allowing users to toggle between them.

10. PharmlnfoNet
http.V/pharminfo. com/pin_help. html

PharmlnfoNet offers access to English-language databases of records on

generic substances and commercial preparations. Two indices (DrugDB and
DiseaseDB) facilitate browsing through the site and elsewhere on the Internet for
information on specific drugs and diseases.
158  On-line Medical Terminology Resources

The site also offers links to publications and other on-line drug information
sources oriented toward patients and medical professionals, and all suitable for
parallel text and subject research activities.

11. RxList - The Internet Drug Index

http://www. rxlist. com/

Another resource for English-language pharmaceutical information, this site

was compiled and maintained by Neil Sandow, Pharm.D., and allows for
"fuzzy" (pattern matched) searches by brand, keyword, generic substance, drug
category and imprint codes of some 4,000 drugs, either on the US market or
near approval. Over 300 monographs on generic substances can be searched
simultaneously by keyword or string. A link is also provided
(http://www.Mosby.COM/Mosby/PhyGenRX/) to Physicians GenRx: Mosby's
Complete Drug Reference 1997 one of the definitive drug reference resources,
available by subscription via the WWW, on CD-ROM, on diskette and in print.

12. BioTech Life Science Dictionary

http://biotech. chem. indiana. edu/pages/dictionary. html

BioTech is the result of a Title Π-D grant project at Indiana University, the
aim of which is to provide a "...hybrid biology/chemistry educational resource
and research tool on the World Wide Web" (BioTech 1997). An English-
language resource containing over 6,200 records in the domains of chemistry,
biochemistry, biotechnology, medicine, pharmacology, botany, cellular biology,
genetics, ecology, and toxicology, the BioTech dictionary is consultable on-line
by keyword and definition search string.
Records contain definitions and author references (unless authored by
BioTech Resources), both of which are enhanced by embedded links to other
resources, related material or specific terms.
A number of subject-specific, full-text reference resources can also be
consulted at this site, and many links are provided to other sources of biomedical
literature collections on the Internet, such as the WWW Virtual Library:
Biosciences (http://golgi.harvard.edu/biopages.html), and the WWW Virtual
Library: Biotechnology (http://www.cato.com/interweb/cato/biotech/). The
former is maintained by Harvard and has a Spanish-language mirror site in
Ecuador. The latter is maintained by Cato Research, Ltd., and has a European
mirror site.

13. Medscape
http://www. medscape. com

A medical information warehouse, Medscape should be of interest to

translation and terminology professionals as one of the few sites offering WWW
access to the National Library of Medicine's MEDLINE, AIDSLINE and
TOXLINE databases at no charge. The NLM databases are considered to be the
"...largest biomedical resource library in the world" (Medscape 1997), with
abstracts from some 3,800 medical journals. Medscape also offers full-text
search and retrieval in its database of over 1,000 articles, all annotated with links
to related material elsewhere on the Internet and providing a good resource for
parallel texts and searches for terminology in context. While most articles
indexed are in English, some are available in other languages.
MEDLINE (also accessible via HealthGate, as described above) offers the
medical terminologist and translator abstracts of articles from a broad range of
medical journals, including non-English publications which can be ordered on-
line. Many articles deal specifically with terminology issues, some from the
medical informatics community, some from subject specialists and research
160  On-line Medical Terminology Resources

teams attempting to document problematic, new or changing terminology in a

given area. Currently, a general keyword searchfor"terminology" in MEDLINE
lists some 948 abstracts. The author was able to locate resources ranging from a
discussion of knee surgery terms in Polish to a 27-page trilingual epidemiology
glossary (López-Cervantes et al. 1994). Alternatively, with access to a medical
library of substantial serial holdings, users can avoid charges incurred by
ordering articles and can benefit from rapid access to the database from their
personal computers, yet without the constraints of having to consult the database
in a designated location.


Notwithstanding the sheer volume of data to sift through on the Internet,

medical terminology work benefits significantly from the wealth of on-line
resources currently available. Apart from the advantages of interactivity, regular
updates, dynamic linking, and scope, most resources are additionally "free,"
apart from Internet Service Provider (ISP) access fees.9 The apparent
disadvantages of Web-served resources include the required investment in time
to find and evaluate useful sites, the relative instability of these sites (servers that
are temporarily inoperational, pages that have moved, links that are not
updated), and the fact that even the most established sites have few on-line
consultable or downloadable resources.
Though the sites reviewed in this article represent a small percentage of
WWW resources currently available to medical terminologists and translators,
with a wide variety of content and authoring techniques, they provide a point of
departure for criticism, focused development and continuous improvement. The
number and content of WWW sites offering medical terminology is growing,
and more sites will no doubt refine and increase their contents as the subgroup
of information consumers that uses them becomes more sophisticated in its
browsing techniques and more demanding with respect to content.

1. Criticism of popular medical resources in translation rarely focuses on the accuracy of
this meaning-based transfer from language to language. See Granados and Garcia (1994) for a
highly useful critique of a translated medical dictionary.
2. Many classification systems in use and development offer multilingual records, which
are essentially concept-based vocabularies. Unfortunately, these resources are largely proprietary
and contain more information than professional translators require. However, the basis on
which they are prepared is close to the "ideal" model for terminological work, and they can be
considered highly reliable resources for translators. An example is the International
Classification of Diseases (ICD), the tenth revision of which should be available soon, and
various translations of which are used by health care systems worldwide.
3. "...WWW: an Internet service that provides access to documents with hypertext links,
giving users easy access to related documents anywhere on the Internet" (WRQ 1996: 45).

4. Many sites invite users to dispute term information presented and to submit
alternative linguistic representations for terms.
5. The European Commission Host Organization.
6. "An electronic mailing list...using LISTSERV software, whereby users post
messages by e-mail, and these messages are then distributed via e-mail to all list subscribers"
(Anonymous 1996: 332).
7. This is not to criticize the content of sites not offering multiple links to other
resources, merely to point out that rich link authoring enhances the content and usefulness of
sites (Bergeron and Bailin 1997).
8. "(File Transfer Protocol) The Internet standard high-level protocol for transferring files
from one machine to another over TCP/IP networks" (WRQ 1997: 16).
9. Generally, monthly ISP charges for unlimited access are far less than the one-time
costs for most reliable, conventional medical resources.

Anonymous. 1996. "Internet Glossary." Technical Communication 43(4):
Bergeron B.P., and Bailin, M.T. 1997. "The Contribution of Hypermedia Link
Authoring." Technical Communication 44(2): 121-28.
Blair, J. 1996. An Overview of Healthcare Information Standards. CPRI.
Felber, H. 1984. Terminology Manual Paris: UNESCO; INFOTERM.
Granados, J.T., Garcia, J.N. 1994. "A propόsito de la versiόn espanola del
diccionario de epidemiologia de J.M. Last." In Gaceta Sanitaria 8(41):
International Conference on Harmonization. 1996. MEDDRA Version 1.5:
Introductory Guide. London: MCA; ICH.
López-Cervantes, M. et al. 1994. "Diccionario de términos epidemiolόgicos." In
Salud publica de México 36(2).
Neubert, A. and Shreve, G. 1992. Translation as Text. Kent: KSUP.
Pastor, J. 1997. Personal communication. ECHO/INFO2000 Central Support
Roth well, D.J. et al. 1994. "Developing a Standard Data Structure For Medical
Language - The SNOMED Proposal." In Seventeenth Annual Symposium on
Computer Applications in Medical Care. New York: McGraw-Hill.
World Health Organization. 1997. "Health and related terminology activities in
WHO." In PLL ONLINE: WHO Technical Terminology Service. Geneva:
WRQ. 1996. Glossary of Networking Terms. Seattle: WRQ.

Verόnica Sáenz Albin is a medical translator in private practice in Houston,

Texas. An ATA member since 1984, she is accredited in English <> Spanish
and serves on the ATA Accreditation Committee as an English into Spanish
grader. She is a founding member and past President of the Houston Interpreters
and Translators Association. Since 1994, in cooperation with the University of
Texas Health Science Center, Hermann Hospital, M.D. Anderson Cancer
Center, and St. Luke's Episcopal Hospital, she has organized translation
seminars and taught interpreters and translators on staff at Texas Medical Center

Henry Fischbach, Founding Director of The Language Service, Inc. since 1950,
was co-founder of the American Translators Association in 1959 and later its
President, an Honorary Member, and a recipient of its Alexander Gode Medal.
He was formerly Vice President of FIT and currently serves as Co-chair of its
Technical and Scientific Translators Committee. He is a member of the American
Medical Writers Association and an ΑTA-accredited translator from German,
French, Spanish, and Portuguese. He has been a contract translator of medical
literature, from Dutch and Italian as well, for the past 50 years.

Maria Gonzalez Davies holds a Ph.D. in English from the University of

Barcelona. She is head of the Translation Department at the Faculty of
Translation and Interpretation, University of Vic (Barcelona, Spain). She has
also taught translation at the School of Modern Languages (EIM) and the
English Department at the University of Barcelona. She is a freelance translator
and translator of the SAL (Servei d'assessorament linguistic) at the University of
Barcelona. Her current research centers around the teachability of translation
strategies and translation in foreign-language acquisition.

Hannelore Lee-Jahnke holds a Ph.D. from the University of Montpellier,

France. She is Head of the German section of the translation department at the
University of Geneva where she has been teaching translation for the past 18
years. She is also Vice Chair of the FIT committee for training and qualification
of translation and coordinates the Paneuropean project POSI (practice-oriented
study contents). She is a member of the German Translators Association (BDÜ)
and President of the Swiss Translators Association (ASTI).

Clove Lynch has a Masters in Translation Studies and Spanish from Kent State
University, and is an ΑΤΑ-accredited translator. Having worked as an
Management Information Specialist for the U.S. Department of Housing and
Urban Development, an in-house terminologist for Family Health International,
and a contract translator, he currently manages multilingual localization projects
and glossaries. He has published articles and given presentations on medical
terminology management, and is a member of the Drug Information Association,
the American Translators Association, and the Society for Technical

Leon McMorrow, Ph.D., is an applied linguist, educated in Europe and the

U.S., who moved into medicine under a variety of titles: translator, medical
writer, medical records reviewer. As a linguist he has long maintained an interest
in the development of professional languages. Currently, he is a full-time
medical translator from Italian, French and German into English.

Maria J.F. O'Neill, MD, MPH is a Baltimore-based physician who translates

from French, Spanish and Italian into English. She lived in Bolivia for two
years as a medical missionary of the United Methodist Church, where her work
involved both primary care and public health. She was able to combine her
interest in languages with her medical vocation in her studies for the Master of
Public Health degree from Johns Hopkins University by focusing on medical
interpretation and its impact on health. She is also a graduate of the Georgetown
University translation program and is ΑΤΑ-accredited from French into English.

Barbara Reeves-Ellington began her translating career as a clinical research

associate in the pharmaceutical industry in Germany and France. She has been
an independent medical writer and translator and a research associate at the
Center for Research in Translation, Binghamton University, Binghamton, New
York. In addition to medical translation, she has a teaching interest in English as
a Second Language and a research interest in the translation of oral history

Sally Robertson received her B.A. in German from Carleton College in

Northfield, Minnesota. She has been a freelance German-to-English translator
since 1985, specializing in medicine and pharmacology, a member of ATA since
1980, and has served as secretary and newsletter editor for its National Capital
Area Chapter. She is a charter member and past president of The Translators and
Interpreters Guild.

Jack Segura is a veteran English o Spanish medical and technical translator. He

has also written original materials in both languages for medical specialists,

including a series of monographs for the American Association of Family

Practice. He was scientific and technical editor of the Spanish-language edition
of LIFE magazine. He has edited publications on anesthesiology, cardiology,
infectious diseases, and other subjects. He is an active ATA member, a full
member of the American Academy of the Spanish Language, and Chairman of
its Translation Commission, as well as corresponding member of the Spanish
Royal Academy.

Henri Van Hoof has been a medical translator, copywriter, lecturer and
organizer of medical congresses worldwide since 1954. He has published
several books, including the Précis pratique de traduction médicale anglais-
français (1986), Dictionnaire des éponymes médicaux français-anglais (1993),
and many articles on medical translation in Belgian, French, German and
Canadian journals. He was awarded the international FIT Prize for Non-Literary
Translation in 1996. He was a co-founder of the Belgian Translators Association
in 1954 and an early member of the FIT Council. In conjunction with the latter's
"General History of Translation" project, he published the first International
Bibliography of Translation (1972) and later the Histoire de la traduction en
Occident (1991) and Dictionnaire universel des traducteurs (1993).
ATA Corporate Members
(as of 3/1/1998)

A2Z Printing Center

A L Madrid & Associates
A & M Logos International, Inc.
ABLE International, Inc.
Academy of Languages Translation & Interpretation Services
Academy of Legal and Technical Translation, Ltd.
Academy Translations
Accent Typography & Translation
Accento, The Language Company
Access Language Experts
Accu Trans, Inc.
Accura International Translations
Accurapid Translation Services, Inc.
Accurate Spanish Translations by Spanish Business Services, Inc.
ACCURATE Translation, Inc.
Accuword International, Inc/dba inlingua International
ACE Translation Center
Acentos, Marketing & Advertising & Translations
Adams Translation Services
Adaptive Language Resources, Inc.
Advance Language Studios
AE Inc. - Translations
Agnew Tech-Π
AIM Translations, Inc.
Albanian Translation Services
Albors and Associates, Inc.
Alexandria Translations
Allen Translation Service
Allied Languages Cooperative
Ambassador Translating, Inc.
America Translating Services

Amway Corporation
AND ALEX International, Inc.
Antiquariat Literary Services, Inc.
Arabic Scientific Alliance
Argo Translation, Inc.
ASET International Services Corporation
Asian Translations, Inc.
ASIST Translation Services, Inc.
Astratec Traduçoes Técnicas Ltda
ATG Language Solutions
ATL Ultrasound
AT&T Language Line Services
Auerbach International, Inc. dba Translations Express
Avant Page
Babel, Inc.
Babel Translation Services
Baker & McKenzie
Banta Information Services Group
BCBR - Business Communications Brazil
Benemann Translation Center - BTC
Berkeley Scientific Translation Service, Inc.
Berlitz Interpretation Services
Berlitz Translation Services
Bilingual Services
Bowne Translation Services
BRADSON Corporation
Bureau of Translation Services, Inc.
Burg Translation Bureau
C. P. Language Institute
CACI Language Center
Calvin International Communications, Inc.
Cambridge Translation Resources
Canadian Union of Professional & Technical Employees
Carioni & Associates, Inc.
Carolina Polyglot, Inc.
Caterpillar, Inc.
Center for Professional Advancement/The Language Center
Chicago Multi-Lingua Graphics, Inc.
Cial Lingua Service International
Ciba Corning Diagnostics Corporation
CinciLingua, Inc.
Cm-Translation Center, Inc.
Cogtec Corporation

Columbia Language Services

ComNet International
Contact International
Continental Communications Agency
Copper Translation Service
CopyGroup, Inc.
Corporate Language Services, Inc.
Corporate Translations
Corporate Translations, Inc.
Corporate Translation Services, Inc.
Cosmopolitan Translation Bureau
Coto Interpreting, Translating & Graphics
Course Crafters, Inc.
Crestec (UK) Ltd.
Crimson Language Services
Crossword Translation Services
Cybertec, Inc.
CyraCom International, Inc.
Czech Translation Services
Delta Translation International
Die Presse Editorial, Ltd.
Digital Publishing, Inc.
Diplomatic Language Services, Inc.
Direct Language Communications
Diversified Language Institute
Documents International, Inc.
Dynamic Language Center, Ltd.
East-West Concepts, Inc.
Echo International
Edimax, S.A. de C.V.
Elite Language Productions
Eriksen Translations Inc.
Escalante Translations
Euro - Translation
Excel Translations, Inc.
Executive Linguist Agency, Inc.
Expert Language Services
First Translation Services
FLS, Inc.
Foreign Ink Ltd.

Foreign Language Center

Galaxy Systems, Inc.
GARJAK International, Inc.
Geonexus Communications
Geotext Translations
GeoText Translations & Typesetting Services
Global Advanced Translation Services Inc.
The Global Institute of Languages and Culture, Inc.
Global Language Services, Inc.
Global Language Solutions/The Russian Word, Inc.
Global Languages & Cultures, Inc.
Global Translation Services, Inc.
Global Translations & Interpreters Services, Inc.
The Global Word, Inc.
GlobalDoc, Inc.
Globalink, Inc.
Glorbet Consultants, Inc.
Harvard Translations
Health Outcomes Group
Heitmann of America, Inc.
HG Translations
Hightech Passport Limited
Honda R&D North America, Inc.
HSN Linguistic Services Ltd.
i. b. d., Ltd.
IBS-International Business Services
ICN Language Services
IDEM Translation
in FRENCH only inc/in SPANISH too!
Information Builders, Inc.
Inlingua International Services
Inlingua Language & Intercultural Services
Inlingua Language Services Center
Institut fur Fremdsprachen und Auslandskunde
Intel Corporation
Interclub, Inc.
Interlanguage SNC Di Abbati Α. Ε C.
InterNation Inc.
International Communication by Design, Inc.
International Communications, Inc.
International Contact, Inc.
International Effectiveness Centers

International Language Engineering Corporation

International Language Services, Inc.
International Translation and Publishing, Ltd.
International Translators International & Typesetters, Inc.
International Access/Ability Corp.
Interpreters International & Translations
Interpreters Unlimited
Interpreting Services International Inc.
InterSol, Inc.
Interspeak Translations, Inc.
Intertech Translations, Ltd.
InterTrans, Inc.
IRU International Resources Unlimited
Iverson Language Associates, Inc.
J.D. Edwards & Company, Inc.
Jackson Graphics, Inc.
Japan - America Management, Ltd.
Japanese Language Services, Inc.
JKW International, Inc.
JLS Language Corporation
John Benjamins Publishing Company
Josef Silny & Associates, Inc.
JTG, Inc.
Κ & L Language Services
Korean Technical Communications
Langua Translations, Inc.
Language Company Translations, L.C.
The Language Connection
The Language Exchange, Inc.
Language Innovations, LLC
Language Intelligence, Ltd.
Language Interface, Ltd.
The Language Lab
Language Link Corporation
Language Management International (The Corporate World, Inc.)
Language Matters
The Language Network, Inc.
Language Plus
The Language Service, Inc.
Language Services Associates
The Language Solution, Inc.

Languages International
The Languageworks, Inc.
Latin American Translators Network, Inc.
Legal Interpreting Services, Inc.
Liaison Language Center
Liaison Multilingual Services
Lingo Systems
Lingua Communications Translation Services
LINGUAE Translation & Interpretation Bureau
Lingualink Incorporated
LinguaNet, Inc.
Linguistic Consulting Enterprises, Inc
Linguistic Systems, Inc.
Localization Associates of Utah
Logos Corporation
LRA Interpreters, Inc.
Lucent Technologies-ILT Solutions
M2 Limited
Magnus International Trade Services Corp.
Master Translating Services, Inc.
MasterWord Services, Inc.
Gene Mayer Associates
McDonald's Corporation
Ralph McElroy Translation Company
McNeil Technologies, Inc.
ME Sharpe, Inc., Publisher
Mercury Marine
Metropolitan Interpreters & Translators Worldwide, Inc.
Mitaka Limited
Morales Dimmick Translation Service Inc.
Morgan Guaranty Trust Company
Multilingual Translations, Inc.
N.O.W. Translations
NCS Enterprises, Inc.
New England Translations
Newtype, Inc.
NIS International Services
Ntext Translations
Occidental Oil & Gas Corporation
Okada & Sellin Translations, LLC
Omega International
OmniLingua, Inc.

Oriental Communication Services, Inc.

O'Sullivan Menu Corporation
Pacific Interpreters, Inc.
Pacific Ring Services, Inc.
Paragon Language Services
Peritus Precision Translations, Inc.
Peters Translation, Inc.
Planning S.N.C.
Polyglot International
Precision Translating Services, Inc.
Premier Translation Services, Ltd.
Prisma International
Professional Translating Services
ProTrans, Inc.
PSC, Inc.
Quantum, Inc.
Quark, Inc.
Quintana Multi-Lingual Services, Inc.
R.R. Donnelley Financial Translation Services
Rapport International
Rennert Bilingual Translations
Resource Network International, Inc.
Richard Schneider Enterprises, Inc.
Routledge, Inc.
Sally Low & Associates
Schreiber Translations, Inc.
SH3, Inc.
Shoreline Translations, Inc.
Showorks, Inc.
Simulacrum LLC/Context
SinoMetrics International, Inc.
Slovak Translation Services
Sohsei, Inc.
Spectrum Multilanguage Communications
Sputnik Translation Services
Square D Company
Suzuki, Myers & Associates, Ltd.
Sykes Enterprises, Incorporated
Tech Link, Inc.
Techlingua, Inc.
Technik-Sprachendienst Gmbh

Techno-Graphics & Translations, Inc.

TechTrans International, Inc.
Techworld Language Services, Inc.
Terra Pacific Writing Corporation
TEXTnology CORPoration
TnCO-Translating Interpreting International Company
Total Benefit Communications, Inc.
Trade Typographers, Inc.
Trados Corporation
Traducciones LinguaCorp
Trans-Caribe Communications
Transcript Communications, Inc.
Transemantics, Inc.
Transglobal Translations & Immigration Services, Inc.
Translation Company of America, Inc.
Translation Services International Inc.
Translingua, Inc.
TransLingual, Ltd.
Transperfect Translations International, Inc.
Universal Translations, Inc.
Universe Interpreters and Translators Corporation
University Language Center, Inc.
U.S. Technical Translations, Inc.
U.S. Translation Company
Vanguard Academy
Victory Productions, Inc.
Vormbrock Translating, Inc.
West-Star Consultants
Whitman Language Services
Winter Wyman Contract Services, Inc.
WKI International Communications
World Trade Center Portland
Worldwide Translations
YAR Communications, Inc.
ATA Institutional Members

(as of 3/1/1998)

Academy Interpreting and Translations International

American Education Research Corp.
American Institute of Physics
AN-NAHDA Educational Office
Binghamton University (SUNY)
Boston School of Modern Languages, Inc.
California State University
Center for Applied Linguistics
Christian Science Publishing Society
The Church of Jesus Christ of the Latter-day Saints
Community Interpreter Services Catholic Charities/Greater Boston
Community Management Staff
Eureka - Foreign College Evaluators & Translators
Executive Office for Immigration Review
Florida A&M University
The French Library & Cultural Center
Gallaudet University
Georgetown University
Georgia State University
Instituto Superior de Interpretes y Traductores, S. C.
Inter-American Development Bank (IDB)
Inter-American Air Forces Academy
International Refugee Center of Oregon-International Language Bank
International Institute of Connecticut, Inc.
International Institute, Inc.
Kent State University
Language Interpreter Services and Translations/WA State Department of Social
and Health Services
The Language School
M. D. Anderson Cancer Center
Marygrove College

Mayo Medical Center

Monterey Institute of International Studies
New York University
Northern Illinois University
Ordre des Traducteurs et Interprètes Agréés du Québec
Purdue University
Quba Institute of Arabic and Islamic Studies
Queen of the Valley Hospital
Rose-Hulman Institute of Technology
San Diego City Schools
School District of Palm Beach County International Student
Support/Multicultural Awareness Department
Southwest Washington Medical Center
Summer Institute of Linguistics
Thammasat University
Translation & Critical Languages Institute of Florida A & M Univ.
Tucson Unified School District Title I Program/School-Community Relations
University of Hawaii
University of Idaho
University of Miami
University of Nebraska at Kearney
University of La Verne
The University of Texas Medical Branch at Galveston
University of Washington
Western Michigan University
Western Wisconsin Technical College
World Bank
American Translators Association
Officers and Board of Directors, 1997
Muriel M. Jérôme-O'Keeffe, President Ann G. Macfarlane, President-Elect
Eric Norman McMillan, Secretary Monique-Paule Tubb, Treasurer

Allan W. Adams, Gertrud Graubart Champe, Jo Anne Engelbert, Marian S.

Greenfield, Alan K. Melby, L. Manouche Ragsdale, Courtney Searls-Ridge,
Izumi Suzuki, Thomas L. West

Recipients of the Alexander Gode Medal

1964 Alexander Gode

1965 Kurt Gingold
1966 Richard and Clara Winston
1967 The National Translations Center (University of Texas)
1968 Pierre-François Caillé
1969 Henry Fischbach
1970 Carl V. Bertsche
1971 Lewis Bertrand
1972 Lewis Galantière
1973 Jean-Paul Vinay
1974 Eliot F. Beach
1975 Frederick Ungar
1977 Eugene A. Nida
1978 Royal L. Tensley, Jr.
1980 Gregory Rabassa
1981 Georgetown University
Monterey Institute of International Studies
State University of New York at Binghamton
1983 Françoise Cestac
1984 Charles M. Stern
1985 Ludmilla Callaham
Richard Ernst
1986 William I. Bertsche
1987 Patricia E. Newman

1988 Marilyn Gaddis Rose

1990 Ben Teague
1992 Deanna L. Hammond
1993 Karl Kummer
1996 Javier Collazo
William Gladstone
1997 Danica Seleskovitch
ATA Past Presidents

1995-97 Peter W. Krawutschke

1993-95 Edith F. Losa
1991-93 Leslie Willson
1989-91 Deanna L. Hammond
1987-89 Karl Kummer
1985-87 Patricia E. Newman
1983-85 Virginia Eva Berry
1981-83 Ben Teague
1979-81 Thomas R. Bauman
1977-79 Josephine Thornton
1975-77 Royal L. Tinsley
1973-75 William I. Bertsche
1971-73 Thomas Wilds
1970-71 William I. Bertsche
(completed Moynihan's term)
1969-70 Daniel Moynihan
(resigned in June 1970)
1967-69 Boris Anzlowar
1965-67 Henry Fischbach
1963-65 Kurt Gingold
1960-63 Alexander Gode
Subject Index  181

Subject Index

abbreviations 2, 4, 24, 49, 58, 59, Baghdad House of Wisdom 2, 35,

78, 91, 126, 137, 138, 139, 37
140, 141, 142, 145 Basler Rezepte 81
academic vocabulary 94, 96 biochemistry 22, 25, 40, 44, 69,
acceptability 6, 14, 93, 96, 98, 99, 158
100, 108, 110, 120, 136 bioengineering 25
acronyms 2, 21, 22, 24, 78, 86, BIOETHICSLINE 155
87, 126 Biological Abstracts 131, 137
adjectival use of nouns 60 biology 3, 21,26, 44, 69
advice for newcomers 84, 87, 94, biomedical papers 6, 75, 108, 109,
107, 113, 119, 120, 141, 110, 155, 158, 159
142 Biosciences Information Service
AIDSDRUGS 155 (Biosis) 131, 132, 137,
AIDSLINE 155, 159 140, 141, 143
AIDSTRIALS 155 BioTech 158
Alta Vista 78 blanket purchase agreements
ambiguities 4, 56, 119, 141 (BPAs) 135
American Academy of the Spanish Bologna 2, 15
Language 3, 46, 165 Bonzes 29
American Medical Association Buddhism 29, 30
(ΑΜΑ) 25, 27, 63, 114, bullets 120, 121, 123
115 Byzantine Empire 15
American Translators Association camera-ready copy 135
(ATA) 114, 132, 142, 163, CANCERLIT 155
164, 165 Canon 38
Anglo-Saxon English 17, 18, 19 Capital Translator (CT) 142
anthrax 136 carpal tunnel syndrome 143
Arabic 2, 15, 16, 20, 25, 26, 35, Castilian Spanish 3, 37, 38, 39
37, 38, 39, 43 CD-ROM 79, 94, 120, 145, 149,
Asilomar Working Group 109, 110, 158
114 Chinese medicine 3, 13, 29, 30, 31,
ATA Chronicle 80, 142 32, 33, 34, 35, 156
ATA Scholarly Monograph Series class discussion 45, 46, 88, 95, 97
1, 8, 101, 102, 128 client contact 6, 7, 14, 76, 79, 100,
Azuchi-Momomaya period 31 106, 107, 110, 119, 127,
background knowledge 4, 5, 6, 37, 129, 132
39, 43, 62, 69, 70, 71, 72, clinical trial reports 7, 25, 88, 108,
73, 74, 75, 76, 82, 84, 85, 109, 114, 115, 133
88, 89, 93, 94, 95, 117, cognitive knowledge 86, 95, 102
124, 131, 140, 142
182  Subject Index

collaboration 6, 33, 38, 40, 47, 93, Dutch influence in Japan 3, 29, 31,
94, 101, 136, 142 32, 33, 34, 36
common mistakes 41, 70, 80, 87, ECHO 8, 151, 161
99, 105, 141 editing 3, 6, 7, 43, 46, 72, 73, 75,
communicator 1, 20,47 76, 78, 79, 80, 109, 111,
compound adjectives 55, 60 119, 129
CompuServe 79 Edo Academy of European medicine
computer-aided translation 47, 150 33,34
computers 13, 46, 47, 74, 79, 120, Edo period 31
121, 123, 135, 137, 149, electronic information exchange 77,
154, 160, 161 79, 148, 155, 161
concordance 79, 99 EMBASE 155
contractors 131, 134, 135, 141, Encyclopedias 25, 27, 30, 47, 64,
142 79, 94, 95, 128, 138, 139,
cooperative advantage 6, 106, 107, 157
108, 110, 112, 114 endnotes 119, 121, 123
corpora 79 endocrinology 3, 39
course on medical translation 6, 44, English-French doublets 4, 17, 50,
46, 72, 86, 94, 95, 100 51, 52, 53, 54
cultural accessibility 1, 3, 7, 82, eponyms 2, 4, 5, 8, 21, 22, 23, 24,
107, 108, 114, 118, 126 49, 57, 58, 84, 87
cultural mediator 6, 107 ethics in medicine 39, 88, 105, 107,
databases 5, 8, 46, 77, 78, 86, 105, 136
109, 147, 149, 150, 151, EURODICAUTOM 8, 151
155, 157, 159, 160 European influence 3, 29, 30, 31,
descriptive terms 4, 49, 56, 60, 125 32, 33, 34, 35, 36, 114,
dictation 34, 78, 135 157
dictionaries 3, 7, 14, 19, 20, 21, Eurospin Group 89
22, 24, 25, 26, 27, 32, 33, everyday English 49, 60, 61, 70,
35, 40, 41, 42, 43, 46, 62, 117
64, 65, 79, 86, 90, 91, 94, exchange of medical data 147, 148,
131, 137, 138, 139, 141, 160
142, 144, 145, 146, 153, experimental research 45, 89, 90,
154, 156, 157, 158, 160 93, 100
Dogpile 138 faking it 76
dominance model 13, 14 false friends 3, 42, 46, 84
downloadable resources 8, 134, field specialist 6, 21, 39, 75, 76,
149, 150, 160 86, 87, 88, 93, 94, 95, 96,
Dr. Schueler's Health Informatics 97, 98, 99, 100, 101, 102,
(DSHI) 154 150, 154, 159
drug package inserts 6, 25, 45, 46, FLEF0 79
71, 108, 110, 157 font 120
drug warnings 25 footnotes 2, 119, 121, 123
Subject Index  183

foreign literature 3, 7, 33, 38, 40, in-house translations 112, 117,

76, 131, 133, 134, 137, 134, 142
141, 143 inconsistency of resources 110, 148
formatting 96, 97, 98, 100, 109, inconsistent use of terminology 74,
119,137 110, 119
freelance translators 124, 134 Index 21, 131, 137, 140, 141, 155,
genetic engineering 89, 133, 145, 156, 158, 159
German medical texts 3, 83, 84, 87, instructional texts 7, 117, 118, 119,
110 120, 126, 127, 128, 129
get it in writing 107, 113, 114 intentionality 108, 110
Glosas 3, 46 Interagency Language Roundtable
glossaries 7, 8, 25, 30, 86, 87, 89, 142
95, 124, 139, 140, 146, intercultural communication 15,
147, 149, 150, 153, 154, 113, 148
157, 160, 161 interface 151, 153, 155
Golden Age 40 International Classification of
Greco-Latin terms 4, 14, 17, 19, Diseases (ICD) 160
20, 21, 24, 25, 49 International Code of Nomenclature
Greek 2, 4, 14, 15, 16, 18, 19, 20, of Bacteria 21
21, 22, 23, 24, 25, 26, 27, Internet 4, 5, 8, 41, 42, 47, 71, 72,
35, 37, 38, 43, 49, 50, 51, 77, 78, 85, 133, 138, 140,
52, 53, 54, 63, 82, 83, 85, 141, 148, 149, 150, 153,
96, 157 154, 156, 157, 158, 159,
Greek civilization 13, 15 160, 161
Greek physicians 15 Internet searches 8, 77, 78, 79,
HealthGate 8, 155, 159 105, 133, 148, 149, 151,
HealthSTAR 155 152, 157, 158, 159, 160
Hebrew 2, 15, 26, 37, 38, 39, 43 Internet Service Provider (ISP) 160,
Heian period 30 161
hospital-patient communications 6, Internet-based resources 72, 77, 78,
7,46, 108, 118 94, 147, 149, 151, 154,
human resources 94 155, 156, 158, 160
humoral theory of disease 2, 15, 18 internships 89
hyperlink 149 interpreters 3, 14, 31, 32, 34, 71,
hyphenation 120, 121 101, 114, 124, 125, 163
I*m Europe 151 inverted terms 42, 127
idiosyncratic phrases 4, 70, 84 Japanese Congress of Medicine,
immunology 25, 89 2nd 34
implicit knowledge 70 Japanese medicine 3, 29, 35
IMRAD scheme 84, 87, 90, 109 Japanese school of surgery 31
in-house quality control 75,79, 132 Japanese-Latin nomenclature 35
184  Subject Index

journals 8, 25, 36, 43, 46, 73, 77, lists 87, 110, 120, 121, 123, 125,
78, 79, 80, 89, 90, 95, 102, 157
108, 109, 110, 111, 114, listserv 71, 79, 80, 152, 161
115, 128, 133, 134, 137, literacy 7, 117, 118, 119, 120, 121,
141, 144, 148, 155, 159 128
justification 120,121 Literacy Volunteers of America
Kalila wa-Dimna 38, 39 (LVA)118
Kamakura period 30 literal translations 19, 26, 100, 111,
KWIC (key-word-in-context) 8,77, 113
78, 79, 150, 151, 157, 158, loan words 19, 22, 23
160 love of language 5,41, 80
language components 49, 85 Managed Care Glossary 153, 154
language of medicine 1, 2, 4, 14, masking 125
15, 16, 17, 19, 21, 26, 27, mass media 42, 94, 95, 149
43, 49, 58, 60, 63, 69, 70, Materia Medica 29, 30, 31, 32, 33
85, 123, 147, 161 medical information 8, 71, 73, 89,
languages of special purposes 147, 148, 149, 150, 153,
(LSPs) 5, 46, 83, 84, 90, 154, 155, 159
128 medical literature 2, 3, 6, 7, 29, 30,
Lantra-L 71, 74, 77, 78, 79, 80 32, 33, 38, 46, 54, 62, 70,
Latin 2, 3, 4, 14, 15, 16, 17, 18, 88, 133, 143
19, 20, 21, 22, 23, 24, 25, medical professionals 1, 4, 5, 25,
26, 27, 35, 37, 38, 39, 43, 41, 69, 70, 71, 72, 74, 75,
49, 50, 51, 52, 53, 54, 63, 76,77,80, 117, 158
81, 83, 85, 96, 134, 139, medical terminology 1, 2, 4, 5, 8,
144 14, 16, 18, 19, 20, 21, 24,
latinized English 19 27, 35, 43, 46, 49, 54, 56,
lay terms 7, 22,71, 88, 117, 119, 58, 60, 61, 62, 63, 70, 72,
124 83, 84, 85, 86, 87, 88, 94,
leading-edge technologies 7, 133 95, 96, 97, 98, 101, 109,
learned terms 4,49, 60 119, 122, 124, 138, 140,
legibility 118, 119, 120, 122, 127 144, 147, 148, 149, 150,
levels of language 82, 94 153, 154, 156, 157, 159,
lexicography 4,22, 23 160, 161
Life Sciences 44, 158 medical translation 1, 2, 3, 4, 5, 6,
linguistics 2, 4, 5, 13, 14, 19, 20, 7, 8, 9, 35, 41, 43, 44, 45,
47, 62, 69, 71, 72, 73, 75, 46, 62, 69, 71, 72, 74, 75,
87, 88, 96, 98, 100, 107, 76, 77, 79, 80, 81, 85, 86,
114, 118, 122, 124, 137, 89, 90, 93, 94, 95, 108,
141, 147, 157, 161 127, 131, 147, 148
links 8, 134, 149, 150, 152, 153, medical writing style 2, 4, 13, 14,
154, 155, 156, 157, 158, 16, 18, 19, 25, 26, 41, 44,
159, 160, 161
Subject Index  185

8 1 , 8 3 , 8 6 , 8 7 , 8 8 , 9 5 , 117, Nomina Anatomica 21, 26, 35

119, 127, 143, 144 Norman English 17, 19
medically knowledgeable linguists Norman French 19
1, 4, 5, 69, 71, 72, 74, 75, nuclear magnetic resonance (NMR)
76, 80, 140 87,89
Medieval Europe 2, 13, 16, 26, 27, numbering 120, 121, 123
47 obsolete terms 19, 22, 57, 138, 139
medieval physician 85 ophthalmology 3, 39, 40, 50
MEDLINE 5, 8, 72, 77, 78, 80, Osaka Dutch School of Medicine 34
109, 133, 155, 159, 160 Padua 2, 15
Medscape 8, 159 parallel Greek and Latin derivatives
MedWeb Electronic Publications 20,21,49,50,51,56
155 parallel texts 5, 43, 83, 94, 100,
Meiji period 3, 35 101, 158, 159
Merck Index 157 patient Bill of Rights 118
Merck Manual 76, 86, 145, 146, pedagogical expectations 6, 94, 96,
157 99, 100, 101
Metacrawler 78 Permuterm subject 137
microbiology 22, 158 PharmlnfoNet 157
Middle English 18, 19 physician translators 2, 4, 31, 39,
molecular biology 25,44 69, 70, 71, 73, 74, 75, 76,
Montpellier 2, 15, 16, 163 82
Moorish invasion 37, 38 physician-patient communications
multilingual medical resources 79, 16,46,70, 105, 118, 125
147, 148, 153, 157, 160 Physicians GenRx: Mosby's
Muromachi period 30 Complete Drug Reference
Nagasaki Office for Translation of 158
Foreign Books 32 pinyin 156
Nagasaki school of medicine 33 Plain English 123
Nara period 29 Plain Language Campaign 123
National Cancer Institute 136 PLL ONLINE 150, 161
National Institutes of Health (NIH) Portuguese influence in Japan 3,
1, 7, 131, 132, 133, 134, 29, 30, 31
135, 136, 137, 141, 143 postgraduate training for translators
National Library of Medicine 82,89
(NLM) 8, 80, 136, 137, predominance of English 40, 73,
141, 155, 159 74, 75, 78, 83, 87, 124,
naturalist method 2, 15 154, 156, 159
neuroanatomy 3, 39 prefixes 4, 16, 20, 43, 49, 52, 53,
neurology 23, 50, 75, 76, 133, 144 85
new terms 22, 25, 40, 42, 46, 140 prepositions 46
New York University 44, 176
newcomers 141
186  Subject Index

professional expectations 1, 6, 7, Shôwa period 35

93, 94, 99, 100, 102, 106, sight translations 7, 124, 135
108, 109, 110, 114 simplification 117, 118, 119, 121,
professional vocabulary 94, 96 122, 124, 125, 126, 127
PsycINFO 155 Simplified English 124, 125
Publishing, Language and Library simplifying the work process 107,
Services (PLL) 150 119
push-pull factors 13, 14, 20 situationality 108, 110
readability 5, 7, 118, 119, 122, skopos theory 5, 82, 108, 115
123, 127, 128 socioculturally determined
reading skills 118, 119, 120, 121, information 5, 82, 108,
128, 129 126, 127
receiver-specific approach 5, 82 software resources 47, 79, 94, 135,
redundancies 88 161
reflective teaching 95 source language (SL) 5, 8, 42, 43,
register 1, 4, 5, 7, 70, 71, 72, 76, 78, 83, 84, 95, 100, 111,
79, 107, 111, 142 117, 118, 119, 121, 147,
reliability of information 8, 78, 148, 151
160, 161 source text (ST) 7, 77, 82, 83, 84,
research reports 8, 84, 86, 87, 88, 87, 89, 96, 97, 106, 107,
134, 152 108, 109, 110, 112, 113
research skills 6, 43, 71, 76, 77, Spanglish 40, 42, 127
79, 87, 94, 95, 100, 147, Spanish Academy 3, 41, 43, 46
148, 150, 156, 158 Spanish-speaking physicians 39,
Roman Empire 2, 13, 15, 17, 20, 40, 124
37 specialized terminology 5, 35, 43,
Romance 3, 37, 38, 39, 43, 132, 61, 94, 99, 100
138, 145 spelling changes 4, 19, 22, 49, 50,
root words 4, 16, 26, 49, 50, 51, 51
52, 53, 54, 85 standard English 19, 22, 23, 24,
rough translations 111 26, 41, 60, 124
RxList 158 standards 6, 79, 89, 100, 106, 108,
Salerno 2, 15, 16 161
scanners 43, 44, 135 stems 50, 54
Science Citation Index 137 student assessment 6, 93, 94, 95,
scientific English 4, 26, 60, 117 96, 98, 99, 100
scientific French 4, 60, 61 subject-matter knowledge 5, 7, 26,
scientific reports 5, 84, 94, 109, 40, 43, 44, 46, 76, 77, 82,
124, 155 83, 84, 85, 86, 88, 89, 119,
search engines 47, 78, 138, 149 142, 148, 159
selective translation 19 suffixes 4, 16, 20, 43, 49, 53, 54,
sentence length 122 55, 60, 84, 85
share of the market 81
Subject Index  187

surgery 2, 3, 26, 31, 32, 34, 39, translation bureaus 4, 5, 71, 74, 75,
40,44,76, 114, 160 79, 112, 131, 132, 134,
synonyms 21, 49, 50, 51, 55, 56, 143
57, 58, 59, 60 translation for information only
Syriac 15, 35 110,111
Taishô period 35 translation for publication 4, 6, 73,
target language (TL) 3, 5, 8, 41, 89,93, 105, 109, 110, 111
43, 72, 76, 87, 95, 117, translation process 1, 4, 6, 35, 49,
118, 121, 125, 127, 147, 62, 75, 76, 79, 88, 94, 95,
151 105, 108
target text 82, 83, 87, 89, 108, 113, translation request form 134
115 translation situation 6, 106, 107,
teaching methods 5, 6, 44, 84, 89, 108, 110, 111, 112, 113,
94, 95, 101, 102, 128 114
teamwork 5, 20, 30, 72, 74, 75, translation specifications 6, 106,
76, 79, 80, 89, 106, 132, 110, 113, 114
133 translation strategy 6, 94, 95, 101,
technical terminology 5, 7, 8, 26, 106, 108, 113, 114
43, 46, 57, 61, 109, 117, translationese 77, 143
119, 124, 125, 150, 153, translator's diary 140
157, 161 translator-client relationship 1, 6,
technical writing skills 4, 5, 6, 73, 79,93, 107, 109, 112, 113,
94, 100, 127, 129 119
term length 122 transliteration 16, 26, 50, 53
term sequence 121, 123, 126, 127 typeface 120
TERM-ONLINE 152, 153 typography 118, 120, 127
text genres 6, 83, 108, 110 typos in the original 77, 78, 139
text length 83,90 Ukrainian characters 136, 137
text types 82, 88, 89 university medical libraries 77, 85,
textbooks 5, 25, 30, 33, 38, 43, 149, 155
76, 83, 86, 90, 91, 102 University of Innsbruck 79
textual-contextual approach 108 University of Paris 2, 15, 26
The Translators and Interpreters URL 8, 150
Guild 135, 164 usage 7, 8, 42, 43, 46, 77, 79, 83,
Tokugawa period 31 109, 112, 137, 142, 143,
Toledo School of Translators 2, 3, 147
15, 16, 35, 38 vernacular speakers 17, 18, 19, 20,
TOXLINE 159 25, 26, 36, 47
Training models 1, 4, 5, 49, 69, virtual library 77, 150, 158
73, 75, 83, 84, 85, 86, 88, Webpage 8, 134
89, 101 WHOTERM 150, 153
workshops 89
188  Subject Index

World Health Organization (WHO)

8, 89, 150, 153, 161
World Wide Web (WWW) 8, 47,
78, 79, 148, 149, 150, 151,
152, 157, 158, 159, 160
Author Index

Abenzoar 38 Blair 161

Aberroes 38 Boada 101
Ackerknecht 14, 15, 16, 26 Boerhaave 33
Agard 25, 26 Bonvalot 63
Agnew 64 Boyd 144
Albertus Magnus 38 Brackman Keane 64
Albin 146, 163 Braier 146
Alexander the Great 15 Brockhaus 139, 144
Alfonso the Wise 38, 39, 43, 47, Brown 64, 101
48 Bunjes 138, 144
Alfred the Great 38 Bussi 145
Allan 63 Butterworth 64
Alley 128 Caberlotto 75
Almeida 30 Cahn 73, 76
Alzheimer 133 Callaham 139, 144, 177
Aoyagi 35 Carpovich 139, 144
Archbishop Raimundus 38 Casal 3, 39
Archimedes 37 Cassany 122, 124, 128
Ardouin 36 Castro viej o 40
Aristotle 37, 38 Cattaneo 74
Arnemann 33 Celsus 16
Asclepaides 2 de Cervantes 40
Ashikaga 30 Chakalov 139, 144
Aston 36 Charcot 24
Auerswald 84 Charpentier 34
Avicenna 2, 38 Chaumuzeau 64
Bailin 150, 161 Chavez 40
Balliu 101 Che-Tchen 31,32
Barnes 105, 106, 114 Cheselden 34
Baroja 39, 47 Chevalier 63
Barraquer 3, 40 Chiampo 145
Bartholin 32 Childers 80
Batten 32 Chinzan 32
de Beaugrande 108, 114 Choei 33
Bender 14, 16, 25, 26, 27 Chôshun 33
Bergeron 150, 161 Christensen 63
Bernthal 63 Chuan 31
Bischoff 33 Chupyatova 139, 144
Black 64 Cicero 88
Blacque-Bélair 64 Cognazzo 145
190  Author Index

Cohen 47 Favaloro 40
Colton 36 Felber 148, 161
Condoyannis 144 Feneis 91
Constantinus Africanus 16 Ferreira 31
Corn 139, 144 Field 63
Craddock 47 Finlay 40
Crawford 122, 128 Fischbach 8, 9, 75, 81, 90, 126,
Crombie 14, 16, 20, 25, 27 129, 163, 177, 179
Crump 7, 131, 143, 144 Fishbein 143, 144
Crystal 118, 125, 128 Fontaine 64
Cunningham 64 Foster 139, 144
Danckers 32 Frenay 25, 27
Danner 31 Friedbichler 79
Davis 27, 63 Fujii 36
Delamare 64 Fujikawa 36
Delgado 73 Gadamer 113, 114
Delisle 86, 88, 90 Galen 2, 15, 16
Dennerll 27 Gallardo 101
DePorte 132, 143 Ganong 83, 84, 86, 91
Derizhanov 136 García 101, 128, 160, 161
Dirckx 14, 16, 17, 21, 25, 26, 27, García Yebra 37,47,48
63 Garnier 64
Doak 1l8, 119, 120, 125, 128 Garrido Juan 146
Dôkai 34 Garrison 14, 27
Dollerup 101, 102 Gemboku 33
Dorca 101 Gempaku 32
Dorland 20, 22, 23, 27, 64, 141, Genetsu 34
144 Genjô 32
Dôsan 30 Genkyô 33
Dôshun 32 Gennai 33
Dressier 108, 114 Genshin 33
Dunglison-Stedman 23 Genshô 32
Durieux 83, 90 Gentaku 32
Edmonson 63 Gentetsu 32
Ehrlich 25, 27, 133 Genzui 33
Eiho 34 Gerard of Cremona 16
Eliseenkov 139, 144 Getz 16, 18, 26, 27
emperor Hirohito 35 Gilbertus Anglicus 18, 19, 27
emperor Kimmei 29 Gile 94, 101
emperor Mutsu Hito 35 Gladstone 43, 64, 145, 178
emperor ôjin 29 Góngora 40
Euclid 37 Gonsai 34
Falbe 144 Goodman 36
Author Index  191

Göpferich 82, 90 Keele 27

Gordon 63 Kelly 101
de Goiter 33 Ki-sien 31
Grabb 146 Kichibei 31
Granados 160, 161 Kim Mu 29
Grant 75 Kiraly 101
Gross 138, 144 Kleiweg de Zwaan 36
de Gruyter 91 Kôan 34
Hageman 34 Koch 133
Halma 33 Kôgyû 32
Hamblock 138, 144 Kohaku 32
Hamburger 64 Kokimei 34
Hammond 106, 114, 178, 179 Konyô 32
Harrap 145 Kowalowa 145
Harrison 63, 86, 91 Kravchuk 136
Hartley 120, 127, 129 Kulmus 32, 33
Harvey 26 Kytzler 47
Hatim 108, 114 Lafferty 77
Haywood 101 Laguna 3, 39
Heister 33, 90 Lama 132, 134, 138, 143
Hemingway 39 Lambert 145
Hervey 101 Lang 139, 144
Higgins 101 Lapesa 47, 48
Hippocrates 2, 15, 18, 37, 81 Larsson 78
Hirosada 30 Lasègue 105, 115
Hiroyô 30 Lea 25, 27
Hobson 34 Lee-Jahnke 81,90, 163
Hoffmann 31, 32 Lépine 64
Hoshû 32 Levy 36
Houssay 3, 40 Liotta 40
Huard 36 Loddegaard 101, 102
Hufeland 34 López-Cervantes 160, 161
Hunter 70, 80 Luther 38, 88
Inglis 80 MacLean 63
Jaeger 63 MacNalty 64
Jammal 86, 90 Macura 139, 144
Ju-an 31 Mahoney 25, 27
Jun-an 32 Maier 94, 101, 107,114
Junzo 34 Maimonides 38
Kamakura 30 Manao 30
Kan-Jin 29 Mansion 145
Karkalas 143 Manuila 64, 145
Katz 31 Marañón 3, 39
192  Author Index

Marshall 114 Nord 90, 108, 114

Martí-Ibáñez 2, 9 Noro 32
Mason 108, 114 O'Neill 75, 164
Massardier-Kenney 94, 101 Ochoa 40
Mathews 124, 129 Ogata 34
Matsutoshi 35 Ohya 36
Mayoral 101 Ortega y Gasset 48
McCulloch 25, 27 Ozin 30
McCullogh 63 Paddock 63
McDowell 101 Pagano 89, 90
McElroy 146 Palm 31
Meiji 35 Palmer 114
Menéndez Pelayo 47 Paré 32
Menéndez Pidal 37,47 Parr 64
Mestruans 32 Pastor 151, 161
Meyers 144 Patterson 138, 144
Michelfelder 114 Patwell 20
Miller 64 Peacock 64
Minetsugu 30 Percy 34
Mohnike 34 Pernkopf 136
Moisan 65 Peterson 25
Morgagni 24 Petrelli 145
Morris 114 Petrov 139, 144
Mosig 36 Petrovskii 144
Mounin 88 Plato 37
Munjack 101 Pliny the Elder 16, 25
Nagamura 32 Pompe van Meerdervoort 34, 36
Nagaoka 36 Poynter 27
Nakagawa 32 prince Wakairatsuko 29
Naohisa 33 Procter 48
Narabayashi 31,32 Ptolemy 39
Navarro 105, 106, 114 Quevedo 40
Neubert 108, 114, 161 Ramón y Cajal 3, 39, 40
Newman 144, 177, 179 Ransui 33
Newmark 94, 97, 102 Reeves-Ellington 106, 114, 164
Newton 37 Regitz 144
Nicole 145 Reiss 82, 90
Niedereke 47 Remmelin 32
Nieuwenhuis 33 Retzke 32
Nishi 31,32 Rhazes 2
No-Shitago 30 Richerand 33
Nobel 65 Riley 64
Nöhring 138, 144 Rinsô 33
Author Index  193

Roberts 63 Spiller 63
Robinson 76 Spilman 63
Römpp 138, 144 Spinoza 37, 38
Röntgen 105, 111 Spranger 90, 91
Rothwell 147, 161 St. Isidore of Seville 37
Rottauscher 36 St. Jerome 38, 88
Rubens 119, 124, 127, 129 St. Thomas Aquinas 38
Rutkow 105, 114 Stedman 64, 146
Ryan 118, 129 Stenn 14, 27
Ryôi 32 Stoerck 33
Ryôjun 34 Strand 63
Ryôtaku 32 Stypura 145
Ryûen 33 Sugita 32
Sanpaku 33 Taber 64
Santoyo 48 Taizô 35
Schamberger 31 Tarutz 121, 129
Schefe 88, 91 Ten Rhyne 31
Schertel 90, 91 Thorn 14, 25, 26, 27
Schmidt 63, 114 Thomas 70, 73, 74, 75
Schramm 36 Thomson 64
Scribonius Largus 16 Thunberg 32
Seiken 33 Tissot 33
Servet 39 Titsingh 34
Serveto 3 Tokugawa 35
Shakespeare 40 Tokuhon 30
Shibata 36 Tomotoshi 30
Shingû 34 Torres 146
Shipp 139, 145 Toury 108, 115
Shôzen 30 Toussaint 36
Shreve 108, 114, 147, 161 Tovar 48
Sibata 36 Ulfilas 37
Sirnões 73 van de Water 34
Skinner 25, 27, 63 van Deth 105, 115
Sliosberg 8 Van Hoof 49, 81, 87, 88, 90, 91,
Smith 25, 27, 63 165
Snell-Hornby 101, 102, 108, 114 van Houte 33
Sofer 48 van Swieten 33
Soken 34 Vandereyeken 105, 115
Song 30, 36 de Vega 40, 48
Sôrin 30 Veilion 65
Sournia 63 Vermeer 82, 90, 108, 115
Sozui 30 Virchow 133
Spaulding 122, 128 von Plenck 34
194  Author Index

von Recklinghausen 133, 144

von Ronsenstein 33
von Siebold 33, 34
Vossler 48
Wallace 74
Wallnöfer 36
Walther 139, 145
Walton 64
Wani 29
Wataru 35
Watt 48
Webster 139
Wessels 138, 144
Westphal 133, 144
Wetlesen 105, 106, 115
Wiener 40
Wong 36
Wright 8, 101, 102, 128
Yasuyori 30
Yernault 102
Ylönen 87,91
Yokoyama 35
Yoshio 31,32, 35
Yoshioka 35
Yoshitaka 35
Young 64
Ypey 33
Yukinaga 30
Yurin 30
Zensetsu 35
Zequeira 39