Withdrawing Epilepsy
Originally published July 25, 2022.
How to Choose the Context-Specific Meaning of a Character
How do you choose between different meanings of a single character when you are working on a particular passage and the answer is not immediately obvious? This is a common problem that anybody who is trying to read classical literature has to confront on a regular basis. The importance of this challenge to find the correct meaning in a specific context is obvious, especially when we are dealing with clinical literature like indications for formulas or medicinals. In today’s post, I shall use the Shénnóng běncǎojīng 《神農本草經》 (“Divine Farmer’s Classic of Materia Medica”) to introduce you to my world of navigating this challenge and arriving at what I consider the best decisions at any given moment.
Over the past few years of teaching classical Chinese, I have realized that the ability to look up characters in dictionaries is a skill that is acquired gradually over a number of years. In fact, it is a common misunderstanding made by people without proper training to think that you can just look up a character in a Chinese-English dictionary and use whatever English word you happen to find as a direct equivalent of the Chinese. The easiest example for this, which most of you are probably familiar with, is the erroneous equation of Qì with “energy” or “vital breath” or any other English term. Qì is Qì, and there is simply no concept in the Indo-European tradition that is a direct equivalent of it, as much as people would like that. So no matter what term we choose, it may be helpful initially as a bridge but ultimately mislead the reader.
The more your skills as a reader of classical Chinese grow, the more you will become aware that it is a rare fortune indeed when you find a direct overlap between the classical Chinese term and the modern English meaning. Much more often, you are stuck with a long and sometimes confusing list of possible English candidates, which can appear to have little in common with each other and none of whom feel quite right.
In the context of medical literature, Nigel Wiseman has done a gigantic service to the profession of Chinese medicine internationally by compiling the Practical Dictionary of Chinese Medicine, which was published in 1998 and has remained unsurpassed to this day. Given how much the field has evolved since then, that fact speaks for itself. The database of technical terms in this dictionary is a wonderful starting point and baseline for any Chinese-English translator, even if you might quibble over individual term choices like “vacuity” and “repletion.” At some point, however, you realize that even the best dictionary has limitations and that it is unfortunately still true that the vast majority of Chinese characters have no direct and perfect single equivalents in English. For this reason, I have shifted my own strategy of publishing my books from doing literal translations with short or long lists of footnotes (depending on the intended readership) to tackling shorter texts or projects but adding “discussions” after most passages to explain the meaning beyond the literal translation. In addition, I have actually moved much of my energy to the project of teaching students how to do their own translations since I have become clearer and clearer over the decades that no single translation could do justice to the more philosophical classical texts of our tradition like the Yellow Emperor’s Inner Classic.
But returning to my original aim with this short article, let me demonstrate the process by which I have chosen different English definitions for a single character even within a single text, in today’s post on the Shénnóng běncǎo jīng:
Depending on context, the character diān 癲 can have two different meanings in classical Chinese medical literature:
Most commonly, and in several places in the Shénnóng běncǎojīng, especially when it is found as part of the compound diānxián 癲癇, it clearly refers to “epilepsy.” Examples of this usage range from the preface to the entries on fángkuí 防葵 (Peucedanum japonicum), shéchuángzǐ 蛇床子 (Cnidium monnieri), etc. In my published edition, I have intentionally marked technical terms like “epilepsy” in capitals to indicate their specialized meaning in a Chinese medicine context, and created a glossary with detailed explanations for such terms. Here I should also note that some entries, like the ones for mùlán 木蘭 (Magnolia liliflora), qiāndān 鉛丹 (minium), or the “hair, hooves, and nails of the six domestic animals,” use the term 癲 diān in the meaning of “Epilepsy” either by listing it as a single character or in the compound 癲疾 diānjí. In these instances, the meaning is clear based on context, such as the fact that the preceding or following signs are types of seizures like 驚癇 jīngxián “fright seizures” or 痙 jìng “tetany.”
In a slightly different, but related, context, however, we find a slightly different meaning: Usually as part of the compounds diānkuāng 癲狂 or fēngdiān 瘋癲, the character refers to a particular type of mental disorder that is associated with Yīn, as opposed to 狂 kuāng, which is the specific term for a Yáng type of mania. To reflect this meaning, Nigel Wiseman translates 癲 diān in such contexts as “withdrawal” and explains it as “a disease characterized by taciturnity / soliloquy, and feeble-mindedness and attributed to binding depression of phlegm and Qì or to dual vacuity of heart and spleen” in his Practical Dictionary (entry on the term in the Pleco version online). Cháo Yuánfāng offers an explanation of these two types of mental disorder in Vol. 37 (on gynecological conditions) of the Zhūbìng yuánhòulùn 《諸病源候論》in an entry that sheds important additional light on the classical Chinese meaning of diān as “withdrawal”: He explains that diān-type insanity results when wind evil enters the Yīn aspect, while kuáng-type insanity is the result of wind in the Yáng aspect. In the same essay, Cháo describes the symptoms of diān as sudden loss of consciousness, drooling, deviated mouth, and loss of sensation in the hands and feet, while kuáng manifests with perverse, crazy speech, whether expressed as exaggerated self-praise or yelling or cursing, and failure to distinguish between relatives and strangers. As Cháo further explains in Volume 2 (on wind), both conditions are caused by emptiness of Qì and blood, which then allow wind evil to enter the Yīn or the Yáng channels respectively.
While the difference between “mania” and “withdrawal” on the one hand, and between “withdrawal” and “epilepsy” on the other, appears pretty straightforward in English, the line between them is not as clear-cut as the English terms would lead you to believe. To the uninitiated English reader, the connection or even potential equivalence between “withdrawal” and “epilepsy” doesn’t make a whole lot of sense initially, does it? This is where it becomes so empowering and enlightening, in my humble opinion at least, if not downright fun, to be able to look at the Chinese source text and realize that--ha!-- they actually refer to the same Chinese character! Might that affect the way you think of these conditions or employ a substance like lónggǔ 龍骨 (“dragon bones”)?
龍骨 lónggǔ (fossil bones, “dragon bones”)
味甘，平，无毒。
治心腹鬼疰，精物老魅，欬逆，泄利膿血，女子漏下，癥瘕堅结，小兒熱氣驚癇。
龍齿，平。治小兒、大人驚癇，癫疾，狂走，心下結氣，不能喘息，諸痙，殺精物。
久服輕身，通神明，延年。
生川谷及巖水岸土穴中死龍處。
flavor: sweet, balanced, non-toxic
Treats demonic infixation in the heart and abdomen, spectral entities and old evil sprites, counterflow cough, diarrhea with pus and blood, women’s vaginal spotting, concretions and conglomerations, hardenings and binds, and heat qì and fright seizures in small children.
Dragon teeth: balanced. Indicated for fright seizures in small children and adults, withdrawal disease, manic running, bound Qì below the heart, inability to pant and breathe, and all sorts of tetany, and for killing spectral entities.
Consumed over a long time, it lightens the body, facilitates the breakthrough of spirit illumination, and extends the years.
Grows in river valleys and in places where dragons have died inside earthen caves in cliffs and coastal and river embankments.
As a third alternative, some later editions of the Divine Farmer’s Classic and therefore also some commentators suggest that we can read 癲 as a textual error for lài 癩, meaning “leprosy.” I personally reject this last option and tend to interpret it in most cases first as more closely associated with “epilepsy” for three reasons:
1. The etymology of the character includes the concept of jolting or toppling (diān 顛);
2. Some early editions actually have the character 顛 instead of 癲, including in passages where it clearly refers to epilepsy;
3. Third, the compound 癲疾 diānjí is clearly defined as referring to epileptic fits in such important early classics as the Língshū 《靈樞》 (see chapter 22). Similarly, the above-mentioned definition by Cháo Yuánfāng suggests that this Yīn-type of mental disorder was associated with epileptic fits and wind in the seventh century.
Nevertheless, the direct terminological connection between “epilepsy” and a Yīn type of mental disorder embodied by the Chinese character 癲 diān should give the clinicians among my readers a good reason to pause and perhaps expand your diagnostic and therapeutic repertoire? I look forward to any comments you may have on this, especially if you specialize in either of those conditions in your clinical practice.
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