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Submitted by Robert Felt on February 22, 2007 - 12:31pm.
Part One: Where the Infringement Hides
I was anxious to move on to analyzing the arguments in favor of term chaos because I think they are all almost transparently weak. Yet, the more I thought about the idea that standards are an infringement the more I thought that this idea had to be further addressed. I kept coming back to the thought that of all the things anyone could have concentrated upon - openness, accuracy, database development and other field-enhancing investments to name a few- the idea most prominent in their minds was that term standards would be an infringement upon scholars in the field. What then could their idea of a term standard be other than a list of words that everyone must use? And, isn't a list of words that everyone "must use" the current reality?
I recognize that I'm playing "catch-up" and the Term Chaos team has raced well head with this inaccurate characterization. So, let's set the record straight:
I would like to show you that in the real world, standardization does not mean a single set of rules imposed by a single authority. The actual practice is quite different. In many cases standardization is the existence of multiple implementations that are carefully interfaced with each other. It does not limit personal preferences. In fact, an "Open Standard" gives individuals a maximum freedom of choice. The only people limited by an Open Standard are those who would impose a standard for their own benefit. Like the rule of law, standards avoid capricious and arbitrary controls. A term standard is not a list of words you must use but a method for linking your words to those of others. 
Let's write an open standard that, if promulgated by a field authority, would appreciably and positively enhance the development of the field.
Just where is that field authority? Is it in the schools? It is to some extent because the schools fund and compose the leadership of all our field authorities. It is a minority of faculty who speak Chinese, and a minority of that minority who have any training in linguistics, translation theory or have published any contribution to this field of knowledge. In fact, the scholars with the training and experience to judge linguistic issues are generally outside the schools. Practically, it is the exam authorities where the real power lays. People go to school to get a license to practice. The schools must prepare them to pass those exams. Teachers must effect that preparation. Thus, it is at the exams where a standard will have an effect.
Imagine that the various testing authorities were to agree to the following standard:
Before we will use any English language source (text or otherwise) for questions included in the construction of our examination, there must be convenient and public access to the Chinese characters for the concepts tested by that question. Following is a Chinese - English list of concepts we may test on our examination; it will be updated as we choose.
Now, we could modify this in a number of ways. For example, immediate exercise of such a standard would have significant economic consequences. The "exam texts" now used almost never provide "convenient and public access to the Chinese characters." So, we could add, for example, a three year grace period before exam materials that fail the standard requirement would be dropped. This would give writers and teachers time to revise what text and curriculum they decide to revise. Such a standard would accomplish benefits for the field without imposing anything on anyone, except of course the requirement that Chinese medical concepts have a known source in Chinese medicine. That is not so much an infringement as a quality control.
If writers believe that "dream emission" or "swill diarrhea" are useless folklore, they may continue to speak of "spermatorrhea" or just plain "diarrhea" without the differentiation. No exam authority would be required to test those concepts. If writers believe that all the various sub-categories of supplementation can be forgotten in favor of using "tonification" for all, they may do so. If writers think that "vacuity" is a horrible word they are not obliged to use it. If you want to use a random number generator to select your terms, nothing stops you. Thus, while there is no imposition involved, there are strong positives that would derive from such a standard.
First, the concepts tested by license exams are generally known so publishing a Chinese-English list of testable concepts will not change any student's need to prepare. Concepts may be questioned in several different ways, and the trend toward case-based examination will be enhanced because exam writers will be able to include concepts that belong with a case, even when an exam text has simplified that concept out of existence. What such an open standard will do is manifold and positive:
1. It will take all the exam authorities out of the business of endorsing one commercial text over others as an exam source.
2. It will reduce the incentive to steal exam questions; in particular, it will destroy the market for exam-prep books based on collecting remembered exam questions.
3. It will reduce the extent of misinformation distributed in student-prepared test preparation tools that treat as equivalent same English terms that reflect different Chinese ideas (and visa-versa).
4. It provides a foundation for the development of public databases.
5. By eliminating the imposition of "exam texts" on teachers, it will open the market for new writers, new curriculum, and a broader more representative view of what it is important for clinicians to know.
A very significant benefit, as the title of this piece suggests, is that it will end the onerous, on-going infringement that scholars in the field have long endured. In particular, the imposition of simplified descriptions of Chinese medical knowledge, the imposition of select writers' views and terms on all teachers via the artificial "standardization" of those views as English language Chinese medicine.
I believe I have spoken to more writers and teachers, reviewed more project descriptions, and read more manuscripts than anyone in our field. In projects that had a potential educational impact, the imposition of the decisions of exam text writers has always played a role. It forces attempts to reverse engineer the exam text language, which are doomed to inaccuracy without comprehensive published lists, or imposes conceptual limits based on estimates of what fits with curriculum. I can say, without fear of contradiction, that standardizing the field on commercial texts, unpublished terms sets, paraphrases and simplified views has discouraged investment and limited the availability of knowledge.
A clear example of how changing the closed standard of the status quo for an open standard would benefit the field is the removal of a major impediment the development of reliable databases for the field. Is everyone familiar with "GIGO?" GIGO, "garbage in - garbage out," refers to the fact that if the basis for an automated outcome is false, that outcome will be false. In regard to the much-desired data basing of Chinese medical information, so long as there is no reliable relationship between the set of Chinese concepts and their representations in English, any attempt to present Chinese medicine in database form will contain significant and numerous errors. That relationship can be one-to-one, one-to-may, many-to-one, or many-to-many, but it must exist and that cannot be accomplished so long as these relationships are hidden by the absence of a term standard.
In sum then, the real imposition on scholars, teachers, students and clinicians is not an open standard, but the closed standard that exists by default in the current system.The previous entry in this series is, The Yin and Yang of Academic Freedom.
 Please note, for reader convenience footnotes in this series are consecutively numbered and composed of links. http://www.aaom.info/2006_conf_nomenclature_binder.pdf page 77
 Take a look at the comparison between "Foundations" and "Fundamentals" and ask how you could test for knowledge of pathomechanisms or treatment principles, much less a realistic case, using "Foundations," See: the linked paper for the chart on page 6. Keep in mind that "Fundamentals" is an exact translation of a Chinese language beginners' text.
 For example, look at the chart at the end of "The Tyranny of Familiar Words " and ask yourself how to database the Manual of Acupuncture indication without throwing away the Chinese language based indications. This chart is in fact a database, a trivial one, but a database nonetheless. Go down the first and second columns, when databased every entry for "shan disorter" in the Manual of Acupuncture would lose the indications in the last three columns. Again, keep in mind that this is not a comparison between what one writer or another say, it is a comparison of the information in a commonly-used teaching manual and its Chinese language counterparts.