In 2004 to 2005, France saw one of the most major incidents of medical mistranslation in history. A hospital in the eastern commune of Épinal accidentally provided massive overdoses of radiation to patients with prostate cancer, resulting in several deaths and dozens of affected patients. The cause, according to an article by Afaf Steiert and Matthias Steiert, was a “dose defining software used for cancer therapy,” which ran only on English without a French user guide. “The hospital’s administration relied on bilingual staff members who used the software,” writes the Steierts, leading to mistranslations that ultimately ended in great tragedy.
This is but one of many instances of mistranslations in the medical field. Unlike other modes of translation—legal, patent, science—medical translation is more closely connected to the livelihoods of people. Sure, other forms of specialized translation are also prone to mistranslations that result in tragedies. Mistranslated legal texts could massively hinder legal proceedings and possibly and wrongfully convict an innocent person; mistranslated technical documents could possibly harm a worker by providing wrong instructions for a piece of heavy equipment; mistranslated commerce documents could possibly result in large monetary losses for an enterprise. Medical translation, however, almost always affects human lives at some level, sometimes to fatal degrees as can be seen in the preceding example.
Today’s blog deals with the nuances, history, and difficulties of medical translation. We hope that the contents of this blog serve to enlighten you in the perils and importance of medical translations and provide a deeper understanding of the important role it has in our lives.
History of medical translation
Like all forms of interlingual exchanges, medical translation has been a part of humankind for as long as it can be documented. In the textbook Medical Translation Step by Step, authors Vicent Montalt Resurrecció and Maria González Davies traces the origin of medical translation to Ancient Mesopotamia, where “medical, chemical mathematical, and astrological knowledge was gathered, organized and stored in cuneiform symbols written on clay tablets, some of which contained information in different languages such as Ugaritic, Akkadian, Sumerian, hittite, and Hurrian.” Later, in the 5th century BCE, comes Hippocrates, known for his role in drafting the Corpus Hippocraticum and founding the tenets of ancient medical practices. Montalt Resucció and González Davies charts the history of medical translation thereafter, to the Greek city of Pergamon (an “important center of scholarship” between Arabic, Greek, and Latin medical scholars), the School of Toledo (featuring “collaboration between Islamic, Christian, and Jewish scholars” leading to translations in Romance Castilian and other European languages), the Middle Ages, and the Renaissance (when Latin established itself as the lingua franca of medical knowledge).
This is only in the Western hemisphere; other civilizations elsewhere—such as Asia, Africa, the Americas, etc.—have developed and continued their own histories of medical practices, charted and codified in numerous documents spanning centuries and millennia.
Fields of medicine
One of the reasons why medical translation is so difficult is the sheer variance and range of specialities and studies involved in medicine. “Medical translation involves the communication of knowledge generated and needed in various specialties,” writes the authors. Following are some examples of medical specialties that compound the field of medical writing:
- Internal medicine
- Obstetrics and gynecology
The authors also note that medicine doesn’t exist in isolation; often enough, medical texts overlap with other areas of knowledge and expertise, such as “anthropology, psychology, sociology, economics and law,” for example. The interconnected nature of medicine makes it all the more difficult for translators to equip themselves with all the knowledge necessary to translate a particular medical text, as the required knowledge doesn’t just stop at a certain medical field, or even the field of medicine.
Perhaps the most difficult of all factors involved in medical translation is the complex, historical, and confounding nomenclature and terminology utilized by medicine. In the English language, medicine derives largely from both Greek and Latin terminology. Furthermore, medical language—like other specialized forms of translation—utilize grammatical processes such as nominalization and distillation to create non-colloquial sentence and word structures, which further add to the difficulty of medical translation.
Languages that share these Greek and Latin roots are often prone to miscommunication when being translated among themselves. For example, French, Spanish, and English have striking similarities in their medical terminology, as can be seen in the following example provided by the authors:
However, English isn’t Latinate at its root; due to its complex Germanic and Norman linguistic history, English has a “double-layered medical vocabulary,” having two words for a single concept where other languages would only have one. Take the following for example:
The authors also note examples in which concepts that only have one term in English may have more than one terms in other languages:
Often, two synonymous terms for a single concept differ in registers; the Latinate term is considered to be of a “high register,” whereas the Germanic/Norman term is “low register.” This might not be the case, however, in other languages, leading to confusion:
|Birth defect||Malformation congénitale||Malformación congénita|
|One-egg twins||Jumeaux univitellins||Gemelos univitelinos|
|Growth of germs||Prolifération microbienne||Proliferación microbiana|
|Sweat canal||Canal sudorifère||Canal sudoríparo|
|Caked breast||Engorgement mammaire||Obstrucción mamaria|
|Taste buds||Papilles gustatives||Papilas gustativas|
Then, of course, there are cases in which similar-sounding terms with similar origins may refer to completely different concepts across languages, such as “schizophrenia, chronic bronchitis, and peptic ulcer, [which] have different meanings in German, French and English.” Another example is the English “amygdala,” which “does not coincide semantically with the Spanish ‘amígdala’.” In some cases, certain languages might not even differentiate certain anatomical features; “French and German have no terms for knuckle, and Russian has no distinction between hand and arm.”
Another difficulty in medical terminology is the overlapping usage of Greek and Latin roots in nomenclature. The authors provide the following example of “etymologically synonymous morphemes” that are present in the English language:
|vein||phléps phlebós (phleb-, phlebo-)||vena (ven-, vene-)|
|blood vessel||aggeion (angi-, angio-)||vas (vas-, vasculo-)|
|breast||mastós (mast-, masto-)||mamma (mammo-)|
|mouth||stoma stómatos (stom-, stoma-, stomat-)||os (or-, oro-)|
|face||prosópon (prosop-, prosopo-)||facies (facio-)|
|eye||ophthalmós (ophthalm-, ophthalmo-)||oculus (oculo-)|
|nose||rhís rhinós (rhin-)||nasus (nas-)|
|ear||oûs otós (ot-, oto-)||auris (auri-)|
|tongue||glóssa (gloss-, glossa-)||lingua (linguo-)|
|spine||rháchis (rachi-, rachio-)||spina (spin-, spino)|
|white||leukós (leuk-, leuko-)||albus (alb-, albi-)|
|milk||gála gálaktos (gal-)||lac lactis (lac-)|
|sugar||glykys (gluc-, gluco-)||sácharon (sacc-)|
In some cases, there are numerous names associated with a single affliction, such as “Basedow’s disease, Flajani’s disease, Graves’ disease, Parry’s disases, all of which refer to exophtalmic goiter.” Sometimes, languages might employ names based on people where others do not; the English terms atrophic arthritis, chronic infectious arthritis, proliferative arthritis, and rheumatoid arthritis are referred to as maladie de Heine-Médin, paralysie spinale infantile, and polyomyélite anterieure aigüe in French.
Other times, intralinguistic differences pose problems for translators. For example, the chemical term “phosphoglyceride” is now referred to as “glycerophospholipid” in modern times; some texts will feature both terms, which confuse not only readers but translators as well. Speaking of chemical terminology in medicine, different cultures and regions use different names to describe the same chemical or pharmaceutical object. An example of this is “the international non-proprietary name for Nolotil®, one of the most common analgesics in Spain” which is metamizole. In the Anglophone world, metamizole is called “dipyrone”; in India, China, or Russia, it is called “analgin”; France calls it “noramidopyrine”; and Hungary and post-Yugoslav nations might call it “noraminophenazone.”
Not all is difficult, however. Due to the prevalence of the English language and its influence in the medical sector, there exists loanwords and calques, accepted by non-English languages. Examples include: stress, bypass, feedback, shock, test, borderline, etc.
All these factors, among many not mentioned, present difficulties for translators seeking to accurately translate from their source language to their target language of choice. Modern developments in medical translation and translation technology have made it easier for translators to carry out more accurate, proper translations in hopes of decreasing the amount of mishaps and miscommunications that might possibly prove fatal to patients.
However, translators still must undergo rigorous education and studies to make sure that their techniques and knowledge are sound; medicine develops with each passing day, and medical translators must keep up to date with changes in the field.
González Davies, M. & Montalt, V. (2015). Medical translation step by step: Learning by drafting. Routledge.
Steiert, A., & Steiert, M. (2011). Medical translation basics. MultiLingual, (July/August), 27–28.