







































 Humanities and Social Science Research; Vol. 8, No. 5; 2025 

ISSN 2576-3024   E-ISSN 2576-3032 

https://doi.org/10.30560/hssr.v8n5p96 

 96 Published by IDEAS SPREAD 

 

Research on the English Translation of Traditional Chinese Medicine 

Idioms and Allusions from the Perspective of Cross-cultural 

Communication 

Huang Yan1 

1 Faculty of Chinese Medicine Science Guangxi University of Chinese Medicine, China 

Correspondence: Huang Yan, Faculty of Chinese Medicine Science Guangxi University of Chinese Medicine, 

Nanning, GuangXi, China. 

 

Received: October 4, 2025; Accepted: October 15, 2025; Published: October 16, 2025 

 

Abstract 

This research, based on cross-cultural communication, explores and studies the English translation of idioms and 

allusions in traditional Chinese medicine. These idioms and allusions in traditional Chinese medicine have 

profound cultural connotations. Due to the international language and cultural gap, their English translation faces 

many difficulties. This article meticulously sorts out the cultural connotations of traditional Chinese medicine 

idioms and allusions as well as the translation difficulties they encounter during the translation process. It also 

proposes numerous different translation strategies, such as literal translation with annotations, free translation with 

image substitution, and transliteration with supplementary explanations, hoping to achieve the goal of cross-

cultural dissemination and understanding of traditional Chinese medicine through appropriate translation strategies. 

Keywords: Idioms and allusions in traditional Chinese medicine, English translation, Cross-cultural 

communication, Translation strategy 

1. Introduction 

Idioms and allusions are precious components of traditional Chinese medicine culture and an important way to 

endow it with cultural color when introducing the treatment concepts and methods of traditional Chinese medicine. 

However, when traditional Chinese medicine idioms and allusions are disseminated to the outside world, it is 

somewhat difficult to truly express the culture within them. The theory of cross-cultural communication can help 

us better understand the idioms and allusions in traditional Chinese medicine and their culture, and attach 

importance to the influence of cultural and language environments on the translation. The purpose of writing this 

article is to master the cultural meanings of traditional Chinese medicine idioms and stories, identify the difficulties 

in their translation, explore how to optimize the translation of traditional Chinese medicine idioms and allusions 

by using cross-cultural communication methods, and ensure the important value of traditional Chinese medicine 

idioms and allusions. 

2. Cross-cultural Communication Theory and Its Application in Translation Studies 

The most significant function of cross-cultural communication theory in the research of translating idioms and 

allusions in traditional Chinese medicine lies in resolving the relationship among language, culture and context, 

and assisting translators in effectively and accurately translating the cultural elements of the source language. 

Translation is not only the transformation at the lexical level, but also the transmission between cultures. By 

drawing on the theory of cross-cultural communication, translators can understand the historical and cultural 

context, philosophical thinking and cultural meanings contained in traditional Chinese medical idioms, and 

formulate effective strategies based on this understanding and perception to deal with misinterpretations caused 

by cultural differences[1]. For instance, when encountering the traditional Chinese medical idiom "imbalance of 

Yin and Yang", translators need to apply the theory of cross-cultural communication to grasp the accuracy of the 

connotation of traditional Chinese medical techniques. The theory of cross-cultural communication emphasizes 

the role of context, suggesting that translators adapt translation methods according to cultural differences, so that 

readers of the target language can not only understand the meaning of the text but also appreciate its rich cultural 

connotations. 

 

 



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3. Cultural Connotations of TCM Idioms and Allusions 

3.1 Origins and Classification of TCM Idioms and Allusions 

The vast majority of idioms and allusions in traditional Chinese medicine originate from ancient Chinese medical 

books, Taoist and Confucian traditions, folk tales and historical allusions. Some of these idioms and allusions 

originate from ancient Chinese medical books such as the "Huangdi Neijing" and "Shanghan Lun", and they are 

the direct sources of basic theoretical concepts and expressions of traditional Chinese medicine terms, as well as 

important materials for Chinese medical idioms and allusions[2]. Meanwhile, some idioms and allusions have been 

deeply influenced by the theories of Yin-Yang and Five Elements, as well as the theories of qi, blood and meridians 

in Taoism, making the holistic concept and syndrome differentiation and treatment in traditional Chinese medicine 

more humanistic. 

Chinese idiom stories can roughly be divided into idioms related to disease diagnosis and treatment. For instance, 

"strengthening the body's resistance and eliminating pathogenic factors" reflects the fundamental concepts of 

traditional Chinese medicine. And idioms related to the recognition ability of traditional Chinese medicine, such 

as "Four Diagnostic Methods combined", which reflects the diagnosis and treatment process that traditional 

Chinese medicine goes through when diagnosing and treating diseases. There are also many idioms in the form of 

metaphor and symbolism used to express the thinking of traditional Chinese medicine, such as "harmony of qi and 

blood", which is the thinking and law of the harmonious unity of traditional Chinese medicine and nature. 

3.2 Cultural Characteristics of TCM Idioms and Allusions 

The core cultural characteristics of traditional Chinese idioms and allusions lie in their profound theoretical 

speculation and unique language style. Firstly, traditional Chinese idioms and allusions widely reflect the "Yin-

Yang and Five Elements" theory and the holistic view of traditional Chinese medicine, emphasizing the harmony 

between humans and nature, as well as between the body and the environment. For instance, most idioms such as 

"tonifying both qi and blood" and "imbalance of Yin and Yang" reflect the holistic and dialectical thinking of 

traditional Chinese medicine. Traditional Chinese idioms and allusions often contain analogical symbols and have 

strong visual appeal and descriptive power. For instance, in traditional Chinese medicine idioms and allusions, the 

phrase "medicine cures the illness" not only imparts basic knowledge of traditional Chinese medicine but also 

implies the precision of treating the disease and dispensing drugs during the treatment process. Finally, the idioms 

and allusions of traditional Chinese medicine are integrated into the ethical and cultural thoughts of ancient China, 

such as the Confucian concepts of "benevolence and harmony" and the Taoist idea of "governing by non-action". 

The combination of the two forms a unique language system of traditional Chinese medicine[3]. 

3.3 Cross-cultural Communication Value of TCM Idioms and Allusions 

Chinese idioms and allusions are the core content of the dissemination of Chinese medical culture, the soul of 

Chinese medical theory, and a cultural treasure trove that showcases traditional Chinese philosophy, views on 

nature, and wisdom about life. Through the dissemination of Chinese idioms and allusions, Western countries can 

understand the theories of syndrome differentiation in traditional Chinese medicine, such as the harmony of Yin 

and Yang and the balance of qi and blood[4]. This will provide another perspective for health concepts from 

different cultures, which is of great help in enhancing the understanding and acceptance of traditional Chinese 

medicine by all mankind. Chinese idioms and allusions often use vivid and highly meaningful metaphors to explain 

complex theoretical knowledge of traditional Chinese medicine, and thus have a relatively high acceptance rate 

across cultures. 

4. Major Difficulties in the English Translation of TCM Idioms and Allusions 

4.1 The Dual Barriers of Technical Terms and Cultural Allusions 

From the perspective of translation, the English translation of traditional Chinese medicine idioms and allusions 

should confront two major challenges - the exclusivity of language and the complexity of culture. First of all, the 

language of traditional Chinese medicine is complex and specialized, and many words cannot be interpreted with 

corresponding words in English. For instance, terms like "qi", "Yin and Yang", and "pulse" can be expressed by 

translators using some cognates or explanations, but this might sever their inherent connotations. Meanwhile, 

traditional Chinese idioms carry profound cultural and historical connotations. Their imagery often originates from 

Chinese philosophy, records of the Grand Historian, folk customs and allusions, etc., which also increases the 

difficulty of cross-cultural understanding. 

 

 



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4.2 Ambiguity and Polysemy in Cross-cultural Transmission 

There are problems of cultural ambiguity and polysemy in the cross-cultural dissemination of traditional Chinese 

medicine idioms and allusions. Many terms and related stories in traditional Chinese medicine have clear and 

definite meanings in the Chinese cultural context, but there may be multiple interpretations and understandings in 

English and other languages. For instance, "qi and blood imbalance" in China refers to the normal imbalance of 

Yin and Yang within the body. However, during the translation process, due to differences in language composition 

and culture, external readers may be easily misled and interpret it merely as physical discomfort symptoms, thus 

losing its deeper philosophical connotations of traditional Chinese medicine. For instance, some terms in 

traditional Chinese medicine carry different meanings for a single concept. The specific meaning of polysemous 

words can only be determined based on the context. 

4.3 The Dilemma of Foreignization and Domestication in Metaphorical Images 

In the process of translating Chinese idioms and allusions into English, the problem of the alienation and 

domestication of metaphorical images is obvious. There are often many metaphorical elements in traditional 

Chinese medicine vocabulary. For instance, the phrases "seeing the sun through the clouds" or "curing the illness 

with the medicine" in "acupuncture" are all metaphors based on China's natural conditions, philosophical thoughts 

and cultural symbols. Such metaphorical symbols are difficult to be directly interpreted in the cultural background 

and context of foreign countries. Adopting the means of alienation can preserve the cultural characteristics in the 

original text, but it also has the disadvantage of causing comprehension obstacles for the target reading group. The 

adoption of domestication is conducive to the acceptance of the text by the target reading group, but it also means 

the loss of some cultural information in the source language. 

5. Translation Strategies and Approaches to TCM Idioms and Allusions 

5.1 Literal Translation with Annotation: Addressing the Dual Barriers of Technical Terms and Cultural Allusions 

Annotation literal translation is a combination of direct translation and annotation. It conveys the meaning of words 

through literal translation and, through appendices, enables readers to understand the cultural and medical 

knowledge corresponding to the translated words, ensuring the accuracy of the word translation and the readers' 

comprehension. This kind of annotation in translation is not merely a simple annotation of a certain word, but an 

interpretation of the cultural background, historical basis and the extension of philosophical thinking in the original 

literature. For example, for the translation of "Imbalance of Yin and Yang", use the literal translation method 

"imbalance of Yin and Yang", and add "' imbalance of Yin and Yang 'is a basic principle of traditional Chinese 

medicine, referring to the state of imbalance of Yin and Yang in the human body, which often leads to the 

occurrence of diseases." Annotations 

To evaluate the effectiveness of literal annotation in translation, the efficiency of information transmission can be 

measured by the following mathematical formula: 

I=
S+C

T
                                       (1) 

Here, I represents the efficiency of information transmission, S is the accuracy of literal translation of terms, C is 

the quality of cultural and medical annotations, and T is the degree of information loss during the translation 

process. According to this formula, the efficiency of information transmission is influenced by the literal 

translation of terms and the quality of annotations, and is inversely proportional to the time consumption or 

information loss during the translation process. 

In practical applications, the effect of literal translation of annotations can be further quantified as: 

I=
(1-p)S+pC

T
                                      (2) 

Here, p represents the proportion of annotations in translation. The optimal information transmission efficiency 

can be achieved by adjusting the ratio of annotations to literal translations. The translation effect is most ideal 

when the proportion of annotations is 30%. Assuming the accuracy of literal translation is 0.8, the quality of 

annotations is 0.9, and the information loss during the translation process is 0.1, the formula is used to calculate 

and obtain: 

This result indicates that the literal translation method of annotations has a significant advantage in the efficiency 

of information transmission and can effectively improve the accuracy of terms and the transmission of cultural 

connotations. 



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5.2 Free Translation with Image Substitution: Coping with Ambiguity and Polysemy in Cross-cultural 

Transmission 

Image substitution translation is an effective translation strategy to address the issues of uncertainty and diversity 

in cross-cultural communication and is applicable to the translation of traditional Chinese idioms and allusions. 

When the source language culture, traditional Chinese medicine theories and concepts, etc. cannot find a 

completely corresponding translation in the target language, image substitution translation will adopt the same or 

similar and visualized expression methods in the target language to prevent cultural confusion and meaning loss. 

For example, for traditional Chinese medicine terms such as "insufficiency of qi and blood", if they are directly 

restated, it is difficult for the target language readers to understand their deep meaning during the reading process. 

At this time, they can be transformed into "insufficient vitality" by using the method of image substitution to 

convey the main content of the source language. This way, it can not only ensure the understandability of the target 

language readers, but also avoid the discomfort caused by overly mechanical paraphrasing during the reading 

process, making the translation more fluent and understandable. 

To quantify the translation effect of image substitution for free translation, a calculation model of information 

transmission efficiency can be utilized to evaluate the effectiveness of different translation strategies. The formula 

is as follows: 

I=
W1A+W2B+W3C

W4D
                                  (3) 

Among them, I represents the efficiency of information transmission, reflecting the degree of effective information 

transmission during the translation process; A represents the literal translation accuracy of the term or idiom; B 

represents the acceptance of the target culture, which measures the degree to which the target language users 

understand the cultural elements of the source language. C represents the vividness of image substitution 

expression, reflecting whether image substitution can effectively convey the emotions and images in the source 

language. D stands for information loss, which measures the information lost due to cultural differences during 

the translation process. W1,W2,W3 and W4 are weighting coefficients, representing the relative importance of 

each factor in information transmission. Through this formula, the impact of different translation strategies on the 

efficiency of information transmission can be evaluated, and then the effectiveness of image substitution for free 

translation in actual translation can be determined. 

To further optimize the translation effect, adjusting the proportion of image substitution can also enhance the 

efficiency of information transmission. Through the following optimization formula, the translation effects in 

different proportions of image substitution free translation can be calculated: 

Iopt=
(1-p)W1A+pW2B+W3C

W4D
                                      (4) 

Among them, p represents the proportion of image substitution, with a value range from 0 to 1. In actual translation, 

assuming the accuracy of literal translation is 0.8, cultural adaptability is 0.75, the vividness of image substitution 

is 0.85, information loss is 0.2, and the proportion of image substitution is 0.5, then: 

Iopt=
(1-0.5)×0.8+0.5×0.75+0.85

0.2
  

Iopt=
0.4+0.375+0.85

0.2
=

1.625

0.2
=8.125                               (5) 

This result indicates that when the proportion of image substitution is 50%, the information transmission efficiency 

of translation is 8.125, demonstrating the powerful advantages of image substitution free translation, especially its 

effectiveness in resolving ambiguity and polysemy in cross-cultural communication. 

5.3 Transliteration with Supplementary Explanation: Solving the Dilemma of Foreignization and Domestication in 

Metaphorical Images 

Annotated transliteration is an effective means adopted to address the predicament of alienation and domestication 

of metaphorical images in traditional Chinese idioms and allusions. It transliterates the original words and phrases 

to retain their cultural and phonetic specificity, and adds annotations to enable the target group to understand the 

deep cultural implications behind the original words. Especially in the translation of traditional Chinese medicine 

terms, when encountering cultural factors that are difficult to convert directly, annotated transliteration can play a 

role in preserving cultural uniqueness to the greatest extent, avoiding excessive transplantation and localization. 



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For example, the English name of "Si Zhen He Can" is "Si Zhen He Can", and it has been explained. “a diagnostic 

method in Traditional Chinese Medicine that involves the four diagnostic methods—inspection, "auscultation, 

inquiry, and palpation - to form a comprehensive diagnosis." In this way, readers of the target language not only 

know the pronunciation of this idiom, but also understand its connotation. At the same time, I have also fully 

understood the cultural background knowledge. For instance, the term "meridian" can be directly translated into 

the English word "Jing Luo" and annotated: “the system of channels in Traditional Chinese Medicine through 

which Qi and blood flow, "believed to connect all parts of the body." This approach not only retains the original 

cultural implications of the word but also clarifies its specific meaning in traditional Chinese medicine to the 

readers. The comparison of the application effects of transliteration strategies in the translation of traditional 

Chinese medicine idioms and allusions is shown in Table 1. 

 

Table 1. provides a comparison of the application effects of transliteration strategies in the translation of traditional 

Chinese medicine idioms and allusions 

Translation 

strategy 

Degree of 

understanding (%) 

Cultural 

adaptability (%) 

Ambiguity 

(%) 

Polysemy 

(%) 

Translation 

effect index 

Explanatory 

Transliteration 
85 92 8 12 9.2 

Literal translation 65 55 25 30 4.0 

Free translation 75 80 18 20 6.4 

 

As can be seen from Table 1, in terms of the judgment of comprehension ability and cultural matching degree, the 

evaluation obtained by the method of phonetic translation with explanations is very high. The comprehension 

ability for the target audience is 85%, and the cultural matching degree is 92%, thus enabling readers to have a 

deeper contact with the academic information of traditional Chinese medicine in the original text. At the same 

time, the annotation of transliteration effectively reduces ambiguity and polysemy, with scores of 8% and 12% 

respectively. It can be seen that this translation method has significant advantages in the translation of traditional 

Chinese medicine idioms and allusions, and can effectively convey more textual information related to traditional 

Chinese medicine. 

6. Conclusion 

From the perspective of cross-cultural communication, the English translation of traditional Chinese medicine 

idioms and allusions should choose appropriate translation techniques to ensure the transmissibility of cultural 

sources. For instance, literal translation of annotations, figurative substitution of free translation, and transliteration 

with explanations can resolve cultural and language barriers existing in the translation process in different 

situations. From the perspective of the interpretation of the meanings and cultural implications of the vocabulary 

with the characteristics of traditional Chinese medicine, these methods can to a certain extent clear the language 

and cultural barriers between countries, allowing readers' understanding to further approach the core concepts and 

practical levels of traditional Chinese medicine. 

Acknowledgments 

Project: 2023 Guangxi Basic Research Ability Improvement Project for Young and Middle-

aged University Teachers — A Study on the English Translation of TCM Idioms and Allusions from the Perspec

tive of Intercultural Communication (No. 2023KY1733)   

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