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. hssr.ideasspread.org Humanities and Social Science Research Vol. 8, No. 5; 2025 97 Published by IDEAS SPREAD 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. hssr.ideasspread.org Humanities and Social Science Research Vol. 8, No. 5; 2025 98 Published by IDEAS SPREAD 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. hssr.ideasspread.org Humanities and Social Science Research Vol. 8, No. 5; 2025 99 Published by IDEAS SPREAD 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. hssr.ideasspread.org Humanities and Social Science Research Vol. 8, No. 5; 2025 100 Published by IDEAS SPREAD 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) References [1] Li, Q. (2024). A study on translation strategies for TCM terminology based on knowledge translation theory. Studies in English Language Teaching, 12(3). [2] He, H. (2024). A study on the multimodal discourse construction of traditional Chinese medicine classics cross- cultural communication: The case of “China in the Classics—Compendium of Materia Medica.” Research and Commentary on Humanities and Arts, 2(7). [3] Song, C. (2024). A study on the application of Chinese medicine and tea business' English translation based on schema theory. Advances in Humanities Research, 6(1). [4] Zhang, Y., & Zhang, Y. (2024). Introduction and dissemination studies of contemporary German translations of traditional Chinese medicine classics. Journal of Humanities, Arts and Social Science, 8(4). hssr.ideasspread.org Humanities and Social Science Research Vol. 8, No. 5; 2025 101 Published by IDEAS SPREAD Copyrights Copyright for this article is retained by the author(s), with first publication rights granted to the journal. 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