Chapter Five Practices of Medical Translation
    In the previous chapter, we have discussed the three principles in translating medical texts. Armed with these principles, the translator may attend to translation problems more readily. This chapter discusses some translation problems arising from domain-specificity, non-equivalence between source language and target language, and genre- stereotypicality, and how they are solved with the guideline of three principles.

5.1 Translating Collocation
    It goes without saying that words rarely occur on their own; they almost always occur in the company of other words. Translators of medical English may feel confused about collocations in the medical texts. Why? To quote Mona Baker:
          Some collocations may seem untypical in everyday language but are common in specific registers ...Register-specific collocations are not simply the set of terms that go with a discipline. They extend far beyond the list of terms that one normally finds in specialized dictionaries and glossaries…What a word means often depends on its association with certain collocates. When the translation of a word or a stretch of language is criticized as being inaccurate or inappropriate in a given context, the criticism may refer to the translator s inability to recognize a collocational pattern with a unique meaning different from the sum of the meanings of its individual elements…
(Baker, 2000: 52)
    Look at the example we selected. "Open" is an active word in the filed of medicine bearing the different meanings and different Chinese versions in different collocations.We are trying, in our own way, to analyze out how these Chinese versions are established in the hope to provide the translator with some hints to deal with the problem of different collocation containing the same word. "Open-heart surgery" is a surgery of, relating to, or performed on a heart temporarily relived of circulatory function and the heart is surgically opened (for inspection and treatment) (Merrian Webster’s Medical Desk Dictionary, 1996). The established translation for this term is
“心脏直视术”.We analyze as that if it is translated literally as“开心术”，the Chinese version might possibly arouse unnecessary association of a surgery or therapy of happiness, open-heartedness or something like that and the characteristics of formality and rigor in a medical word are therefore undermined. To ensure the understanding in its right sense, the term is extended with regard to medical knowledge as“心脏直视术”，as we put that extension is a helpful strategy in medical translation when discussing the first principle of medical translation. On the one hand this version can distinguish itself from another kind of "open-heart" surgery, done with only a small incision or no incision at all, such as through endoscope(内窥镜)，therefore it is absolutely faithful to the original content. On the other hand, this version sounds formal and scientific, hence cohesive to medical style. Other collocations like "open reduction", realignment of a fractured bone after incision into the fracture site; "open tuberculosis", tuberculosis shedding the infective agent to the exterior; and "open bowels", not constipated, can easily match with their literal translation“切开回复术，’，“传染性结核”and“大便通畅”.Furthermore, the collocations like "open lesion", an lesion not covered, enclosed, is translated as“开放性创伤”， and "open treatment", treatment not involving or encouraging a covering or enclosure, as“开放性治疗”.Although the word "open" is a common word with different connotations, it possesses an established
connotation in medicine, therefore it has come to be a semi-medical term that should be standardized and conventionalized. Its Chinese equivalent“开放性”is therefore correspondingly accepted by the professional community as a medical term rather than with other meanings.
    Translating collocation requires more familiarity with both the medical and
linguistic knowledge in a translator than single words do. The translator has to be up todate and seeks to data banks, medical experts, latest editions of medical literature and reference books in case that he meets newly created collocation and feels challenged to render it into Chinese.

5.2 Selecting among Synonyms
    As is shown in the previous section, the same English word may be rendered into different Chinese when collocated with different words. It is much the same case with Chinese-English translation, only with higher demands. Word for word translation or literal translation can cause great loss of exactness in content not to mention standardization in style.
    For a standardized medical word, when it is used as such there should be only one correct equivalent and it is completely synonym free provided it is used in the same situations.“恶性肿瘤”equals to "malignant tumor", in which the word "malignant" means tending to produce death or deterioration;“恶性贫血”is translated as "pernicious anemia"，where "pernicious" means highly injurious or destructive;“恶性循环”is "vicious circle"; and“恶性疟疾”should be understood in English as "subtertian malaria", since in medical English "tertian" means recurring at approximately 48-hour intervals in the vivax malaria, and "subtertian" is used to indicate a more severe malaria with an interval less than 48 hours.
      While it is indeed true that some sub-medical words in medical texts are not synonym-free, selecting among synonyms is never "free". Wrong choice for these synonyms would contribute to loss of meaning to greater or lesser degree. Cite a group of phrases as examples:“全食”，“全血”，“全适供应者”，“全子宫切除术”，whose English equivalents are "full diet", "whole blood", "universal donor", and "total hysterectomy" respectively. Take another group for example,“止血”，“止咳”，“止痛”，and“止痛药”，all of which have established choices as "arrest bleeding", "soothe cough", "relieve pain", and "pain killer".
    However there are cases where different choices would not necessarily mean much to the meanings as well as style of translation, but there just exist the conventional ways of expressing. Therefore the translator should not take risk of impressing native professionals as a layman. We often meet with these expressions in our readings: "there is pronounced correlation between一;"there is no significant difference between二，:;
"no marked correlation (difference) was found between一However we found
during our editing that some of the Chinese medical workers wrote as "there is obvious correlation between:!;"no evident difference:!;or "there is outstanding difference..".:

5.3 A Case Study on Translating Neologisms
    Science of medicine has been in ever increase with new discoveries being made
and concepts established continuously. To give a neologism a proper Chinese name always presents a hard task, also a deserving one to the translator.
    In the following, we will analyze the case of a neologism translation process to see how the principle of equivalence to source language and appropriateness for target language is embodied in translation of medical neologisms. "Prion" is a newly discovered pathogenic agent in humans and animals, abbreviated from "proteinaceous infectious particles"感染性蛋白颗粒in literal meaning). It was introduced into China not long ago, therefore it is not surprising to notice the confusion in translating this loan word until recently a Chinese equivalent is preferred, which is“阮毒”.We investigated
the relevant articles and found several Chinese versions had ever been adopted like“阮病毒”、“普利昂”、“感染性蛋白子”.Why at last the translation "阮毒”was accepted rather than other three? We analyzed the reasons as follows: First,“普利昂”，according to medical translation practices, is more like a drugs name, which usually comes from transliteration, for example,“阿托品”from "atropine",“西地兰”from "cedilanid" and“可的松”from "cortisone", all of which are drugs names. This kind of version servesas a symbol instead of a concept, and usually contains no sense at all. As Newmark put "in science the language is concept centered"( Newmark, 2001:155), while translation of“普利昂”does not suggest any of its original concept, hence no equivalence. Then looking at "阮病毒”，we found that it is not faithful to original content, because "prion" is not kind of virus but toxin. So this version again fails in equivalence to the original content, while on the other hand it is worth mentioning that this translation embodies brevity, simplicity of scientific language, and is appropriate for Chinese language, since“阮" is an old name for protein, simple and easy to pronounce. Finally,“感染性蛋白粒
子”is obviously a literal translation and can be regarded as a typical translation of "formal equivalence". Since "Prion" is a short word from abbreviation, in that way the Chinese version of "感染性蛋白粒子”looks long and not easy to pronounce or to remember. It is more a paraphrasing than a translation, and it can not be made as short as“感蛋子”or“感蛋”because we are not supposed to do so on the basis of Chinese
language norm. In the end, the translation as“阮毒”compensates the inaccuracy of“阮病毒”while at the same time overcomes the redundancy of "感染性蛋白粒子". It has reasonably adopted“阮”as translation for protein while“阮毒”conforms well to the Chinese language norm, as Chinese people call“蛇毒”and“病毒”.Anything that is toxic can be called as“毒”in Chinese, and“阮”indicates its attribute. Last but not the
least, "阮病毒”coincides with“细菌”，“真菌”，“病毒”to compose four elements in the pathogenic category, which seems more acceptable to medical workers and researchers.
    In short, it is no easy task to establish a closest natural equivalent for a source neologism, both intellect of medical knowledge and proficiency in target language are required.

5.4 Recasting Complex and Complicated Sentence
    In translating the units larger than lexicons, more complex processes are involved and higher demands for translators language competence required. In our research we compared the English source texts and the translated target texts of students and medical workers, and found out complex and complicated sentences are the recurrent stumbling blocks in their translating. Therefore we will spare more efforts on translating compound and complicated sentences in this section.
    As is mentioned before, complex and complicated sentence in medical English usually bear the following two characteristics. One is that the sentence is long and complicated in structure, having several subordinate clauses and/or in combination with interjected parts, inversion, ellipsis and varied sentence structures. Take the following sentence for example, "These examples illustrate how important it is, in all situations in which it is proposed to alter the balance of factors which determine coronary flow, to take into account myocardial reserve, aortic systolic and particularly, diastolic pressure, the energy demanded upon the heart (that is, its work)，and the
ability of the coronary vessels to alter these lumina".
    Analysis: the above sentence is made of four subordinate sentences. The sentence underlined is an objective clause, and italicized sentences are attributive clauses. The whole sentence is made complicated by the interjected part "in all situations in which it is proposed to alter the balance of factors which determine coronary flow".
    If the translator follow Nida s four steps of translating (described in the second principle in chapter 4), analyzing the deep structure of the English sentence and properly transferring it into the surface structure of the Chinese one, he will get the following version:“这些例子表明:凡是在需要改变冠状动脉血流决定因素平衡状态的情况下，极为重要的是考虑心肌储备、主动脉的收缩压和舒张压(特别是后者)，心脏所需的能量(即心脏的功)以及冠状动脉血管改变管腔的能力”.
    Another feature of complicated sentence in medical writing is that the sentence iscomplicated in meaning and its expression does not conform to Chinese language custom. Here we would like to point out a fact that many, particularly non-native medical writers also lack English writing skills and training in writing in English, or medical English. The result is that use of some rhetorical devices are not only grating but often positively confusing and seems to leave the translator on uncertain territory.We suggest that the translator should follow Newmark，s (2001) idea of communicative translation and write better than the original.
    Look at the following sentence we found in the Journal of American MedicalAssociation, "In the realm of interesting speculation calling for further studies of the alterations in fibroblastic activity resulting in elastin syntheses rather than collagen are certain aspects which might help to explain some of the clinical problems of chronic acidosis"(JAMA, 1984).
This is a formidable sentence. What is the author trying to say? The message simply does not get across at the first reading. Later we found "aspects" is the subject, governing the verb "are". However, before we got there we must traverse 23 words which moved downward in chains of prepositional phrases, until we were not sure what the point may be. Then, after we finally reached the subject of the sentence, we found a further long modifying clause, 39 words in length. To make sense of this sentence we adopted Walmsley s three steps of translating to solve the problem.
              First, the text is to be rewritten in the source language using sentence patterns of the target language in an effort to isolate the deep structure. Then, the text is to be rewritten in the target language following the first structures exactly. Finally, the complete text is to be stylistically reconstituted by applying appropriate transformations (Walmsley, 1970: 195).
    Thus we analyzed out that the author was apparently trying to say something like this: "We may speculate that altered fibroblastic activity, producing elastin rather than collagen, has relevance to clinical problems of chronic acidosis. To test this hypothesis, further studies would be appropriate".
    Based on the deep structure of the original, we got a surface structure of Chinese as follows:“我们可以推测纤维原活动改变产生弹性蛋白而非胶原，导致慢性中毒。验证这一假设，还需作进一步研究”.
    Newmark wrote that "in a technical translation you can be as bold and free
recasting grammar as in any other type of informative text provided the original is defective"(Newmark, 2001:159), so we are encouraging Chinese non-professional translators in medical field to apply this rule in order to free the readers from unduly hard work or misunderstanding.

5.5 Meeting Conventional Pattern
    As is introduced in chapter three, medical text contains some characteristic morphological and syntactical structures which presents itself as formal and concise.Among them is "it" sentence structure, which we found in our editing as one of the common problems for Chinese medical writers to prevent their writings or translations from stylistically appropriate. "it" sentence structure in medical English mainly refers to sentence structure with "it" as formal subject to replace the real subject of“infinite",
"gerund" or "subject clause". We picked out some examples gathered during our research of medical journals as follows:
(1) It is +adjective/noun +real subject
It is preferable (desirable, advisable)..……是可取，最好…，.需要二”二
It is available that ... .....是适用的，二”.是有效的
It is essential that…必须二”，…”.是必不可少的
It is appropriate that... ....是适当的
It is a common practice…通常是……
It is no use ... .....是无用的
It is frequently the case... ..…是屡见不鲜的
It is no harm... .....是无害的
(2) It+intransitive+real subject (often that clause)
It follows that…从而，于是，由此可见
It may be that…可能
It happens that…恰好，碰巧，有时
It turns out that二结果是二”，.结果表明
(3) It+passive voice+real subject
It has been proved (demonstrated) that据证明，已证实
It is hoped (expected, anticipated ) that.可以希望，可以预期
It is recommended (suggested, proposed) that.有人建议，有人提出
It is supposed(assumed, hypothesized, postulated)that.据推测，假设
It has been illustrated that .据图所示，据说明
It has been reviewed that二回顾了
It has been shown (indicated) that已经表明
    Compare these established expressions with what we found in our editing of the articles written by the Chinese medical writer or translator.
(1)当前习惯的做法是对大多数患者施行胃切除术或胃窦切除或迷走神经切断术.
    Original version: The current practice is to perform gastric resection in most cases,
or antrectomy and vagotomy and see what we did with these sentences.
    Our revised version: It is currently the common practice to perform gastric
resection in most cases, or antrectomy and vagotomy.
(2)尽管动脉硬化的原因尚未完全了解，显然，硬化是以一种叫做胆固醇的脂性物质沉积在动脉下开始的。
    Original version: While the cause of arteriosclerosis is not entirely known,
obviously the process begins with a deposition of a fatty substance known as cholesterol
beneath the lining of the arteries.
    Our revised version: While the cause of arteriosclerosis is not entirely known, it is
clear that the process begins with a deposition of a fatty substance known as cholesterol
beneath the lining of the arteries.
(3)对一般情况较好的患者，可以在2周的抗结核治疗后立即进行手术治疗。
    Original version: For some patients of relatively healthy body, the surgery could be
operated immediately after two-week anti-tuberculosis therapy had been taken.
    Our revised version: It is recommended(advisable, suggested, appropriate) to perform surgical therapy on those patients with fair general condition after two-week anti-tuberculosis medication.
    To produce a good piece of medical translation is no easy job, it requires the translator equip himself with every details of the target language linguistically and stylistically.

5.6 A Case Study on Translating a Specific Genre
    Until now we have presented a comprehensive discussion on translating medical texts at lexical and grammatical levels to help the translator arrive at an desirable target text linguistically and stylistically. Our last section in this chapter would be set on a wider perspective to look at medical translation as a whole and unfold what factors are involved which make the translator select as he selects. Before we begin we will clarify the concept of genre analysis.
    ESP or EST and its organization, have been subjected to various types of analysis over a long period of time, starting with register analysis, followed by discourse analysis and more recently, genre analysis(Jordan, 1997). Genre analysis is one fruitful area of research in the 1980s, continuing into the 1990s. Swales has elaborated his earlier working definition of genre to the following:
          A genre comprises a class of communicative events the members of which share some set of communicative purposes. These purposes are recognized by the expert members of the parent discourse community, and thereby constitute the rationale for the genre.This rationale shapes the schematic structure of the discourse and influences and constrains choice of content and style. ...in addition to purpose，exemplars of a genre exhibit various patterns of similarity in terms of structure, style, content and intended
audience. If all high probability expectations are realized, the exemplar will be viewed as prototypical by the parent discourse community(qtd in Jordan, 1997:230).
    As noted before, the principles and rules for the production of medical texts are highly genre-specific. The use of modality varies from genre to genre. Before translating the translator should assign the source text to a specific genre and as Zhang Meifang wrote，he should "act as the receptor of the source text and producer of the target text. He needs to make discourse analysis both in reception and production and compare the results of the two analyses. Only like this can he succeed in translating"(Zhang Meifang, 2001).
      A genre is embodied through two aspects: "schematic structure" and
"realizational patterns"(Zhang Meifang, 2001). "Schematic structure is a step-by-step structure, while realizational patterns consists of specific language structures" (Zhang Meifang, 2001).
      We will discuss how genre analysis can affect ones translating in the following by a case study. We selected the translation of "admitting note" as the case, as it is one of the primary English medical writings required for medical students and medical workers.
    We put the Chinese admitting note and selected out two typical versions from the students(both revised for grammatical and spelling mistakes), one of which was made before they had any knowledge about the genre conventionality of an English admitting note, only they were provided with necessary medical words; another was rendered after they had been prepared with both linguistic and stylistic knowledge of this special
genre.
                                    入院记录
    患者，女，30岁，已婚。因发热，咳嗽7天，于1996年8月3日入院。
    7天前开始发热，、咳嗽、吐薪液痰，至今未治疗。近3天，持续高热。咳嗽加剧。吐铁锈色痰，胸痛，随呼吸加剧。
    患病期，乏力，食欲差，大、小便正常。
    既往体健，很少就医。
    家中无人患结核病，患者是否有与结核病人密切交往史不详。
    体检:体温39，脉搏107次/min，呼吸26次/min，血压110/70mmHg
    发育正常，营养不良。急性病容，神志清楚。无发给，皮肤无疹子及紫瘫，无浅淋巴结肿大。头颅正常，巩膜无黄染。颈活动自如，甲状腺未肿大。气管无偏移，颈静脉不充盈。胸廓对称。右上胸语颤有增强，可听到许多中小湿性咯音。心跳正常，无杂音。腹平软，无触痛。肝脾未及，肠鸣音正常。脊柱和四肢无异常。双侧膝反射活跃。无病理反射。
    血常规:红细胞450万/mm3，血红蛋白140 5g%，白细胞21000/mm3，中性，淋巴19%,嗜酸1%。
    血小板计数:15万//mm3
    胸透:右上肺有大片状阴影。
Version 1
                                        Admission Note
    The patient is a 30-year-old married woman. Because she had fever and cough for 7 days, she was admitted to the hospital on August 3, 1996.
    Seven days ago she began to have a fever, cough and spit mucuous sputum, but she had not received any medical treatment up to know. In the past three days, she had a persistent fever, and the cough became serious. She spit rusty sputum. She felt chest pain and it intensified with respirations.
    During her illness, she was lack of strength .Her appetite was poor .Her urine and stools were normal.
    She was healthy in the past and seldom went to doctor.
    Nobody in her family had ever got tuberculosis and she did not know of any intimate contact with patients with this disease either.
    Physical Examination: the patient was normally developed and poorly nourished.She looked acutely ill but her mind was still clear. There was no cyanosis, no eruption, or purpura over skin. Superficial lymph nodes were not enlarged. Skull and head organs were normal and there was no jaundice on sclerae. The neck could move freely and
thyroid glands were not engorged. Chest was symmetrical. Tactile fremitus exaggerated slightly over the right upper chest and a lot of small and moderate moist rales were heard. Heart beats were normal without any noise. Abdomen was flat and soft and free from tenderness. Liver and spleen could not be palpated .Bowel sounds were normal.There was no abnormality in spine or limbs. Knee jerks of both sides were active. There were no pathological reflexes.
    Routine blood test: RBC 4500000/mm3, Hb 14.5g%, WBC 21000/mm3, N 80%, L19%, E 1%.
    Platelet count: 150000/mm3.
    Chest fluoroscopy: there was a big patchy shadow over upper right lung.
Version 2
                                        Admission Note
    A 30-year-old married female was admitted to the hospital on August 3, 1996, because of a 7-day fever and cough.
    Seven days ago, she began running a fever and having a bad cough productive of mucous sputum, for which she has not taken any medical treatment up to now. in the past three days, she has been having a persistent high fever, an exacerbated cough productive of rusty sputum and a thoracalgia intensified with respirations.
    During her illness, she has been weak and has had a poor appetite without specific urine or stools. She has been in good health and has seldom consulted physicians in the past.
    There is no tuberculosis in her family medical history and she does not know of any intimate exposure to patients with this disease either.
    PE T:39c; P: 107/min. R:26/min.; BP: 110/70 mm Hg.
    Well developed, poorly nourished. Acutely ill-looking, still mentally clear,. No cyanosis. No eruption or purpura over skin. Superficial lymph nodes not palpable. Skull an head organs not abnormal. No jaundice on sclerae. Neck soft and supple. Thyroid not enlarged. trachea not deviated. No engorgement of jugualr veins. Chest not asymmetrical. Tactile fremitus exaggerated slightly over the right upper chest and a lost of small and moderate moist rales heard here. Heart beat regular with no murmur. Abdomen flat, soft and free from tenderness. Liver and spleen impalpable. Intestinal peristaltic sounds not abnormal. No abnormality detected in spine or limbs. Knee jerks
of both sides active. No pathological reflexes elicited.
    Routine blood test: RBC 4500000/mm3, Hb 14.5g%, WBC 21000/mm3, N 80%, L19%, E 1%.
    Platelet count: 150000/mm3.
    Chest fouoroscopy: a big patchy density over upper right lung.
    Genre analysis:
    Admission note is "a class of communicative event" (Jordan, 1997). Its
communicative purpose is to record information of the patient for audit trail and provide accurate, reliable, systematic and scientific support for consultation and diagnosis. These purposes are recognized by the physicians, because both the source text and target source share the same schematic structure as follows:
General data(一般项目)
Chief complaint(主诉)
History of present illness(现病史)
Past history(既往史)
Family history(家族史)
Physical examination(体格检查)
Laboratory and aided examination(实验检查和其他辅助检查)
Diagnosis(诊断)
    However the same purpose and same schematic structure may be realized through different patterns, as is seen from two English versions. The criterion to view a version as prototypical is, according to Dudley-Evans, whether "it has characteristic features of style and form that are recognized by those who use the genre" (qtd in Jordan, 1997:231), namely realizational patterns. Therefore we will compare these two versions with regard to the aspects of the form and style.
    The intended audience of admission note is the doctor not the patient himself.Therefore the admitting note is an expert-to-expert communicative event, which should be highly professional and contain, first and foremost, highly specialized terminology. These terminologies are accurate, standardized, and unified so as not to cause any ambiguity in communication. Then let us compare the two English versions of the same
admitting note and find out how this style of specialization is realized.

Source text version 1 version2
吐黏液痰spit mucous sputum/           a cough productive of  mucous sputum
                                                                             
吐铁锈色痰spit rusty sputum/         a cough productive of rusty  sputum
                                                                              
胸痛chest pain/         thoracalgia
乏力lack of strength /        weak
家中无人患结核病nobody in her family had ever got tuberculosis/      
                                 there is no tuberculosis in her family medical history
                      
与结核病人密切交往intimate contact with patients with    this disease /
                                    intimate exposure to patients  with this disease
颈活动自如neck could move freely /             neck soft and supple
无杂音no noise /                                               no murmur
阴影shadow /                                    density
既往体健，很少就医she was healthy and seldom went to doctors /
                                    she was in good health in the past and seldom consulted doctors

    We should admit both versions are faithful to the original content. However, all the italicized words or structures characterize the standard medical English language and are readily recognizable to the "expert members of the native discourse community" (qtd in Jordan, 1997: 230), while expressions like "spit mucous sputum", "spit rusty sputum" and "contact with" are prone to be interpreted as intentional act rather than
diseased or unconscious one. Moreover, "lack of strength", "chest pain", "neck could move freely" and "no noise" are typical "patients descriptions", resulting in loss of flavor of professionalizaion.
    Admission note, like any other medical texts, should be written in formal style except the part of physical examination, which is written in short and simple sentences, even nominal phrases, preferably the latter, and in which "the" or "a" are general omitted; "be" is often left out, and abbreviations are commonly used. Most typically the structure of "understatement"( Zhou Tiecheng, 2001:115) is employed. The so-called understatement refers to "negative words (not, without)+words with negative prefixes or phrases with negative connotations". This sentence structure is used in the part of physical examination to express the conviction of the doctor in patient s physical
condition. Look at the sentences in version 2:Skull and head organs not abnormal. Chest not asymmetrical. Heart beat not abnormal with any murmur. Intestinal peristaltic sounds not abnormal. No abnormality detected in spine or limbs.
    In translating the part of physical examination, the translator should take this exceptional structure into much consideration to make his translation more adherent to genre of admission note.
    As for the rest parts of admitting note, it is appropriate to use compound complex sentence to distinguish the major from the minor and fit for the style of logic and conciseness of medical English. This feature is best represented in the opening sentence, which generally contains information about sexuality, age, occupation, admission time and reason. Choppy sentences would result in loss of focus and break the unity of the sentence. To help clarify we give this typical example,“患者，女，成年，未婚，因间
歇陛腹痛6年，近3天加剧，于1982年2月14日入院”.The standardized and conventional translation should be "the patient, an unmarried adult female, was admitted to the hospital on February 14, 1982, because of a 6-year intermittent abdominalgia which has been worsening in the last three days". Then Let us compare the opening sentences of versionl and version2 in the present case.
    Version 1:The patient is a 30-year-old married woman. Because she had fever and cough for 7 days, she was admitted to the hospital on August 3, 1996.
    Version 2: A 30-year-old married female was admitted to the hospital on August 3, 1996 because of a 7-day fever and cough.
    The first version is composed of two sequential sentences in English, bearing the same degree of importance, while the second version is a concise simple sentence, which is concise and logically rigorous.
    The present case study showed that in translating a medical text, it is essential for the translator to recognize the genre and find out the distinguishing features of structure, style as well as content in order that his translation could be recognized and accepted by the intended audience.

Chapter Six Conclusion
    Rapid development as well as frequent international exchanges in the field of medical sciences necessitate medical workers to read and translate medical literature in a massive way. In proportion to its magnitude, discussion on theories in medical translation becomes a must. The author made a comprehensive analysis of medical texts on all levels and attempted to seek for some principles, a kind of guiding framework in the process of medical translation.
    Analysis showed the specific features of medical texts at lexical, morpho一syntactic and genre levels, which shed light on our understanding of translating process. That is the principles and rules for the production of translated medical texts are highly subject-specific, receptor-oriented and genre-specific.
    First, medical English, more than any other EST, typifies itself by its massive use of specialized terms and phrases, among which semi-medical words present a great challenge for their meanings are not always readily available. Accuracy in medical translation attributes a lot to the translator s familiarity with relevant medial knowledge.
    Secondly, differences between English language and Chinese language remain the stumbling blocks for medical translators, which may be embodied at lexical, morpho一syntactic and genre levels. Lexical problems might arise from where concepts are culture-specific or where the source language is not lexicalized in the target language. The carefully structured and highly idiomatic medical texts demand the translator to facilitate himself with strategies in dealing with morpho一syntactical structures of medical English into equivalent Chinese ones to ensure readily comprehensible and acceptable Chinese, and vice versa.
    Last but not the least, medical texts vary from genre to genre. Genre analysis, from a macrostructure point of view, always helps a translator arrive at a stylistically appropriate and communicatively effective texts. knowledge of genre conventions and realization strategies is therefore of great importance. Enlightened by this findings, we put forth the following three principles in translation of medical texts.
1 .faithfulness to medical content and cohesiveness to medical style
    Translation of medical texts is generally a life or death matter, thereby first priority should always be given to accuracy in content from start to finish. The unit of translation in this sense should be as small as possible to mainly involve words and phrases. Better still, much importance should be attached to the choice of non-medical expressions so as to make the target text keep a flavor of medical language of the original, namely cohesive to medical style.
2. equivalence to source language and appropriateness for target language
    Medical language belongs to the style of informative function, in whose translation communicative approach should be adopted, as suggested by Newmark. And communicative efficiency should be pursued at many levels. Meaning more than form, reader rather than writer should be focused in translating process. Target language norm should be seeked, and lexical as well as grammatical ambiguity from language differences should be avoided.
3. conventionality and standardization
    One of the most crucial aspects of medical translation, which has long been neglected in previous studies, is the concern to follow conventionality and meet standardization in terms of content, structure and style. To follow the established way of expression, to vary the format in relation to the intended publication and to stick to the characteristic even exceptional structures of a specific genre would all contribute to best recognition of the translated text by the native discourse community.
    The overall study of medical translation from a theoretical none the less practical point of view, and establishment of its principles always lag behind the increasing volume of translation and growing team of translators. The thesis is only an attempt to cast a brick to attract jade. Much has still to be done in this field.

ACKNOLEDGEMENTS
    I would like to express my sincere gratitude to my supervisor, Professor Jiang Zhiwen, who has supervised me from start to finish with his warm encouragement, constructive advice and insightful criticism as well as his unselfish support to lend me precious source books, without which I could not have finished this dissertation. I have also benefited greatly from the opportunity o study in College of Foreign Languages of Chongqing university, and I am grateful to Professor Yu Weishen, Professor Li Hong,
Professor Wen Jun, Professor Xiang Chaohong, and Professor Gu Xiangdong for their enlightening lectures. I also own my thanks to my students and the contributors of the journal for which I work as an English editor, who have enabled me to gather some first-hand materials useful for my research. Besides all the help that I have been gratefully acknowledging, my final and most heartfelt thanks must be to my family. My husband has been supporting me with his love and encouragement; my mother has been
selflessly helping me with the house work; my daughter, too, has always offered her naive support and seems never to have loved me the less for the loss of my accompany.

                            REFERENCES
[1] Baker, M. 2000. In other words: a coursebook on translation. Beijing: Foreign Language  Teaching and Research Press. p.15
[2] British Medical Journal. 1995-2000. London: British Medical Association
[3] Jordan, R. R. 1997. English for academic purposes. Cambridge: Cambridge University Press.pp.230-231
[4] Journal of American Medical Association. 1996. Chicago: American Medical Association
[5] Journal of Pathology and Bacteriology. 1998. USA: Oliver and boyd Ltd
[6] Kussmaul, P. 1997. Text-type conventions and translating. In Trosborg, A. (Ed.), Text typology and translation. Amsterdam/Philadelphia: John Benjamins Publishing Co. p. 67
[7] Newmark, P. 2001. A textbook of translation. Shanghai: Shanghai Foreign Language Education Press
[8] Newmark, P. 2001. Approaches to translation. Shanghai: Shanghai: Shanghai Foreign Language Education Press
[9] Nida, E. A. 1993. Language, culture, and translating. Shanghai: Shanghai Foreign Language  Education Press. p.146
[10] Nida, E. A. 2002. The theory and practice of translation. In Shen Yuping (Ed.),《西方翻译理论精选》，北京:外语教学与研究出版社
[11] Pease, R.W. 1996. Merrian-Websters Medical Desk Dictionary. Springfield: Merrian-Webster, Incorporated
[12] Pilegaard, M. 1997. Translation of medical research articles. In Trosborg, A. (Ed.), Text typology and translation. Amsterdam/Philadelphia: John Benjamins Publishing Co. pp. 159-169
[13] Roland. C. G. The passive voice. Ed. in Medical English writing by West China University of Medical Sciences
[14] Spatola, A.L. 1982. Mastering medical language. New Jersey: Prentice-Hall, Inc. pp.6-7
[15] Tytler, A. F. 2002. Essentials on the principles of translation. In Shen Yuping (Ed.)，西方翻译理论精选，北京:外语教学与研究出版社
[16] W. B. Saunders company, 2001. Dorlands illustrated medical dictionary, 29`h edition. Beijing: People s Medical Publishing House, Harcourt Asia Pte Ltd
[17] Wilss, W. 2001. The science of translation of translation: problems and methods. Shanghai: Shanghai Foreign Language Education Press
[18]常克强，1987，从语言学角度看科技翻译与文学翻译，上海:《上海科技翻译》第1期
[19」陈莉，1998，普通词在医学上的特殊涵义，北京:《中国科技翻译》第4期
[20]陈忠年，2000，准确，完整一科技英语翻译的基本原则，收在姜治文，文军(编著)《翻译标准论》，第377页，成都:四川人民出版社
[21]董哲，1998，生物医学英语写作教程，第155页，北京:北京医科大学，中国协和医科大学联合出版社
[22]韩其顺，王学铭，1990，英汉科技翻译教程，上海:上海外语教育出版社
[23]侯维瑞，1988，文体研究和翻译，北京:《外语教学与研究》第3期
[24]华仲芬，1999，医学英语构词纵览，北京:人民卫生出版社
[25]黄绪先，张春敬，1997，医学论文标题的英译，北京:《中国科技翻译》第1期
[26]贾德江，1998，医学英语汉译方法初探，北京:《中国科技翻译》第3期
[27]李亚舒，黎难秋，2000，中国科学翻译史。长沙:湖南教育出版社
[28]李延林，1999“疾病、生病”的英译，北京:《中国科技翻译》第4期
[29]刘必庆，1998，文体与翻译，北京:中国对外翻译出版公司
[30]刘学俊，2000，医学英语汉泽，北京:《中国科技翻译》第1期
[31」刘祖慰，1986，现代语言学和翻译理论，上海:《上海科技翻译》第1期
[32]刘治，倪传斌，2000，论医学英语中人名冠名术语的汉译，北京:《中国科技翻译》第3期
[33]卢思源，1988，从“貌合神离”到“形神皆似”一谈翻译的“层次感”，上海:《上海科技翻译》第1期
[34]马邦新，1998，英文药品说明书的翻译，北京:《中国科技翻译》第3期
[35]马清海，1997，科技翻译的标准和科技术语的翻译原则，北京:《中国翻译》第1期
[36]邵循道，1980，英语医学书刊阅读与翻译教程，北京:人民卫生出版社
[37]谭载喜，1999，新编奈达论翻译，第203页，北京:中国对外翻译出版公司
[38]田辛耕，1987，谈谈科技英语的模式与翻译，收在《科技翻译技巧文集》，第38页，北京:中国对外翻译出版公司
[39]王重稼，1995，医学英语实用语法和翻译技巧，上海:上海医科大学出版社
[40]王立夫，蒋鹏，1986，实用医学英语汉译技巧，石家庄:河北科学技术出版社
[411杨玉文，1998，英语常见词在医学中的翻译问题，北京:《中国科技翻译》第4期
[42]叶子南，2001，高级英汉翻译理论与实践，北京:清华大学出版社
[43]余富林，2001，医学英语缩略语的特点，北京:《中国科技翻译》第3期
[44]袁崇章，1987，论科技译文的语体特征，北京:《外语教学》第4期
[45]岳中生，曾方明，2000，科技翻译标准新议，北京:《中国科技翻译》第3期
[46]张春敬，黄绪先，1995，医学论文摘要英译应注意的问题，北京:《中国科技翻译》第2期
[47]张登峰，屈榆生，1996，中西医病症比较与翻译，北京:《中国科技翻译》第3期
[48]张帆，2001，我国医学期刊英文摘要的几个问题，北京:《中国科技翻译》第2期
[49]张美芳，2001，从语篇分析的角度看翻译中的对等，广州:《现代外语》第1期
[50]张梦井，1995，药品说明书的翻译，北京:《中国科技翻译》第2期
[51]周铁成，1995，易懂，自然的汉译英，北京:《中国科技翻译》第2期
[52]周铁成，1996，论医学英语文体特点，北京:《中国科技翻译》第3期
[53]周铁成，1996，医药卫生用语的翻译，北京:《中国科技翻译》第3期
[54]周铁成，1999，英译汉的大忌:对号入座，北京:《中国科技翻译》第2期
[55]周铁成，2000，医学英语特点剖析，第115页，北京:人民军医出版社