Domestication vs. Foreignization in TCM Translation: A Constitution-Oriented Strategy for Resolving Jia-Term Ambiguities in Shang Han Lun

The accelerated global dissemination of traditional Chinese medicine (TCM) has led to a surge in demand for English translations of foundational texts like Shang Han Lun (Treatise on Cold Damage Disorders). However, the translation of culturally specific jia-character terms (e.g., wang xue jia, chuan jia), which embody unique cultural and constitutional concepts, has become a critical bottleneck hindering international clinical practice and education. Inaccurate translation of these terms can readily cause Western practitioners to misinterpret patients constitutional backgrounds, adversely affect treatment choices (e.g., misinterpreting han jia merely as excessive sweating rather than recognizing a fluid-depleted constitution), and exacerbate the confusion within the international standardization process of TCM terminology. Current translation approaches are often caught in a dilemma: domestication risks losing cultural connotations, while foreignization compromises clinical clarity. There remains a lack of systematic solutions grounded in audience needs. Confronting this practical challenge head-on, this study conducts an in-depth analysis of the translational differences and their impact on clinical applicability for 18 high-frequency jia-character terms across two authoritative English versions of Shang Han Lun. This framework directly serves the goals of enhancing diagnostic and therapeutic precision, ensuring the suitability of educational materials, and informing terminology standardization. It provides an actionable toolkit designed to break through the translation bottlenecks impeding the effective going global of classical TCM texts.