# Conveying Imagistic Thinking in Traditional Chinese Medicine Translation: A Prompt Engineering and LLM-Based Evaluation Framework

arXiv: https://arxiv.org/abs/2512.01198 · HTML: https://mlsanity.com/paper/2512.01198/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 12 of its 34 references that are in the map.
- First posted on arXiv 1 Dec 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 12 of 12)

- [COMET: A Neural Framework for MT Evaluation](https://mlsanity.com/paper/2009.09025/) (2020)
- [BARTScore: Evaluating Generated Text as Text Generation](https://mlsanity.com/paper/2106.11520/) (2021)
- [LLMs instead of Human Judges? A Large Scale Empirical Study across 20 NLP Evaluation Tasks](https://mlsanity.com/paper/2406.18403/) (2024)
- [Human-in-the-loop or AI-in-the-loop? Automate or Collaborate?](https://mlsanity.com/paper/2412.14232/) (2024)
- [Machine Translation with Large Language Models: Prompt Engineering for Persian, English, and Russian Directions](https://mlsanity.com/paper/2401.08429/) (2024)
- [The power of Prompts: Evaluating and Mitigating Gender Bias in MT with LLMs](https://mlsanity.com/paper/2407.18786/) (2024)
- [CMDAG: A Chinese Metaphor Dataset with Annotated Grounds as CoT for Boosting Metaphor Generation](https://mlsanity.com/paper/2402.13145/) (2024)
- [LiTransProQA: an LLM-based Literary Translation evaluation metric with Professional Question Answering](https://mlsanity.com/paper/2505.05423/) (2025)
- [What do Large Language Models Need for Machine Translation Evaluation?](https://mlsanity.com/paper/2410.03278/) (2024)
- [Human-in-the-loop Machine Translation with Large Language Model](https://mlsanity.com/paper/2310.08908/) (2023)
- [From Metaphor to Mechanism: How LLMs Decode Traditional Chinese Medicine Symbolic Language for Modern Clinical Relevance](https://mlsanity.com/paper/2503.02760/) (2025)
- [Long-context Reference-based MT Quality Estimation](https://mlsanity.com/paper/2509.13980/) (2025)

## Abstract (arXiv)

Traditional Chinese Medicine (TCM) theory is built on imagistic thinking, in which medical principles and diagnostic and therapeutic logic are structured through metaphor and metonymy. However, existing English translations largely rely on literal rendering, making it difficult for target-language readers to reconstruct the underlying conceptual networks and apply them in clinical practice. This study adopted a human-in-the-loop (HITL) framework and selected four passages from the medical canon Huangdi Neijing that are fundamental in theory. Through prompt-based cognitive scaffolding, DeepSeek V3.1 was guided to identify metaphor and metonymy in the source text and convey the theory in translation. In the evaluation stage, ChatGPT 5 Pro and Gemini 2.5 Pro were instructed by prompts to simulate three types of real-world readers. Human translations, baseline model translations, and prompt-adjusted translations were scored by the simulated readers across five cognitive dimensions, followed by structured interviews and Interpretative Phenomenological Analysis (IPA). Results show that the prompt-adjusted LLM translations perform best across all five dimensions, with high cross-model and cross-role consistency. The interview themes reveal differences between human and machine translation, effective strategies for metaphor and metonymy transfer, and readers' cognitive preferences. This study provides a cognitive, efficient, and replicable HITL methodological pathway for the translation of ancient, concept-dense texts such as TCM.