Table 229.2Illustration of Cultural Differences in the Understanding of Physical Problems: Hmong Terminology for Liver Problems and What They Signify a

Hmong termTranslationCausesSymptoms
siab phem"ugly liver"Congenital, early learning, spiritual causes, natural disaster (e.g., lightning), injury, great personal lossDestructive behavior, verbal abuse or inability to verbalize, disorientation
nyuab siab"difficult liver"Loss of family, status, home, country, or any important itemExcessive worry, crying, confusion, disorganized speech, loss of sleep, poor appetite, delusions
tu siab"broken liver"Loss of or quarrel with spouse, sweetheart, family member, or friendGrief, worry, loneliness, guilt, insecurity
siab luv"short liver"Congenital, hereditary, early experience, trauma, severe illnessExtreme temper, violent behavior, restlessness, sweating, flushed appearance
kho siab"murmuring liver"Separation, loss of loved one, guiltNervous habits (e.g., whistling, pacing, humming, eccentric or deviant actions)
lwj siab"rotten liver"Stressful family relations, unfulfilled goalsMemory loss, short temper, delusions

Hmong is an unwritten language. The Hmong terms are written in arabic characters using a missionary-developed system but are not strictly phonetic (the last consonant is silent and indicates the tone in which the word is to be spoken).

Source: Modified from Bliatout (1982).

From: Chapter 229, Dealing with Patients from Other Cultures

Cover of Clinical Methods
Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.
Walker HK, Hall WD, Hurst JW, editors.
Boston: Butterworths; 1990.
Copyright © 1990, Butterworth Publishers, a division of Reed Publishing.

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