Background: The woman was 18 years old and had four children. She had given birth to the fourth child approximately 3 months ago. On the evening of her death her husband stated that he heard her in the bathroom and then found her dead a short while later.
The autopsy revealed her to be healthy with no obvious cause for her death. The most striking finding at the postmortem analysis was that her stomach contents were a violet color and that all other body components were pink (urine, bile, brain, breast milk, etc). We have analyzed the purple stomach contents and founf it to contain the dye, Rhodamine B. This is a dark red or purple dye, that has many common uses. It is not toxic enough, though, to be the cause of her death.
My long about question to you is: are their any traditional medicines, etc. that are dark red or purple powders. I have heard that contraception is not practiced openly amoung the Hmong. Could she have been taking a folk remedy of some sort to prevent pregnancy?
We have obtained information about a similiar case in Fresno, CA involving a young Hmong woman who had given birth approximately six months before her death. She was also pink. I am hoping that gaining some insight into Hmong culture and medicine will help us solve this case. Can you point me to some sources of appropriate information?
Dr. Saykao and Dr. Winecker, thank you for sharing the case of the young Hmong women who died suddenly after giving birth a few months before. The Hmong fairly frequently use five substances that have a red or purple dye effect. The five substances are listed below. Three are often used in foods to "build the blood" of a mother who has recently given birth. The first three on the list, noted with an asterick, are the ones used to "build the blood", the fourth substance is used for women who have amennorhea, and the fifth substance is for the prevention of bloody stools.
1. Ncas Liab*
2. Nkaj Liab*
3. Hmab Ntsha Liab*
4. Txhub
5. Red Dye
May I suggest you take this list to the family of the deceased and ask them if the deceased had been consuming any of these traditional herbal substances. I would also like to note here that in Hmong history, no one has ever talked about a sudden death after ingesting any of these five substances. While not commonly consumed every day, they are used medicinally from time to time by many families with no apparent ill result.
I hope this information helps in some small manner. If you come to any conclusions regarding this case, I hope you will share it on the internet so we can spread the information to our respective communities.
B.Thowpaou Bliatout, Ph. D.; Dr. Ac.
Tuberculosis Program & Clinic Manager
Disease Prevention and Control Division
Multnomah County Health Department
426 SW Stark Street; 3rd Floor
Portland, Oregon 97204-2347
Internet: Bruce.T.BLIATOUT@co.multnomah.or.us
Phone: (503) 248-3417 ext: 22289
Directline: (503) 248-3663 ext: 22289
Fax: (503) 248-3917