Misunderstandings about folk medicine practiced by Vietnamese refugees have led to charges of child abuse and at least one suicide, an article in The Western Journal of Medicine reports.

The practice of cao gio -- rubbing coins with hot balm oil on the chest and back of a sick person -- led to the jailing of one father, who subsequently committed suicide, writes Maj. Duong Nguyen, a U.S. Army doctor.

Such confusion, he writes, is one example of the differences between American and Vietnamese cultures that make western medical care difficult for the 580,000 Indochinese refugees in the United States.

Among the examples Nguyen cites:

*The oriental life style is less stressful, so Vietnamese have a more "elastic" view of time. And they tend to arrive late for doctor appointments.

*The Vietnamese have only a few family names, with Nguyen being the most common. This causes medical records confusion.

*Vietnamese are considered 1 year old at birth and gain a year every lunar new year, or Tet. A child could be 2 years old by Vietnamese counting yet less than a month old by American counting.

*Because of the importance of the family, medical decisions are rarely left to the patient. "In most cases, the relatives, more than the patients, are the ones to be convinced before the patient can start or continue a therapeutic program," one psychiatrist says.

*A diet heavy in salt is mistakenly believed to be good for pregnant women.

*Many Vietnamese believe that eating tiger bones, cooked to a gelatinous product, will make them strong.

Understanding of the cultural differences, Nguyen writes, could help prevent "futher unfortunate incidences such as the child abuse accusations and subsequent suicides."