Questions whether modern psychiatric nosography represents scientific advances or merely changes in attitude. The case history of an African migrant worker in France is presented to illustrate cultural differences in client symptom explanation and medical diagnosis. The S's belief that he was poisoned by an old lover was a typical North African explanation of illness, but was regarded as delusional and paranoid by French psychiatrists. Different images of the location of illness in the heart or head also produced confusion. The concept of "love sickness," which was prevalent in antiquity and is still used in Arab cultures, is contrasted with modern psychiatric concepts such as the Oedipal complex. The importance of language and culture in the description and explanation of the common human themes of sex and death is discussed.