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BMJ 1996; 313 doi: (Published 03 August 1996) Cite this as: BMJ 1996;313:0

Different cultures, different attitudesThe Germans believe hypotension to be a disease. The French prescribe cerebral vasodilators for failing cognition. The Americans can't resist heroic surgery. The British are obsessed with their bowels. We are used now to cultural variations in medical practice, but this week illustrates two that may be less familiar. Herbal medicines are used much more in Germany than Britain, and German doctors have long prescribed Hypericum perforatum (St John's wort) for psychological complaints. But does it work? A systematic review of 23 randomised trials that we publish today (p 253) suggests that it does work in patients with …

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