Indian Journal of Pharmacology 2002; 34: 100-110 REVIEW ARTICLE

INDIGENOUS ANTI-ULCER DRUGS-A REVIEW

ANTI-ULCER DRUGS FROM INDIGENOUS SOURCES WITH EMPHASIS ON MUSA

SAPIENTUM, TAMRABHASMA, ASPARAGUS RACEMOSUS AND ZINGIBER
OFFICINALE

R.K. GOEL, K. SAIRAM

Department of Pharmacology, Institute of Medical Sciences,

Banaras Hindu University, Varanasi-221005. India

Manuscript Received: 27.2.2001 Revised: 14.9.2001 Accepted: 15.9.2001

ABSTRACT Sula, Parinamasula and Amlapitta are clinical entities recognized by ayurveda, akin to peptic ulcer and
functional dyspepsia. Many indigenous drugs have been advocated in ayurveda for treatment of dyspepsia.
Our laboratory has been engaged in screening of various indigenous herbal and metallic drugs for their
potential use in peptic ulcer diseases, taking lead from Ayurveda and have reported anti-ulcer and ulcer-
healing properties of Tectona grandis (lapachol), Rhamnus procumbens (kaempferol), Rhamnus triquerta
(emodin), Withania somnifera (acylsteryl glycoside), Shilajit (fulvic acid and carboxymethoxybiphenyl),
Datura fastuosa (withafastuosin E), Fluggea microcarpa and Aegle marmelos (pyrano- and iso- coumarins)
etc., along with their mechanism of action. The present article includes the detailed exploration of ulcer
protective and healing effects of unripe plantain banana, tambrabhasma and Asparagus racemosus on
various models of experimental gastroduodenal ulceration and patients with peptic ulcer. Their effects on
mucin secretion, mucosal cell shedding, cell proliferation, anti-oxidant activity, glycoproteins, and PG
synthesis have been reported. Clinical trials of these drugs for evaluating their potential ulcer healing
effects in peptic ulcer patients have been done. Their potential ulcer protective effects both, experimental
and clinical seemed to be due to their predominant effects on various mucosal defensive factors rather
than on the offensive acid-pepsin secretion. Thus, the above herbal / herbo-mineral drugs do have
potential usefulness for treatment of peptic ulcer diseases.

KEY WORDS Herbal drugs herbo-mineral drugs rasayanas acid-peptic disorders

non-ulcer dyspepsia sula parinamasula amlapitta

INTRODUCTION the defensive factors is gaining importance. It is now

Peptic ulcer therapy has undergone many strides over
the past few years and a number of drugs are now
available for treatment. These drugs are broadly clas-
sified into two, those that decrease or counter acid-
pepsin secretion and those that afford cytoprotection
by virtue of their effects on mucosal defensive fac-
tors. These drugs act by different mechanisms. Most
of the commonly used drugs such as H2- blockers
(ranitidine, famotidine etc), M1- blockers (pirenzepine,
telenzepine etc), proton pump inhibitors (omeprazole,
lansaprazole etc), decrease secretion of acid while,
drugs like sucralfate and carbenoxolone promote mu-
cosal defenses. Of late the role of these drugs on
assumed that these drugs ultimately balance the ag-
gressive factors (acid, pepsin, H. pylori, bile salts)
and defensive factors (mucin secretion, cellular mu-
cus, bicarbonate secretion, mucosal blood flow and
cell turnover)1. Although these drugs have brought
about remarkable changes in ulcer therapy, the effi-
cacy of these drugs is still debatable. Reports on
clinical evaluation of these drugs show that there are
incidences of relapses and adverse effects and dan-
ger of drug interactions during ulcer therapy. Hence,
the search for an ideal anti-ulcer drug continues and
has also been extended to herbal drugs in search
for new and novel molecules, which afford better pro-
tection and decrease the incidence of relapse.

Correspondence: R.K. Goel

e-mail: rkgoel@banaras.ernet.in
101 R.K. GOEL AND K. SAIRAM
In Ayurveda, peptic ulcer mostly refers to Amlapitta
or Parinamasula. Amlapitta is a disease of the gas-
trointestinal tract, especially of the stomach. It has
not been described as an independent disease in
major Ayurvedic texts, but has been mentioned in
short in Kashyapa samhita2. Amlapitta literally means,
pitta leading to sour taste. Apart from the stress laid
on food habits and personal hygiene, some herbal
drugs have also been mentioned. Modern medicine
has not adequately evaluated the usefulness of these
drugs in ulcer therapy, although studies have been
reported. Some active constituents have also been
isolated from these potential anti-ulcerogenic plant
drugs (Table 1 and 2).
An attempt has been made to summarize some of
the important anti-ulcer studies done with herbal
plants in our laboratory and elsewhere during the last
few decades to highlight the developments made and
also to provide clues and avenues for future research.
A detailed review would be practically difficult due to
enormity of information available. Thus, this presen-
tation reviews in detail some plant products like un-
ripe plantain banana (Musa sapientum var.
paradisiaca), Tamrabhasma (an indigenous prepa-
ration of copper), ginger (Zingiber officinale) and
satavari (Asparagus racemosus) and gives an over-
view on other potential anti-ulcerogenic drugs.
Musa sapientum var. paradisiaca (unripe plantain
banana)
Extensive investigations regarding anti-ulcerogenic
and ulcer healing activities of plantain banana have
been carried out in our laboratory for the past 30
years. Sanyal et al, have reported the anti-ulcerogenic
activity of dried powder of banana pulp (DRBP)
against ulcers induced by histamine in guinea pigs
and, phenylbutazone, restraint stress and
prednisolone in rats3-6. Other workers like Elliott and
Heward7 and Best, et al 8 have also confirmed the
anti-ulcerogenic activity of banana against histamine-
induced gastric ulcers in mice and aspirin-induced
gastric ulcers in rats respectively. In a comprehen-
sive study done with DRBP and its various extracts
against various experimental gastro-duodenal ulcers
and radiologically proved cases of peptic ulcers,
DRBP showed its usefulness as mentioned in
Ayurveda9. The study further proved that the anti-
ulcer effect of banana in 4 hr pylorus-ligation (PL)
rats was not due to its 5-HT content as presumed
earlier, but could be due to its predominant effect on
mucosal defensive factors. The effect of biological
variables like size, season and soil on the anti-
ulcerogenic activity of DRBP has been evaluated and
it was reported that the activity was primarily ob-
served with unripe, mature, green plantain banana
obtained from Musa sapientum Linn. Var. paradisiaca
collected between the months of September to March
along the Gangetic belt in the northern parts of the
Indian sub-continent. Activity was lost due to ripen-
ing or drying of pulp at temperature above 60oC and
absent in the small sized fruits. Less or no activity
was found in the banana collected from the southern
states during the same period. DRBP was reported
to have no activity on offensive acid pepsin secre-
tion and the effect was mostly ascribed to increase
in gastric mucus secretion quantified in terms of to-
tal carbohydrate:protein ratio (TC:P ratio)10. Further
studies with DRBP on the changes induced by
ulcerogenic agents like aspirin (ASP),
phenybutazone, indomethacin and prednisolone in
the dissolved mucosubtances of gastric juice showed
that it not only increased the TC:P ratio of the gastric
juice, but also reversed the decrease in ratio induced
by ulcerogenic drugs11. While, there was no change
in the individual carbohydrates significant decrease
in protein content of the gastric juice was observed
leading to increase in TC:P ratio. Decrease in pro-
tein content signifies decreased leakage from gas-
tric mucosa indicating increased strengthening of
gastric mucosal barrier. Increase in glycoprotein con-
tent of the mucosa and cell shedding in the gastric
juice were also reported as further evidence for
strengthening of mucosal resistance12. Apart from
mucosal resistance DRBP was also reported to in-
crease cell proliferation as observed from increase
in DNA and [3H]-thymidine uptake by the mucosal
cells and increase in mucosal thickness. This prop-
erty was also reported to be involved in healing of
ulcers13.
Ethanolic extract of banana (BE) was reported to in-
crease the accumulation of eicosonoids like pros-
taglandins E and I2 (PGE and PGI2) and leukotrienes
 INDIGENOUS ANTI-ULCER DRUGS-A REVIEW 102

Table 1. Extracts of some medicinal plants possesing antiulcerogenic activity.

Plants Extracts Models Mode of action

1.Tectona grandis L. Ethanolic fraction PL-, RS- and prendnisolone- No effect on acid-pepsin
(Trunk Bark and induced GU in rats. secretion but caused
wood chips)57 HIST- induced GU and DU an increase in
in GP mucin secretion.

2.Withania somnifera SG-1 [total methanol RS- induced GU in rats Anti-stress activity
(Roots)58 -H2O (1:1)]
SG-2 (sitoindosides VII,
VIII and withaferin-A)
59
3. Shilajit per se effect PL-, IS- and ASP- induced GU in Tendency to decrease acid-
rats and CYS-and HIST- induced pepsin secretion and
DU inrats and and GP respectively significant increase in mucin
secretion

4.Wedelia calendulacea Aqueous and ethanolic extracts ASP- and RS-induced (antiulcer) -
(Leaves)60 and acetic acid (healing)-
induced GU in rats

5.Pongamia pinnata (seeds)61 PE, AE, CE and EE extracts RS- induced GU in mice
(Roots)62
RS- and PL- induced
GU in rats
-
Decrease in acid-pepsin and
increase in mucin secretion by
ethanolic extract

6. Abies pindrow Royle CE, AE and EE extracts CRS- induced GU in rats Antistress activity
(Leaves)63

7. Sitavirya drugs35
a. Asparagus acemosus Fresh juice PL- and CRS- induced GU in rats No effect on acid-pepsin
(Roots) secretion and promotes
b. Glycyrrhiza glabra Water decoction PL- and CRS- induced GU in rats mucosal defensive factors
(Roots) by enhancing mucin
c. Holarrhene Water decoction PL- and CRS- induced GU, CYS- secretion and life span of
antidysenterica induced DU in rats mucosal cells
Wall. (Barks)
d. Ficus religiosa Water decoction PL- and CRS- induced
(Barks) GU and CYS- induced DU in rats

8.Bacopa monniera Fresh juice CRS-, ethanol-, ASP- and PL- No effect on acid-pepsin
(Whole plant)64 induced GU in rats secretion, increase in mucin
secretion and life span of
mucosal cells.

9. Convolvulus pluricaulis Fresh juice CRS-, ethanol-, ASP- and PL- No effect on acid- pepsin
(Whole plant)65 induced GU in rats secretion, increase in mucin
secretion and life span of
mucosal cells.

10. Centella asiatica Fresh juice CRS-, ethanol-, ASP- and PL- No effect on acid-pepsin
(Whole plant)66 induced GU in rats secretion, increase in mucin
secretion and life span of
mucosal cells.

Ê
103 R.K. GOEL AND K. SAIRAM
Plants Extracts
11. Emblica officinalis Fresh juice
(Fruits)67,68
12.Selaginella Ethanolic extract
bryopteris69
13.Camellia Hot water extract
sinensis70
14. Cissampelos Methanolic extract
muronata 71
(Leaf)
15. Ginkgo biloba72 Ethanolic extract
16. Vitex negundo73 Aq. extract
AE-Acetone; ASP-Aspirin; CE-Chloroform; CRS-Cold restraint stress; CYS-Cysteamine; DU-Duodenal ulcer; EE-Ethanolic;
GP-Guinea pig; GU-Gastric ulcer; HIST-Histamine; PE-Petroleum ether; PL-Pylorus ligation; RS-Restraint stress
B4, and C4/ D4 (LTB4, C4/ D4) in the human gastric
and colonic mucosal incubates. PGs are reported to
be one of the factors involved in the anti-ulcerogenic
activity, while LTs caused it. Water extract of banana
was comparatively ineffective 14. The effect of banana
on LTC4 /D4 explains its ineffectiveness against etha-
nol-induced gastric ulcers as leukotrienes are re-
ported to be one of the important causes of ulcera-
tion induced by ethanol (EtOH)15.
Best, et al 8, reported that the anti-ulcerogenic and
ulcer healing effect of DRBP against aspirin induced
gastric ulcers in rats was due to its ability to stimu-
late the growth of gastric mucosa and the active con-
stituents were thermolabile, water soluble and insolu-
ble in organic solvents8. They also reported the ab-
sence of anti-secretary effects and that even though
DRBP contains high amount of 5-HT the activity was
not due to it.
Ghosal and coworkers have isolated and character-
ized many active principles from vegetable banana.
They have reported anti-ulcerogenic activity of
sterylaclyglycosides, sitoindosides I-IV isolated from
Musa paradisiaca Linn. against ulcers in rats and
humans16-18. Sitoindoside IV was also reported to sig-
nificantly mobilize and activate peritoneal macro-
phages with increase in DNA and [3H]-thymidine up-
Models Mode of action
CRS-, ethanol, ASP- and PL- No effect on acid- pepsin
induced GU in rats secretion, increase in mucin
secretion and life span of
mucosal cells.
RS ulcers in rats
Cold + Restraint
stress induced ulcers in rats
Indomethacin-, HIST-,
stress-induced GU
Ethanolic induced GU
Piroxicam-induced GU
take in different organs indicating possible role of
macrophages in aiding wound healing, which may
account for its anti-ulcer activity19. Lewis, et al had
reported the antiulcer activity of a flavanoid,
leucocyanidin isolated from unripe plantain banana
pulp20. Recently the methanolic extract of banana was
reported to have anti-oxidant effect but not anti-
H.pylori activity in vitro21.
The clinical usefulness of DRBP was substantiated
using radiological and endoscopic studies. It was
found to decrease or delay the relapse of peptic ul-
cer to 6-12 months after 3 months continuous treat-
ment with banana powder, when given in the dose of
1 g q.i.d. It was available as MusapepR after Phase
IV clinical trials. Double blind study done at many
centers have shown that about 40-70% of
endoscopically proved duodenal ulcers healed after
12 weeks of treatment with DRBP, as compared to
about 16 % with placebo9.
In another clinical study with MusapepR in non-ulcer
dyspepsia (NUD), Arora and Sharma have reported
relief in symptoms by 75% after 8 weeks of treat-
ment compared to only 20% in the controls22. They
advocated that the therapeutic trials with this dose
justified the use of DRBP on clinical grounds to be
safe and effective in the treatment of NUD.
 104
INDIGENOUS ANTI-ULCER DRUGS-A REVIEW

Table 2. Ulcer protective effect of some active constituents isolated from herbal drugs.

Plants Active constituents Models Mode of action

1.Tectona grandis Lapachol IS- and ASP- induced per se no significant effect on both offensive
Linn. (Trunk bark GU in rats. CYS- and HIST- and defensive factors, but reversed the ASP-
and wood chips)74 induced DU in rats and induced increase in peptic activity and decrease
GP respectively. in sialic acid and mucin secretion.

2. Rhamnus Kaempferol PL-, ethanol, IS- and CRS- induced GU Decrease in acid-pepsin secretion and increase
procumbens in rats and HIST- induced GU in mucin secretion, Endogenous increase in PGs
(Whole plant)75,76 and DU in GP. and decrease in LTs4

3. Shilajit77 Fulvic acid, PL-, PL+ASP- and RS- induced GU per se decrease in acid-pepsin secretion and
4/- methoxy and CYS- induced DU in rats. cell shedding, tendency to increase mucin
6-carbomethoxy secretion, but reversed the increase in cell
bi phenyl shedding and decrease in mucin secretion
induced by ASP.

4. Rhamnus Emodin RS-, PL- and IS- induced GU in rats Decrease in acid-pepsin secretion and increase
triquerta Wall in mucin secretion in ASP- treated group.
(Whole plant)78

5. Datura fastuosa Withafastuosin- E CRS-, PL- and ASP- per se decrease in acid-pepsin and no effects
(Leaves)79,80 induced GU in rats on mucin secretion, mucosal cell shedding,
proliferation and glycoproteins
Significant increase in endogenous PGs.

6. Flueggea Bergenin/ PL- and ASP- induced GU in rats and Increase in endogenous PGs
microcarpa norbergenin CRS- induced GU in rats and GP.
(Leaves and
roots) 81

7. Aegle marmelos Luvangetin -do-

Correa (Seeds)81

8. Azadirachta Nimbidin ASP-, prednisolone-, indomethacin-,

indica 82 serotonin stress- and acetic acid-
induced GU in rats. HIST- induced
DU in GP. CYS- induced DU in rats

9. Picrasma MeOH extract, ASP- induced GU in rats

quassioides83 CHCI3 soluble
fraction,
Nigakilactone and
Methynigakinone

10. Ocimum Fixed oil ASP-, indomethacin-, ethanol, HIST-, Antisecretory

basilum84 reserpine-, Serotonin-, PL- and stress-
induced GU in rats

11. Bacopa Standardized CRS-, ethanol, ASP- and PL- induced No effect on acid-pepsin secretion, increase in
monniera extract of GU in rats mucin secretion and life span of mucosal cells.
(Whole plant)85 bacoside A (35%)

AE-Acetone; ASP-Aspirin; CE-Chloroform; CRS-Cold restraint stress; CYS-Cysteamine; DU-Duodenal ulcer; EE-Ethanolic;
GP-Guinea pig; GU-Gastric ulcer; HIST-Histamine; IS-Immobilization stress; PE-Petroleum ether; PL-Pylorus ligation;
RS-Restraint stress;
105 R.K. GOEL AND K. SAIRAM
The results of the above studies with dried plantain
banana pulp powder, therefore makes it a potent
herbal drug for the treatment of peptic ulcer disease
and prompts that chemistry of banana pulp should
be studied extensively to find out the active
principle(s), which can be promising ulcer healing
drug/s. Till then one should not hesitate to use its
dried powder in the treatment of peptic ulcer disease
as the powder seemed to be safe and potent, and
only a self-limiting diarrhea was reported as an
adverse effect.
Tamrabhasma
Use of herbo-mineral preparations in Ayurveda is well
documented. Tamrabhasma (TMB), a traditional
preparation of copper has been suggested for its use
in Amlapitta 23. An earlier published study has given
the composition of TMB as: CuO > 44.45 % < 66.13%;
Fe2 O3 < 6.03 % & S < 2.75%24. Extensive studies
have been undertaken to unravel the anti-ulcerogenic
activity of TMB. TMB has shown to possess ulcer
protective activity against various gastric ulcers in-
duced by 8 h - immobilization stress (IS), 4h PL and
aspirin in rats and histamine- induced gastric and
duodenal ulcers in guinea pigs. The activity was due
to both, decrease in offensive acid-pepsin and in-
crease in defensive mucin secretion25. Further evalu-
ation of TMB from different sources compared to pure
compound and mixture of major ingredients of TMB
for anti-ulcerogenic activity, revealed that TMB prepa-
ration was better than pure copper compound or a
mixture of known ingredients. Quantitative differences
in TMB preparation also showed the importance of
pharmaceutical processing in the therapeutic activ-
ity of TMB26. TMB has an overall solubility in water of
approximately 1 % and 12 ng/ml CuO forms a satu-
rated solution at 50oC27 implying that, when used
orally it would have local effect than being systemi-
cally absorbed. This reduces the possibility of sys-
temic toxicity with copper. Toxicity studies have shown
that TMB was safe and even 1000 times of the effec-
tive antiulcer dose was tolerable in rats26.
TMB was also found to have anti-ulcerogenic effect
against aspirin-induced ulcers without affecting the
anti-inflammatory activity of aspirin. TMB seemed to
have prolonged effect as the protective effect of TMB
lasted up to 5 days after discontinuation of treatment.
So aspirin - copper combination may reduce
ulcerogenic activity of aspirin without affecting its anti-
inflammatory effect26. Goel and Maiti, have reported
the gastric protective effect of TMB against CRS-in-
duced gastric ulcers in rats and guinea pigs and its
healing effect against acetic acid- induced gastric
ulcers in rats15. TMB was reported to increase PGE
and decrease LTC4 in human gastric and colonic
mucosal incubates. The mucosal protective effects
of TMB and CuCl2 could be due to their effect on
endogenous PGs and LTs. TMB showed better and
potent effect compared to CuCl2 on PGs release both
in gastric and colonic incubates suggesting that other
ingredients of TMB add on to its effects28,29. TMB sig-
nificantly protected rats against ethanol-induced ul-
cers and the effect was ascribed to decrease in LTC4/
D4 synthesis15.
TMB has also been reported to increase the defen-
sive mucopolysaccharides including sialomucin and
fucose, decrease DNA in gastric juice suggesting
decrease in cell shedding and increase in life span
of mucosal cells, with no change in mucosal DNA
and incorporation of [3H]-thymidine uptake in mucosal
tissues, indicating absence of activity on cell prolif-
eration30.
Thus, the effect of TMB on offensive acid-pepsin se-
cretion and leukotrienes, and defensive mucus secre-
tion, mucosal glycoproteins, prostaglandin and cell
shedding may contribute to its ulcer protective activity.
Asparagus racemosus (Hindi-Satavari)
Asparagus racemosus (AR) is commonly mentioned
as a rasayana in the Ayurveda. Rasayanas are those
plant drugs, which promote general well being of an
individual. They are considered to prevent aging, in-
crease longevity and offer resistance to diseases by
augmenting the immune system31. AR is one of the
sitavirya drugs and has been cited in treatment of
peptic ulcer diseases by Chakradutta, a connotation
on Caraka samhita 32 and Susrutha Samhita 33.
Sitavirya property is usually present in madura
(sweet), tikta (bitter) and kasaya (astringent). Rasa
containing drugs usually purifies the pitta (Astanga
Hridaya, Sustrastana, 16/11)34.
The anti-ulcerogenic activity of juice of fresh roots of
AR has been reported against cold-restraint stress-
and pylorus ligation-induced gastric ulcers. The
activity was reported to be due to both decrease in

offensive acid-pepsin secretion and increase in de-
fensive mucin secretion. Mucin secretion was quan-
tified in terms of TC:P ratio in the gastric juice. The
strengthening of the mucin barrier further led to a
decrease in DNA content of the gastric juice indi-
cating decrease in cell shedding35. In continuation of
earlier experimental work, a Satavari containing Ay-
urvedic preparation, Satavari mandur (SM) has un-
dergone clinical trails and has shown promising re-
sults. It has been observed that SM, when given in
the dose of 1.5 g, twice daily for a month not only
produced significant improvement in symptoms of
peptic ulcer, but also healed endoscopically proved
cases of ulcer dyspepsia by 75%. The biochemical
estimations of offensive acid-pepsin and defensive
mucin secretion and cell shedding (µg DNA/ml) be-
fore and after treatment with SM showed a tendency
to decrease acid-pepsin secretion, significant de-
crease in cell shedding and increase in mucin se-
cretion indicating its predominant effect on mucosal
defensive factors36.
Zingiber officinale Roscoe
Ginger consist of the near surface and underground
rhizomes of Z. officinale. Ginger has been used as
a condiment and medicine for centuries. Its use is
recorded in early Sanskrit and Chinese texts and is
also documented in ancient Greek, Roman and Ara-
bic medical literature37. Numerous uses of ginger
are reported38-43. Powdered rhizome of ginger root
has been used as a traditional remedy for gastroin-
testinal complaints including in treating peptic ul-
ceration despite the fact that ginger promotes gas-
tric secretions38.
Water decoction of ginger making up one of the con-
stituents of Mahakasyaya drugs along with water
decoction of Piper longum and colloidal solution of
Ferula asafoetida has been reported to protect
against CRS-, ASP- and PL- induced gastric ulcers
in rats. Although increase in offensive acid-pepsin
secretion was observed in this study, the increase in
defensive mucin secretion was sufficient enough to
protect against experimental ulcers44.
Gingerols have been reported to be responsible for
the characteristic taste and many pharmacological
activities including motion41,42. It was speculated that
the anti motion sickness properties of ginger resulted
from effects on the gastrointestinal tract rather than
INDIGENOUS ANTI-ULCER DRUGS-A REVIEW 106
effects on the central nervous system45. Studies show
that ginger increases gastrointestinal propulsion46.
Several anti-ulcer compounds have been isolated
from ginger, including 6-gingesulphonic acid47, 6-
shogaol and ar-curcumene48. Most notable is 6-
gingesulphonic acid, which showed weaker pun-
gency and more potent anti-ulcer activity than 6-
gingerol and 6-shogaol49-51. The antiulcer activity of
ginger may also be due to the potent thromboxane
synthetase inhibition52,38. High doses of ginger prob-
ably act as a gastric irritant. Fresh ginger in quanti-
ties of 6 g or more caused a singnificant increase in
exfoliation of gastric surface epithelial cells in hu-
man volunteers46. Ginger was shown to significantly
scavenge superoxide and hydroxyl radicals and
inhinit lipid peroxidation53.
MISCELLANEOUS PLANTS/NATURAL AGENTS
Various other herbal drugs have been reported to
posses anti-ulcerogenic activity. These are summa-
rized in Table 1. Some of these drugs have been
chemically characterized and the entities involved in
the activity have been isolated. These are summa-
rized in Table 2.
Mild irritants are known to protect the gastric mu-
cosa from ulcerogens by adaptive cytoprotection54.
In a conclusive study, it was reported that hypertonic
saline (5 % NaCl) significantly provided protection in
ASP-, CRS-, EtOH- and PL-induced gastric ulcers
by reducing offensive acid-pepsin secretion and in-
creasing defensive factors like mucin secretion and
mucosal endogenous PGs55.
CONCLUSION
Ulcers were previously thought to be due to increase
in offensive factors namely acid and pepsin, but it
has been found that acid secretion is either normal
or below normal in gastric ulcer patients, and that 40
- 70 % cases of duodenal ulcer patients show acidity
within normal range56, suggesting that other factors
are also involved in ulcerogenesis. Hence the inter-
est then shifted to the defensive factors, whose im-
balance with the offensive factors are now thought
to be the cause of ulcers. Most of the anti-secretory
drugs reduce acid secretion, thus giving immediate
symptomatic relief, but there are reports of adverse
effects and relapses in the long run. On the contrary
natural drugs mostly augment the defensive factors
107 R.K. GOEL AND K. SAIRAM
and may be slow in activity but are reliable and safe.
Hence use of natural drugs alone or with combina-
tion with other drugs should be seriously considered.
With emphasis on quality and also our market going
global, it becomes a necessity to isolate, identify,
characterize and standardize the active constituents
from herbal sources. Standardization is indispensa-
ble to maintain reproducible quality in biological evalu-
ation. With more information being available on
gastro-duodenal ulcerations, consideration of these
modern aspects in evaluation of herbal drugs be-
comes important. Hence the blend of Ayurvedic
knowledge supported by modern science is neces-
sary to do a comprehensive study.
It is apparent that experimental evaluation of herbal
drugs for the treatment of gastric ulcer is rather im-
pressive, but very few have reached clinical trials
and still few have been marketed. This shows that
the benefits of research are not reaching the peo-
ple to whom medical research is directed and hence
the time, manpower and resources are not efficiently
utilized.
Hence, pharmacologists need to take more active
interest in evaluation of herbal drugs for potential
antiulcer activity and standardization of such herbal
drugs to be clinically effective and globally com-
petitive.
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ESSENTIAL OILS FOUND TO FIGHT BACTERIA

A pair of orthopaedic surgeons report that two essential oils--eucalyptus and tea-tree oil--are sur-
prisingly effective at treating methicillin-resistant Staphylococcus aureus (MRSA) infections.
Dr. Eugene Sherry of the University of Sydney in Australia said that, applied to the skin of infected
wounds an antibacterial wash derived from Eucalyptus radiata and Melaleuca alternifolia--better known
as eucalyptus and tea-tree oil--can work when modern antibiotics fail.

He said that he used the combination "once a day for several months" in a series of 25 patients with
MRSA. "Twenty-two of the infections resolved completely," Sherry reported. In 19 patients, the infec-
tions resolved without the use of antibiotics, while three patients required antibiotic treatment, he
said. In addition, 10 of the patients were diabetic, which "makes healing of wounds very difficult,"
Sherry said in an interview.
Two years ago, Sherry attended a presentation about the antibacterial properties of essential oils and
decided to research the subject. He said that he discovered a wealth of 50-year-old research con-
cerning essential oils, but said "all that research was abandoned when modern science discovered
antibiotics."

When Sherry decided to initiate a trial of eucalyptus and tea-tree oil in MRSA patients, he discovered
that Dr. Patrick H. Warnke, an orthopedic surgeon at the University of Kiel in Germany, was pursuing
a parallel study. So the two combined their work to produce the 25-patient MRSA study.
Both doctors said that they have received no funding from the makers of the essential oils, nor do
they have financial interests in companies producing the substances.

"Most medicinals come from plants," he noted, "so the natural progression is to look to more plants
for more treatments."