Review Article

A review on gastric ulcer remedies used in

Unani System of Medicine
Anwar Jamal1*, Aisha Siddiqui2, Tajuddin2 and M A Jafri3
1
TKDL, NISCAIR, Dr. K. S. Krishnan Marg, New Delhi-110012, India
2
Department of Ilmul Advia (Unani Pharmacology), A.M.U., Aligarh-202 202, Uttar Pradesh, India
3
National Institute of Unani Medicine, Dhanvanthri Road, Near Majestic, Bangalore-560 091, Karnataka, India
*Correspondent author, E-mail: [email protected]

Abstract Etiology and Pathogenesis

Peptic ulcer is the erosion in lining of stomach or duodenum. The word ‘Peptic’ refers
to pepsin, a stomach enzyme that break downs proteins. Peptic ulcer located in the stomach is Genetic predisposition:
called gastric ulcer. Normally the linings of the stomach and small intestine have protection against Heredity has been postulated to play a role
the irritating acid produced in stomach. For a variety of reasons, the protective mechanism may
in the pathogenesis of ulcer disease.
become faulty, leading to a breakdown of the lining. The result is inflammation (gastritis) or an
ulcer. Several rare genetic syndromes are
It is believed that adults in high stress jobs are mostly affected by gastric ulcer, but people associated with peptic ulcer, e.g. multiple
of any age even children are found affected by this problem. Ulcer is curable with the combination endocrine neoplasias, etc.
of different kind of antibiotics, an acid reducer and H2 receptor blockers, proton pump inhibitors,
Abnormalities in secretion of
etc., which are expensive to a common man and have prolong side effects also. In Unani system of
medicine plants, animals as well as mineral origin drugs are being used clinically for the treatment acid and pepsin: Acid-pepsin appears
of this disease without any side effect. These are time tested, centuries old, safe for use and cost to be important in the pathogenesis of
effective. However, there is a need to maintain their purity, quality and safety by subjecting to gastric ulcer. However, in contrast to
scientific validation. Experimentally studied as well as potential medicinal plants used for gastric duodenal ulcer, gastric ulcer patients
ulcer in Unani system of medicine are being discussed in this paper.
generally have acid secretary rates that are
Keywords : Peptic ulcer, Gastric ulcer, Unani system of medicine, Unani drugs.
normal or reduced as compared with non-
IPC code; Int. cl.7 — A61K 35/78, A61P 1/04 ulcer patients.
internal surface of stomach which causes Abnormalities of mucosal
Introduction
excessive gastric secretions, chronic defense: Diminished blood flow may
gastritis and indigestion, prolonged stress lead to cell injury and ulceration in some
Qarah-e-Medi (Gastric Uslcer) is patients. Gastric mucosal ischemia is
a common disorder of the gastrointestinal and strains and unabsorbed gastric
secretions1-11. believed to be a factor in the pathogenesis
system, which causes much discomfort to of acute mucosal injury and decreased
patients, disrupting their daily routines In western medicine, ulcers are
defects in the gastrointestinal mucosa that bicarbonate secretion is a possible cause
and causing mental agony. It is generally
penetrate the muscularis mucosa. This for diminished mucosal defense.
more common in those who keep
distinguishes them from superficial Delayed gastric emptying:
themselves in hurry, becomes worry and
erosions, which do not extend through Gastric emptying has been found to be
consumes curry. In Unani system of
the muscularis mucosa. Originally, delayed in gastric ulcer. Prolonged
medicine, Unani scholars mentioned the
following causes of Qarah-e-Medi all the ulcers in the upper gastrointestinal gastric emptying causes stasis and
(Gastric Ulcer), viz. Khilte Had (Hot and tract were believed to be caused delayed clearing of duodenal contents
Irritant humour), Fuzlat (Waste by the aggressive action of hydrochloric that have refluxed into the stomach.
Products), intake of hot and spicy foods, acid and pepsin on the mucosa. This in turn could damage gastric
excessive intake of rotten food, alcohol Thus, they are known as peptic mucosa, cause gastritis and lead to
and hard fibrous diet, desensitization of ulcers12. ulceration.

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Reflux of bile and pancreatic 5. To prevent haematemesis, Qurse antiulcer activity has been validated by
juice: Regurgitation of duodenal Kahruba, Rubbe Ghafis and Rubbe pharmacological studies are summarized
contents, especially those containing Afsanteen are given as drug10. below:
bile, may induce gastric mucosal 6. To clear the site of ulcer munaqqiat 1. Elva (Aloe barbadensis Mill.;
injury and subsequent gastric (cleansers) like Jali (detergent) and Family- Liliaceae)
ulceration. Muzalliq (demulcent) drugs, e.g. Oral administration of the plant
Emotional stress: Emotional Maul Asl (aqueous solution of honey) extract (leaves) significantly reduced
stress may alter factors that maintain and Julab (compound of honey and both the number of ethanol induced
mucosal integrity and thereby ulcers Arqe Gulab) are given. gastric lesions as well as lesion index
developed because of decreased mucosal
7. To clear slough and debris from the in experimental rats15.
defense13.
ulcer, Ayaraj faiqra followed by
Role of Microbes: The bacteria 2. Khulanjan (Alpinia galanga
Sharbat-e-Anar (Punica granatum
Helicobacter pylori have revolutionized Willd.; Family- Zingiberaceae)
syrup) or Sharbat-e- Bel (Aegle
approach of peptic ulcer diseases and
marmelos syrup) are given. Ethanolic extract of rhizomes
gastritis. Almost all patients with duodenal
ulcer and 80% of patients with gastric 8. Jazib (desiccant) and mudammil exhibited gastric antisecretory,
ulcers are infected with H. pylori. The (cicatrizent) drugs are effective after antiulcer and cytoprotective activities
organism is also associated with chronic complete clearing of slough from in rats16.
active gastritis (stomach inflammation) ulcers 1, 2, 4, 5, 11, 14. 3. Khatami (Althaea rosea Linn.;
and may also play a role in non-ulcer 9. Constipation can be treated with Family- Malvaceae)
dyspepsia (the belching and drugs like Amaltas (Cassia
bloating symptoms of indigestion). fistula). The damages of mucus membrane of
H. pylori infection has also been rat stomach, caused by Aspirin and
10. Diarrhoea may be managed with Atophan were considerably decreased
associated with a slightly increased risk Qurse Tabashir Qabiz1, 4, 11.
of gastric cancer. by polysaccharides obtained from
Unani physicians recommend 11. In case of nausea and excessive stem17.
Usool-e-Ilaj (Unani principles for secretions of bile, vomiting is induced
treatment) in following steps for the by Aabe Anar after giving Maush 4. Gaozaban (Anchusa strigosa
Shaeer1, 4. Labill.; Family- Boraginaceae)
treatment of Qarah-e-Medi.
Aqueous extract of roots showed
1. Use of Qabizat (Astringent drugs) for The present paper deals with both significant protection against ethanol
binding effect of ulcers. types of antiulcer plants: (i) plants which induced ulcers18.
are used in Unani System of Medicine and
2. Intake of easily digestible food. have been validated by experimental 5. Bhui neem (Andrographis
3. Avoiding of corrosive drugs, e.g. studies; (ii) potential antiulcer plants, paniculata Wall. ex Nees; Family-
Copper sulphate, White lead, animals and minerals which are used in Acanthaceae)
Verdigris, Rust, etc. Unani medicines but experimental study A flavone from the herb produced
4. Mugharriat (agglutinant) along is yet to be done. significant antiulcer activity in rats and
with mudammilat (cicatrizent) drugs guinea pigs19.
is used in case of oesophageal Experimentally studied plants
ulcers, e.g. Samaghe arbi (Gum 6. Asl-us-soos (Glycyrrhiza glabra
acacia) or Samaghe kateera (Gum Some plants which are used in Linn.; Family- Fabaceae)
kateera). Unani System of Medicine and their Carbenoxolone, isolated from
154 Natural Product Radiance
 Review Article

rhizome was found to be quite The butanolic extract of the water ulcerogenesis in Indomethacin
effective in the management of peptic fraction of fruits possess an pretreated rats and diethyl
ulcer20. Powdered drug (3g) is given antioxidant property, responsible for di-thio-carbamate induced ulcer
twice a day in empty stomach in cytoprotective action in rats gastric models29.
weekly follow up and recovered cases ulcers induced by Indomethacin. The
14. Haldi (Curcuma longa Linn.;
followed up monthly up to three alcoholic extract of fruits also
Family-Zingiberaceae)
months, which showed significant indicated a significant reduction in
results21. the ulcer score and acidity26, 30. Ethanol extract produced significant
anti-ulcerogenic activity in rats
7. Adrak (Zingiber officinale 11. Kalonji (Nigella sativa Linn.;
subjected to hypothermic restraint
Rosc.; Family- Zingiberaceae) Family- Ranunculaceae)
stress, pyloric ligation, Indomethacin
On oral administration of acetone The administration of Nigella and Reserpine administration31.
extract of rhizome, zingiberone, the sativa oil produced a significant
15. Heel kalan or Bari Ilaichi
main terpenoid of acetone extract increase in glutathione level, mucin
(Amomum subulatum Roxb.;
and gingerol, terpenoid pungent content and free acidity and a
Family-Zingiberaceae)
principle of the rhizome, significantly significant decrease in gastric mucosal
prevented gastric lesions in histamine content in ethanol induced Crude methanolic extract and its
27
HCl/ethanol induced gastric ulcers in rats . different fractions inhibited gastric
22
lesions in rats . Sesquiphellandrene, 12. Kela (Musa paradisiaca Linn. lesions induced by ethanol
besabolene and 6-shogaol, some significantly. Ethyl acetate fraction
syn. M. sapientum Linn.; Family-
active principles of Taiwan ginger also protected the wall mucous in pylorus
Musaceae)
produced antiulcer activity in HCl/ ligated rats. Gastric motility reduced
ethanol induced gastric lesion in Methanolic extract of Plantain banana by essential oil and petroleum ether
23
rats . pulp (50mg/kg, twice daily for fractions suggests the gastro-
5 days) showed significant antiulcer protective action32.
8. Asgand [Withania somnifera effect and antioxidant activity in
(Linn.) Dunal.; Family- 16. Heel khurd or Choti Ilaichi
gastric mucosal homogenates,
Solanaceae] (Elettaria cardamomum
where it reversed the increase in
Maton.; Family- Zingiberaceae)
Withanolide-free aqueous fractions ulcer index, lipid peroxidation and
exhibited significant antistress activity super oxide dismutase values in 2 hours A crude methanolic extract (TM),
28
in immobilization induced gastric cold restraint stress induced rats . essential oil (EO), petroleum ether
24
ulceration . soluble (PS) and insoluble (PI)
13. Karela (Momordica charantia
fractions of methanolic extract, were
9. Kutki (Picrorhiza kurroa Linn.; Family- Cucurbitaceae)
studied in rats at doses of 100-500,
Royle ex Benth.; Family- The Olive oil extract and dried 12.5-50, 12.5-150 and 450mg/kg,
Scrophulariaceae) powdered fruits in filtered honey respectively for their ability to inhibit
showed significant and dose the gastric lesions induced by Aspirin,
Ethanolic extract of rhizomes and
dependent anti-ulcerogenic activity ethanol and pylorous ligature. All
roots on oral administration showed
significant prevention of ulcers25. against ethanol-induced model. fractions (TM, EO, PS, PI) significantly
Furthermore ethanol extract of inhibited gastric lesions induced by
10. Amla (Emblica officinalis the fruits showed significant activity ethanol and Aspirin but not those
Gaertn.; Family- Euphorbiaceae) against HCl-EtOH induced induced by pylorus ligation33.

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17. Satawar (Asparagus racemosus Stearic and palmitic acid isolated Potential antiulcer plants,
Willd.; Family- Liliaceae) from the nimbidin fraction of neem animals and minerals
seeds oil showed antiulcer activity36.
Oral administration of powder of dry
roots prevented the formation of 20. Taj (Cinnamomum cassia Unani system of medicine has vast
duodenal ulcer in rats34. Blume; Family-Lauraceae) treasure of natural products in its
repository that cure Qarah-e-Medi (Gastric
18. Bael (Aegle marmelos Correa ex Cassioside and cassiol, two Ulcer) significantly. But there is a need to
Roxb.; Family-Rutaceae) components obtained from the bark validate their efficacy and safety by
produced antiulcer activity37. experimental studies and clinical trials.
Luvangetin, a pyranocoumarin
isolated from the seeds showed 21. Jaiphal (Myristica fragrans List of such potential plants, animals and
significant protection against pylorus Houtt.; Family- Myristicaceae) minerals with their Unani, English and
ligated and Aspirin induced gastric Eugenol, active principle of Nutmeg botanical names along with parts used are
ulcers in rats35. seeds significantly reduced gravity of given in Table 1.
lesion and numbers of gastric
19. Neem (Azadirachta indica A.
ulcers38.
Juss.; Family- Meliaceae)
Table 1 : List of potential single drugs of plant, animal and mineral origin in
vogue in Unani System of Medicine1, 3-11, 39

S. No. Unani common name English name and parts used Botanical/Scientific name

1. Aaqarqarha Spanish Pellitory (Root) Anacyclus pyrethrum DC.

2. Aas Myrtle (Fruits) Myrtus communis Linn.
3. Afsanteen Common Sagewort (Whole Herb) Artemisia absinthium Linn.
4. Afyoon White poppy (Latex) Papaver somniferum Linn.
5. Ajwain Desi Ajowan (Fruits) Trachyspermum ammi (Linn.) Sprague
6. Amaltas Golden Shower (Pods) Cassia fistula Linn.
7. Anar Pomegranate (Flower, Seeds) Punica granatum Linn.
8. Anisoon Anise (Seeds) Pimpinella anisum Linn.
9. Anjabar Bistort (Root) Polygonum bistorta Linn.
10. Aqaqia Babul (Extract) Acacia arabica Willd.
11. Aspaghol Spogel Seeds (Seeds, Husk) Plantago ovata Forsk.
12. Babuna German Chamomile (Whole Herb) Matricaria chamomilla Linn.
13. Badam Almond (Kernels) Prunus amygdalus Batsch.
14. Badiyan Sweet fennel (Fruits) Foeniculum vulgare Mill.
15. Bartang Ribwort (Seeds) Plantago lanceolata Linn.
16. Bedanjeer Castor Plant (Oil) Ricinus communis Linn.

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S. No. Unani common name English name and parts used Botanical/Scientific name

17. Behi Quince (Fruits) Cydonia oblonga Mill.

18. Boora-e-Armani Arminian Earth Aluminium silicate
19. Busad Coral Corallium rubrum
20. Damm-ul-Akhwain Socotra dragon (Gum) Dracaena cinnabari Balf.f.
21. Gul-e-Surkh Red Rose (Flower) Rosa damascena Mill.
22. Kahruba Baltic Amber (Resin) Pinus succinifera Linn.
23. Kasni Chicory (Leaves, Root) Cichorium intybus Linn.
24. Kateera Gum tragacanth (Gum) Astragalus gummifer Linn.
25. Khira Garden cucumber (Seeds) Cucumis sativus Linn.
26. Khurfa Common purslane (Seeds) Portulaca oleracea Linn.
27. Kishniz Coriander (Fruits) Coriandrum sativum Linn.
28. Kundur Indian Olibanum (Exudates) Boswellia serrata Roxb. ex Coleb.
29. Marwareed Pearl Calcium carbonate and conchiolin
30. Mastagi Mastic tree (Resin) Pistacia lentiscus Linn.
31. Maweez (Munaqqa) Dried grape (Raisins) Vitis vinifera Linn.
32. Mazu Aleppo oak (Gall) Quercus infectoria Olivier
33. Murdaar Sang Massicot Lead oxide
34. Mur Makki Myrrh (Oleo-resin) Commiphora myrrh Linn.
35. Mushk Musk Musk pods
36. Pudina Field mint (Whole Herb) Mentha arvensis Linn.
37. Rewand Chini Chinese rhubarb (Rhizome) Rheum emodi Baill.
38. Sandal Safaid Sandal (Wood) Santalum album Linn.
39. Sandal Surkh Red Sandal (Wood) Pterocarpus santalinus Linn. f.
40. Sang Sar-e-Mahi Fish Otolith Ear Stone of Calcium carbonate
41. Tabasheer Bamboo Manna (Exudate) Bambusa arundinacea (Retz.) Roxb.
42. Tamar Hindi Tamarind (Fruit) Tamarindus indica Linn.
43. Teen-e-Roomi (Geru) Red Ochre Anhydrous iron oxide
44. Zafran Saffron (Stigma) Crocus sativus Linn.
45. Zarishk Indian Barberry (Fruits) Berberis aristata DC
46. Zufa Hyssop (Leaves) Hyssopus officinalis Linn.

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Anacyclus pyrethrum

Cydonia oblonga

Cassia fistula

Quercus infectoria

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