Licorice & Ulcers

For a dozen years, Dr. Richard Doll, Britain's most famed physician-statistician, had been testing and comparing a dozen treatments for gastric ulcers (those in the stomach proper). Sadly he had concluded that no drugs helped an ulcer to heal, though peace of mind, bed rest and nonsmoking did some good. Then a drug company offered Dr. Doll something called carbenoxolone, which is a chemical modification of a substance extracted from licorice.

Licorice extracts have been used since the days of Hippocrates for the relief of indigestion, but Scientist Doll has little faith in old wives' remedies. Still, he could not forget that digitalis, the first useful drug for heart disease, came from an old wives' brew of foxglove, and he remembered that a Dutch pharmacist had made a reputation during World War II selling a licorice concoction for ulcers. Dr. Doll decided that there was no harm in trying.

At London's Central Middlesex Hos pital he gave carbenoxolone (Biogas-trone) to outpatients who had severe gastric ulcers. When more than two-thirds of them showed substantial healing of their ulcers on their X rays, Dr. Doll was still doubtful. It was all a mistake, he decided, or "a statistical sport." He spent more wearisome months repeating the test on another batch of patients--and he got the same results. There was, he concluded, something to licorice extract after all.

Dr. Doll's research showed that car benoxolone has no effect on the more common duodenal ulcers, and it has some unwanted side effects on gastric ulcer patients; about 20% suffered from water retention, and others suffered from a rise in blood pressure. Both groups needed a second drug to control these symptoms. If a gastric "ulcer" patient gets no benefit from the licorice medicine, says Dr. Doll, this may be a desirable early warning that he should have surgery.

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