CHURCHILL LIVINGSTONE An Imprint of Elsevier Science Publishing Manager:Inta Izols Development Editor:Karen Gilmour Project Manager:Peggy Fagen Design Manager:Mark Bernard Design:Sheilah Barrett Design CLINICAL AROMATHERAPY 2e ISBN 0-443-07236-1 Copyright 2003,Elsevier Science. All rights reserved.No part of this publication may be reproduced in any form or by any means,elec- tronic or mechanical,including photocopy,recording,or any information storage and retrieval system, without permission of the publisher (Churchill Livingstone,The Curtis Center,Independence Square West,Philadelphia,PA 19106). Churchill Livingstone and the sailboat design are registered trademarks. NOTICE Complementary and alternative medicine is an ever-changing field.Standard safety precautions must be followed,but as new research and clinical experience broaden our knowledge,change in treatment and drug therapy may become necessary as appropriate.Readers are advised to check the most cur- rent product information provided by the manufacturer of each drug to be administered to verify the recommended dose,the method and duration of administration,and contraindications.It is the re- sponsibility of the licensed prescriber,relying on experience and knowledge of the patient,to deter- mine dosages and the best treatment for each individual patient.Neither the publisher nor the editors assume any liability for any injury and/or damage to persons or property arising from this publication. Library of Congress Cataloging in Publication Data Buckle,Jane,RGN,MA,BPhil,Cert Ed,MISPA,MIScB. Clinical aromatherapy / Jane Buckle.—2nd ed. p.;cm. Rev.ed.of:Clinical aromatherapy in nursing / Jane Buckle.c1997. Includes bibliographical references and index. ISBN 0-443-07236-1 1. Aromatherapy. 2. Nursing. I. Buckle,Jane,RGN,MA,BPhil,Cert Ed,MISPA, MIScB.Clinical aromatherapy. II. Title. [DNLM: 1. Aromatherapy—methods. WB 925 B924ca 2003] RM666.A68B83 2003 615(cid:2).321—dc21 2003043823 Printed in the United States of America. Last digit is the print number:9 8 7 6 5 4 3 2 1 This book is for all those who walk the path with me. Thank you. W Foreword Aromatherapy is possibly the most simple of all complementary therapies to integrate because when we inhale air,we inhale aroma,although we are usually unaware of it.However,aromatherapy is rarely presented in a cogent,scientific way;as a result,it has been difficult for physicians and nurses to take the field seriously,or to understand how we could use it in our practice.Here is a book from a health professional who writes about aromatherapy in a way that we can understand and apply. As a small boy growing up in Turkey, I had my own special paradise—my grandfather’s walled garden—where I became aware of the power of the senses; in particular,how the fragrance of plants made me feel good.Now,as a cardio- vascular surgeon,I work on repairing the heart.I know the heart is perceived by many to be more than a pump, the epicenter of emotion, and I continue to be aware of how important our senses are to our well being,and how feelinggood can help recovery.The very smell of many hospitals is unpleasant,alien,or distressing to our patients.Patients feel at their most vulnerable in a hospital’s high-tech sur- roundings,so a familiar and comforting smell can do much to put them at their ease.In common with several forward-thinking hospitals in the United States,we now use aromatherapy at Columbia Presbyterian,and we have been working with Jane Buckle on research since 1995. Our sense of smell is located in the catacombs of the most primitive area of the brain and is extremely powerful.Smell can produce all sorts of physical reac- tions ranging from nausea to napping.The amygdala,the brain’s emotional cen- ter,is located in the limbic system and is directly connected to the olfactory bulb. Rage and fear are processed in the amygdala and both contribute to heart disease. Our studies at Columbia have found that diluted essential oils rubbed on the feet affected some volunteer’s autonomic nervous system within minutes. Clinical Aromatherapy is presented logically, with considerable background information given at the outset.I expect many readers will go straight to the clin- ical section and look at their own specialty.In each specialty,a few symptoms or problems have been explored, and the way in which aromatherapy might help treat those symptoms or problems is clearly outlined.The information will be of particular interest to readers working in that clinical specialty.However,I think the book will also be of great interest to those who want to know what aro- matherapy really is,and how it can be used in a scientific way. Jane Buckle is well qualified to write this ground-breaking book.She brings a wealth of knowledge and clinical experience acquired over 25 years in the field. vii viii Foreword With a PhD in health service management,a background in critical care nursing, a teaching degree and a fistful of degrees from the world of alternative medicine, she writes authoritatively,and she speaks from the heart.Jane was a co-presenter with me at The World Economic Forum in Davos,Switzerland,a few years ago. We were invited to talk about the economics of alternative medicine and its im- pact on globalization.I was impressed by Jane’s passion,as she also hosted four different events that helped bridge the divide between big business, alternative medicine, pharmaceutical organizations, and political leaders. An underlying question permeated all her presentations:What can we do to get the caring back into healthcare? When Jane speaks,people listen. Jane Buckle is a pioneer and she uses writing,researching,and teaching to get her message across.Her message is one of holism and she inspires those in healthcare to evaluate how they use simple things like smell and touch to help people heal.In the United States,many hospitals are beginning to integrate clin- ical aromatherapy and use Jane’s program.She is involved in numerous hospital research programs (apart from our own) and has been a reviewer for NIH grants. Under her guidance,hundreds of students have carried out small pilot stud- ies in American hospitals. She has written templates for aromatherapy policies and protocols that are being used by hospitals.More than any other person,Jane Buckle has labored to integrate clinical aromatherapy into hospitals,not as a pos- sible add-on but as a legitimate part of holistic care.That achievement alone is remarkable.But,she has another string to her bow.She has pioneered a registered method of touch,called the “m”technique.This technique was tested in our lab- oratory at Columbia Presbyterian on the legs of students and found to have a pronounced parasympathetic response in some.The technique is very relaxing (I have experienced it myself!) and eminently suitable for hospital patients (with or without the use of essential oils),so I am delighted to see a section on the “m” technique in this book. Essential oils offer extraordinary potential from a purely medicinal stand- point,and the recent studies on MRSA and human subjects show just how pow- erful they can be.That an essential oil can be effective against resistant organisms is medicine indeed and I think the chapter on infection will be of great interest to pharmacists as well as those involved in infection control.When nausea is re- lieved through the inhalation of peppermint and insomnia is alleviated through the inhalation of lavender or rose,we are witnessing clinical results—not just the “feel-good”factor.The studies on alopecia and topically applied essential oils,or Candida albicansand teatree,show that aromatherapy can work at a clinically sig- nificant level.However the strength of clinical aromatherapy is that it offers care as well as,in some instances,cure.This is of particular relevance in the field of chronic pain where the perception of pain can be altered using smell and touch. The subject of clinical aromatherapy is vast and will be of interest to nurses and physicians, chiropractors and massage therapists, pharmacists and natur- opaths, pharmaceutical companies and herbalists. I share a goal with Jane Buckle—to enhance patient care and give the best of what we have to offer,what- Foreword ix ever that may be.As a physician,I believe clinical aromatherapy has an important role to play in integrative medicine.Jane Buckle gives us a glimpse of the future, and it smells good! Mehmet Oz Mehmet Oz,MD,is a cardiac surgeon.He is the Director ofthe Cardiovascular Institute and Vice Chairman ofthe Department ofSurgery at Columbia Presbyterian Medical Center,New York,NY. W Preface This book is intended for health professionals in the United States want- ing to use aromatherapy in a clinical way to enhance their practice. It draws from Clinical Aromatherapy in Nursing(London:Arnold,1997) but is a different book as it is no longer written from a nursing perspective and has been substantially expanded to meet the needs of allhealth professionals.Things have changed since 1997.I have gained a PhD (which helped my thinking!) and much has improved in the aromatherapy world.Several clinical studies have ap- peared in peer-reviewed medical journals.Aromatherapy is finding its way into wellness clinics,hospices,and hospitals,and courses are being taught at leading universities.Aromatherapy has become part of everyday language.Despite this, popular misconceptions abound.This book was written to try to correct those misconceptions and to indicate the important role that essential oils could play in future healthcare. The book is laid out in a similar way to the first book but with several im- portant differences. 1. The book is no longer written from a nursing perspective,although there is a section on aromatherapy as part of nursing care. 2. The text has been reviewed and edited by experts in the field (see Ac- knowledgments). 3. The text includes many new tables to help the reader assimilate the in- formation. 4. The chemistry section has been expanded and improved and includes molecular drawings. 5. There are new sections on psychology,psychiatry,and aromatic medicine (which covers internal use).There are specific sections for the physician, massage therapist,chiropractor,and naturopath. 6. The individual clinical sections have been updated and expanded,espe- cially the part on immunology. 7. The book is intended for U.S.residents and so OSHA and JCAHO re- quirements are covered and education in the United States is addressed. 8. The number of references has almost doubled. 9. The reference system has been changed to make it easier to identify the references in the text. 10. There is an extensive index. xi xii Preface The book is divided into two broad sections.These are Overviewand Clin- ical Use.The overview begins with a background section,which covers such top- ics as historical use,where essential oils come from,how they are obtained,what they consist of,how they work,and how they are absorbed into the body.Then there is a short introduction to the psychology of smell.This is immediately fol- lowed by contraindications,toxicology,and safety issues.After this broad intro- duction, the book begins to become more specific, with sections on how aro- matherapy could be used by nurses,massage therapists,and physical therapists,or as part of prescriptive medicine used by physicians, chiropractors, and natur- opaths.A general hospital section follows,addressing how the generic problems of infection,pain,insomnia,nausea,and stress could be relieved by essential oils. Finally the clinical section is divided into departments found in a medical setting, and there is a discussion of how aromatherapy could alleviate some of the com- mon problems found in each clinical section with reference to published research, my own clinical experience,and that of my students. I am greatly indebted to the many physicians,nurses,and other profession- als who edited and reviewed these sections.At the end of the book there are ap- pendixes covering OSHA and JCAHO requirements,training and education in the United States, and some recommended reading, websites, and essential oil companies. This book has been a labor of love.I hope you enjoy reading it as much as I enjoyed the journey.If one piece of good research is carried out because of this book,all the hours will be have been well spent. Jane Buckle Acknowledgements Iwould like to acknowledge the following people who edited specific parts of the book.Thank you for your generosity of spirit and your nurturing editor- ship. Ann Adams,RN,CMN Elizabeth Barrett,RN,PhD James Duke,PhD Charlotte Eliopoulos,RN,PhD Ben Evans,MSN Claire Everson,MSN Debbie Freund,RN,LMT Howard Freund,PhD Ron Guba Diana Guthrie,RN,PhD Sue Hageness,MSN Bob Harris Rhi Harris,RN Dorothy Larkin,RN,PhD Michael McCrary,MA Lee McGunnigle,DC Lori Mitchell,RN,MSN Gayle Newsham,RN,PhD Tom Numark Mary Poolos,RN,PhD Ganson Purcell,MD Scottie Purol-Hershey,RN,PhD Linda Scaz RN,PhD Kurt Schaubelt,PhD Paul Schulick Neal Schultz,MD Keith Shawe,PhD Kay Soltis,MSN Brenda Talley,RN,PhD Mark Warner,MD xiii e section I Overview
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