Clinical aromatherapy

12 Pages·2008·7.42 MB·English

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Clinical aromatherapy
K*ywords Wolfgang Steflitsch and Miclraela Steflitsch
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Aromatherapy
Abstratt
Essential oils
Essential oils, made out of naturai aromatic molecules, are endowed with so many physiologtcal and
Cancer care pharmacological properties that they find applications in almost every field of medicine, not only
Dementia curatively but also from a preventative medicine point of view. Although the perception of, and reaction
to, essential oils seems to be slightly different between women and men, al! people of all ages benefit
Depression
from aromatherapy. Provided that the practitioner has the relevant information and has undergone the
lmmune system appropriate training, and that the arornatic extracts used conform to medical quality criteria, aromather-
Psychological apy and aromatology can bring real cornplementary help to many patients, far beyond the anti-stress
disorders rnassage approach.
Arornatherapy can provide a useful complementary medical service both in healthcare settings and in
private practice, e.g. in cancer care, dementia, and depression. There are also many indicatrons for the
useful and successful application of essentiai oils. especially for men, such as stress, sleep djsorders, back
pain, urinary tract infections, rectal abscess, and sexual hea{th. @ 2oo8 WPMH GrnbH. Pubiished by Elsevier
lreland Ltd.
i*ltr*ductior"l Fortunately, progress in analytical chemis-
try has enabled us to begin to understand the
Arornatherapy is one of the fastest growing extraordinary laboratory that exists inside
branches of complernentary and alternative the aromatic plant cell; we can only be spell-
medicine. One definition is: 'the therapeutic bound by the realisation of the fantastic com-
use of fragrances or at least of rnere volatiles plexity of the biochernical compounds
to cure or to rnitigate or to Prevent disease, rnanuf,actured therein. and the harrnonious
infections, and indispositions only by rneans and powerful result that is represented by the
of inhalation' l1l But this does not mention arornatic substance inside the plant called
massage or the absorption of essential oils 'the essence'.
through the skin and their effect on target
organs, which is the rnainstay of arornatherapy
in the UK, LJSA and many other countries. There Wide-ranglng applieetior:
is a general difficulry with the concept of mas-
saging with a volatile solution because, by defi- Essential oiis can be put to a multitude of uses
nition, it volatilizes into the air, so perhaps a both in general practice and in hospitals, as
Wolfgang 5teflitsch,
MD deflnition from the Concise )xford Dictionary this quotation illustrates [2]:
:lir(i Df)aiifn€in1 <;f i|tllca: (1995) that is rnore relevant to aromatherapists
li4e iicine, üric ilja.ji€r is: 'use of aromatic plant extracts and essential 'The doctor who is familiar with essential
ilc:;:rial, \.rrerriu, /ir:it r; oils in massage and other treatment' oils can use them to treat a whole range of
Aromatic plants have been used for thou- infections - pulmonary, hepatic, intest-
Michael;: SteJlitsch
ÖC vu'irli:r 5;,,\ S c.r rci sands of years in every part of the world by inal, urinary, uterine, rhinopharyngeal
L,leflril*. i'r::iri:a, At:sl:ra numerous civilizations which, driven by their and cutaneous (infected wounds and sup-
intuition and their sense of observation, were purating dermatoses). The use of these oils
t -:Iali: able to find answers to their health problems usually produces satisfactory results, pro-
*f lfraaq.s:ellitsi:h'!l'
in the plant environment. The lack of under- vided they have been prescribed wisely and
i-i1r-::lc.äl
standing of the biochemical mechanism of that, in the case of certain long-standing
action ofa substance has never been an obsta- complaints, the treatment is followed for a
(,'rtl:r,l: .ilj I l,l.,it,irv )]'i)fl8 cle to its effective use! long enough period. Aromatic therapy can
74 I imh vol. s, No 1, pp.74-85, March 2oo8 O 2008 WPIVH GmbH. Published bv Elsevier lreland Ltd
j FrnutlsE*g ft$*r$ä**r:+*
neutralise enteritis, colitis and putrid fermen- the terpenes. According to Harborne [5] there
tations. and can relieve chronic bronchitis and are more than 1000 monoterpenes and possi-
pulmonary tuberculosis. The colon bacillus bly 3000 sesquiterpenes presently identifled.
cannot resist essential oils.' Valnet (1990) The phenylpropanoids constitute another
much smaller, but significant, group. In essen-
Orthodox medicine currently uses plant
tial oils most of the components belong either
material to help cure diseases that previously
to the terpene group, which is based on the
had a high death rate. Twenty years ago, four
mevalonic acid pathway, or to the phenylpro-
out of every flve children with leukaemia lost
pene group, which is based on shikimic acid.
their lives; now, four out of flve are returned to
In medicine, the quality and wholeness of
health with the aid of vincristine and vinblas-
any essential oil used is of paramount impor-
tine, derivatives of the rosy periwinkle - a plant
tance irrespective of the cost, whereas when
used for hundreds ofyears by tribal healers as a
used in flavours and fragrances the taste and
medicine. The snakeroot plant from India is
the aroma, respectively, are the most impor-
now used in the western world to treat hyper-
tant considerations. For the food and perfume
tension; digitalis, for heart conditions, is pro
industries essential oils may be adjusted or
duced from the humble foxglove and the well-
changed to suit the particular need of the
known rhododendron is used in the treatment
purchaser or the vendor.
offatigue. 'Plants are an intrinsic part ofnatural
It is important also to preserve the whole-
medicine, and not even the most orthodox
ness of an essential oil in order to guard its
doctor can get by without them; indeed they
natural synergy (from the Greek: syn=to-
represent the link between the natural and the
gether, ergon = work). The components making
orthodox, the traditional and the ultra-new' [3]. up an essential oil co-operate to produce their
Phytotherapy is the name increasingly given healing effect and if these are altered in any
to the use of the whole, or part, of a plant for
way the natural synergy is upset. \Mhen a single
medicinal purposes. Aromatherapy and aroma-
active component is removed, not only is the
tology (which is similar to aromatherapy but
synergy of the remaining constituents dimin-
without massage) are branches of phytother-
ished, but the isolated component generally
apy, utilizing only the essential oils produced
needs much greater care when used alone. It
by distillation and the citrus oils produced by
may produce side-effects with continued use.
expression. These are simple to use and admin-
However, when present in the whole oil, the
ister, yet can compete with the steroids and
other constituents seem to act as'quenchers'
antibiotics used in allopathic medicine today
of these unwanted effects, enabling the oil to
without the body's defence mechanism becom-
be used without harm.
ing exhausted or tolerance developing to them.
It is extremely difficult to judge the prob-
'The basic reason which accounts for the able effects of an essential oil solely by know-
diversity ofconception and application of ing its principal chemical constituent(s),
aromatherapy lies in the very nature of the important though this knowledge is. The
aromatic substance. Lending itself to easy whole oil has to be considered in all its com-
cutaneous penetration, being endowed plexity, the mixture of possibly hundreds of
with the capaciry to influence the mind different types of molecules, their molecular
through its powerful impact upon the olfac- energy and the overall synergy. There is no
tive sense, and owing multiple and strong simple direct relationship between any one of
pharmacological properties to its highly the chemical constituents and the therapeutic
active molecular components, it was nat- effect - or even the hazard - of the whole
ural for the aromatic substance to find essential oil
[6].
developments in so many areas' P{noe'l The complexity of essential oils should be
(1ee3) I4l borne in mind when referring to the therapeu-
tic qualities of a given oil, and helps to explain
why one oil can be simultaneously listed as
The genesis of genuine sssential eils being'analgesic, anticonvulsive, antidepres-
sant, antimicrobial, antirheumatic, antiseptic,
Plants produce a tremendous variety of chemi- antispasmodic, antitoxic, carminative, chola-
cals, including a major group of compounds, gogic, choleretic, cicatrizant, cordial, cytophy-
jmh
Vot. 5, No. 1, pp.74-85, March 2OO8 I 75
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lactic, deodorant, diuretic, emmenagogic, or carbolic acid. The aroma itself also has
hypotensive, insecticidal, nervine, parasitici effects on the person using them.
dal, rubefacient, sedative, stimulant, sudorific, The healer should have precise control over,
tonic, vermifuge, vulnerary.' This staggering and full knowledge of, the substances being
array ofproperties perhaps overstates the case, employed in the treatment. If this is the case
but demonstrates the 'shotgun' holistic and if the healer determines the therapeutic
approach in contrast to the 'single bullet' materials to be used, not some faraway labora-
symptomatic approach tory, the medicine may be tailored precisely to
[71.
the individual patient. Generally speaking
there is an absence of unwanted side-effects
Therapeurtic pr*perties o'f es$üntiäi arising from the use of essential oils in a
oils healing situation, and plant extracts are eco-
logically sound, causing no pollution, unlike
There are many reasons why essential oils need the antibiotics that are flushed down the drain
to be included in the armoury of weapons for t0 pollute the land [101.
the fight against disease. They have many posi- Aromatherapists are well aware of the
tive properties and effects that are desirable remarkable balancing powers of the essential
and few drawbacks (Table 1!. They are capable oils. At times this can cause puzzlernent because
of being anti-inflamrnatory, antiseptic, appe- of the apparently contradictory effects of the
titestimulating, carminative, choleretic, circu- oils, but essential oils are cornplex mixtures of
lation-stimulating, deodorizing, expectorant, rnany nätural constituents, some of which are
granulation-stimulating, hyperaemic, insecti- stirnulating and others sedative, so a single oil
cidal, insect-repelling and sedative. They are may demonstrate an arousing effect on one
natural antirnicrobial agents able to act on occasion and a sedative effect on another. This
bacteria, viruses and fungi, and rnany rrials is known as the adaptogenic effect.
have been performed in this field. Tropical
countries have traditionally used lots of spices
HssentiaE oil selsctlon
in their cuisines, not only for the flavour, but
also to kill the nicrobes which flourish in hot
climates. It is thought that the antiseptic One of the challenges of the use of essential
powers of essential oils are due to their lipid oils in clinical care is rhat u''hile research
solubility [8] and their surface activity {91, studies rnay be done both in vivo and in vitro,
Essential oils are applied to the skin by few use human subjects. Evidence-based ratio-
various methods, ingested or inhaled, and nale for the use of specific oils or techniques is
all of these are harmless unless used incor- not always supported or discussed in the lit-
rectly. A significant point in rheir favour is erature. Some is inferred due to the chemical
their pleasant aroma. They are much used in constituents and the known or purported
products for the home (examples are lemon actions. Thus, essential oil choices are based
and lavender) and are well accepted - they are on the following factors:
much pleasanter and safer to use than bleach
r
Diagnosis
o Holistic medical. emotional and social his-
Table 1 Main therapeutic properties of essential tory with any contraindications
r Need for allopathic medications along with
oils
essential oils
r Antiseptic, antibacterial, antiviral, antifungal
o Suspected or identified organism ifinfection
o Wound-healing, granulation-promoting
is oresent
o Analgesic, anti-inflammatory, antitoxic, hyperaemic
r Presence of body and mind symptoms such
Relaxing, sedative, antidepressive
as pain, stress, depression, or fatigue
o Spasmolytic, digestive, diuretic
a Degree of inflammation
e lmmunostimulant, hormonal
r a Rate of wound healing
r Insecticidal, repellent a Essential oil properties
Mucolytic, expectorant
a Patient preference when possible
o Deodorant
a Personal experience and intuition
Z6 | lmh Vol. 5, No. 1, pp.74-85,lvlarch 2008
I ff r,,tt.tisir:6 iVrt::i l*.l *': r.l
Anormn{herep3r and the frrnmun* Other essential oils that are thought to
systsril elevate levels of lymphocytes and inhibit pros-
taglandins include Matricaria recutita (German
If aromatherapy elicits a 'feel-good' factor, chamomile), which increases the number of B
then it may well enhance the immune system. lymphocytes [15], and Citrus bergamia (berga-
However, some essential oils may impact the mot), which is thought to be an immune-sys-
immune function at a cellular level. Although tem stimulant [141. Philippe Mailhebiau wrote
there is nothing clear-cut here, Penoöl [ ] has that Thy mus v ul gar is ct. thy m ol h a s s tro n g i m mu-
suggested that the effects of phenols could be nostimulant properties and is less hepatotoxic
compared to those of human immunoglobulin than Satureja montana ct. thymol1761.
M (IgM). IgM is secreted for a short period of Perhaps two of the most common immunol-
time when the immune system encounters a ogy problems encountered by health profes-
pathogenic organism. sionals are rheumatoid arthritis and HIV/AIDS.
Immunoglobulin G (IgG)is secreted for long- Although there is no suggestion that aro-
matherapy can 'cure' rheumatoid arthritis or
toefr mIg Gd eisfe nmcier.r oPr6endo öbl y[4 ]t htheo bueghhat vtihoautr thoef macotnioon- HIV/AIDS, it may have a positive impact on
terpenic alcohols. Berkarda et al repofied on immune function through the feel-good fac-
tor, as well as through direct and indirect
the ability of coumarins to increase lymphoryte
transformation values in cancer patients [11]. effects on immune competent cells and immu-
Coumarins are found (although only in small noglobulins (Tables 3 and 4). After all, Marette
quantities) in citrus-peel oils and lavender. Per- Flies, an 11-year-old with lupus erythematosus,
haps this is why Rovesti & Columbo thought was able to produce the same physiological
that lavender stimulated lymphocytosis response from smelling a rose as from receiv-
[12].
J.-C. Lapraz, an eminent aromatherapy practi- ing chemotherapy when she thought she was
tioner, has been quoted as saying that the receiving both [17].
presence 'of essential oils in the bloodstream
produces leukocytosis' [13]. Valnet cites work
by Novi & P. Rovesti in Italy who demonstrated The arsmät*gr*nx
the stimulant effect of 'essences of thyme,
lavender, lemon, chamomile and bergamot Just like synthetic antibiotics, many essential
on the white corpuscles by which curative oils are effective against particular pathogens.
leukocytosis is activated, enabling the body The skill lies in knowing which essential oil to
to combat toxins and to resist infectious dis- use for which infection. Conventional medi-
ease' [2]. Roulier has suggested that clove, true cine regularly takes wound or throat swabs, or
verbena, niaouli and patchouli essential oils urine or blood samples to cultivate and iden-
could help to balance the immune system tify a pathogen.
[14]. However, no studies have measured the The French scientist R.-M. Gattefosse used
effect of aromatherapy on immunoglobulins in exactly the same principle as used in that
hurnan blood or saliva, yet. Table 2 lists the process, which is called an antibiogram, and
essential oils that mav assist imrnune function. renamed it an aromatogram. The only differ-
Table 2 Essential oils that may help immune function
Common name Botanical name Refeience
Clove Syzygium aromaticum Roulier (1990)[14]
Lemon verbena Lippia citriodora Roulier (1990)[14]
Niaouli Melaleuca viridiflora Roulier (1990) [14]
Thyme Thymus vulgaris d.. thymol Valnet (1990) [2]
Lavender Lava ndu I a angustifol ia Valnet (1990) t2l
Lemon Lttrus lrmon Valnet (1990)[2]
German chamomile Matricaria recutita Wagner (1986) [15]
Bergamot Citrus bergamia Valnet (1990) [2]
Patchouli Pogostemon patchouli Roulier (1990) [14]
jmh Vot.5, No. 1, pp 74-85, l\4arch ZOOS I ZZ
Table 3 Anti-inflammatory components of some common essential oils
€.öfi-mon name Botanical name Anti-inflammatory Referencds)
component(s)
German chamomile Matricaria recutita Bisabolol, Carle & Gormaa (1992) [18],
chamazulene Safayhi et al (1994) [19]
Helichrysum Helichrysum italicum Italidiones Franchomme & P6noöl (1991) [201
subsp. serotinum
Rosemary Rosmari nus off ici nalis 1,8-cineole Juergens et al (1998) [21]
ct. crneoie
Black pepper Piper nigrum Beta-caryophyllene Tambe et al (1996) {221
Iable 4 Analgesic components of some common essential oils
Common name Botanical namä Analgesiccornponen(sl ßeference
Lavender Lavandula angustifol ia Linalyl acetate, linalooj Re et al (2000) {231
West Indian {emongrass Cymbopgan {itratus Myrcene Lorenzetti et al (1991) {241
Peppermint Mentha pipertta Menthol Tyler et al (1988) {251
Turkish oregano Origanurn onites Carvacrol Aydin & Ozturk (1996) [26]
Braziiian mint Mentha X villosa Rotundifolene Alrneida et al (1995) [27]
ence in the procedure is that with an arorna- land, patients received a massage wirh or with-
togram an essential oil is added to the Petri out Roman chamornile. The grcup that
dish instead of an antibiotic. received the arornatherapy massage u/as found
In England, Deans & Ritchie used the aro- to haye a statistically significantly improved
matogram technique in a comprehensive and quality of life and reduced anxiety {311" In
impressive study that examined 25 genera of another study, conducted to asses the accept-
bacteria and 5O essential oils [281. This kind of ability of using arornatherapy in palliative
sensitir.ity testing for essential oils in the treat- care, doctors, nurses, paramedics and volun-
ment of bacterial infections is being carried teers were reported to be extrernely enthusias-
out by several l,ondon hospitals, and there is tic about the concept
[321.
an active campaign to increase the under- Corner et al. used a prernade mixture of
standing of how aromatograms work [29]. It lavender, rosewood, lemon, rose and valerian
is hoped that this scientific method of select- in their randomised controlled srudy of 52
ing essential oils in sensitiviry testing will patients with a variety of cancers [331. Just over
becorne more widespread as it becomes better half of the patients received chemotherapy,
understood. However, a new rnicrodilution radiation, or surgery during the 8-week study.
method using the redox dye Resazurin has also Patients were randomly assigned to a group to
been developed for determining the minirnum receive a weeldy massage with or without
inhibitory concentration {MIC) of an essential essential oils. A matching control group was
oil [30]. This method overcomes the problem of selected from patients who were unable to
adequate contact between an essential oil and attend the 8-week course of massage. The
the test bacteria and obviates the need for a results showed a statistical difference in anxi-
chemical emulsifier. ety between the two groups receiving massage,
but pain and mobility showed almost equal
improvement.
Benefits of aromatherep3r for cancer Evans conducted an audit into aromather-
patients apy massage in cancer patients in a palliative-
care setting [3a]. The study lasted 6 months and
Aromatherapy is often used to enhance the involved 69 patients. Participants were offered
quality of life of cancer patients. In a study an aromatherapy session with an aromather-
at the Marie Curie Centre in Liverpool, Eng- apy massage and therapist advice on symptom
78 | jmh Vol. 5, No 1, pp.74-85, March 2008
Table 5 lsolates thought to have anticarcinogenic properties
Irolate Source Eb€tiEät name n-fei-na-
Sclareol Clary sage Salvia sclarea Dimas et al (1999) [35]
Bergamottin Bergamot Citrus bergamia Miyake et al (1999) [36]
Perillyl alcohol Peppermint Mentha piperita Bellanger (1998) [37]
Spearmint Mentha spicata
Lavandin Lavandula intermedia
D-limone, geraniol Lemongrass Cymbopogon citratus Zheng et al ('1993) [38]
Carvone, anethufuran, limonene Ditl Anethum graveolens Zheng et al (1991) [39]
Carvone, anethufuran, limonene Caraway Carum carvi Zheng et al (1991) [a0]
control using aromatherapy. Eighty percent of essential oils from plants and flowers have the
the patients felt they benefited, although it is potential to reduce stress. Certain essential
difficult to assess whether this was due to the oils, such as lavender, rose, neroli and petit-
essential oils, massage, or the one-on-one care. grain, are well known for this ability.
Table 5 provides a list of the isolates that are Dunn et al. found 122 patients felt anxiety
thought to have anticarcinogenic properties. reduction following aromatherapy massage
with lavender in an intensive-care unit
[40].
Burns & Blamey studied 585 women in labour
Stress to determine whether aromatherapy with any
of 10 essential oils could reduce anxiety,
Stress is a well-known trigger for depression and increase contractions, and reduce pain [411.
it can also affect physical health. Some common The oils used were lavender, clary sage, pep-
signs of too much stress include increased irrit- permint, eucalyptus, mandarin, chamomile,
ability, heightened sensitivity to criticism, signs jasmine, rose, frankincense and lemon. Their
of tension (such as nail-biting), diff,cultygetting results showed much satisfaction expressed by
to sleep and early morning waking (irregular mothers and the delivery team concerning the
sleep patterns), constant fatigue, drinking and reduction of stress with all of the essential oils
smoking more, indigestion and loss of concen- used. A further analysis of 8058 mothers who
tration and short-term memory. had received aromatherapy between 1990 and
Many situations can lead to stress at work. 1989 indicated that more than 50% of mothers
These include poor relationships with collea- found it helpful for relaxation la2l.
gues, an unsupportive boss, lack of consulta-
tion and communication. too much
interference with private, social or family life, Sleep disorders
too much pressure with unrealistic deadlines,
lack of control over the way the work is done, In the USA, a 2005 National Sleep Foundation
poor working conditions, being in the wrong poll found that 75o/o of adults frequently have
job, feeling under-valued and insecurity and symptoms of a sleep problem, includingwaking
the threat of unemployment. during the night. A new generation of sleep
Important brain chemicals affected by stress scientists are overturning the conventional wis-
are serotonin (involved in the regulation of dom about parasomnia. They say that 'with a
sleep, appetite and mood), dopamine (part of few simple changes in the patient's routine, a
the brain's reward system), noradrenaline little visualization, a couple of surprisingly
(involved in regulating energy and drive), y counter-intuitive moves, specific breathing
aminobutyric acid (GABA: general sedative techniques, "stretch and release tension", an
effect), glutamate (tending to activate nerve attitude adjustment, and some relaxing smells,
cells) and corticotropin-releasing factor (CRF: a peaceful night of slumber can be yours'.
increases steroid levels). Weihbrecht investigated the effect of
Familiar smells associated with happy mem- inhaled true lavender on 10 adults (3 men
ories can help re-establish feelings of happi and 7 women) who had a history of chronic
ness. To be happy is to be unstressed. Most insomnia [43]. For days 15-29 of the study,
jmh
vot. s, No. 1, pp 74-8s, Nilarch zoos I ZS
Fr*c€iruE*tg ffä*d$aimc
I
2 drops of true lavender were placed on the roleptic treatment and other conventional
patients' pillows or on a tissue kept nearby at treatments where necessary: this was therefore
bedtime. Subjects mailed back a sleep question- a study of complementary aromatherapy treat-
naire, and a telephone interviewwas completed ment - not an alternative treatment.
with each of them following completion of the The 'Melissa group' showed a higher signifl-
study. One participant pulled out of the study cant improvement in reducing aggression
because she did not like the smell of lavender. than the control group by week 4; the total
Eight participants had improved sleep in 1 of Cohen-Mansfleld Agitation Inventory (CMAI)
the 4 areas measured, and eight reported less scores had decreased signiflcantly in both
difficulty in getting to sleep. One person groups, from a mean of 68 to 45 (35o/ü P <
reported that his diff,culty was neither 0.0001) in the treatment group and from 61 to
improved nor worsened by the use of lavender, 53 (77oÄi P = 0.005) in the placebo group. Clini-
but he had the flu during the experimental cally significant reduction in agitation,
stage. Out ofall the participants, eight reported defined as a 30% decrease in CMAI score,
feeling more rested in the morning. The sleep occurred in 60% of the Melissd group compared
aids normally used by the pafticipants did not wit}:. 74% of placebo responders (P < 0.0001).
change. But many other studies have shown a Neuropsychiatric Inventory {NPI) scores also
significant reduction in sleeping medication, declined with Melissa treatment, and quality
such as benzodiazepines, when aromatherapy of life was improved, with less social isolation
is also used. and more involvement in activities. The latter
Henry et al. camied out a study on human was in contrast to the usual neuroleotic treat-
subjects at Newholme Hospital in Bakewell, UK rnent effects.
[44]. The effects of the night-time diffrrsion of Further clinical studies have also shown
lavender in a ward of dementia patients was beneficial effects of essential oils in the treat-
monitored. The trial ran for 7 weeks and ment of agitated behaviour and other beha-
showed that lavender had a statistically sig- vioural problems l4V-491and on resistance to
nificant sedative effect when inhaled. Hudson nursing care procedures and other dernentia-
also found that lavender was effective for related behaviours
[49].
elderly patients in a long-term unit [a51. Eight
out of nine patients in the study had improved
sleep at night and alertness during the day. Depression and anxiety
Depression affects about one in five men at
D*rnentia some time in their lives. It is caused by chan-
ged brain and body chemistry. Depression
Ballard et al. conducted a doubleblind study often comes on so slowly that many men have
involving 72 dementia patients with clinically difficulty noticing the change. Depressed peo-
signiflcant agitation treated with Melissa oil; the ple flnd it difficult to get to sleep, or to feel
patients came from eight National Health Ser- rested when they wake. Waking through the
vice nursing homes in the UK caring for people night, or waking far too early in the morning,
with severe dementia [46]. Agitation included is quite a strong sign of depression.
anxiety and irritability, motor restlessness and Depressed people have little energy, and
abnormal vocalisation - symptoms which often they often flnd it difficult to motivate them-
lead to disturbed behaviours such as pacing, selves to do anything. Appetite and interest in
wandering, aggression, shouting and night- food diminishes, and many people lose weight.
time disturbance, all characterised by appropri- Aches and pains and a general physical malaise
ate inventories. Melissa oil, 10% (by weight) are also very common.
(active) or sunflower oil (placebo), combined Studies have shown that the depression
with a base lotion (Prunus dulcis oil, glycerine, levels of elderly people living in assisted-care
stearic acid, cetearyl alcohol and tocopheryl facilities were reduced by the arornas of fruit
acetate), was dispensed in metred doses and and flowers [50]. Citrus was found to relieve
applied to the face and both arms twice daily depression and improve immune function
[511.
for 4 weeks by a care assistant, the process After the treatment of depressed patients with
taking 1-2 min. The patients also received neu- a continuous application of a citrus fragrance
80 | imh Vot. 5, No. r, pp. 74-85, March 2008
|I *H fl#flqE$$ffi# $V*Sffia '$ {$+$rtr
for 4-77 weeks there was a significant reduc- Essential oils that are suitable for pain man-
tion in the Hamilton rating scale for depres- agement are, e.g., black pepper (Piper nigrum),
sion (as with antidepressant therapy) and the clove bud (Syzy gtum aromaticum), frankincense
use of antidepressants was greatly reduced [51]. (Boswellia carterü), ginger (Zingiber oficinale),
A number of essential oils, including laven- Juniper (luniperus communisl, spike lavender
der, jasmine, rosemary, rose and chamomile, (Lavandula latifolial, true lavender (Lavandula
are used for treating depression. They are pri- anpstifolia), Lemo ngrass (C.ymb op o gon citr atus),
marily given as inhalants, but Valnet also marjoram ()riganum majoranal, myrrh (Commi-
suggests taking thyme and lavender orally phora molmol), peppermint (Mentha piperita),
using between 2-5 drops 2 or 3 times a day rose (Rosa damascene), rosemary (Rosmarinus ffi-
[21. In a different study, Itai et al. proved the cinalis), verbena (Aloysia tnplryIla) and ylang
of
psychological effects aromatherapy on ylang (Cananga odorata).
chronic haemodialysis patients [52]. Extracts of myrrh were found to have a
Essential oils are chosen according to the strong local anaesthetic effect in a study by
particular symptoms presented by the patient. Dolara et al. [58]. The anaesthetic action
If the patient's symptoms are due to deep blocked the sodium current of excitable mam-
anxiety, the following oils can be very useful: malian membranes. Iftall & Krause conducted
Cananga odorata, Chamaemelum nobile, Citrus aur' an open, randomised study of 100 patients to
antium var. amara fol./per., Citrus bergamia, Citrus evaluate the effects of topically applied gel
limon, Citnts reticulata, Coriandrum sativum, containing peppermint oil (30%) on periarti-
Cupressus sernpentirens, Lavandula angtsffiIia, cular pain [59]. In 78% of cases both the phy-
Melissa fficinalis, Ocimum basilicum var. album, sician and the patient considered the results
}riganum majorana and Pelargonium graveolens. with mint therapy to be highly effective. At the
Recently published clinical trials were able to end of the study, 79% of the mint-oil patients
show a significant reduction in anxiety in were still suffering from pain, compared with
patient groups with different diseases such 36% of the hydroxyethyl salicylate gel group.
as dementia, tumours, etc [53-57].
Urinary tract infections
*ack pain änd periarticular pain
Millions of men acquire urinary tract infec-
Every morning, back pain erupts across the tions each year. Although most urinary tract
land. It is the second most-common reason infections are not serious, they are painful. The
for missing work, behind the common cold. choice of medication and the length of treat-
One in six adults in Western societies lives with ment depend on patient history, type of bac-
back pain every day. Aromatherapy works on teria, cause of the urine infection and the
the sensory system and appears to enhance the patient's response to treatment.
parasympathetic response, which is closely Many essential oils have specifi.c antibiotic,
linked with endorphins, through the effects antiviral and antifungal properties and have
of touch and smell, encouraging relaxation at been classifled accordingly [00]. The primary
a deep level. effect of essential oils on bacteria and viruses
The analgesic effects of aromatherapy can appears to be on the cell membrane, where they
be traced to several factors: seem to alter the osmotic regulatory function.
The essential oils that are mainly used for bac-
o A complex mixture of volatile chemicals terial urinary tract infections, applied in a sitz/
reaching speciflc sites within the brain hip bath, as washes or as a soft lower abdominal
o Certain analgesic components within the aroma-massage, are German and Roman cha-
essential oil affecting the neurotransmitters momile, sandalwood, juniper berry, lavender,
dopamine, serotonin, and noradrenaline at bergamot, lemongrass, manuka, myrtle, savory,
receptor sites in the brain thyme, blue gum and cedarwood.
r The interaction of touch with sensory flbres Like many other research teams, Friedman
in the skin, which affects the transmission of et al. were able to show a signiflcant antibac-
referred pain terial activiry for a broad selection ofessential
o Rubefacient effect (counter-irritant effect) oils
[611.
jmh vot 5, No. '1, pp.74-85, March 200s 81
|
Fractis$n6 $\#*dlcinm
I
Anorectal, perianal and anal bad enough, new research shows that the
abscesses decline can also increase the risk of prostate
cancer, heart disease and even death.
A rectal abscess is caused by a bacterial infec- Five ways to increase manpower and reduce
tion. As the body attempts to combat the health risks are:
infecting bacteria, white corpuscles and body
o Reduce the waist size
fluids collect. This forms pus. Rectal abscesses
o Build up the biceps by lifting weights
can form near the opening or be much higher
o Fill up on fat: eat foods high in mono-unsa-
up in the rectum. Signs and symptoms include
turated fats
painful hard swelling in the anus, red swel-
o Push away from the bar
ling, pus discharging from the swelling, fever
o Stop stress, can also be done with aromather-
and pain with bowel movements. Treatments
aPy
for rectal abscesses include surgical drainage,
antibiotics, medication for pain relief and
Low sexual desire is rapidly becoming the
warm baths with analgesic, anti-inflammatory
most common issue treated in psychosexual
and antimicrobial essential oils.
therapy. Common causes include poor self-
esteem, relationship issues, partner problems,
bad experiences, fears, depression, chüdbirth,
Sexual health alcohol and drug abuse, illness or daurage to
testes, which can affect hormone production,
A testosterone shortage can be life-threaten- illnesses such as pituitary conditions, hypothyr-
ing. As if losing muscle mass, bone density and oidism, cirrhosis, or stress, as well as certain
sexual drive to low testosterone levels was not prescription drugs.
Vaporized oils
perfumes, sprays
inhalations
All organs, joints, systems
Hypothalamus
ry
Schematic diagram showing the potential pathways of action for plant essential oils in a clinical aromatherapy context. Source: Price &
Price (1999) [6].
8z I jmh Vol. 5, No. 1, pp.74-85, March 2008
Frm*täsin:g ffi*S$cim*
I
Many essential oils can improve sexual regarding indirect action (on the limbic system,
desire. Examples are ylang ylang, sandalwood, sympathetic and parasympathetic pathways).
geranium, hosho, black pepper, nutmeg, jas- Not forgetting the various indications men-
mine, cardamom, rose, patchouli, vetiver, tioned previously in this article.
honey and clary sage. The future clinical application of aromather-
apy will probably be as an adjunct to clinical
medicine, especially in hospitals, hospices, ger-
Conclusions iatric wards and general practice, under the
guidance of consultants and senior nursing
The main action of essential oils is probably on staffl. Future studies may reveal the individual
the unconscious, limbic system of the brain (see beneflts of different essential oils for many
Fig. 1), which is not under the control of the more different ailments, as essential oils exhibit
cerebrum or higher centres and has a consider- their pharmacological, physiological, antimi-
able subconscious effect on the person. Aro crobial, psychological and miscellaneous
matherapy can be effective in reducing stress effects.
and improving mood. Many plant essential oils
are extremely potent antimicrobials and can Further information
positively affect different bacteria, viruses and
fungi. Many are also strong antioxidant agents Austrian Saciety for Scientific
and have recently been shown to stop some of
Aromatherapy änd Arorr":e f{ursing
the symptoms of ageing in animals.
Practice {ASsAi
The use ofcamphor, turpentine oils and their
components as rubefacients, causing increased The ASsA was founded in Vienna in 2006 to
blood flow to a site of pain or swelling when unite the leading forces in holistic aromather-
applied to the skin, is well-known. There is also apy and aroma nursing practice in Austria. Its
long-standing evidence for the beneflts of inhal- aim is to promote the fields of aroma-culture
ing certain essential oils to relieve coughs and and aroma science. The interdisciplinary power
congestion and to prevent or treat infections of ofthe ASsA is based on having excellent experts
the upper and lower airways. in the areas of 'pharmacy', 'nursing', 'medi-
Some essential oils have also been shown in cine', and 'science and research,' together with
studies to alleviate sleeping disorders and a rapidly growing number of members, suppor-
could, apparently, save on the use ofdiazepam ters and partners in Austria and worldwide.
and other sleepinducing drugs. Various oils, As the representative Society for high quality
mostly those derived from plants of the Umbel- in Clinical Aromatherapy and Aroma Nursing
liferae family, are used for treating indigestion, Practice, the ASsA is setting internationally
flatulence and dyspepsia. There is also evidence recommended standards in education and good
and experience regarding the direct action of clinical and nursing practice.
essential oils applied through massaging of the For more information. visit the website at:
skin on specific internal organs and, ofcourse, www.oegwa.at (in German).
Recommended reading
[1] Price S, Price 1., Aromatherapy for Health Professionals London: Churchill Livingstone; 1995.
[2] Buckle J. Clinical Aromatherapy - Essential Oils in Practice, 2nd Edition. London: Churchill Livingstone; 2003.
[3] Lis-Balchin M. Aromatherapy Science. Pharmaceutical Press; 2006.
[4] Steflitsch M, Steflitsch W. Aromatherapie: Wissenschaft - Klinik - Praxis. Springer Verlag; 2007.
[5] Harris Bob. Essential Oil Research Database. Available at: wvwv.essentialoilresearch.com.
[6] Harris R. (editor). The International Journal of Clinical Aromatherapy. Available at: wvwv.ijca.net.
jmh
vot. 5, No. 1, pp.74-85, March 2008 | 83