Chapter 9 Aromatic medicine

Introduction

The practice of aromatic medicine has undergone something of a revolution in recent times. It has its origins in France, where essential oils are used internally and externally in larger dosages – and prescribed by those who are trained as medical practitioners. Unfortunately, in the UK there is a great suspicion of those who advocate internal use of essential oils. The fear is based on current legislation, which allows aromatherapy under a single exemption (Section 12(1) of the Medicines Act 1968), effectively treating the use of essential oils as a cosmetic. To advance to claims for therapeutic use would necessitate new legislation, with the fear that current aromatherapeutic uses would be endangered by such revision. The exception permissible at the moment is that trained and qualified herbalists (who are not specifically qualified in the administration of essential oils) may prescribe them for internal use. However, there are aromatherapists who want to hold on to a distinct, yet related, aromatic practice that has little or no association with massage. Given that there are some clients who for various reasons may be unable – or do not wish – to receive massage, the acceptance of aromatic medicine may be an equal opportunities issue, in that it allows access to the use of essential oils for those who, limited by movement, use of limbs or weight, cannot receive what would in the UK be regarded as a ‘normal’ aromatherapy treatment.

Aromatic medicine explained

Aromatic medicine has a number of distinctive elements that distinguish it from aromatherapy as it is practised in the UK:

• It is a therapy in which essential oils are used confidently and efficaciously in the most appropriate way for any presenting condition. The therapy is aromatic because it uses the aromatic, volatile molecules that constitute essential oils.

• It moves beyond the near-homoeopathic normal doses associated with aromatherapy massage and involves a considered response to a particular situation, balancing the presenting condition with a detailed knowledge of essential oils.

• It is built on knowledge of the therapeutic actions of the chemical components that make up essential oils, plus an understanding of the synergy within a single oil and the synergistic potential of blended oils.

It may well be that practitioners of aromatic medicine may have to train to the same level of recognition as herbalists before they will be permitted to prescribe for internal use, but as this is not the entire therapy one should look to building both understanding and confidence in what is a very precise and exacting branch of aromatherapy. There certainly should be no restriction in the intensive topical use. The intensive and specific use of essential oils is a valid expression of aromatherapy and is:

• intensive because of the higher dosage than that used in massage

• intensive because it is more focused on a particular presenting condition

• intensive because of the application of chemistry as the principal tool used in oil selection

• specific because essential oils are engaged for a particular health improvement rather than general wellbeing

• specific because whole-body massage is not always needed or wanted, a more focused application being more necessary.

Those who teach aromatherapy tend to attribute the advent of contemporary aromatherapy to the rediscovery made by Gattefossé of the healing properties of Lavandula angustifolia following a burn. Certainly this was an epiphany, supporting the intensive use of essential oils rather than the English-style aromatherapy, which owes as much to massage (a separate and independent therapy) and the use of carrier oils as it does to essential oils. It is this intensive use that will now be explored.

Beginning with essential oils

Any credible course in aromatherapy has an element of training in the chemistry of essential oils. This provides a foundation on which aromatic medicine is built. A much more detailed knowledge of the chemistry of essential oils and the therapeutic action of the various chemical components gives the use of essential oils in aromatic medicine its distinctiveness.

It is easy to read books on aromatherapy and to have claims for the various benefits from essential oils delineated. Many of these claims are based on traditional use (which is not to be disparaged, in that it has been tested through time – as valid a form of research as any), and without these uses practitioners may not be aware of how a benefit is to be achieved.

In aromatic medicine, treatment is based on the known and verifiable therapeutic effects of the chemical components found within the oils (Table 9.1), which means that practitioners need a sound working knowledge of the constituent parts of the oils to be used. They also need to be competent enough to work out what the components in the synergy of an essential oil mix will achieve – this can only be understood by detailed training in the chemistry of essential oils.

Table 9.1 Essential Oil Component Reference Chart Diagram (simplified) By kind permission of Penny Price Aromatherapy Ltd (www.penny-price.com)

Perhaps this approach is best illustrated with a recent example that caused a great deal of anxiety. Avian flu was followed by swine flu as a threatened pandemic. The few fatalities that ensued fuelled the hysteria that grew – disproportionately to the risk. The author, when taking a long-haul flight to China for a punishing teaching schedule of 7 days (including 10 flights), responded to the situation by researching the possible aromatic responses, the development in approaches 1–4 below showing the difference between the populist aromatherapy approach and that used in aromatic medicine (see Case 4.4 for the antiviral recipe used).

The available literature indicates that there are some essential oils and related products that are helpful in the treatment of viral conditions.

1. The general aromatherapy literature states that some essential oils are powerfully antiviral. Davis (2000 p. 308), for instance, suggests that bergamot, eucalyptus and tea tree may be used, but does not specify the oils, giving only the common names. These may indeed be effective, but there is no explanation as to how or why they work.

2. There is much more precision in the work of Pénoël and Franchomme. Franchomme (Franchomme & Pénoël 1990 p, 190) suggests that enveloped viruses respond to essential oils having a predominance of terpene-alcohols and phenols, whereas naked viruses respond to oils rich in terpenoid ketones. Pénoël is even more specific, suggesting that α-terpineol and the oxide 1,8-cineole should be administered. The oils suggested, in which these constituents are found, are Laurus nobilis [bay leaf], Eucalyptus radiata [narrow leaf peppermint] and Melaleuca viridiflora [niaouli].

3. Schnaubelt (1997 p. 98) states that terpenes enhance the immune system and metabolic activity by changing the receptors present on cell surfaces, and that new work is being undertaken on the reaction between sesquiterpenes and cell penetration.

4. Price and Price (2007 p.106) suggest that the effectiveness of essential oils may not be dependent upon any specific molecule, but rather on a property common to essential oils, perhaps lipid solubility.

5. The hypericin in Hypericum perforatum [St. John’s wort] has been indicated as inhibiting the development of a virus within an infected cell (Miller 1998). Hypericin is active against several viruses, including cytomegalovirus, the human papilloma virus, hepatitis B and herpes virus. This antiviral activity has been shown in the laboratory and animal studies, but not in human studies. The herb seems to work against viruses by oxidation and its antiviral effect is stronger when exposed to light (as when animals eat the herb). St. John’s Wort was studied in 1991 in people with HIV disease (Freeman & Lawlis, 2001, 415), where the doses were much higher than for treating depression. Patients were given intravenous doses of purified hypericin, but the study was stopped when every white-skinned patient in the trial became very sensitive to light. They developed skin rashes and some could not go outside until after they stopped taking hypericin. The one black-skinned patient did not have this reaction.