4 (Part II) The therapeutic properties of essential oils
There are many reasons why essential oils need to be included in the armoury of the fight against disease. They have many positive properties and effects which are desirable and have few drawbacks. They are capable of being anti-inflammatory, antiseptic, appetite stimulating, carminative, choleretic, circulation stimulating, deodorizing, expectorant, granulation stimulating, hyperaemic, insecticidal, insect repelling and sedative (Schilcher 1985 p. 217). They are natural antimicrobial agents able to act on bacteria, viruses and fungi, and many trials have been performed in this field (see below).
Essential oils are applied to the skin, ingested or inhaled, and all are harmless unless used incorrectly. They are much used in products for the home (obvious examples are lemon and lavender) and are well accepted, and the aroma can have beneficial effects on the person using them (see Ch. 7).
The aromatherapist determines the therapeutic materials to be used so that the treatment is tailored to the individual patient. Generally speaking there is an absence of unwanted side effects from the use of essential oils (see Synergism in Ch. 3 Part I); also, plant extracts are ecologically sound, causing no pollution, unlike antibiotics, which are flushed down the drain and pollute the land (Verdet 1989).
Essential oils have multiple actions and effects, e.g. when used for a respiratory infection an oil may be not only antiseptic but also mucolytic and anti-inflammatory (Duraffourd 1987 p. 17). In the digestive system, the oils are antiseptic in action but do not act unfavourably on flora and the digestive secretions, in contrast to some unwelcome effects of antibiotics. The molecules of essential oils are not inimical to the human body: they support the immune system and can be considered as pro– and eubiotic as opposed to synthetic antibiotics.
Essential oils are especially valuable as antiseptics because their aggression towards microbial germs is matched by their total harmlessness to tissue; one of the chief drawbacks of some antiseptics used today is that they are likely to be as harmful to the cells of the organism as to the cause of the disease. It is very important to remember that antiseptics can destroy not only the microorganisms but also the surrounding cells (Valnet 1980 p. 44).
The use of essential oils is a sure way of avoiding the phenomenon of developed resistance in microbes as experienced with antibiotics, because the aromatic essences are able to destroy even resistant strains
This blend was applied directly onto the wound 2 or 3 times a day and 1-2 drops of hypericum hydrolat and hypericum oil were also put into the wound 3 times a day. Hypericum oil was placed on bread and eaten with half a glass of hypericum hydrolat (diluted 50/50).
The antibacterial and cicatrizant essential oils of Boswellia carteri [frankincense], Pelargonium graveolens [geranium] and Pogostemon patchouli [patchouli] were put into aloe vera gel and applied twice a day to help minimise the scar. The skin was almost perfectly recovered after six weeks.
selectively (Pellecuer, Allegrini & De Buochberg 1974). Germs resistant to synthetic antibiotics are susceptible in certain cases to some essences in high dilution, e.g. 1 in 16,000 for Satureia montana (Belaiche 1979 p. 31) (Table 4.1).
Acquired resistance on the part of a germ can be avoided by prescribing three or four essential oils in combination. The editors strongly advise using a synergistic mix of oils in any treatment: it is unlikely that bacteria will be resistant to all oils in the mix.
Tests have been carried out on the antiseptic and antibacterial properties of essential oils for more than a century, and now there is a reasonably good knowledge base on this aspect of the effects of essential oils – Koch’s 1881 investigation of turpentine with respect to the anthrax bacillus and Chamberland’s 1887 investigation into the activity of cinnamon oils, angelica and geranium. Since then the antiseptic and bactericidal powers of many essential oils have been tested many times in laboratories across the world using the aromatogram technique, a recognized standard test; the results obtained are repeatable and universally accepted: it is virtually the same as the antibiogram test.
An antibiogram can test the validity of an antibiotic agent for the treatment of, say, a chest infection. A sample of sputum is taken and a culture grown in a dish. The antibiotic is introduced into the centre of the culture and its activity against the offending microorganism measured by the diameter of a clear ‘killing zone’, which indicates the power of the antibiotic: the greater the diameter, the greater the effectiveness of the antibiotic agent. An aromatogram is carried out in exactly the same way except that essential oil is used instead of an antibiotic. Both methods are subject to the proviso that in vitro activity is not always echoed in vivo, which is modified by absorption, metabolism, bioavailability etc. Finding the most effective essential oil to counteract a specific germ can be a lengthy undertaking: if there were no previous experience to draw on it would be necessary to test all the oils available to the therapist. This testing procedure has confirmed the antiseptic powers of many oils and at the same time has revealed previously unsuspected antiseptic powers in other oils. Foeniculum vulgare var. dulce [fennel] was known only for being an appetite stimulant, Myristica fragrans [nutmeg] as a stomachic and Artemisia dracunculus [tarragon] as an antispasmodic, but now the antiseptic qualities of these oils are also recognized. A huge number of aromatogram results have now been published, making it possible to list the major essential oils by their antimicrobial properties (Table 4.2).
Essential oils provide a very pleasant and effective means of disinfecting the air in an enclosed area (Kellner & Kober 1954, 1955, 1956) and are therefore ideal for use in sick rooms, burns units, reception areas, waiting rooms etc. A test describing the use of a blend of pine, thyme, peppermint, lavender, rosemary, clove and cinnamon essential oils for the bacteriological purification of the air concluded that ‘the atmospheric dispersion of the prepared liquid brought about a very marked disinfection of the air, as demonstrated by the considerable reduction in the number of pre-existing micro-organisms, some types being destroyed completely’ (Valnet 1980 pp. 36–38).
Hospital-acquired infections and antibiotic-resistant bacteria continue to be major health concerns worldwide. Particularly problematic is MRSA and its ability to cause severe soft tissue, bone or implant infections, but recent experience has indicated that essential oils have an important part to play in dealing with this resistant bacterium. At a presentation to the Royal Society of Medicine, Michael Smith, pathologist, stated that several essential oils (including Ormenis multicaulis, Origanum vulgare, Thymus vulgaris ct. thymol, Lavandula intermedia ‘Super’, Cupressus sempervirens, Mentha x piperita, Ravensara aromatica, Juniperus communis (unspecified), Citrus limon, Cymbopogon martinii, Eucalyptus globulus and Eucalyptus smithii) were effective against MRSA (cited in Buckle 1997 p. 125). Sherry et al. (2001) successfully used a blend of phytochemicals (Eucalyptus globulus, Melaleuca alternifolia, Thymus sp., Syzygium aromaticum, citrus extracts and bioethanol) to treat two cases of MRSA infection with no reported recurrence. More recently several common and hospital-acquired bacterial and yeast isolates (six Staphylococcus strains including MRSA, four Streptococcus strains and three Candida strains, including Candida krusei) were tested by Warnke et al. (2009) for their susceptibility to eucalyptus, tea tree, white thyme, lavender, lemon, lemongrass, cinnamon, grapefruit, clove bud, sandalwood, peppermint, kunzea and sage oil with the agar diffusion test. Large zones of inhibition were observed for white thyme, lemon, lemongrass and cinnamon oil, and other oils also showed considerable efficacy. Almost all the tested oils demonstrated efficacy against hospital-acquired isolates and reference strains.
Many essential oils have analgesic properties and there seems to be no single reason. It is thought that the effect is partly due to the anti-inflammatory, circulatory and detoxifying effects of some oils and to the anaesthetic effect of others. The phenol eugenol found in the oil of clove is well known for its use in calming dental pain, wintergreen oil (containing methyl salicylate, an ester) has traditionally been used in rubs for muscle pain, and menthol has been used specifically for headaches. On the skin, oils rich in terpenes have an analgesic effect, especially those containing p-cymene (Franchomme & Pénoël 2001 p. 99); many aromatherapists report that the oil of Melaleuca alternifolia [tea tree] has this effect, as have azulene and chamazulene (found in the chamomiles). Some essential oils have a universal sedative or soporific action leading to an easing of pain, e.g. Chamaemelum nobile, Cananga odorata, Citrus reticulata (fol.) (Rossi et al. 1988), Citrus bergamia per., fol. (Franchomme & Pénoël 2001 p. 99). According to Roulier (1990), the analgesic and antalgic essential oils are white birch, chamomile, frankincense, wintergreen, clove, lavender and mint (common names only given).
At Monklands Hospital in Scotland more than 75% of patients suffering from chronic complaints (e.g. back or shoulder pain, long-term problems, premenstrual tension, depression, anxiety or mood swings) referred by local GPs found that complementary therapies helped to provide short-term relief of their symptoms. The patients were treated with essential oils, reflexology or acupuncture during an 8-week trial (Anderson 1998) (see Appendix B.9 on the CD-ROM for a list of effective oils).
Many essential oils have been reported as having an antifungal effect (Table 4.3) and many investigations have taken place, some more than half a century ago (Schmidt 1936), showing the fungicidal and fungistatic effects of cinnamon, clove, fennel and thyme; these were active against Candida albicans, Sporotrichon and Trichophyton species (Gildemeister & Hoffmann 1956 p. 140). The fungicidal activity of the oil of Chamomilla recutita and its components, including chamazulene and (–)-α-bisabolol, has been well investigated and shown to
Case 4.2 Analgesic (headache)
She had just attended an Open Day at PPA and had bought a bottle of Len Price’s special hydrolat blend (an experiment when he had some plants left in his field but not enough of each one to fill the still).
Two days later she had a severe headache, which felt like the beginning of a migraine, and because she saw there were two types of lavender as well as peppermint in the special blend, she thought she ‘would give it a try’ (along with a little sweet marjoram massaged into the back of her neck).
Case 4.3 Antifungal (Candida albicans)
Mrs F (aged 40) was suffering from a continuous urinary tract infection (with inflammation, incontinence and pain) which antibiotics failed to control. She was given intermittent self?catheterization (ISC) and by April 1992 major surgery (removal of the bladder) was considered. She also developed a vaginal inflammation – thrush, being eventually unable to perform the ISC and complaining of constant pain and swelling of the abdomen (caused by having to have residual catheterization using microcatheters).
It was suggested to the consultant that aromatherapy be tried. Mrs F’s vagina was the consistency of ‘raw liver’ and she suffered frequent discharges, thus intercourse was impossible. Her husband attended with her and was checked over, as this side of the partnership, although important, is often overlooked – Mrs F had had this recurrent form of candida for several years and the relationship was beginning to suffer.
A colonic massage with essential oils was decided upon for Mrs F, to benefit the swelling, pain and infection. Equal quantities of the following oils were used in a 15 min massage and at 50% dilution with grapeseed oil:
Mr F was taught how to perform a simple, clockwise abdominal massage, to be carried out once daily to aid Mrs F’s constipation. This was a good morale booster for him, as he had previously felt helpless – he now became part of her recovery process. The 3% mix for him to use contained the following essential oils:
Treatment with live yogurt and essential oils was also given; the client?s vagina was too swollen to use a tampon soaked in this mix, so the yogurt mixture was poured into the vagina (the client was propped up with raised legs to allow the mix to penetrate). Although messy and difficult, the swelling had reduced enough after several days to insert a tampon, changing it morning and night.
A few months later the abdominal swelling was going down and the urinary tract was almost clear. Mrs F was on only 3 acidopholus tablets daily, the marigold tea and yogurt with tea tree internally occasionally. Abdomen massage by her husband continued once or twice a week only and with a reduced concentration of oils to 1.5%.
be effective against Trichophyton rubrum, T. mentagrophytes, T. tonsurans, T. quinckeanum and Microsporum canis in concentrations of 200 mg/mL (Janssen et al. 1984, 1986, Szalontai, Verzar-Petri & Florian 1976, 1977, Szalontai et al. 1975a,b). Satureia montana has been found to be active against Candida sp. (Pellecuer et al. 1975). A general review of some essential oils with antifungal properties was carried out by Pellecuer et al. (1976) and in other trials a number of compounds found in essential oils, especially the aldehydes and esters, were effective against various fungi, including candida infection (Larrondo & Calvo 1991, Maruzella 1961, Thompson & Cannon 1986). Melaleuca alternifolia has been investigated in vaginal infection with candida and found to be effective (Belaiche 1985, Pena 1962, Shemesh & Mayo 1991). Rosemary, savory and thyme also have antifungal properties (Pellecuer, Roussel & Andary 1973) and Ocimum basilicum has both antifungal and insect-repellant properties (Dube, Upadhyay & Tripath 1989).
The oils of Lavandula angustifolia [lavender] and Chamomilla recutita [German chamomile] are widely used to soothe minor inflammations such as sunburn, small burns and insect bites, and plenty of people can testify to their effectiveness in this respect. Jakovlev, Isaac and Flaskamp (1983) showed the anti-inflammatory effect of yarrow, chamomile and turpentine. Although chamazulene and (–)-α-bisabolol found in chamomile oils are anti-inflammatory agents (Weiss 1988 p. 24), other azulenes that may be added to anti-inflammatory preparations are not so effective, e.g. guaiazulene (manufactured from guaiol) and elemazulene (from elemol). Also (+)-α-bisabolol and synthetic (–)-α-bisabolol are not as effective as the natural form.
Otitis media is an infectious and inflammatory disease which may lead to impairment of hearing; over a 2-year period Kang Mok Yoo, an otolaryngologist in South Korea, used aromatherapy to treat 200 patients suffering from chronic mucoid otitis media with effusion and found that the success rate was 90% achieved in just 13 days on average (personal communication) (Table 4.4 and Appendix B Table B1 on the CD-ROM).
Lavender and tea tree oils (both unspecified) were diluted in jojoba wax and sweet almond oil used in massage in a study to determine the effects of aromatherapy on pruritus and Stratum corneum hydration pruritus in patients undergoing haemodialysis: the results showed pruritus to be significantly decreased and skin hydration greatly enhanced (Ro et al. 2002).
Chamomile oil has been found to be capable of inactivating toxins produced by bacteria. The amount of oil obtained by distilling 0.1 g of chamomile is sufficient to destroy, within 2 hours, three times that amount of staphylococcal toxins – the highest concentration of toxin so far found in the human organism; streptococcal toxins proved even more sensitive (Weiss 1988 p. 26).
Case 4.4 Anti-inflammatory (gangrene)
Mr A developed gangrene on the toes of his left foot and the whole area was inflamed. There was also a large patch on his shin and a smaller area below his knee. As the gangrene was in its acute stage, Mr A wanted to see an aromatherapist that he knew, to try anything she might suggest, before it reached the stage of needing amputation. The consultant was in agreement, as there was nothing the hospital could do except amputate.
The three pieces of cotton – the size of the areas to be treated – were first wetted (and squeezed well) in cold water, before being immersed in this well-stirred blend, making sure all the liquid was absorbed. Each was squeezed lightly to remove excess liquid before being applied to the areas concerned.
Two and a half years later Mr A had an accident and the patches reappeared on the same three areas as before. He refused to go into hospital, sending instead for the aromatherapist, who repeated the treatment above. In between visits, the district nurse was given permission to apply the lotion on every visit.
Most people practising aromatherapy have reported success in the control of viruses causing herpes simplex type I, but there is no consistency in the choice of oils used (as can be seen from Table 4.5). Speaking from personal experience, the editors have found the oils Melissa officinalis, Pelargonium graveolens and Eucalyptus smithii to be helpful for herpes simplex I (cold sore). The use of melissa agrees with tests showing this plant to be antiviral (Cohen, Kucera & Herrman 1964, Herrman & Kucera 1967, Kucera & Herrman 1967). For herpes zoster (shingles) the oil of Pelargonium graveolens [geranium] is specifically recommended; it is best applied at the first sign of an attack to prevent virus replication. Used early it prevents blisters from forming and damps down the pain. For herpes simplex II (genital herpes) the many oils suggested include Melaleuca alternifolia [tea tree] and M. viridiflora [niaouli] (Franchomme & Pénoël 2001 pp. 397, 398), but little success has been reported. Despite the lack of
Case 4.5 Antiviral
Clément was suffering from Molluscum contagiosum, a serious viral infection, which had developed while the family were on holiday in Corsica. His whole body (including his genitals) was covered with boils; he was feverish and screaming with pain day and night.
His parents firmly believed in natural medicine and did not wish to send Clément to the hospital, knowing that no allopathic cure existed for viral diseases. The boy was also prone to eczema and allergic reactions. Not only was the medical condition of the child assessed, but the family were asked to undertake the therapeutic programme prescribed.
Because of the extreme cutaneous condition, the hydrolat of Melissa officinalis [melissa] (undiluted) – antiviral, anti-inflammatory, calming – was selected first and sprayed around the little boy, who felt relief for the first time in many days of intense suffering.
• A 5% concentration with a 95% blend of vegetable carrier oils, also active in the healing process: macerated oils of calendula (60%) and St John’s Wort (25%) and oil of Calophyllum inophyllum (5%). The parents were asked to apply this blend to each boil, using a fine paintbrush.
After the first treatment at the clinic, the blends and suppositories were given to the parents to continue treatment at home; the spraying equipment was lent to them for the period of intensive care.
Nine days later the family returned to see me. Clément’s skin was almost perfect and he had regained his vitality. This remarkable and speedy result was helped not only by the determination of the parents, but also by the high-quality aromatic and vegetable oils.
The following blend was formulated by the editors’ daughter and son-in-law for their flight to China (they wanted to ensure that they had some protection in that incubator of viruses!) for use by inhalation and in the bath; it was in a 10 mL bottle, so that it would not be a problem at the security checks:
It was used by inhalation on Dr Stephen’s moustache, although a paper tissue had to serve for Penny; a face-mask would work well also for those without the necessary equipment. Did it work? They travelled for 2 weeks on seven flights and in contact with a great many people without any evidence of viral infection, despite a punishing schedule and becoming extremely exhausted. The regime of baths and inhalation continued for 14 days after their return, as a precaution.
scientific support, many aromatherapists find that herpes simplex type II and other viral infections such as glandular fever and influenza do respond to essential oil treatment, and there is research to support the use of Piper nigrum [black pepper] (Lembke & Deininger 1988). Cymbopogon flexuosus [lemongrass], Mentha arvensis [cornmint] and Vetiveria zizanioides [vetiver] (Pandey et al. 1988), and Eucalyptus viminalis, E. macarthurii [woolly-butt] and E. dalrympleana appear to be effective both in vitro and in ovo on two strains of influenza virus (Vichkanova, Dzhanashiya & Goryunova 1973). There have been other papers published on this topic in India, Russia and China, and a Swiss patent was filed in 1979 for an antiviral preparation using essential oils.
Table 4.5 shows the essential oils that have been recommended for antiviral use. The information has been culled from many sources, which often use only the plant’s common name. Many other oils have been mentioned anecdotally as having antiviral properties, but without specific indications.
Several constituents found naturally in a wide range of essential oils (anethole, β-caryophyllene, carvone, cinnamic aldehyde, citral, citronellol, eugenol, limonene, linalool, linalyl acetate, α-sabinene, γ-terpinene) were found to be active against herpes simplex (Lembke & Deininger 1985, 1988). If the oils are effective it could well be because of some property common to all of them – perhaps lipid solubility. The in vitro studies conducted so far indicate that many essential oils have antiviral properties but that they affect only enveloped viruses and only when they are in a free state, before the virus has entered or is attached to the host cell (e.g. Schnitzler et al. 2008). This is in contrast to the majority of synthetic agents, which either stop complete penetration of viral particles into the host cell or interfere with replication once the virus is inside the cell (Harris 2010 p. 319).