Tuesday, 16 March 2010

Do essential oils have therapeutic properties?

The use of plant oils to get clincal results and for antisepsis was once the norm particularly in military medicine where camp life meant gathering materials locally. Napoleon went on campaign with eau de cologne for his soldiers while the British Army and Navy based around the world made extensive use of plant oils like Chamomile Oil to combat infestation and infection and deal with injuries.

Today Aromatherapy has to fight hard for its position in hospitals and hospices with managers to be convinced that the budget saving in synthetic drugs, perception of client care to say nothing of the clinical results are worth the cost. Fortunately Aromatherapy is very cheap and non invasive while the side effects from its use in trained hands are negligible. This represents a low risk intervention.

Of course there are limits to aromatherapy's application but what it does it does very well. Today few seriously dispute the available scientific evidence for clincal results from essential oils. Whether aromatic chemicals are derived naturally or synthetically matters little to non aromatherapists. That said the published evidence base for the efficacy of aromatherapy used to treat medical conditions remains poor with few methodologically rigorous studies.

In part this is because of the nature of essential oils which contain a cocktail of hundreds of aromatic chemicals from which the body picks and chooses and responds very individually. Aromatherapists also argue that results may depend on constituents present in the oil in tiny quantities and so there is a need to use the whole oil with nothing added or taken away. There is no magic bullet. If there were it pretty soon wouldnt work as micro-organisms evolved their way around it. This scattergun self healing strategy has enabled the more highly evolved flowering plants who produce these oils in particular to become extremely long lived. Rootstock of eucalyptus has been found to be 10,000 years old.

Numerous over the counter medicines exist which contain essential oils and are licensed for sale as medicines. There is no incentive for the evidence supporting those licenses to be published. Consider for example Olbas oil which contains a mixture of essential oils and is licensed for marketing as a medicine. The ingredients and their proprtions are published as they must be. If this medicine effective but the individual essential oils which make it up not effective? To do so is to deny the whole basis of western medicine that chemicals (of which essential oils are a plant derived cocktail)can have therapeutic effect.

It is understandable for the medical profession to be cross. Surgeons study for years to be able to perform the miracles of surgery they do. Medical practicioners resussitate patients expiring before them. Yet their patients are often prepared to put their whole faith and gratitude in natural medicine whose practioners are relatively unqualified. Sp's own diploma in clincial aromatherapy is for example no more demanding intellectually than the first year of a Batchelor of science course.

The whole evidential debate is of course ongoing but if we waited until someone understood and published a learned paper on everything that humanity does in the world we would be living in a strange and disappointing place. I dont do something that I think is not a good idea. I dont need to know why. If I did it and waited to find out why I and others might get a shock! Is that not the logic here? The fact is we are instinctively drawn to the aromas of the more highly evolved flowering plants and have made 'eating our steamed green vegetables and fruit' as habitual as previous generations. We are increasingly learning why.

A whole spoof christmas BMJ (British medical journal) feature was devoted to frankincense adopting a modern rigorous approach to the literature concluding by debunking the oil's effectiveness in slowing breathing and so promoting reflection and meditation despite thousands of years of observation. Aromatherapists had the final laugh with the simple observation that the learned studies referred to were not studies of somalian but of indian frankincense.

It is interesting to see the sometimes outlandish claims in US marketing material (not permitted in the UK) put to the test of legal evidence.

Attorney Mehrban received $5700 from Aroma Vera, Inc in full and final settlement of his claim that their marketing material was misleading consumers. One amusing anecdote from the case was that no consumers in the entirety of California could be found to aver to the fact that they had been misled! The day was saved when an MD was found to be an ‘expert witness’. Presumably this was not an expert witness appointed by the court but by Attoney Mehrban. This fascinating tale which dates from 2000 can be found online under the rather ironic title of quackwatch.

As regards Sp the record should be put straight.

Stephen Barrett, M.D. states
Aromatherapy for Common Ailments, by Shirley Price, tabulates which oils are to be used for more than 40 problems, including depression, sex-drive problems, bronchitis, athlete's foot, high blood pressure, cystitis, head lice. Her table identifies from three to nine oils "likely to help" each problem. She reassures:

With self-help aromatherapy, you will be using oils recommended for a particular ailment or preventative treatment, but it should not take you long to discover which of them work best for you as an individual, particularly since simply liking the aroma of an oil may indicate that it will help you.

Shirley Price Aromatherapy Ltd would like to observe that this ‘expert witness’ does not refer to Shirley and Len Price’s Aromatherapy for Health Professionals, nor to Franchomme and Dr Penoel’s l’aromatherapie exactement which are standard texts with hundreds of references for BSc level courses in Complementary therapies. Is not california home to Tisserand and Schnaubelt?

Then there is the Pharmaceutical Trade which aromatherapy suppliers serve. British Pharmacopoeia (BP) 2004 is published on recommendation of the Medicines Commission UK. There is the European Pharmacopoeia 4th edn 2002 (Eur. Pharm 4th edn); United States Pharmacopoeia (USP); also the pharmacopoeia’s of individual nations such as China, India etc. Earlier editions of The British Pharmaceutical Codex (BPC), such as BPC 1949, contain more on essential oils and is still in use today. The German Commission E monographs provide a useful summary of essential oils therapeutic properties without endorsing their use.

Without wishing to be unkind to our californian cousins and their certainties and allowing for the 'sturm and drang' of litigation I would suggest that had the available evidence in French, Italian, German, Italian, Arabic and Chinese been adduced (much of translated into English and dating from the sixteenth century) even Aroma Vera Inc's claims might have appeared more credible. In ancient times warriors wielding spear and oar and athletes knew Rosemary relaxed soft muscle long before the days of in vitro tests proved it and Basil gave a nervous tonic before battle. God Bless America.

Given the astounding weight of US litigation against medical malpractice and the appalling side effects of legal and illegal synthetic drugs this is proof positive that in California at least all is well with aromatherapy.

In fact it reminds us that there is much we do not know. For example it was taken for granted in previous generations that the family would eat from silver cutlery where this could be afforded. How pretentious we cry! Now Science knows that silver inhibits bacteria and Sp sell towelling with this feature for sensitive care envionments.

Are all those familes around the world who reach for their Shirley Price essential oils and common ailments blends any differant? There is nothing less scientific than to deny the evidence of our own eyes and experience of several generations.

Today in 2010 we can take it for granted that essential oils do indeed 'purify the air'. Even if there is a legal bar against such a claim in california whole towns in ancient egypt thousands of years ago were laid out on the basis that in times of pestilence the burning of aromatic plants releasing aromatic oils do just that. In this regard at least it is hilarious to think of Attorney Mehrban dogging the heels of the great names who have come down to us from antiquity with a writ alleging misleading claims long before science recognised their observations. But perhaps that is my misplaced english sense of humour.

Lets not forget the greeks blamed the fall of athens and democracy on the mortgage and the solicitors. A lesson for our times?

Ian Brealey BSc FCA, Hinckley


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