Aromatherapy

Maria Lis-Balchin

Aromatherapy has slowly crept into our lives and has now become a household name. However, few people know what it actually means: the majority of men think it's a massage using perfumes and women think it could also mean fragrant candles and cosmetic products using "pure" essential oils. The definitions abound in the many Aromatherapy books, one of the first of which was Robert Tisserand's in The Art of Aromatherapy, 1979 in which he alluded to both internal and external application of aromatherapy for treating internal disorders. This definition was based on the works of René-Maurice Gattefossé, the so-called pioneer of modern aromatherapy, who actually used perfumes or at most deterpenated essential oils and not pure natural essential oils obtained directly from plants. Most of the essential oils on the market nowadays are not pure and have synthetic components added and some are completely synthetic (Lis-Balchin, Aroma Science, 1995)

Gerhard Buchbauer, from Vienna University has always ridiculed the aromatherapy definitions, as aroma means an odour and one cannot massage an odour into the skin. One must therefore think of effects of chemicals rather than odours. This brings further sub-divisions like aromachology to mind.

There is often some linking of aromatherapy to herbal medicine (Valerie Worwood's The Fragrant Pharmacy ) and this is where the greatest defects lie in the aromatherapist's interpretation of herbal usage of plants and their extrapolation to that of the essential oils themselves: herbal medicines are often teas and at best alcoholic extracts, which contain per se mainly water-soluble components in contrast to the essential oils, which are volatile, fat-soluble extracts. This misconception is also pervaded by the lack of botanical knowledge of aromatherapists, who have often confused genera e.g. Geranium species, our hardy European countryside plants have been used for the action of "geranium oil" which actually originates from Southern African Pelargonium species (Lis-Balchin, 2001).

Despite the aromatherapists' numerous case studies of the effectiveness of essential oils in curing almost every malady, including cancer, more serious studies have yielded negative results (Andrew Vickers Massage and Aromatherapy, 1996; Maria Lis-Balchin's (1997) article in the Journal of the Royal Society of Health). More recent studies of all the available literature on controlled studies (Cooke and Ernst, 2000) have shown absolutely no benefit other than a transient effect on mood or stress. However, aromatherapists, having no scientific training, will dismiss any criticisms of studies by scientists and maintain that aromatherapy "works". Some of the worst studies have involved the use of aromatherapy during child-birth, an exercise which has gone on for about 8 years and yielded absolutely no credible findings (Burns & Blaney, 1994; by Burns et al., 2000); there is no way that a scientific study that involves several thousand women using a range of different essential oils applied singly or together in at least 6 different ways (using the same or different essential oils) to the body or the atmosphere could ever yield any results - even the title of the study was unclear.

Aromatherapy is often linked with curing ailments (Price, 1983): often these are microbial infections (tea tree oil used for Athlete's foot) and other wonderful aromatherapy cures for baldness and genital diseases like thrush which do not really relate to the action of the odour, but rather the chemical composition of the essential oil acting as a disinfectant. The effect of massage itself can be said to be beneficial for managing stress-related conditions and the addition of essential oils to the massage therapy has never proved to be of significant difference. In fact in a study involving eczematous children, there was originally an improvement in the condition for both massages with and without essential oils, but after the second session of essential oil and massage therapy there was a reversal of effectiveness suggesting that there had been a sensitisation (Caroline Anderson et al. 2000). Many aromatherapists are linking aromatherapy with a number of other "therapies" like crystals and colours as well as dowsing: this is probably in order to improve sales of their books.

The main action of essential oils is on the primitive, unconscious, Limbic System of the brain, which is not under the control of the cerebrum or higher centres and has a great subconscious effect on the person.the placing of perfumery departments at the entrance of department stores influences the buying capacity of the client as does freshly-baked bread in supermarkets. Mood and behaviour could be influenced by odours and memories of past odour associations could also be dominant, an area which needs to be fully explored before aromatherapy is used by psychologically unqualified persons in the treatment of Alzheimer's or other ageing diseases. There is however growing evidence that aromatherapy can be used in reducing stress and improving moods of terminally-ill patients and perhaps that is where its greatest benefits lie, but only in association with touch and the capacity to listen to the patient. It has been suggested that aromatherapy, like other alternative medicines, has a placebo effect due to the greater time spent by the therapists with the patient, the belief imparted by the therapist and the willingness of the patient to believe in the therapy (Lis-Balchin, 2001).

There is growing evidence that essential oils can be sensitisers and many of the components have been shown to act as potent sensitisers, like limonene, which is used in many industries as a cleaner and diluent as well as being the major component of citrus oils (Maria Lis-Balchin and Charla Devereux in Aromatherapy: Fact and Fiction, 2001). The cosmetics and aromatherapy industry is now under threat from extremely restrictive EEC Legislation in which any essential oil containing a sensitiser component must bear a warning of sensitisation and danger (New Amendment: European Parliament 20 March, 2001. To Annex lll - Part 1 (Directive 76/768/EEC). The probable outcome will be the banning of sales of essential oils to the public by the many outlets and restricting the sales to pharmacists.

Key texts

Anderson, C., Lis-Balchin, M & Kirk-Smith, M. (2000). Evaluation of Massage with Essential oils on Childhood Atopic Eczema. Phytotherapy Res . 14, 452-456
This paper describes the treatment of children with atopic eczema with massage with or without essential oils. There was no significant difference between the two treatments and there was in fact a deterioration of the eczema in the children after the aromatherapy massage was resumed after a period of rest. This suggests sensitization as a likely cause, which may have serious implications as a large number of different essential oils were used in this study.

Buchbauer G (1992). Biological effects of fragrances and essential oils. Perfumer & Flavorist, 18: 19-24. Here the author tries to explain the true definition and likely significance of aromatherapy. Aromatherapy means the treatment using volatiles and massaging in aromas is unlikely to be effective, most of the aroma having being smelt. Lavender oil vapour, breathed in, definitely has a detrimental effect on the movement of mice hence it is said to be a sedative. Other essential oils and components have also being studied and some are sedative (lime blossom) and others stimulatory (rosemary). Later, the same group discovered that certain essential oils had an effect on brain blood flow on inhalation.

Burns E and Blaney C (1994). Using Aromatherapy in childbirth. Nurs. Times, 90: 54-58 and Burns et al. (2000). These were studies carried out over a period of many years at the John Radcliffe laboratories, Oxford, where aromatherapists designed a study which was to prove that aromatherapy is an ideal tool in giving birth. Unfortunately the number of different essential oils and their application at different times during labour resulted in the study being a complete nonentity and the fact that aromatherapy hearsay was used as the basis for the presumed action of the essential oils used proved to be completely unscientific e.g. that clary sage was oestrogenic and speeded up labour and also that " lavender was used to calm down uterine tightenings if a woman was exhausted and needed sleep while clary sage was given to encourage the establishment of labour". This shows complete bias and a belief in unproven clinical attributes by the authors and presumably the perpetrators of the study. The further study also had similar drawbacks and comparisons with a large group of "untreated" women proved to be of no statistical significant difference. Such useless studies are however interpreted by aromatherapists as proving the virtue of using essential oils in childbirth.

Cooke, B. and Ernst, E. (2000) Aromatherapy: a systematic review. Br. J. Gen. Pract., 50, 493-6. The authors selected relevant clinical studies which fell within the remits of a proper scientific study and were extremely critical of the assumptions made by aromatherapists as to the benefits of using aromatherapy: their interpretations yielded nil positive results. However, they found other individual studies to be more positive, but really outside the scope of aromatherapy as they utilized essential oils as chemicals e.g. treating Alopecia areata or athlete's foot by external application of essential oils to the area affected.

Gattefossé, René-Maurice (1928/1993), Formulaire du chimiste-Parfumeur et du Savonnier, (Formulary of cosmetics) Librairie des Sciences, 1932, Paris see also: Gattefossé's Aromatherapy, Saffron Walden, England: C W Daniel Co. Ltd. ISBN 0 85207 236 8. The original books by Gattefossé, the "father" of aromatherapy, showed that he was a perfumer, dabbling in essential oil therapy. He is famous for putting in his badly burnt hand into a tank of lavender oil which he said healed rapidly. However, he only used deterpenated oils, the ones used in perfumery which have a greater solubility in alcohol and therefore make good untainted perfumes. This is against the great doctrine of aromatherapists, who only use pure unadulterated essential oils (bought from perfumery wholesalers, need one say more).

Lis-Balchin. M. (1995). Aroma Science : The Chemistry and Bioactivity of Essential Oils, Surrey: Amberwood Pub. Ltd.ISBN 1-899308-21-0.
The book provides a basic introduction to the main essential oils used in aromatherapy and their composition, adulteration, and biological activity, which included pharmacological action, antimicrobial and insecticidal action and other functions. It is simple and also informative.

Lis-Balchin M. (1997). Essential oils and "Aromatherapy": their modern role in healing. J. Royal Soc. Health. 117 (5) 324-329. The extended essay was intended to discuss the relevance of aromatherapy as part of the number of alternative therapies now used. The author showed that the latter were all acceptable to a large public as there was no other method of achieving a one-to-one therapy session for a half hour or longer, where the therapists actually listened to problems. The healing process also depended on the ability of the therapist to persuade the clients that the therapy would work. The article also discussed the scientific literature, which did not really support aromatherapy practices, although showed that essential oils acted as chemicals specifically on certain bacteria etc.

Lis-Balchin, M. (Ed.) (2001). Genera Geranium and Pelargonium: in the series of: Medicinal and Aromatic Plants - Industrial Profiles. Harwood Academic Publishers (now under Taylor Francis Books Ltd.). No ISBN available as yet.
The book explores the basic botany and biological activity of commercial geranium oil (from Pelargonium species) as opposed to the genus Geranium and its functions, written by international experts in their fields. The many aspects of biological activity versus purity and consistency of the essential oils and their adulteration is discussed. New data is presented on the pharmacological and antimicrobial functions of both "geranium oil" and Geranium species.

Lis-Balchin, M. and Devereux, C. (2001). Aromatherapy : Fact and Fiction, Oxford: Butterworth-Heinemann. No ISBN available as yet. This book is designed to separate the many anecdotes propagated by aromatherapists from the scientific basis of essential oil function. It illustrates the many incorrect chemical and functional properties in most aromatherapy books. It describes both the historical and present day aspects of aromatherapy, the chemistry of the oils and its relationship with function, the safety aspects (both actual and anecdotal) and the modern legislation regarding essential oils and their components. It is written in a readable style but contains concise scientific evidence.

Price, Shirley (1983), Practical Aromatherapy, Northamptonshire, England: Thorsons Publishing Group.0 7225 2645 8. This is a typical aromatherapy book in which the author gives explicit guidance as to the use of specific essential oils for the treatment of various diseases, none of which are scientifically documented, but are simply anecdotal. Case studies are presented with no controls and are obviously chosen because they show something positive happening: no negative results are given.

Tisserand, R., (1988) Art of Aromatherapy, Essex, England: C.W. Daniel. ISBN absent. This is one of the first aromatherapy books written in England. The author provides an anecdotally-based regimen for the application of essential oils in various diseases and also gives an account of their botanical origins and uses. The accuracy of the latter are thrown into doubt on many occasions as the botanical origins are misinterpreted from 16thC herbals, as are the uses of essential oils, which are directly based on the whole herb usage, mainly as teas and alcoholic preparations taken by mouth (and not massaged into the body). Various associations are provided for the essential oils with the planets (after Gerard in the 16th C and Yin and Yang.

Vickers, A. (1996) Massage and Aromatherapy, London: Chapman & Hall. ISBN 0 412 576309.
This is a scientific study of aromatherapy based on the literature available. The author shows the difficulty in assessing the numerous functions for each essential oil in the light of numerous divergent aromatherapy book sources. He indicates that there is little if any basis for the aromatherapists' usage of essential oils based on clinical studies and suggests strongly that the main benefit is through the massage itself.

Worwood, V.A. (1991) The Fragrant Pharmacy. London: Bantam Books. 0 553 40397 4.
This aromatherapy book does not differentiate between the whole herb and the essential oil obtained from it regarding the many functions, mainly anecdotal. There is a wide array of both medicinal and cosmetic recipes provided for almost every possible occasion. The different essential oils not only have numerous functions, but also the numerous functions seem to be surprisingly performed by a variety of completely different essential oils: as often found in other aromatherapy books.

Dr. Maria Lis-Balchin was until recently a senior lecturer at South Bank University in London.