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History of Aromatherapy

I have to say that this is probably one of my favourite elements of aromatherapy study; where it all came from and how it started. Of course, I can’t really do it justice in a 1500 word article in a magazine as all the information I have accumulated over the years could easily form a complete book on the subject! I even wrote my dissertation in aromatherapy on the history of rose oil, combining my favourite topic with my favourite oil!

So instead of trying to condense 5000 years into 1500 words, I have decocted it to help all those students who have just embarked on their aromatherapy diplomas by giving an overview and where to go to find more information, especially as they will all be asked to complete an essay on the subject themselves for coursework very shortly (if not asked already).

Primitive man may have used aromatics, certainly as foods but probably also as medicine. It would have been on a ‘trial and error’ basis and probably they got it wrong sometimes. Certainly, archaeologists have shown that primitive tribes have always had special individuals, both men and women, who took on the job of healer and were responsible for preventing illness and curing the sick and injured. In addition to magic, spells, prayers, and charms, shaman and healers often used signature, or symbolic, items to treat their patients. When they worked, these remedies would be passed on to the next generation by word of mouth.

We can trace the use of aromatics, in written form on stone tablets, back to 3000 BC in Mesopotamia. Evidence of simple stills have been discovered where probably myrrh and grasses were heated to collect the oils. In those times, Mesopotamia was part of the great kingdom of Egypt. In 2800 BC the physician, Imhotep, was known to have lived and hieroglyphs describe the use of fragrant materials. Ancient Egyptians revered fragrances so much that they even had a God of Fragrance (or God of Perfume) called Nefertem. Please see the website http://touregypt.net/magazine/magl0012000/mag 4.htm, which has a lovely account of Nefertem. I love the account that Egypt was a holistic nation and thus the God of Fragrance was also a healer. There is of course a lot more information about aromatics and Egypt, too much to include here. I will give a list of resources at the end of this article.

Quite independently, the Chinese were also developing a herbal tradition which dates back, in written terms at least, some 5000 years. Most aromatherapists will be aware of the most famous book the Yellow Emperor’s Book of Internal Mediicne written by Huang Ti, which lists no less than 8160 different formulae, most of them plants. India also has its herbal medical traditions in the form of Ayurveda, which basically translates as the ‘Laws of Health’ and is around 3000 years old.

By 1250 B, Greece was emerging as a force. Asklepios of Epidaurus was regarded as the founder of medicine and with his two daughters Hygeia, who was later identified as the Goddess of Health, and Panacea the all healer.

Discorides collected knowledge of the plants in the Mediterranean and compiled the five volume De materia maedica. In 460 BC, Hippocrates, the most famous of all ancient physicians, was born on the island of Kos. He and his students wrote over 70 books that tell much about ancient Greek healthcare and the beginning of ‘professional medicine’. The Greeks believed that physicians should not work for personal gain but for love of mankind, and many of today’s professionall medical standards can be traced back to the Hippocratic School. The Greeks had a long tradition in oils, unguents and perfumes. Most women were skilled in the preparation of perfumes for therapeutic purposes.

We see lots of references to the use of aromatics in the Old and New Testament of the Christian Bible, especially frankincense and myrrh, which were as precious as gold as a commodity. Ancient Persia was also known for its use of aromatics and Alexander the Great helped to spread the knowledge of perfumes, gums and aromatics during his conquests. Dealers in perfumes were also called ‘aromatopyles’.

Now we come to one of my favourite periods of history – that of ancient Rome.. To coin a phrase “what did the romans ever do for us?” I can report that the Romans were lavish with their perfumery and use of aromatic oils. They use three types of perfumes: ladysmata (solid unguents), stymmata (scented oils) and diapasmata (powdered perfumes). A large amount were used for massage. Roman perfumeries wer called ‘unguentaril’ and were numerous. The Romans had a real love affair with roses. Temples of Venus were adorned with roses, rose water perfumed their baths and flowed from fountains and rose petals were strewn everywhere. Even wine was rose scented.! Roman baths that specialised in fragrances were called ‘unctuaria’. The famous physician Galen comes from this period and he wrote 300 volumes dividing plants into their medicinal categories, even today referred to as Galenic.

We have to mention the Arabs, and the most famous of all in terms of aromatherapy in the 15th century was Abd Allah ibn Sina. It is easier to remember him by his Latin name of Avicenna. He was a physician and was extremely gifted in various areas including healing. He wrote the Canon of Medicine. Here he gave such detailed description of plant use and also instructions on massage that they could be used in a modern aromatherapy classroom. I was lucky enough to see one of the original copies at the British Museum a few years ago at a special viewing of ancient medicine.

In Europe, following the decline of the Roman Empire, there was little advance in medicine during the Middle Ages. Healing fell into the religious sphere, and clerics were more interested in curing the soul than the body. Although distillation was known at that time, it seems most aromatics were floral waters and infused oils. Eventually herbals became fashionable again and special apothecary shops were set up, stocking all manner of herbs, fresh and dried, including what was called ‘chymical oyle’. In the 17th and 18th centuries, famous herbalists sprang up, such as Parkinson, Gerard and Culpeper.

During the 19th century chemists were able to look into the essences of plants in a more scientific way. However, most essences were abandoned in favour of chemical drugs which acted more powerfully. The perfume industry grew steadily in the 19th century and the region of Grasse in France became well known for its extraction of essences. They created what is now known as ‘Eau de Cologne’. Chemists like Cadeac and Meuvier and later Gatti and Cajola recognised the antiseptic properties of essential oils and the first research on this was undertaken by Chamberland in 1887 during his study on the anthrax bacillus. Despite this research, aromatherapy and phytotherapy went into a period of neglect from which it is now only slowly emerging.

In 1876, the first factory was established for preparation of synthetic perfume. The first artificial musk was created in 1887 and the first steps into the chemical era had been taken.

In 1928, Gattefossé published his book entitled Aromathérapie, his interest being spurred by an accident in his laboratory where he had used Lavender essential oil on his burned hand and was amazed at the speed of healing. The two World Wars halted any more advance in studies into essential oils but Dr Jean Valnet used essential oils while treating soldiers in World War I when penicillin was in short supply. In his book Aromathérapie published in France in 1964, he explains the remarkable properties of essential oils mostly used internally.

About the same time, Madame Marguerite Maury was pursuing similar research into essential oils. She was a biochemist not a doctor and so could not prescribe internal use. She pursued a method of external use which is now the way aromatherapy is used in the UK. She really is the Mother of modern aromatherapy. In 1961, she published The Secret of Life and Youth (which was later republished under the name Marguerite Maury’s Guide to Aromatherapy, published by CW Daniel, 1989). Her best known protégé is Danièle Ryman, and if you go to her website www.danieleryman.com, you can read a beautiful tribute Danièle has written for her mentor.

Personally, I feel that aromatherapy is more akin to the perfume industry than herbal medicine as essential oils were used in perfumery (they are now all synthetics). The effect of fragrance on the mind and emotions is very powerful and the real beauty of aromatherapy lies with reminiscence and smell therapy. It is such a shame that every ‘natural product’ on the market with an aroma is being labelled as aromatherapy or ‘containing essential oils’ because of course it is ALL synthetic and not real aromatherapy at all.

Now before I completely run out of space and start going off on another whole subject, here are some very useful resources that you can use to learn more about aromatherapy history:

  • The Greatest Benefit to Mankind: A Medical History of Humanity by Roy Porter
  • The Art of Aromatherapy by Robert Tisserand
  • Sacred Luxuries: Fragrance, Aromatherapy, and Cosmetics in Ancient Egypt by Lise Manniche
  • Essence and Alchemy: A Book of Perfume by Mandy Aftel
  • Aromatherapy for Lovers: Using Oils and Fragrances for a More Sensual Love Life by Maggie Tisserand
  • The Secret of Life and Youth by Marguerite Maury
  • The Practice of Aromatherapy by Dr Jean Valnet
  • Gattefossé’s Aromatherapy by René-Maurice Gattefossé
  • DanièIe Ryman’ä Aromatherapy Bible by Danièle Ryman
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Setting up a pilot study

Setting up a pilot study of complementary therapies in a specialist palliative care setting

by Janet Leitch, RN, MICHT

Introduction

According to NICE (2004)’ a significant number of people with cancer have reported using complementary therapies, yet there is little evidence on the effectiveness of these therapies for the relief of pain, anxiety or distress, or for improving quality of life. However, complementary therapies, such as massage and aromatherapy, are rising in popularity and are increasingly being used in palliative care to improve the quality of life of patients (Wilkinson et al. 1999). Research within palliative care is scant and there are limited randomised controlled trials to draw any firm conclusions from. However, a recent randomized controlled trial assessing the effects of massage and aromatherapy on 103 cancer patients in a palliative care setting demonstrated a statistically significant reduction in anxiety after each massage, and the patients who received aromatherapy also noted improvements in their disposition, physical comfort and their quality of life (Wilkinson et al, 1999). Barnett (2001) also suggests that complementary therapy promotes quality of life by providing comfort, aiding relaxation, and promoting a sense of emotional and psychological well-being.

Complementary therapies (aromatherapy, reflexology, massage and reiki) had been available for some time at the Marie Curie Centre Belfast within the In-patient Unit and Day Therapy setting. However, the therapies were being delivered on an ad hoc basis by a variety of staff and volunteers, and although highly valued by the patients, there was no structure in place to effectively evaluate the patients’ experience and also to coordinate and monitor the standards of therapies delivered.

Against this background a proposal was put forward to Senior Nurse Management for a ‘Nurse Therapist’ whom, in line with Clinical Guidance, would work a 25 hour week and be responsible for the provision and implementation of a complementary therapy service. A six month pilot study was agreed to, running from November 2004 – April 2005. The remainder of this article will now focus upon the aims, integration and development of this pilot study.

Potential scope of practice

Mane Curie Centre Belfast provides holistic, multi-disciplinary care to patients with life-threatening and life-limiting disorders. There is a nineteen bed In-patient Unit in Belfast and four Satellite Day-Care Units in Belfast, Newtownards, Lisburn and Downpatrick. In order to create a professionally credible service, a structure was required which incorporated: the provision of high quality, patient-centred care; appropriate choice of therapeutic intervention: cost-effectiveness; safety; policies and standards; education and training: research and development; audit; evaluation strategies: and practice development.

Throughout the UK. Marie Curie Hospices supply Complementary Therapy Services in Penarth, Bradford, Edinburgh, Solihull, Glasgow, Newcastle, Belfast, Edenhall, Caterham and Tiverton. A total of 65 therapists provide the following therapies: aromatherapy; bowen therapy; hypnotherapy; IHM; kinesiology; massage (therapeutic, sports and remedial); music therapy; reflexology; reiki; Shiatsu; spiritual healing: and stress management.

Aims and objectives of the pilot study

  • To develop a complementary therapy service that is flexible and responsive to patient needs and delivered by appropriately trained staff.
  • To evidence the perceived benefits to patients and families through evaluation.
  • To demonstrate the need to further develop and expand complementary therapy services within a palliative care setting.

Role of the Nurse Therapist

  • To communicate and work closely with all members of the multi-disciplinary team and volunteer complementary therapists.
  • To be responsible for recruiting, managing and developing a team of volunteer complementary therapists, including maintaining an up-to-date register of therapists who meet the criteria set out in the complementary therapy policy,
  • To offer monthly support and supervision sessions to the volunteer complementary therapists.
  • To identify needs in relation to the development of complementary therapies and co-ordinate the introduction of other therapies.
  • To address issues of quality, training, audit, research and development in complementary therapies in collaboration with the education department.

Policy and procedures

In order to ensure safe and professional practice a policy for complementary therapy within Marie Curie Centre Belfast was developed incorporating National Guidelines for the use of Complementary Therapies in Supportive and Palliative Care.

Documentation

Documentation was designed and continues to be developed and
improved. Documentation consists of five parts: referral form: patient information leaflets; consent form; patients’ notes; and an evaluation form at the end of treatment (if appropriate),

Integration into the multi-disciplinary team

Integration of the new service began by attending weekly team multi-disciplinary meetings. A brief introduction of the new service was given. To obtain a baseline and to establish understanding and experiences of complementary therapy, a questionnaire was given to the multi-disciplinary team members attending on the first week of the pilot study. After twelve months the same questionnaire will be used to establish change in knowledge and experiences.

The benefits of complementary therapies observed by the multi-disciplinary team (in descending order) were as follows: relaxation improved sense of well-being; reduced anxiety; promoted sleep reduced pain; felt pampered; invoked pleasant memories (aroma) reduced breathlessness; diversion therapy; fatigue management.

Treatments carried out in the In-Patient Unit

The Nurse Therapist provides aromatherapy, reflexology and Indian head massage (IHM), Monday to Friday, in the In — Patient Unit. On Fridays only, three volunteer therapists provide aromatherapy, reflexology and reiki to relatives and carers, Reiki is also provided on request to Patients in accordance with the National Guidelines (2003).

Treatments carried out in the Satellite Units

There are four Satellite Units located at Lagan Valley Hospital, Downpatrick Hospital, Newtownards Hospital and Belfast Day Therapy Unit, Each of these units have a Volunteer Therapist or Nurse Therapist offering two or more of the following: aromatherapy, reflexology and IHM. A retrospective audit of these satellite units will be conducted later in the year.

Development of the Complementary Therapy Service

Partnership with Link Nurses.

  • Wound Care Nurse – the use of essential oils in wound and odour management. Proactive measures in the prevention of pressure sores.
  • Infection Control Nurse – trial in the use of a skin protection lotion to prevent contact dermatitis.
  • Mouth Care Nurse – the implementation of the use of essential oils in mouth care.

Development of the Volunteer Team

Since commencement of the pilot study, the following have been introduced/implemented: a volunteer therapists’ register; more efficient use of existing volunteer therapists ; coordination of complementary therapy to Satellite Units; recruitment of new volunteer therapists; induction programme; education programme; training and development programme; mentorship programme; clinical supervision; monthly departmental meetings: new therapies; extension of service to relatives/carers; extension of service to Marie Curie staff.

Education

  • As part of the induction programme for new staff, a power point presentation is now given explaining the evolution of complementary therapy in the In-Patient Unit.
  • Presentations have also been given to nursing and medical staff.
  • A simple foot and hand massage demonstration has been given to nursing staff, to enable them to feel confident in this procedure. Therapeutic application of creams has also been demonstrated.
  • Relatives/carers are taught to give a gentle foot massage to enable them to participate in therapeutic touch which benefits both patient and relative/carer.
  • Two articles have been published in BUZZ (the hospice’s bimonthly in — house magazine), one explaining the role of the Nurse Therapist and the other providing information about reflexology,
  • Complementary therapy is now included in the monthly Professional Development Forum Programme,
  • A Complementary Therapy Information Folder has been compiled to disseminate knowledge on recent research findings.

Evaluation

Despite the obvious challenge, several methods of evaluation have been used throughout the pilot study and continue to be developed. Initially, a standard tick box evaluation form was used and although positive it was not giving insight into the patients’ personal experience. A simple quick response sheet was piloted which asks the patient to describe in just a few words how they found their treatment. This allowed patients to express their comments about the service in a way that was not too taxing. The following comments are just a handful noted from patients taking part in the study:

  • “Massage has really helped ease my back”
  • “It has helped me relax and sleep better”
  • “This is the first peace I have had in a long time”
  • “Massage has helped my breathing”
  • “I feel my body relaxing -1 feel happy now”.

As a further means of evaluation a qualitative nursing approach will be undertaken by using patients’ case studies.

Delivery of the Complementary Therapy Service

Table I (below) details the complementary treatments which have been provided in the In — Patient Unit and the four Satellite Units from 1st November 2004 – 30th April 2005. Unfortunately, no recordings of family members receiving complementary therapy were made and those taken for reiki are inaccurate. This will be addressed in future by the use of a complementary therapy database.

Auditing

To influence practice and improve quality of care, auditing is necessary to measure the complementary therapy service. Initially, a baseline audit was taken from analyses of a questionnaire given to a representative number of the multi-disciplinary team at the beginning of the pilot study. This questionnaire was to establish the current level of knowledge or experience the clinical staff had with regards to complementary therapy. The same questionnaire will be repeated annually, Retrospective audits on documentation will be carried out from the In — Patient Unit and Satellite Units later in the year.

Table I – Therapies audited in the In — Patient and Satellite Units (Nov 04 – April 05)

Comp Therapy

No. treatments

No. patients

Aromatherapy

285

81

Indian Head Massage

4

4

Reflexology

174

69

Reiki

4

4

Total

467

467

Our thanks to Today’s Therapist Magazine for allowing us to share past articles

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Acne: spot the difference

Up to 50% of teenage girls and 75% of boys have acne, but if you are seeing clients who are suffering with acne into their twenties or older their hormones may well be the problem.

Acne can be an ongoing problem for people whose skin has become sensitive to a hormone imbalance with excess androgens (male hormones) such as DHEAS (dehydroepiandrosterone) and testosterone. (Women should naturally have about 10% of the male level of testosterone.)

Why does acne happen? 
Excess testosterone will stimulate the sebaceous, or oil-making, glands in the skin and this will cause pores to block. This generates an ideal environment for bacteria to thrive and when that happens it will stimulate an immune response. It is the immune response that causes the inflammation, redness, pus and any possible scarring. Consideration of the impact of constant stimulation to the immune system like this should be taken into account with acne sufferers but often is not. The immune response is modulated by the stress hormone, cortisol, which means that stress can also play a role in the problems of acne by way of creating vicious circle. The acne constantly stimulates the immune system, which requires a response from the adrenals to modulate it, and then the adrenals become tired and eventually depleted so that the person’s immune system no longer functions at its optimal level and leaves them susceptible to colds, viruses and whatever else may be going around at the time.

Treating the symptom of the skin outbreak in these cases is not addressing a possible cause! Nonetheless, there are some medical treatments on offer, such as topicals containing Retin-A, the use of antibiotics such as tetraclycline and erythromycin and even the use of the Pill (especially those brands containing cyproterone acetate such as Dianette, which is approved for women with severe acne). However, Dianette should only be prescribed for a few menstrual cycles because there are serious health concerns. For example, a UK study, involving nearly 100,000 women showed that women taking this type of Pill (containing cyproterone) had four times the risk of blood clots than a Pill containing another type of synthetic progestin (levonorgestrel) (Lancet, 2001). Unfortunately we regularly hear of women who have been on Dianette for quite some time. Another familiar prescription on the acne circuit is Roaccutane or Accutane, which works by reducing sebaceous gland activity. However, it has been found to be a major factor in birth defects, an increase in depression with suicidal thoughts as well as decreased night vision to mention just a few of its side effects. Other research has found that it may also increase the level of blood fats which can affect the liver and/or increase the risk of colon cancer. It has been linked with at least 15 suicides in the UK and around 200 in the US.

So, what may be the underlying cause?
Female acne can be a sign of PCOS (Polycystic Ovarian Syndrome), the most common hormone disorder in women of reproductive age.
An explanation of cystic ovaries …
A high testosterone level may be indicative of cystic ovaries (only about 25 – 50% of women with cystic ovaries also have elevated levels of DHEAS) and this condition presents a baffling array of symptoms:

  • Ovarian cysts with ovaries up to 2.5 times larger than normal;
  • Irregular or absent periods;
  • Acne;
  • Inability to lose weight;
  • Excessive body or facial hair and thinning of scalp hair;
  • High blood pressure; and,
  • Hormonal imbalance symptoms that include depression and irritability.

Ovarian cysts ae products of failed or disordered ovulation. Part of the cystic ovary question is whether it is full-blow syndrome or not and to determine whether it is, it could be a good idea to test for insulin resistance as this can add to the acne problem through poor blood sugar control and its dietary consequences. Dietary consequences can mean reaching for a high sugar or high carbohydrate snack to address a real energy deficit, but the resultant rapid rise in blood sugar will cause an insulin response, which will cause an inflammatory response which will perpetuate an acne problem.

There is no medical treatment for PCOS until, perhaps, a woman wants to become pregnant and finds a level of infertility that seems to need medical assistance. However, this is not a condition that requires medication or intervention if a hormone balancing approach is adopted.

What can be done about acne?
It is likely that it is because of a hormonal imbalance, and with testing the bio-available levels of hormones it is much easier to establish what the imbalances are and how to address them in the most effective and targeted way. However, if it is shown that testosterone and/or DHEAS levels are elevated this is what can be done …

If PCOS is likely, an approach can be put forward using natural progesterone cream in a specific way that will help to suppress ovulation attempts and allow the ovaries to heal. This will also help to balance out oestrogen and testosterone levels and the impacts of these hormones as well as support the adrenals, from where the DHEAS comes.

Anti-androgen botanicals can also be helpful when they are complemented by a good general nutritional support supplement as well as botanicals and vitamins for support of the adrenal glands.

If the insulin question is also addressed through changing the diet and extra help with insulin sensitisation from nutritional support formulas this can prevent further problems that can evolve into the serious health condition of diabetes.

Combine this approach with a good and natural skin cleansing programme that will allow your skin to find its natural balance again and you should start to see sustainable results that nurture the body and the skin.

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Essential Oils in Primary Care Trusts

The increasing use of essential oils and aromatherapy techniques in Primary Care and NHS Trusts

Written by Duncan Bain, Natural Touch Aromatherapy 
Duncan Bain has been involved with aromatherapy for many years. He has a special interest in blending and discovering new oils. He has a strong commitment to education and has qualifications in chemistry and botany of essential oils.

A recent survey by The Times revealed that three quarters of people would like to see complementary therapies available on the NHS. Yet only a small minority can currently access free complementary therapies through NHS referrals.

The general public has an appetite for alternatives to conventional medical treatment. The big question for decision and policy makers within government, healthcare and CAM is how to integrate complementary therapies with conventional healthcare.

There are considerable scientific, professional and practical difficulties around integration. The scientific difficulty centres on proof. Many GPs and academics are reluctant to embrace CAM because of concerns about the lack of evidence. The lack of formal rigorous scientific trials remains an issue.

Many health professionals also still think of as aromatherapy as a somewhat ‘soft’ therapy, particularly when linked with therapeutic and cosmetic massage.  Without a sound scientific and clinical base, its contribution to healthcare has until recently been limited.

Yet in recent years, there has been a fast evolution as aromatherapy follows a more scientific and clinical path yet retains its holistic heritage. Increasing numbers of qualified nurses and midwives have added aromatherapy training to their skills.  More doctors and hospital managements are turning to complementary therapies (CTs) to supplement the healthcare they offer. That said some Primary Care Trusts (PCTs) and NHS Hospital Trusts, remain resistant.

At the same time, patients are becoming disenchanted with conventional medicine. The Times survey found that 10% of people turn to CTs because they have lost faith in conventional approaches. Hardly surprising, given increasing media exposure of the failure of widely prescribed drugs in many cases and well-documented side effects. Also growing numbers of patients are aware that CTs may be available if they ask.

Just as important is the push by nurses, midwives and therapists for CTs to be more widely available. They are becoming more experienced and benefit from training based on more scientific and clinical foundations. Evidence is available from real life hospital experiences that essential oils and aromatherapy treatments not only benefit patients, but may result in substantial savings in hospital budgets through the reduced use of pharmaceutical drugs in certain areas.

The ultimate referral by the doctor is the key and, the more confidence doctors have, the more they are likely to grant permission to treat using CTs. The GMC states that ‘Doctors may delegate treatment to non-medical practitioners as long as they are satisfied of their competence and that they continue to maintain overall clinical responsibility’.

Medical staff from all areas are referring patients to nurse-therapists for treatment. Some family practices are good examples of fully integrated NHS primary care service with patients offered courses of treatments, including aromatherapy, in the same way as orthodox treatment. More hospitals are encouraging aromatherapy treatments and a significant number are using essential oils in controlled research projects in a variety of situations. Undoubtedly confidence is growing.

At Natural Touch Aromatherapy we believe that the next five years will see a significant leap forward in the use of truly integrated medicine using essential oils and aromatherapy techniques in our NHS hospitals. The interest in the subject from nurses and their desire to learn more about the oils and their chemistry, is a driving force behind this. Qualifications in clinical aromatherapy, including botany and chemistry of essential oils, are available from Natural Touch Aromatherapy and run in conjunction with our sister company The Raworth College. These are ‘distance learning’ courses, allowing nurses to fit additional training into their busy careers.

Some examples of hospitals and other areas of care, which are already active in integrated medicine, specifically the use of essential oils follow. The list is not exhaustive and apologies to those not mentioned.

Natural Touch Essential Oils, which are tested independently at the Scottish Agricultural College and other independent test centres, are all guaranteed, consistently, 100% pure. They all are offered with a purity analysis certificate. Natural Touch Essential Oils are used in some, but not all, of the examples of aromatherapy activity listed below.

Oncology

Over 70% of cancer centres in the UK offer at least one CT and Aromatherapy is the most commonly practised in palliative care for cancer patients. Aromatherapy massage and relaxation treatments are offered to both patients and staff at the Hammersmith, Charing Cross and Royal Marsden hospitals.

The Neil Cliff Cancer Centre has a comprehensive aromatherapy support service in place using essential oils and offers aromatherapy education for home use to its patients. The adult Leukemia unit at The Christie Hospital NHS, Manchester has two aromatherapists who offer support to patients, predominantly to improve the quality of life in a highly stressful environment. The unit is also carrying out long term research into essential oils and testing their effectiveness in a number of conditions and hospital situations.

Aromatherapy and Hospice Care

There are increasing examples where an aromatherapist is employed by a hospice trust. This started some years ago, initially instigated by the IFA’s ‘in care’ scheme.
At the Oakhaven Hospice in Lymington, Hants, essential oils are used to promote improved quality of life and to provide help with such conditions as nausea, anxiety and depression, stiff and aching joints, as well as pain. A holistic approach is used for the aromatherapy treatments used to enhance mood.

Great care is taken to complement the treatments individuals may be receiving, such as chemotherapy or radiotherapy, and this may result in partial massage such as hands and feet, or neck and shoulders only, as well as olfactory introduction.

Using Aromatherapy for Effective Pain Management

There is increasing evidence that aromatherapy may offer a positive contribution as part of an integrated health approach to chronic pain management, a major challenge facing health care providers.

For seven years aromatherapy massage has been a key treatment strategy at the Royal Hallamshire Hospital in Sheffield, for example, in the management of chronic pain in sufferers of multiple sclerosis. Sufferers appear to obtain some symptomatic relief of pain and other benefits including improved sleep, relaxation, improved joint mobility and a sense of well being.

Intensive Care

This is one of the first instances of aromatherapy being used in a medical environment, predominantly with massage to reduce patient stress levels. Studies demonstrating these benefits have been conducted and reported on in the intensive care and coronary care units at the Middlesex Hospital, the Battle Hospital, Reading and the Royal Sussex County hospitals.

Using Aromatherapy in Midwifery

Aromatherapy has been practiced in the midwifery and obstetrics sector for a number of years.  It is well-established practice, run mainly by midwife-aromatherapists.  The John Radcliffe hospital in Oxford has operated an aromatherapy service since 1990. A survey was carried out by the hospital involving some 8,000 women. It concluded that 50% of women who used aromatherapy during labour found it effective in the reduction of fear and anxiety.

Other areas

Aromatherapy plays a role in many other environments. Working with deaf and deaf-blind; with autism; attention deficit hyperactive disorder; and with addictions. Care of the elderly and mental health are areas where aromatherapy is widely used. Details on both is available in Today’s Therapist March/April issue and not covered here.

Conclusion

To what extent CTs will be further integrated into the NHS depends on the attitudes of those who organize and provide the funding for PCTs. A soon-to-be published DoH survey is expected to show that a third of Trusts are funding complementary therapy.

In addition a combination of factors including government focus on patient choice and the pressure on NHS trusts to be accountable to local people means it’s likely that extra budget will become available for the integration of CTs.

While these pressures are important, at Natural Touch we also believe that nurses and aromatherapists in the NHS will, through their own efforts, gain the confidence of doctors, as aromatherapy continues to display sound achievements and a more scientific pedigree.

 

Duncan J Bain

Natural Touch Aromatherapy  Tel 01329 835550   Fax 01329 835559
E mail: duncan@naturaltoucharomatherapy.com

Acknowledgements: Thanks for contributions to Rhiannon Harris, Linda Blackburn, Kevin Wilson, Gillian Anstey, Ann Whithear, Janina Johns

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Tea Tree Hydrolat

Latin names and synonyms: Melaleuca alternifolia, Ti-tree, Paperbark tree

This small elegant tree grows in Australia and is farmed specifically for its essential oil, with the hydrolat being a pleasant by-product. Legend has it that the tree got its name when Captain Cook first discovered Australia and asked his crew members to make him a cup of tea with the leaves of the plant. Although the tea did not taste particularly good, the name has stuck. The essential oil and hydrolat come from the distillation of the grey-green leaves.

Tea tree has a long history of use for almost every ailment for the Aboriginal people of Australia and is used in much the same way as lavender is in Europe – for
everything! Tea tree oil and hydrolat are very powerful immuno-stimulants and antiseptics.

Tea tree hydrolat is analgesic when used as a wash for open cuts and wounds, meaning that pain is lessened and the wound is less vulnerable. The hydrolat is also slightly anti-bacterial, anti-fungal and anti-infectious and can be used for acne, athlete’s foot, infected skin and oily skin. It is also slightly anti-
inflammatory for insect bites and sunburn.

The hydrolat can be used as a mouthwash to promote healthy gums and also as an aid to healing gingivitis and bad breath. Internally it can be anti-depressing and uplifting.

Wound care 
Use the hydrolat undiluted to wash out surface wounds, cuts and grazes. For venous ulcers, bed sores and similar, wash thoroughly using plenty of hydrolat and lint free gauze or other suitable material. Using an atomiser can help in the latter situations as the hydrolat is them forced deeper into the wound. If appropriate, make a compress with the cloth and soak in warm tea tree hydrolat and leave for up to 40 minutes to clean thoroughly and reduce inflammation and infection. For follow-up treatments on cuts and grazes, blend 80m1 of aqueous cream with 20ml of hydrolat and apply when necessary. This can also apply to ulcers and similar if appropriate and suitable.

Acne treatment 
Add 20m1 of tea tree hydrolat and five drops of tea tree essential oil to 80ml aqueous cream for cleansing. Massage lightly into the face and leave for one minute before washing off with warm, clean water. Apply the hydrolat as a toning lotion, undiluted to the skin using cotton pads and allow to dry naturally. Mix 10ml of hydrolat with two drops of lavender essential oil into 90ml of moisturising base cream and use as a moisture cream day and night. TT

References
Price L, Price S, 2004 Understanding Hydrolats: The specifIc hydrosols for aromatherapy Elsevier: London.
© Penny Price

Posted on

New international standard for sustainable wild collection of medicinal and aromatic plants

It is heartening to see that there is growing global awareness of the ever-increasing demand for medicinal and aromatic plants and of the need to ensure they are properly protected, especially vulnerable and endangered species.

Used for thousands of years to promote well-being, they are an important health and economic resource for humanity. The great majority is collected in the wild and provides valuable income for rural households, especially in developing countries. However, unsustainable collection is commonly practised, which not only threatens the survival of the species, but also the livelihoods that depend on them.

It is estimated that 50,000 – 70,000 plant species are used in traditional and modern medicine throughout the world. More than 400,000 tonnes of medicinal and aromatic plants are traded annually, with around 80% of the species harvested from the wild. Many species are in danger of over-exploitation and even extinction through uncontrolled wild harvesting, over-collection and habitat loss.

Global demand for these plants has rocketed in the past decade or so and is constantly increasing. It has been estimated that 80% of the world’s population relies on plants and herbs for their primary healthcare needs because they simply cannot afford western medicines. In their September/October 2007 issue,Organic Monitor (www.organicmonitor.com) reports that global sales of natural and organic cosmetics, estimated at some US$7 billion, are soaring and that North America and Europe are the two engines of growth comprising the bulk of the US$1 billion sales increase. With the resulting additional demand for aromatic plants and essential oils, it is even more important that they are obtained from ethical and sustainable sources and that manufacturers and consumers alike are aware of the impact this could have on the survival of plant species and people involved in their production.

To address this issue, the Medicinal Plant Specialist Group (MPSG) of the IUCN (The World Conservation Union) – the world’s largest and most important conservation network – has published a new international standard based on the recognition that there is currently no international standard for wild harvesting, see http://www.iucn.orglthemeslssc/news/2007_articles/medicinal_plant.htm.

Organically certified plants are already covered by international standards but non-organic and wild harvested plants are not. These standards go a long way to meeting the urgent need to provide specific guidance for industry, resource managers, collectors and other stakeholders on sustainable practices. Drawn up following extensive consultation with plant experts and the herbal products industry world-wide the new standard promotes appropriate management of wild plant populations to ensure plants used in medicine and cosmetics are not over-exploite.

The ATC’s PR Chairman, Susan Curtis, is a member of the IUCN Medicinal Plant Specialist Group and, with her guidance, ATC members adopted the new standard at theirAGM in September. This will further strengthen the ATC’s policy on the conservation of plants used to produce essential oils for aromatherapy, adopted in 2004, as follows:

  • The ATC supports the maintenance of biodiversity and the conservation of plant species in natural habitats. They are essential to the interests of aromatherapy, the quality of the environment and the welfare of future generations.
  • The ATC supports the principles of sustainable harvesting and protection of endangered species.
    Wild harvesting should only be undertaken with strict controls. In the usage of non-cultivated medicinal plants, ATC members should endeavour to respect:
  • The Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) and any relevant national regulations have been observed.
  • Neither plant species nor their natural habitats are threatened by irresponsible harvesting or over-exploitation.
    Further information on CITES can be found from www.cites.org.

Some ATC members are already addressing these issues by supporting community projects in developing countries, offering financial support and managing their exports giving indigenous farmers the opportunity of presenting their products to the international market. Others are UK farmers, growers and producers who grow plants as alternative crops and distil them for essential oils. All ATC members are aware of the issues involved in the conservation and sustainability of medicinal and aromatic plants and how important they are.

Although there is relatively little cultivation of these plants in the UK at present, with the likely climate change in the future it may be possible to grow more Mediterranean type plants for essential oils here in the UK to swell the production of these much needed plants. It could also encourage more farmers to diversify into these alternative crops.

© Sylvia Baker, ATC – Dept TT,
P0 Box 387, lpswich lP2 9AN
Email: info@a-t-c.org.uk
Website: www.a-t-c.org.uk
Tel/Fax: 01473 603630