Aromatherapy is the use of essential oils for therapeutic effect, but clinical aromatherapy is the use of essential oils for clinical outcomes that are measurable: outcomes such as pain, insomnia, infection, depression. So the main difference is in the clinical outcome, and how that outcome is measured. Measurement can be a simple analogue (0-10) or something more sophisticated like POMs Depression Scale.

This more analytical approach to aromatherapy can be learned through foundation courses run at universities. Here the critical skills of practitioners are honed to a whole new level and the end result is practitioners who really understand how to test their therapy with research and critical appraisal. This is a really exciting time for all complementary therapists, not just aromatherapists, as evidence-based medicine is the way forward for integration. If a therapy works and saves money, the NHS wants it!

The 2003 Nobel Prize for Medicine was won by two USA scientists who researched how smell works. Since then, aromatherapy has been taken a lot more seriously as research clearly shows that smell has a profound physical and physiological effect. The first cranial nerve is the olfactory nerve - a direct link from the outside world to the inner world of the limbic system deep within the brain. The limbic system governs how we react to fear, anxiety, phobias, addiction, stress, and chronic pain.

Hippocrates wrote that aromatics could play an important role in health and suggested this effect went way beyond a nice smelling pick-me-up. He promoted the use of aromatics as protection against the plague and infectious diseases. Essential oils, as used in aromatherapy, could in fact turn out to be lifesavers, as some are effective against MRSA (Methicillin-resistant Staphylococcus aureus) which is a major problem in some hospitals. Essential oils have also been shown to be effective in human clinical studies on alopecia, insomnia, nausea, inflammation and infection.

This more clinical approach to aromatherapy has survived in France and Germany, where aromatherapy is seen as an extension of orthodox medicine. German doctors and nurses are tested in the use of essential oils in order to become licensed. The antibiotic, antifungal, antiviral potential of essential oils is vast. A search on PubMed or Medline using the botanical name of the individual aromatic plant coupled with essential oil will produce between twenty and a hundred papers per essential oil. The studies will be in-vitro (carried out in a laboratory, not on a human being) but it is a start.

Recently, there has been negative press attention regarding tea tree and lavender following the publication of an article about three prepubescent boys (aged 4-10), who manifested gynecomastia (enlarged breasts).1 It was suggested that somehow lavender or tea tree was to blame - rather surprising since millions of people all over the world use tea tree and lavender on a regular basis and many of them are prepubescent boys! Critical appraisal skills are urgently required for all therapists so they are able to rebut this kind of negativity in a professional and academic way.

A more positive (and potentially lifesaving) study using tea tree was carried out on 30 adult inpatients infected or colonised with MRSA.2 This study took place at John Hunter Hospital, Newcastle, New South Wales, Australia. Participants were randomly assigned to receive either conventional treatment (2% mupirocin nasal ointment and triclosan body wash) or a 4% tea tree nasal ointment and a 5% tea tree oil body wash. Treatment lasted for a minimum of three days. Two of the regular treatment groups (13%) were cleared of MRSA, compared to five of the tea tree group (33%). Eight of the regular treatment group (53%) remained chronically infected or colonised at the end of the treatment, compared to three of the tea tree group (20%). No one complained of adverse effects from the tea tree oil body wash.

The message is clear: clinical aromatherapy could play a key role in health care. The key is in training. TT

1 Henley D, Lipson N, Korach K, et al. (2007). 'Prepubescent Gynecomastia Linked to Lavender and Tea tree Oils', New England Journal of Medicine, 356 (5), 479-85.

2 Caelli M, Porteous J, Carson C, et al. (2000). 'Teatree Oil as an Alternative Agent Decolonization for Methicillin-Resistant Staphylococcus Aureus',

Journal of Hospital Infection, 46: 236-7.

Dr Jane Buckle PhD RN, MIFPA is the programmes manager and principal lecturer in Complementary Medicine at Thames Valley University (TVU), London, where the foundation degree Complementary Therapies in Healthcare (Aromatherapy and Reflexology) is taught in the brand-new CAM Clinic .

visit www.cchim.com for more details.

MarApr 07