Aromatherapy - Case Study Example

Essential Oils as Aromatherapy Medicines: Evidence of Their Importance In Health and Social Care Mounts Introduction Aromatherapy is the medicinal use of plant extracts as scent, massage oil or pharmacological preparation, which is at the heart of complementary and alternative medicine (CAM). As key component of complementary and alternative practice, it suggests that aromatherapy is not to be dispensed on its own but as an adjunct to conventional medicines or treatments and then only for palliative care requirements. For example, when the drug statin is prescribed to a heart patient to normalise his heartbeat, mainstream medicine may allow that patient to take omega-3 fatty acid preparation only as supplement and never one without the other. On palliative care, the prevailing attitude is that unorthodox therapy methods like dance, touch, yoga, acupuncture, homeopathy and osteopathy may be tolerated on managing chronic bodily pain but unacceptable in other areas of medical treatment outside palliative care. Thus, Bausell (2007) notes that although alternative medicine has grown in popularity in the past 15 years as a healthcare system, people still largely use it as complement to conventional healthcare. However, evidence continues to mount that aromatherapy, especially the use of essential oils, has displaced conventional medicine as treatment of choice in many countries. In fact, the Cochran Complementary Medicine Field in 2007 revealed that what is considered complementary or alternative therapy in one country is now considered conventional medical practice in another (Manheimer & Berman, 2007). This only confirms what the World Health Organisation (WHO) reported as early as 1978 that majority of the world’s population has come to depend on traditional medicine for primary healthcare. Such reported increase in the clinical importance of essential oil use among all aromatherapy methods is the main topic selected for this paper because of its high social relevance and potential for achieving the goals of the primary healthcare program, which means health for all. The reason is that while other plant-based medicines are now prepared commercially to come at a cost, essential oils can be extracted at home by anyone with a backyard plot of volatile herbs and are therefore affordable to everyone. For a nurse like me, the socially oriented and community-based healthcare scenario promised by plant-extracted therapeutic oils is a special concern because, together with midwives, nurses belong to the primary healthcare loop that may work for a public health center or a general physician within a community. In this connection, Ersser (1990, in Price & Price, 1999) observed: “A significant number of nurses within the health authority are now using essential oils and/or massage in their practice.” To gather the confirmatory empirical evidence, this paper reviews the existing literature on the increasing use of essential oils for therapeutic massage. Based on the literature review and my own clinical experience, I then set the question to guide the research and subsequently identify the appropriate methodologies to be used to address the research problem. The final chapter summarises the findings, in the process justifying the methodology approach used in answering the research question. Literature Review 1. Search The search for the relevant literature was focused on the Oracle database, which hosts the web search engine Yahoo. All in all, the search yielded 16 sources, of which 5 are books, 1 a medical review and 10 journal articles, most of which are research papers. Only two of the selected sources hark back to the late 1980s as time reference (Valnet, 1980; Mitscher, et al., 1987), 8 refer to the 1990s (Craker, 1990; British Medical Association, 1993; Prudent, et al., 1995; Reynolds, 1997; Jones, 1996; Darokar, et al., 1998; Price & Price, 1999; Zollman & Vickers, 1999), and 6 speak of the more recent conditions (Cavanagh & Wilkinson, 2002; Arias & Ramon-Laca, 2005; Prabuseenivasan, et al., 2005; Mayo Clinic, 2007; Manheimer & Berman, 2007; Bausell, 2007). The country setting for majority of the sources is France, where the people are considered among the world’s largest aromatherapy users since earlier times. There is only brief reference to UK and India, while the authors from outside of these countries did not refer to any particular country or population. The methodology of choice for the research papers in the reference list is the qualitative method, which was used to generate the primary data of research from surveys and interviews, experimentation and observation. This amounts to empirical research, since the findings were based on observation or experimentation as test of accuracy. When it comes to the findings, the research papers generally agree that there has been an upsurge in the use of essential oils for treatment of both major and minor ailments. The consensus is that it is about time aromatherapy, being inexpensive and affordable to all, be promoted as a valid branch of medicine the way it is now considered part of mainstream medicine in France. Thus, the authors call for the publication and distribution of a pharmacopoeia that would give aromatherapy its stamp of legitimacy and respectability and be finally treated as a science instead of an art. This would also address some safety concerns related to essential oil therapy. The reason is that essential oils are highly concentrated and can thus irritate the skin when used as is. They have to be diluted with for topical application otherwise toxic reactions may occur. Also, many essential oils have chemical components that are sensitisers, meaning they cause skin reactions after a number of uses (Cavanagh & Wilkinson, 2002; Darokar, et al., 1998). Moreover, oils both ingested and applied to the skin can potentially have negative interaction with conventional medicine. For example, the topical use of methyl salicylate heavy oils like sweet birch and wintergreen may cause hemorrhaeging in users taking the anticoagulant Warfarin. 2. Overview The word aromatherapy was first used in the 1920s by French chemist Rene-Maurice Gattefosse, who pioneered research on the healing properties of essential oils. During an accident at his lab, Gattefosse burned his hand and, in panic, thrust the injured hand into the nearest cold liquid that turned out to be a vat of lavender oil. The pain relief was immediate and the healing process was quick, without the redness, inflammation, blisters and scarring associated with orthodox burn ointments (Valnet, 1980). Other French scientists improved upon this discovery and developed essential oils to treat gangrene among wounded French soldiers in World War II. Now, essential oils are popularly used in France as antiseptic and for antiviral, antifungal and antibacterial control (Durante & Malerba, undated). In a process called aromatogram, French doctors first culture a sample of infected tissue or secretion from patients, then divide this growing culture among petri dishes supplied with agar (Price & Price, 1999). Each dish is inoculated with a different essential oil and the specific oil extract that displays the most activity against the target strain of microorganism is then used for treatment. These aromatherapy practices first came to UK as massage oil, which engendered the belief that aromatherapy is only for relieving muscle pains. To this day, the House of Lords Select Committee reports that alternative therapies used in UK are confined to massage and other body works, flower remedies, hypnotherapy, reflexology, meditation and yoga (Bausell, 2007). Attitudes are changing, however, as a more recent research conducted at the University of Exeter shows. The study found that 93 percent of all GPs and 70 percent of hospital doctors in UK had suggested a referral to alternative treatment at least once, while 20 percent of GPs and 12 percent of house doctors confessed to having practiced aromatherapy. Essential oils are aromatic oily liquids obtained from plant materials such as flowers, buds, seeds, leaves, twigs, bark, herbs, wood, fruits and roots. They can be obtained by expression, fermentation or extraction but the method of steam distillation is most commonly used for commercial production. An estimated 3,000 essential oils are known, of which 300 are commercially important in fragrance market. Essential oils are complex mixes comprising many single compounds, and are chemically derived from terpenes and their oxygenated compounds. Each of these constituents contributes to the beneficial or adverse effects. Essential oils such as aniseed, calamus, camphor, cedarwood, cinnamon, citronella, clove, eucalyptus, geranium, lavender, lemon, lemongrass, lime, mint, nutmeg, orange, palmarosa, rosemary, basil, vetiver and wintergreen have been traditionally used by people for various purposes in different parts of the world (Darukar, et al., 1998; Arias & Ramon0Laca, 2005). Continuous use has established that cinnamon, clove and rosemary oils show antibacterial and antifungal activity, with cinnamon oil also possessing anti-diabetic properties. Anti-inflammatory activity has been found in basil, while lemon and rosemary oils possess antioxidant property. Peppermint and orange oils have shown anticancer activity and citronella oil has shown inhibitory effect on biodegrading and storage-contaminating fungi. Lime oil has shown immuno-modulatory effect in humans, while lavender oil has shown antibacterial and anti-fungal activity and effective as well in treating burns and insect bites (Jones, 1996). These findings were supported by the research of Prabuseenivasan, et al., 2005) in India, which identifies the essential oils with major anti-infection effects as cinnamon bark, Spanish oregano, savory and thyme. Those with similar though limited activity are clove buds, marjoram, coriander and tea tree. The Indian study evaluated the antibacterial activity of 21 plant essential oils against 6 bacterial species using the disc diffusion method popularised in France with a concentration of agar ranging from 0.2 to 25.6 mg. The findings showed that cinnamon oil works best against bacteria even at low concentration, followed by clove, geranium, lemon, lime orange and rosemary in their order of efficacy. Essential oils used as scent activate the limbic system and the emotional centres of the brain. Internal application as pharmacological preparation, they may stimulate the immune system, and applied to the skin as massage oil, they stimulate the thermal receptors to kill microbes and fungi (Manheimer & Berman, 2007). According to Price & Price (1999), the reason why plants contain essential oil that though toxic can be beneficial when taken in the right amount is simple. Plants develop this toxicity as self-defense mechanism, such that some plants produce a repellent action to prevent attack by herbivores; increase oil glands against attacks from insects; develop antifungal and antibacterial properties to protect themselves against attacks by bacteria, fungi and microorganisms; help in healing wound when the plant itself is cut; produce allelopathic compounds like camphor to survive in difficult conditions; and surround themselves with volatile oil to prevent dehydration in hot climates. Healthcare practitioners gravitate toward essential oils because these are very inexpensive and thus augurs well for public health in poor countries. This is what primary healthcare is all about, which means that all people can access health services. Primary healthcare also aims to address the perceived imbalances in the system by shifting its core services from cities where majority of the health budget is spent to the rural areas where the majority live in most countries (Mayo Clinic, 2007). Research Question The main question for this paper is: Having established that essential oils for massage are effective in the treatment of certain ailments, is there a practical, scientifically solid and socially acceptable reason for this form of alternative medicine to be transposed from the periphery to the centre of mainstream medicine? Also worth asking are such sub-questions as: 1) What sector of the healthcare service finds massage oils most useful and why? 2) Why do nurses specify the use of massage oils for heart patients and convalescing patients? 3) Are there risks of side effects from essential oils that can discourage their extensive use for medical treatment? Addressing the Question The qualitative method of research using the techniques of survey and in-depth interviews is the most appropriate methodology for this paper that needs to explore the subject in detail and probe for latent attitudes and feelings. This method generates primary data that focuses on known sources that are deemed reliable. If the quantitative method is used in its place, the study is likely to be led astray by various viewpoints expressed in a plethora of sources since the quantitative method needs to examine a large number of variables to arrive at a conclusion. This is also more expensive and time-consuming. In-depth interview is a qualitative research technique that requires face-to-face discussion to gain insight into people’s thoughts, attitudes and behaviour on certain issues. Thus, the technique emphasises the use of probing, unstructured and exploratory questions that are open-ended in design to encourage interviewees to respond enthusiastically and answer in their own words. An interview session is unstructured if the interviewer allows the respondent to talk freely about the topic of interest. It aims to ask the reasons behind a problem or practice in a target group of the population. For the purpose of this paper, the in-depth interviews will be complemented by observation and experimentation to validate two theories: 1) that massage oils are as effective as medically accepted treatments, and 2) that no patient has ever suffered side effects as severe as those suffered from regular drugs like antibiotics. This completes the make-up of the study as an empirical research, which is defined by Geisel Library of UK’s St. Anselm College as a research method that bases its findings on observation and experimentation as test of reality and uses the survey method as well. Using these methods, the study found that many nurses are already adding massage oil therapy to their caring and helping a lot of patients. Ersser (1990, in Price & Price, 1999) observed: “A significant number of nurses within the health authority are now using essential oils and/or massage in their practice.” Several GP practices also now have a room where complementary practitioners can treat patients referred to them by one of the GPs and aromatherapy is one of the treatments most in demand. This agrees with the survey of nurses in relation to complementary therapies carried out by the Nursing Times (Manheimer & Berman, 2007). Studies show the importance of touch in the development of healthy human beings, touch being a basic human behavioural need (Zollman & Vickers, 1999). The health benefits of massage include increasing circulation of the blood and lymph, slowing pulse rate, lowering blood pressure, releasing muscle tension, toning underused muscles and relieving cramps. Massage therapy used to enjoy a high status in medical care but lost its appeal as the development of effective drugs forged ahead in the 1960s (Bausell, 2007). Nurses lead the healthcare practitioners that want massage therapy to occupy a place of importance in patient care. During a nursing conference at St. Catherine’s College in Oxford, a senior nurse at Battle Hospital in Reading said: “I felt more like a super technician than anything else, my caring role was just not being fulfilled.” Nurse Chrissie Dunn also reported at the conference that use of essential oils for massage at the intensive therapy unit in another UK hospital significantly reduces blood pressure and heart rate. The same observation was made by nurse Sheena Hildebrand of Royal Marsden Hospital in London, where use of essential oils and massage bring about relief of tension and promote peace and tranquility among patients. On the question of side effects and efficacy, there is a growing conviction that essential oils are even safer and more effective than antibiotics, both in medical and environmental terms. Antibiotics are flushed down the drain to pollute the land but essential oils are ecologically sound and cause no pollution. Also, microbes often develop resistance to antibiotics after prolonged and frequent use (Mitscher, et al., 1987). This problem has never been associated with essential oils, which can destroy the resistant strains of microbes selectively. Essential oils are also better than chemical antiseptics in that their aggression towards microbial germs is matched by their total harmlessness to tissue. Chemical antiseptics tend to be harmful to cells of organism and thus destroy not only the target microorganisms but also the surround cells (Reynolds, 1997). The methodology approach used for this paper hopes to uncover the reasons why essential oils are replacing conventional medicines in many healing processes. In the rural environment, people can gather plants and process their own medicines, which is important in this era of skyrocketing prices and widespread poverty. Conclusion From the literature review and my own clinical experience, aromatherapy, especially the use of essential oils for therapeutic massage, has become so well accepted and popular that the practice is now even considered part of conventional medicine in some countries, notably France. True, many alternative treatments lack solid research on which to base sound decisions unlike conventional medicines that have been proven safe and effective through carefully designed trials and research. Thus, aromatherapy could not come up with scientific proof and is largely considered an art than science. Yet it survives and continues to grow through the years, which means that it is proven safe and effective. Otherwise, people will stop using it. In fact, the Mayo Clinic (2007) says conventional doctors are finding that more than half of people try some kind of alternative treatment. Moreover, many health institutions are now integrating massage therapies into their treatment programs, even as medical schools have included non-traditional techniques into their curriculum, with essential oils sold openly in generic drugstores that have started to proliferate. References 1. Arias, B.A. & Ramon-Laca, L. (2005). “Pharmacological Properties of Citrus and their Ancient and Medieval Uses in the Mediterranean Region.” Journal of Ethnopharmacology 97. 2. Bausell, R.B. (2007). “Snake Oil Science: The Truth about Complementary and Alternative Medicine.” Oxford University Press. 3. British Medical Association (1993). “Complementary Medicine: New Approaches to Good Practice.” Oxford University Press. 4. Cavanagh, H.M & Wilkinson, J.M. (2002). “Biological Activities of Lavender Essential Oil.” Phytotherapy Hepatology 8. 5. Craker, L.E. (1990). “News and Commentary.” The Herb, Spice and Medicinal Plant Digest 8 (4). 6. Darokar, M.P., Mathur, A., Dwivedi, S., Bhalla, R., Khanuja, S.P.S. & Kumar, S. (1998). “Detection of Antibacterial Activity in the Floral Petals of some Higher Plants.” Current Science 75. 7. Durante, A. & Malerba, S. (undated). “The Aromatogram: A Valuable Therapeutic Tool.” France. 8. Jones, F.A. (1996). “Herbs Useful Plants: Their Role in History and Today.” European Journal of Gastroenterology Hepatology 8. 9. Mayo Clinic (2007). “Complementary and Alternative Medicine: What is it?” Mayo Foundation for Medical Education and Research. 10. Mitscher, L.A., Drake, S., Gollapudi, S.R. & Okwute, S.K. (1987). “A Modern Look at the Folkloric Use of Anti-infective Agents.” Journal of Natural Products 50. 11. Prabussenivasan, S., Jayakumar, M. & Ignacimuthu, S. (2006). “In Vitro Antibacterial Activity of some Plant Essential Oils.” Entomology Research Institute; Chennai, India. 12. Price, S. & Price, L. (1999). “Aromatherapy for Health Professionals.” 2nd ed. Churchill Livingstone Publishers. 13. Prudent, D., Parineau,, F., Bessiere, J.M., Michel, G.M. & Baccou, J.C. (1995). “Analysis of the Essential Oil of Wild Oregano from Martinique.” Journal of Essential Oil Research 7. 14. Manheimer, E. & Berman, B. (2007). “Cochran Complementary Medicine Field.” Scope and Topics. 15. Valnet, J. (1980). “The Practice of Aromatherapy.” Saffron Walden. 16. Zollman, C. & Vickers, A. (1999). “ABC of Complementary Medicine.” Users and Practitioners of Complementary Medicine, 25 September 1999. Read More