Clinical Aromatherapy: Essential Oils in Practice by Jane Buckle. London & New York: Churchill-Livingstone, 2003. 236 pp. ISBN: 0-443-07236-1. $37.95.>

Essential oils and the aromas they produce have enticed and intrigued humans for centuries. The art of blending and using these concentrated plant oils for clinical purposes goes far back into the history of medicine. The use of essential oils is recorded as early as Egyptian times; royalty would place cones of ox fat imbued with fragrant essential oils on the tops of their heads to perfume their bodies. In the history section of the book, author Buckle, an expert in medical research on aromatherapy, reminds the reader that “in almost every part of the world” there exists “some use of aromatics in its healthcare system.”

The sixteenth-century Swiss physician and alchemist Paracelsus believed that aromatic plant oils contained the quintessence—the fifth essence—of the plant. The first four essences were earth, air, fire and water; the fifth essence was the highest and believed to permeate all of nature and form the heavenly bodies. It was also called >ether and hence, essential oils have also been called >ethereal oils.>

In the last several hundred years, the cosmetic industry has developed an elaborate science of extracting and concentrating a wide variety of plant oils in the development of alluring aromas—blends of many plant oils (and often other natural and synthetic ingredients) that are sold as perfume (from French par fume, from Latin >per fumum— “through smoke”>—based on the custom of adding aromatic ingredients to burning coals, the smoke diffusing the agreeable fragrances; >fumigate has a similar origin). Today the recipes for these mixtures are jealously guarded by their creators because these scents have such an enormous capacity to influence consumers’ behavior and their pocketbooks. >

Yet until recently, the complex nature of the intricate relationship between emotions, scents, and their influences on human health has been a scientific mystery, mostly because the mechanics of how it works has eluded the ability of science to define it. But medicine has evolved and aromatherapists and researchers are learning how extraordinarily small amounts of a fragrant essential oil can send people’s emotions into an explosive set of chain reactions. A 1990 study showed that subliminal effects of certain scents could now be recorded below the level of human awareness. Subjects were exposed to four concentrations of two odorants while hooked up to an EEG (electroencephalograph) machine. At the lowest concentrations of scents, none could detect the presence of odors despite the distinctive tracings and mood shifts correlated with each aromatic exposure.

Medicine is beginning to derive a greater interest in using natural substances that may offer therapeutic benefit without harmful side effects. Essential oils are one of many modalities that offer this potential. Yet, this ancient modality has been largely ignored by the evidence-based but open-minded healthcare practitioner, primarily due to the lack of good reference materials available to bridge the scientific gap. Dr. Buckle’s publication is a useful reference narrowing this gap for all interested in the healing power of essential oils and aromatherapy. Technical aspects pertaining to use, extending beyond simple inhalation, are discussed (e.g., topical applications versus ingestion). Buckle explains that specific carrier oils when applied to the skin in a fatty base “may inhibit the germicidal effects of a phenol,” a common constituent of many essential oils. Those concerned about pesticide concentrations in these products will learn that “expressed” (or pressed) essential oils are more likely to have high levels of pesticides.” The section on essential oil toxicity and its contraindications is succinctly outlined for ingestions, topical applications, and inhalations. An informative section on lethal oral doses of essential oils for children, though briefly discussed, is quite useful—especially in the case of the inexperienced consumer or essential oil practitioner who may commonly overlook the potential toxicity in these concentrated botanical substances. >

Section II, “Clinical Use of Aromatherapy,” addresses a wide range of topics. It begins by looking at essential oil uses for infection control, insomnia, nausea and vomiting, as well for the management of pain, inflammation, and stress. A published case study about a methacillin resistant Staphylococcus aureus infection in the bone, commonly referred to as osteomyelitis, is discussed. An unlucky 49-year-old man suffered from a trauma resulting in an open wound with a complex fracture of the shin. He underwent numerous operations to remove infected and decaying tissue while being given powerful antibiotics. The unwanted organisms in the bone developed drug resistance to every possible antibiotic that could be administered and persisted in the wound despite numerous cleaning procedures. As a last resort, in an effort to circumvent amputation, the medical team packed the wound with pellets of calcium sulfate, impregnated with lemongrass, eucalyptus, tea tree, clove bud, and thyme with a catheter left in place to allow further delivery of the sterilized oils to the infected site. After three months the wound healed and cultures were clear. This information, while only a case report, illustrates the potential of these oils for further research in addressing challenging medical cases. >

Other interesting medical cases are sprinkled throughout each subsection including cardiology, critical care, endocrinology, immunology, oncology, pediatrics, and more. Skeptics requiring large trials will remain unsatisfied because in many of the areas covered controlled scientific trials are still lacking. Nevertheless, Buckle has attempted, wherever possible, to cite the latest scientific literature pertaining to each topic. Those interested in developing clinical depth while maintaining an evidence-based approach to aromatherapy will find Buckle’s text useful.

Enhancement of patient care has been a timeless goal for all healers throughout time. Hippocrates reportedly once said, “The way to health is to have an aromatic bath and a scented massage every day.” Now in the twenty-first century we may finally be learning why.

—Roberta Lee, M.D.