By Cheryl A. Sweet
Posted: Wednesday, October 1, 1997
ARTICLES
Publication Date: October 1, 1997
Aromatherapy is a "branch" of herbal medicine that centers on using fragrant substances, particularly oily plant extracts, to alter mood or to improve individuals' health or appearance. The alleged benefits of aromatherapy range from stress relief to enhancement of immunity and the unlocking of "emotions from past experiences." But skeptics cite a lack of credible supportive studies published in reputable scientific or medical journals.
Scents of Well-Being?
"Aromatherapy" is a buzzword used by the cosmetics, fragrance, and alternative-medicine industries. Although the method has ancient roots, proponents did not call it "aromatherapy" before the 1930s. This expression derives from the French word aromathérapie, coined by René Maurice Gattefossé, a chemist whose book of the same name was published in 1928. After a lab explosion Gattefossé conveniently plunged his badly burned hand into a vat of lavender oil. He noticed how well it healed, and thus began the development of modern aromatherapy, which French homeopaths Dr. and Mme. Maury revived in the 1960s.
Proponents of aromatherapy maintain that the tools of the trade—wood-resin distillates and flower, leaf, stalk, root, grass, and fruit extracts—contain antibiotics, antiseptics, hormones, and vitamins. Some proponents have characterized essential oils—i.e., oils that are volatile, aromatic, and flammable—as the soul or spirit of plants. Indeed, one of aromatherapy's premises is that essential oils have a "spiritual dimension" and can restore "balance" and "harmony" to one's body and to one's life. One of its principles, the "doctrine of signatures," holds that a plant's visible and olfactory characteristics reveal its "secret" qualities. For example, because the configuration of the violet suggests shyness, proponents hold that the scent of violets engenders calmness and modesty.
Aromatherapy en-compasses topical application of essential oils, bathing in water to which essential oils have been added, sniffing essential oils, and even ingesting them. Products marketed under the "aromatherapy" umbrella are legion, including shaving gels, aftershaves, facial cleansers, bath salts, bath soaps, shower gels, shampoos, hair conditioners, "body masks," moisturizers, sunscreen preparations, lipsticks, deodorants, candles, lamps, diffusers, pottery, massage oils, massage devices (e.g., the Aromassager), and jewelry (e.g., lockets and pendants for carrying essential oils).
"The most common aromatherapy field is aesthetic, the sense of well-being derived from enjoying perfumes, scented candles, baths, and other fragrances," states Jane Buckle, R.N., M.A., who claims the world's first master's degree in clinical aromatherapy (her M.A. degree), from Middlesex University in London. At the opposite end of the spectrum, says Buckle, is medical aromatherapy, also known as aromatic medicine. Practitioners of medical aromatherapy include massage therapists, naturopaths, nurses, and a smattering of medical doctors.
The alleged beneficial effects of aromatherapy are numerous. Proponents claim, for example, that essential oil from lavender or peppermint clears "negative energy"; that essential oil from bergamot normalizes emotions; that essential oil from roses or sandalwood increases confidence; that essential oil from eucalyptus alleviates sorrow; and that patchouli creates a desire for peace. Essential oils can have side effects, however, and even proponents warn about risks. Essential oil from cinnamon, clove, nutmeg, and ginger can burn the skin; ingestion of essential oil from pennyroyal can cause miscarriage.
Raphael d'Angelo, M.D., is a Colorado family practitioner who began incorporating aromatherapy into his practice over two years ago. D'Angelo uses eucalyptus oil and peppermint oil adjunctively in treating respiratory disease. He alludes to "studies indicating these oils not only have soothing properties, but reduce mucous production, as well as possessing antiviral and antibacterial properties." But these studies, he adds, were conducted in Europe, and the degree of scrutiny and peer review they underwent was not necessarily as high as the usual degree of such in the United States.
Can You Trust Your Aromatherapist?
Outside the U.S. aromatherapy is widely accepted. In France, medical students are taught how to prescribe essential oils; in Britain, hospital nurses use aromatherapy to treat patients suffering anxiety and depression and to make terminal-care patients more comfortable.
But the science behind aromatherapy is meager, and in the U.S. no legal standards exist concerning education in aromatherapy, certification therein, or the occupational practice of aromatherapy. Dr. d'Angelo is taking courses offered by the Australasian College of Herbal Studies, a nonaccredited correspondence school in Oregon whose six-lesson aromatherapy course leads to a "Certificate in Aromatherapy." The school also offers certificate courses in homeopathy [see Priorities, Vol. 9, No. 1, 1997, p. 45]; Homeobotanical Therapy, which centers on the use of botanical tinctures that purportedly have been prepared homeopathically; and iridology—so-called iris diagnosis. According to Dorene Peterson, the school's principal: "In the last 18 months, we've had a 75 percent increase in aromatherapy students." Peterson holds a "Diploma in Acupuncture" ("Dip ACU") and two degrees: a baccalaureate and a "Diploma in Natural Therapeutics" ("DNT") from New Zealand. She says her school has 400 enrollees, ranging in age from 18 to 68 and including "professionals adjuncting an existing career": medical doctors, registered nurses, licensed massage therapists, and some radiologists. Other students are planning on jobs in beauty salons, in health food stores, and in the fragrance industry.
The American Aromatherapy Association, also nonaccredited and in Oregon, offers certification based on attendance at two three-day meetings and submission of a paper that includes case histories. The association's course covers the use of essential oils as internal remedies. Another nonaccredited organization, the International Association of Aromatherapists, offers an 11-month correspondence course leading to certification as an "Aromatherapist Practitioner."
Business Stinks?
As director of his Smell and Taste Treatment and Research Foundation, in Chicago, neurologist and psychiatrist Alan Hirsch, M.D., specializes in treating people with smell disorders. His passion, however, is investigating how odors affect behavior. Hirsch's most attention-getting study focused on whether an odor could affect weight. Hirsch had noticed that, after losing the sense of smell, people's weight increased. He theorized that people would eat less if they were subject to odors more often. For the study, 3,193 people were given an inhaler that imparted an odor somewhat reminiscent of corn chips. At the outset of the study the subjects' average weight was 217 pounds; some subjects weighed nearly 600 pounds. Hirsch found that the more often the subjects sniffed the odor, the more weight they lost. The average weight loss over six months was 30 pounds. Some subjects sniffed the odor more than 200 times daily and lost more than 100 pounds.
Most researchers are skeptical of Hirsch's work. They complain that he doesn't publish in respected scientific journals, that his studies therefore do not undergo rigorous peer review, and that his experiments are not well controlled. Hirsch concedes: "At this point, I wouldn't use aromatherapy myself, as a physician to deal with disease. I don't think we're there yet. If I saw a physician using aromatherapy, rather than tranquilizers, I'd say that's inappropriate at this point." But Hirsch predicts that by 2010 aromatherapy will be a part of mainstream medicine. "In the future, odors may be used to diagnose disease," he says. "If we ever find the odor associated with the greatest impairment, we could potentially use that to diagnose the recurrence of disease."
Hirsch also describes more mundane purposes: "Maybe ten minutes before you wake up in the morning, the alarm clock will spray a scent to make you more alert. You'll go to the kitchen, where an odor will be released to increase or suppress your appetite. Your office may be scented to make you more productive." And at bedtime? "An aroma," he replies, "to make you sleepy—or more amorous."
Observes principal Dorene Peterson of the Australasian College of Herbal Studies: "There is a philosophical difference between hard science and the approach that believes there's vibrational energy that's part of the healing process. Alternative medicine is offered now in quite a number of medical schools. I think a lot of hard-core scientists and doctors who have been trained in that data-oriented scientific approach are realizing there's more to heaven and earth than we really know about." Still, Peterson admits that empirical evidence is necessary for widespread acceptance:
This is such a new area that there are a lot of studies at this point that aren't reproducible. Even though there's been some interesting work done in Japan and Germany, it's one thing to get results once. But it doesn't appear that researchers have been able to duplicate these results again. While I believe there's a scientific basis for aromatherapy, and enough basis to show that physiological reactions occur in the body when individuals inhale certain fragrances, there's also a tremendous range of subjective reasons for reactions. For instance, If someone's had a negative experience with fragrances in the past, and it's caused anxiety, that person will react negatively, even though other people may react positively.
Smell the Roses
Generally, insofar as odors and topical essential-oil preparations are pleasurable, they are healthful. Consumers don't need to be told what smells good. And which odors evoke pleasant thoughts in an individual is knowable only personally. But consumers ought to be told what's risky and what's unfounded. Aromatherapists and marketers of aromatherapy products do not seem reliable sources of such information. Popular and higher-education acceptance of a method is not evidence that the method has therapeutic utility. As a health system, aromatherapy is largely unsubstantiated.
Cheryl A. Sweet is a freelance health writer who lives in Phoenix, Arizona.
(From Priorities, Vol. 9, No. 4)
