A very happy New Year!  As it is, I am  writing this at the beginning of December because, once into the festive spirit, I know that I shall be disinclined to come into the office whilst all are still  on holiday.  Justin and Tim are heading North of the Border to prepare early for  Hogmanay and Rebecca and Jade, the powerhouses of packaging, are off to snowboard somewhere in The Alps.  Undoubtedly I shall be gainfully employed clearing the guttering and drains, raking the leaves (again!), endlessly washing-up (machines are O.K. but they do not get rid of that deep-down grease) and, hopefully, catching up on some reading.

Meanwhile I am grappling with the threats of Y2K (Millenium "bomb" is already ticking), R65 (Essential Oils with Potential for Aspiration  Hazard) and the EURO (A cauliflower will cost you 56 centimes - in  Rotherham).  The doomsters have been having a field day. 

Already, I read, many companies are experiencing year 2000 (Y2K) software-related failures and this trend will gather pace, even though the new millenium is still more than a  year away.  I do not know about you but it seems that every other letter we  receive is enquiring whether we are Y2K Compliant?  Justin assures me that we are but, while much has been discussed about the potential consequences of hundreds of millions of computer clocks turning over to the 2000 date and  triggering software failures, the fact is that Y2K failures are already becoming  increasingly common.

Should I take my money out of the bank?  Will it be safe to fly?  These seem to be the most frequently asked questions.  Frankly I do not know but Peter de Jager,  whose background is in mathematics and computer science and who forecast some  seven years ago the problems that would occour for computers when 2000 arrived,  strongly believes there needs to be some good news about the year 2000 issue.  Now is the time for companies to say honestly what they have achieved, what they have actually fixed and what remains to be done.  Unless these achievements  start becoming widely known, people will assume nothing has been done and there  will be justifiable panic.  He says the banks have done a tremendous amount  of work which must be communicated to their depositors, otherwise they will be nervous.  And if they are nervous, they will take their money out.  Also, he  believes that if the airline industry can convince him it is safe to fly, he  will put an end to a lot of arguments simply by booking his flight!  Seems reasonable to me, but I intend to keep myself abreast of things through Peter's The Year 2000 Information Center (http://www.year2000.com).

With all this going  on the EURO could be the worst thing Europe has ever done, not as a  comment on principle, but as a conflicting resource demand to the year 2000.  Surely it could be delayed.  However, at this stage, the euro's arrival is imminent.  Therefore, it was interesting to see it trialled in Rotherham at the beginning of November.  Special euro vouchers were handed out free (worth 70p) to shoppers and schoolchildren received euro wallets and information packs; but not everybody was impressed.  Everybody is worried that they are going to be ripped off.....It's all a bit of a struggle, like decimalisation.....It's not why we won the war is it?   Like it or not, we  are preparing our Euro Price List!

Like Peter de  Jager, it behoves one to listen to what my old friend Bernie Hephrun has to say and, therefore, I took immediate note of his presentation at the recent Annual General Meeting of The International Federation of  Aromatherapists.  Towards the end, he commented....During 1998 this was followed by R65 - perhaps one of the most dangerous concepts based upon  little or no evidence of terpenes as dangerous for inhaling. 

Within the European  Union, Regulation R65refers to liquid substances and  preparations presenting an aspiration hazard in humans because of their low viscosity which, if they meet certain criteria, are deemed to be "Harmful: may cause lung damage if swallowed".

The first of these criteria is based upon essential oils containing 10% or more of hydrocarbons.   Do you know how many of these there are?  79, according to a list  compiled by the British Essential Oil Association which includes many aromatherapy favourites such as Bergamot (55%), Chamomile (15%), Cypress (70%), Grapefruit (95%), Juniper Berry (90%), Orange (97%), Tea Tree (50%), etc., etc.

Although somewhat  confused by the anomaly of aspiration and swallowing,as they refer to different physiological processes, Bernie suggests that it is quite likely that other legislation could follow once it is  established and made public that oils are either harmful, irritant or  toxic. 

He calls for aromatherapists to come out of the closet and to set up immediately one national organization, The British Institute of Aromatherapy, which inter alia should oppose any European legislation not based upon sound evidence.  He believes that the current lack of activity and response means that such legislation goes through unopposed.  At this stage I would make only one comment, which is oft inscribed on the faces of sun-dials, labuntur et  imputantur (The moments glide away and are set down to our account).  Be warned!

When I first read R65, I racked my brains to think what evidence there might be to  support it.  I then remembered an article which appeared in Complementary  Therapies in Medicine (1997) 5 , 112-115, entitled COSHH (The Control of Substances Hazardous to Health Regulations) and  CHIPS (The Chemical (Hazard Information and Packaging for Supply)  Regulations) : ensuring the safety of aromatherapy.  The authors  mentioned that they knew of a worker who had acute anaphylactic reaction to  lavender (from inhalation) which had been applied to a client in the workplace.  The worker collapsed, requiring antihistamines and oxygen to  recover.  They suggested that the potential effect of any aromatherapy must  be considered in respect to sensitivity or known ill-effects and discussed with others at work before use of the oil.  The cognitive function of someone other  than the patient/client could be affected, thus altering his or her behaviour  and reaction time, resulting in suppression of the cerebral inhibiting systems as described by Boyle (Boyle, A.J., Human reliability, risk  assessment and control, version 2., Occupational Health and Safety Training  Unit, Portsmouth University, 1993, Sect. 9-13).  Furthermore, synergistic effects of essential oils also need to be considered, whereby the oil reacts with another substance, potentiating harmful effects. 

Unfortunately, at  present,  there is no formal reporting system for the effects of essential oils as there is for pharmaceuticals, so therapists are disadvantaged when making an  assessment of risk or identifying potential hazards.  There is no single organization from which guidance or information can be obtained.  Could this be why the EU is pre-empting the issue?   Of course, taken to its logical conclusion and as just pointed out to me by Jan, it does beg the question of whether to assess the risk of environmental fragrancing, the use of perfume  and aftershave and, even, B(ody) O(dour) in the workplace.  Perhaps Brussels already has the matter under review?!

Whilst on the  subject, I thought that I would dig a bit deeper to discover what adverse reactions, toxicology and plant poisoning had been reported in recent, published, literature.  At this point, I should mention that there is  considerable information available but it takes hours to find and I do not think  that the working therapist can be expected to search for it and therefore, for the time being, it will remain the responsibility of the supplier.

For example, I have  always considered Aloe vera (Aloe barbadensis Miller) gel pretty safe and yet the results of two different assays (Avila, H.; Rivero, J.; Herrera, F.; Fraile, G. Cytotoxicity of a low molecular  weight fraction from Aloe vera gel.  Toxicon (Oxford) (1997) 35 (9) 1423-1430) confirm that the gel contains toxic (comparable with  sodium dodecyl sulfate) low molecular compounds, and every effort must be made to limit the amounts of these toxins in commercially prepared gel products.

Recently, whilst updating my Fact Sheet on Nutmeg Oil (Myristica fragrans Houtt.), I stumbled across a review of available toxicity data on myristicin , or methoxysafrole, the principal aromatic constituent of  Nutmeg Oil (Hallstrom, H.; Thuvander, A. Toxicological evaluation of  myristicin. Natural Toxins (1997) 5 (5) 186-192). 

Some will remember that the organoleptic properties of nutmeg oil are influenced by composition; West Indian oils are low in alpha-pinene, safrole and myristicin, with a higher sabinene content; conversely East Indian oils are higher in myristicin.  The  greater proportion of myristicin and safrole in East Indian oils and the different monoterpene component ratio probably gives the stronger nutmeg flavour.

Nutmegs have long  been used in herbal remedies, in medicine, and preserved in syrup were formerly  a delicacy in Europe, but became unpopular when their toxic effects were  generally appreciated.  Whilst they have a long history of use as a narcotic, the first recorded hallucinogenic effect was by Lobelius in 1576 who, in his Plantarum seu Stiripium Historia, described a pregnant English lady who  "became deliriously inebriated after eating 10-12 nutmegs" apparently to induce an abortion.  The physiologist J.E. Purkinje in 1829 ate three nutmegs and described the effects as similar to Cannabis intoxication, including  disorientation, hallucinations and later deep sleep.  The response to nutmeg  intoxication is extremely varied, some individuals experience a profound  distortion of time and space and have visual hallucinations, and freshly grated  nutmeg produces the most profound effect.

The aromatic ethers  are the most likely source of hallucinations, but the mode of action remains  obscure.  Myristicin constitutes about 4% of nutmeg oil, and 25% of this fraction is elemicin, which degrades to two potent hallucinogens, TMA  (trimethoxy amphetamine) and MMDA (3-methoxy-4, 5-methylenodioxy amphetamine) by becoming ammoniated in the body.  It should be noted however, while in vitro studies have shown conversion of nutmeg oil to amphetamines, it has not yet been shown to occur in vivo.

Hallstrom and  Thuvander suggest that the acute toxicity of myristicin appears to be low.  No  toxic effects were observed in rats administerd myristicin perorally at a dose  of 10mg/kg, while 6-7mg/kg may be enough to cause psychopharmacological effects  in man.  A weak DNA-binding capacity has been demonstrated, but there are no indications that myristicin exerts carcinogenic activity in short-term assays in mice.  Intake estimations indicate that non-alcoholic drinks may be the most important single source of myristicin intake.  Based on available data, it seems unlikely that the intake of myristicin from essential oils and spices in food, estimated to be a few mg/day in this report, would cause adverse  effects in humans.  It is, however, at present not possible to make a complete  risk assessment, as studies regarding genotoxicity and chronic toxicity,  including reproductive toxicity and carcinogenicity, are still  lacking.

Another thing to watch for is the effects of long-term use of  perceived safe products.  I have just read a case report of a 68-year-old teacher, who had used a cosmetic hand cream containing chamomile (Anthemis nobilis L.) and glycerol daily for many years and periodically drank a  chamomile tea, who developed oedema and erythema in the periorbital regions and  slight nausea after drinking strong chamomile tea (Rudski, E.; Rebandel, P. Positive patch test with Kamillosan in a patient with hypersensitivity to  chamomile.  Contact Dermatitis (1998) 38 (3) 164-184).  This  case is rare. Out of 830 consecutive patients with dermatitis, the above patient was the only one positive to Kamillosan.

In a later edition of Contact Dermatitis (1998) 39 (1) 35, a case report is presented of a 71-year-old woman with a three-year history of a sore mouth, with fissuring  of the lips, and scaling and oedema of the surrounding skin.  Topical  corticosteroids and various over the counter preparations had been ineffective.   The culprit?  Patch tests with toothpaste ingredients were positive for  spearmint oil (Mentha spicata L.) (Skrebova, N. et al. Allergic contact cheilitis from spearmint oil.).

Even Ginkgo biloba does not escape unscathed (Vale, S.  Subarachnoid haemorrhage  associated with Ginkgo biloba.  Lancet (British Edition) (1998) 352 (9121) 36).  A 61-year-old man developed headache, back pain, nausea and sleepiness, due to a subarachnoid haemorrhage, after taking G. biloba (40mg tablets, 3 or 4 times a day) for 6 months.  He recovered  after stopping the intake of the herbal remedy.  

Needless to say, there are numerous other examples.  Are they relevant?  I think so: not only to  assess risk but also to be aware of the adverse argument.

And now for  something entirely different!  Every year Pam Igwe bounces in from continental Europe, full of vitality and verve, I suspect to check out if I am still alive!  Her visit this year coincided with a particularly damp and chilly  spell of weather.  One of my fingers was bent double and just would not  straighten out, even with Monoi, and my ribs ached like mad from a recent, nasty, fall.  In fact, all in all, it was doubtful that I would pass my annual M.O.T.!

Spotting my  discomfort, Pam whipped out of her bag something akin to a knuckleduster.  A couple of magnetic balls, shaped like mini battle maces, which she assured me would relieve my pain.   These sturdy metal balls, when rotated between palms  and fingers, are designed to refresh and stimulate thanks to the physiological  connections between hands and the rest of the body.    Well?  I could not  believe it!   My finger straightened, and has remained straight ever since, and  my ribs ceased to ache.  What more can I say?  Quite amazing! 

A couple of days later I received my Autumn edition of PROOF! magazine and in the Mind & Matter column there was an examination of The healing power  of magnets!  Apparently, today, doctors are rediscovering the benefits of magnet therapy to cure illness, injury and alleviate pain.  Already well established in India, Japan, China, Austria and Germany, where people are  sleeping on magnetic beds and wearing small magnets by day for greater energy and to prevent illness, it does not seem yet to have taken off in Britain and  the United States.

As usual, PROOF! provides good bibliographical evidence.  Therapists report  successful treatment in arthritis, rheumatism, fibromyalgia, headaches, muscle  sprains and strains, joint pain, tendonitis, carpel tunnel syndrome (aah!) and  torn ligaments.  Magnets appear to raise the nerve's depolarisation potential so  that the signal is blocked from depolarising the cell and hence not  transmitted.  In addition, the magnetic field slows the ability of the nerve to  transmit pain (M.J. Malcolm et al.., Second World Congress for  Electricity and Magnetism in Biology and Medicine, 8-13 June 1977, Bologna, Italy).  

Further, injured tissue emits a positive charge, but placing a magnet's negative pole over the  area seems to restore a natural balance by improving circulation, enabling blood  vessels to dilate and bringing a larger amount of blood flow to the area.  This helps to introduce natural healing agents and remove toxic by-products of inflammation that contribute to pain and inflammation.  Both the latter are thus  reduced and tissue healing stimulated ( Lancet, 1984; i: 695-8).   It seems that treatment can also help the body ward off microbial invaders such  as viruses, bacteria and fungi partly by increasing immune function through  oxygenating white corpuscles, a major part of the body's defence system.   Hormonal production is also regulated, changing enzyme activity (J. Cell Biochem, 1993; 51: 387-93).  There is much, much, more!  Let me know if the subject fascinates you as much as it does me.

Back in the early  '60s, when I worked in the City, it was traditional to "fire" people on Christmas Eve.  At the time it seemed particularly harsh but, looking back, I suppose that it was quite logical.  It was the final review of the year and, if you had not performed to expectation during the previous twelve months, it was simply a case of no bonus cheque and no job!  In reality, most of us knew how littleto do to ensure that we had another year's free  Luncheon Vouchers!  By the way, do companies still provide free LVs?  I remember that my daily 1/3d (about 7p in new money) bought a sizeable steak and kidney pudding (I still relish them!), a huge plate of chips, and a liberal dollop of "greens".  Still, my gastronomic delights of yesteryear are not really the point  that I am trying to make!

According to the latest edition of Natural Product News, it seems that The Medicines  Control Agency (MCA) is adopting similar Draconian tactics: dishing out the bad news at Yuletide.  The MCA has issued a proposal that will give it statutory powers to categorise borderline products as medicinal and place the burden of  proof on the manufacturer.  If that is not enough, they are only allowing until  31st December 1998 to object to the proposal.  Many will remember the fight of 1994.  On this occasion, I am reliably informed that our respective trade representatives already have a dialogue going with the MCA and, at this stage, we should not be too alarmed.  I shall keep you informed.

Meanwhile, the MCA is currently using its existing powers to investigate Wild or Mexican Yam (Dioscorea mexicana) products - sold to women primarily in creams.  Having initially singled out the Bodywise distributed Perfect Woman range, following a complaint, the MCA now appears to have  broadened its investigation.

Confusion regarding  wild yam abounds but the fact is that wild yam by itself does not contain the  hormone progesterone and cannot be converted by the body into progesterone.  It seems that the MCA is no longer questioning this.  Instead it appears to be  looking at whether some unscrupulous manufacturers  are bypassing regulations by including progesterone in their wild yam products without declaring the fact.  Susie Hewson of Bodywise points to the growing number of mail order products as possible catalysts for the MCA's crackdown.  Apparently more and more products are coming in from the Channel Islands that contain progesterone,  so it has come to a point where the MCA has to act.

To explain: since  progesterone is fat-soluble it is usually ineffective when digested, so it is now commonly sold in the form of creams which contain no wild yam at all and are commonly made from soya.  In the UK, these products are classified as  medicines and can only be obtained on prescription.  Confusion arises from products commonly available in health food stores that contain wild yam - often  mexican yam which contains a high amount of diosgenin.  Unless a prescription is required for these products, they should not contain progesterone and the  unconverted diosgenin in them cannot be converted into progesterone by the human body.  However, progesterone-like effects are  attributed to these products by their manufacturers.

Caution: Women who are using prescription progesterone creams should also be aware  that, according to some, natural progesterone can cause side effects.  This new shaped progesterone works to some degree in the human body, but it does not fit exactly on to the progesterone receptors (it is not nature identical) and side effects soon follow, says Marcus Webb , naturopath and osteopath.  I should like to know more about his evidence.

Finally.  I am  reminded that back in 1988, at the first WHO/IUCN/WWF International Consultation on Conservation of Medicinal Plants, Olayiwola Akerele (Programme Manager, Traditional Medicine, Division of Diagnostic, Therapeutic and Rehabiliative Technology, World Health Organization, Geneva) declared:

Traditional  medicine has been with the World Health Organization (WHO) for the last twelve years or so and for the rest of the world for the last several thousand years of recorded history.  One might say that we are new at the game.  Traditional medicine is widespread throughout the world.  It comprises those practices based on beliefs that were in existence, often for hundreds of years, before the  development and spread of modern scientific medicine and which are still in use today.  As its name implies, it is part of the tradition of each country and  employs practices that have been handed down from generation to generation.  Its  acceptance by a population is largely conditioned by cultural factors and much of traditional medicine, therefore, may not be easily transferable from one culture to another.   

In dealing with  traditional medicine, WHO aims at exploiting those aspects of it that provide  safe and effective remedies for use in primary health care.

More than a decade later, let us hope that they can still honour their collective commitment to "Health for All by the Year 2000".

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