April showers bring forth May flowers chants the old rhyme: today, looking out of the window, April snow showers may break burgeoning May bowers would be more apt.  One of our pair of resident jenny wrens shrills inconsolably as her newly woven nest lists precariously in the ivy beneath the weight of overnight snow.  Cock and hen pheasant, forced early from their overnight lair by the dripping undergrowth, rap endlessly on the garden door demanding shelter. Nature, awakening from her wintry slumber, seems momentarily shocked: daffodils dip their sodden heads, freshly-opened tulips strain at breaking point to remain upright, and primroses flounder helplessly amongst the mounting crystals.  All victims of Spring’s false dawn. Meanwhile Mungu the ridgeback joyously jives amidst the swirling snowflakes, putting the pheasants to spluttering flight.
More Magazines?!
It seems that barely a day passes when I am not asked to advertise in yet another magazine.  The most recent, Aromatherapy: Your Complete & Practical Guide to Essential Oils, is already in its second issue. Glossy, well photographed, and nicely laid out, I note that it has attracted the “names” of the trade as advertisers, but who will buy it?  The Editor suggests that it could be the complete newcomer to essential oils, or even the old hand.  Certainly it would not disgrace any coffee table and covers a great deal of ground in a single issue, but can it be sustained I wonder? I note that there has already been a change of editors between issues 1 and 2!

Perhaps I am old-fashioned but I like to search for my aromatherapy hints amongst the pages of the “professional” journals: I am not too sure that I am all that keen on publications which seem to promote too much self-help, believing that aromatherapy should be left to professional aromatherapists.  I am not an aromatherapist, but I do know a little about essential oils and their actions, and therefore I choose to depend upon the advice of those whom I know to be not only accomplished therapists but also knowledgeable about essential oils. For this reason I have been a long-term advocate of The International Journal of Aromatherapy edited by Robert Tisserand and Aromatherapy World edited by Shirley Price. Both cracking good journals, upon the contents of which I know that I can rely.  Latterly I have embraced Aromatherapy Today, edited by John Kerr and Sal Battaglia, for much the same reason. Simply, I trust the editors to ensure the veracity of the contents.

As a scribe, I need to be absolutely confident about my sources of information.  I set-aside only two days each month during which to research and write the Newsletter.  There is little margin for error and, contrary to what Len Price conjectures most amusingly in the latest edition (Seeding 2000) of Aromatherapy World, I never resort to “clever devices” to check my spelling. I write with The Concise Oxford Dictionary at my side: I would trust rather the written word than technology. Thus, preferring to sift through books and periodicals than surf the net in search of information, all has to be done at breakneck speed. I write it, you check it: the facts have to be unquestionable!      

Padma 28 revisited.
Whilst checking past Newsletters [better than keeping a diary!] to see what the weather had been like in previous Aprils [1998 was very similar], I noticed that I had mentioned two years ago a soon-to-be-launched product, Padma 28, made from a 2,000-year-old Tibetan formula, “to help re-balance extreme states in the body”.  It was attracting interest from medical researchers at Middlesex Hospital and Kolding Hospital in Denmark who were trying to deal with the disabling effects of vascular disease.  There was evidence that this product had the ability to help “intermittent claudication” - the hardening of arteries in the legs - which result in cramps and an inability to walk longer distances. At the time several enquired whether I knew more: I did not [and here am I writing about unquestionable facts!].

Months later I did stumble across a research report [Sallon et al., The efficacy of Padma 28, a herbal preparation, in the treatment of intermittent claudication: a controlled double-blind pilot study with objective assessment of chronic occlusive arterial disease patients. J. Vasc. Invest., 1998, 4(3): 129-136], but gave it not another thought until I read a recent research review by Evelyn Leigh of the Herb Research Foundation in the United States.

The present study, carried out at the School of Public Health of the Hadassah Medical Organization in Jerusalem, Israel, was designed to further investigate the efficacy, safety, and tolerability of the formula in the treatment of peripheral arterial occlusive disease (PAOD).  I had never realised that PAOD affects an estimated 12% of older adults, and that number is expected to increase as the population ages. 

This study involved a total of 72 patients, 37 of whom were randomized to treatment with Padma 28 (two 403mg capsules twice daily) and 35 to placebo.  After six months of treatment, results were assessed with haemodynamic tests, including measurement of ankle pressure after exercise on a treadmill, an indicator of how blood flow changes to meet the increased demand placed on the limbs by exercise. According to these objective measurements, those taking Padma 28 had a significant mean 12% improvement in post-exercise ankle pressure drop.  More than 44% of the Padma 28 patients had greater than 15% improvement, compared to 22% of placebo patients.

Patients also completed subjective self-assessment questionnaires. These showed that 58% of participants taking Padma 28 perceived improvement in pain-free walking distance, compared with 39% of those on placebo. In addition, 40% reported an overall improvement in well-being, including increased energy and better mood and concentration, compared to only 15.4% of control patients. The investigators speculated that the effectiveness of Padma 28 in treating PAOD may be due to its antioxidant activity, but presented no strong evidence to support their theory. [It should be noted that a small percentage of the Padma 28 group reported side effects of either gastrointestinal upset or tiredness].

Where do you get it? The Padma 28 capsules used in the study were supplied by Padma AG of Schwerzenbach, Switzerland.  What’s in it? Of the 20 dried and powdered herbs contained in each 403mg tablet, those present in quantities of 30mg or more include Indian Costus (Saussurea lappa [Decne.] C.B. Clarke., Asteraceae), 40mg; Iceland Moss (Cetraria islandica [L.] Ach., Parmeliaceae), 40mg; Neem (Azadirachta indica A. Juss., Meliaceae), 35mg; Myrobalan fruit (Terminalia chebula [Gaertner] Retz., Combretaceae), 30mg; Cardamom fruit (Elettaria cardamomum [L.] Maton, Zingiberaceae), 30mg; and Red Sandalwood (Pterocarpus santalinus L. f., Fabaceae), 30mg. What a mixture!

Mulling over the Mix.
Costus root has been used for millenia in China and India as a tonic, stomachic, carminative, and stimulant in treating asthma, cough, dysentery, and cholera, among others.  It is also used in incense and, smoked, is quite narcotic.  Some Indian literature [Medicinal and Aromatic Plants of Himachal Pradesh] suggests that it can be used in some cases of heart troubles. I have read [O.P. Gupta and B.J.R. Ghatak, 1967, Indian J. Med. Res., 55, 1078] that various fractions of costus oil have hypotensive activities, with 12-methoxy-dihydrocostunolide and the delactonized oil being the most potent, acting through direct peripheral vasodilation and cardiac depression.

The therapeutic efficacy of neem must have been known to man since antiquity as a result of constant experimentation with nature.  Ancient man observed the unique features of this tree: a bitter taste, non-poisonous to man, but deleterious to lower forms of life. The word neem is derived from Sanskrit Nimba, which means “to bestow health”.  In 1978 E.B. Thompson and and C.C. Anderson [Cardiovascular effects of Azadirachta indica extract. Journal of Pharmaceutical Sciences, 67, 1476-1478] studied the effects of a crude extract of neem on the cardiovascular system, which included profound hypertension and a minimal negative chronotropic effect, which increased at higher doses. The rise in arterial blood pressure with low doses of the extract supports the suggestion that it may have a two-phase effect on  arterial blood pressure. 
The presence of Iceland Moss in the mixture did confuse me until I remembered that it is used for disguising the taste of nauseous medicines. It contains a very bitter depsidone, cetraric acid. Apart from that I cannot comment, except that it can be used to make jellies! However Andrew Chevallier [Encyclopedia of Medicinal Plants] reminds me that it has been used since ancient times as a cough remedy, and also has been used in European folk medicine as a cancer treatment.  Its effect, within the gut, is both demulcent and bitter tonic - a combination almost unique in medicinal herbs. It is thus of value in all kinds of chronic digestive problems, for instance irritable bowel syndrome.

I know the myrobalan tree best as a host for silkworms, but it is held in high esteem in Hindu medicines as a prime remedy for all manner of digestive problems. The fruits contain about 20-40% of tannin, beta-sitosterol, anthraquinones, and a fixed oil containing principally esters of palmitic, oleic and linoleic acids.  Chevallier explains that the tannins protect the gut wall from irritation and infection, and tend to reduce intestinal secretions.  It may be used as a treatment for diarrhoea and dysentery, and also to counter acidic indigestion and heartburn. Indian literature confirms this, but suggests that it is also used as a cardiac tonic as it assists blood pressure.

The inclusion of Red Sandalwood, rather than the more familiar Santalum album L., is probably explained by the fact that references to sandalwood in the earliest Vedic commentaries, such as the Nirukta (c. 500BC), the Vinaya Pitaka (400-300BC) and the Arthasastra and Milinda Pahna both dating from around 200BC, were probably in fact to Pterocarpus santalinus.  Therefore, be it a 2000-year-old formula, it makes sense to stick to the original  ingredients.  The heartwood has been taken as a remedy in China since around AD500, and is still held to be useful for chest and abdominal pain.

Concentrating on Cardamom.
I first became really interested in Cardamom when requested by an ice cream manufacturer to supply 500 litres of the oil.  Not quite pistachio or raspberry ripple, my preferred flavours, but pleasant all the same and most effective in relieving wind and treating colic, cardamom fruit is official in most pharmacopoeias.

The use of cardamom as a highly esteemed spice, a masticatory and an aphrodisiac by the wealthier classes of India goes back to early times, and was known in Greece in the 4th century BC.  Cardamomum appears in a list of Indian spices liable to duty at Alexandria, about AD176-180. According to Gildermeister and Hoffmann, Die Ätherischen Öle, 3rd Edition, Vol. I, 122, the first definite record of cardamom as a spice from the Malabar Coast, written by a European, appears to be that of the Portuguese navigator Barbose, who in 1514 explored the west coast of southern India for spices. About thirty years later, Valerius Cordus, tried distilling cardamoms, thus isolating the essential oil for the first time.

A large perennial herb, native to tropical Asia but now cultivated extensively in India, Sri Lanka, Laos, Guatemala and El Salvador, with lance-shaped leaves borne on long sheathing stems, it grows up to about 4m high. The rhizome also thrusts out flowering stems up to 1m in length, which tend to spread horizontally and produce numerous most attractive, orchid-like flowers arranged in panicles.  The fruit is an ovoid, three-celled capsule, containing numerous seeds covered by an aril. The inside of the fruit is soft, protecting the seeds.  The latter contain most of the essential oil, the hard pericarps very little. In general, the capsules should be gathered from the fruit stems just before complete maturity, when still somewhat green but beginning to turn yellow. If left on the fruit stems to ripen, the capsules will split open and eject their seeds.

The fruits are dried slowly, either outdoors or in a curing shed.  Too rapid drying is to be avoided, as it causes the fruits to split and shed their seeds.  Sometimes the capsules are remoistened and further exposed to the sun but this sun-bleaching, although improving the appearance, does increase the number of split fruits.   

The essential oil, obtained by steam distillation of the crushed fruits, is composed mainly of alpha-terpinyl acetate and 1,8-cineole, each of which may be present up to 50% or more; lesser components include alpha-pinene, limonene, linalool, sabinene, alpha-terpineol, terpinen-4-ol, myrcene, nerol and geraniol, amongst others. Gas chromatography has shown oils from different varieties of cardamom to have qualitatively the same composition, but variations in the proportions of individual components are evident. So-called Alleppi greens, shipped from the port of Alleppi on the Malabar coast, are the cardamoms thought most suitable for distillation: Mysore fruits are also well regarded.

For those who may wish to check which variety they have in the spice rack, Mysore fruits have a cream or pale buff colour and a nearly smooth surface. Malabar are usually smaller and have a rather darker and less smooth pericarp. Mangalore resemble the Malabar but are usually more globular and have a rougher pericarp; they occur both bleached and unbleached. Alleppi fruits are narrower than the above varieties, have markedly striated pericarp and vary in colour from greenish-buff to green. Ceylon greens resemble Alleppi, but are generally greener and more elongated.  The seeds of the above, however, are almost indistinguishable from one another.  Cooking curries will never be the same again!

Drs. Light and Bryan Miller, in their book Ayurveda & Aromatherapy, say that Cardamom stimulates the mind and heart and brings clarity and joy.  Its quality is sattvic and it is particularly good for opening and soothing the flow of the pranas in the body. Indeed, as Peter and Kate Damian confirm in Aromatherapy: Scent and Psyche, its positive nervine and cephaliuc properties have a brightening psychological influence. The Complete Guide to Aromatherapy reminds that Hippocrates recommended it for sciatica, coughs, abdominal pains, spasms, nervous disorders and bites from venomous creatures (!).  The Aromatherapy Practitioner Reference Manual suggests that it may even ease pregnancy and assist PMS. A useful oil, from all accounts.

Turning to Turmeric.
Another useful member of the Zingiberaceae is Turmeric (Curcuma longa L.) which, for some unknown reason, we have never previously stocked. This is strange as, during the last two decades, turmeric’s ancient use as a treatment for digestive and liver problems has been largely confirmed by scientific research. The herb has also been shown to help blood clotting, relieve inflammatory conditions and help lower cholestrol levels.  In fact it is rare that the monthly research literature does not have something about turmeric!

Turmeric, sometimes called Curcuma or Indian saffron, is a perennial herb with a thick rhizome from which arise large sheathing leaves with an elliptic blade and pinnate veins.  The flowers are yellow, gathered into a spike with bracts, and have an irregular corolla with a developed posterior petal.

Several cultivars of this species are currently grown in India, Sri Lanka, Indonesia, China and Jamaica. For the most part (up to 94% according to some references) the world production comes from India, particularly the states located on the Bay of Bengal: Andhra Pradesh, Tamil Nadu, and Orissa, among others. The rhizomes are harvested after the aerial parts have dried out, freed of roots, cooked in water which is at one point carbonated, dried in the sun or, to speed up the process, in driers, then polished mechanically to eliminate root residues, scales, and superficial layers.

Commercial turmeric usually consists of the ovate primary rhizomes (“bulb” or “round” turmeric), the cylindrical secondary rhizomes (“fingers”), or a mixture of both. The fingers have a gray and grooved surface and a diameter of about 1cm. They break with a clean fracture and look reddish-yellow inside; the odour is aromatic and the taste somewhat bitter.

Rich in starch (45-55%), it contains arabinogalactans (ukonans) and 2.5 to 6% of an orange-yellow oil that is composed mainly of turmerone (c. 60%), S-(+)-ar-turmerone, curlone, a- and g-atlantone, zingiberene (25%), b- and d-curcumene, with minor amounts of 1,8-cineole, a-phellandrene, d-sabinene, borneol, and dehydroturmerone, among others.  Sesquiterpenes (bisabolanes and germacranes) are also present in the oleoresin and the various extracts, which generally contain more ar-turmerone than the essential oil (steam distillation is thought to induce aromatization). The colouring principles are curcuminoids, which include curcumin, monodesmethoxycurcumin, and didesmethoxycurcumin [N. Krishnamurthy et al.,1976, Trop. Sci., 18, 37]. These molecules occur at a concentration that varies considerably with the cultivar and can reach 8%.  The chief component (50-60%) is curcumin. Turmeric and its water-, alcohol-, and ether-soluble fractions have been reported [F. Hirahara et al., 1974,  Eiyogaku Zasshi, 32, 1] to have antioxidative activities; curcumin is mostly responsible for these activities [S.B. Xu et al., 1991, Zhongcaoyao, 22, 140].

The anti-inflammatory activity of curcumin has been demonstrated on acute inflammation as well as on chronic inflammation [D. Chandra and S.S. Gupta, 1972, Indian J. Med. Res., 60, 138].  The mechanism of action remains poorly understood: inhibition of the increase in activity of lysosomal enzymes, effect on the synthesis of prostaglandins, or interference with the response of granulocytes to stimuli linked to the inflammatory phenomenon [H.P.T. Ammon et al., 1992, Planta Med., 58, 226]. A small number of observations reported in India in humans highlight the anti-inflammatory potential of this molecule which is apparently devoid of side effects.

In addition to curcumin, it is suggested that the essential oil may also be responsible in part for the antiinflammatory activity [H.P.T. Ammon and M.A. Wahl, 1991, Planta Med., 57, 1].  The oil also has antibacterial activity [J. Lutomski et al., 1974, Planta Med., 26, 9] and choleretic action, which is attributed to tolmethyl carbinol [G.S. Randhawa and R.K. Mahey in L.E. Craker and J.E. Simon, eds., Herbs, Spices, and Medicinal Plants: Recent Advances in Botany, Horticulture, and Pharmacology, Vol. 3, 1988, p. 71].

In aromatherapy, it is suggested that it is useful for the treatment of arthritis, muscle aches and pains, and rheumatism.

Helpful Hints.
The Medicines Control Agency (MCA) has released the final wording for warning labels to be put on products containing St. John’s wort (Hypericum perforatum L.), reports NPN (Natural Products News, April 2000). Manufacturers of all such products are being advised to include the following warning ‘as soon as feasible’ on permanent labels: Before taking this product - Please check with your doctor or pharmacist if you are taking any prescribed medicines, as St. John’s wort may affect the way they work. Retailers are advised to display an information sheet for customers, either on the shelf containing St. John’s wort products or at the point of purchase.

NPN suggests that the recent attention given to drug-herb interactions should help sales of a new online and CD-based reference guide - Interactions - produced by Integrative Medical Arts, a division of IBIS medical.com (www.IBISmedical.com/Interactions.html).  Another recent initiative based on public safety is a side effects tracking system for complementary practitioners on a new website (www.healingonline.co.uk), which is partly funded by Government.

Moringa Update.
My word, how time flies! I first mentioned Moringa  (Moringa oleifera Lam.) in March 1996.  At that time I mentioned that Behen or ben oil was the most desired oil used by the ancient formulators of ointments for cosmetics and religious purposes, because of its excellent stability and good perfume-fixation properties.  Thanks to Marlene Plimley, I now know a little more.  According to Mark Fritz, writing in the International Herald Tribune, this gnarly tree can cure the ill, purify water and feed the hungry!

Would you believe that it can rebuild weak bones, enrich anaemic blood and enable a malnourished mother to nurse her starving baby?  Ounce for ounce it has the calcium of four glasses of milk, the Vitamin C of seven oranges and the potassium of three bananas. A dash of moringa can also make dirty water drinkable [Newsletter, March 1996].  Doctors use it to treat diabetes in West Africa and high blood pressure in India.  Not only can it inhibit skin infection but it is also an efficient fuel, fertilizer and livestock feed.  No wonder the National Science Foundation, National Geographic Society and the Andrew Mellon Foundation have financed attempts to collect the world’s 13 Moringa species!

Malnutrition causes high infant mortality and an incredible array of health problems among an estimated one billion people. Though it is doubtful that a single food source could solve all problems, moringa has built an enviable reputation during the past couple of years. More people are aware that the plant is a proven water purifier, with nutritional and medicinal properties, that is able to thrive in places where bad water, poor diets and the diseases they promote are leading killiers.  Trees for Life, a Kansas-based group that has been planting food-bearing trees in impoverished parts of the world since 1984, is running Moringa cultivation programmes in India after persuading a town of 40,000 to make the tree a structured part of the local diet. Some, however, still remain sceptical. You’d think Monsanto or somebody would have patented it by now, joked Ian Bray, a spokesman for Oxfam, we’ve been looking for silver bullets for so long I think they don’t exist. Maybe he should look a little closer!

Worth reading.
It seems difficult not to pick up a magazine in which Ron Guba’s excellent article, Toxicity Myths: the Actual Risks of Essential Oil Use, does not appear but, if you have missed it, do try and get a copy. Guba suggests that....amongst the wide variety of aromatherapy books and periodicals today, we find recommendations regarding the safe, therapeutic use of essential oils....such recommendations are often contradictory and seldom supported by either references, research or actual clinical experience.  Involved both in the practice and the business of aromatherapy since 1986, he has long noted the many incongruous and exaggerated statements regarding essential oil toxicity. In this article he attempts to put the record straight.  However I was a little surprised to find it featured in the current edition of Perfumer & Flavorist: not so long ago I doubt that this impressive journal would have given aromatherapy the time of day.  Is it finally coming of age? What’s more, in the same issue, Gerhard Buchbauer mentions aromatherapy en passant in his article, The detailed analysis of essential oils leads to the understanding of their properties. 

Buchbauer points out that the most important tool for considering the proper application of an essential oil is detailed analysis via a capillary GC. He explains that the composition of an essential oil is dependent on such characteristics as the geographic character from which the plant is obtained, seasonal variations and climate, production techniques, and purity.  Certain geographic places very often bring forth specific species of essential oil-producing plants.  Therefore, the same plant from different geographic origins produces varying constituents of the essential oil in either the concentration pattern or the lack of certain volatiles.   He then makes a confusing statement....Chamomile oil from Morocco is not the same as the English or German versions, though the material is always obtained from the flowers of Matricaria chamomilla L.....which, in aromatherapy terms, is little sense!  I shall drop him a line to find out exactly what he means because, if detailed analysis of essential oils is to lead to a greater understanding of their properties, we must first sort out our “trivials” from our “botanicals”!

Finally....
A couple of interesting reports have just landed on my desk. The first is of a study to evaluate the effect of an emulsion formulated from a crude extract of Aloe vera (Aloe barbadensis (L.) Burm. f.) [30% crude extract in the emulsion base] on seborrhoeic dermatitis.  Various aloe vera extracts are widely used in a variety of over-the-counter skin products, but only a few studies have been conducted to provide support for its use in the treatment of inflammatory skin conditions.  Seborrhoeic dermatitis is a common inflammatory skin disorder for which available topical treatment may be helpful but not curative.

A double-blind, randomized, placebo-controlled prospective clinical trial was performed in 44 adult patients with seborrhoeic dermatitis. A comparison of symptom scores in the aloe vera and placebo groups, before and after treatment revealed a significant decrease in scaliness, pruritis and the number of sites involved in seborrhoeic dermatitis, but not in erythema.  Global improvement rates in patients treated with aloe vera were significantly higher than in placebo-treated patients, as assessed by both dermatologists (58% and 15%, respectively) and patients (62% and 25%, respectively). The results of the present study indicate that aloe vera crude extract emulsion is effective in the therapy of patients with seborrhoeic dermatitis [D.A. Vardy et al.: A double-blind, placebo-controlled trial of an Aloe vera emulsion in the treatment of seborrhoeic dermatitis. Journal of Dermatological Treatment (1999) 10(1), 7-11].

Following my comments in last month’s Newsletter about the successful treatment of Beaky with a borage-based shampoo, I was particularly keen to read the report of the second study [B.M. Henz et al.: Double-blind, multicentre analysis of the efficacy of borage oil in patients with atopic eczema. British Journal of Dermatology (1999) 140(4), 685-688].  The effect of 23% GLA-containing borage oil (Borago officinalis L.) was examined in adults with staple atopic eczema of moderate severity in a double-blind, multicentre trial. 160 patients were randomized to take daily 500mg of borage oil-containing capsules or the bland lipid miglyol as a placebo for 24 weeks.  Use of topical diflucortolone-21-valerate cream was allowed as rescue medication, with the amount used until response being defined as primary, and clinical improvement as secondary efficacy criteria.

Although several clinical symptoms improved compared with placebo, the overall response to borage oil did not reach significance.  Significant differences in favour of borage oil were, however, observed in a subgroup. GLA metabolites increased in borage oil-treated patients only, and serum IgE [immunoglobulin E] showed a trend to decrease on overall and subgroup analysis. No substance-related adverse effects were observed.  It is concluded that this study shows no overall efficacy of GLA-containing borage oil in atopic eczema, with steroid use being the primary response parameter, although it suggests that a subgroup of patients may benefit from this well-tolerated treatment. Personally I find this report rather inclusive: had they applied borage oil topically I suspect that the results might have been more encouraging, and more comparable!

 

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