Bright, but nippy, the morn dawns early and I shiver involuntarily as I watch the awakening crowd camped out to secure a prime place for today’s event - the largest state occasion since the funeral of Sir Winston Churchill in 1965. Undoubtedly the nation’s affection following the death of the 101-year-old royal matriarch has surprised many.

I met her only once. Recently arrived at Gray’s Inn to pursue my legal studies I found the place abuzz with chatter about the impending visit of the Queen Mother.  Have you a morning suit?  Somewhat surprised, I replied that I did. Fine.  You’ll be one of the ones accompanying her around the place tomorrow!  Absolutely horrified, I rushed to the cleaners.

Forty years ago even a dark lounge suit would not really pass muster when being presented to royalty.  In fact I recollect having had to telephone my father, who was well versed in such matters, to enquire which colour waistcoat I should wear.  I believe that black, rather than grey, was correct when receiving royalty.  How things have changed!

The visit went exceeding well, and Her Majesty placed me immediately at my ease. A truly treasured moment, and one that will remain with me throughout my life. God-speed Ma’am.
Austrian armies awfully arrayed battered by battery besieged Belgrade.....
I was reminded of this alliterative rhyme when reading an account of the IFA Emergency Meeting at the end of March. Apparently, and this is only hearsay as I was not present, the merger with ISPA and RQA was rejected by a narrow margin.  The Chairman resigned, leaving others to forge the way. Sad, but not entirely unexpected.  I am sure that it will only be a temporary glitch and that wisdom will prevail, because logical consequences are the scarecrows of fools and the beacons of wise men (T.H. Huxley 1825-95).

IFPA launched.
Meanwhile the first leg of the merger, the much-heralded union twixt ISPA and RQA to form the International Federation of Professional Aromatherapists, gets underway this month. I wish it all success.

The central aim of the IFPA is to promote a greater understanding of the full therapeutic potential of aromatherapy, and to raise its profile at both National and International levels. 

Personally I would have thought its profile already quite high (on occasions perhaps too lofty for its own good), but its full therapeutic potential is far less clear. In this regard, it is as well to remember the two definitions of the word therapeutic.  1 of, for, or contributing to the cure of disease. 2 contributing to general, especially mental, well-being.   
 
With a concern to safeguard the interests of their public, IFPA practitioners will adhere to the highest standards of training and practice, and are committed to a rigorous programme of continuous professional development.

High standards and professionalism will be the key to the IFPA’s pursuit of official statutory recognition of aromatherapy as an important approach to complementary health care, but will this be enough?

A poke in the eye!
I was frankly staggered to discover recently in a book of 376 pages, discussing clinical research in complementary therapies, that aromatherapy warranted less than one third of a page, and even that was somewhat disturbing [Clinical Research in Complementary Therapies: Principles, Problems and Solutions. Eds. Lewith G, Jonas W.B., Walach H.].

Aromatherapists apply plant-based essential oils, usually by gentle massage techniques, to the body surface of their patients. A 39-year-old woman had a 10-week history of pruritic, erythematous lesions on her face and chest [James W.D., Weiss R.R. 1997. Allergic contact dermatitis from aromatherapy. American Journal of Contact Dermatitis 8: 250-251].  She had been using aromatherapy for the past 2-3 years. Patch testing was positive for neomycin, fragrance mix and benzoylperoxide.  Discontinuation of aromatherapy led to a rapid resolution of the allergic reaction. Similar cases of allergic contact dermatitis have been associated with tea tree oil [Kranke B. 1997. Allergy inducing potency of tea tree oil. Hautarzt 36: 268-269] and black cumin oil [Agothos M, Breit R, Schatzle M, Steinmann A. 1997. Allergic contact dermatitis from black cumin (Nigella sativa) oil after topical use. American Journal of Contact Dermatitis 36: 268-269] and many other herbal medicinal products.  And that’s it.

Wowee!!  That’s certainly socking it to me.  Of course there are numerous reports of allergic reactions to essential oils, but I could undoubtedly muster even more about reactions to everyday domestic products. Nonetheless I do understand from where Professor Ernst is coming in his investigation of the safety of complementary medicine, but I do wish that he would pop in the occasional bit of good news about aromatherapy. Perhaps the IFPA could have a word in his ear!

Research requirements.
More seriously however, I do agree with Professor Ernst that the investigation of  the safety of complementary and alternative medicine (CAM) is as much a matter of urgency as is research into its effectiveness. Such research is not aimed at demonstrating how dangerous CAM can be.  On the contrary, such research could demonstrate how safe CAM really is.

Ideally, if the aspirations of aromatherapy are to be achieved, the IFPA should strive for controlled clinical trials, spontaneous reporting schemes, cohort studies, case-control studies, case registers, surveys, outcome studies, and systematic reviews. However such research, although urgently required, takes time and money. In all likelihood, therefore, it will not be available in the foreseeable future.

Meanwhile all practitioners should apply the highest standards to their own clinical practices; ensure that they are up to date with the most recent knowledge in the field; be open to the possibility of adverse effects in their own clinical setting; be meticulous in recording all details of suspected adverse effects; report adverse effects to the appropriate authorities; be cautious, particularly with highly vulnerable patients such as young children and elderly individuals; and be aware of concomitant use of treatments.

Although long-standing traditional use, as it often exists in aromatherapy, can tell us much about short-term safety it is not the most reliable method for detecting rare or delayed adverse effects. A treatment might have changed over time due to a change in the source of raw material or production process, which can impact on its pharmacological properties.  Many essential oils marketed today have no history of traditional use. The vast majority of today’s drugs were not available during the time when traditional aromatherapy experience was generated and, therefore, interactions may occur. A given oil may have been used safely for one indication but current use for other conditions may not necessarily be risk free. Today’s users of aromatherapy may have different characteristics from their traditional counterparts, because of different diets or concomitant diseases.

The onus of demonstrating the safety of aromatherapy unquestionably lies with those who employ and promote it.

The research methodologies for investigating safety issues of a given therapy are similar to those used in mainstream medicine.  To rigorously apply these methods provides one of the biggest challenges that aromatherapy faces today because, without reliable safety data,  integration into conventional health care will be extremely difficult.

Home Study.
OK, let’s do a little research of our own.    

In March I offered essential oil of Purple Coneflower (Echinacea pupurea Moench.). I knew little about what it might do, but suggested that you might like to try some.

As many as one in five persons with atopy [hypersensitivity to common environmental agents] who have never taken Echinacea have a positive reaction on allergy tests with the herb, according to a new report [Ann. Allergy Asthma Immunol., 2002; 88: 42-51].

To investigate adverse reactions to the popular herbal, scientists in Australia evaluated five patients who reacted adversely to Echinacea as well as reviewed case reports.

The five patients had experienced symptoms ranging from skin rash to acute anaphylaxis after taking Echinacea.  Three of the patients developed wheals after skin-prick testing with an aqueous Echinacea solution.

The scientists also searched the Australian Adverse Drug Reactions Advisory Committee database and found 41 reports in which Echinacea was the sole triggering substance.  Of these cases, say the authors, 26 suggested IgE-mediated hypersensitivity, four of which required hospitalisation for treatment of the allergic reaction.

The researchers then conducted skin-prick tests on a further 100 atopic patients who had never taken Echinacea. Of these, 20 developed wheals in response to extracts of the herb.

Echinacea is used worldwide to treat the common cold and some, ironically, use it to treat allergies. These findings suggest why Echinacea is not always effective and why a worsening of symptoms may be an adverse reaction to the herb rather than a “healing crisis”.

Unaware of this report at the time of my Special Offer, I am most interested to hear of any adverse, or positive, effects that you may have experienced when using the essential oil. As I know that considerably more than 100 of you have had the opportunity to try this oil, your comments could be most meaningful.

Meanwhile responses to Plai (Zingiber cassumunar Roxb.) have thus far corroborated what I wrote about its efficacy: several claiming almost immediate results. Ongoing Thai research suggests that Plai has potential for drug development.  Some pharmacological reports show antiasthmatic activity, but further studies on the effective dose of the active components need to be carried out.

Unsolicited testimonial.
Your April newsletter prompted me to write!  Following my telephone call with you last year, and then the ‘Open Day’, I was getting very ‘het-up’ about Lichen planus which had affected my finger nails.  You very kindly gave me some Sea Buckthorn  with a “try this - it may help and can’t do any harm!”

How right you were - I now have healthy regrowth of nails with half moons again - and so thank you very much. I’m still using the oil - and am now a devotee.  Good news indeed!


A disappointment, or flawed research?
A small UK study has found no benefit with regular reflexology in patients with irritable bowel syndrome (IBS).

In a study of 34 patients diagnosed with IBS, each patient was allocated to receive either a reflexology foot massage or a non-reflexology foot massage. Success was defined as a reduction in three symptoms - abdominal pain, constipation/diarrhoea and abdominal distention.  An analysis of patient responses showed that there was no significant difference, either clinically or statistically, between the groups.

The results are disappointing, but not conclusive. This study may have been more useful had it been carried out over a longer period of time, since a single application of any therapy is unlikely to affect health problems built up over a period of years [Br. J. Gen. Pract., 2002; 52: 19-23].
 
I must admit that I am a little surprised that this piece of research even justified publication, but it does provide an idea for further research!

A long haul!
Apparently, if Jackie Griffin, a nutritionist brought in by Eddie Stobart, head of Britain’s biggest independent road haulier, has her way truckers will be advised to abandon fried eggs, bacon and black pudding  for cereal, fruit and toast.  She must be joking!

Another hoax?
British teens are stealing Pantene shampoo in the belief that some of the additives are hallucinogenic if the shampoo is injected intravenously.....was a mind-jolting bit of news which turned up in my e-mail recently. I couldn’t believe it. And yet....

According to news reports, children in Sunderland have been stealing bottles of Pantene Pro V, believing the product to contain additives that would induce hallucinations.  Shampoo had been slipping off the shelves and into youngsters’pockets since late 1999, initially leaving shopkeepers mystified. So far the habit has remained confined to the northern town of Sunderland.

Dr. David Tregoning, Sunderland’s consultant in Public Health Medicine, commented at the time: “It appears to be an urban myth that there is an active ingredient that will cause a high.  There is no evidence of that at all.” Proctor & Gamble, Pantene’s producer, said: “There is nothing in the shampoo that could cause any sort of hallucinogenic or psychotropic effect. Injecting shampoo into your veins is an extremely dangerous thing to do. We can only urge people not to.” Thank goodness there weren’t any cases of the children being foolish enough to actually inject the shampoo. 

However this story does illustrate a couple of important points: 1) People can be more gullible than you could possibly imagine and 2) what can appear unlikely can occasionally contain an element of truth. The report was genuine even if the teenagers’beliefs were unfounded.

The growth of the internet and e-mail has led to something of a boom industry in urban myths and legends being propagated as truth. I receive daily numerous e-mails, from undoubtedly well-meaning correspondents, drawing my attention to miracle cures.  Invariably backed up by reams of spurious research, many products must seem most appealing. But.....

A case in point.
There is considerable evidence - and controversy - over the view that vitamin B17 - laetrile - is effective against cancer.  My interest is in the prostate.

Recommendations about B17 combined with diet are numerous and treatment is usually via injections of synthetic laetrile or by tablets, and some enzyme support.

The medicinal plant and pharmacognosy communities suffered an immense loss with the sudden death last year of Varro E. “Tip” Tyler.  Professor Tyler was a true giant in the field of pharmacognosy and herbal medicine education in the U.S. and abroad, and his comments about laetrile are worth noting.

During the 1970s, laetrile began to be widely promoted and used as a cure for cancer.  Despite the fact that absolutely no scientific evidence existed for its therapeutic efficacy, demand for the product became so great that by 1981 the legislatures of some twenty-three American states had legalized its use.

Tyler was prompted to write in his Honest Herbal (A Sensible Guide to the Use of Herbs and Related Remedies) that fraudulent and ineffective cancer cures are as old as the disease itself, and the intervention of well-meaning but medically naive “politicians”to treat cancer stems from an early date as well.

In 1748, the House of Burgesses of the Commonwealth of Virginia undertook a study of one of Mary Johnson’s herbal “receipt of curing cancer.” As a result of the anecdotal testimony provided, the House voted Mrs. Johnson a reward of £100. Similarly, in 1964, fifty-six U.S. Congressmen co-sponsored a resolution, which failed to pass, authorizing the expenditure of $250,000 for the study of another unproven cancer remedy, krebiozen [R.N. Grant and I. Bartlett. In Unproven Methods of Cancer Management.  American Cancer Society, 1971, pp. 1-2.].

This whole history, highlighted by (but not restricted to) Mary Johnson’s “receipt”, krebiozen, and laetrile, apparently indicates that in the absence of a cure for a terminal disease desperate people want hope, not facts. But what are the facts?

A look at laetrile.
Laterile, as originally patented in the United States in 1961, is not the same as the one called laetrile today. The former was technically known as mandelontrile glucuronide, but it was relatively difficult to procure.  Consequently, a closely related compound, amygdalin (mandelontrile b-gentiobioside), became the laetrile of commerce. 

Amygdalin occurs naturally in a number of plant materials; however, the usual commercial source is the kernel of various varieties of Prunus armeniaca L., commonly referred to as apricot kernels. These vary appreciably in their amygdalin content, which may reach 8%, but the kernels of some wild varieties contain twenty times as much as those of cultivated varieties.  Serious cases of poisoning, especially amongst children, have been reported as a result of eating quantities of these seeds.

Advocates of laetrile therapy for cancer believe that an enzyme, b-glucosidase, capable of breaking down laetrile to release toxic cyanide, exists in large amounts in tumorous tissue but only in small quantities in the rest of the body. They further hypothesize that another enzyme, rhodanese [sic], which has the ability to detoxify cyanide, is present in normal tissues but deficient in cancer cells.  These two factors supposedly combine to effect a selective poisoning of cancer cells by the cyanide released from the laetrile, while normal cells and tissues remain undamaged [D.L. Poulson. Herbalist 4(4): 2-5, 1979].

In other words, laetrile was claimed to be preferentially hydrolized in cancer cells by b-glucosidases to benzaldehyde and hydrogen cyanide, which killed the cell, but amygdalin does not appear to be absorbed from the gastro-intestinal tract, and both normal and malignant cells contain only traces of b-glucosidases [Chandler, R.F. et al. Controversial laetrile. Pharm. J. 1984; 232: 330-2].

Laetrile has also been claimed to be ‘vitamin B17’, although it is definitely not a vitamin, the deficiency of which is said to result in cancer; there is no evidence for accepting this view and laetrile is of no known value in human nutrition.

Clinical trials conducted by the National Cancer Institute of the United States, in collaboration with four major U.S. medical centres, showed that laetrile failed on four counts: it did not make cancer regress; it did not extend the life of cancer patients; it did not improve cancer patients’symptoms; and it did not help cancer patients to gain weight or otherwise become more physically active [Science News 119: 293-294, 1981]. Laetrile and natural products containing it, such as apricot kernels, were thus found to be “ineffective as a treatment for cancer.”

Martindale (The Complete Drug Reference) advises that there have been several reports of cyanide poisoning and other adverse reactions associated with the use of laetrile, especially when taken by mouth.

Amygdalin taints almonds.
The almond tree, Prunus dulcis, has several varieties; two of them, var. dulcis and amara, yield sweet and bitter almonds respectively.

Sweet almonds are used as food, but bitter almonds are not; this is due to the amygdalin in bitter almonds that can be hydrolyzed to yield deadly hydrocyanic acid (HCN).

Two major types of products are derived from the almond, namely a fixed oil and a volatile oil.  The fixed oil is commonly called sweet almond oil; it is made from both sweet and bitter almonds by pressing the kernels.  It does not contain benzaldehyde or HCN.

The volatile oil is called bitter almond oil.  It is obtained by water maceration and subsequent steam distillation of the expressed and partially deoleated bitter almonds or kernels of other Prunus species. During maceration, the enzyme (emulsin) present hydrolyzes the amygdalin into sugar, benzaldehyde, and HCN, the last two being distilled by steam.  Sweet almond does not yield a volatile oil.

Bitter almond oil contains mostly benzaldehyde (95%) and HCN (2-4%). It is highly poisonous, and fatal poisoning of an adult after ingesting 7.5ml has been reported.

Bitter almond oil FFPA (free from prussic acid, outdated term for HCN) can be regarded as pure benzaldehyde; it has antipeptic, local anaesthetic, and antispasmodic properties, but it also has narcotic properties at high doses and ingestion of 50-60ml can be fatal due to central nervous depression with respiratory failure. 

What is triethanolamine stearate?
Don’t ask me, read Cosmetic Watch (Lifting the lid off cosmetic ingredients) by Maurene Charlwood and Cheryl Robertson.  For a penny under a fiver, it answers many of your most frequently asked questions.

Every day millions of you apply cosmetics to your skins. But what exactly are you putting on them? What do the ingredients listed on the packaging mean?  Do you know why such items are included?  How could they affect your skin? 

Cosmetic researcher Maurene and journalist Cheryl explain over 400 of the most common ingredients used in skin care cosmetics today. They de-mystify such baffling names as AHAs, cetyl alcohol, dimethicone, stearic acid, nanospheres and propyl paraben.

Whatever skin care cosmetic you use - cleansing milk, facial scrub, moisturiser, toning lotion, “anti-wrinkle” cream, foundation cream, sunscreen, hand lotion, deodorant, antiperspirant, shaving cream, bath oil and shower gel - now you will know what’s in it!

Finally (and I’m indulging myself a little!).....
The Essentially Oils Newsletter is a welcome break from all the bills and junk mail that comes through our letter boxes these days.....I have saved all your newsletters and have referred to them often.....I particularly love Sea Buckthorn and have found it useful in both therapeutic and cosmetic blends.....I used it in a product to treat a rash.....Success was 100%.

By the way, this Plai is magic, or is it all in the head?  I suffer from arthritis in my left hand, and massage is torture, however yesterday after giving a shoulder massage to someone I had no pain afterwards.  I mixed it with Kunzea [Kanuka].  I have also noticed it reduces inflammation.

So many thanks to all who encouraged me to keep writing.

charles@essentiallyoils.com
 

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