Phew!  These last few days I could have believed that I was back in the Tropics: even my trusty African hound Mungu has been seeking the shade.  Unfortunately good weather tends to be terrible for business as many, whilst it lasts, drop aromatherapy in favour of sun therapy.Nevertheless it has given me ample opportunity to rummage through the stock cupboard in search of some tempting special offers for this month.

Unlike Waitrose at 5 o’clock on a Saturday afternoon I am not fearful of the monkfish not lasting the weekend but, I do like to see stock turning over briskly.  However, despite this, I doubt that I am as generous with my discounts: Justin rarely seems to come home without a most amazing bargain.  An intuitive cook, he has a fine eye for the appealing dish: I really look forward to the weekend feast.  Fast and furious, meat, fish, fowl, or simply vegetables, are tossed adroitly into the waiting wok and, with a pinch of this and a pinch of that, voilà!  I never do know what he puts in it, but it tastes fantastic.  All of which reminds me.
Specifications, or not?
I was interested to read your summary of GC/MS testing of essential oils in 136 [I’m glad somebody was!].  This, together with the whole issue of traceability, is a subject I would like to “get to grips with”. As a former food technologist - now aromatherapist - I have always felt slightly uneasy about knowing so relatively little about my raw materials. Justin...!!!!  ISO [International Organization for Standardization] specifications: do you hold these to measure your analyses against? asked Stella Matthews.

The Laboratory of the Government Chemist (LGC) North West Operations, which does all our analyses, of course has access to ISO specifications, as do we, but we depend far more heavily upon comparison with the published literature.  ISO specifications are really quite broad, and nomenclature often confusing. It is not unusual to encounter, in the essential oil market, products for which the source organ (leaf, bark, or other), or the geographical origin, or even the botanical origin, are not specified with all desirable diligence.

For example, oregano or oregano oils are often discussed, but are they Greek oregano (Origanum vulgare L. ssp. viride (Boiss.) Hayak), Spanish oregano (Corydothymus capitatus (L.) Hoff. and Link), Mexican oregano (Lippia graveolens HBK) or Turkish oregano (Origanum onites L.)?  Chemotypes are also quite a problem, e.g. Thymus vulgaris L.  ISO is often hard-pressed to keep up with the variables.  Of course this leads to quite a lot of detective work, because the chemical constituents of the oil may vary greatly throughout the vegetative cycle of the plant: for example, fennel, carrot, and coriander, in which the level of linalool is 50% higher in the ripe fruit than the unripe fruit.

Temperature, relative humidity, total duration of daylight, and wind patterns exert a direct influence, especially on species that possess superficial histological storage structures (e.g. glandular trichomes of Lamiaceae).  In peppermint, for example, long days and temperate nights lead to higher yields in oil, and to an increase in the menthofuran level. In contrast, cold nights favour the formation of menthol.

Another influence on the variability of oils is the preparation method.  The lability of the constituents of essential oils explains why the composition of the product obtained by steam distillation is most often different from that of the mixture of constituents initially present in the secretory organs of the plant.  During the steam distillation, the water, the acidity, and the temperature may induce hydrolysis of the esters, and also rearrangements, izomerizations, racemizations, oxidations, and more.

Bearing all this in mind, you will appreciate that it would be unwise to generalize anything and yet I think that this is what specifications try to do.  Therefore I personally prefer to sift through the published literature in search of analyses which might approximate our own, based upon the organ source, geographical origin, watering regimen, etc., etc. 

To put this into perspective, it should be understood that hundreds of analyses are published every month, and so there is much to take into consideration.  However comparison with the literature can sometimes leave me flummoxed.

Deciphering dittany.
Recently I was sent from Crete a sample of essential oil steam distilled from cultivated Dittany (Origanum dictamnus L.). I reached instinctively towards the bookshelf: Volatile Constituents of Bracts and Leaves of Wild and Cultivated Origanum dictamnus [Planta Medica, 1999, 65(2):189-191].   

Origanum dictamnus L. or “Cretan dittany” of the Lamiaceae family is a gray green woolly herb, up to 25cm high, endemic on Crete, with ovate or round leaves, and large purple bracts.  Wild plants are found on the rocky slopes of mountainous Crete. However, it is also cultivated because of its therapeutic properties, and its essential oil which has been known since antiquity. It is known under the common name “dictamos” and “erontas”.
According to transcripts of the International Plant Genetic Resources Institute [CIHEAM, 8th-10th May, 1996, Vallezano-Bari, Italy], the herb is bactericidal, fungicidal, antiseptic, anaesthetic, anti-inflammatory, carminative, expectorant, antirheumatic, analgesic, and much more.

For aromatherapy use, it is suggested that the essential oil is useful for intense anti-stress therapy, muscular aches and pains, headaches, rheumatism, cellulitis, anti-ageing, and acne. Fine, but what’s in it?

According to the report published in Planta Medica, the qualitative and quantitative analysis of the constituents of the oils of the bracts showed qualitative differences, whereas in the case of the leaf oils only quantitative differences were observed.  Good heavens, I shall have to read this carefully! 

In the wild specimens, sabinene, oct-1-en-3-ol, 3-octanol, carvone, thymoquinone, b-bisabolene and d-cadinene were identified only in the essential oil of leaves, whereas in the essential oil of the bracts these compounds were totally absent. On the contrary, myrcene was found only in bracts but not in leaves of the wild specimen. Tricyclene, myrcene, a-terpinene, g-terpinene and camphor were in higher percentages in the bracts of the wild plant, whereas a-pinene, camphene, 3-octanol, g-terpinene, linalool, terpinen-4-ol and thymol were also in higher percentages in the leaves of the wild plant, than in the three cultivated specimens in both cases.  Carvacrol was the predominant compound in all cases. Quantitative differences among the three cultivated specimens in the case of the bracts were the amount of thymol and (Z)-caryophyllene, whereas in the case of the leaves were the amount of linalool, camphor, terpinen-4-ol and carvone.

Qualitative differences were also observed among the cultivated specimens. Carvone, thymoquinone, and d-cadinene were not identified in the essential oils of the bracts, whereas in the essential oils of the leaves these compounds were found in large amounts.

Well, if I was ISO, I would be pulling my hair out by now, but how does all this stack up with my own sample?  My Cretan supplier advised that the sample was steam distilled from “drained herbs”.  Drained herbs?  I presumed that he meant the “whole” herb, including both bracts and leaves, and therefore anticipated a rare cocktail of the chemical constituents of both, but expected carvacrol to dominate.

I was not wrong: analysis revealed 51.74% carvacrol, 14.10% g-terpinene, 8.78% p-cymene, 2.82% a-terpinene, 2.6% (Z)-caryophyllene, 2.24% a-copaene, 1.63% myrcene, 1.52% carvone, 1.07% d-cadinene, and smaller amounts of terpinen-4-ol, b-bisabolene, 3-octanol, oct-1-en-3-ol, and thymol among others, but no thymoquinone.  I sent the analysis to Greece, for comparison with the data in the Planta Medica report, hoping that I might learn more.

I had yesterday a meeting with Mrs. Chinou [Associate Professor, University of Athens, School of Pharmacy, Department of Pharmacognosy and Chemistry of Natural Products] and studied the analysis of Dr. Demetzos [the author of the report in Planta Medica].  The herbs which Dr. Demetzos used were from experimental cultivation in flowerpots,  from another area, and (so) we cannot compare the two analyses.  There was no further comment. That’s me sorted!

Dystonia discussed.
In response to my request in last month’s Newsletter for suggestions to assist spasmodic dysphonia, many recommended that Elizabeth’s client try the Alexander Technique.

However, before I have a closer look at this process of psychophysical reeducation to improve postural balance and coordination in order to move with minimal strain and maximum ease, let us consider first the experience of Carol Garforth who has suffered from spasmodic dysphonia for more than twelve years.

A non-practising qualified aromatherapist, Carol has been having botox injections for nearly ten years.  Her problem was not diagnosed for at least two years and she had no speech at all. She finally diagnosed herself from a radio programme. Her first treatment was in London but for most of the time she is treated every three months in Middlesborough.  She tells me that dystonia is the second most common muscle movement disorder after Parkinson’s disease, but is less known by the medical profession than most rare diseases.

A member of The Dystonia Society [46/47 Britton Street, London EC1M 5UJ - Telephone 020 7490 5871], she advises me that most sufferers have not been diagnosed for years, and she wonders how many may never be. To her knowledge there is no alternative treatment, although she has searched hard to find one. There is, however, a book by an American doctor, Dr. Morton Cooper, which suggests that botox injections do more harm than good and that breathing exercises and humming are the only way to overcome the problem [unfortunately I do not have the title of the book but, as Carol mentions, there is more to it than this]. Jan de Vries, whom she met some years ago, recommended acupuncture, but she has yet to come across an acupuncturist who has heard of dystonia let alone treated it. Is there one out there, I wonder?

Carol is also a member of Action for Dystonia, Diagnosis, Education & Research, which is located at Bath Cottage, Dinsdale Park, Middleton St. George, Co. Durham, DL2 1DJ, the founder of which is the only person in the U.K. with a Ph.D. in Dystonia.  A very useful contact, I would think [Tel/Fax: 01325 332723 - Email: butler.adder1@btinternet.com - Website: www.dystonia.co.uk].

Meanwhile Helen Gazeley e-mailed to say that she also has a patient who has suffered with spasmodic dysphonia for many years. Helen has been giving her reflexology weekly for almost a year, although not for this problem.  However, when her client, a 48-year old lady, attended recently for her botox injection, the hospital was extremely pleased with how well the previous injection had lasted.  Her client puts this most encouraging result down to the reflexology that she has been receiving. I would agree with Helen that it probably helps to relax the muscles.

Alexander Technique.
When Pat Ki first suggested that Elizabeth’s client might benefit from Alexander Technique, I hadn’t an idea what it was about and so had to mug up a little.

The technique was developed around the turn of the last century by Frederick Alexander, an Australian actor [Pat tells me that in fact he might have been an elocutionist and reciter] who suffered a recurring loss of voice. By observing himself in the mirror, he concluded that it was due to the tense position in which he perpetually held his head. By correcting the relationship between head, neck and spine during activity, he solved the problem over a number of years.  Having “freed his neck”, his voice was immensely strong from then on and he was invited to Britain to teach his technique. Incidentally, so Pat informs me, he raised his fare for the trip from betting at the races. He studied the horses in the paddock and in each race put his money on the nag with the most “free neck”. Sounds very Australian to me!

The Alexander technique, so I learn, is based on three principles - function is affected by use: an organism functions as a whole: and the relationship of the head, neck and spine is vital to the organism’s ability to function optimally.

Human movement is thought to be most fluent when the head leads and the spine follows. This new experience is practised repeatedly to create new motor pathways, improving proprioception and upright posture and leading to enhanced coordination and balance.

The notion that learning the Alexander technique allows the conscious changing of habitual and detrimental physiologic reactions receives some support from psychophysiology research, suggesting that the mind can modulate aspects of the autonomic nervous system.  Specific investigations of the Alexander technique have demonstrated that it improves the efficiency of moving from the sitting to standing position.

My investigations reveal that there about 2000 Alexander teachers worldwide. They typically come from a background of performing arts, dance, theatre and music or, more recently, physical or occupational therapy and massage.  Certified teachers undergo at least three years of training on an approved course involving 1600 hours of training.  The conditions most frequently treated are chronic pain, asthma, osteoarthritis, stress and headaches. It is also used by performing artists and sportspeople.

What’s a typical treatment like? Sessions last between 45 and 60 minutes and take place in an Alexander studio with the aid of a bodywork table and mirror.  You are encouraged to wear loose, comfortable clothing to facilitate movement.  The teacher guides the Alexander process using a gentle hands-on approach to teach movements with the head leading and the spine following. Within 5-10 lessons you are able to experience and recreate an expansive quality of movement known as poise.  The skill can then be refined to specialist activities.  Thirty lessons are recommended in order to learn the basic concepts.  Serious students of the technique may undertake up to 100 lessons.

Does it work?  Controlled trials have reported enhanced respiratory function in healthy volunteers, greater functional reach in elderly women and improvements in performance and anxiety in music students following training in the Alexander technique. An uncontrolled trial of a multidisciplinary programme for 67 chronic back pain sufferers incorporating lessons in Alexander technique reported improvements in pain which persisted for 6 months.

Another observational study involving seven patients with Parkinson’s disease reported improvements in depression and performance of daily activities following instruction in the technique [Stallibrass, C. An evaluation of the Alexander technique for the management of disability in Parkinson’s disease - a preliminary study. Clin. Rehab. 1997; 11: 8-12].     
Multiple cases of successful application of the Alexander technique to people with learning difficulties [Maitland, S. et al. An exploration of the application of the Alexander technique for people with learning disabilities. Br. J. Learning Disabil. 1996; 24: 70-76] and craniomandibular disorders [Knebelman, S.  The Alexander technique in diagnosis and treatment of craniomandibular disorders. Basal Facts 1982; 5: 19-22] have also been reported.

Want to know more? The Society of Teachers of the Alexander Technique, 1st Floor, Linton House, 39-51 Highgate Road, London NW5 1RS, would be a good place to start, but do remember that learning the Alexander technique requires commitment and a great deal of practice by the student [Tel: 0845 230 7828 - Website: www.stat.org.uk].

Confused by Chamomile.
Would you please advise us of the active ingredients of Rose [Rosa damascena] and Chamomile [Chamaemelum nobile] hydrosols, particularly those that support the saying Rose/Chamomile soothe the infection, conjunctivitis, and over-fatigue of the eye, e-mailed a gentleman from the Far East.  It seems a simple enough question, and yet...... 

Chamomile water has been used in Britain since time immemorial for puffiness around the eyes.  John Gerard (1545-1607), in his enchanting “Herbal or General Historie of Plantes”, wrote of Chamomile “It is special helpe against wearisomnesse, it easeth and mitigateth paine, it mollifieth and suppleth”.  Of course he was not writing specifically about eye infections, but I can readily understand why, four hundred years ago, many might have thought it could assist such ailments.

Nicholas Culpeper (1616-1654), in his “English Physician” (containing “a Compleat Method of Practice of Physic, whereby a man may preserve his Body in Health, or cure himself when sick, with such things one-ly as grow in England, they being most fit for English Bodies”), is more specific and tells us red rose-water “is of much use against the redness and inflammation of the eyes to bathe therewith and the temples of the head”.

However, to better understand why these ancient physicians might have come to these conclusions, I looked at some more modern research [Seal, D.V. et al.  Aetiology and treatment of acute bacterial infection of the external eye.  Br. J. Ophthalmology 1982; 66: 357-60].

Conjunctivitis is an inflammation of the conjunctiva (the mucous membrane that covers the outer layer of the eyeball and lines the eyelids). It is generally caused by either viral or bacterial infection, or by an allergic reaction to substances such as pollen, cosmetics, and solutions used by contact lenses.  Either one or both eyes may be affected.  Viral conjunctivitis is a common ailment which sometimes occurs in epidemic proportions.

During 1980 in a UK hospital, investigation of the microbial flora of patients with acute bacterial infection of the external eye, including acute bacterial conjunctivitis, corneal ulceration, blepharitis, dacryocystitis and discharging sockets revealed that Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae were the main pathogens.
 
Analysis of the volatile portion of our rose hydrosol reveals ethanol (antiseptic, bactericide), b-myrcene (analgesic), linalool (bactericide, fungicide, possible viricide), phenylethyl alcohol (antimicrobial), b-citronellol (bactericide, fungicide), geraniol (antiseptic, fungicide), and methyleugenol (anaesthetic, antiseptic, bactericide, fungicide).  It seems that Culpeper knew what he was talking about.

Chamomile’s action, however, is not so easy to determine.  Analysis of the hydrosol shows a mixture of 2-methylpropanal, 2-methyl-2-proponal, 3-buten-2-one, 2-butanone, isobutanol, 2-methyl-2-propen-1-ol, 3-methylbutanal, 2-methyl-1-butanol, isobutyl acetate, methyl angelate/tiglate, and ethyl 2-methylbutanoate, among others.

Are any of these constituents familiar?  Probably not, because few aromatherapists seem to be aware of the chemical composition of the essential oil itself: surprising perhaps, but true.

The essential oil of Roman Chamomile (Chamaemelum nobile (L.) All.) is composed of over 85% mono- and bifunctional esters of aliphatic acids and alcohols of low molecular weight (i.e. C4, C5 or C6) themselves arising from leucine, isoleucine, or valine metabolism; angelates, tiglates, methylacrylates, crotonoates, isobutanol, 3-methylbutanol-1-ol, or 2-methylbutan-1-ol butyrates, etc. Some of these esters occur in the fresh plant as peroxidized derivatives [like many Asteraceae, Roman chamomile contains sesquiterpene lactones, specifically germacranolides (nobilin, 3-epinobilin, and close derivatives) which give it its bitter taste]. The essential oil also contains monoterpenes; azulenes are present only in trace amounts. Other known constituents of the flowers are phenolic acids, coumarins, and flavonoids, namely apigenin and luteolin glucosides.
I think it a rather complex oil.

Nevertheless, is the anti-inflammatory activity recognized for the plant due to its essential oil? If it is, we can assume perhaps the same anti-inflammatory activity for the hydrosol.

However, unlike the essential oil of German chamomile (Matricaria recutita L.), the essential oil of Roman chamomile contains only traces of azulenes (and sometimes not even that), and no sesquiterpene derivatives of the bisabolene type, which are responsible for the anti-inflammatory activity of German chamomile.  What’s more it is unlikely that germacranolides behave themselves in vivo as do proazulenes.

On the other hand, we cannot exclude the possibility that the anti-inflammatory activity, as well as the antispasmodic activity, may be linked to apigenin, luteolin, and their glycosides, whose activity has been established in animal experiments.

Is this, therefore, why Roman chamomile is traditionally used for the symptomatic treatment of gastrointestinal disorders, and as an adjunct in the treatment of spasmodic colitis pain?  Topically it is considered an emollient and itch-relieving adjunct in the treatment of skin disorders and it is used as an antalgic in diseases of the oral cavity, oropharynx, or both, as well as for eye irritation or discomfort, but researchers don’t really seem to know the reason why.  Do you? Perhaps it is simply a case of if it works......

Onwards, and upwards?
At the Aromatherapy Regulation Working Group (ARWG) AGM held on the 8th July, the lay Chair Geoffrey Lawler withdrew his candidacy to be re-elected, according to a recent ARWG press release.  Mr. Lawler had held this position for two years.

The Group, made up of all the main organisations representing aromatherapists, continued the meeting following this announcement and Mr. Lawler’s immediate departure.  Under a meeting chairperson the Group discussed how it could build on the success of the last 18 months and how to now accelerate the process of regulation for the aromatherapy profession.  Only one association did not remain to partake in this discussion but it is hoped that they will remain full and active partners.

The members of the group present re-affirmed their individual commitment to the regulation process.  All options will be considered in the best interests of both public safety and that of the therapists who the group ultimately represents. This may involve a multi-therapy approach as it is recognised that many therapists are trained in more than one discipline (i.e. the majority of aromatherapists have trained as massage therapists also), and may be concerned about the potential costs of regulation.  The Group is therefore dedicated to working out the best possible solution for all concerned.

It was agreed that the National Occupational Standards (NOS) for aromatherapy, which were revised and launched on 14th March 2002, would be adopted by the Group as the working document for regulation and that the formation of a true single voluntary register could be achieved very quickly as a result.  This is one of the first aims of the Group, including the setting out of a formal Constitution and Terms of Reference to reflect the work that needs to be accomplished.     

This development in the aromatherapy regulation process is heralded as a very positive and constructive turning point and it is envisaged that the whole process will now move forward expediently and in unity, which ultimately gives the profession the credibility it deserves.

Good luck!

Chick-Chack?
Which essential oils will get rid of head lice? we are often asked.  Some suggest that bergamot, eucalyptus, geranium and lavender will do the trick, whilst others swear by manuka, kanuka, neem, rosemary, lemongrass, and thyme linalol. In fact I have found that
all will help, invariably in combination rather than singly. However I would never have thought of combining aniseed (Pimpinella anisum L.) with ylang-ylang (Cananga odorata genuina Hook & Thom. f.) to tackle the six-legged nipper, but new evidence suggests that this combination may be effective in clearing infestations of Pediculus humanus.

In a study involving 119 Israeli school children with head lice, a spray using these oils plus coconut oil was compared with a conventional spray including permethrin and malathion.

The natural spray was applied for 15 minutes on days 1, 6 and 11 of the study, and the conventional spray was applied twice for 10 minutes on days 1 and 11.  The treatments were equally effective, with complete head lice eradication in 92% of the children in each group [Isr. Med. Assoc. J., 2002; 4: 790-3].

The herbal preparation used in the study is marketed in Israel as Chick-Chack!
Something we’ve known for years but........
New evidence suggests that people with dandruff can improve the condition of their scalp considerably by washing it once a day with a shampoo containing tea tree (Melaleuca alternifolia Cheel).

In this study, 126 dandruff sufferers were randomly assigned to wash their hair once a day with a shampoo containing 5% tea tree oil or the same shampoo, but without the tea tree oil, for one month.

The area of the scalp affected and the severity of the dandruff were measured before the treatment began, and at two and four weeks into the study. At both of these time periods, these measurements had dropped 28 and 23%, respectively, with tea tree oil-containing shampoo versus only 13 and 3%, respectively, with the “control” shampoo.

In addition, compared with those in the control group, the participants using the tea tree shampoo reported significant reductions in itchiness (23 versus 12%) and greasiness (26 versus 8%) of the scalp [J. Am. Acad. Dermatol., 2002; 47: 852-5].

However, only one individual had complete resolution of his dandruff by the end of the study. Whether a stronger dilution or a different solution is needed is not known. Any suggestions?

...........not everyone is convinced!

I wonder if you or any therapist reader has had any success in treating folliculitis of the scalp? My Merck states that folliculitis is a superficial or deep bacterial infection and irritation of the hair follicles.  It is usually caused by Staphylococcus aureus and shows as pustules/papules in the scalp surrounding a hair follicle. Tea tree shampoo has not given good results, neither has using tea tree neat on the papules.  The doctor has prescribed Fucidin for this condition which is not acceptable to my client. Any help, advice, suggestions and information on treatment of this condition would be appreciated, e-mailed Mary King.

Bacterial infections of the skin and soft-tissue include the pyodermas, namely impetigo, erysipelas, cellulitis, folliculitis, furunculosis, and ecthyma gangrenosum. As Mary mentions, common causes are Staphylococcus aureus and Streptococcus pyogenes but I wonder if  folliculitis of the scalp may instead be caused by Pityrosporum ovale, a fungus associated with dandruff and seborrhoeic dermatitis: certainly several textbooks suggest this.  However, as tea tree is a proven antifungal (in cases of athlete’s foot at least), its lack of efficacy in this case probably means I’m wrong.  Nevertheless, I should like to know what others think.

The prescription of Fucidin makes sense, if it is indeed due to Staph., because fusidic acid is a steroidal antibiotic with a bacteriostatic or bactericidal activity mainly against Gram-positive bacteria.  Fungi, however, are resistant I believe.

Applied topically, fusidic acid can cause hypersensitive reactions in the form of rashes and irritation and, in any event, should only be used short term because of the risks of bacterial resistance [Anonymous. Topical antibiotics and antiseptics for the skin. Drug. Ther. Bull., 1987; 25: 97-9].

Finally......
I detect that this Newsletter is a little “heavier” than usual, probably because the questions are getting weightier! Still, now that it is written, I feel quite light-headed and have decided to try to compensate with the special offers. Go for it!
 

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