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Aromatherapy in a Clinical Setting
by Eva Urbaniak, N.D.

What is scientific or medical aromatherapy?

Simply, it is the use of essential oils for therapeutic purposes. It is a natural, sophisticated "bio-chemotherapy" based on the relationship between the chemical compounds found in essential oils and the therapeutic effects experienced as a result from their use. It uses a rigorous methodology based on solid scientific data that has been confirmed both in the laboratory and the clinical setting. It is a high quality, natural therapy. Prodigiously efficient, it complements admirably well all other alternative and allopathic approaches. As long as authentic essential oils are used, and used correctly, the results are often amazing and impossible to duplicate by any other means.

What is an essential oil?

An essential oil is simply a concentrate of the volatile extract from an aromatic plant, obtained by steam distillation.

Properties of essential oils…

Essential oils have potent properties, such as anti-bacterial in the phenolics, thymol, eugenol, and carvacrol, {from Satureja Montana (winter savory)}, anti-infective, in aldehydes such as cinnamon and citronella, or for mucupurulent infectious states, the ketones menthone, piperitone, and borneone (camphor) verbenone, thujone, anti-inflammatory as in Eucalyptus radiata, analgesic, such as peppermint, and calming, such as lavender, chamomile, ylang-ylang, and sandalwood, for which aromatherapy is most commonly associated. There are other oils containing ethers, cineols, monoterpenols, and linalools, contained in Hyssop, or Hissopus officinalis, but we won't go into depth with them other than to note they are very effective in viral pathologies of the lower respiratory tract.
The lists of the specific oils at the end will show more specific properties.

Aromatherapy is effective, fast, reliable and safe if used correctly. It is a 100% natural therapy (as long as authentic oils are used). There are few or no side effects or contraindications. Aromatherapy complements other approaches. It is a precise, rational methodology. Treatment is adapted to the patient's individual needs and there is a broad intervention range, with multiple properties.

Quality control and criteria: What you smell is not necessarily what you get.

The intimate bond between chemical structure and therapeutic activity is the foundation of scientific aromatherapy. Only quality criteria will guarantee the authenticity of the oils, their relative safety, and their full therapeutic value. The slightest modification of their molecular profile entails a higher rate of side effects (allergies, dermocausticity, neurotoxicity, etc.) and lower potency.

Hand Harvesting-wild or organically grown with soluble mineral salts in the soil is preferred. And different parts of the same plant can yield very different essences, such as Cinnamomum verum. The root contains the neurotixic borneone (camphor), the leaf contains eugenol, a powerful anti-infective agent, and the bark contains cinnamic aldehyde, an aphrodisiac.

Certified Botanical Species: only the genuine botanical species, identified by two Latin names, the first name denoting the genus, as Cupressus, and the second, the species, sempervirens, thus, Cupressus sempervirens or evergreen cypress. Only the healthiest plants of the desired species must be harvested when the plant is richest in essence. This moment varies depending on the plant. For example, mint must be harvested before blooming (before it develops toxic ketones). Time of day is also critical-roses and lavender must be harvested in the morning, while thyme must be harvested in the afternoon.

Finished product-mode of extraction and quality control-
The only methods of extraction allowed in aromatherapy are mechanical expression, limited to citrus peels, and steam distillation. The still must be stainless steel, distillation must be at low pressure, since overoxidations occur at high pressure, and the essential oils can become tainted with carcinogenic tars. Time factors must be observed-for example 3/4ths of the essential oil of thyme is extracted within the first 30 minutes, but the anti-infectious phenols take another 60 to 90 minutes. Only spring water is used in the distillation process to avoid having to descale the finished product. Following distillation, the essential oils must be filtered, then stocked in airtight, inalterable casks and kept cool. Bottles are opaque blue or brown to protect the oils from light and oxygen.

The worldwide essential oil market is monopolized by the cosmetic and perfume industries, whose only imperative is making money. This is why essential oils destined for those industries are not acceptable for therapeutic purposes. Most essential oils sold as 100% pure and natural are really cut, diluted and altered with vegetable or mineral oils, turpentine, alcohol, and even gasoline! These serious alterations can render an essential oil allergenic, toxic, or even carcinogenic. They can also be cut with closely related essential oils. For example, true lavender is often cut with cheaper lavandin. Some rare essential oils such as rose or melissa are usually only found on the market reconstituted.

So in order to have quality control of the finished product, that control must be consistent throughout the entire process. Physical controls such as color, smell, and sometimes taste are compared to an aroma-library made up of certified essential oils. Density, alcohol-solubility, fusion, boiling and freezing points, and refraction index are also tested. Chemical controls made by gaseous chromatography of the samples to be analyzed serve as an absolute reference point to guarantee authenticity of the essential oils.

Three grades of essential oils-

a) Standard Industrial Grade: These essential oils come from uncertified plants, cultivated industrially, harvested without care to the proper time of day, distilled quickly and incompletely at high temperatures and high pressure, often rectified, thinned, altered and stripped of some of their molecules. They are to be avoided at all costs for therapeutic purposes, and should be restricted to the cosmetic and perfume industries.

b) 100% Pure and Natural: Already more rare than the preceding category, these essential oils are of average quality. They do not always come from certified plant species (since several species can be confused with one another), picked wild or organically grown. Harvesting is not always done at the optimal time. Distillation is incomplete, taking place over a short period at high temperatures and high pressure. They are also rectified and altered like the preceding category but are not diluted. Their use for therapeutic purposes is possible, but not recommended.

c) Authentic: These oils are 100% pure, natural and complete, and meet all the criteria previously mentioned. Therapeutically, they are the most active. They are rare, and thus more expensive, but their quality and effectiveness fully justifies their higher price. They are the only oils that should be used for therapeutic purposes.

Routes of Interface/Safety Measures

1. Cutaneous:

a) Simple anointment consists of applying a variable quantity of an essential oil or a complex of essential oils, either pure or diluted on a pre-determined area for a specific purpose. Areas most commonly used are the chest; anterior, posterior and lateral for effects on the respiratory system (eucalyptus); spine, for effects on the nervous system (various Citrus and Lavendula vera); abdomen for internal organs, liver, stomach, gallbladder, pancreas, to activate digestive functions (Rosmarinus officinalis); solar plexus, corticoadrenal area, neck area for infections of the throat, and the temples, forehead and earlobes, for migraines and headaches in general.

b) Aromatic perfusion is useful in emergency situations and consists of getting the maximum number of molecules into the body in a minimum of time. The venous system of the antecubital fossa and/or inner wrist is used to allow for rapid penetration into the bloodstream. Three to five drops of essential oil, single or complex, are deposited on the inside of the elbow using the opposite wrist, five or six rotary movements are made on the aromatized zone, and repeated for the other arm. In about 10 seconds, the whole is totally absorbed. Effects are immediate and extraordinary especially for respiratory infections and congestion. This treatment can be repeated every five minutes for 1,2, or 3, hours, then phased out gradually, depending on the rate of improvement.

c) Living embalming uses every centimeter of skin (except sensitive areas face, genitalia, axillae) to allow for maximum penetration. This technique is very effective for viral or microbial epidemics, or for detoxification and revitalization. A source of heat is used after whole body application, such as a warm blanket, or hot water bottle, or even a hot air gun to allow for optimal warming and thus, greater vasodilation.

2. Respiratory interface is used for treatment of the pulmonary interface itself: rhinitis, sinusitis, pharyngitis, tracheitis, bronchitis, pneumonia, complications of emphysema, etc. Another interesting aspect of aerosoltherapy is the induction of deep relaxation states. Labdanum has shown a real capacity for inducing a "disconnected" psychic state, which is useful in dealing with drug withdrawal.

3. Other means of introduction: Uro-genital, for local action only, for vulvitis, salpingitis, in females, and in males, for prostatic infections especially the Chlamydiae type, intra-urethral injections using a special canule. A mix of 2% essential oils of Thymus vulgaris thujanoliferum+ Eucalyptus polybractea cryptonifera+ Melaleuca alternifolia in equal parts is injected intravesically. Auricular administration, although usually contraindicated, can be used with the oil diluted according to the aggressivity of the essential oil. For very painful otitis, some oils can be used pure, like true lavender, and eucalyptus radiata, but only one drop per ear. Ocular administration should be approached with caution also, and only as eye baths, with aromatic hydrosols like Hypericum perforatum, Myrtus communis cineolifera or Chamaemelum nobile. In some cases, oily solutions (with non-aggressive essential oils) can be used around the eye area.
Excipients: Oily solution: 1-50% E.O. in first cold pressed virgin vegetable oil, Honey: 3 drops E.O. to 1 T honey, 2-3 times a day, alcohol solutes, 5%E.O. in 94% alcohol (30 drops 3 times daily before meals) Capsules: kaolin, sorbitol and silicilic acid, between 25 to 125mg of E.O. per capsule, Oleo-aromatic capsules, 50mg of E.O. in fatty vegetable oil reduces digestive intolerance, Suppositories and gynecological ovules, made with a special oily blend with kaolin, 50mg for infant suppositories, 75-125mg for children's suppositories, and 150-300mg for adults used 2-3 times per day.

4. Safety Measures-

  • Be wary of so-called natural "essences" Choose products whose quality is irreproachable and controlled.Essential oils obtained from the distillation of wild or healthy cultivated plants have virtues far superior to those of plants grown with chemical substances.
  • Essential oils rich in phenolic compounds (clove, oregano, savory, thyme, or cinnamon are very aggressive, they must never be used pure except in very localized external use (like a pimple or a wart) and must be sufficiently diluted in an appropriate excipient like oil to prevent burning.
  • Essential oils, without exception, must never be applied pure on sensitive areas (genital and anal areas, eyes and ears) without competent advice.
  • Ketonic essential oils (hyssop, garden sage, thuya, lavender, rosemary-camphor type) must only be used externally, and internally only on the advice of an aromatherapist. The uncontrolled use of ketonic essential oils is dangerous, as ketones can cause convulsions, epilepsy attacks and abortions.
  • In cases of known allergic terrain, use the greatest caution (especially skin and respiratory allergies).
  • In case of eye contact, immediately pour vegetable oil in the eye to dilute the essential oil. In case of accidental ingestion of essential oils, take 3-4 tablespoons vegetable oil to reduce irritation of the digestive membranes.
  • During pregnancy, essential oils are to be used carefully, especially ketonic essential oils. For children, essential oils must be diluted (more diluted for younger children). Ketonic oils are best avoided.
  • No E.O internally for children under 3.
  • Avoid exposure to sun during the day following the use of photosensitizing essential oils (citrus peels, bergamot, hypericum perforatum)
  • Essential oil of peppermint (Mentha piperita) must not be applied to a large surface of skin (chilling action). It must not be used on babies because of risk of pharyngeal spasm.

Six Basic Essential Oils (First Aid Kit)
Common Names added here -

Palmarosa or Cymbopogon martinii
Main constituents: Monoterpenols 80-95%
Properties: Tonic, neurotonic, major antibacterial, anti-viral, antifungal.
Indications: uretritis, cystitis, vaginitis, salpingitis, bacterial and viral enteritis, infectious diseases, skin infections, eczema, devitalized, aging skin, eases childbirth.
Usage: On the skin: a few drops several times a day on the affected area, neck (pharyngitis), sinuses (sinusitis), around ear (otitis), on eczematous skin, lower back and abdomen (enteritis and cystitis), uterotonic action, after childbirth: massage lower back with 4 drops palmarosa and 4 drops hazelnut oil.
Interface:Cutaneous, oral and aerial.
Contraindications: none known

Lemon Eucalyptus or Eucalyptus citriodora
Main constituents: Terpenic aldehydes 40-80%, citronenellal 40-80%.
Properties: Anti-inflammatory, antirheumatic, analgesic.
Indications: Inflammatory arthritis, rheumatoid polyarthritis, epicondylitis, tendonitis, tennis elbow, rheumatism, skin irritations, insect bites (curative and preventive).
Usage: On the skin, 5 drops 5 times a day on articular or cutaneous inflamed areas.
Interface: Cutaneous, oral, and aerial.
Contraindications: None known at physiologic dosage.
Black Peppermint Eucalyptus or Eucalyptus radiata
Main constituents: Oxides 72%, 1.8 cineole 62-72%, Monoterpenols 20%, (-)-a-terpinol 14%
Properties: Anti-catarrhal, expectorant, antibacterial, antiviral.
Indications: Rhinitis, rhinopharyngitis, flu, otitis, sinusitis, bronchitis, cough.
Usage: On the skin, 3-5 drops, 4 times daily on chest and back (for respiratory and viral infections). Ideal for inhalations 5-6 drops in a bowl of boiling water; breathe in vapors.
(This pure essential oil is so mild, it can also be directly applied under the nostrils and inhaled or placed on a tissue and held up to the nose and inhaled. It can also be placed directly into the ear canal without dilution for congestive ear infections.)
Interface: Cutaneous, oral, and aerial.
Contraindications: None known at physiological dosage.

Lavandin or Lavandula Hybrida or Burnatii (clone super)
Main constituents: Esters: linaloyl acetate 45%, Monoterpenols: linaloil 30%
Properties: Powerful sedative, antispasmodic, anti-inflammatory, healing, anticoagulant, heart tonic, regulates sebaceous secretions.
Indications: Nervousness, insomnia, sleep disorders, anxiety, depression, migraines, dermatoses, wounds, bedsores, cramps and muscle contractures.
Usage: Skin care: 5 drops 5 times daily on the skin
Anxiety and insomnia: 2 drops under the tongue (diluted) and 3 drops on the solar plexus, along the spine and soles of the feet, and by using a diffuser.
Interface: Cutaneous, oral, and aerial.
Contraindications: None known

Peppermint or Mentha X Piperita
Main constituents: Monoterpenols: Menthol 38-48%, Monoterpenones (ketones) menthone 20-30%
Properties: Anesthetic, analgesic, tonic and stimulant, digestive tonic, cardiotonic, hepatotonic, and uterotonic.
Indications: Nausea, vomiting, indigestion, motion sickness, liver problems and insufficiency, migraines, headaches, herpes zoster, neuralgia, sciatica, all traumatic and inflammatory pain, heavcy legs, venous congestion, varicosities.
Usage: Externally, 2-3 drops, 3 times daily, on painful areas, on herpes zoster (shingles), for headaches, on forehead, temples and over brows. For digestive or hepatic problems, 1-2 drops internally, mixed with a little honey, oil, maple syrup or water.
Interface: Cutaneous, oral, and aerial.
Contraindications: Infants and breastfeeding or pregnant women should avoid all use.

Ajowan or Trachyspermum ammi
Main constituents: Phenols: thymol 40-48%, carvacrol 5%, Monoterpenes: y-terpenine 20-35%, paracymene 20-25%
Properties: general tonic, carminative, anti-nausea, anti-bacterial, anti-viral, antiseptic, anti-parasitic.
Indications: urinary, skin, respiratory, digestive, or gynecological infections, bronchitis, rhinitis, infectious colitis, infectious diarrhea, fatigue, flatulence, digestive atonia, dyspepsia, indigestion, cholera.
Usage: This oil is slightly dermocaustic. Apply 20-50% oil in a diluted vegetable oil base.
Interface: Cutaneous (always diluted in vegetable oil), oral (always diluted in vegetable oil).
Contraindications: Slightly dermocaustic. Always dilute! Do not use on infants.

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