CHURCHILL LIVINGSTONE An Imprint of Elsevier Science Publishing Manager: Inta Izols Development Editor: Karen Gilmour Project Manager: Peggy Fagen Design Manager: Mark Bernard Design: Sheilah Barrett Design CLINICAL AROMATHERAPY 2e ISBN 0-443-07236-1 Copyright 2003, Elsevier Science. All rights reserved. No part of this publication may be reproduced in any form or by any means, elec- tronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission of the publisher (Churchill Livingstone, The Curtis Center, Independence Square West, Philadelphia, PA 19106). Churchill Livingstone and the sailboat design are registered trademarks. NOTICE Complementary and alternative medicine is an ever-changing field. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, change in treatment and drug therapy may become necessary as appropriate. Readers are advised to check the most cur- rent product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the re- sponsibility of the licensed prescriber, relying on experience and knowledge of the patient, to deter- mine dosages and the best treatment for each individual patient. Neither the publisher nor the editors assume any liability for any injury and/or damage to persons or property arising from this publication. Library of Congress Cataloging in Publication Data Buckle, Jane, RGN, MA, BPhil, Cert Ed, MISPA, MIScB. Clinical aromatherapy / Jane Buckle.—2nd ed. p. ; cm. Rev. ed. of: Clinical aromatherapy in nursing / Jane Buckle. c1997. Includes bibliographical references and index. ISBN 0-443-07236-1 1. Aromatherapy. 2. Nursing. I. Buckle, Jane, RGN, MA, BPhil, Cert Ed, MISPA, MIScB. Clinical aromatherapy. II. Title. [DNLM: 1. Aromatherapy—methods. WB 925 B924ca 2003] RM666.A68B83 2003 615Ј.321—dc21 2003043823 Printed in the United States of America. Last digit is the print number: 9 8 7 6 5 4 3 2 1 This book is for all those who walk the path with me. Thank you. ForewordW romatherapy is possibly the most simple of all complementary therapies to integrate because when we inhale air, we inhale aroma, although we Aare usually unaware of it. However, aromatherapy is rarely presented in a cogent, scientific way; as a result, it has been difficult for physicians and nurses to take the field seriously, or to understand how we could use it in our practice. Here is a book from a health professional who writes about aromatherapy in a way that we can understand and apply. As a small boy growing up in Turkey, I had my own special paradise—my grandfather’s walled garden—where I became aware of the power of the senses; in particular, how the fragrance of plants made me feel good. Now, as a cardio- vascular surgeon, I work on repairing the heart. I know the heart is perceived by many to be more than a pump, the epicenter of emotion, and I continue to be aware of how important our senses are to our well being, and how feeling good can help recovery. The very smell of many hospitals is unpleasant, alien, or distressing to our patients. Patients feel at their most vulnerable in a hospital’s high-tech sur- roundings, so a familiar and comforting smell can do much to put them at their ease. In common with several forward-thinking hospitals in the United States, we now use aromatherapy at Columbia Presbyterian, and we have been working with Jane Buckle on research since 1995. Our sense of smell is located in the catacombs of the most primitive area of the brain and is extremely powerful. Smell can produce all sorts of physical reac- tions ranging from nausea to napping. The amygdala, the brain’s emotional cen- ter, is located in the limbic system and is directly connected to the olfactory bulb. Rage and fear are processed in the amygdala and both contribute to heart disease. Our studies at Columbia have found that diluted essential oils rubbed on the feet affected some volunteer’s autonomic nervous system within minutes. Clinical Aromatherapy is presented logically, with considerable background information given at the outset. I expect many readers will go straight to the clin- ical section and look at their own specialty. In each specialty, a few symptoms or problems have been explored, and the way in which aromatherapy might help treat those symptoms or problems is clearly outlined. The information will be of particular interest to readers working in that clinical specialty. However, I think the book will also be of great interest to those who want to know what aro- matherapy really is, and how it can be used in a scientific way. Jane Buckle is well qualified to write this ground-breaking book. She brings a wealth of knowledge and clinical experience acquired over 25 years in the field. vii viii Foreword With a PhD in health service management, a background in critical care nursing, a teaching degree and a fistful of degrees from the world of alternative medicine, she writes authoritatively, and she speaks from the heart. Jane was a co-presenter with me at The World Economic Forum in Davos, Switzerland, a few years ago. We were invited to talk about the economics of alternative medicine and its im- pact on globalization. I was impressed by Jane’s passion, as she also hosted four different events that helped bridge the divide between big business, alternative medicine, pharmaceutical organizations, and political leaders. An underlying question permeated all her presentations: What can we do to get the caring back into healthcare? When Jane speaks, people listen. Jane Buckle is a pioneer and she uses writing, researching, and teaching to get her message across. Her message is one of holism and she inspires those in healthcare to evaluate how they use simple things like smell and touch to help people heal. In the United States, many hospitals are beginning to integrate clin- ical aromatherapy and use Jane’s program. She is involved in numerous hospital research programs (apart from our own) and has been a reviewer for NIH grants. Under her guidance, hundreds of students have carried out small pilot stud- ies in American hospitals. She has written templates for aromatherapy policies and protocols that are being used by hospitals. More than any other person, Jane Buckle has labored to integrate clinical aromatherapy into hospitals, not as a pos- sible add-on but as a legitimate part of holistic care. That achievement alone is remarkable. But, she has another string to her bow. She has pioneered a registered method of touch, called the “m” technique. This technique was tested in our lab- oratory at Columbia Presbyterian on the legs of students and found to have a pronounced parasympathetic response in some. The technique is very relaxing (I have experienced it myself!) and eminently suitable for hospital patients (with or without the use of essential oils), so I am delighted to see a section on the “m” technique in this book. Essential oils offer extraordinary potential from a purely medicinal stand- point, and the recent studies on MRSA and human subjects show just how pow- erful they can be. That an essential oil can be effective against resistant organisms is medicine indeed and I think the chapter on infection will be of great interest to pharmacists as well as those involved in infection control. When nausea is re- lieved through the inhalation of peppermint and insomnia is alleviated through the inhalation of lavender or rose, we are witnessing clinical results—not just the “feel-good” factor. The studies on alopecia and topically applied essential oils, or Candida albicans and teatree, show that aromatherapy can work at a clinically sig- nificant level. However the strength of clinical aromatherapy is that it offers care as well as, in some instances, cure. This is of particular relevance in the field of chronic pain where the perception of pain can be altered using smell and touch. The subject of clinical aromatherapy is vast and will be of interest to nurses and physicians, chiropractors and massage therapists, pharmacists and natur- opaths, pharmaceutical companies and herbalists. I share a goal with Jane Buckle—to enhance patient care and give the best of what we have to offer, what- Foreword ix ever that may be. As a physician, I believe clinical aromatherapy has an important role to play in integrative medicine. Jane Buckle gives us a glimpse of the future, and it smells good! Mehmet Oz Mehmet Oz, MD, is a cardiac surgeon. He is the Director of the Cardiovascular Institute and Vice Chairman of the Department of Surgery at Columbia Presbyterian Medical Center, New York, NY. PrefaceW his book is intended for health professionals in the United States want- ing to use aromatherapy in a clinical way to enhance their practice. It Tdraws from Clinical Aromatherapy in Nursing (London: Arnold, 1997) but is a different book as it is no longer written from a nursing perspective and has been substantially expanded to meet the needs of all health professionals. Things have changed since 1997. I have gained a PhD (which helped my thinking!) and much has improved in the aromatherapy world. Several clinical studies have ap- peared in peer-reviewed medical journals. Aromatherapy is finding its way into wellness clinics, hospices, and hospitals, and courses are being taught at leading universities. Aromatherapy has become part of everyday language. Despite this, popular misconceptions abound. This book was written to try to correct those misconceptions and to indicate the important role that essential oils could play in future healthcare. The book is laid out in a similar way to the first book but with several im- portant differences.