The efficacy and safety of capsules containing peppermint oil (90 mg) and caraway oil (50 mg), when studied in a double-blind, placebo-controlled, multicenter trial in patients with nonulcer dyspepsia was shown by May et al. (1996). Intensity of pain was significantly improved for the experimental group compared with the placebo group after 4 weeks.
Six drops of pure lavender oil included in the bath water for 10 days following childbirth was assessed against "synthetic" lavender oil and a placebo (distilled water containing an unknown GRAS additive) for perineal discomfort (Cornwell and Dale, 1995). No significant differences between groups were found for discomfort, but lower scores in discomfort means for days 3 and 5 for the lavender group were seen. This was very unsatisfactory as a scientific study, mainly because essential oils do not mix with water and there was no proof whether the lavender oil itself was pure.
Alopecia areata was treated in a randomized trial using "aromatherapy" carried out over 7 months. The test group massaged a mixture of 2 drops of Thymus vulgaris, 3 drops Lavandula angustifolia, 3 drops of Rosmarinus officinalis, and 2 drops of Cedrus atlantica in 3 mL of jojoba and 20 mL grapeseed oil into the scalp for 2 min minimum every night. The control group massaged the carrier oils alone (Hay et al., 1998). There was a significant improvement in the test group (44%) compared with the control group (15%). The smell of the essential oils (psychological/physiological) and/or their chemical nature on the scalp may have achieved these long-term results. On the other hand, the scalp may have healed naturally anyway after 7 months.
Ureterolithiasis was treated with Rowatinex, a mixture of terpenes smelling like Vicks VapoRub in 43 patients against a control group treated with a placebo. The overall expulsion rate of the ure-teric stones was greater in the Rowatinex group (Engelstein et al., 1992). Similar mixes have shown both positive and negative results on gallstones over the years.
In a double-blind, placebo-controlled, randomized crossover study involving 332 healthy subjects, four different preparations were used to treat headaches (Gobel et al., 1994). Peppermint oil, eucalyptus oil (species not stated), and ethanol were applied to large areas of the forehead and temples. A combination of the three increased cognitive performance, muscle relaxation, and mental relaxation, but had no influence on pain. Peppermint oil and ethanol decreased the headache. The reason for the success could have been the intense coldness caused by the application of the latter mixture, which was followed by a warming up as the peppermint oil caused counterirritation on the skin; the essential oils were also inhaled.
A clinical trial on 124 patients with acne, randomly distributed to a group treated with 5% tea tree oil gel or a 5% benzoyl peroxide lotion group (Bassett et al., 1990), showed improvement in both groups and fewer side effects in the tea tree oil group. The use of tea tree oil has, however, had detrimental effects in some people (Lis-Balchin, 2006, Chapter 7).
A 10% tea tree oil was used on 104 patients with athlete's foot Tinea pedis) in a randomized double-blind study against 1% tolnaflate and placebo creams. The tolnaflate group showed a better effect; tea tree oil was as effective in improving the condition, but was no better than the placebo at curing it (Tong et al., 1992). Surprisingly, tea tree oil is sold as a cure for athlete's foot.
In the past few years, the theme of the case studies (reported mainly in aromatherapy journals) has started to change and most of the aromatherapists are no longer announcing that they are "curing" cancer and other serious diseases. Emphasis has swung toward real complementary treatment, often in the area of palliative care. However, the so-called clinical aromatherapists persist in attempting to cure various medical conditions using high doses of oils mainly by mouth, vagina, anus, or on the skin. Many believe that healing wounds using essential oils is also classed as aromatherapy (Guba, 2000) despite the evidence that odor does not kill germs and any effect is due to the chemical activity alone.
Because of the lack of scientific evidence in many studies, we could assume that aromatherapy is mainly based on faith; it works because the aromatherapist believes in the treatment and because the patient believes in the supposed action of essential oils, that is, the placebo effect.
Decreased smoking withdrawal symptoms in 48 cigarette smokers were achieved by black pepper oil puffed out of a special instrument for 3 h after an overnight cigarette deprivation against mint/menthol or nothing (Rose and Behm, 1994).
Chronic respiratory infection was successfully treated when the patient was massaged with tea tree, rosemary, and bergamot oils while on her second course of antibiotics and taking a proprietary cough medicine. She also used lavender and rosemary oils in her bath, a drop of eucalyptus oil and lavender oil on her tissue near the pillow at night, 3 drops of eucalyptus and ginger for inhalations daily, and reduced her dairy products and starches. In a week, her cough was better and by 3 weeks, it had gone (Laffan, 1992). It is unclear which treatment actually helped the patient, and as it took a long time, the infection may well have gone away by then, or sooner, without any medicinal aid.
After just one treatment of aromatherapy massage using rose oil, bergamot, and lavender at 2.5% in almond oil, a 36-year-old woman managed to get pregnant after being told she was possibly infertile following the removal of her right fallopian tube (Rippon, 1993)!
Aromatherapy can apparently help patients with multiple sclerosis, especially for relaxation, in association with many other changes in the diet and also use of conventional medicines (Barker, 1994). French basil, black pepper, and true lavender in evening primrose oil with borage oil was used to counteract stiffness and also to stimulate; this mixture was later changed to include relaxing and sedative oils such as Roman chamomile, ylang ylang, and melissa.
Specific improvements in clients given aromatherapy treatment in dementia include increased alertness, self-hygiene, contentment, initiation of toileting, sleeping at night, and reduced levels of agitation, withdrawal, and wandering. Family carers reported less distress, improved sleeping patterns, and calmness (Kilstoff and Chenoweth, 1998). Other patients with dementia were monitored over a period of 2 months, and then for a further 2 months during which they received aromatherapy treatments in a clinical trial; they showed a significant improvement in motivational behavior during the period of aromatherapy treatment (MacMahon and Kermode, 1998).
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