Clinical Aromatherapy: Essential Oils in Healthcare, 3rd ed., by Jane Buckle. St. Louis, MO: Churchill Livingstone, an imprint of Elsevier, Inc.; 2015. Paperback, 418 pages. ISBN: 978-0-7020-5440-2. $66.95.

This is the first peer-reviewed, evidence-based book on clinical aromatherapy and includes reviewers from around the world. The wide-ranging applications of essential oils, from beauty aids and pharmaceuticals to cleaning products and beverage ingredients, explains why these plant extracts were a billion-dollar industry in 2013. Jane Buckle’s, PhD, RN, third edition of this book (which includes additional tables, updated citations, and new chapters) is evidence of the popularity and importance of this subject. The book’s foreword by Mehmet Oz, MD, confirms an interest from the integrative medical community, and may encourage others to take another look at essential oils as viable phytotherapeutic agents in integrative and, perhaps, primary health care.

The author provides an excellent overview of how essential oils can contribute to a healthier medical system, enhancing patient care and lowering medical costs at a critical time in this community. Nurses have been the champions of aromatherapy in healthcare settings, as demonstrated by the many studies conducted by Dr. Buckle’s students, but this book may encourage physicians to take a closer look at the potential of essential oils as a viable option in some primary-care situations, especially when antibiotics fail. This text examines issues within conventional and integrative medical practices with applications relevant to a variety of settings and circumstances. Rigorously cited with an impressive number of references, even the harshest skeptic will be convinced by the author’s thorough research and personal clinical experience that there is no better authoritative voice to bring forth this important information that is pertinent for our time.

The book is divided into three sections:

“Section I: Overview” provides basic historical background on the emergence of aromatherapy in different cultures up to modern times, and it parses out the three main segments of aromatherapy practice in aesthetic, holistic, and clinical care. Chapters in this section include: “The Evolution of Aromatherapy,” “How Essential Oils Work,” “Basic Plant Taxonomy, Basic Essential Oil Chemistry, Extraction, Biosynthesis, and Analysis,” “Essential Oil Toxicity and Contraindications,” “Aromatherapy and Integrative Healthcare,” and “The ‘M’ Technique^®” (a hands-on technique for persons who cannot receive conventional massage, or for those not adequately trained in massage). By reporting on the pharmacokinetics of essential oils, the author helps clarify the misunderstood theories and misuse of dermal and respiratory absorption; in addition, Dr. Buckle expounds on the involvement and role that the brain plays in the effects and applications of aromatherapy in physiological and psychological health. Section I even tackles the much-maligned and misconstrued subject of internal uses via oral, vaginal, and rectal applications.

The chapter on taxonomy, essential oil chemistry, extraction methods, and analysis includes information on how to assess and obtain high-quality oils. Some practitioners may consider this topic irrelevant to medical practice, but Dr. Buckle makes a clear case for the need to understand this material in order to use aromatherapy to its fullest potential. The toxicity and contraindication chapter provides readers with details on how to cultivate a healthy respect for the power of these very concentrated, (mostly) distilled extracts and their safest applications.

As a nurse, the author’s many years of experience come to bear in Chapter 5, in which she discusses the various ways of incorporating aromatherapy into an integrative model of health care. Outlining the many instances of this integration, Dr. Buckle provides copious examples of healthcare systems in a variety of states in America and countries throughout the world that have adopted an integrative model for incorporating essential oils in patient care. The chapter includes a discussion on how a practitioner might go about bringing this modality to a more skeptical organization, as well as a detailed guide of how to create a hospital clinical aromatherapy policy. Dr. Buckle’s extensive research is apparent in the explanation of her own registered method of gentle touch for fragile, distressed, or dying patients known as the “‘M’ Technique,” a new subject for this edition, and the dozens of facilities using it.

“Section II: Clinical Use of Aromatherapy” covers a broad range of evidence-based applications for essential oils in a medical setting, which includes efficacy data and chapters on infections, insomnia, nausea and vomiting, pain and inflammation, and stress and well-being. The data on drug-resistant pathogens is particularly relevant in this era of the situational failing of antibiotics. The author has paid explicit attention to this subject in Chapter 7, “Infection,” an extremely well-referenced section that contains more than 200 citations — a significant increase from the previous edition. The subsection, “Evolutionary Pharmacology,” at the end of this chapter discusses a topic familiar to most clinical aromatherapists: that of non-standardized essential oils (NSEOs). The author makes a good case for using whole essential oils, foregoing isolates or fractions sometimes known as standardized essential oils (SEOs). Isolating what some consider “active” ingredients dismisses the synergy of other constituents that may contribute to how and why essential oils are less susceptible to pathogenic resistance than SEOs, a topic with which many phytotherapists are familiar for various reasons.

“Section III: Aromatherapy in Clinical Specialties” spotlights the clinical potential of aromatherapy within specific medical departments and addresses elder care, intensive care, dermatology (viruses, fungi, and acne), mental health, oncology, pediatrics, respiratory care, women’s health, and palliative, hospice, and end-of-life care, many of which are new to this edition. The numerous citations go beyond animal studies and reference clinical research, which she establishes is available more often than is perceived.

Despite the excellent overview of Section I, this is not a beginner’s book; it contains no materia medica or detailed formulas. It is, however, an excellent review of how essential oils are being used currently in medical facilities and their potential for incorporation into a wider range of clinical settings. While simply reading this information is not enough to qualify one as a skilled practitioner, it certainly will help to expand a reader’s understanding of the current scope and future prospects of the practice of aromatherapy and advance further investigation of the great potential of one of the most powerful and misunderstood forms of phytotherapy available today.

Even the most conservative of medical professionals cannot deny the body of evidence compiled in this book and the relevance for clinical aromatherapy to take its rightful place in the therapeutic arsenal against a wide variety of human ailments. Dr. Buckle makes this complex subject easy to understand, whether the reader is exploring for the first time the viability of essential oil use or is experienced with these particular plant distillates. The third edition of Clinical Aromatherapy is an excellent guide for the clinically inclined aromatherapist, and it will enrich the role of healthcare professionals in their exploration, development, and understanding of the value of aromatic oils and their extensive benefits in primary, integrative, and palliative care, or in any holistic setting. It is thoughtfully laid out, very well organized, and of great value for forward-thinking pharmacists and anyone interested in expanding their use of phytotherapy.

I highly recommend this book, both as a resource and a highly informative read; the compilation of bibliographic citations alone is significant. Some of the most useful summaries for quick-scanning data are the “Chapter Assets” on chapter title pages, where tables and page numbers offer accessible, organized, and relevant information. A broader range of essential oil suppliers for the United States may have been useful for American readers (the book was written in the United Kingdom), but these are also available through mining some of the other US resources provided.

—Mindy Green, MS, RH (AHG), RA

GreenScentsations.com

Boulder, Colorado