A spoonful of oil makes the medicine unwanted

The recent revelation that some patients taking an antibiotic for chronic acne developed severe arthritis and damage to their liver and lungs highlights again the fact that we have become too reliant on these one-time wonder drugs. We know they can have harmful side-effects and we know that an increasing number of bacteria are becoming resistant to them, but we do not know what to use instead.

However, there is an alternative, especially for the range of relatively minor infections for which doctors routinely prescribe antibiotics. "For acne, tea tree oil works very well and so does Palma Rosa," says Colin Nicholls, a medical herbalist. He is talking about the aromatic oils that many people are familiar with from aromatherapy, but the difference is that he prescribes them for internal use. "Acne is partly hormonal, but it is also connected with toxins in the gut and tea tree oil can help with that."

If you lived in France, none of this would be new. There, doctors and hospitals have regularly used essential oils as an alternative to antibiotics, but here the concept of swallowing them is still a radical one. What promises to make it rapidly accepted is the arrival of the aromatogram - a laboratory technique for discovering which oil is best for treating a particular infection.

Again, this is something widely used in France, but it was only last year that it became available at the laboratory of the London pathologist Mike Smith.

"The principle is the same as the one I use to let doctors know which antibiotics are effective against certain bacteria," Mr Smith says, "only the aromatogram shows which aromatic oils to use." Bacteria from the infected area are cultured and then exposed to a range of oils to see which kills them off most effectively.

A demonstration of the aromatogram at the Royal Society of Medicine last year so impressed Dr Tony Stellon, a GP from Dover, that he has begun a clinical trial comparing the effectiveness of essential oils with antibiotics.

Of particular interest to many who were at the demonstration was the ability of essential oils to clear up infections caused by MRSA (methicillin resistant staphylococcus aureus). At the moment, hospital operating theatres are immediately closed down if MRSA is found in them because it infects open wounds and antibiotics do not work against it.

"We are not talking about a complete substitute for antibiotics," says Mr Smith. "The two need to be used together, which is why it is vital to see someone with proper training before using them. For instance, an inner-ear infection with a nasty little bug called Pseudomonas needs to be brought under control very quickly with antibiotics or there is a danger of the eardrum bursting.

"On the other hand, doctors regularly prescribe an antibiotic for something as minor as a fungal infection of the toenail. But it makes far more sense to treat that locally with an oil which can actually penetrate the nail, rather than handing out a powerful drug that has known effects on the liver and will probably knock out some of the bacteria in your gut as well."

The relationship between essential oils and the gut is an important one for Rosalind Blackwell, a medical herbalist who trained in France and was responsible for introducing French expertise with oils to this country. "Do you know that the weight of bacteria in the gut is three pounds?" she asks. "There is a delicate balance in there that is upset not only by antibiotics but also by contraceptives, anti-inflammatory drugs and antacids."

When that happens the effects, such as irritable bowel syndrome, are not limited to the gut but can be seen all over the body - interesting examples are catarrh and sinusitis. "Taking oils internally can rebalance the intestinal flora and clear up all sorts of chronic infections."

The vagina is another area packed with benign bacteria that can be destabilised by modern drugs. Mr Nicholls says he regularly sees women who are stuck in the debilitating cycle of cystitis, antibiotics, thrush, cystitis. "Antibiotics have put their vaginal flora out of balance, allowing a fungus like thrush to run wild, and doing nothing to address the root cause of the infection," he says. "Aromatic oils taken orally or in a pessary can be effective in clearing up the infections and setting the balance right again."

One of the intriguing aspects of the aromatogram is that different people show up as responding to different oils when they have the same infection. "It's because the oils don't just knock out bacteria the way antibiotics do," says Mr Nicholls. "They also affect the balance of chemicals and nutrients in the area of the infection. Sometimes they may work by creating an inhospitable environment for the bacteria, rather than by killing them off directly."

This much more complex reaction can be seen in the one of Mr Nicholls's cases involving a woman who came with cystitis problems; clary sage, an essential oil which has an oestrogen-like effect, was indicated by the aromatogram. "Clary sage isn't normally effective against bacteria, but it got rid of the infection," he says. "Putting the oestrogen balance right meant that the body could take care of the infection."

Something similar was happening in the case of a man with a chronically infected prostate. The three oils that showed up on the aromatogram had no known antibacterial activity but were used to treat diabetes. Together with other antidiabetic herbs, they cleared up the infection in a month.

Two obvious questions spring to the conventional medical mind at this point. "Where's the evidence from clinical trials?" and "if these oils are so potent, what are the side-effects?" They are questions that Rosalind Blackwell is all too aware of. She points out that a lot of highly reputable research has been done on the oils in France, but, because it is written up in French, British doctors are not familiar with it. All the same, she has some trials already under way.

"I regularly monitor my patients' blood to forestall the possibility of liver or kidney damage," she says, in reply to the second question. "The fact is that the dangers come from conventional drugs which are far more toxic. There are a few things to watch out for, however. For instance, someone who is using a lot of paracetamol shouldn't be given oils with certain phenols in because they have similar elimination pathways, but if you use a properly qualified practitioner there should be no problems."

Antibiotics are chemically simple substances; they may only involve a single molecule and that is why bacteria are constantly able to develop resistance to them. Aromatic oils, on the other hand, are very complex, containing an array of molecules in different proportions which reinforce each other.

"The most active anti-infection ingredient in tea tree oil, for example, is terpinenol," says Ms Blackwell. "But if you extract it and use it on its own, it is not nearly so effective." As a result, resistance to oils does not develop at anything like the same rate, if at all. This could prove handy as we enter the era of the superbug.

Colin Nicholls, 01892 547628; Mike Smith, PMC Laboratories, 0171-436 9395; Rosalind Blackwell, 01934 712848.