The Medicinal Properties of Traditional Incense
Think of all the ways we take in medicinal plants. We drink them (infusion, decoction, tincture, syrup), eat them (capsule, tablet, electuary, culinary spices), absorb them through our skin (salve, poultice, compress, bath) and mucus membranes (suppository, sinus wash, enema, douche), and utilize them in magical and spiritual ways (talismans, charms, medicine bundles, smudges). We also inhale their medicine through cigarettes, pipes, steams, essential oil diffusers, and, yes, incense.

Inhaling incense smoke is a way to quickly and directly benefit from the medicinal properties of plants. One of the ways this process occurs is through our sinuses, when aromatic molecules are inhaled and dissolve into the mucosal lining. Here they are detected by the receptors on the tips of the olfactory sensory neurons. How these molecules are sensed has been debated for hundred of years, though modern science has established that the neurons sense the vibrations of the molecules and send these messages directly to the brain. Another way this process occurs is through the lungs, where aromatic molecules that are inhaled can be absorbed directly into the bloodstream to be distributed system-wide by the heart.
Smell is the only sense perceived in the right brain, the side focused on intuition and imagination, versus the left brain, which is focused on analyses and logic. Because of this, the affect of incense is not just physical, it also affects our non-material thinking and feeling selves on a psychoactive and emotional level. Interestingly, in herbal medicine the fragrance of a plant is considered to be its most etherial component, the plant's spirit as it were, and is why aromatic plants are thought to have such a profound emotional effect us. Inhaling the plant's fragrance is considered to permit direct communication between our spirit and theirs. Smell is also our oldest sense and is processed through the limbic system, part of the primordial "lizard brain," which is 450 million years old and pre-dates all other senses, such as sight and balance. The limbic system deals with elementary emotions, lust, hunger, memory, and imagination, and is why smell can trigger such strong feelings and memories.
There are records of the use of incense all over the ancient world. The oldest written records of its use are found in Egypt, though it was also used extensively in other cultures in Africa, as well as in Arabia, India, the Americas, and Europe. The Incense Road transported frankincense thousands of years ago via camel caravan, from southern Arabia northward along the Red Sea to the Mediterranean Sea, then westward to Europe and eastward onto Mesopotamia and India. The Spice Trade of centuries past moved other aromatic spice and incense plants between Europe, India, and the islands of Indonesia via the Red Sea and the monsoon winds. The Silk Road brought the use of incense along with Buddhism from India, through China and on to Japan, where it arrived around the first century A.D.
In Japan, where some of the highest quality incense is manufactured today, the incense ceremony (kohdo, "way of incense") is still considered to be one of the most important traditional Japanese arts, along with tea ceremony (chado), flower arranging (ikibana), and the Japanese lyre (koto). Formal incense ceremony schools were established by the ruling classes during Japan's Edo period (1603-1867), though there was a decline in its practice in the 19th century due to the disintegration of the royal shogunate and the reopening of Japan and China with the ensuing westernization of these cultures. Fortunately, the craft and ceremony of incense were revitalized in the 1920's in Japan by descendants of the kohdo masters, and in the 1960's incense schools began offering classes again. There are many traditional incense companies in Japan that have been around for hundreds of years, some even from the 1500's, keeping this tradition alive by passing family trade secrets on from generation to generation.

Incense is historically used for a multitude of different reasons, especially ambient, medicinal, and spiritual applications. Because of its pleasing smell and relaxing effect, it is a simple way to enhance the atmosphere. Medicinal uses include boosting energy, inducing and promoting restful sleep, stimulating the libido, enhancing positive emotions, and reducing negative ones like anxiety and stress. It is also used to treat and prevent illness, primarily as a fumigation to drive off evil spirits, negative energy, and insect pests, or to clear the air of spores, allergens, and infectious microbes. The spiritual uses of incense are many. Incense smoke is seen as a way to attract the gods and sweeten prayers, and the rising smoke is said to carry both prayers and the spirit of the deceased up to heaven. It can also induce meditative states, dreams, and visions, and help with focus during prayer, the study of sacred texts, or the writing of illuminated manuscripts. It can even improve the acoustics in churches and other large spaces by buffering sound and, for those who practice plant spirit medicine, can help one accept communication directly from plants. It has been used to purify and sanctify spaces, people, and ceremonial objects, to mark celebrations and rites of passage, and is burned as a sacramental offering itself. Historically, before mechanical clocks, it was even used to track the passage of time during meditation, formal meetings, or at the geisha house.
Without exception, every single plant used in traditional incense is considered to be a medicinal plant. For example, in Japan natural incense is made with a base of tabu no ki, which is naturally water soluble, adhesive, odorless, and burns smoothly and evenly. This is the powdered inner bark of the katsura tree (Cercidiphyllum japonicum), an evergreen in the Magnolia family, which functions as both a natural binder and as a source of ignition. Other examples of important incense plants in this family include cinnamon, cassia, bay laurel, champa, nutmeg, mace, star anise, ylang-ylang, camphor, and magnolia. In India the traditional incense base is halmaddi (Ailanthus triphysa), which has an unusual hygroscopic (moisture retaining) property that makes Indian incenses feel characteristically damp to the touch. Halmaddi combined with honey is what gives most Indian incense its characteristically sweet note. Incense sticks get their distinctive aromas from the aromatics that are added to these bases: ground and powdered resins, barks, flowers, seeds, roots, leaves, fruits, twigs, rhizomes, bulbs, woods, lichens, seaweeds, and animal ingredients like ambergris and musk.
Synthetic incense is very different in composition from natural incense. Synthetic incense is typically made with a base of charcoal powder that is blended with sodium nitrate (salt peter), paraffin, or petroleum solvents to make it burn. This base is then mixed with a binder and glued onto thin bamboo splints which are dipped into synthetic petroleum-based fragrance oils. These synthetic aromas are favored by certain manufacturers because they are lower in cost, more consistent, can be used to create novel scents not found in nature, and are an ethical substitute for ingredients from endangered animal species like ambergris and musk. However, synthetic incense contains no actual medicinal ingredients so they do not have the same physical, emotional, and psychoactive properties of natural scents. Furthermore, the fumes from burning synthetic incense contain known carcinogens and allergens. Unfortunately, the smoke produced by synthetic incense is neuro-toxic and is known to cause asthma, skin reactions, nausea, dizziness, sneezing, and headaches. It is also a known irritant for sensitive mucus membranes like those found in the eyes, nose, and throat. As for testing and safety issues, there are no legal restrictions on the quantities or combinations of synthetic fragrance chemicals, the ingredients of these synthetic aromas do not have to be listed, and only a fraction of them have been tested for safety, so they are best to be avoided.
In closing I would like to offer the "Ten Virtues of Koh." Koh is the Japanese word for incense and this list was compiled by a 16th century Japanese Buddhist monk.