Panax Ginseng is probably the single most famous herb out of the thousands that constitute the Chinese material medica. It is revered by the Chinese as a key herb to treat a wide range of illness and in ancient times its use was reserved exclusively for the Emperor even its Latin name means ‘to cure all illnesses’. Yet how can a herb that is held as the ‘King of the Myriad herbs’ by a medical system that spans over two millennia be recognized as nothing more than ‘a mild stomachic tonic and stimulant, useful in loss of appetite and in digestive affections that arise from mental and nervous exhaustion.’ by western medicine?

 

This review shall look at the history of ginseng and why it is held with such high regard by the Chinese. It will look into its many uses in Traditional Chinese Medicine and the different types of ginseng available. Finally it investigates the western scientific view of ginseng and their explanations for its efficacy.

 

Panax ginseng C. A. Mey is also known as true ginseng or Asian ginseng and belongs to the family Araliaceae. It grows in hilly, wooded areas mainly in Jilin, Liaoning and Heilongjiang provinces. Ginseng grown in Fusong of Jilin (Ji Lin Shen)is considered the best quality. Ginseng should only be cultivated during autumn between ‘white due and autumn equinox’ when it is six years old.

 

The herb consists of the dried root of Panax Ginseng, the other parts of the plant are removed. The rootlets (Shen Xu), the root neck (Ren Shen Lu) and even the leaves (Ren Shen Ye) all have their own pharmaceutical properties. The herb can be designated with different names depending if it is grown in the wild (Ye Shan Shen) or cultivated (Yuan Shen). It can be prepared in a number of different ways in order to slightly alter its property and leading to it receiving different names.

 

Much confusion has arisen around ginseng due to the fact that the same herb can appear with many different names and also the fact that the western name ‘ginseng’ has been given to a multitude of different herbs, whether they are from Araliaceae family or not. Some of these herbs have very similar actions to Ren Shen and some of them are simply named ginseng because they have the action of strengthening the internal organs.

 

It is unclear how long Ren Shen has been used as a medicine by the Chinese but it is know that the first book that mentions it is Shen Nong Ben Cao Jing (Shen Nong’s Classic of the Materia Medica), thought to have been compiled during the Han dynasty (B.C. 202 - A.D. 221), is most probably based on earlier writings.

 

 

Ren Shen is classified as a tonifying herb, this category of herbs is able to strengthen or supplement an area or process of the body that is insufficient or in a weakened state. These herbs assist the recovery of patients who have been ill with chronic or degenerative disorders by strengthening the various physiological processes of the body and supplementing insufficient substances.

 

Specifically Ren Shen is classified as being sweet and bitter in flavour, while being slightly warm in property. It acts on the channels of the spleen, lung and the heart. Its actions include strongly tonifying the Yuan (basal) qi, tonifying the qi of the lungs and spleen, promoting the generation of body fluids to stop thirst and benefiting the heart qi and calming the spirit.

 

Its action of tonifying the yuan qi is used to treat very severe cases of prostrational collapse showing symptoms of shortness of breath, listlessness, cold limbs, profuse sweating and a pulse so weak that it can hardly be felt (minute or weak pulse). This property can also help in cases of extreme deficiency after severe blood loss or prolonged illness.

 

By tonifying the lung qi it can treat lung qi deficiency syndrome with symptoms of wheezing, shortness of breath, coughing, asthenia, spontaneous sweating and a feeble pulse. This syndrome is usually combined with an inability of the kidneys to grasp the qi due to poor kidney function.

 

Ren Shen’s ability to tonify the spleen qi means that this is the key herb used when dealing with deficiency syndrome of the spleen and stomach with symptoms of lethargy, lack of appetite, chest and abdominal distension, chronic diarrhoea and even in severe cases prolapse of the stomach, uterus or rectum.

 

If the patient suffers from severe thirst as seen in diabetes or cases of high fever then Ren Shen can be utilized due to its ability to generate the body fluids and resolve thirst. It can also be used in consumptive diseases with manifestations of shortness of breath, thirst, profuse sweating and a feeble and thready pulse.

 

If the qi and blood have been damaged due to high fever, heavy sweating or chronic diarrhoea Ren Shen can be used to redress the balance.

 

By benefiting the heart and calming the spirit Ren Shen can be used to treat patients suffering from irritability, insomnia, forgetfulness, listlessness that are caused by a deficiency of both the spleen and the heart.be used to treat patients suffering from irritability, insomnia, ed  

 

Ren Shen can also be used to treat a number of other cases such as: impotence due to deficiency of the kidney and strengthening the body’s resistance and eliminating pathogenic factors. It is also used if a patient is too weak to endure strong purgative treatments and is often used in purgative formulas as a supplement to enhance the body’s resistance to disease.

 

All of these actions are explained in TCM by the nature and property of the herb and also the channels that it enters. As Ren Shen is slightly warm and sweet it is able to warm (improve) the function and nourish the organs that it enters. By nourishing and tonifying the lung it is able to treat the deficiency syndrome and also improve its functions drawing the qi downward to the kidneys. By tonifying the spleen it again can treat the deficiency syndromes of the spleen and stomach and improve the spleens function of sending clarity up to the lungs to once again improve their functioning and condition.

 

As the lung function is improved the quality of the qi sent down to the kidneys is improved and thus the kidneys functional ability is strengthened. The kidneys responsibility of sending up yin fluid to nourish the heart, spleen and liver is improved as a result of this. Because of the interrelation between all of the organs it can be seen how Ren Shen is said to strengthen all of the internal organs.

 

In the cases of blood and qi deficiency, by the tonification of the spleen and kidneys the production of blood and body fluids is improved. With the function of the lung spleen and kidneys both improved the condition of the qi will be maintained.

 

The bitter flavour of the herb is mild in comparison to the effects of its sweet and warm nature but it does help the action of the herb entering the heart channel and also supporting the function of the lung in sending down qi.

 

Even though the functions of Ren Shen have been well established in China for more than two thousand years, the theories of how it works are not easily adopted by western science. For a herb to be accepted in the west as a medicine, the exact reasons how a herb influences the body must be investigated. Ginseng has been researched extensively since the 1950’s as it began to become popular with consumers. Some of the properties of Ren Shen have been easy to prove in a laboratory but how all of these findings all relate to one another has been much more difficult for western bioscientists to understand.

 

On a chemical level 4-ring steroid-like chemicals with sugar attached called saponins seem to be the biologically active ingredients of Ren Shen. In the 1960’s the unique saponins in Ren Shen were identified and dubbed ginsenosides or panaxosides. Eleven major ginsenosides have been identified with a further nineteen that appear in smaller amounts in the different species of Ginseng. These levels tend to change depending upon the species and the type of preparation undergone by the herb (Hobbs 1996, p87)

 

The main area that has been investigated by researchers is the ability of Ren Shen to harmonize the interior of our bodies. In other words it promotes homeostasis. Not only has it been found to be able to restore homeostasis but also it has proven to the help the body cope with stress in a unique way. The forms of stress that were tested ranged from mild stressful situations to the extremes of sugary, X-ray bombardment, intoxication by strong chemicals and biological infection and exposure to very hot and very cold environments. Ren Shen does not act like a normal stimulant, in that causes pure excitation of the brain. Instead it demonstrates the ability to promote readiness to deal with stress and fight or flight arousal. Ren Shen clearly showed that it had the ability to improve the chances of survival in the extremes, where the application of stimulants, would if anything, make the subject more vulnerable.

 

In the west we have no one drug that is able to achieve this, we develop drugs that seek only to restore the balance to one specific area, i.e. lowering blood pressure but we need another drug to be used if we wish to raise blood pressure. We develop drugs to help the body resist X-rays, to remove poisons and to raise or lower blood sugar levels. Through extensive testing of Ren Shen it has been proven to work on all of these areas. Not only that but it ‘appears to have no apparent effect in the absence of stress. As soon as stress is applied it restores body processes to normal, whatever the direction in which they have strayed’. This ability of Ren Shen and other herbs in its class to restore harmony and reinstate homeostasis only when stress is applied, have lead to them being termed ‘adaptogens’.

 

Stephen Fulder, an esteemed Oxford-trained doctor of pharmacology, hypothesizes that the key to the action of Ren Shen is on the effects it exerts on the hormonal systems of the body. He believes the reason there are so many reports on the different effects of Ren Shen ranging from the blood pressure to blood formation, from the brain to the nerves and from the kidneys to the liver, is the one thing that links them all: the hormonal system. One group in particular seem to play a key role, these are the glucocorticoid stress hormones.

 

Through his investigations he was able to prove that the sites of action not only included the glands involved in stress reactions, namely the adrenal glands, the hypothalamus and the pituitary gland but also at the target areas of the hormones released by these glands. He found that Ren Shen enabled the adrenal glands to act more sensitively and effectively to stress by not only amplifying the effect of the hormones but also the quantities in which they are used. During stress, Ren Shen helped the adrenal gland mount an immediate hormonal response.

 

It also caused them to shut down quicker than normal after the stress ceased. If the stress was prolonged, Ren Shen was able to help the glands conserve their resources by reducing the amount released.

 

Numerous other studies have been carried out all around the world on Ren Shen. Its effect on the central nervous system has been proven to work by shortening the latency period of nerve reflexes, accelerated transmission of nerve impulses and strengthened conditioned reflexes. The cardiac system showed improved myocardial utilization of nutrients and cardiac function after taking Ren Shen, as well being able to stabilize blood pressure due to acute shock. Ren Shen is able to increase the synthesis of proteins and nucleic acids. In the treatment of mild cases of diabetes Ren Shen was able to lower the blood glucose level by 40-50mg% with results lasting up to two weeks. In moderate and severe cases however the herb did not have a significant impact on blood glucose levels and it was unable to treat the systemic symptoms of lassitude and thirst.

 

It can be seen why Ren Shen is held in such high regard by the practitioners of TCM. Its unique combination of range of effect combined with its potency has maintained its position as the ‘King of Herbs’. In the west herbs will always be met with skepticism, especially when they claim to be able to have effects on the body that no western designed drug can match. Even though its effects have been proven in many countries by numerous studies, Ren Shen is still to be accepted by the medical profession at large. This is chiefly because the majority of trials have been carried out on animals and when humans are used the trials are not ‘blinded’ and control groups are rarely used. This leaves very little data on its actual clinical efficacy. With time this may change as patients continue to demand better treatment and interest in alternative health systems increases.

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Fan W. (1996).  A Manual of Chinese Herbal Medicine : Principles & Practice for Easy Reference. Boston: Shambhala Publications Inc.

Fulder S. (1993). The Book of Ginseng : And Other Herbs For Vitality. Rochester: Healing Arts Press

Hobbs C. (1996). The Ginsengs : A Users Guide. Santa Cruz: Botanica Press

Reid, D. (1995). A Handbook of Chinese Healing Herbs. London: Simon & Schuster

Qu J, Zhang S andXie R. (1990). The Chinese Materia Medica. Shanghi: Publishing House of Shanghai College of Traditional Chinese Medicine