Materia Medica

Panax ginseng C.A. Meyer, Panax quinquefolius L.   Araliaceae.  The common name in both English and Chinese is ginseng.

History:  Panax ginseng has been used in China for thousands of years, perhaps for five thousand.  It grew wild in the same areas that now cultivate it, Korea, Manchuria and Siberia. The wild root is extremely rare in China, as it has been over harvested almost to extinction.  It has primarily been used to restore vital energy, particularly by the elderly and debilitated.  It is a main ingredient in literally hundreds of formulas in TCM.

Panax quinquefolius, the American ginseng, was known and used by various Native American tribes, including the Menominee, Cherokee, Chippewas and Creeks.  The uses varied from energy restorative, tonic, headaches, asthma, emphysema and fevers.  It was discovered in Canada by a Jesuit priest in 1711, and soon became a valuable export product to China.  The fabulous prices being paid for the root ($1 per pound) encouraged the harvest to spread into the Midwestern United States and Appalachia.  It provided a valuable income for frontiersmen, and even Daniel Boone became a well-known ginseng digger.   The ginseng trade with China was damaged in 1752 by the sale of poor quality roots, and took a number of years to recover and then selling at lower prices.  Records of ginseng export have been kept since 1821, in which year 352,992 pounds were shipped out.  By 1981, 496,037 pounds were exported.

Cultivation of American ginseng had begun as early as 1891.  Wisconsin is the primary producer of  ginseng at this time.  Wild ginseng has become extremely rare, although some ginseng is being woods cultivated and is considered better quality than the cultivated.  In 1983 prices, wild ginseng was selling for $260 a pound, while the cultivated sold for $75 a pound.

Ginseng was historically not a popular herb in Western medicine.  It was official in the U.S. Pharmacopoeia from 1840-1870.  It was considered little more than a mild digestive tonic and gentle stimulant. 

Ginseng is a perennial that grows in the cool, rich soil of hardwood forests.  It is less than a foot tall with three to seven compound leaves.  It bears clusters of red or yellowish fruit in which there are a number of seeds.  It is a slow maturing plant and should not be harvested until it is at least three years old.  There are seven species in the Panax family, and all appear to have some tonic and restorative properties, but only ginseng and quinquefolius are considered to be tonics of great superiority.

Due to the popularity of ginseng, there is a bewildering array of products in the marketplace claiming that they contain ginseng, including soft drinks, liqueurs, wines, candy, gum, power bars and cosmetics.  The supplement market includes teas, instant and teabags, tablets, capsules, varieties of extracts and tinctures, and whole root.  Many of these products have negligible amounts of ginseng and even previously extracted roots have been used in unscrupulous products.  Some products are standardized to at least 4 or 5 percent ginsenosides and that can help as a guide to buying.  It is frequently found in formulas with other herbs, and, indeed, the Asians believe that it is better to take it in combination with other herbs.

American ginseng (P. quinquefolius) is a white ginseng, which is either cultivated, woods cultivated or wild.  Asian ginseng  (P. ginseng) is classified by where it is grown, how it is processed and the age and quality of the root.  It is mostly grown in China or Korea and sometimes has a province name attached also.  The white roots are dried with no extra processing.  The red root is made by steaming the roots for several hours, then drying them over a low fire or in the sun; resulting in a root that is hard and brittle with a translucent, reddish color.   The Chinese classify the quality and age of the roots by the terms heaven, earth and man.  The heaven quality is the best, selling for up to $1000 an ounce. 

Saponin glycosides, called ginsenosides are considered the primary active ingredients.  Most of these appear in pairs with antagonistic effects, giving one probable reason for reports of opposite effects of ginseng.¹  This is part of the reason it is considered an adaptogen, and provides a nonspecific resistance to various kinds of stress.²  Although many studies conducted do not meet current standards, there is good indication that ginseng  does increase resistance to stress and improves learning and memory.  It modulates immune function, neuroendrocrine system activities, cellular metabolic processes and cardiovascular activities.³  It has also been shown to have antihepatotoxic actions, the red ginseng being stronger than white.⁴

There are also flavonoids that influence cardiac performance.  Polysaccharides  have been isolated that stimulate phagocytosis and modulate the immune system.  It has beta-sitosterols that may have estrogenic activity.  It appears that, in general, there is such a wide range of therapeutic actions that are produced by multiple constituents that it is advisable to use products that are made from the whole root.⁵

The German E Commission considers it a “tonic for invigoration and fortification in times of fatigue and debility, for declining capacity for work and concentration, and also during convalescence.”⁶  It is considered particularly useful for the aging and those convalescing from illness, and has been used extensively by the Chinese for these purposes.

 It is considered a Chi energy tonic.  The red Panax is considered a hot, energetic, yang tonic.  The Chinese white being cooler and less energizing, and American white being even cooler and classified as a yin tonic.  It is usually taken in combination with other herbs in TCM.  It is not taken for overt illness, but used during times of wellness for its tonic effects.

American and Asian ginseng, though considered different species, are virtually identical in appearance and chemical composition.  The Chinese maintain that there is a difference.  They consider the American variety to be cooler, causing less excitation, better for summer and warm climate use. 

The major active compounds are a group of  saponin glycosides that are collectively called ginsenosides or panaxosides.  There have been 28 ginsenosides found throughout the plant, including leaves and flowers.⁷  There are twelve major ginsenosides that are considered the most important are located in the root, and these are in variable amounts according to the species, age, location and drying method.   In addition to the saponin glycosides, ginseng contains flavonoids, essential oils, beta-sitosterol, carbohydrates, sugars, organic acids, nitrogenous substances, amino acids, peptides, vitamins and minerals.

The dosage is 1 to 2 grams of the root daily or the equivalent preparation.  It is usually taken for a fairly long period of time, such as three months.  After a short break it can then be resumed for another three-month period. 

Ginseng should not be used by children, in pregnancy or with high blood pressure, headaches, heart palpitations, fever, emotional or psychological imbalances, caffeineated beverages.  Diabetics should monitor their blood sugar as ginseng can be hypoglycemic.

 Nervousness, excitation and insomnia have been reported as side effects. There was a controversial report describing “ginseng abuse syndrome,” but this has been largely discounted because of poor controls.⁸   There have also been several reports of estrogen-like effects from ginseng, such as vaginal bleeding. 

Concurrent use with phenelzine has resulted in manic symptoms.⁹ There is evidence it should be avoided with blood thinning remedies, such as warfarin.¹⁰