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Panax: Indications and contraindications for ginseng and other “chi tonics.”

by Michael Tierra, C.A., O.M.D.

Medical Herbalism 2(3):1,4

[Ed. Note: Because appropriate ginseng use is best understood in the paradigm of Chinese medicine, we have invited Dr. Tierra to write the following article. Tierra is author of The Way of Herbs, and Planetary Herbology, and co-author of the East-West Herbal Correspondence Course, integrating western herbs and oriental medical approaches.

Chinese medicine terminology (from Bergner)

Ginseng is appripriate for “deficiency” or “emptiness” or “vacuity”  conditions, in Chinese terminology

Deficient chi: signs: general weakness or lethargy; shallow respiration; weak pulse; quiet voice; little movement; pale tongue; pale, puffy face; poor appetite; spontaneous daytime sweating.

Deficient yang: Deficient chi may progress to deficient yang with additional signs of coldness, that is, slow pulse, aversion to cold, white tongue coat, and undigested food in the stool.

Deficient blood: The Chinese concept of blood is not identical with that of Western medicine. Signs of deficient blood include: pale face, tongue and lips; thinness and emaciation; “thin” pulse (narrow like a thread); dizziness’ scanty menses; dry skin and hair; poor vision or spots before the eyes.

Deficient yin: Deficient blood pay progress to deficient yin: as the cooling a lubricating  qualities of the fluids are lost, the patient may exhibit signs of ‘false heat”: warm hands and feet, red tongue and cheeks, faster pulse, thirst, night sweats, insomnia.

[Tierra sections starts]

Chinese ginseng (Panax ginseng) is classified in the Chinese materia medica as a chi (energy) tonic, having a sweetish, slightly bitter flavor and warming energy. It enters and affects the organs and meridians of the spleen, lung and heart. Its function is

1. to replenish vital energy

2. to promote the secretion of body fluids.

3. to tonify the spleen and lung.

4. sedative, cardiotonic and antifatigue.

 It is often used for shock and prostration, diarrhea and loss of appetite, dehydration, diabetes, palpitation, insomnia, forgetfulness, fatigue and weakness.

 The recommended dose is 2 to 9 grams of the root. taken two or three times daily.

 Ginseng is contraindicated for individuals with genuine inflammatory symptoms, infections, colds, flus and acute disease. [Clinical question—do you instruct a patient using ginseng to discontinue use during a cold or flu? —editor] While it is thought to be a yang natured herb (because it tends to raise metabolism), it also has definite yin (essential substance) tonic properties. Thus besides increasing energy in one who is severely depleted, it is also the most effective herb for quenching thirst, a quality associated with the moist aspects of yin energy.

 Dr. Henry Lu says that ginseng is the most effective herb when there is any genuine deficiency in the body—a deficiency of energy, blood, yin or yang aspects. It is equally good for women when a clear deficiency of any of these attributes is present.

 The contraindications for the use of ginseng involve acute stagnation and congestion. Taking ginseng with such a condition can cause an aggravation of acute syumptoms and further symptoms of congestion and stagnation. I have known individuals who have inappropriately used ginseng over a long period without adding herbs to break up the congestion and suffered from ginseng abuse syndrome—a feeling of heaviness, aggressiveness, and chronic spasmodic pains.

 For these reasons one must observe due precautions when using a full substantial dose of ginseng. One way is to prescribe it only when there is a clear indication of energy or blood deficiency, and to begin tentatively with a low dose. If ginseng is either appropriate or inappropriate it will be clearly observed within the first three days to a week of use.

 Another method is to take a cholagogue and possibly a laxative to relieve the congestion before taking ginseng or other chi tonics. The most common method if one is not sure of the particular situation for which ginseng might be applicable is to combine a smaller amount of carminative herbs such as citrus peel or fresh ginger to help circulate the energy of the ginseng. Finally, make ginseng-rice porridge by slowly cooking ginseng on the lowest possible heat for six to eight hours using one cup of rice to seven to ten cups of water. This is the best way to smooth out the effects of ginseng and utilize the powerful nutritive powers of the two ingredients.

 Ginseng is generally very good for men from the age of 40 on to take in a small amount of one to two grams daily. Younger men should not take too much ginseng as it may overstimulate sexual energy.

 Stress and anxiety is often a kind of excess for which Chinese or the warmer Korean Ginseng may not be appropriate. The more bitter American Ginseng (Panax quinquefolium) American ginseng is more yin and cooler and is less stimulating and more appropriate for stress. For this reason Chinese herbalists and pharmacists living in stressful urban environments favor taking American ginseng over their own Eastern variety.