Ginseng (Chin. ren shen, 人参) is a renowned herb known for its adaptogenic properties. It is considered one of the oldest and most well-known herbs in the world. According to Chinese beliefs, ginseng possesses exceptional abilities to absorb strength from the earth, making it highly valued as an herb for nourishing qi, the vital energy.

The earliest written reference to ginseng can be found in the Classic of the Materia Medica (Chin. 神农本草经 Shennong Bencao Jing), which was written between 206 BC and 220 AD. Shennong (Chin. 神農), commonly known as the "Divine Farmer," was a legendary figure in Chinese mythology. He is credited with introducing essential agricultural practices, such as the use of the plow, and teaching humans about medicinal plants. It is in this context that ginseng is mentioned for the first time in traditional texts, indicating its early significance in Chinese culture.

Ginseng has been clinically known in China for thousands of years. The herbal root is named ginseng because of its resemblance to the shape of a man. In fact, the term 'ginseng' represents two Chinese ideograms: "ren" (人) which means "man," and "shen" (参) which signifies 'essence'. It is believed to encompass the three aspects of man: body, mind, and spirit. Consequently, it is also referred to as the "king of herbs." Ginseng can be classified into three categories based on its growing environment:

  1. Ginseng cultivated on a ginseng plantation is typically harvested four to six years after being planted.
  2. Ginseng cultivated in the wild, in a natural environment.
  3. Wild ginseng is naturally found in the deep mountains. It is the wild-growing form and is considered to be the most potent. However, it has become so scarce that harvesting it has become prohibitively expensive. As a result, it is only used in the most severe cases of Qi deficiency or collapse, if used at all. These roots may have been grown for 10+ years before being harvested.

Different processing types of ginseng

  1. Fresh ginseng: This is ginseng in its original form after four to six years of cultivation.
  2. White ginseng: This type of ginseng is obtained by peeling and sun-drying 4- to 6-year-old ginseng roots until the moisture content is reduced to below 14%. It can be stored for extended periods and is commonly used in herbal medicine and tea. White ginseng can have various shapes, such as straight, curved, half-curved, or tail ginseng. It is considered the best type of ginseng for simultaneously tonifying Qi and nourishing Yin fluids. After harvest, it undergoes a cleaning process where rootlets are removed, followed by sun-drying or drying on indoor drying racks. Indoor drying is preferred to preserve the therapeutic actions of the ginseng, as sun drying may bleach the root to an attractive pale yellow color but could potentially diminish its therapeutic properties.
  3. Red ginseng: This type of ginseng is produced by steaming and drying fresh ginseng.

Different varieties of ginseng

Different varieties of ginseng belong to the Panax genus, which is a part of the Araliaceae family, commonly known as the ginseng family. While there are several species within the Panax genus, all of them share the common name "ginseng."

  1. Ren Shen (Panax ginseng): Also known as Chinese or Korean ginseng, it is the most well-known variety. It primarily grows in northern China and Korea, along a mountain range shared by both countries. The roots of Ren Shen are typically cultivated for a minimum of 5 years before being harvested.
  2. American ginseng (Panax quinquefolius): American ginseng is found in the wild from Quebec and Manitoba in Canada south to states like Alabama, Oklahoma, and Florida (although it is scarce in the wild). Indigenous communities in these areas traditionally used it for various medicinal purposes, such as indigestion, sore eyes, earaches, menstrual cramps, fever, and bronchitis. Most American ginseng is now cultivated in Wisconsin and Canada, with a significant portion being exported to Asia. Wild American ginseng is native to the Appalachian Mountain region of the United States. The roots of wild plants are harvested after 8–10 years of growth. Wood-grown American ginseng refers to the cultivation of ginseng within the forest environment, where the soil is mounded to enhance production while maintaining the plant's natural habitat. These ginseng plants are typically harvested after 6–8 years of growth. On the other hand, cultivated American ginseng is grown in fields under tarps, primarily in Canada and Wisconsin. This method allows for faster crop development, with ginseng ready for harvest within 3–4 years.
  3. Dwarf ginseng (Panax trifolius) is a subspecies of American ginseng that predominantly grows in the southern Appalachians, although its range extends from Nova Scotia to Georgia. Native American tribes utilized the root of this plant to treat headaches and nervous conditions, while the whole plant was used for various ailments such as colic, cough, indigestion, rheumatism, and skin problems.
  4. Tian qi ginseng (Panax notoginseng) is a plant with seven leaflets, distinguishing it from Panax ginseng, which typically has five leaflets. It is found in the wild and cultivated in China's Yunnan province. Also known as pseudoginseng or noto-ginseng, it is sometimes used as a substitute for Panax ginseng as a tonic, although it is not considered an adaptogen. In Chinese hospitals, it is employed in emergencies to stop bleeding, reduce pain, alleviate swelling, and redirect blood flow away from injuries. It is also commonly prescribed for excessive blood loss, blood in the urine, or blood in the lungs, with a typical dose ranging from 5 to 10 grams in decoction form. It can also be consumed in powdered form mixed with water, typically in doses of 1-3 grams.
  5. Himalayan ginseng (Panax pseudoginseng subsp. himalaicus) is a subspecies native to Tibet and western Bhutan. Its ginsenoside content and medicinal properties lie between those of Korean and Japanese ginseng. Some botanists classify this subspecies as Japanica.
  6. Japanese ginseng (Panax japonicus) has been cultivated in Japan since 1607. It grows in mountain forest areas and reaches a height of around 50-80 cm. It has four to seven leaflets, pale green flowers, and red fruits. Japanese ginseng is commonly used for treating heart palpitations, fluid around the heart, lung congestion, and digestive problems such as nausea and poor appetite. It is also known to help lower fevers, alleviate coughs, and manage asthma.
  7. Siberian ginseng (Eleutherococcus senticosus) is native to Russia, particularly Siberia. While it has a history of medicinal use in China, it is not as popular as Panax ginseng. Siberian ginseng is renowned for its effectiveness in treating rheumatism, weak or debilitated conditions, and improving overall health by increasing endurance and mental performance.

How to consume ginseng?

When consuming ginseng, it is available in various forms, such as tea, tincture, or capsule (generally 300 to 500 mg). Tinctures tend to act faster due to the partial breakdown of components during the tincture-making process. However, fast action is not necessarily required for a tonic. A typical dosage is one to three pills, a few cups of tea, or one to three dropperfuls of tincture daily. Since ginseng is a popular herb, it is often included as part of a formula, blended with other herbs and sometimes nutritional supplements. In such cases, the recommended amount of the formula is usually the same as that for ginseng alone. The optimal time to consume ginseng is between meals, although exceptions can exist depending on the individual and their condition.

To prepare ginseng tea, bring a teaspoon of sliced or powdered ginseng root per cup to a boil in a pan of water. Let it simmer very gently for 20 to 30 minutes, then remove from heat and let it steep for at least another 20 minutes. After steeping, strain out the ginseng, and the tea is ready to drink. If you want to make a larger quantity of tea to last for a few days, you can store it in the refrigerator. It's worth noting that the second batch of tea made from the same roots will not be as strong as the first. If you have whole roots, you can soak a piece overnight to soften it before cutting.

Contraindications

When it comes to contraindications, ginseng is generally considered safe with few side effects. However, individuals with hypertension or diabetes should use ginseng in very small amounts and monitor their response. Ginseng can be too stimulating for people who are manic, schizophrenic, or highly nervous, so caution should be exercised. If you take antipsychotic drugs, it's important to be extra cautious about using ginseng. Additionally, ginseng may interfere with the absorption of certain pharmaceutical drugs and can alter hormonal treatments. It's advisable to avoid combining ginseng with stimulants like coffee, as it can result in overstimulation of the body.

Excessive consumption of ginseng, particularly at extremely high doses like 50 grams per day or more, has been associated with adverse effects such as depression and nervous system problems. Most scientific studies typically use moderate amounts, ranging from three to nine grams per day. Taking more than the recommended dose is not advisable. It's important to note that even large amounts, such as 10 grams, are not absorbed by the body as effectively as smaller doses. When ginseng is taken in excessive quantities or over an extended period, potential side effects can include heart pain and palpitations, vomiting, earaches, nosebleeds, decreased sexual potency, headaches, itchy skin eruptions, diarrhea, and a low white blood cell count.

The Chinese view of ginseng

In traditional Chinese medicine, herbs like ginseng are evaluated based on their energetic properties, which include heating, cooling, expanding, or contracting effects. It also examines the herbs' capacity to direct or regulate qi, the fundamental energy or life force within the body.

As a tonic herb, ginseng is commonly included in formulas that aim to strengthen weak conditions such as general fatigue, weakness, anemia, lack of appetite, shortness of breath, nervous agitation, forgetfulness, thirst, and impotence. It is rarely used as a standalone herb in Chinese medicine but is often combined with other herbs to enhance various types of treatments. However, in traditional Chinese medicine, ginseng is believed to be incompatible with certain conditions or individuals. For example, due to its warming nature, it is generally not given to individuals with a fever or infection. Similarly, individuals who exhibit excessive heat in their bodies, such as those who are hot-tempered, physically strong, and have a strong sexual drive, may experience a "burnout" effect from taking ginseng. It's worth noting that a healthy and energetic individual under 40 years of age typically does not require ginseng unless they show specific physical deficiencies.

In Traditional Chinese Medicine (TCM), ginseng is classified as a "qi deficiency tonic herb." It is known for its ability to replenish the "Four Treasures" of the body, namely qi, blood, yin, and yang. With its warm nature, ginseng is beneficial for individuals who have excessive "cold" in their body, such as those with yin excess or yang deficiency, helping to restore a harmonious balance between yin and yang. With its bitter and sweet taste, ginseng has cleansing properties, aiding in heat clearing, dampness drying, and facilitating elimination through urination and bowel movements. It can also alleviate acute reactions, support detoxification, and tonify the body. Ginseng is particularly targeted at nourishing the heart, lungs, and spleen.

The uses of ginseng in traditional Chinese medicine

Ginseng has long been utilized in traditional Chinese medicine, and its significance is evident in the Treatise on Cold Injury (Shanghan Lun), written in 220 AD. This book outlines 107 formulas compiled by the physician Zhang, with ginseng being a key ingredient in 21 of them, underscoring its importance in herbal medicine. Ginseng is primarily employed to address symptoms associated with qi deficiency. It proves beneficial in cases of spleen-qi deficiency, characterized by weakness, poor appetite, loose stools, emaciation, edema, and prolapse of the anus. It is also effective in treating lung-qi deficiency, which manifests as a lack of desire to talk, a low voice, shortness of breath, spontaneous sweating, or dyspnea during physical exertion. Vigorous qi can benefit blood production, as qi governs the blood. Therefore, ginseng and other qi tonics are also used for conditions such as blood-deficiency and bleeding syndrome caused by qi deficiency. When taking qi tonics, individuals may experience feelings of chest fullness and poor appetite. These symptoms arise due to blocked qi in the body. As a result, qi tonics are usually prescribed together with a small amount of Chinese medicinal herbs that stimulate qi circulation and strengthen the stomach.

In China, ginseng is primarily produced in the provinces of Jilin, Liaoning, and Heilongjiang. Among these provinces, the ginseng from Fusong County in Jilin Province is considered the highest quality. There are two types of ginseng: wild ginseng, also known as "mountainous ginseng," and cultivated ginseng, known as "garden ginseng." Cultivated ginseng is usually harvested in the autumn and undergoes various processing methods, such as drying in sunlight, steaming, or stir-baking with sugar. Depending on the specific processing method, the ginseng is classified as sunlight-dried ginseng, red ginseng, or sugar ginseng. On the other hand, wild ginseng is dried naturally in the sunlight without any additional processing, and it is referred to as "dried wild ginseng." The head of the ginseng is typically removed, and it is sliced for use.

TCM medical properties of ginseng

Sweet and slightly bitter in flavor, warm in nature, and attributed to the spleen, lung, and heart meridians, ginseng invigorates renal qi, strengthens the qi of the spleen and lungs, promotes the production of body fluids to quench thirst, and calms the mind to promote intelligence. In traditional Chinese medicine, ginseng is used for various purposes.

  1. Collapse syndrome due to qi deficiency manifests as shortness of breath, fatigue, a feeble pulse, and extreme weakness following severe disease, prolonged illness, heavy blood loss, or severe vomiting. It is recommended to prepare a thick decoction of single ginseng in large quantities, known as Dushen Tang (Decoction). In cases of yang depletion, such as qi collapse accompanied by sweating and cold extremities, it is used in combination with Fuzi.
  2. Deficiency of the spleen is characterized by fatigue, poor appetite, fullness in the upper abdomen, or diarrhea, along with qi deficiency and weakness resulting from various factors.
  3. Deficiency of lung qi presents as shortness of breath, weakness, a feeble pulse, and spontaneous perspiration.
  4. Diabetes causes thirst due to the consumption of body fluids. For febrile diseases involving both qi and body fluid depletion, characterized by excessive sweating, shortness of breath, or a weak and thin pulse.
  5. Deficiency of both qi and blood can lead to inadequate nourishment of the heart, resulting in symptoms such as palpitations, amnesia, insomnia, or weakness. Ginseng is commonly combined with Danggui (Radix Angelicae Sinensis), Suanzaoren (Semen Ziziphi), and Guiyuanrou (Arillus Longan) to replenish heart-qi and calm the mind. An example of such combination is Guipi Tang (Decoction).
  6. Deficiency of both qi and blood or blood deficiency syndrome may require specific treatment approaches. In cases of combined qi and blood deficiency, it is common to use ginseng together with Shudihuang (Radix Rehmanniae Praeparata), such as in the form of Liangyi Gao (Soft extract). When addressing blood deficiency alone, ginseng can be combined with blood tonics like Danggui (Radix Angelicae Sinensis) to enhance its effectiveness.

In addition, ginseng is recommended for treating impotence caused by kidney deficiency. It can be used in combination with yang-invigorating tonics to address this condition. Furthermore, when there is susceptibility to pathogenic factors due to weakness, ginseng is used in conjunction with other herbs to strengthen the body's resistance to disease, promote healthy qi, and eliminate the pathogenic factors.

Usage and dosage

The recommended dosage for ginseng is 5–10 grams in decoction form. It should be individually decocted over low heat and mixed with decoctions of other herbs before consumption. Alternatively, the powdered form of 1-2 grams can be swallowed. In the case of collapse syndrome, a larger dosage of 15–30 grams can be used in decoction, divided into multiple administrations. Ginseng is contraindicated for individuals with sthenia and heat syndrome without a deficiency of healthy qi.

Famous TCM prescriptions containing ginseng

  1. Si Jun Zi Tang (Four Gentlemen Decoction) is a well-known Chinese medicine formula that contains ginseng as one of its principal ingredients. It was invented in 1107 AD and belongs to the category of formulas that tonify Qi. Its main actions are to tonify Qi and strengthen the spleen and stomach. However, long-term use of this formula may result in a dry mouth and thirst. From a modern medicine perspective, these patterns can contribute to various conditions such as chronic gastritis, peptic ulcers, or irritable bowel syndrome.
  2. Liu Jun Zi Tang (Six Gentlemen Decoction) is a Chinese medicine formula that was created in 1107 AD. It is known for its ability to tonify Qi and is used for conditions such as anorexia, acid reflux, and peptic ulcers. The mother formula of Liu Jun Zi Tang is Si Jun Zi Tang. In addition to tonifying Qi, it also strengthens the spleen and stomach, clears phlegm and mucus, and promotes appetite.
  3. Gui Pi Tang (Restore the Spleen Decoction) is another Chinese medicine formula that was invented in 1529 AD. It is primarily used for conditions such as anemia, colitis, and anxiety. Gui Pi Tang tonifies and nourishes the Qi and blood of the heart and spleen. In modern medicine, this prescription is also used to treat abnormal uterine bleeding, heavy menstruation, or late menstruation, among other conditions.