Ren Shen, also known as ginseng, is a perennial herb belonging to the genus Panax in the family Araliaceae. Ren Shen is a highly revered herb in traditional Chinese medicine (TCM) and has been used for thousands of years to promote overall health and well-being.The most well-known species of ginseng include Panax ginseng (Asian ginseng) and Panax quinquefolius (American ginseng), which have been used for their medicinal properties for centuries.
The ginseng plant typically grows in cooler, temperate climates and prefers well-drained, slightly acidic soil. It has a slow growth rate, taking several years to reach maturity. The plant features compound leaves consisting of three to five leaflets and produces small, greenish-white flowers that eventually develop into red berries.
The primary medicinal component of the ginseng plant is its root, which is harvested when the plant reaches 4-6 years of age. The root is fleshy, often resembling a human figure, and can vary in color from light yellow to dark brown. It is rich in bioactive compounds, including ginsenosides, polysaccharides, triterpenoids, flavonoids, and volatile oils. Among these, ginsenosides are considered the most pharmacologically active compounds, responsible for many of the herb's health benefits
In terms of TCM, Ren Shen has a warm temperature, sweet and bitter taste, and primarily affects the Spleen, Lung, and Heart channels. The typical dosage for ginseng root ranges from 3 to 9 grams per day as a decoction, 0.5 to 1 gram as a powder, and up to 30 grams in emergency situations.
Ren Shen has several key actions that contribute to its powerful healing properties:
Powerfully tonifies the primordial qi: Ren Shen is known to boost the body's vital energy or qi, providing a strong foundation for overall health and vitality. By replenishing the primordial qi, Ren Shen helps to enhance physical strength, increase energy levels, and improve resistance to illness.
Strengthens the Spleen and tonifies the Spleen qi: Ren Shen supports the proper functioning of the Spleen, which plays a crucial role in digestion and the transformation of food into energy. By strengthening the Spleen and tonifying its qi, Ren Shen aids in the digestion process, reduces fatigue, and promotes a healthy appetite.
Tonifies the Lungs and augments the qi: Ren Shen is known to benefit the respiratory system by tonifying the Lungs and augmenting their qi. This action can help alleviate symptoms of chronic respiratory conditions, such as shortness of breath, wheezing, and coughing.
Generates fluids and stops thirst: Ren Shen is effective in generating body fluids and alleviating thirst, which is particularly beneficial for those suffering from dry mouth or throat, excessive thirst, or conditions that cause fluid depletion, such as diabetes.
Benefits the Heart and calms the shen: Ren Shen has a positive impact on the cardiovascular system by benefiting the Heart and promoting mental stability. It is known to calm the shen (spirit) and reduce anxiety, stress, and insomnia.
Commonly reported adverse effects are nausea, diarrhea, euphoria, insomnia, headaches, hypertension, hypotension, vaginal bleeding, blood pressure abnormalities.
Ginsenosides
Ginseng contains active triterpene saponins called ginsenosides, which have various pharmacological effects such as aphrodisiac, anti-inflammatory, anticancer, antidiabetic, cardioprotective, gastroprotective, antiamnestic, and antioxidative properties. Ginsenosides are classified into two groups: 20(S)-protopanaxadiol (PPD) and 20(S)-protopanaxatriol (PPT). Ginsenosides have low oral bioavailability due to low membrane permeability and gastrointestinal degradation. They have been found to affect neurotransmission pathways and impact the immune, nervous, and cardiovascular systems. Generally, ginseng has a good safety profile with mild side effects like gastrointestinal and sleep disorders. However, ginseng toxicity mainly results from drug interactions with cytochromes P450 inhibitors and serotoninergic drugs.
Ginsenosides are believed to exert their effects by interacting with multiple cellular targets, such as receptors, enzymes, ion channels, and signaling molecules. These interactions result in a diverse array of biological activities, including:
- Anti-inflammatory effects: Ginsenosides can modulate the production of pro-inflammatory cytokines and other mediators, helping to reduce inflammation and alleviate inflammatory-related conditions.
- Antioxidant properties: Ginsenosides possess antioxidant activity, which helps protect cells from damage caused by free radicals and oxidative stress. This can contribute to the prevention of chronic diseases and support overall health.
- Immunomodulatory effects: Ginsenosides can influence the immune system by regulating immune cell function, promoting immune response, and enhancing resistance to infections and diseases. (Scaglione F, Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold [corrected]. Drugs Exp Clin Res. 1996;22:65-72.) (Hyun SH, Ahn HY, Kim HJ, Kim SW, So SH, In G, Park CK, Han CK. Immuno-enhancement effects of Korean Red Ginseng in healthy adults: a randomized, double-blind, placebo-controlled trial. J Ginseng Res. 2021 Jan;45(1):191-198. doi: 10.1016/j.jgr.2020.08.003. Epub 2020 Sep 16.)
- Neuroprotective effects: Ginsenosides can protect neurons from damage, promote neuronal regeneration, and improve cognitive function, making them potentially beneficial for neurodegenerative diseases and age-related cognitive decline.
- Adaptogenic properties: Ginsenosides are considered adaptogenic, meaning they can help the body adapt to various types of stress, thereby enhancing overall resilience and well-being.
- Anti-diabetic effects: Some ginsenosides can improve glucose metabolism and insulin sensitivity, which can help manage blood sugar levels in individuals with diabetes.( Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care. 1995;18:1373-5.)
Contraindications
Bleeding due to heat in the blood: Ren Shen is not recommended for individuals who have bleeding caused by excessive heat in the blood, as its warming properties may potentially worsen the condition.
- Hyperactive fire from yin deficiency: People with yin deficiency accompanied by hyperactive fire should avoid using Ren Shen, as its warming nature can further aggravate the imbalance and worsen symptoms such as night sweats, hot flashes, or insomnia.
- Hyperactivity of Liver yang: Ren Shen should not be used in cases of hyperactivity of Liver yang, which can manifest as symptoms like irritability, dizziness, or headaches. Since Ren Shen can be stimulating, it may exacerbate these conditions.
- High doses of caffeine: Ren Shen should not be taken with high doses of caffeine, as both substances have stimulating effects on the central nervous system. Combining them may lead to increased heart rate, blood pressure, and anxiety.
- Potential herb-drug interactions: Ren Shen may interact with certain medications, such as central nervous system stimulants, anticoagulants (blood thinners), and immunosuppressants. Therefore, it is essential to consult with a healthcare professional before using Ren Shen if you are taking any of these medications. Caution advised about concomitant use with phenelzine (Nardil), warfarin (Coumadin), oral hypoglycemics, insulin.
- Surgery: Research suggests that Ren Shen should be discontinued at least one week before surgery due to its effects on blood circulation. Ginseng may interact with anesthetic agents or increase the risk of bleeding during surgery.(Commonly Used Dietary Supplements on Coagulation Function during Surgery. Wang CZ, et al. Medicines (Basel). 2015;2(3):157-185. - Ren Shen, Ginkgo, Saint John's wort, etc.)
Cold or Warm?
Based on the different sources you provided from Ben Cao Gang Mu, the temperature of Ren Shen (ginseng) can be interpreted as follows:
Ming Yi Bie Lu(別錄) states that the nature of Ren Shen is slightly warm. Wu Pu Ben Cao(吳普本草) mentions that the nature of Ren Shen is somewhat cold with a reference of Shen Nong Ben Cao Jing
Zhang Yuan Su(張元素,장원소) describes Ren Shen as warm in nature, with a sweet and slightly bitter taste. It also says that it is light and ascending and contains both yang within yang and a slight amount of yin within yang.
《別錄》曰︰微溫. 普曰︰神農, 小寒. 桐君ㆍ雷公, 苦. 黃帝ㆍ岐伯. 甘, 無毒. 元素曰︰性溫, 味甘ㆍ微苦, 氣味俱薄, 浮而升, 陽中之陽也. 又曰︰陽中微陰.
Ben Cao Gang Mu states taht the temperature of Ren Shen is considered to be slightly warm or cold in nature depending on the source.
According to the passage from Shen Nong Ben Cao Jing, Ren Shen (ginseng) is described as having the following properties. The taste is sweet (味甘) and slightly cold (微寒) in nature. Ren Shen is known to nourish the five internal organs (补五脏), calm the spirit (安精神), stabilize the soul (定魂魄), relieve palpitations (止惊悸), expel evil qi (除邪气), improve vision (明目), open the heart (开心), and increase wisdom (益智). Consuming Ren Shen for an extended period can lead to a lighter body (轻身) and longevity (延年). The passage also mentions that different sources have varying opinions on the nature and taste of Ren Shen. Shen Nong considered it sweet and slightly cold, while others (Tong Jun and Lei Gong) described it as bitter. Qi Bo and Huang Di regarded it as sweet and non-toxic, while Bian Que believed it to be toxic.
味甘，微寒。主补五脏，安精神，定魂魄，止惊悸，除邪气，明目、开心、益智。久服，轻身、延年。一名人衔，一名鬼盖。生山谷。《吴普》曰∶人参，一名土精，一名神草，一名黄参，一名血参，一名人微，一名玉精，神农∶甘，小寒；桐君、雷公∶苦；岐伯、黄帝∶甘，无毒；扁鹊∶有毒。生邯郸。三月生叶，小兑，核黑，茎有毛，三月、九月采根，根有头、足、手，面目如人
Ren Shen in Shang Han Lun
This contradiction can be explained by historical context. The Song Dynasty's herbal medicine book, Zhen Lei Ben Cao(證類本草), which compiled herbs from before the Song Dynasty, describes various types of ginseng with illustrations. Among these illustrations, only the first one corresponds to the ginseng we know today.
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| Goya Choi· Literature Review of Korean Ginseng on the Classics of Oriental Medicine, The Korean Ginseng Research and Industry Vol 5, no 1, 2011 |
This shows that various types of plants were used under the name of ginseng at that time. In particular, Korean ginseng from the Goryeo, Silla, and Baekje (ancient nations in Korean peninsula) was highly valued. The active importation of these ginseng varieties to China began during the Sui and Tang Dynasties. It is difficult to assume that Korean ginseng was used before that, especially during the Han Dynasty. Therefore, the 'Shen Nong Ben Cao Jing' recorded that the nature of ginseng is cool, which corresponds to Chinese ginseng, which is likely wild ginseng. The ginseng used in the Treatise on Cold Damage Diseases is also considered to be wild Chinese ginseng. Thus, it is not appropriate to interpret the ginseng in the Treatise on Cold Damage Diseases as the current warm and potent tonic ginseng.
Gingseng and Sexual Function
Ginseng and Hypertension
Several modern literature often advises individuals with hypertension to avoid ginseng, particularly red ginseng, based on the assumption that its warm and Qi-raising nature may increase blood pressure. However, ginseng can both lower and increase blood pressure, depending on the patient's pattern in terms of Traditional Chinese Medicine (TCM).
Although the evidence for using ginseng to reduce blood pressure in hypertensive patients is not conclusive, some studies have shown positive effects. A systematic review and meta-analysis by Park et al. found that Panax ginseng supplementation led to significant reductions in various metabolic markers, including systolic and diastolic blood pressures, compared to a placebo group. This suggests that ginseng supplementation could help prevent the development of metabolic diseases by improving markers related to blood glucose, blood pressure, and blood lipids.(Park SH, Chung S, Chung MY, Choi HK, Hwang JT, Park JH. Effects of Panax ginseng on hyperglycemia, hypertension, and hyperlipidemia: A systematic review and meta-analysis. J Ginseng Res. 2022;46(2):188-205. )
Similarly, another systematic review and meta-analysis by Lee et al. evaluated ginseng's efficacy in treating hypertension. The results showed that Korean Red Ginseng (KRG) positively impacted blood pressure reduction in patients with pre-hypertension and hypertension, both acutely and long-term. However, North American ginseng did not demonstrate the same effect.(Lee HW, Lim HJ, Jun JH, Choi J, Lee MS. Ginseng for Treating Hypertension: A Systematic Review and Meta-Analysis of Double Blind, Randomized, Placebo-Controlled Trials. Curr Vasc Pharmacol. 2017;15(6):549-556. )
These findings indicate that the effects of ginseng on blood pressure may depend on the type of ginseng used and the specific population studied. It is crucial to consider the patient's TCM pattern when using ginseng for hypertension. KRG may be beneficial for some individuals, while others may not experience the same benefits or may even experience adverse effects.
In conclusion, ginseng, particularly Korean Red Ginseng, has shown promising results in managing hypertension. However, it is essential to consider the patient's individual TCM pattern and the type of ginseng used to determine the appropriate treatment approach. Just connecting Western diagnosis and TCM diagnosis and treatment can be quite stupid reasoning.
Ginseng and its Friends
Ren Shen, or ginseng, can vary its effects depending on the herbs it is combined with.
Zhang Yuansu stated, "When Ren Shen meets Sheng Ma, it is led to tonify the Yuan Qi of the upper jiao and clear fire from the lungs. When it meets Fu Ling, it is led to supplement the Yuan Qi of the lower jiao and clear fire from the kidneys. When it meets Mai Men Dong, it generates pulses(Sheng Mai), and when it meets Gan Jiang, it tonifies Qi."
元素曰︰人參得升麻引用, 補上焦之元氣, 瀉肺中之火;得茯苓引用, 補下焦之元氣, 瀉腎中之火. 得麥門冬則生脈;得乾薑, 則補氣.
장원소는 "인삼은 승마를 만나면 이끌어서 상초의 원기를 보해 주고 폐 속의 화를 쓸어내린다. 복령을 만나면 이끌어서 하초의 원기를 보해 주고 신(腎) 속의 화를 쓸어내린다. 맥문동을 만나면 원기[脈]를 생성시키고, 건강을 만나면 기를 보해 준다."라고 하였다.
Lee Gao explained that when Ren Shen encounters Huang Qi and Gan Cao, it provides a sweet and warm nature that dispels 'great heat', clears Yin fire, and supplements Yuan Qi. Furthermore, it is considered a miraculous medicine for treating wounds and injuries.
杲曰︰得黃耆ㆍ甘草, 乃甘溫除大熱, 瀉陰火, 補元氣, 又爲瘡家聖藥.
이고는 "황기ㆍ감초를 만나면 단 맛과 따뜻한 성질이 큰 열을 제거하고 음화(陰火)를 쓸어내리며, 원기를 보해 주므로 또한 창병의 성약으로 여긴다."라고 하였다.
Ren Shen's effects can be altered depending on the herbs it is combined with. By pairing it with different herbs, it can target various health issues, such as clearing fire from different organs, tonifying Qi, and even treating fever. This highlights the importance of understanding the properties of each herb and their synergistic effects when combined in a formula.
Seven 'Shen's
https://acupunctureherbalmedicine.blogspot.com/2023/04/five-shen-herbs-in-ahm.html