The Ups and Downs
of Self-Prescribing;
A Tale of Two Man Roots
By Piper Dunlap, L.Ac.

Korean Ginseng (Panax ginseng) is the most famous, and perhaps the most misused of the Asian adaptogens. Ren Shen is its Chinese name, which means “man’s plant” or “man root,” a reference both to its appearance and to its most renowned action. It enjoys an almost mythic reputation as an energy and sexual tonic, commanding spectacular prices, especially for the wild-crafted herb. You will always find it displayed front and center in any authentic Chinese herb apothecary.

Ren Shen treats impotence (among many other things), but not all types! As with most Chinese herbs, it is best taken in a formula with other herbs, yet many people, mostly men, self-prescribe it as a single herb. There are literally thousands of Chinese and western ginseng products that include so little of the herb that they are harmless but ineffective. When taken at a sufficiently high dosage, however, especially without other buffering herbs, it can cause unpleasant and even dangerous side effects. This happens when the actions or effects of the herb do not correspond with the Chinese medical diagnosis (called pattern or syndrome). That is to say, when it is the wrong medicine for the job.

A typical case of inappropriate use of Ren Shen goes something like this: John, a middle-aged businessman has noticed that his libido and sexual performance aren’t what they used to be, and a friend tells him about how Korean ginseng helped him with a similar problem, but only after he found the good stuff in Chinatown. Following his buddy’s directions, John finds the herb shop next to the butcher with whole chickens and ducks, feet, heads, and all, hanging in the window. The ancient pharmacist is happy to take John’s money for a few ounces of the second best quality Ren Shen that he has. (The shopkeeper keeps the best for himself!)

John prepares the root as instructed and drinks the tea religiously for three days at which point he develops a mild but persistent headache and realizes that he hasn’t slept well for the past couple of days. His vision seems blurred and his face and eyes are redder than usual. John stops drinking the tea and tells his friend about what has happened. His friend shrugs and doesn’t understand since the herb was working so well for him. John goes back to the herb shop and tells the old pharmacist who smiles and says that John must be too “hot” to take Ren Shen. “You try the American kind. It’s cooling. I have some of high quality.” But by this time John has lost his sense of adventure and his faith in the herbal approach. He goes to his M.D. and gets a prescription for Viagra, swearing off ginseng forever and maybe even herbs in general.

Over the years I’ve heard many variations on this unfortunate story. Had John consulted an herbalist first and taken his prescription to the herb pharmacist instead of the advice of his friend, he would have had a far better chance of a good outcome, and he most likely would not have been given Korean ginseng. The pharmacist was right, if a little late, in his assessment. John was too “hot” to take the famous root. His Chinese diagnosis (or pattern) is Liver and Kidney Yin deficiency with some deficiency of Essence and some Liver Fire. John’s friend couldn’t have known that unless he practiced Chinese Medicine or was at least a good student of it. John’s friend has Kidney Essence and Yang deficiency, so the Korean ginseng worked for him. To oversimplify, it is a matter of hot and cold, yin and yang. John would have been better off with American ginseng (Panax quinquefolium) though as a single herb it would not have been as effective as its Asian cousin was for John’s buddy. Best would have been a complex herb formula tailored to John’s complete picture as it is seen through a comprehensive intake made by a practitioner of Chinese medicine.

Before I studied Chinese medicine I used to wonder why some people who take Echinacea and Goldenseal to fight colds have stellar results, while others seem to get dramatically worse with this remedy. Now I get it. In Chinese medicine we differentiate between different cold presentations. The same virus can cause different symptoms in different people and should be treated differently. Some have cold cold symptoms like sneezing, chills, copious clear nasal discharge, etc., and should be treated with warming herbs. Others develop hot cold symptoms like fever, cough, sore throat, sweats, thick yellow nasal discharge, and they should be treated with cooling or cold herbs. Echinacea is a cool herb with great immune up-regulating properties and could be helpful for either presentation, but Goldenseal, though possessing great anti-viral properties, is a very cold herb and will invariably make a cold cold person feel worse.

The good news is that there are literally hundreds of Chinese herbs, besides the most famous one, that can be used to treat all conditions using a system that is elegant, highly refined, and time tested. And the moral of the story is that if you, as a healthcare consumer, are going to use this brilliant medicine, it’s best to get the help of one of its licensed practitioners.

Piper Dunlap, L.Ac. practices Chinese medicine in Port Townsend, Washington and can be reached at piperdunlap@gmail.com.