A patient's health status is assessed in the Chinese system of medicine through the measure of three basic polarities. These are" hot vs. cold," "exterior vs. interior" and "excess vs. deficiency," patients belonging to one type of polarity alone are almost nonexistent, and most patients tend to usually swerve towards one end of a polar type spectrum. For this reason, a five phase method of constitutional evaluation or referral system exist within traditional Chinese medicine to asses different types of patients and their polarities. As far as the use of the ginseng and other tonic herbs is concerned, the essential six principles of Chinese medicine are sufficient and can be used to come at an understanding of dosages required for any patient. In the Chinese system of medicine, cautious use or complete avoidance of the herbs and ginseng is usually required for the administration of any herbal remedy if the essential state is hot, excess and an exterior condition, while both the general herbal tonics and the ginseng can be given for the cold, deficiency, and interior patterns.
Patients in this essential state of "excess vs. deficiency" polarity are to use the ginseng and other tonic herbs - and this polarity is taken to be an important indication for using of the general tonic herbs as well as the ginseng remedy. The definition of the word "deficiency" in Western medicine as an absence of some health factor is not connected or related to the use of the word in the Chinese medicine term - for example a "calcium deficiency" and the Chinese medical idea of deficiency are different terms. A more accurate and sometimes used meaning of the Chinese medical term is "vacuity" or "emptiness" and the word deficiency in Chinese is often translated this way. Taking ginseng and other tonic herbs in excess polarity is not advised and can cause problems to the patient, aggravating the disorder in some cases, the ginseng and the other herbal tonics are contraindicated for all patients with excess polarity. Patients with deficiency polarity patterns can ideally benefit to a great extent from using the ginseng and the other herbal tonics and these remedies are often administered to patients with deficiency problems. Chinese ginseng in particular and the other ginseng species and herbal tonics are to be used with caution and care in only a single type of deficiency pattern apparent in some patients, this form of deficiency comes with heat signs and in these cases, dosage is usually restricted or the herbs are not used at all. In patients with heat sign patterns, the Chinese ginseng herb is contraindicated and avoided.
A fever is not necessarily the indication of the hot pattern in a patient; the heat pattern can be discerned on examination of the patient. This hot feeling is a subjective event, the actual temperature of the patient may be 98.6�F or in the normal range for humans. The pulse of the patient may be faster than it normally is, and the patient may develop redness in the facial region, patients are also normally agitated and very restless and may complain of heat in the body. In the same manner, the patients with a cold pattern are otherwise having a normal body temperature, they subjectively feel cold in the body and may complain about how cold they feel thought the skin is at a normal temperature. Cold patients may be characterized by a pale complexion, and similar to the hot patients have a quickened pulse rate at all times. As was mentioned previously, patients with heat sings suffering at the same time with the deficiency pattern are not given the Asian ginseng and the other herbal warming tonics and self-medication should not be carried out using these herbs and tonics. However, the hot and deficient pattern patient can ideally benefit from taking the American ginseng as an herbal remedy for his or her condition. For any patient suffering from cold or heat patterns, the appropriate herbal tonic is used as all the herbs have been classified as being either heating or cooling in effect and patients with one or the other signs are given the appropriate herbal medication.
The place of origin of symptoms determine the nature of the terms "exterior" and "interior" and such patterns determine the area of the body where the symptom are dominant in the patient. There is a concentration of the symptoms at the surface of the body in patients who are said to suffer from exterior patterns - these patients are affected in areas of the body such as the skin, the various external muscles, and areas such as the mucous membranes on the nose. Thus the term exterior pattern can be applied to the symptoms attributed to the majority of the common acute illnesses, including the various colds or flu, different allergies and allergenic reactions, problems in the muscle and problems such as joint aches, different types of headaches, and to skin rashes and other disorders. Interior patterns refer to all the other physical complaints that are not externally manifested and the treatment is different for the patients with such patterns. As the herbs can aggravate the exterior symptoms, the use of the ginseng and all the other herbal tonics are contraindicated in cases of patients suffering from exterior conditions. For example, while taking ginseng, if a patient suddenly develops a cold, he or she should stop taking the herb until the cold has subsided or the most acute part of the condition passes off and then resume taking the ginseng. Heat and cold signs can also characterize both the exterior and interior patterns affecting the patient, the ginseng and other tonic herbs normally contraindicate very apparent external symptoms and therefore these should be used with caution by all patients. The first priority for ill patients before beginning any self medication using different tonic herbs or the ginseng, is to go and consult a physician as a first step, the doctor may be from a Western or Chinese medical background - the priority however, is to find out what the illness is before starting on any treatment strategy.