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Curr Res Complement Altern Med, an open access journal
ISSN: 2577-2201
1Volume 2018; Issue 01
Current Research in
Complementary & Alternative Medicine
Review Article
Forman M and Kerna NA. Curr Res Complement Altern Med. CRCAM-133.
Merging Ayurvedic Ashwagandha with Traditional Chinese
Medicine Part 1. Foundation in Ashwagandha: Physiological
Effects, Clinical Efcacy, and Properties
Michael Forman1,2 and Nicholas A. Kerna1*
1College of Medicine, University of Science, Arts and Technology, Montserrat, BWI
2Atlantic Institute of Oriental Medicine, USA
*Corresponding author: Nicholas A. Kerna, College of Medicine, University of Science, Arts and Technology, 4288 Young eld
Street, Wheat Ridge, CO 80033 USA. Email: nicholas.kerna@usat.edu
Citation: Forman M, Kerna NA (2018) Merging Ayurvedic Ashwagandha with Traditional Chinese Medicine Part 1. Founda-
tion in Ashwagandha: Physiological Effects, Clinical Efcacy, and Properties. Curr Res Complement Altern Med. CRCAM-133.
DOI:10.29011/ 2577-2201 /100033
Received Date: 08 September, 2018; Accepted Date: 04 October, 2018; Published Date: 12 October, 2018
DOI:10.29011/ 2577-2201 /100033
Abstract
Traditional Chinese Medicine (TCM) has a methodical and organized system for the classication of herbal medicines.
These classications have been developed over many hundreds of years of careful observation and documentation of each of the
traditional herbs and their effect on the human body. Due to isolation and long distances between different countries and cultures,
certain signicant herbal medicines (such as Ashwagandha from India) are not currently classied per TCM principles.
The systems of Ayurveda and TCM are juxtaposed, herein, to establish a parallel between the two systems. In TCM,
each herbal substance has its distinct attributes; therefore, a side-by-side comparison was made between each relevant herb and
Ashwagandha. Because of this comparison, in the TCM herbal classication system, Ashwagandha can be categorized as “Tonify
Qi” and “Tonify Blood and Essence”. This comparison, depicted in (Table 1), provides evidence to classify Ashwagandha in
TCM accurately and establishes a methodology by which other relevant herbal medicines can be joined with Chinese medicine
and classied under TCM categories and terms.
Keywords: Abortifacient; Adaptogen; Ashwagandha;
Ayurveda; Chínese Medicine; Dunal; Qi; Materia Medica; TCM;
Withania somnifera
Abbreviations
PDR : Physicians’ Desk Reference
TCM : Traditional Chinese Medicine
Preface
The Compendium of Materia Medica (written by Li
Shizhen), upon which TCM is based, lists and classies, among
grasses and plants, those herbs that were found or known to exist
in China at the time of its writing during the Ming Dynasty (the
rst draft completed in 1578). The essence and purpose of this
paper is to propose well-documented herbs outside of the historical
TCM “universe” be included in Materia Medica; and by doing
so, certain herbal medicines, such as Ashwagandha (Withania
somnifera)–a foundational herb in traditional Indian Ayurveda
(Ayurvedic Medicine)–can be used effectively in accordance with
existing TCM diagnostic criteria and treatment protocol.
Withania somnifera and Withania somnifera (Dunal) are
interchangeable scientic names for the herb Ashwagandha.
Michel Felix Dunal (1789-1856) was a French botanist and
professor of botany in Montpellier, France. Some herbal experts
use “Dunal“to acknowledge the professor involved in classifying
the Solanaceous plant genus, under which Ashwagandha is listed.
(The name Withernia somnifera is sometimes seen in the literature,
mistakenly or not.)
This paper is the rst in a series of papers; the series title
being “Merging Ayurvedic Ashwagandha with Traditional
Citation: Forman M, Kerna NA (2018) Merging Ayurvedic Ashwagandha with Traditional Chinese Medicine Part 1. Foundation in Ashwagandha: Physiological Effects,
Clinical Efcacy, and Properties. Curr Res Complement Altern Med. CRCAM-133. DOI:10.29011/ 2577-2201 /100033
2Volume 2018; Issue 01
Curr Res Complement Altern Med, an open access journal
ISSN: 2577-2201
Chinese Medicine”. This rst paper’s subtitle is “Foundation
in Ashwagandha: Physiological Effects, Clinical Efcacy, and
Properties”. The subsequent papers will investigate apoptogenic
herbs; physiological effects; TCM herb classication and Ayurvedic
herb classication, and a comparison thereof; and a conclusion that
supports the recognition of Ashwagandha in TCM and its inclusion
in Materia Medica which is TCM’s herbal equivalent to Western
medicine’s pharmaceutical PDR. Each paper is standalone, and
can be read as such if the reader simply has an interest in one topic.
However, the papers will also be linked resulting in an in-depth
review of the herb, Withania somnifera (Ashwagandha), and its
proposed inclusion and role as a fundamental herb in TCM.
Introduction
The Proposition for the Inclusion of Ashwagandha in
TCM
Traditional Chinese Medicine (TCM) has a 5,000-year history
and describes the 2,000-year-old tradition of medical theories and
herbal classication and applications for the intervention in and
prevention of illness and for maintaining health and well-being.
In TCM, the primary therapeutic component is herbal substances.
The herbs utilized have been methodically classied and organized
following Chinese medical theories, which have culminated in
several monumental works detailing the discovery and therapeutic
development of herbal medicines. The following are three classical
written works (Chinese herbal texts) dating back to 125 CE:
Shen Nong’s Herbal Classic (Shen Nong Ben Cao Jing) (200-•
250 CE)
Materia Medica Tang Edition (Tang Ben Cao) (1057 CE)•
Compendium of Materia Medica (Bencao Gangmu) (1578 •
CE)
Two contemporary texts in English are as follows:•
Chinese Medical Herbology and Pharmacology, 1st Edition, •
by J. Chen and T. Chen (2004)
Materia Medica, 3rd Edition, by Dan Bensky, et al. (2015)•
In the past century, with the worldwide dominance of
Western medical science and its pharmaceutical intervention
orientation to health management, many herbs have been counter-
classied regarding their physiological effects and potential. These
herbs have now been arranged based on their direct physiological
impact on the body from a microbiological perspective. In this
regard, many herbs fail to meet scientic criteria on par with the
anecdotal evidence of historical and contemporary proponents and
users of the herbs or derivatives. Empirical studies are required
to prove efcacy. These studies and observations must be of high
quality-with peer-review acceptance-making them suitable for the
scientic and medical communities.
The TCM “herbal classics” include mainly herbs found in
China and surrounding areas; those were the herbs principally
at hand during the period these herbs were commonly used, and
subsequently documented. However, some of the herbs included
were those found in other parts of the world, beyond China, where
they were recognized for medicinal properties in those different
cultures and countries. As trade foreign trade found its way with
China, “foreign” herbs found their way into the TCM system
through the purview of Chinese herbal medicine scholars and
authorities [1].
Withenia somnifera (Dunal) is referred to in Indian Ayurvedic
medicine as Ashwagandha. This extraordinary herb, with its
signicant healing and medicinal properties, warrants inclusion in
the TCM Materia Medica. In this way, Ashwagandha would be
included in TCM textbooks, taught at TCM schools, and recognized
by TCM practitioners as an effective herbal medicine in the
treatment and prevention of certain diseases (Table 1).
Table 1: Comparison of Ashwagandha and classic Chinese herbs.
Note: Comparison of characteristics of Ashwagandha with
traditional TCM herbs evidencing Ashwagandha’s similarities thus
supporting the case for its inclusion in Materia Medica. Copyright
© 2016 by Michael Forman.
Classication and Etymology of Ashwagandha
Ashwagandha is scientically classied as Withania
somnifera (Dunal); it belongs to the botanical family Solanaceae.
Long revered as a cure-all herb in India and its importance in
Ayurvedic medicine. Ayurveda is a traditional system of healing
Citation: Forman M, Kerna NA (2018) Merging Ayurvedic Ashwagandha with Traditional Chinese Medicine Part 1. Foundation in Ashwagandha: Physiological Effects,
Clinical Efcacy, and Properties. Curr Res Complement Altern Med. CRCAM-133. DOI:10.29011/ 2577-2201 /100033
3Volume 2018; Issue 01
Curr Res Complement Altern Med, an open access journal
ISSN: 2577-2201
that can be traced back to 6,000 BCE. Ashwagandha’s reputation
is one of the essential herbs in Ayurvedic medicine. This “famous”
herb is classied as Rasayana (a tonic), e.g., a group of plants
having properties to rejuvenate the body, promote the body’s
defense against disease, slow the aging process, and enhance
memory [2].
Ashwagandha derives its name from the Sanskrit words
“ashva” (meaning horse) and “gandha” (meaning smell) due to the
horse-like odor of the roots. Another reason for its name is the
belief that consuming the plant’s extracts will give a person the
strength and vitality of a horse [3].
Customarily in India, the root of the plant is considered the
crucial component which is crushed and used as a ne powder,
called “churna”. This powder form allows for easy blending
with water, milk, honey or other uids [4]. Ashwagandha has
been used as an aphrodisiac, liver tonic, diuretic, astringent, and
anti-inammatory Withania Somnifera, 2004. It has been given
to children as a tonic and to elderly for rheumatism, insomnia,
constipation, and nervous breakdown [4].
Description of Ashwagandha
Ashwagandha grows as a small, woody shrub, usually 2 to 5
feet tall. It has oval, small yellowish-green leaves with ve-petaled
owers and has red and yellow berries (Figure 1).
Figure 1: Image of the Ashwagandha plant (Withania somnifera) with its
typical smallish green leaves and red and yellow berries. Public domain.
Though the leaves and berries have also been tested and
used for medicinal properties, Ashwagandha’s main therapeutic
components are found in its whitish-brown roots that can grow up
to 2 feet in length Withania Somnifera, 2004 (Figure 2).
Figure 2: Image of the Ashwagandha plant (Withania somnifera) with its
native whitish-brown roots. Public domain.
The plant commonly grows in India, especially in areas
closest to the Himalayan region. It has been found growing in Africa
and the Mediterranean. It blooms year-round and can survive in
hot, arid conditions where many other plants cannot. In Ayurveda,
plants that can survive in harsh conditions are considered to have
strong healing and tonication properties Withania Somnifera,
2004.
Ashwagandha is a known adaptogen; therefore, each TCM
herb that was used for comparison is considered apoptogenic. A
comparison of the active chemical constituents was made, including
phytochemicals and alkaloids, to demonstrate a distinctly close
relationship-on a chemical level-among the herbs compared.
According to the online dictionary meriam-webster.com, an
adaptogen or apoptogenic substance is “a nontoxic substance, and
especially a plant extract, that is held to increase the body’s ability
to resist the damaging effects of stress and promote or restore nor-
mal physiological”; in other words, an herb used to restore homeo-
stasis. To continue from the website medical-dictionary.thefreed-
ictionary.com: “adaptogens may act on serum glucose, leukocytes,
temperature, blood pressure or pulse by increasing or decreasing
the substance of interest” (Table 2)
Citation: Forman M, Kerna NA (2018) Merging Ayurvedic Ashwagandha with Traditional Chinese Medicine Part 1. Foundation in Ashwagandha: Physiological Effects,
Clinical Efcacy, and Properties. Curr Res Complement Altern Med. CRCAM-133. DOI:10.29011/ 2577-2201 /100033
4Volume 2018; Issue 01
Curr Res Complement Altern Med, an open access journal
ISSN: 2577-2201
Table 2: A Comparison of Adaptogens in Different Medical Systems.
Note: Comparison of classication and actions of adaptogens
among various disciplines. Adapted from D. Winston and S.
Maimes [5].
Preparation
Ashwagandha is primarily prepared and used as a ne
powder made from drying and crushing the roots. It has, however,
been prepared in a variety of ways. In Ayurveda, the preparation of
many herbs corresponds to the effect one is trying to achieve with
that herb [6].
The most common traditional preparation of Rasayanas is
called the “milk decoction”. The usual method is to mix one-part
herb with eight parts of milk and thirty-two parts of water and boil
it with low heat until the water is evaporated.
In the case of Ashwagandha, however, the preferred method
is to cook the herb directly with milk. It is said that milk augments
the tonifying and nutritive effects of the herb. It is important to
note that the preparation should take place in an earthenware pot;
it is also said that earthenware combines with the herbs in a similar
way plants combine with the soil. Currently, Ashwagandha is most
often taken in the form of a powder extract of high concentration,
usually in capsules. [6].
Ashwagandha’s Active Constituents
Various studies have sought to discover the constituents
responsible for Ashwagandha’s observed and professed medicinal
properties. Alkaloids are the primary chemical constituents of
the plant including Isopelletierine, Anaferine, Cuseohygrine,
Anahygrine, Somniferine, Somnine, Somniferinine, Withananine,
Pseudo-Withanine, Tropine, Pseudo-Tropine, and Cuscohygrine
[7]. It also contains signicant amounts of saponins and steroidal
lactones including withanolides and withaferins [8-10].
Currently, twelve alkaloids including thirty-ve withanolides and
many sitoindosides (withanolides containing glucose at C-27)
have been isolated from the plant and studied. The withanolides
have been extensively investigated and are believed to be the main
constituents responsible for Ashwagandha’s medicinal effects.
Two withanolides, withaferin A and withaferin D, were found to
be the most medicinally active [11]. Withanolides are steroidal and
resemble the ginsenosides found in Panax ginseng (Ginseng) both
in structure and activity [4].
Alkaloids, Withanolides, and Sitoindosides
(Glycowithanolides)
Alkaloids are active compounds, found in naturally occurring
substances, consisting of nitrogen-containing bases. There are
many well-known alkaloids, such as morphine, strychnine, quinine,
ephedra, and nicotine. They are found in owering varieties of
plants and have been studied extensively. Alkaloids are believed
to be the waste materials given off by a plant during the metabolic
process and are very powerful. It has been suggested that they
may play a role in a natural insecticide action as a mechanism
to preserve plant quality [12]. The primary chemical structures
of alkaloids contain at least one nitrogen atom in an amine type
structure. They are called alkaloids because, like their inorganic
counterparts, they react with acids to form salts [12].
The medical properties of alkaloids are well known; they
are potent and have been the basis for the formation of many, if
not most, pharmaceutical drugs over the past 100 years. Many
analgesics, like morphine and codeine, are derived from plants,
and less addictive substances have been developed that treat
cardiac and respiratory impairments. One of the more common
alkaloids is nicotine derived from the tobacco plant and smoked
in cigarettes, cigars, and pipes. Many hallucinogens are alkaloid-
based substances, such as mescaline and psilocybin mushrooms;
these have given way to inorganic hallucinogens like LSD made
from lysergic acid [12].
Withanolides, a type of alkaloid found in Ashwagandha,
are believed to be the active ingredient that provides the healing
effects. The primary withanolides, which have been isolated
chemically, are withaferin A and withaferin D. These two
isolates are steroidal; they are fat-soluble organic compounds
that synthesize readily in the body and can function as signaling
molecules to affect the cell membranes. These characteristics help
explain many of the anti-inammatory and analgesic properties
associated with Ashwagandha, like those found in other alkaloid
plant compounds [13]. Sitoindosides (Glucowithanolides) are
withanolides containing a glucose molecule at carbon-27. The
active sitoindosides are sitoindoside VII and VIII; they have been
shown to have a dramatic inhibitory effect on the inammatory
process [9].
Citation: Forman M, Kerna NA (2018) Merging Ayurvedic Ashwagandha with Traditional Chinese Medicine Part 1. Foundation in Ashwagandha: Physiological Effects,
Clinical Efcacy, and Properties. Curr Res Complement Altern Med. CRCAM-133. DOI:10.29011/ 2577-2201 /100033
5Volume 2018; Issue 01
Curr Res Complement Altern Med, an open access journal
ISSN: 2577-2201
Doses and Contraindications
Ashwagandha has been recognized for thousands of years
as an herb that can be taken long term with no toxic effects. It is
extremely safe when used in a predened range of doses. Many
toxicity studies have indicated Ashwagandha to be completely
safe [14]. A study by Sharma et al., as cited in Aphale, Chhibba,
Kumohakarna, Mateebuddin, & Dahat (1998) [15], showed that
Ashwagandha exhibited no toxic effects in laboratory rats after
eight months of continuous daily dosing. A follow-up study by
Aphale et al. (1998) [15] also showed no signicant organ damage
from prolonged doses of Ashwagandha.
A study by Raut et al. (2012) [16] on the human tolerability
of Withania (in which 18 subjects were given doses of aqueous
extract of Ashwagandha root in doses of 750mg/day graduating
to 1,250mg/day for 30 days) found no immediate intolerance or
adverse effects in any vital functions or organ health. Also, no
adverse effects were noted in the quality of sleep, appetite or bowel
habits. Padmavathi, Rath, Rao, & Singh (2005) [17] showed that
continuous doses of Withania had no adverse effects on the P450
system in laboratory mice and body weight gain prole.
The recommended dosage of the roots is different for each
form of the herb and different depending on the source. Yance
(2013) [14] suggests–for an average size adult–the raw dried root
can be taken in doses of 3-10 grams per day, a standardized powder
extract (1:1) up to 1000 mg/day or a concentrated liquid extract 2-8
ml per day. Other researchers suggest slightly higher doses; with
all agreeing that staying within recommended ranges is critical
for long-term safety. As with any substance, large doses should
be avoided and have been associated with gastrointestinal upset,
diarrhea, and vomiting. Large quantities may also be abortifacient
and should, therefore, be used with caution during pregnancy.
[14]
Conclusion
Traditional Chinese Medicine has a 2,000-year recorded
history. Most of TCM’s historical ndings, prescriptions, and
practices are noted in the extensive Materia Medica which was
compiled over twenty-seven years during the Ming Dynasty by
a scientic naturalist, Li Shizhen; the rst draft was completed in
1578 AD. At that time, due to the long distances and lack of prompt
communications between other countries and cultures, many
herbs, renowned in their country of origin–such as Ashwagandha
from India’s Ayurvedic tradition–were not known or included in
these earlier Chinese reference books. Even though Ashwagandha
has been proven over Ayurvedic’s 6,000-year history, it is yet to
be included in TCM’s Materia Medica. Currently, studies are
underway to investigate Ashwagandha’s bioactive physiological
components on a microbiological level that seem to support certain
practitioners’ and patients’ historical health benet claims.
Ashwagandha is scientically classied as Withania
somnifera (Dunal); it belongs to the botanical family Solanaceae. It
is a sturdy plant, of two to ve feet in height, able to survive in hot
climates. Ayurvedic considers such plants to have strong healing
and tonication properties. Its whitish-brown roots are rich in
bioactive ingredients of alkaloids, withanolides, and sitoindosides
(glycowithanolides); therefore, it is usually ingested in the form
of a powder in a liquid mix or capsule form. If consumed in the
recommended doses, Ashwagandha can be taken long term without
any signicant adverse effects. Caution must be used in pregnancy
as Ashwagandha has potential abortifacient properties. In a side-
by-side comparison of Ayurvedic and TCM herbs, Ashwagandha
can be categorized in TCM as having the properties to “Tonify Qi”
and “Tonify Blood and Essence”.
In subsequent articles, Ashwagandha will be investigated
as an adaptogenic herb. Also, the physiological effects of
Ashwagandha will be explored including anti-inammatory and
analgesic properties, immunostimulating and immunoprotective
properties, neuroprotective and neuroregenerative properties,
anticancer and anti-tumor properties, among others. A review of
TCM and Ayurvedic herb classications will follow, as well as a
specic and comparative study between Ashwagandha and ve
fundamental TCM herbs. The series will conclude with a summary
and support for Ashwagandha being included in Materia Medica
resulting in more specic and effective treatment by Traditional
Chinese Medicine practitioners, in being readily available and
condently utilized by the public, and in gaining further recognition,
acceptance, and integration by Western allopathic medicine.
Acknowledgments
None
Conict of Interest Statement
The authors declare that this paper was written in the
absence of any commercial or nancial relationships that could be
construed as a potential conict of interest.
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Citation: Forman M, Kerna NA (2018) Merging Ayurvedic Ashwagandha with Traditional Chinese Medicine Part 1. Foundation in Ashwagandha: Physiological Effects,
Clinical Efcacy, and Properties. Curr Res Complement Altern Med. CRCAM-133. DOI:10.29011/ 2577-2201 /100033
6Volume 2018; Issue 01
Curr Res Complement Altern Med, an open access journal
ISSN: 2577-2201
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