The nature of the illness
There appears to be no direct relationship between the severity of an illness and the possibility of psychological problems accompanying it. However, the likelihood of psychological problems may be higher if the part of the body with the clinical disorder has particular significance. An obvious example is a hand injury for pianist. It has been suggested that disabling diseases are more threatening for men, whereas disfiguring diseases are more threatening for women. This does not mean that this correlation is natural. We are all at the mercy of the roles we play and the assumptions we make about what makes us attractive or our lives more meaningful. What is socially normal may not always be good or sane. Illness, even when extreme, can be an agent of change and an opportunity to grow beyond previous personal boundaries.

The social context
An illness of any severity may have a greater or lesser impact on us depending upon the social context within which it occurs. We may perceive it very unfavorably if it occurs at a bad time, such as when we are starting a new job, but we may accept it with relief if it helps us avoid an unpleasant social situation, such as exams! The reactions of the people around us will also play a role in determining the ultimate impact. The social context can have a direct effect on the perceived severity of a symptom, and may even cause us to delay seeking medical help.

Psychological Reactions to Illness
People commonly respond psychologically to major illness in one of a few ways: with depression, anxiety, or denial. These responses may even occur in more sensitive people when the illness is apparently minor. The psychological response is unique to the person involved and shouldn't be labeled hypochondriacal.

Depression
The most common response is depression . Studies have shown that between 20 and 30 percent of all medical patients suffer some degree of depression. This may be relatively mild and seem like a "flattening" of the emotions together with some loss of interest in the outside world, or it may be quite pronounced, with emotional discomfort, withdrawal, and even suicidal feelings.

Depression is often associated with an actual or threatened loss. Illness can involve loss of parts of the body or loss of bodily and social functions. There are direct parallels between such losses - real or imagined - and the psychological effects of bereavement.

Depression most often occurs after the initial stages of an illness, when its full implications become apparent. We may interpret the illness as punishment for something we have or have not done in the past, in which case the depression is commonly colored by feelings of guilt and self-criticism, especially if we consider the "punishment" justified.

A "giving-up" complex commonly develops if the patient feels there is little to live for. This complex is characterized by feelings of helplessness and hopelessness. By helplessness, I mean feelings of impotence and failure, or frustration in getting help from the world and other people. Hopelessness refers to the feeling of no longer being able to cope with problems. This complex is common in a short-lived form and passes away when the situation improves. However, for some people, the complex can persist and radically affect both their response to their current illness and their openness to subsequent illnesses.

Anxiety
The anxiety commonly associated with illness stems partially from the reasonable uncertainty the patient may have about the cause and outcome of the illness. It can be compounded by inadequate information given by doctors as to the nature of the problem and the treatment prescribed, As one doctor has put it, "For the patient, no news is not good news; it is an invitation to fear." An herbalist or other practitioner of holistic medicine should not fall into this trap.

Anxiety usually shows as fear, apprehension, and bodily symptoms. These are most prominent in the early stages of the illness and represent a reasonable reaction to the onset of illness and the related uncertainties. In this situation, we should talk freely of our fears and our medical practitioner should supply clear information. This will not only minimize anxiety but also bring about a better healing response.

Denial
Denial is one way in which we deal with threatening situations and it may even be a necessary and adaptive response to the full physical and psychological impact of an illness. It has a protective function, preventing us from being overwhelmed by anxiety. However, it can go too far when it prevents us from making a realistic assessment of the severity of our symptoms. Thus, denial can be the cause of delay in seeking medical help and so may reduce the chances of a favorable outcome.

Disease and Stress
From this discussion, it should be apparent that illness does not occur in isolation but happens to an individual with a particular personality and in a particular social context. Both personal and social factors play a role in determining the impact of an illness, and the nature of the psychological response can provide considerable insight into the patient's underlying personality.

Pharmacological research suggests that the active principle of these plants are the glycosides present. The eleutherosides from Siberian Ginseng and panaxosides from Ginseng are examples. They increase the general non-specific resistance of the body to a whole range of diverse chemical, physical, psychological and biological factors. However, it comes as no surprise to the herbalist that the extracted chemicals cannot reproduce the effects of the whole plant.

Siberian Ginseng, one of the most remarkable of these plants, has a broad action range and very low toxicity. There has been a great deal of excellent clinical and laboratory research conducted in the USSR, where Prof. Brehkman and his team in Valdivostock have been studying the herb for over 20 years. Large scale clinical trials have been undertaken on both health and sick people with more than 1000 research papers published devoted to its application, the mechanism of action and investigation of its active principles.

Its safety and ability to increase the resistance of the normal human body to extreme conditions, make it a remedy of great social importance. Siberian Ginseng and analogous herbs might be seen as sources of substances that would have been naturally evolved by nature in the human body given time. However, the rate of evolution has been outpaced by the growth of the adverse effects of `civilization' on the human body!

Russian research findings
Studies on Siberian Ginseng provide some of the best clinical trials done on herbal medicines so far. Large numbers of people were involved, using controls groups and long term planning. In one such experiment with adaptogens 30, 000 people took part! The results were favorable and sometimes very noticeable. The Soviet concern with production and efficiency is very evident in the findings, where quality of life and individual health are only touched upon as factors in economic equations. However the results speak for themselves.

In another clinical trial a group of 54 miners received the extract before the beginning of their shift daily in June & July of 1976. The number of people reporting sick dropped by 33.3% and the number of days lost through illness by 45.6%.

Clinical findings from Vladivostok

• A Reduction of total disease incidents. Between the years 1973 & 1975, 1200 drivers engaged at the Volga Automobile Plant (V.A.P.) were given 8-12 mg of Siberian Ginseng extract daily for two months each year in the spring and autumn. By the end of experiment the total disease incidence had decreased by 20-30%. In the winter of 1975 the authorities at the factory undertook a mass program of preventative medicine with the herb. It was included in the diet as Siberian Ginseng sugar at a dose of 2 ml. Altogether 13, 096 persons were engaged in experiments. Disease incidence dropped by 30-35% as compared to a control group that did not use the remedy.

• A Reduction of influenza and Acute respiratory disease. Siberian Ginseng is an adrenal `stimulant' and not an anti-viral herb. However, the Russians have accumulated much data on the anti-influenzal effect of the herb. Such findings imply that either it possesses an invigorating and tonic action on natural immunity, or it has direct anti-virus activity. In the Primorye region of Pacific Russia, a group of 180 men were given 0.5ml every other day during March. As compared to the control group, the influenza and acute respiratory disease incidence decreased from 17% to 12.7%. In the winter of 1972-1973, about 1000 workers received 22ml of Siberian Ginseng extract daily for two months. The influenza and acute respiratory disease incidence reduced almost 2.4 times versus the same number of workers engaged at a shop with the same working conditions.

• Reduction of hypertension and ischemic heart disease. The test group were 1200 drivers of the Volga Automobile plant. In 1973, the number of cases of hypertension at the motor transport administration was approximately the same as that at the whole plant. After prophylactic treatment with the herb in 1975, the number of hypertensive drivers reduced 3.5 times. The number of cases with exacerbation of ischemic heart disease was 6.7 per 100 workers in 1973; in 1978 it dropped to 0.2. In 1973 the number of work days lost was 282 which in 1978 decreased to 3.

Other early clinical findings

• Improvement of vision. An hour after taking it, in healthy young people with normal vision, acuity increased from 1.15/1.16 to 1.26/1.32. Eight hours following the intake of the herb it had increased to 1.46-1.52 and remained high for 32 hours. By the end of the second day visual acuity returned to normal.
• Reduction in disease under environmental stress. During long term navigation in the tropics where high temperature and humidity affect endurance, sailors were given an extract from the root of Siberian Ginseng. The herb substantially reduced unpleasant shifts on the part of the central nervous system, cardiovascular system and thermo-regulation that characterize physiological stress under such conditions. It promoted an increase in physical and mental endurance, improving vision & the ability to think analytically.

• neurasthenia
• diabetes
• tuberculosis
• infectious disease
• chronic gastritis
• atherosclerosis
• brain injuries

Results found in Surgical Studies
It is of great interest to note that the published papers also cover the field of surgery. Apart from the actual findings, it demonstrates the open approach of orthodox medicine to plants in other parts of the world. The provisional results indicate that: