Ju He Wan (橘核丸) — Tangerine Seed Pill

Ju He Wan is the classical Chinese herbal formula for Cold-Damp stagnation in the Liver channel affecting the scrotum, testes and groin — used for hydrocele, chronic epididymitis, varicocele, inguinal hernia and chronic testicular pain. First recorded in the Song-dynasty Ji Sheng Fang (1253 AD), it combines Ju He (tangerine seed) with multiple Qi-moving and softening-hardness herbs to disperse Cold, resolve Damp accumulation and break up the hard nodular swellings of TCM “shan” pathology. Always prescribed alongside conventional urological assessment.

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions
7. Frequently asked questions

Overview

Ju He Wan — the “Tangerine Seed Pill” — is from the Song-dynasty Ji Sheng Fang. It addresses Cold-stagnation with Damp accumulation in the Liver channel, particularly affecting the scrotum and testes, producing hard swelling, dragging pain or hydrocele. The chief herb, Ju He (tangerine seed), has a strong affinity for the Liver channel and the testicular region. Multiple Qi-moving herbs (Mu Xiang, Chuan Lian Zi, Wu Yao, Yan Hu Suo) plus softening-hardness herbs (Hai Zao, Kun Bu, Tao Ren) make this a focused formula for the chronic scrotal swellings of TCM “shan” pathology.

I prescribe Ju He Wan as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan, always alongside medical assessment.

TCM pattern

Ju He Wan is prescribed for Cold-Damp stagnation in the Liver channel with Qi and Blood stagnation:

• Hard swelling in scrotum/testis, possibly cold
• Dragging pain in groin or lower abdomen
• Possibly hydrocele (fluid swelling)
• Possibly inguinal hernia
• Pain worse with cold, eased with warmth
• Tongue — pale-purplish, white greasy coat
• Pulse — deep, wiry

Key herbs

1. Ju He (tangerine seed, 9-30g) — chief; moves Liver Qi in the testicular region; relieves swelling
2. Hai Zao (Sargassum, 9-30g), Kun Bu (Thallus Eckloniae, 9-30g), Hai Dai — soften hardness; dissolve nodules and swellings
3. Tao Ren (Dry-fried Sm. Persicae, 3-30g) — moves Blood; resolves stasis
4. Yan Hu Suo (Dry-fried Rz. Corydalis, 3-15g) — moves Blood and Qi; relieves pain
5. Chuan Lian Zi (Dry-fried Fr. Toosendan, 3-30g), Mu Xiang (Rx. Aucklandiae, 3-15g), Zhi Shi (Dry-fried Fr. Aurantii Immaturus, 6-15g) — move Liver Qi; relieve pain
6. Hou Po (Ginger-fried Cx. Magnoliae Officinalis, 6-15g) — moves Qi; resolves Damp
7. Rou Gui (Cx. Cinnamomi, 1-15g) — warms the channel; disperses Cold
8. Mu Tong (Mu Tong substitute, no aristolochic acid, 6-15g) — drains Damp from the lower burner

Formula actions

1. Moves Liver Qi
2. Disperses Cold-stagnation
3. Softens hardness; dissolves nodules
4. Moves Blood; relieves pain

Conditions treated

1. Hydrocele (with medical assessment)
2. Chronic epididymitis with cold-pattern
3. Varicocele with dragging pain
4. Inguinal hernia (with medical assessment)
5. Chronic orchialgia with cold-pattern
6. Spermatocele
7. Post-vasectomy pain with cold-stagnation pattern

Cautions

Mu Tong: must use Akebia stem (mu tong), NOT Aristolochia (guan mu tong) which is nephrotoxic. Pharmaceutical-grade Sun Ten product uses safe Akebia only.

Acute severe scrotal pain with swelling needs urgent assessment to exclude testicular torsion — call 999.

Testicular swelling, lump or change always requires urology assessment to exclude testicular cancer — especially in younger men.

Strangulated hernia (severe pain, vomiting^[12], irreducible) is a surgical emergency.

Always consult a qualified Chinese herbalist registered with the RCHM.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.

Frequently asked questions about Ju He Wan

What is Ju He Wan used for?

Ju He Wan (Tangerine Seed Pill) is used for Cold-Damp stagnation in the Liver channel affecting the scrotum and testes — classically hydrocele, chronic epididymitis, varicocele with dragging pain, inguinal hernia and chronic orchialgia. It is also used in post-vasectomy pain when the pattern is cold-stagnation. It is never the right formula for acute hot, red, swollen presentations — those need urgent urological assessment.

Is Ju He Wan safe?

Ju He Wan is generally well tolerated when prescribed by a qualified RCHM herbalist using pharmaceutical-grade granules. The original classical version contained Mu Tong — modern preparations must use safe Akebia stem (mu tong), never the nephrotoxic Aristolochia (guan mu tong). Pharmaceutical-grade Sun Ten granules use the safe Akebia source only.

How long does Ju He Wan take to work?

For chronic cold-pattern scrotal swelling, expect 4–8 weeks of daily granule treatment before clear improvement, with full courses typically 3–6 months. Acute pain or inflammation needs urgent medical assessment first — herbal medicine is for the chronic cold-stagnation pattern, not for acute presentations.

Can Ju He Wan treat hernia?

Ju He Wan can support the cold-stagnation patterns underlying chronic inguinal hernia, particularly small or recurrent presentations. It does not replace surgical repair when that is clinically indicated, and a strangulated hernia (severe pain, vomiting, irreducible swelling) is a surgical emergency. Any new hernia needs general surgery review before Chinese herbal treatment.

Can Ju He Wan treat varicocele?

Ju He Wan is one of the classical Chinese herbal formulas for varicocele presenting with dragging scrotal pain, cold testes and a heavy sensation worse on standing. It works by moving stagnant Liver Qi and Blood and dispersing Cold-Damp. In male sub-fertility^[21] related to varicocele, it is often combined with Blood-invigorating and Kidney-tonifying herbs in a bespoke formula and used alongside urology review.

References

[12] Zhai X, He Q, Chen M, Yu L, Tong C, Chen Y, et al. Pinellia ternata-containing traditional Chinese medicine combined with 5-HT3RAs for chemotherapy-induced nausea and vomiting: A PRISMA-compliant systematic review and meta-analysis of 22 RCTs. Phytomedicine. 2023 Jul;115:154823. https://doi.org/10.1016/j.phymed.2023.154823. PMID: 37099981.

[21] Ried K. Chinese herbal medicine for female infertility: an updated meta-analysis. Complement Ther Med. 2015 Feb;23(1):116-28. https://doi.org/10.1016/j.ctim.2014.12.004. PMID: 25637159.