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Differs from the fruit of Cao Guo (Tsaoko). Those produced in Jianning, Fujian, resemble Longan but are slightly longer and sharper at the tip. The peel is yellowish-white and thin, with ridges like Gardeniae Fructus (Gardenia), lacking scales or armor. The seeds inside are connected, as large as Suansha (Bai Doukou). Its aroma is pungent, fragrant, intense yet harmonious. If produced in Yunnan and Guangdong, where the qi is fierce and turbid, it is called Cao Guo (Tsaoko).

The taste is slightly bitter and pungent, slightly fragrant, nature hot, belonging to Yang, floating. It enters the Foot Taiyin Spleen and Foot Yangming Stomach meridians. It dispels cold, dries dampness, opens depression, moves stagnation, warms the middle jiao, treats all types of cold qi causing heart and abdominal pain, removes exogenous cold causing heart and stomach pain, strengthens the spleen, promotes digestion, stops cholera-like vomiting, treats miasma pestilence, cold malaria, diarrhea and dysentery, yige (dysphagia), piman (fullness), phlegm-fluid retention, and accumulation. Medical texts also treat wheezing, diarrhea, inability to eat, distension, convulsions, jaundice, lower back pain with fixed bi-syndrome, Hong Kong foot (podagra), dysentery, and hernia. Caodoukou is extremely pungent and warm; it regulates and disperses cold qi very rapidly. (Li Dongyuan) It mainly disperses cold in the middle jiao, and dampness transformed into stagnation due to cold. Whenever wind-cold pathogenic factors lodge above the stomach opening, causing pain in the epigastrium, it is suitable to use after baking. (Li Dongyuan) It can disperse stagnant qi and eliminate phlegm above the diaphragm. Only when it is clearly known that the body has been invaded by cold pathogens or cold food has been consumed, causing stomach pain, can it be used for warming and dispersing. It is also effective for diseases caused by damp-phlegm stagnation. However, it cannot be used for heat stagnation; formulas containing Gardeniae Fructus (Gardenia) are necessary instead. (Zhu Danxi) For those who are weak and unable to eat, it should be used together with Chaenomelis Fructus (Qu木瓜), Mume Fructus (Wumei), Amomi Fructus Rotundus (Suansha), Alpiniae Oxyphyllae Fructus (Yizhi), Fermented Grain (Qu), Plagiotrichi Semen (Baizi), Glycyrrhizae Radix et Rhizoma (Gancao), and Zingiberis Rhizoma Recens (Shengjiang). (Li Dongyuan) Using Caodoukou to treat cold pain in the Zhongwan area rarely yields true results. Market vendors often substitute it with false Caoren, how could one expect miraculous effects? (Jiamo) General discussion detailed previously.

Cao Guo (Tsaoko):
Caokou produced in Yunnan, Southern Guizhou, and Southern Guangdong has a fierce and turbid qi, commonly called Cao Guo. Its shape is large and long like Chezi (Terminalia chebula). The peel is black and thick (tight, dense, black, and wrinkled, differing from the yellowish-white and thin peel of Caodoukou), with dense ridges. The seeds are large grains forming clusters. Its nature is extremely fierce, its odor pungent and foul, exactly like the odor of Mylabris (Banmao). When decocted with other herbs, its odor alone assaults the nose.

Its main efficacy is good at breaking up miasma pestilence, digesting grain and food, and treating all types of retained food stagnation causing distension, fullness, and pain. (Chen Shigong) Its nature is most pungent and fierce. Although it specializes in digestion and guidance, it greatly depletes the primordial yang of the spleen and stomach. The elderly, weak, and emaciated must strictly avoid it. (Jiamo) Cao Guo is also suitable for certain conditions. Medical texts use it to treat malaria, edema, distension and fullness, cholera, summerheat, deficiency consumption, accumulation, phlegm-fluid vomiting, regurgitation, coughing blood, blood stasis with hypochondriac pain, wasting-thirst, diarrhea, and dysentery. As an assistant or attendant herb, it generally combines tonification with movement. Used together with Anemarrhenae Rhizoma (Zhimu), it treats malarial chills and fever, taking advantage of their yin-yang balance to prevent excess. This is because Cao Guo treats cold dominating the Taiyin, while Zhimu treats fire dominating the Yangming. For qi-deficiency malarial fevers, characterized by less heat and more cold, or only cold without heat, or deficiency-heat without cold... (Refer to this formula) Take equal parts of Caoguo Ren (Tsaoko Seed) and Prepared Aconiti Lateralis Radix (Fuzi), seven slices of Zingiberis Rhizoma Recens (Fresh Ginger), one Jujubae Fructus (Date), one cup of water, decoct until half a cup remains, then take. This is "Guofu Tang," treating spleen-cold malaria with diarrhea, frequent urination, and inability to eat, which is the above formula. It applies to spleen-kidney insufficiency and deficiency-cold diarrhea. One tael of Caoguo Ren, stir-fried with one tael of Badian Fruit (Fennel), remove the fennel before use.

Wuzhuyu:
Remove the calyx.
Regarding the two formulas above, one addresses qi deficiency, the other addresses spleen-kidney insufficiency. Observing the auxiliary flavors used in each reveals why Cao Guo is employed thus.