(5) Spiky dots:  it is normal for the surface of the tongue to have nipple-like texture.  However, when these “nipples” become spiky looking, it indicates noxious heat.  The more spiky dots there are, the greater the heatiness.  The position where these spiky dots appear would indicate the affected organ of the viscera.  For instance, if the spiky dots concentrate at the tip of the tongue, it means hyperactivity of the heart-fire.  If the dots appear at the sides of the tongue, it is the liver and gall bladder appears what they have hyperactive fire.  If the dots appear at the center of the tongue,  the heatiness will be inside the stomach and intestines.