Qi stagnation points are the initial stage form of punctate tongue. Many Qi stagnation points on the tongue may be caused by liver depression and Qi stagnation (poor transportation of Qi and blood in the liver and depression), dampness-heat, and spleen-Qi deficiency. 1. Liver depression and stagnation of qi: clinical manifestations include depression, chest tightness, rib pain, distension and pain in the lesser abdomen (belly), and thin white tongue coating. 2. Dampness-heat: mainly due to the spleen, stomach, liver, gallbladder, bladder and other internal organs causing lesions, headache, loss of appetite, abdominal distension, short and yellow urine, yellow tongue coating and other symptoms. 3. Spleen qi deficiency: also known as spleen qi deficiency, spleen and stomach weakness, may appear limb weakness, abdominal distension, indigestion and other symptoms. All of the above conditions may lead to Qi stagnation spots on the tongue coating, and the specific cause of the disease should be determined by a professional doctor after comprehensive diagnosis.