Tongue position and its relation to the cause of death and sequential stages of body decomposition observed during 608 forensic post-mortems

The purpose of this study was to document tongue position and its relation to the cause of death and sequential stages of body decomposition, as observed during the routine forensic pathological examination of bodies. The sample of 608 included all bodies examined by the first and third authors during the period April 2016 to September 2016. Tongue position was recorded in all cases where position of the tongue could be visually determined. The condition of the body was recorded as follows: fresh flaccid, fresh with rigor mortis, early decomposition, and advanced decomposition. The cause of death was recorded where known. The results showed that 86% of all bodies examined did not show a protruded tongue and that 92.8% of the bodies were in a state of fresh rigor mortis. The study also showed that tongue protrusion was more prevalent in certain causes of death, namely, hanging, burning, and drowning, but was never absolute. The authors believe that due to the low numbers of bodies presenting with protruded tongues, this phenomenon has previously been overlooked, the significance thereof underestimated, and the pathophysiology and pathomorphology never fully investigated.