Have you ever heard that you should tilt your head backwards during a nosebleed? Or that you should urinate on a jellyfish sting? Or that in case of a seizure you should put a spoon into the victim’s mouth? These common first-aid myths, though well-intentioned, can be more harmful than helpful. And they come up each time I teach a first-aid course!
The spoon myth stems from the belief that swallowing the tongue is possible and that placing an object into the mouth can prevent this. When I ask where people picked up this belief, they seldom remember. How did this misguided information get so ingrained?
A 2020 study sought to investigate just that. The researchers conducted a review of both medical and popular literature — finding that both science and society are in part to blame for this misinformation. The phrase “swallowing one’s tongue” has appeared in medical writing since 1884, mostly in reference to epilepsy and seizures. Some articles reported rare cases of patients biting off parts of their tongue and swallowing it. Then, between 1954 and 1991, physicians and caretakers began recommending the use of an object or hand placed in the mouth to prevent tongue injury or swallowing. In many cases, they used “swallowing the tongue” as a way to describe the tongue sliding backwards in the throat to block the airway, clarifying that literally swallowing the tongue would be impossible. But between excerpts taken out of context and the idiomatic use of the phrase, we came to believe in this myth.
There’s now scientific consensus that swallowing the tongue is an anatomical impossibility because the root is firmly anchored in the mouth. The “root” of the tongue colloquially refers to the extrinsic muscles as well as the lingual frenulum, which you can see if you look in the mirror and lift your tongue! This band of tissue, also called the tongue tie (for any parents out there, this would be the tissue that gets affected when a baby is known to be “tongue-tied”), connects the tongue to the bottom of your mouth. And it is often credited for preventing the tongue from falling backwards into the throat. In reality, it’s a combined effort between the lingual frenulum and the many extrinsic muscles (see diagram below). These muscles insert into the tongue, hence the suffix “glossus” and also have an attachment to a nearby bone. In the genioglossus muscle, the “genio” refers to the Greek word for “chin,”; the “stylo” of the styloglossus muscle refers to the styloid process of the skull; the “hyo” of the hyoglossus muscle refers to the hyoid bone in the throat; and the “palate” of the palatoglossus muscle refers to the palate, or roof, of the mouth.
Image Source: https://compass.onlinelibrary.wiley.com/doi/full/10.1111/lnc3.12447
The body of the tongue is made up of intrinsic muscles, which allow for fine movement in all directions. This is the part of the tongue that moves freely to help you speak, clean your teeth, move food around the mouth, or French kiss your hot date. Combined, the tongue is capable of very complex movement, thanks to both its intrinsic and extrinsic muscles.
From the medical journal archives to my first-aid classroom, this myth appears in reference to epilepsy and seizures. In these types of emergencies, people don’t have proper control over their muscles and it’s scary to think that the tongue might interfere with their breathing. The latest guidelines, however, emphasize that in case of a seizure, the priority is to prevent further injury by moving hazards away, loosening tight clothing, and staying around to assess the person following their seizure. Placing objects or fingers into their mouths can result in further injury for the patient or the first-aider. The recovery position is a great way to help protect the airway and if you’re ever unsure, it’s best to call for help.
So while attempting to treat a seizure with a leather strap might be good for dramatic effect, I’d say it’s best to hold your tongue than to spread misinformation.
