Throw punch ultimately into middle of mouth and tongue (7)
I believe the answer is:
unhorse
'throw' is the definition.
(thesaurus)
'punch ultimately into middle of mouth and tongue' is the wordplay.
'ultimately' indicates one should take the final letters.
'into' is an insertion indicator.
'middle of' indicates the central letters.
'and' says to put letters next to each other.
'tongue' becomes 'norse' (Norse is an example**).
The central letter of 'mouth' is 'u'.
The last letter of 'punch' is 'h'.
'u'+'norse'='unorse'
'h' placed inside 'unorse' is 'UNHORSE'.
(Other definitions for unhorse that I've seen before include "Throw" , "Unship rider" , "Overthrow" .)