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I have opened my mouth ... my tongue has spoken in my mouth

These mean the same thing. Elihu is emphasizing that he is now ready to speak. His "tongue" speaking represents himself speaking. Alternate translation: "I have opened my mouth and I have begun to speak" (See: rc://en/ta/man/translate/figs-parallelism and rc://en/ta/man/translate/figs-metonymy)