Fatal hilarity

:"For fatal hilarity as a figure of speech [cite book |title= The Sunday Excursionist |last= Henry |first= O. |quote= Men who have braved the deepest troubles and emerged unscathed from the heaviest afflictions have gone down with a shriek of horror and despair before the "fatal hilarity" of the Sunday excursionist.] , see hyperbole."Fatal hilarity refers to death resulting from the physiological effects of laughter. Versions of the phrase date back to 1596cite book |title=The Compact Oxford English Dictionary |author=Oxford: Clarendon Press |year=1993 |id=ISBN 0-19-861258-3] and records of laughter causing death date back to Ancient Greece.

Pathophysiology

Fatal hilarity may result from several pathologies that deviate from benign laughter. These include:

*Asphyxiation caused by the inability of the thoracic diaphragm to expand or contract fully. One of the main processes of laughter involves the continuous expansion and contraction of the thoracic diaphragm, bringing in and releasing air into and from lungs. It is possible to overexert and strain this muscle to where it becomes too weak to perform normally. Abnormal lung conditions such as asthma, bronchitis, hypersensitivity pneumonitis, or Acute Respiratory Distress Syndrome (ARDS) may contribute to this cause of death.

*Heart failure, heart attack, and cardiac arrest brought on by cardiac arrhythmia resulting from excessive laughter. During laughter the heart rate increases above the normal ranges and may reach dangerous levels that the heart is not accustomed to, straining and damaging it. Abnormal heart conditions such as coronary heart disease, pre-existing cardiac arrhythmia, or ischaemic heart disease may contribute to this cause of death.

* Infarction of the pons and medulla oblongata in the brain may cause pathological laughter.cite journal | last=Gondim | first=FA | coauthors=Parks BJ, Cruz-Flores S et al. | title="Fou rire prodromique" as the presentation of pontine ischaemia secondary to vertebrobasilar stenosis | journal=Journal of Neurology, Neurosurgery, and Psychiatry | volume=71 | issue=6 | pages=802–804 | date=December 2001 | pmid=11723208 | pmc=1737630 | doi=10.1136/jnnp.71.6.802 ]

* Laughter can cause atonia and collapse ("gelastic syncope"),cite journal |author=Reiss AL, Hoeft F, Tenforde AS, Chen W, Mobbs D, Mignot EJ |title=Anomalous hypothalamic responses to humor in cataplexy |journal=PLoS ONE |volume=3 |issue=5 |pages=e2225 |year=2008 |pmid=18493621 |pmc=2377337 |doi=10.1371/journal.pone.0002225 |url=http://www.plosone.org/article/info:doi/10.1371/journal.pone.0002225] cite journal |author=Nishida K, Hirota SK, Tokeshi J |title=Laugh syncope as a rare sub-type of the situational syncopes: a case report |journal=J Med Case Reports |volume=2 |issue= |pages=197 |year=2008 |pmid=18538031 |pmc=2440757 |doi=10.1186/1752-1947-2-197 |url=http://www.jmedicalcasereports.com/content/2//197] cite journal |author=Totah AR, Benbadis SR |title=Gelastic syncope mistaken for cataplexy |journal=Sleep Med. |volume=3 |issue=1 |pages=77–8 |year=2002 |month=January |pmid=14592259 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S1389945701001137] cite journal |author=Lo R, Cohen TJ |title=Laughter-induced syncope: no laughing matter |journal=Am. J. Med. |volume=120 |issue=11 |pages=e5 |year=2007 |month=November |pmid=17976409 |doi=10.1016/j.amjmed.2006.07.019 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(06)00898-9] which in turn can cause trauma. See also laughter-induced syncope, Bezold-Jarisch reflex.

*Gelastic seizures can be due to focal lesions to the hypothalamuscite journal |author=Cheung CS, Parrent AG, Burneo JG |title=Gelastic seizures: not always hypothalamic hamartoma |journal=Epileptic Disord |volume=9 |issue=4 |pages=453–8 |year=2007 |month=December |pmid=18077234 |doi=10.1684/epd.2007.0139 |url=http://www.john-libbey-eurotext.fr/medline.md?issn=1294-9361&vol=9&iss=4&page=453] Depending upon the size of the lesion, the emotional lability may be a sign of an acute condition, and not itself the cause of the fatality. Gelastic syncope has also been associated with the cerebellum.cite journal |author=Famularo G, Corsi FM, Minisola G, De Simone C, Nicotra GC |title=Cerebellar tumour presenting with pathological laughter and gelastic syncope |journal=Eur. J. Neurol. |volume=14 |issue=8 |pages=940–3 |year=2007 |month=August |pmid=17662020 |doi=10.1111/j.1468-1331.2007.01784.x |url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=1351-5101&date=2007&volume=14&issue=8&spage=940]

Historical deaths attributed to fatal hilarity

*In the third century B.C. the Greek stoic philosopher Chrysippus died of laughter after giving his donkey wine, then seeing it attempt to feed on figs.cite book
title=What a Way to Go, Deaths with a Difference
author=Peter Bowler and Jonathan Green
id=ISBN 0-7537-0581-8]
*Martin I of Aragon died from a lethal combination of indigestion and uncontrollable laughing in 1410. [ [http://www.cc.jyu.fi/mirator/pdf/Morris.pdf Morris.pdf ] ]
*Pietro Aretino "is said to have died of suffocation from laughing too much." [Waterfield, Gordon, ed. "First Footsteps in East Africa", (New York: Praeger Publishers, 1966) pg. 59 footnote.]
*It is cited that the Burmese king Nanda Bayin, in 1599 "laughed to death when informed, by a visiting Italian merchant, that Venice was a free state without a king."cite book
title=Schott's Original Miscellany
author=Schott, Ben
location=London | publisher=Bloomsbury Publishing
year=2003
id=ISBN 0-7475-6320-9]
*In 1660, the Scottish aristocrat, polymath and first translator of Rabelais into English, Thomas Urquhart, is said to have died laughing upon hearing that Charles II had taken the throne. [cite book | title = Rabelais in English Literature | last = Brown | first = Huntington | isbn = 0-714-620-513 | publisher = Routledge | pages = p. 126 | year = 1968] [cite book | title = The History of Scotish Poetry | publisher = Edmonston & Douglas | year = 1861 | pages = p. 539]
*The phenomenon is also recorded in the book "Crazy History" where a Celtic soothsayer was able to predict the hour of his demise. As with the death of Calchas, when the time arrived and the soothsayer found himself still alive, he purportedly laughed hysterically, eventually killing himself through either heart attack or asphyxiation.Fact|date=December 2007

Modern deaths attributed to fatal hilarity

*On 24 March 1975, Alex Mitchell, a 50-year-old bricklayer from King's Lynn, England, died laughing while watching the Kung Fu Kapers episode of "The Goodies", featuring a Scotsman in a kilt battling a vicious black pudding with his bagpipes. After twenty-five minutes of continuous laughter Mitchell finally slumped on the sofa and expired from heart failure. His widow later sent the Goodies a letter thanking them for making Mitchell's final moments so pleasant.cite web | url = http://www.snopes.com/horrors/freakish/laughing.asp | title = The Last Laugh's on Him | work = Urban Legends Reference Pages | date = 2007-01-19 | accessdate = 2007-06-23]
*In 1989, a Danish audiologist, Ole Bentzen, died watching "A Fish Called Wanda". His heart was estimated to have beat at between 250 and 500 beats per minute, before he succumbed to cardiac arrest. [ [http://www.canongate.net/Lists/Death/9PeopleWhoDiedLaughing 9 People Who Died Laughing - Death - Book of Lists - Canongate Home ] ]
*In 2003, Damnoen Saen-um, a Thai ice cream salesman, is reported to have died while laughing in his sleep at the age of 52. His wife was unable to wake him, and he stopped breathing after two minutes of continuous laughter. It is believed that he died either of heart failure or asphyxiation.

ee also

*Motif of harmful sensation
*Kuru (disease), also known as "laughing sickness".
*The Funniest Joke In The World, a Monty Python sketch about comic warfare

References

External links

* [http://www.snopes.com/horrors/freakish/laughing.asp Snopes.com article]