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File:Laughter 2 by David Shankbone.jpg


Laughter is an audible expression or appearance of merriment or amusement or an inward feeling of joy and pleasure (laughing on the inside). It may ensue (as a physiological reaction) from jokes, tickling and other stimuli. Inhaling nitrous oxide can also induce laughter; other drugs, such as cannabis, can also induce episodes of strong laughter. Strong laughter can sometimes bring an onset of tears or even moderate muscular pain as a physical response to the act. Laughter can also be a response to physical touch, such as tickling.

Laughter is a part of human behaviour regulated by the brain. It helps humans clarify their intentions in social interaction and provides an emotional context to conversations. Laughter is used as a signal for being part of a group — it signals acceptance and positive interactions with others. Laughter is sometimes seemingly contagious, and the laughter of one person can itself provoke laughter from others. This may account in part for the popularity of laugh tracks in situation comedy television shows.

The study of humor and laughter, and its psychological and physiological effects on the human body is called gelotology.

Laughter in animals

Main article: Laughter in animals

Laughter might not be confined or unique to humans, despite Aristotle's observation that "only the human animal laughs". The differences between chimpanzee and human laughter may be the result of adaptations that have evolved to enable human speech. However, some behavioral psychologists argue that self-awareness of one's situation, or the ability to identify with another's predicament are prerequisites for laughter, and thus certain animals are not laughing in the "human manner".

An Orangutan "laughing"

Research of laughter in animals may identify new molecules to alleviate depression, disorders of excessive exuberance such as mania and ADHD, or addictive urges and mood imbalances.

Non-human primates

Chimpanzees, gorillas and orangutans show laughter-like vocalizations in response to physical contact, such as wrestling, play chasing, or tickling. This is documented in wild and captive chimpanzees. Chimpanzee laughter is not readily recognizable to humans as such, because it is generated by alternating inhalations and exhalations that sound more like breathing and panting. The differences between chimpanzee and human laughter may be the result of adaptations that have evolved to enable human speech. There are instances in which non-human primates have been reported to have expressed joy. One study analyzed and recorded sounds made by human babies and bonobos (also known as pygmy chimpanzees) when tickled. It found that although the bonobo’s laugh was a higher frequency, the laugh followed the same spectrographic pattern of human babies to include as similar facial expressions. Humans and chimpanzees share similar ticklish areas of the body such as the armpits and belly. The enjoyment of tickling in chimpanzees does not diminish with age. Discovery 2003A chimpanzee laughter sample. Goodall 1968 & Parr 2005

Brown Rat


It has been discovered that rats emit short, high frequency, ultrasonic, socially induced vocalization during rough and tumble play, and when tickled. The vocalization is described a distinct “chirping”. Humans cannot hear the "chirping" without special equipment. It was also discovered that like humans, rats have "tickle skin". These are certain areas of the body that generate more laughter response than others. The laughter is associated with positive emotional feelings and social bonding occurs with the human tickler, resulting in the rats becoming conditioned to seek the tickling. Additional responses to the tickling were those that laughed the most also played the most, and those that laughed the most preferred to spend more time with other laughing rats. This suggests a social preference to other rats exhibiting similar responses. However, as the rats age, there does appear to be a decline in the tendency to laugh and respond to tickle skin. The initial goal of Jaak Panksepp and Jeff Burgdorf’s research was to track the biological origins of joyful and social processes of the brain by comparing rats and their relationship to the joy and laughter commonly experienced by children in social play. Although, the research was unable to prove rats have a sense of humour, it did indicate that they can laugh and express joy. Panksepp & Burgdorf 2003 Chirping by rats is also reported in additional studies by Brain Knutson of the National Institutes of Health. Rats chirp when wrestling one another, before receiving morphine, or when mating. The sound has been interpreted as an expectation of something rewarding. Science News 2001


The dog laugh sounds similar to a normal pant. But by analyzing the pant using a sonograph, this pant varies with bursts of frequencies, resulting in a laugh. When this recorded dog-laugh vocalization is played to dogs in a shelter setting, it can initiate play, promote pro-social behavior, and decrease stress levels. In a study by Simonet, Versteeg, and Storie, 120 subject dogs in a mid-size county animal shelter were observed. Dogs ranging from 4 months to 10 years of age were compared with and without exposure to a dog-laugh recording. The stress behaviors measured included panting, growling, salivating, pacing, barking, cowering, lunging, play-bows, sitting, orienting and lying down. The study resulted in positive findings when exposed to the dog laughing: significantly reduced stress behaviors, increased tail wagging and the display of a play-face when playing was initiated, and the increase of pro-social behavior such as approaching and lip licking were more frequent. This research suggests exposure to dog-laugh vocalizations can calm the dogs and possibly increase shelter adoptions. Simonet, Versteeg, & Storie 2005 A dog laughter sample. Simonet 2005

Laughter in humans

Laughter is a common response to tickling

Recently researchers have shown infants as early as 17 days old have vocal laughing sounds or spontaneous laughter. Early Human Development 2006 This conflicts with earlier studies indicating that babies usually start to laugh at about four months of age; J.Y.T. Greig writes, quoting ancient authors, that laughter is not believed to begin in a child until the child is forty days old. [1] "Laughter is Genetic" Robert R. Provine, Ph.D. has spent decades studying laughter. In his interview for WebMD, he indicated "Laughter is a mechanism everyone has; laughter is part of universal human vocabulary. There are thousands of languages, hundreds of thousands of dialects, but everyone speaks laughter in pretty much the same way.” Everyone can laugh. Babies have the ability to laugh before they ever speak. Children who are born blind and deaf still retain the ability to laugh. “Even apes have a form of ‘pant-pant-pant’ laughter.”

Provine argues that “Laughter is primitive, an unconscious vocalization.” And if it seems you laugh more than others, Provine argues that it probably is genetic. In a study of the “Giggle Twins,” two exceptionally happy twins were separated at birth and not reunited until 40 years later. Provine reports that “until they met each other, neither of these exceptionally happy ladies had known anyone who laughed as much as she did.” They reported this even though they both had been reared by adoptive parents they indicated were “undemonstrative and dour.” Provine indicates that the twins “inherited some aspects of their laugh sound and pattern, readiness to laugh, and perhaps even taste in humor.” WebMD 2002

"The physical and psychological benefits of laughter come second only to the physical and psychological benefits of sex." Raju Mandhyan

Gender differences

Men and women take jokes differently. A study that appeared in Proceedings of the National Academy of Sciences found in a study, 10 men and 10 women all watched 10 cartoons, rating them funny or not funny and if funny, how funny on a scale of 1–10. While doing this, their brains were scanned by functional magnetic resonance imaging (fMRI). Men and women for the most part agreed which cartoons were funny. However, their brains handled humor differently. Women’s brains showed more activity in certain areas, including the nucleus accumbens. When women viewed cartoons they did not find humorous, their nucleus accumbens had a “ho-hum response.” A man's nucleus accumbens did not react to funny cartoons, and its natural activity level dropped during unfunny cartoons.

Researchers suspect the element of surprise may be at the heart of the study. They suggested that maybe women did not expect the cartoons to be funny, while men did the opposite. When the men in the study “got what they expected, their nucleus accumbens were calm.” However, the women’s brains could have had increased activity when they were “pleasantly surprised” by the cartoons’ humour. Researchers also suspect that men might have been “let down by unfunny cartoons, causing a dip in that brain area’s activity.”

It was indicated that this study might be a clue about the different emotional responses between men and women and could help with depression research. The research suggests men and women “differ in how humour is used and appreciated,” says Allan Reiss, M.D. WebMD 2005

Laughter and the brain

Principal fissures and lobes of the cerebrum viewed laterally. (Frontal lobe is blue, temporal lobe is green.)

Modern neurophysiology states that laughter is linked with the activation of the ventromedial prefrontal cortex, which produces endorphins after a rewarding activity.

Research has shown that parts of the limbic system are involved in laughter[How to reference and link to summary or text]. The limbic system is a primitive part of the brain that is involved in emotions and helps us with basic functions necessary for survival. Two structures in the limbic system are involved in producing laughter: the amygdala and the hippocampus[How to reference and link to summary or text].

The December 7, 1984 Journal of the American Medical Association describes the neurological causes of laughter as follows:

"Although there is no known 'laugh center' in the brain, its neural mechanism has been the subject of much, albeit inconclusive, speculation. It is evident that its expression depends on neural paths arising in close association with the telencephalic and diencephalic centers concerned with respiration. Wilson considered the mechanism to be in the region of the mesial thalamus, hypothalamus, and subthalamus. Kelly and co-workers, in turn, postulated that the tegmentum near the periaqueductal grey contains the integrating mechanism for emotional expression. Thus, supranuclear pathways, including those from the limbic system that Papez hypothesised to mediate emotional expressions such as laughter, probably come into synaptic relation in the reticular core of the brain stem. So while purely emotional responses such as laughter are mediated by subcortical structures, especially the hypothalamus, and are stereotyped, the cerebral cortex can modulate or suppress them."

Laughter and the body

The heart

It has been shown that laughing helps to protect the heart. Although studies are inconclusive as to why, they do explain that mental stress impairs the endothelium, the protective barrier lining a person’s blood vessels. Once the endothelium is impaired, it can cause a series of inflammatory reactions that lead to cholesterol build-up in a person’s coronary arteries. This can ultimately cause a heart attack. Psychologist Steve Sultanoff, Ph.D., the president of the American Association for Therapeutic Humor, gave this explanation:

"With deep, heartfelt laughter, it appears that serum cortisol, which is a hormone that is secreted when we’re under stress, is decreased. So when you’re having a stress reaction, if you laugh, apparently the cortisol that has been released during the stress reaction is decreased."

Also according to Sultanoff in his interview for the article for WebMD, laughter has been shown to increase tolerance of pain and boost the body’s production of infection-fighting antibodies, which can help prevent hardening of the arteries and subsequent conditions caused thereby such as angina, heart attacks, or strokes.

Sultanoff also added that research shows that distressing emotions lead to heart disease. It is shown that people who are “chronically angry and hostile have a greater likelihood for heart attack, people who “live in anxious, stressed out lifestyles have greater blockages of their coronary arteries”, and people who are “chronically depressed have a two times greater chance of heart disease.” WebMD 2000


A study in Japan shows that laughter lowers blood sugar after a meal. Keiko Hayashi, Ph.D., R.N, of the University of Tsukuba in Ibaraki, Japan, and his team performed a study of 19 people with type 2 diabetes. They collected the patients’ blood before and two hours after a meal. The patients attended a boring 40 minute lecture after dinner on the first night of the study. On the second night, the patients attended a 40 minute comedy show. The patients’ blood sugar went up after the comedy show, but much less than it did after the lecture. The study found that even when patients without diabetes did the same testing, a similar result was found. Scientists conclude that laughter is good for people with diabetes. They suggest that ‘chemical messengers made during laughter may help the body compensate for the disease.” WebMD 2003

Blood flow

Studies at the University of Maryland found that when a group of people were shown a comedy, after the screening their blood vessels performed normally, whereas when they watched a drama, after the screening their blood vessels tended to tense up and restricted the blood flow. WebMD 2006

Immune response

Studies show stress decreases the immune system. “Some studies have shown that humor may raise infection-fighting antibodies in the body and boost the levels of immune cells.” Web MD 2006“When we laugh, natural killer cells which destroy tumors and viruses increase, along with Gamma-interferon (a disease-fighting protein), T cells (important for our immune system) and B cells (which make disease-fighting antibodies). As well as lowering blood pressure, laughter increases oxygen in the blood, which also encourages healing.” Discover Health 2004

Anxiety and children

According to an article of WebMD, studies have shown that children who have a clown present prior to surgery along with their parents and medical staff had less anxiety than children who just had their parents and medical staff present. High levels of anxiety prior to surgery leads to a higher risk of complications following surgeries in children. According to researchers, about 60% of children suffer from anxiety before surgery.

The study involved 40 children ages 5 to 12 who were about to have minor surgery. Half had a clown present in addition to their parents and medical staff, the other half only had their parents and medical staff present. The results of the study showed that the children who had a clown present had significantly less pre-surgery anxiety. WebMD 2005

Relaxation and sleep

“The focus on the benefits of laughter really began with Norman Cosins' memoir, Anatomy of an Illness. Cousins, who was diagnosed with ankylosing spondylitis, a painful spine condition, found that a diet of comedies, like Marx Brothers films and episodes of Candid Camera, helped him feel better. He said that ten minutes of laughter allowed him two hours of pain-free sleep.” WebMD 2006

Physical fitness

It has been estimated by scientists that laughing 100 times equals the same physical exertion as a 10 minute workout on a rowing machine or 15 minutes on a stationary exercise bike. Laughing works out the diaphragm, abdominal, respiratory, facial, leg, and back muscles.

However, William Fry, a pioneer on laughter research, in an article for WebMd was said to indicate that it “took ten minutes on a rowing machine for his heart rate to reach the level it would after just one minute of hearty laughter.” WebMD 2006


Nearly 2/3 of people with asthma reported having asthma attacks that were triggered by laughter, according to a study presented at the American Thoracic Society annual meeting in 2005. It did not seem to matter how deep of a laugh the laughter entailed, whether it may be a giggle, chuckle, or belly laugh, says Stuart Garay, M.D., clinical professor of medicine at New York University Medical Center in New York.

Patients were part of an 18 month long program who were evaluated for a list of asthma triggers. The patients did not have any major differences in age, duration of asthma, or family history of asthma. However, exercise-induced asthma was more frequently found in patients who also had laughter-induced asthma, according to the study. 61% of laughter induced asthma also reported exercise as a trigger, as opposed to only 35% without laughter-induced asthma. Andrew Ries, M.D. indicates that “it probably involves both movements in the airways as well as an emotional reaction.” WebMD 2005

Strengthening muscles

In addition to helping in many other ways, laughing is also clinically proven to strengthen the abdomen. Jared B. Cohen, Ph.D has run many experiments on laughing at his laboratory in Newark, New Jersey and says "Laughing not only helps your heart, but it also helps you look good for the beach". Although some think it is impossible that something as simple and painless as laughing can strengthen one's abdomen, 14 out of every 15 of Cohen's patients said that laughing was a better, and more humorous workout than sit-ups or crunches. To make laughing a truly effective workout, one must laugh for at least 30 seconds until they feel a small burning sensation.

Therapeutic effects of laughter

While it is normally only considered cliché that "laughter is the best medicine," specific medical theories attribute improved health, increased life expectancy, and overall improved well-being, to laughter.

A study demonstrated neuroendocrine and stress-related hormones decreased during episodes of laughter, which provides support for the claim that humour can relieve stress. Writer Norman Cousins wrote about his experience with laughter in helping him recover from a serious illness in 1979's Anatomy of an Illness As Perceived by the Patient. In 1989, the Journal of the American Medical Association published an article, wherein the author wrote that "a humor therapy program can increase the quality of life for patients with chronic problems and that laughter has an immediate symptom-relieving effect for these patients, an effect that is potentiated when laughter is induced regularly over a period". [2]

Some therapy movements like Re-evaluation Counseling believe that laughter is a type of "bodily discharge", along with crying, yawning and others, which requires encouragement and support as a means of healing.

Types of therapy

There is well documented and ongoing research in this field of study. Psych Nurse 2004This has led to new and beneficial therapies practiced by doctors, psychiatrists, and other mental health professionals using humor and laughter to help patients cope or treat a variety of physical, mental, and spiritual issues. The various therapies are not specific to health care professionals or clinicians. Some of the therapies can be practiced individually or in a group setting to aid in a person's well-being. There seems to be something to the old saying "laughter is the best medicine". Or perhaps as stated by Voltaire, "The art of medicine consists of keeping the patient amused while nature heals the disease."

  • Humor Therapy: It is also known as therapeutic humor. Using humorous materials such as books, shows, movies, or stories to encourage spontaneous discussion of the patients own humorous experiences. This can be provided individually or in a group setting. The process is facilitated by clinician. There can be a disadvantage to humor therapy in a group format, as it can be difficult to provide materials that all participants find humorous. It is extremely important the clinician is sensitive to laugh "with" clients rather than "at" the clients.
  • Clown Therapy: Individuals that are trained in clown therapy, are also versed in proper hygiene and hospital procedures to do this. In some hospitals "clown rounds" are made. The clowns perform for others with the use of magic, music, fun, joy, and compassion. For hospitalized children, clown therapy can increase patient cooperation and decrease parental & patient anxiety. In some children the need for sedation is reduced. Other benefits include pain reduction and the increased stimulation of immune function in children. This use of clown therapy is not limited to hospitals. They can transform other places where things can be tough such as nursing homes, orphanages, refugee camps, war zones, and even prisons. The presence of clowns tends to have a positive effect.
  • Laughter Therapy: A client's laughter triggers are identified such as people in their lives that make them laugh, things from childhood, situations, movies, jokes, comedians, basically anything that makes them laugh. Based on the information provided by the client, the clinician creates a personal humor profile to aid in the laughter therapy. In this one on one setting, the client is taught basic exercises that can be practiced. The intent of the exercises is to remind the importance of relationships and social support. It is important the clinician is sensitive to what the client perceives as humorous.
  • Laughter Meditation: In laughter meditation there are some similarities to traditional meditation. However, it is the laughter that focuses the person to concentrate on the moment. Through a three stage process of stretching, laughing and or crying, and a period of meditative silence. In the first stage, the person places all energy into the stretching every muscle without laughter. In the second stage, the person starts with a gradual smile, and then slowly begins to purposely belly laugh or cry, whichever occurs. In the final stage, the person abruptly stops laughing or crying, then with their eyes now closed they breathe without a sound and focus their concentration on the moment. The process is approximately a 15 minute exercise. This may be awkward for some people as the laughter is not necessarily spontaneous. This is generally practiced on an individual basis.
  • Laughter Yoga & Laughter Clubs: Somewhat similar to traditional yoga, laughter yoga which was developed by Dr. Madan Kataria in 1995 at Bombay of India is an exercise which incorporates breathing, yoga, stretching techniques along with laughter. The structured format includes several laughter exercises for a period of 30 to 45 minutes facilitated by a trained individual. Practiced it can be used as supplemental or preventative therapy. Laughter yoga can be performed in a group or a club. Therapeutic laughter clubs are extension of Laughter Yoga, but in a formalized club format. The need for humorous materials is not necessarily required. Laughter yoga is similar to yogic asana and the practice of Buddhist forced laughter. Some participants may find it awkward as laughter is not necessarily spontaneous in the structured format. A growth of laughter-related movements such as Laughter Yoga, Laughing Clubs and World Laughter Day have emerged in recent years as a testament to the growing popularity of laughter as therapy. In China, for example, the popularity of Laughing Clubs has even led to a detailed lexicon of laughing styles, such as "The Lion Bellow" or "The Quarrelling Laugh" [1].

Abnormal laughter

Researchers frequently learn how the brain functions by studying what happens when something goes wrong. People with certain types of brain damage produce abnormal laughter. This is found most often in people with pseudobulbar palsy, gelastic epilepsy and, to a lesser degree, with multiple sclerosis, amyotrophic lateral sclerosis (ALS), and some brain tumors. Inappropriate laughter is considered symptomatic of psychological disorders including dementia and hysteria, but can also be the result of cerebellar lesions causing Pathological Laughter, curable by antidepressants, such as SSRIs or tricyclic antidepressants. Some negative medical effects of laughter have been reported as well, including laughter syncope, where laughter causes a person to lose consciousness.[3]


A number of competing theories have been written. For Aristotle, we laugh at inferior or ugly individuals, because we feel a joy at being superior to them. Socrates was reported by Plato as saying that the ridiculous was characterized by a display of self-ignorance. Francis Hutcheson expressed in Thoughts on Laughter (1725) what became a key concept in the evolving theory of the comic: laughter as a response to the perception of incongruity.[4] Arthur Schopenhauer wrote that the perceived incongruity is between a concept and the real object it represents. Hegel shared almost exactly the same view, but saw the concept as an "appearance" and believed that laughter then totally negates that appearance. For Sigmund Freud, laughter is an "economical phenomenon" whose function is to release "psychic energy" that had been wrongly mobilized by incorrect or false expectations.

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Philosopher John Morreall theorizes that human laughter may have its biological origins as a kind of shared expression of relief at the passing of danger. The General Theory of Verbal Humor (GTVH) proposed by Victor Raskin and S. Attardo identifies a semantic model capable of expressing incongruities between semantic scripts in verbal humor; this has been seen as an important recent development in the theory of laughter. Recently Peter Marteinson theorized that laughter is our response to the perception that social being is not real in the same sense that factual states of affairs are true, and that we subconsciously blur the distinctions between cultural and natural truth types, so that we do not normally notice their differing criteria for truth and falsehood. This is an ontic-epistemic theory of the comic (OETC).

Robert A. Heinlein's view of why people laugh is explained in one of his most praised novels, Stranger in a Strange Land, "because it hurts", is empathic but also a release of tension. Laughter can be as a coping mechanism for when one is upset, angry or sad. It does not necessarily always occur in a humorous or comedic tone.

How laughter happens (cognitive model)

In modern times, the tendency is toward acceptance of incongruity as the most common cause of laughter. Although incongruity-based theories are gaining ground, other schools of thought still hold some favour.

This is the basis of the cognitive model of humour: the joke creates an inconsistency, the sentence appears to be not relevant, and we automatically try to understand what the sentence says, supposes, doesn't say, and implies; if we are successful in solving this 'cognitive riddle', and we find out what is hidden within the sentence, and what is the underlying thought, and we bring foreground what was in the background, and we realize that the surprise wasn't dangerous, we eventually laugh with relief. Otherwise, if the inconsistency is not resolved, there is no laugh, as Mack Sennett pointed out: "when the audience is confused, it doesn't laugh" (this is the one of the basic laws of a comedian, called "exactness"). This explanation is also confirmed by modern neurophysiology (see section Laughter and the Brain)

Depiction of laughter

As expected for a common occurrence, laughter is frequently depicted in books and cartoons. The actual language used is listed on the table below.

Language How written Notes
Arabic هاهاها(hahaha) (general)
French hahaha (normal)
hihihi (giggle)
ouahahah (loud laughter)
Chinese 哇哈哈 (wahaha) (loud laughter)
哈哈哈 (hahaha) (normal)
呵呵呵 (hehehe) (chuckles)
嘻嘻嘻 (xixixi) (giggles)
German hahaha (normal)
höhöhö (ironic)
Greek χαχαχα


χιχιχι (giggle)
χουχουχου (dumb)
Hebrew חחח(hahaha) (general)
פחח(pkhhhh) (crude;ridiculing)
Hungarian hahaha (classical; the length of it depends on how funny we find the thing we are laughing about)
ha. ha. ha. (sarcastic)
hehehe (can be a bit malevolent, especially if it is combined with raised eyebrows and a little smile)
hihihi (giggle)
ho-ho-ho-hóóó (a la Santa Claus)
kac-kac (ironic)
Indonesian huehehehe (cute way of laughter)
bwahahaha (more satisfied way of laughter)
Japanese ハハハ (hahaha) (normal)
ヒヒヒ (hihihi) (giggles)
ヘへへ (hehehe) (sneering)
ホホホ (hohoho) (often by women with mouth covered by one hand; similar to te-hees)
Lithuanian cha cha cha
chi chi chi (giggle)
Malaysian Kahkahkah
Polish hehe (casual way of expressing laughter)
haha (more crude; can be ironic)
Russian ха-ха-ха! (hahaha)
хи-хи (heehee - giggle)
хе-хе (hehe, very mean laughter)
Serbian ahahaha (loud laughter)
he, he, he (can be a bit meanish)
hi, hi, hi (giggling)
ho, ho, ho (rare, Santa Claus laughter)
ja ja ja (Usual laugh)
je je je (Mischievous little laughter)
ji ji ji (Giggle)
jo jo jo (San Nicolás -Santa Claus- laugh)
jú jú jú (In a high pitch) (mean laugh after a prank)
ujú ja ja ja ja ja jaaaaaa...
(Evil laugh)
Swedish haha (any plain laughter)
hehe (more hissing)
hihi (giggling)
hoho (Santa Claus style)
höhö (ironic)
moahaha (the evil one)
eheh (embarrassed)
Turkish hahaha (very typical laughter, it's usually triple 'ha', not double)
hehehe (sound a bit more 'polite' than hahaha)
ha... ha... ha... (sarcastic)
hihihi (giggling)
ahahaha (got popular after a TV series character who used to laugh this way)
ehehehe (same as hehehe)
eki eki (used in comics, especially as the oldie way laughter)
keh keh/kah kah (sneaky-ish laughter)
muhaha (evil laughter)
nihaha (evil laughter)
puhaha (used if it's too amusing)
uhaha (almost like puhaha)
zuhaha (almost like puhaha)

LOL and its variations are internet slangs to indicated laughter.

See also


  1. J.Y.T. Greig, The Psychology of Comedy and Laughter
  2. "Laugh If This Is a Joke", JAMA, Jan 1989, 261: 558., by Lars Ljungdahl
  3. Shear Hilarity Leading to Laugh Syncope in a Healthy Man, by Dennis Bloomfield and Saad Jazrawi, JAMA, June 15 2005; 293: 2863 - 2864
  4. Peter Ludwig Berger Redeeming Laughter: The Comic Dimension of Human Experience (1997) p.22




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