Why is Laughter Not Always the Best Medicine? A Serious Take on Laughter

Laughter may not be the best medicine, after all. The Christmas issue of British Medical Journal (BMJ), one of the world's oldest and most prestigious medical journals, takes a hard and serious take on laughter. Laugh related dangers range from asthma attacks to strokes, says the article. Laughter is not purely beneficial. The harms it can cause are immediate and dose related, the risks being highest for Homeric (uncontrollable) laughter," the authors wrote.

The authors delved deep into researches related to laughter that were published between 1946 and 2013; an analysis was drawn from nearly 5000 studies.

Harms
Psychological harms:

Laughter weakens resolve and promotes your preference for certain brands. Hence it is better for doctors to be sceptical of those cheer laden witty drug reps.

Laughter may not be that good for the heart:

Hearty laughter can cause syncope, due to neurological changes. It can lead to conduction abnormalities and arrhythmias. 'Laughing fit to burst can cause cardiac rupture,' observes BMJ. There has been a reported case of death after intense sustained laughter in a woman with a condition known as long QT syndrome.

Respiratory harms:

Laugher may provoke inhalation of foreign bodies. It sometimes triggers attacks of asthma. Pilgaard-Dahl syndrome is a rare condition in which middle aged smokers can develop a condition called pneumothorax. Exhaled air flow during laughter can disseminate infections.

Harms to the nervous system:

Laughter can trigger cataplexy, i.e. sudden loss of muscle tone. It may precipitate headaches. In one recorded case, 'a woman with a patent foramen ovale laughed uproariously for three minutes, became aphasic, and had a cerebral infarct.''

Harms to the digestive system:

Laughter is an unusual precipitant of Boerhaave's syndrome, i.e. spontaneous rupture of the food pipe. It may also make hernia protrude.

Laughter is thus not as light as we think. A strong laughter may dislocate your jaw; it can cause stress incontinence.

Gelastic seizures manifest by laughing, thus laughter can be pathological.

Benefits

Don't panic anyway, laughter also has a brighter side. Laughter can increase pain thresholds. Laughter prevents heart attacks; it is good for blood vessels. Authors also note that laughter induced by a clown improved lung function in patients with the lung condition called chronic obstructive pulmonary disease.

'A day of merriment consumes over 8360 kJ (2000 kcal), improves glycaemic control, and cures obesity'. Laughter has obstetric benefits; would-be-mothers undergoing treatment for infertility benefitted from the entertainment provided clown, dressed as a chef de cuisine.

The ENT benefits may be deduced from this line, "A surgeon proceeded to read [to me] the diverting history of 'The Lady Rohesia' [from The Ingoldsby Legends], and how she was cured of her quinsy... The story caused me to laugh, and this led to the bursting of the [tonsillar] abscess, and to my cure without the use of cold steel."

The latest revelations 'refute the proposition that laughter can only be beneficial.' Well, now we have been warned decently well about the risks of outbursts of laughter!

Reference: Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): narrative synthesis. BMJ 2013;347:f7274