What Causes Hiccups?

iStock/damircudic
iStock/damircudic

The cause of hiccups depends on whom you ask. The ancient Greek physician Galen thought hiccups were violent emotions erupting from the body, while others thought they were a sign of liver inflammation. Today, evidence points to spasms in the diaphragm, the large muscle between the chest and abdomen that aids airflow during breathing. This involuntary contraction can be brought on by a number of things that might irritate the nerves that control the movement of the muscle. A full stomach, heavy boozing, rapid shifts in temperature either inside or outside of the stomach, and certain emotions like shock or excitement are all common culprits.

No matter the cause, the result is the same: The diaphragm spasms and causes us to take a quick breath. The sudden rush of air causes the epiglottis (the flap that protects the space between the vocal cords) to shut and interrupt the breath, which makes the familiar "hic" sound.

WHAT CURES THEM?

The best cure for hiccups also depends on the person you ask. Almost all cures are based on one of two principles: One type works its magic by overwhelming the vagus nerve with another sensation. The vagus nerve is a cranial nerve that innervates the stomach and conveys sensory information about the body's organs to the brain. When distracted by overwhelming information of another sort, it basically tells the brain that something more important has come up and the hiccuping should probably be stopped (vagus nerve stimulation is also used to control seizures in epileptics and treat drug-resistant cases of clinical depression). The other method for curing hiccups is to interfere with the breathing, increasing the amount of carbon dioxide in the blood, and causing the body to focus on getting rid of the of the CO2 and not making hiccups.

Swallowing a spoonful of sugar is probably the most commonly prescribed hiccup cure and falls into the first category. A teaspoon of sugar is usually enough to stimulate the vagus nerve and make the body forget all about the hiccups. Even ardent supporters of the sugar cure disagree if the sugar should be taken dry or washed down with water, though.

If this home remedy doesn't work, and your hiccups are both severe and persistent, you may need to bring out the big guns. For chronic cases like this, doctors sometimes use a cocktail of Reglan (a gastrointestinal stimulant) and Thorazine (an anti-psychotic with sedative properties) to quiet things down. In some cases that resist these drugs, Kemstro, an anti-spasmodic, is also used. Other doctors have used vagus nerve stimulators implanted in the upper chest of patients. The pacemaker-like devices send rhythmic bursts of electricity through the vagus nerve to the brain to keep the hiccup cycle in check.

Many people prefer home remedies to battle their hiccups, which may include holding your breath, gargling ice water, or breathing into a paper bag. While the same people will swear by the treatment they've been using all these years, there's no firm scientific consensus that any of them actually work. But if it helps you, isn't that all that matters?

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An earlier version of this article appeared in 2012.

Why Are We So Scared of Clowns?

Warner Bros.
Warner Bros.

With the recent box office-smashing success of Stephen King's It, it’s safe to say that coulrophobia (fear of clowns) isn’t a fringe phenomenon. The colorful circus performers are right up there with vampires and werewolves on the list of iconic horror villains. But unlike other movie monsters, clowns were originally meant to make kids laugh, not hide under their beds in terror. So what is it about clowns that taps into our deepest fears?

According to Yale doctoral candidate Danielle Bainbridge, the unsettling clown stereotype goes back centuries. In the inaugural episode of the PBS digital series Origin of Everything, Bainbridge explained the long history of this pervasive part of our culture.

Before clowns wore floppy shoes and threw pies at each other’s faces, early versions of the performers could be found in royal courts. The court jester wasn’t evil, but he was the only person in the kingdom who could poke fun at the monarch without fear of (literally) losing his head. The fact that fools didn’t fall within the normal social hierarchy may have contributed to the future role clowns would play as untrustworthy outsiders.

From the medieval era, clowns evolved into the harlequins of 16th-century Italian theater. Again, these weren’t bloodthirsty monsters, but they weren’t exactly kid-friendly either. The characters were often mischievous and morally bankrupt, and their strange costumes and masks only added to the creepy vibes they gave off.

Fast-forward to the 19th century, when the white-faced circus clowns we know today started gaining popularity. Unlike the jesters and harlequins that came before them, these clowns performed primarily for children and maintained a wholesome image. But as pop culture in the 1970s, '80s, and '90s showed us, that old perception we had of clowns as nefarious troublemakers never really went away. Steven King’s It, the cult classic Killer Clowns From Outer Space (1988), and that scene from Poltergeist (1982) all combined these original fears with the more modern association of clowns with children. That formula gave us one of the most frightening figures in horror media today.

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Why Do We Call a Leg Cramp a Charley Horse?

iStock.com/Jan-Otto
iStock.com/Jan-Otto

If you’re unlucky enough to have experienced a charley horse—a painful muscle spasm or cramp in your leg—then you may have found yourself wondering what this nonsensical phrase even means. Who is this Charley character? Where did he come from? And what does he know about my pain?

Like the words flaky and jazz, this term likely entered the language from the baseball field. While the idiom’s etymology isn’t 100 percent certain, archived newspaper articles suggest it was coined by a baseball player in the 1880s. We just don’t know which player said it first, or why.

According to a January 1887 article in the Democrat and Chronicle, the phrase was well-known to baseball players at the time—but to the average person, charley horses were as enigmatic as “an Egyptian hieroglyphic.” That year, charley horses were mentioned in a slew of newspapers across America, and some attempted to tackle the phrase’s murky origin. “Nearly every sporting journal gives a different version as to how the term charley horse originated in baseball circles,” the Oakland Daily Evening Tribune reported at the time.

The likeliest tale, according to the paper, centered around John Wesley "Jack" Glasscock, a shortstop who at the time was playing for Indianapolis. At some point a few years earlier, the player had strained a tendon in his thigh during a game and afterwards went home to his farm, where his father looked after a lame old horse called a "Charley horse." When the senior Glasscock saw his son limping along, he reportedly exclaimed, “Why, John, my boy, what is the matter; you go just like the old Charley horse?” John supposedly shared the funny turn of phrase with his teammates, and from there it spread. Similar accounts were reported in other newspapers, but they were attributed to various other players.

Other reports say the phrase has nothing to do with a live animal, but rather the fact that an injured player, while running, resembles a rocking horse or a child riding astride a wooden hobby horse.

The New Dickson Baseball Dictionary by Paul Dickson details a few other theories. In two versions of the same basic tale, Orioles or Chicago Cubs players went to the races and bet on a horse named Charlie who "pulled up lame in the final stretch." The next day, a player pulled a tendon in his leg and was said to resemble “our old Charlie horse.”

Alternatively, its origin may relate to an old workhorse that was tasked with pulling a roller across the infield. “Often in the 1800s, old workhorses kept on the grounds of ballparks were called Charley. The movements of the injured, stiff-legged ballplayers were likened to the labored plodding of these old horses, and the injury itself eventually became known as a ‘charley’ or ‘charley horse,'" Tim Considine wrote in 1982's The Language of Sport.

It also appears that charley horse originally implied a much more serious injury—or perhaps there was a bit of hysteria surrounding a condition that seemed new and scary in the late 19th century. The Democrat and Chronicle described a charley horse as a “giving way of one of the small tendons of the leg” and said an injured baseball player might need an entire season to recover. Another article from 1887 said ballplayer George Van Haltren’s relatives were worried he would get a charley horse, “although they do not know what that is.” He was said to have been “very fortunate” because he had “not yet encountered the terrible charley horse.”

For comparison, Healthline.com now says charley horses “are generally treatable at home” by stretching, massaging, or icing the afflicted area, although the muscle pain can linger for up to a day in some cases. So there you have it. We may never know the exact etymology of the charley horse, but the next time you get a sharp pain in your leg, you can thank an old-timey ballplayer for making your struggle sound so silly.

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