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    A chuckle a day

    A short history of therapeutic laughter

    The concept of laughter being good medicine isn't new, of course. It was mentioned in the Old Testament. ("A merry heart doeth good like a medicine, but a broken spirit drieth the bones." Proverbs 17:22.)

    And it's been more than two decades since the late magazine editor Norman Cousins published his 1979 "Anatomy of an Illness," in which he describes how he was diagnosed with ankylosing spondylitis, a painful rheumatic disease, and how he managed it partly by watching funny videos. Now there's more scientific evidence to buttress Cousins' intuition.

    What a good laugh can do

    Lee Berk, DrPh, a pioneer in laughter studies, says laughter has been found to decrease or attenuate cortisol and other "distress" hormones, although not everyone agrees. And laughter may improve the immune system, adds Berk, associate director of the Center of Neuroimmunology at Loma Linda University School of Medicine and associate professor of health promotion and education in the university's School of Public Health.

    In his oft-quoted study, published in the American Journal of the Medical Sciences in December 1989, he found that laughter is a good kind of stress: It reduces blood levels of cortisol, epinephrine, and other substances. Increased cortisol and epinephrine levels tend to suppress the immune system, so decreasing their levels is believed to be beneficial.

    Laughter may go a long way to reducing pain, too. At UCLA, a five-year program called UCLA/Rx Laughter, in which researchers are studying the effects humorous videos have on young patients' perception of pain, is entering its second year, funded in part by TV's Comedy Central.

    Laughter also may help a patient who already has had a heart attack, Berk says. In a study he and his colleagues presented at the 4th International Conference on Preventive Cardiology in 1997, 24 cardiac rehabilitation patients who watched a 30-minute funny video each day for a year had fewer heart attacks than 24 cardiac patients who did not watch such videos. In the video-watching group, only two had subsequent heart attacks, compared to 10 in the other group.

    It would be easy enough to add laughter to a traditional cardiac rehabilitation program, says Veronica Polverari, RN, board certified in holistic nursing and manager of cardiac rehabilitation services for Santa Monica-UCLA Medical Center. Currently, many programs include lifestyle modifications such as having people watch what they eat and exercise more. Adding advice on how to laugh more would be simple, Polverari says.

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