The origin of hiccups

Those annoying little spasms are a holdover from our ancient past.

By Ben Nimkin

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image courtesy of  Tony Hisgett .

image courtesy of Tony Hisgett.

Charles Osborn was a farmer living in Iowa. At 28 years old, he was 5’4’’ and muscular. One day in 1922, feeling pretty sure of himself, Osborn lifted up a 350 pound pig for slaughter. The pig got the better of him, and he fell to the ground. He picked himself up, dusted himself off, and went back to work.

A little while later he began to hiccup. And hiccup. The hiccups continued for several days. They went on for months. Then Charlie’s hiccups went on for decades. Charles Osborn hiccuped continuously for 68 years.

His hiccups were intractable — very difficult, if not impossible, to cure. Osborn had traveled as far as Alaska to get treatment. A friend even fired a shotgun right behind Osborn to try and scare the hiccups out of him.

Fifty years into his bout of hiccups, he sought the help of Dr. Terence Anthoney, a specialist in Neuro-Anatomy. At the time, Dr. Anthoney was teaching at Southern Illinois University and researching the biological background of behavior. The doctor tried some therapies, but without much success. One of the problems was that Charlie was already in his seventies. On the one hand, he would say he would do anything to get rid of the hiccups; but on the other hand, the hiccups had become something of a social tool for him — a way to get attention. His hiccups had brought him over 4000 letters of sympathy. He was featured on the Johnny Carson Show, in People Magazine, and had made it into the Guinness Book of World Records.

Dr. Anthoney can only speculate the exact cause of Osborn’s hiccups, but he believes that at some point between when Charlie picked up the pig and when he fell, a tiny hemorrhage formed in his brain stem: more specifically, a part of the brain that can be traced back to our earliest air-breathing ancestors.

Dr. Laitman, an anatomist and physical anthropologist at the Ichan School of Medicine at Mount Sinai, as well as a Professor of Medical Education, Otolaryngology, and Anthropology at the City University Graduate School, chimed in on the anatomy of Osborn’s affliction. Laitman states that the most important thing we air-breathing mammals have to do is, well — breathe.

Laitman explains: that first sound of a hiccup , the Hiiii, is the sound of a quick intake of breath, caused by a sudden spasm of the diaphragm — the largest muscle under our lungs. Almost as soon as we start breathing in- the larynx, the doorway to your lungs, closes. The larynx, according to Laitman, deserves all our respect and love: inside this wonderful house are our vocal folds, or vocal cords. It is a key protector.

When you hiccup, your diaphragm spasms, and immediately afterward your vocal folds shut tight. Put them together and you have a hiccup. When your vocal folds close, they increase the pressure in the thoracic or abdominal areas. They allow you to use muscles to help nature do its duty, so to speak. If your vocal folds weren't working correctly, you couldn't lift a heavy object; you couldn't — how to put it — poop if you were constipated; you couldn't give birth to a baby. 

All these parts of the hiccup, the diaphragm and the lungs, along with the larynx and the vocal folds, are controlled by the brain stem, which is where Dr. Terry Anthoney suspects Charlie Osborne had his injury.

Dr. Anthoney studied Charlie Osborn’s hiccups in the presence of changing levels of carbon dioxide and oxygen. After a treatment giving him increased amounts of carbon dioxide in the air he was breathing, the hiccups went away. The CO2 over-powered the part of the brain that was giving Osborn the hiccups, but the results were only temporary. After about an hour, they came back. When his oxygen levels were increased to somewhere between 35% and 40% oxygen, he stopped breathing, and he just sat there hiccuping, without breathing, for five minutes. When the oxygen was decreased, his breathing came right back in without any problem.

Conclusion? Osborn was getting all the oxygen he needed from the hiccups, which shows that hiccups are actually a type of breathing.

That hemorrhage in Osborn’s brain stem affected the part of the brain that regulates breathing. In other people with this type of damage the hiccups just go away after a week or so. But in Osborn the damage was so uniform across the brainstem, and went so long without treatment, that the neural pathway of the hiccup behavior became ingrained.

This part of the brainstem that controls breathing and hiccups is hundreds of millions of years old. This has led some evolutionary biologists to theorize that the hiccup may go back to our earliest air-breathing ancestors.

Dr. David Lahti, professor of biology at the University of New York, studies why traits arise through evolution, but also why they change or disappear. The appendix is the classic example of a vestigial trait-- something that has lost its original function. According to Lahti, “A classic idea in evolutionary biology, a classic prediction, is that behavior should evolve faster than morphology.” In other words, the way we act should change faster than the way we’re built.

If you start paying attention to them, you might just realize that you get the hiccups every day. Or maybe you just get a hiccup. And they can be caused by a million different things. You could hiccup because you ate too fast. Or maybe there was a change in temperature. It could be caused by cancer. Some people even start to hiccup when you scratch a certain spot on their chin. Sometimes it's just the one hiccup. Sometimes they won’t stop for a long, long time. 

Charlie Osborn’s hiccups stopped suddenly in 1990, sixty eight years after they had started. He died a few months later.

Although it is a behavioral trait that serves little purpose to us today, as long as it uses functional morphology that we probably won’t lose anytime soon — like our lungs or our diaphragm — the hiccup will remain.

The original version of this story appeared in Episode 2 of Origin Stories - The Leakey Foundation Podcast

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Ben Nimkin is a standard issue Brooklyn beardo. He enjoys answering questions no one asked. But he isn't weird about it. He just wants to make the world a slightly more magical place. Ben works with sound but thinks in pictures, which led him to the wondrous world of documentary film and radio. He is currently working on his trilogy of hiccups, sneezes and yawns. Find him at

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