Considering the fact that almost everyone experiences hiccups at one time or another, remarkably little is known about them. The name itself is onomatopoeic, which is appropriate considering that the only common understanding of the hiccup is of the characteristic sound. Hiccups can be predictably elicited in some individuals by overindulgence of food, alcohol, or both, sometimes providing evidence of such behaviour and making them a common object of humour. There are, however, instances in which hiccups become intractable (singultus) causing insomnia, wasting, exhaustion, and even death, prompting scientific scrutiny of this otherwise harmless curiosity.1In this issue Fass et al (see page 590) present original investigative work on the afferent limb of the hiccup reflex.

Fass et al used a barostat to characterise the parameters of oesophageal distention that could elicit hiccups in normal volunteers. They report that rapid phasic distension of the proximal, but not distal, oesophagus could reproducibly induce hiccups in four of 10 subjects. Hiccups occurred during rapid inflation of the barostat bag and immediately resolved with deflation, strongly implicating oesophageal mechanoreceptors as the …