A like spasmodic outburst of laughter occasionally occurs during a more prolonged state of painful emotional excitement. It sometimes intrudes itself into a bout of physical suffering. Lange speaks of a young man who, when treated for ulceration of the tongue by a very painful caustic, regularly broke out into violent laughter when the pain reached its maximum.[47] Many persons when thrown into a prolonged state of grief, accompanied by weeping, exhibit a tendency to break out into laughter towards the end of the fit. Shakespeare illustrates this tendency when he makes Titus Andronicus, whose hand has been cut off, answer the question why he laughed with the exclamation: “Why I have not another tear to shed”.[48] Can we find a common element in these different forms of nervous or apparently unmotived laughter? We appear to have in all of them a preceding state of consciousness which is exceptionally intense and concentrated. The situation of fear, of constraint on being made the object of others’ unusual observation, of suddenly hearing news of deep import for which the mind is not prepared, of prolonged emotional agitation, these all involve an intensification of the psycho-physical processes which immediately condition our states of consciousness. Looking at these intensified {68} forms of consciousness more closely, we observe that they include something in the nature of psychical pressure, of the presence of forces which make for disorder, whereas the situation calls for severe self-control. This special strain thrown on the volitional process is illustrated in the demand for closer observation and calm reflection during a fit of fear, or other emotional excitement, which tends to bring about a state of wild movement and of disorderly ideas. It is, I believe, _the specially severe strain_ belonging to such an attitude which is the essential pre-condition of the laughter. It makes the attitude a highly artificial one, and one which it is exceedingly difficult to maintain for a long period. As such, the attitude is eminently unstable, and tends, so to say, to break down of itself; and will certainly collapse, partially at least, if the demand seems, though only for a moment, to grow less imperative. Hence the readiness with which such a means of temporary relief as laughter undoubtedly supplies is seized at the moment.