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In France, they call him Le Roi de Crazy for his comedy roots, but in the U.S. Jerry Lewis is known these days as the King of Telethons. The actor has hosted an epic television outreach for the Muscular Dystrophy Association (MDA) since 1955, when his first 16½-hour show raised more than $600,000 in a live broadcast from Carnegie Hall in New York City. That was before Lewis became the official host and was given the ratings-challenged Labor Day slot to host the show, and since then it's become an even greater test of a performer's endurance. This Labor Day holiday show, the 44th annual MDA telethon, will run for a whopping 21½ hours.

Lewis is arguably the pioneer of the telethon — an indelibly American tradition that has since been adapted around the world to benefit various charities. But the first telethons managed to do without Lewis' particular brand of boosterism for a good four years after their debut in 1951, when a "television fund-raising marathon" — you can see why the name was shortened — aired to help raise money for victims of cerebral palsy. The event pulled in the then whopping amount of $276,408 and marked the creation of United Cerebral Palsy Inc. and its annual Weekend with the Stars telethons. The Easter Seals telethon, to benefit people with disabilities and special needs, also stands as one of the biggest TV fundraisers. (During the original donation campaign donors would emboss "seals" of support on the envelopes they mailed in with their contributions.)

The 1970s and '80s were a boom era for telethons in general, with airtime set aside for appeals for all kinds of products. A two-day telethon in 1975 raised $52,000 to help California's Fresno County Sheriff Guy Langley pay legal expenses after he was charged with laundering campaign funds. (He later pleaded no contest and resigned his position.) Australia held a telethon to fund its 1984 Olympic team. In Argentina, a fundraising program was broadcast to finance the country's two-month war in 1982 with England over the Falkland Islands. (The islands are now a self-governing British territory, although Argentina still claims sovereignty.)

Some might say, though, that the telethon isn't as lucrative a money-getting tactic as it once was. In fact, despite typical production goals of keeping costs at 25 cents to 33 cents of every donated dollar, it's hard to know how much donated money to bank on. Most telethons only collect between 60% and 75% of pledged dollars. During a 1983 Democratic National Committee fundraiser, 800,000 of the 1 million callers rang in just to declare their support for their Republican President Ronald Reagan. Still, Lewis' MDA program remains one of the most enduring hallmarks in telethon history. And in 1998, it joined the computer age when it became the first telethon to be seen worldwide via Internet simulcast. The program's pledged donations have grown from $1 million in 1966 to $65 million during the 2008 broadcast.

While some have called these programs an overly emotional guilt trip, the star power these occasions manage to draw doesn't hurt their cause. Frank Sinatra's performance in the 1976 MDA telethon proved particularly momentous for both the audience and Lewis himself. When Sinatra emerged, he brought Lewis' former comedic partner Dean Martin on the stage with him, bringing a tear to the host's already tired eyes. A lack of stars proved to be the downfall of a 1980 telethon to raise money for burn victims. After comedian Richard Pryor's nearly fatal burning accident that year, noted guests like Redd Foxx, Muhammad Ali and Alex Haley were scheduled to appear, but never showed. Just $140,000 of the $1 million goal was pledged.

Modern-day telethons have been distilled down to shorter, albeit star-studded, benefit concerts to respond to specific catastrophes — 9/11, Hurricane Katrina, the Indonesian tsunami, Australian bushfires — but none have had as lasting an effect as the MDA telethons, which have raised more than $1 billion to date. And if the pity party gets to be a bit too much, follow Lewis' own words from a 1990 broadcast: "If you find I'm annoying, I'm getting to you, you've got a remote-control clicker."