Why do we say “Bless you” to someone who sneezed?

Sternutation, the medical term for sneezing, is a sudden, forceful, involuntary burst of air through the nose and mouth. It can be triggered by irritants in the nose or throat, environmental allergies, or viral upper respiratory infections. Some people even experience photic sneezing, which is sneezing in response to bright light, such as sunlight. The condition is formally known as autosomal dominant compelling helio ophthalmic outburst syndrome. That’s right, ACHOO syndrome.

Regardless of the reason for a sneeze, the polite response is commonly “bless you” or “God bless you.” Unlike with other bodily functions, particularly the closely associated cough, it is considered poor manners to let a sneeze go unanswered. Saying “bless you” is such an expected social custom that not saying it can lead to an awkward and uncomfortable silence, which might explain why a singular sneeze can garner several blessings from people nearby. The question is, why exactly is the phrase “bless you” the standard response to a sneeze?

A Prayer to Protect the Soul

For most of history, and before the advent of modern medicine in the late 19th century, life could be brutally brief. Globally, the average life expectancy of a newborn in 1900 was just 32 years. By 2021, the number had more than doubled to 71 years. Death took many forms, but infectious diseases, including bubonic plague and influenza, could wipe out entire communities in a matter of months. So any outward sign of illness, such as sneezing, was reason for concern — and in turn, prayer.

The tradition of saying “God bless you” after a sneeze is often attributed to Pope Gregory I, also known as Pope Gregory the Great, in the sixth century. He supposedly bestowed such blessings during a bubonic plague outbreak, as it was thought that sneezing signaled imminent death from the disease. But the social custom of verbally acknowledging a sneeze predates Pope Gregory by at least several hundred years. In his 77 CE work Natural History, Roman philosopher Pliny the Elder mentioned the custom of offering a salutation after someone sneezes. “Why is it that we salute a person when he sneezes,” hepondered, “an observance which Tiberius Caesar, they say, the most unsociable of men, as we all know, used to exact, when riding in his chariot even?” The fact that Pliny didn’t know the meaning of the tradition suggests it had been around long enough for its origins to be lost.

Pliny may not have had the answer, but others have offered explanations for why a sneeze garners a blessing. One common theory stems from the ancient beliefs that sneezing made it possible for evil spirits to enter the body, or could momentarily expel the soul from the body, leaving it vulnerable to evil spirits or illnesses. People also used to believe that a person’s heart stopped during a sneeze. In all cases, saying “God bless you” was a prayer to God to safeguard the sneezer’s soul and protect them (and anyone in their proximity) from harm.

Sneeze responses from around the world

Today, saying “bless you” remains the typical response to a sneeze in the U.S. and the U.K., as well as other English-speaking parts of the world (generally due to colonization). But other countries and cultures have different customary responses. Most typical responses in European countries translate as some version of the word “health,” such as “salud” in Spanish-speaking countries, “salute” in Italy, and “gesundheit” in German-speaking regions. (“Gesundheit” is also popular in the U.S., thanks to the influx of German immigrants in the early 20th century.) In Latin Americancultures, the first sneeze will garner the usual response of “salud,” while a second and third sneeze will earn the sneezer wishes of “dinero” (money) and “amor” (love). On the other hand, sneezing usually elicits no response at all in most of East Asia, unless it’s excessive, in which case the typical response is to inquire after someone’s health.