The ancient custom of following an “achoo” with a “God bless you” has held steadfast for nearly seven centuries.

Is there a religious connection to the practice?

Yes.

Is the phrase that’s become almost rote behavior simply a cultural nicety?

Yes.

A deeply ingrained tradition?

Yes.

A superstition?

Maybe.

“The phrase has a clear religious origin,” said professor Jeffrey Scholes of the University of Colorado campus in Colorado Springs. He’s an associate professor and chair of the Department of Philosophy and also directs the UCCS Center for Religious Diversity and Public Life.

When the bubonic plague roamed the Earth in the 14th century, Pope Gregory the Great suggested the faithful say “God bless you” after hearing a person sneeze.

The simple prayer from a loved one or a stranger was offered in protection to potentially ward off a deadly demise during what seemed to be a doomed era.

Sneezing was among the first signs of the plague, also called The Black Death, which is recognized as one of the most lethal pandemics in the world.

Historians estimate up to 50 million people perished between 1346 and 1353. The death toll amounted to as many as half of Europe’s population at the time.

A sneeze generally is not something a person can control, as the body reacts reflexively when something foreign, such as pollen, gets inhaled, says Dr. Marvin Lee, chief medical officer at CommonSpirit St. Francis Hospitals. For most of his career, Lee served as an internist in the Air Force.

“The upper respiratory system has a mechanism in place to expel anything it sees as a threat,” he said. “When we didn’t have antibiotics and society had poor nutrition, that sneeze would be the beginning of a downward spiral that would end your life.”

But as medicine and technology advanced, a sneeze has become more benign, Lee said, and no longer an indicator of looming expiration.

Because a sneeze produces a temporary change in the part of the nervous system that regulates heart rate and blood pressure, the heartbeat usually slows during a sneeze, the doctor said.

Which could have been where the notion that the soul was vulnerable for an evil presence to enter during a sneeze came from, or conversely, the idea that a sneeze could rid the body of evil spirits.

Either way, the small prayerful utterance grew in popularity, “whether from a fear that a sneeze indicated the loss of one’s soul or that it was meant to convey spiritual comfort,” Scholes said.

He finds the phrase’s durability and prominence in today’s more secularized society interesting — because even if the saying is shortened to “bless you,” the religious connotation is still there.

“Nonreligious people instinctually use the phrase, when they’d never use the word ‘bless’ in any other setting,” Scholes noted.

“My suspicion is that its staying power has more to do with our continued need to respond to such an event like a sneeze — which is a rather violent act when compared to a cough or a hiccup — along with the ease with which the words, “bless you,” is to say phonetically,” he said.

“But who knows?”

Americans aren’t the only ones to carry on the throwback. Similar words are said aloud in other countries after a sneeze. The French phrase translates as “to your health,” and the German “Gesundheit” just means “health.”

Wherever you go, “God bless you” has become so commonplace that it’s like a greeting, along the lines of “good morning” or “hello,” Lee believes.

“It can change a person’s mood and give something of a lift,” he said. “It’s like saying, ‘I see you, I value you as a fellow human being.’ We all have a responsibility to make each other’s lives better, and in doing so, we make ourselves better.”

And the usual response of “thank you” also is a cultural nicety.

The words have remained embedded in society over time for good reason, Lee said.

“Even if people disagree on politics or specifics in religion, they ultimately want their neighbors to be well,” the doctor said. “That I should care about you in a way that’s meaningful — as in ‘love thy neighbor as thyself.’

“I hope it never goes away.”

Contact the writer: 719-476-1656.