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Sneeze
The function of sneezing is to expel irritants from the nasal cavity.
Biological systemRespiratory system
HealthBeneficial
ActionInvoluntary
StimuliIrritants of the nasal mucosa
Light
Cold air
Snatiation
Allergy
Infection
MethodExpulsion of air through nose/mouth
OutcomeRemoval of irritant
Shadowgraph visualization of the airflow during a sneeze, comparing an unmasked sneeze with several different methods of covering one's mouth and nose: sneezing into a fist, a cupped hand, a tissue, a "coughcatcher" device, a surgical mask, and an N95 mask

A sneeze (also known as sternutation) is a semi-autonomous, convulsive expulsion of air from the lungs through the nose and mouth, usually caused by foreign particles irritating the nasal mucosa. A sneeze expels air forcibly from the mouth and nose in an explosive, spasmodic involuntary action. This action allows for mucus to escape through the nasal cavity and saliva to escape from the oral cavity.[1] Sneezing is possibly linked to sudden exposure to bright light (known as photic sneeze reflex), sudden change (drop) in temperature, breeze of cold air, a particularly full stomach, exposure to allergens, or viral infection. Because sneezes can spread disease through infectious aerosol droplets, it is recommended to cover one's mouth and nose with the forearm, the inside of the elbow, a tissue or a handkerchief while sneezing. In addition to covering the mouth, looking down is also recommended to change the direction of the droplets spread and avoid high concentration in the human breathing heights.

The function of sneezing is to expel mucus containing foreign particles or irritants and cleanse the nasal cavity. During a sneeze, the soft palate and palatine uvula depress while the back of the tongue elevates to partially close the passage to the mouth, creating a venturi (similar to a carburetor) due to Bernoulli's principle so that air ejected from the lungs is accelerated through the mouth and thus creating a low pressure point at the back of the nose. This way air is forced in through the front of the nose and the expelled mucus and contaminants are launched out the mouth. Sneezing with the mouth closed does expel mucus through the nose but is not recommended because it creates a very high pressure in the head and is potentially harmful.

Sneezing cannot occur during sleep due to REM atonia – a bodily state where motor neurons are not stimulated and reflex signals are not relayed to the brain. Sufficient external stimulants, however, may cause a person to wake from sleep to sneeze, but any sneezing occurring afterwards would take place with a partially awake status at minimum.[2]

When sneezing, humans eyes automatically close due to the involuntary reflex during sneeze.[3]

Description

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Sneeze
Problems playing this file? See media help.

Sneezing typically occurs when foreign particles or certain external stimulants pass through the nasal hairs to reach the mucosa of the nose or paranasal sinuses. This triggers the release of histamines, which irritate the nerve cells in the nose, resulting in signals being sent to the brain to initiate the sneeze through the trigeminal nerve network. The brain then relates this initial signal, activates the pharyngeal and tracheal muscles and creates a large opening of the nasal and oral cavities, resulting in a powerful release of air and bioparticles. The powerful nature of a sneeze is attributed to its involvement of numerous organs of the upper body – it is a reflexive response involving the face, throat, and chest muscles.

The neural regions involved in the sneeze reflex are located in the brainstem along the ventromedial part of the spinal trigeminal nucleus and the adjacent pontine-medullary lateral reticular formation. This region appears to control the epipharyngeal, intrinsic laryngeal and respiratory muscles, and the combined activity of these muscles serve as the basis for the generation of a sneeze.[4]

The sneeze reflex involves contraction of a number of different muscles and muscle groups throughout the body, typically including the eyelids. The common suggestion that it is impossible to sneeze with one's eyes open is, however, inaccurate.[5] Other than irritating foreign particles, allergies or possible illness, another stimulus is sudden exposure to bright light – a condition known as photic sneeze reflex (PSR). Walking out of a dark building into sunshine may trigger PSR, or the ACHOO (autosomal dominant compulsive helio-ophthalmic outbursts of sneezing) syndrome as it is also called.[6] The tendency to sneeze upon exposure to bright light is an autosomal dominant trait and affects 18–35% of the human population.[7] A rarer trigger, observed in some individuals, is the fullness of the stomach immediately after a large meal. This is known as snatiation and is regarded as a medical disorder passed along genetically as an autosomal dominant trait.[8]

Epidemiology

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7-to-8-metre-long (23 to 26 ft) turbulent multiphase plume from a human sneeze.

Certain contagious diseases may be transmitted via respiratory droplets and aerosols created by sneezes. A sneeze can produce 40,000 droplets,[9] with particle sizes commonly ranging from 0.5 to 5 μm).

To reduce the possibility of thus spreading disease (such as the flu), one holds the forearm, the inside of the elbow, a tissue or a handkerchief in front of one's mouth and nose when sneezing. Using one's hand for that purpose has recently fallen into disuse[10] as it is considered inappropriate, since it promotes spreading germs through human contact (such as handshaking) or by commonly touched objects (most notably doorknobs).

Until recently, the maximum visible distance over which the sneeze plumes (or puffs) travel was observed at 0.6 metres (2.0 ft), and the maximum sneeze velocity derived was 4.5 m/s (about 10 mph).[11] In 2020, sneezes were recorded generating plumes of up to 8 meters (26 ft).[12]

Prevention

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Sneezes are covered by handkerchief or forearm

Proven methods to reduce sneezing generally advocate reducing interaction with irritants, such as keeping pets out of the house to avoid animal dander; ensuring the timely and continuous removal of dirt and dust particles through proper housekeeping; replacing filters for furnaces and air-handling units; air filtration devices and humidifiers; and staying away from industrial and agricultural zones. Tickling the roof of the mouth with the tongue can stop a sneeze.[13] Some people, however, find sneezes to be pleasurable and would not want to prevent them.[14]

Holding in sneezes, such as by pinching the nose or holding one's breath, is not recommended as the air pressure places undue stress on the lungs and airways.[15] One computer simulation suggests holding in a sneeze results in a burst of air pressure of 39 kPa, approximately 24 times that of a normal sneeze.[16]

In 1884, biologist Henry Walter Bates elucidated the impact of light on the sneezing reflex (Bates H.W. 1881–84. Biologia Centrali-Americana Insecta. Coleoptera. Volume I, Part 1.). He observed that individuals were only capable of sneezing when they felt in control of their entire environment. Consequently, he inferred that people were unable to sneeze in the dark. However, this hypothesis was later debunked.

Culture

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video of a man sneezing from 1894
Fred Ott's Sneeze, 1894, the oldest surviving motion picture with a copyright

In ancient Greece, sneezes were believed to be prophetic signs from the gods. In 401 BC, for instance, the Athenian general Xenophon gave a speech exhorting his fellow soldiers to fight against the Persians. A soldier underscored his conclusion with a sneeze. Thinking that this sneeze was a favorable sign from the gods, the soldiers were impressed.[17] Another divine moment of sneezing for the Greeks occurs in the story of Odysseus. His waiting wife Penelope, hearing Odysseus may be alive, says that he and his son would take revenge on the suitors if he were to return. At that moment, their son sneezes loudly and Penelope laughs with joy, reassured that it is a sign from the gods (Odyssey 17: 541–550). It may be because this belief survived through the centuries, that in certain parts of Greece today, when someone is asserting something and the listener sneezes promptly at the end of the assertion, the former responds "bless you and I am speaking the truth", or "bless you and here is the truth" ("γεια σου κι αλήθεια λέω", ya sou ki alithia leo, or "γεια σου και να κι η αλήθεια", ya sou ke na ki i alithia). A similar practice is also followed in India.[18][19] If either the person just having made a not most obvious statement in Flemish, or some listener sneezes, often one of the listeners will say "It is beniesd", literally "It's sneezed upon", as if a proof of truth – usually self-ironically recalling this old superstitious habit, without either suggesting doubt or intending an actual confirmation, but making any apology by the sneezer for the interruption superfluous as the remark is received by smiles.[20]

In Europe, principally around the early Middle Ages, it was believed that one's life was in fact tied to one's breath – a belief reflected in the word "expire" (originally meaning "to exhale") gaining the additional meaning of "to come to an end" or "to die". This connection, coupled with the significant amount of breath expelled from the body during a sneeze, had likely led people to believe that sneezing could easily be fatal.[citation needed] Such a theory could explain the reasoning behind the traditional English phrase, "God bless you", in response to a sneeze, the origins of which are not entirely clear. Sir Raymond Henry Payne Crawfurd, for instance, the registrar of the Royal College of Physicians, in his 1909 book, "The Last Days of Charles II", states that, when the controversial monarch was on his deathbed, his medical attendants administered a concoction of cowslips and extract of ammonia to promote sneezing.[21] However, it is not known if this promotion of sneezing was done to hasten his death (as coup de grâce) or as an ultimate attempt at treatment.

In certain parts of East Asia, particularly in Chinese culture, Korean culture, Japanese culture and Vietnamese culture, a sneeze without an obvious cause was generally perceived as a sign that someone was talking about the sneezer at that very moment. This can be seen in the Book of Songs (a collection of Chinese poems)[22] in ancient China as early as 1000 BC, and in Japan this belief is still depicted in present-day manga and anime. In China, Vietnam, South Korea, and Japan, for instance, there is a superstition that if talking behind someone's back causes the person being talked about to sneeze; as such, the sneezer can tell if something good is being said (one sneeze), someone is thinking about you (two sneezes in a row), even if someone is in love with you (three sneezes in a row) or if this is a sign that they are about to catch a cold (multiple sneezes).[citation needed]

Parallel beliefs are known to exist around the world, particularly in contemporary Greek, Slavic, Celtic, English, French, and Indian cultures. Similarly, in Nepal, sneezers are believed to be remembered by someone at that particular moment.[citation needed]

In English, the onomatopoeia for sneezes is usually spelled 'achoo' and it is similar to that of different cultures.[23]

In Indian culture, especially in northern parts of India, Bengali (Bangladesh and Bengal of India) culture and also in Iran, it has been a common superstition that a sneeze taking place before the start of any work was a sign of impending bad interruption. It was thus customary to pause in order to drink water or break any work rhythm before resuming the job at hand in order to prevent any misfortune from occurring.

In Polish culture, especially in the Kresy Wschodnie borderlands, a popular belief persists that sneezes may be an inauspicious sign that, depending on the local version, either someone unspecified or one's mother-in-law speaks ill of the person sneezing at that moment. In other regions, however, this superstition concerns hiccups rather than sneezing. As with other Catholic countries, such as Mexico, Italy, or Ireland, the remnants of pagan culture are fostered in Polish peasant idiosyncratic superstitions.

The practice among Islamic culture, in turn, has largely been based on various prophetic traditions and the teachings of Muhammad. An example of this is Al-Bukhaari's[24] narrations from Abu Hurayrah that Muhammad once said:

When one of you sneezes, let him say, "Al-hamdu-Lillah" (Praise be to God), and let his brother or companion say to him, "Yarhamuk Allah" (May God have mercy on you). If he says, "Yarhamuk-Allah", then let [the sneezer] say, "Yahdeekum Allah wa yuslihu baalakum" (May God guide you and rectify your condition).

Verbal responses

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Main article: Response to sneezing

In English-speaking countries, one common verbal response to another person's sneeze is "[May God] bless you". Even with "God", the declaration may be said by a person without religious intent. Another, less common, verbal response in the United States and Canada to another's sneeze is "Gesundheit", which is a German word that means, appropriately, 'health'.

Several hypotheses exist for why the custom arose of saying "bless you" or "God bless you" in the context of sneezing:

  • Some say it came into use during the plague pandemics of the 14th century. Blessing the individual after showing such a symptom was thought to prevent possible impending death due to the lethal disease.[25]
  • In Renaissance times, a superstition was formed claiming one's heart stopped for a very brief moment during the sneeze; saying bless you was a sign of prayer that the heart would not fail.[26]

Sexuality

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See also: Sexually induced sneezing

Some people may sneeze during the initial phases of sexual arousal. Doctors suspect that the phenomenon might arise from a case of crossed wires in the autonomic nervous system, which regulates a number of functions in the body, including, but not limited to, rousing the genitals during sexual arousal. The nose, like the genitals, contains erectile tissue.[27] This phenomenon may prepare the vomeronasal organ for increased detection of pheromones.[28]

A sneeze has been compared to an orgasm, since both orgasms and sneeze reflexes involve tingling, bodily stretching, tension and release.[29] On this subject, sexologist Vanessa Thompson from the University of Sydney states, "Sneezing and orgasms both produce feel-good chemicals called endorphins but the amount produced by a sneeze is far less than an orgasm."[30]

According to Holly Boyer from the University of Minnesota, there is a pleasurable effect during a sneeze, where she states, "the muscle tension that builds up in your chest causes pressure, and when you sneeze and the muscles relax, it releases pressure. Anytime you release pressure, it feels good...There's also some evidence that endorphins are released, which causes your body to feel good". Endorphins induce the brain's reward system, and because sneezes occur in a quick burst, so does the pleasure.[31]

In other animals

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A sneezing zebra

Sneezing is not confined to humans or even mammals. Many animals including cats,[32] dogs,[33] chickens[34] and iguanas[35] sneeze. African wild dogs use sneezing as a form of communication, especially when considering a consensus in a pack on whether or not to hunt.[36] Some breeds of dog are predisposed to reverse sneezing.

See also

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References

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Further reading

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Revisions and contributorsEdit on WikipediaRead on Wikipedia

Sneeze

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from Grokipedia
A sneeze, also known as sternutation, is a semi-autonomous, convulsive expulsion of air from the lungs through the and mouth, typically triggered by irritation of the . This serves as a protective mechanism to rapidly clear the upper of irritants, foreign particles, allergens, or pathogens, thereby maintaining airway patency and preventing . The sneeze is characterized by a sudden, forceful burst of air, often accompanied by a distinctive and sensation, and it plays a critical role in innate respiratory defense while also contributing to the transmission of respiratory illnesses through expelled droplets. The of sneezing involves a two-phase process: an initial sensory (afferent) phase and a subsequent efferent (motor) phase. In the sensory phase, irritants stimulate endings in the nasal , sending signals to the via the , which integrates the response in the medulla. The efferent phase then coordinates a deep followed by rapid closure and reopening of the , engaging respiratory muscles like the diaphragm, abdominal muscles, and chest wall to generate peak airflow velocities of up to 16 m/s (58 km/h), expelling and contaminants. This neural pathway is mediated by peptidergic neurons, distinguishing sneezing from related reflexes like coughing, which involve different sensory receptors and pathways. Variations in sneeze intensity and pattern can occur due to individual differences in neural sensitivity or environmental factors. Common triggers for sneezing include viral upper respiratory infections, , nonallergic irritants such as dust, smoke, or strong odors, and even non-nasal stimuli like sudden bright light exposure in individuals with the , which affects about 25% of the population. In pathological states, excessive or intractable sneezing may signal underlying conditions like chronic rhinosinusitis or neurological disorders, though the reflex remains largely adaptive. While sneezing effectively removes threats from the , it can inadvertently spread infectious droplets over distances up to several meters, underscoring the importance of practices like covering the mouth and nose.

Physiology

Mechanism

A sneeze is a protective, semi-autonomous reflex that expels irritants from the nasal passages and upper through a series of coordinated muscle contractions, serving to clear potential pathogens or foreign particles. The reflex arc involves both sensory detection and motor response, orchestrated by the to produce a forceful burst of air. The process initiates when an irritant contacts the , stimulating specialized sensory nerve endings known as free nerve endings or polymodal nociceptors. These are primarily innervated by the ophthalmic (V1) and maxillary (V2) branches of the (cranial nerve V), which detect mechanical, chemical, or thermal stimuli. The activated sensory neurons, often type C fibers expressing neuropeptides like or neuromedin B, transmit afferent signals centrally through the to the in the . From there, the impulse ascends to the sneeze center, a localized region in the dorsolateral , which integrates the input and triggers the efferent phase of the reflex. This medullary center coordinates the involvement of additional , including the (VII) for involuntary eye closure, the (IX) for pharyngeal sensation and constriction, and the (X) for modulating laryngeal and respiratory muscle activity. The efferent response unfolds in distinct phases. First, an inspiratory phase occurs, characterized by deep as the diaphragm contracts via stimulation (from cervical spinal roots C3-C5) and engage through thoracic spinal nerves, expanding volume to approximately 2.5-3 liters in adults. The then partially closes, and abdominal muscles (innervated by thoracolumbar spinal nerves) along with internal intercostals contract, compressing the thoracic cage and building intrathoracic pressure up to 100-160 mmHg. This pressure accumulation primes the system for expulsion. In the subsequent expiratory phase, the and velum abruptly open, allowing a rapid release of through the and at velocities reaching up to 16 per second (approximately 36 mph), propelling droplets and particles outward. Neural modulation occurs via peptidergic pathways, where neurotransmitters like neuromedin B from nasal sensory neurons excite premotor respiratory neurons in the medullary , ensuring synchronized muscle activation. Variations in sneeze patterns include single isolated sneezes, triggered by brief stimuli, versus multiple successive sneezes in a fit, which may arise from sustained afferent input or reverberating activity in the pattern generator, leading to repetitive arcs.

Causes

Sneezing is primarily triggered by irritation of the mucous membranes in the nasal passages or , which activates the sneeze reflex as a protective response. Common physical irritants include , , , strong odors, pepper, and foreign particles that enter the , prompting the body to expel them forcefully. These stimuli cause or direct stimulation of endings in the , leading to reflexive sneezing. Physiological triggers often involve infections such as the or , where viral particles inflame the nasal lining and induce sneezing to clear the airways. Allergies, including hay fever, provoke sneezing through an immune response to allergens like , releasing that heightens nasal sensitivity. Additionally, sudden exposure to bright light can elicit the , affecting 18-35% of individuals via a known as ACHOO , an autosomal dominant trait. Certain medical conditions contribute to chronic or recurrent sneezing by altering nasal function or sensitivity. Nasal polyps, benign growths in the nasal passages, can irritate the mucosa and trigger sneezing episodes. Vasomotor , a nonallergic form of , leads to sneezing due to exaggerated vascular responses to environmental changes like or . Neurological issues, such as autonomic dysfunction, may also heighten sneeze susceptibility by disrupting the balance of parasympathetic and sympathetic nerve activity in the nasal region. From an evolutionary standpoint, sneezing serves as an innate defense mechanism to clear irritants, pathogens, and from the upper airways, enhancing respiratory protection. Genetic factors, like those underlying ACHOO syndrome, influence individual susceptibility to specific triggers, reflecting variations in that have persisted across populations.

Health Aspects

Epidemiology

Sneezing is a universal physiological observed in nearly all humans, occurring multiple times daily as a protective mechanism against irritants in the nasal passages. A prospective study monitoring 80 healthy medical students and hospital staff over two weeks found that more than 95% of participants sneezed less than four times per day on average, establishing this as the typical range for adults without underlying conditions. The , triggered by bright light exposure, affects an estimated 18% to 35% of the global population, with studies indicating variations by ancestry, including higher rates among individuals of European descent compared to other groups. Demographic factors influence sneezing patterns, with higher frequency reported among children and those with allergies. , a primary driver of recurrent sneezing, has a global prevalence of 10% to 30% in both children and adults, though children often experience more intense or frequent symptoms due to greater and immature immune responses. Sneezing episodes exhibit seasonal peaks, particularly during spring, summer, and fall seasons when tree, grass, and weed allergens are elevated, as well as during winter outbreaks that amplify respiratory irritant exposure. further modulates these patterns, with urban dwellers facing increased sneeze frequency from heightened irritant exposure, such as air pollutants and indoor allergens; a Swedish population study revealed a clear urban-rural gradient, with allergic rhinitis prevalence reaching 26% in city centers versus 20% on farms. Post-2020 research highlights shifts in sneezing amid the , where heightened public awareness of respiratory symptoms led to elevated reporting of sneezing episodes. Although sneezing is not a dominant symptom, its recognition as a possible early indicator—especially with emerging variants—prompted greater and healthcare consultations for nasal symptoms previously dismissed as benign. This trend underscores how crises can amplify perceived prevalence through behavioral and perceptual changes rather than inherent physiological shifts.

Risks and Complications

Although sneezing is typically harmless, forceful sneezes can occasionally lead to physical injuries. Rare cases of have been documented following sudden sneezing, where the rapid increase in intrathoracic pressure propagates to the neck vessels, potentially causing or neurological deficits. Similarly, rib fractures from sneezing have been reported, particularly in older adults with underlying bone weakness, as the explosive force strains the chest wall. Eye trauma, including retinal vascular occlusions leading to sudden vision loss, has also occurred after intense sneezing episodes due to pressure changes in the ocular vasculature. Suppressing a sneeze by pinching the and closing the generates high Valsalva pressure, which can transmit to adjacent structures and cause complications. This maneuver has been associated with ruptured eardrums from excessive pressure, potentially leading to or . Additionally, the redirected pressure may exacerbate sinus issues by forcing into sinuses or causing mucosal tears, increasing the risk of acute . Chronic sneezing, often stemming from , can aggravate other medical conditions. It is linked to migraine exacerbation, as nasal inflammation and congestion from trigger or intensify episodes in susceptible individuals. In patients with , persistent sneezing worsens bronchial hyperreactivity and airflow obstruction, contributing to more frequent exacerbations. Furthermore, nightly sneezing disrupts sleep architecture, with allergy sufferers more than twice as likely to develop , , or due to nasal obstruction. Certain populations face heightened risks from sneezing. Elderly individuals with are particularly vulnerable to fractures, as their brittle bones can break from the minor trauma of a sneeze, affecting or vertebrae. Post-surgical patients, such as those recovering from , risk complications like bleeding or nasal graft displacement if they sneeze forcefully, as the pressure can strain healing tissues; guidelines recommend sneezing with an open mouth to mitigate this.

Prevention and Control

Suppressing Sneezes

Suppressing a sneeze involves voluntary attempts to interrupt arc before it completes, often through physical interventions that target sensory or pathways. Common methods include pinching the nostrils closed to block nasal , which prevents the expulsion phase of the sneeze. Another technique is pressing the firmly against the roof of the or alveolar ridge behind the front teeth for several seconds, aiming to overload sensory and divert the brain's from the irritant signal. Additionally, applying to the upper or the area just below the with a finger can disrupt the impending by stimulating nearby . The physiological basis for these methods lies in interrupting the neural signals along the pathway that triggers the sneeze center in the . Pinching the nose mechanically halts airflow, thereby inhibiting the activation of respiratory muscles without allowing the full to engage. Techniques like tongue pressure or lip stimulation operate on principles similar to the , where non-noxious sensory input from the mouth or face competes with the irritant signal from the , potentially closing the "gate" to further propagation in the and . These actions aim to desensitize or overload the sensory afferents before the efferent motor response builds. These suppression methods may be effective for mild irritants, such as minor exposure, by interrupting the in its early sensory phase, but they often fail against strong triggers like allergies or infections where the neural drive is intense. Limitations include inconsistent success due to individual variability in sensitivity, and medical experts strongly advise against routine use because suppression can redirect pressure buildup to other areas, potentially causing eardrum rupture, sinus damage, or vascular injuries in the eyes or .

Hygiene Practices

Hygiene practices for sneezing focus on reducing triggers that provoke the reflex and implementing safe habits to limit the spread of respiratory droplets during the act itself. To minimize sneeze induction from environmental irritants, individuals can avoid exposure to common allergens such as , , or pet dander by staying indoors during high- periods, using allergen-proof , and regularly cleaning living spaces. Air purifiers equipped with high-efficiency particulate air () filters can effectively capture airborne allergens, thereby decreasing the concentration of particles that irritate nasal passages and trigger sneezing. Saline nasal rinses provide another proactive measure by flushing out allergens and from the nasal passages, reducing and the likelihood of sneeze-inducing ; these can be performed using a neti pot or with sterile saline solution. For those with allergy-related sneezing, over-the-counter medications like antihistamines (e.g., loratadine or ) block responses to alleviate symptoms including sneezing, while decongestants (e.g., pseudoephedrine) reduce that may exacerbate the reflex. Safe sneezing etiquette emphasizes containing expelled droplets to prevent germ transmission, particularly during respiratory illnesses. authorities recommend covering the mouth and nose with a disposable tissue when sneezing, followed by immediate disposal of the tissue in a receptacle to avoid re-aerosolizing pathogens. If a tissue is unavailable, sneezing into the inner or upper serves as an effective alternative to minimize hand . Post-sneeze handwashing with soap and water for at least 20 seconds, or using an alcohol-based , is crucial to eliminate any residual germs and interrupt transmission chains. In cases of respiratory infections, guidelines from organizations like the CDC and WHO advocate for additional precautions, including wearing a in public or crowded settings to capture droplets from sneezes and coughs, thereby protecting others from potential spread of viruses such as or coronaviruses. Environmental controls, such as using a clean to maintain indoor levels between 30% and 50%, can prevent dry air from irritating nasal passages and provoking unnecessary sneezes, especially in heated or arid climates. Regular maintenance of humidifiers is essential to avoid mold growth, which could introduce new irritants.

Cultural and Historical Perspectives

History

The English word "sneeze" originates from the Old English verb fnēosan, meaning "to sneeze or snort," which derives from the Proto-Germanic fneusaną, an onomatopoeic term mimicking the sound of the act. This root is shared across Germanic languages, such as Middle High German pfnūsen for "to snort or sneeze." In ancient languages, the Greek term was ptarmós (πταρμός), referring to a sneeze, while the Latin equivalent was sternutatio, from the verb sternutare meaning "to sneeze repeatedly." In , viewed sneezing as a symptom of humoral imbalance, particularly excess , and noted its therapeutic effects, such as relieving hiccups or aiding women in labor by expelling impediments. Romans extended this to superstitious interpretations, regarding sneezes—especially unexpected ones—as omens foretelling events, often signaling divine intervention or warnings that influenced decisions in daily life and public affairs. From the medieval period through the early , understandings of sneezing shifted toward anatomical explanations. In the , anatomists like Conrad Victor Schneider advanced knowledge by describing sneezing as a nasal rather than a cerebral event, emphasizing irritation of the in his 1655 De catarrhisenis as the primary trigger. By the , Charles Harrison established sneezing's connection to allergies, demonstrating through self-experiments in the and that pollen exposure caused hay fever symptoms, including sneezing, via direct nasal application and seasonal observations. In the , the —sneezing triggered by bright light—was formally identified and named "ACHOO syndrome" (Autosomal dominant Compelling Helio-Ophthalmic Outburst) in 1978, highlighting its inherited nature and distinguishing it from irritant-induced sneezes. Into the , genetic research has linked sneeze susceptibility to variations in HLA genes, particularly class II alleles like , which influence IgE-mediated responses underlying and associated sneezing.

Cultural Significance

Throughout history, sneezing has been imbued with superstitious meanings as an omen, often interpreted as a sign of spiritual intervention or impending fortune. In ancient , a sneeze was believed to expel evil spirits from the body, creating vulnerability for malevolent forces to enter, a notion rooted in Greco-Roman traditions where it could signal either good fortune or bad luck depending on context. During the in 14th-century Europe, sneezing became associated with imminent death due to its link to plague symptoms, prompting protective blessings to ward off mortality. In , sneezing is viewed as an indicator that someone is discussing the sneezer; a single sneeze often signifies positive gossip or praise, serving as a benign or favorable omen. Sneezing holds symbolic roles in literature and art, frequently employed for comedic effect to humanize characters or provide relief amid tension. In Elizabethan-era works, including those influenced by Shakespearean conventions, sneezing underscored bodily vulnerability and humor, reflecting contemporary superstitions about the soul's momentary escape during the act. In modern media, particularly cartoons, sneezes are exaggerated for slapstick humor, such as explosive reactions propelling characters or disrupting scenes, as seen in Disney animations where they drive plot complications like lost items. Cultural interpretations vary globally, with some traditions treating sneezing as a marker of impurity or spiritual vitality. In certain Middle Eastern contexts, such as , a sneeze prompts pausing all activities, implying a temporary disruption or state akin to ritual impurity. Among Zulu communities in , sneezing signals the approach of ancestral spirits (Itongo) entering the body to inspire or grant vitality, viewed positively as a conduit for divine guidance. In contemporary society, sneezing carries stigma amplified during pandemics, where it evokes fears of contagion and enforces norms. Public reactions often include anger toward perceived lapses in , like not covering the mouth, reinforcing isolation for those displaying symptoms regardless of cause. This phenomenon, termed "sneezing stigma," judges individuals based on the act alone, heightening anxiety in communal settings.

Verbal Responses

In many cultures, a sneeze prompts a verbal response intended to wish the sneezer well, often rooted in historical concerns about or spiritual . In English-speaking countries, the most common phrase is "Bless you" (or ""), which originated in the during a outbreak when reportedly urged the faithful to invoke God's blessing upon those who sneezed, as it was seen as an early symptom of illness. This practice evolved from a religious protective rite into a secular expression of politeness by the modern era. Similarly, in German-speaking contexts, "Gesundheit" is used, literally meaning "," to wish recovery and ward off impending sickness, a custom that gained popularity among English speakers through 19th-century German immigrants in the United States. Across languages, equivalents emphasize or divine favor: Spanish speakers say "¡Salud!" for the first sneeze (meaning ""), often followed by "¡Dinero!" () for the second and "¡Amor!" () for the third in some traditions. In French, the response is "À tes souhaits" (to your wishes, informal) or "À vos souhaits" (formal), with escalations like "À tes amours" (to your loves) for subsequent sneezes, reflecting a whimsical evolution from medieval wishes. Korean culture occasionally employs "건강하세요" (geonganghaseyo, "take care of your "), though it is not universally said. Religious variations add layers of ritual: In Islamic tradition, after praising ("Al-hamdu lillah"), the sneezer receives "Yarhamuk " (may have mercy on you) from others, followed by a reply invoking guidance, as prescribed in . These phrases have shifted over time from invocations against plague or evil—such as those during the 6th-century epidemics—to routine courtesies in diverse, secular societies, where they serve as automatic acknowledgments rather than fervent prayers. For multiple sneezes, customs often escalate blessings progressively, like the Spanish sequence or French additions, to maintain the supportive tone without repetition. Psychologically, these verbal responses foster social comfort by acknowledging a momentary , signaling and reinforcing communal bonds in everyday interactions. They transform an involuntary into a shared , promoting and reducing awkwardness in social settings.

Broader Contexts

Sexuality

Sneeze fetishism, also known as sneezophilia or mucophilia, is a rare characterized by triggered by the act, sound, or sight of sneezing, either one's own or that of others. This condition involves individuals deriving erotic pleasure from the sensations or auditory cues associated with sneezing, often leading to fantasies, , or interpersonal interactions centered on inducing or observing sneezes. The phenomenon was first formally documented in in 1990 through a of a young man who experienced from both his own sneezing and that of others, highlighting its as a fetishistic disorder within . Subsequent reports, such as those in the Journal of Sexual Medicine, have noted similar cases, emphasizing the arousal's specificity to sneezing stimuli without broader atypical sexual interests. Online communities dedicated to emerged in the late , with early sites like Tarot of Sneezing established in 1997, providing a space for individuals to share experiences, stories, and content, which helped normalize the interest within niche groups. The Sneeze Fetish Forum, founded around 2002, grew to thousands of members by the , fostering discussions on triggers, media preferences, and psychological aspects, though participation remains discreet due to societal stigma. These communities illustrate how digital platforms enabled connection for those with this uncommon , predating broader awareness through coverage in the . Physiologically, the sneeze reflex and share overlapping neural pathways in the , particularly involving parasympathetic activation that can lead to bursts of sensory intensity in both processes. This convergence may explain why sneezing can evoke orgasm-like sensations, as both phenomena involve rapid neural discharge from centers. has proposed sneezing as a form of non-genital , where the reflex's pleasurable release mimics climax, though such occurrences are studied primarily in the context of autonomic cross-talk. Due to its intimate and unconventional nature, sneeze fetishism carries a strong , with historical references virtually absent before the late , emerging only through modern psychological case studies rather than cultural or literary records. This discretion persists in clinical discussions, where it is addressed under broader frameworks without emphasis on prevalence, reflecting limited research amid ethical sensitivities in .

In Non-Humans

Sneezing, a reflex action to clear irritants from the nasal passages, occurs across various animal possessing respiratory systems connected to nasal cavities, primarily vertebrates. In mammals, the physiological mechanism mirrors that in humans, involving a coordinated contraction of respiratory muscles to forcefully expel air and particles through the nostrils at speeds up to 160 km/h in some cases. For instance, domestic dogs (Canis familiaris) commonly exhibit sneezing to remove allergens or foreign bodies, while a related phenomenon known as —characterized by rapid, spasmodic inhalations—helps clear irritants from the nasopharynx and is observed in around 50% of canine populations in some surveys, often without underlying pathology. (Loxodonta africana and Elephas maximus) adapt this reflex by channeling the expulsion through their trunks, which amplifies the force and distance of projection, aiding in the removal of dust from environments. Certain mammals repurpose sneezing for social communication. In African wild dogs (Lycaon pictus), sneezes function as acoustic signals during pre-departure rallies, where the cumulative number of sneezes from pack members determines consensus for group actions like or ; rallies with at least 10 sneezes succeed in departure about 80% of the time, promoting democratic decision-making in this highly cooperative species. Birds, equipped with nasal passages linked to their , also sneeze to expel debris or , often manifesting as audible snorts or head shakes; in gallinaceous species like chickens (Gallus gallus domesticus), frequent sneezing signals respiratory infections such as infectious coryza, caused by Avibacterium paragallinarum, leading to nasal discharge and facial swelling. Reptiles demonstrate sneezing primarily for physiological maintenance; marine iguanas (Amblyrhynchus cristatus) in the sneeze forcefully to eject hypertonic salt solution from specialized nasal glands, preventing dehydration after feeding on saline , with each sneeze expelling droplets visible as white crusts on their snouts. Even in lacking nervous systems or true noses, analogous expulsion behaviors exist. Sponges (Porifera), among the earliest multicellular animals, perform periodic "sneezes" by contracting their bodies to eject laden with trapped sediments and microbes from oscules—their water outlets—at intervals of 3-8 hours through contractions lasting 20-50 minutes, to unclog filter-feeding pores and sustain nutrient uptake in sediment-heavy marine environments. Aquatic vertebrates like lack lungs and nasal connections to the exterior, precluding sneezing, while amphibians such as frogs exhibit rare, moisture-dependent nasal clearances rather than true sneezes. These variations highlight sneezing's evolutionary role in respiratory and osmotic across taxa.

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