Whatever the origins of this belabored phrase, it’s wholly unnecessary. As the same for gesundheit or anything else you’re supposed to say when someone sneezes. Okay, there’s a sneeze, so what? Why bother pointing out someone’s sneeze? Whatever spiritual significance that may have been an issue in antiquity should no longer hold our bodily function hostage. I want to sneeze without anyone paying any attention. You don’t say anything when I cough, yawn, or fart. If anything, I should be the one saying something, hopefully an apology (or doorknob) for the last one, when one of those events occurs. But sneezes seem to be unique in that the audience is the first to react.
Now if you can’t shake the need to acknowledge a semi-autonomous, convulsive expulsion of air through my nose and mouth, please don’t expect me to say “thank you.” Is your self-worth so dependent on my validation that you noticed I sneezed? Now instead of wasting one breath by saying “bless you,” I also have to waste a breath in receipt of your blessing? Please, save your breath and let me sneeze in peace.