Everything you always wanted to know about sternutation but were too sneezy to ask

The banal phenomenon of sneezing is analyzed in depth by a former Russian-immigrant neurologist’s Hebrew-language book.

Hit’atshut: Biosemiotica Shel Hahayim Habanaliyim (The Sneeze: Biosemiotics of Banal Life) (photo credit: TNS)
Hit’atshut: Biosemiotica Shel Hahayim Habanaliyim (The Sneeze: Biosemiotics of Banal Life)
(photo credit: TNS)
This 191-page book is nothing to sneeze at.
With color diagrams and 21 pages of scientific references, the Hebrew-language volume on sternutation covers almost everything.
Never heard of sternutation? In simpler words, it’s the semi-autonomous, convulsive expulsion of air from the lungs through the nose and mouth, usually caused by foreign particles irritating the nasal mucosa – or the sneeze.
Prof. Jean Askenasy is a former Russian Jewish “refusenik” who struggled for the right to settle in Israel and finally arrived in 1972.
The neurologist has since worked at Tel Aviv Sourasky Medical Center and Soroka University Medical Center in Beersheba and conducted research at the Weizmann Institute of Science in Rehovot. Today he lectures on medicine and law at Tel Aviv University.
Titled Hit’atshut: Biosemiotica Shel Hahayim Habanaliyim (The Sneeze: Biosemiotics of Banal Life), the book answers everything you always wanted to know about sternutation but were too sneezy to ask. (For the uninitiated, biosemiotics refers to “the production and interpretation of signs and codes in the biological realm”).
SNEEZING IS such a routine function in humans and many animals – but nobody thinks about what causes it, notes the author. “Understanding the banality of life brings me closer to man and his illnesses, just like rare genetic illnesses that I will never encounter as a physician.”
People sneeze to remove from the nasal cavities mucus containing foreign particles or irritants. During a sneeze, the soft palate and palatine uvula are lowered while the back of the tongue rises to partially close the passage to the mouth so that air expelled by the lungs can exist the nose. Because the mouth closes only partially, much of this air is also expelled through it; the power and amount of air pushed through the nose varies. There is actually a “sneezing center” in the brain that causes the nose to react to stimulants.
The air can be expelled by the nose at high speeds – up to 160 kilometers per hour.
Many things – not only a cold but also exposure to bright light, having (or thinking about) sex and orgasm, a drop in temperature or a cold breeze, a full stomach, chemicals, allergies, touching something, being exposed to an electric current – can trigger a sneeze. But, the author notes, there is still no solid scientific explanation for it.

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Breathing is obviously connected to life in the Bible, as when God created Adam, writes Askenasy, but the sneeze is actually mentioned in II Kings when the Prophet Elijah resuscitates the dead son of Shunammite woman by lying on him and the boy sneezes seven times, opens his eyes and returns to life.
The Babylonian Talmud refers to sneezing and yawning as a predictor of the arrival of a woman’s menstrual period.
But saying “God bless you!” or “Gesundheit” in response to another’s sneeze occurred later in history, as in Jewish, Roman, Islamic, Chinese and other cultures sneezing was considered dangerous; it was incorrectly thought to cause the heart to stop beating, or – more logically – to be a sign of oncoming disease. Various cultures include a superstition that sneezes are an attempt by Satan to “kidnap” the soul from a person’s open mouth.
In certain parts of Eastern Asia, especially in Chinese, Japanese, Korean and Vietnamese culture, a sneeze that does not seem to have an obvious cause was generally regarded as a sign that someone was talking about the sneezer at that very moment. Some even believe that one sneeze signifies that something good was said about the person; two something bad and three that someone is in love with them.
But there is a popular notion in Poland that sneezes may mean that a person’s mother-in-law is criticizing her son- or daughter-in law.
THE AUTHOR notes that many types of animals – birds, dogs, pandas, monkeys, cats, ostriches and even iguanas – sneeze. A monkey in Myanmar called Rhinopithecus strykeri that has a hole between its eyes instead of a protruding nose is known as the “sneezing monkey” because of his “atchoo” occurring when it rains.
You can’t sneeze at any time. When you are deep in rapid-eye-movement (REM) sleep, you can’t sneeze because you have gone into a state of atonia when the motor neurons cannot be stimulated and the brain does not receive signals of reflexes.
But if you wake up in the middle of REM, you can start sneezing.
The sneeze reflex, writes Askenasy, involves various nerves in the brainstem that control muscles in the throat and lungs.
Drivers or aircraft pilots often worry about sneezing while in control of the wheel, because most people close their eyelids momentarily during the reflex and risk a sudden accident. But the author writes a whole chapter on how to prevent a sneeze. The advice includes inhaling deeply and keeping the air inside until the count of 10; strongly exhaling a large amount of air; pinching the bridge of the nose; blowing your nose to eliminate mucous; taking short, shallow breaths with short intervals between; or pressing the tongue to the palate while saying the word “lamp” or “pineapple” (in English only).
One is also advised to keep away from pepper, dust, pet hair or feathers, and to keep the house clean. If you’re allergic to any of these, avoid installing rugs and carpets on the floors and regularly clean the filters of your air conditioning or humidifying equipment.
Sneezes should be covered by a handkerchief or forearm and not released into the air because they typically contain some 100,000 microbes if the cause of the sneeze is a cold or other viral infection.
Using one’s palm is not advisable because shaking somebody else’s quickly transfers the microbes to another by contact with the hand or something one touches.
CERTAIN SMELLS stimulate the olfactory receptors in the nose, which transmit the signal to the trigeminal nerve and cause sneezing, writes Askenasy. Sometimes the smell is only faint, but still does the job. Pheromones, which are chemical factors secreted or excreted by animals and possibly even humans to trigger a social response in individuals of the same species may cause creatures to sneeze (they also occur in plants, which are known to cause sneezes).
Although Sigmund Freud reached the conclusion that there is no connection between the nose and sexual organs, various researchers found in the mid-1960s that sneezing can result as a reaction in both men and women to thinking about sex. Sneezing as a result of allergies is caused by inflammation of the nasal passages, Askenasy writes. The difference between allergic sneezing and infectious sneezes is that the latter involves a rise in body temperature. The best ways to avoid allergies are to avoid being exposed to the allergen or to take antihistamine mediations.
Capsaicin, the active chemical component of chili peppers, is a prime cause of sneezing for both animals and humans. Inhaling it produces a sensation of burning in any tissue with which it comes into contact.
A widely used anesthetic called propofol (Diprivan) that veterinarians and anesthesiologists use can cause multiple sneezing, according to a 1995 study in a Canadian medical journal. Some patients react so strongly to this that the operating table shakes, causing the surgeon problems. One involuntarily sneezing patient was even stabbed in the eye by the surgeon’s scalpel. Yet the psychoactive substances known as opioids such as fentanyl have been found to prevent sneezing during surgery, especially on the eyes.
This drug would have been helpful to Donna Griffiths of Worcestershire, England who set a record of sneezing in an unstoppable paroxysm for 978 days.
TACTILE SNEEZES were first noticed in 1919 when a woman was seen sneezing uncontrollably when she rubbed the corners of her eyes with her fingers; when her mother was found to show the same reaction, doctors reached the conclusion that they both carried an inherited gene responsible for it. Touching one’s ankle, neck and other parts of the body – as well as sneezing after taking a shower (even when it was warm) – are also reported as phenomena in the book.
When the ethmoidal nerve on the sides of the inside of the nose is stimulated by mild electricity, one almost inevitably sneezes at least once, while photic sneezes are triggered by light and solar sneezes by exposure to the sun. Here, it is not the nose but the iris in the eye that reacts trigger a sneeze.
“Snatiation” is the word invented by scientist in 1990 for the phenomenon of starting to sneeze after eating a satisfying meal. Genetic inheritance may also been involved in this. Psychiatric disorders can also show up as sneezing.
THIS ENJOYABLE and educational book is Askenasy’s fourth and was proceeded by his autobiography published in Hebrew, File Number 148074; a book on Sleep: The Gray Third of Life; Emotions and Humor; on The Smile, Laughter and Crying; and the fourth on Messages from Yawns and Sighs. His fifth to appear is about – what else – Hiccups. Can belches