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The Midrash Pirkei D'Rebbi Eliezer (54) writes

המופת הרביעי, מיום שנברא העולם לא היה אדם חולה, אלא בכל מקום שהיה אדם אם בדרך אם בשוק ועטש היתה נפשו יוצאה מנחיריו ומת, עד שבא יעקב אבינו ובקש רחמים על זאת ואמר לפני הב"ה, רבונו של עולם אל תקח את נפשי ממני עד אשר אני מצוה את בני ובני ביתי. ונעתר לו, שנ' ויהי אחרי הדברים האלה ויאמר ליוסף הנה אביך חולה. ושמעו כל מלכי הארץ ותמהו שלא היה כמהו מיום שנבראו שמים וארץ, לפיכך חייב אדם לומר לחבירו בשעת עטישותיו חיים שנהפך מות העולם לאור, שנ' (איוב מא, י) עטישותיו תהל אור - The fourth wonder (was): From the day when the heavens and the earth were created no man was ill, (who) sneezed and lived, but in every place where he happened to be, whether on the way or in the market, and (when he) sneezed, his soul went out through his nostrils; until our father Jacob came and prayed for mercy concerning this, and he said before the Holy One, blessed be He: Sovereign of all the worlds! Do not take my soul from me until I have charged my sons and my household; and He was entreated of him, as it is said, "And it came to pass after these things, that one said to Joseph, Behold, thy father is sick" (Gen. 48:1). || All the kings of the earth heard (thereof), and they wondered because there had been no one like him from the days when the heavens and earth had been created. Therefore a man is in duty bound to say to his fellow: Life! when the latter sneezes, for the death of the world was changed into light, as it is said, "His neesings flash forth light" (Job 41:18).

On the other hand, Rashi in Berachos (53a) says

מרפא – לאדם המתעטש שרגילים לומר אסותא. Rabban Gamliel wouldn't say "to health!" in the Beis Midrash, the way that people normally say "Health!"

which seems to imply that it was just a common practice of people rather than a requirement.

Finally, there is a Tosefta Shabbos (8:2) which actually forbids this due to Darkei Emori:

האומר מרפא הרי זה מדרכי האמורי ר' אלעזר ברבי צדוק אומר [אין אומרים מרפא מפני ביטול תורה של בית ר"ג] לא היו אומרים מרפא [מפני דרכי האמורי]

Do Poskim codify a requirement to say "Bless you!", "Health!", or its equivalent when someone sneezes? (Shulchan Aruch OC 170:1 poskins not to say "Bless you" during a meal, but that doesn't necessarily show one is required to do so otherwise)

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  • See 230:4 with beir heitiv
    – Double AA
    Commented May 14, 2021 at 1:16
  • @DoubleAA Your bekius never ceases to amaze me - the Be'er Heitev doesn't seem to lean one way or another, more "One who sneezes and his friend says, bless you then respond..." - מי שמתעטש וחבירו א''ל אסותא - rather than saying "He should 'bless you'. Did you read it differently?
    – NJM
    Commented May 14, 2021 at 2:42
  • 1
    Related judaism.stackexchange.com/q/12587/13811
    – NJM
    Commented May 14, 2021 at 2:44
  • @doubleaa, why not the MB 230:7
    – sam
    Commented May 14, 2021 at 3:17
  • @sam That's not where I remembered it from, and anyway mine is the MB's source
    – Double AA
    Commented May 14, 2021 at 14:00

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