In Hades Bloom thinks of an affliction that gasworks
plants were thought to cure, and then of other perilous
childhood diseases: "Whooping cough they say it cures. Good
job Milly never got it. Poor children! Doubles them up black
and blue in convulsions. Shame really. Got off lightly with
illnesses compared. Only measles. Flaxseed tea. Scarlatina,
influenza epidemics. Canvassing for death. Don't
miss this chance." The catalogue suits a chapter which
meditates relentlessly on death, including the deaths of
children, but it ends with Bloom whimsically picturing the
diseases as advertising canvassers like himself.
Whooping cough, or pertussis, is a highly contagious
respiratory infection that typically afflicts infants and
young children more severely than adults. Caused by a Bordatella
bacterium, a close cousin of the one that causes kennel cough
in dogs, it can now be prevented with vaccines and treated
with antibiotics, but these defenses were not available in the
early 20th century. The disease starts with a mild cough
lasting for one or two weeks and then enters a more severe
stage of extremely violent coughing, often punctuated with
whooping sounds as the sufferer struggles to breathe in.
Sometimes the struggle for air becomes even more acute when
coughing is accompanied by vomiting, or by apnea (a total
interruption of breathing) and cyanosis (bluish skin). These
terrible symptoms can go on for several more weeks until the
patient dies or begins to heal. The infection occasionally
results in brain inflammation and true seizures, but the
thoracic effects are entirely sufficient to produce the
wracking spasms that Bloom thinks of: "Doubles them up
black and blue in convulsions."
The air around gasworks plants was notoriously
polluted and probably injurious to the health of the men who
worked in them, but for several decades at least many people
had believed that children with whooping cough could be
treated by exposing them to this foul air. Commenting on "Whooping
cough they say it cures," Slote quotes from Wayland D.
Hand's Magical Medicine (1980): "The custom of taking
children suffering from whooping cough to the gas-works has
been reported from different parts of England and the United
States.... This was explained as being due to the fact that
the air near a gas-works contains pyradin, which is supposed
to act as an antiseptic and a germicide." Scientists of
Joyce's time suspected, and eventually confirmed, that the
illness was caused by a bacterium.
Bloom counts himself lucky that Milly was spared from this
cruel disease, but the other infections he thinks of were no
less capable of killing children. Until the arrival of a
vaccine in 1963, the supremely contagious "measles"
virus infected most children. Most survived it, but for a
small number it was deadly. Even today, among unvaccinated
people about 1 of every 5 who contract the disease requires
hospitalization, and 1-3 of every 1,000 children die of
pneumonia, encephalitis, or other complications. A 1901 letter
by one Harvey Mackenzie held in the National Library of
Ireland refers to a camp being placed under quarantine because
of a measles outbreak. "Flaxseed tea," a traditional
herbal remedy, may have relieved some symptoms but it was
surely no match for pneumonia or encephalitis.
"Scarlatina" is another name for scarlet fever, a
disease suffered mostly by children ages 5-15, but sometimes
seen in much younger ones, in which Streptococcus
bacteria spread from the throat to other parts of the body,
causing high fever and a widespread bright red rash. There is
no vaccine, but today these strep infections respond readily
to antibiotics (though resistant bacteria are beginning to be
a problem). In the early 20th century, however, scarlatina was
one of the leading causes of death in children. The same was
true of "influenza epidemics," which despite vaccines
continue to sweep through human populations every year causing
many thousands of deaths, especially among the very old and
the very young.
Joyce's stint as a medical student did not last long, but he
learned enough to give Leopold Bloom a compassionate and
fairly knowledgeable grasp of the legion of illnesses that can
make childhood a gauntlet of deadly risks. The meditation
early in the carriage ride anticipates the appearance of a
child's funeral procession later on the route, which plunges
Bloom into mournful recollections of his son Rudy's death.
But at the beginning of Hades his mood seems lighter.
He wryly imagines all the deadly agents of the microbial world
as advertising hacks like himself, drumming up business: "Canvassing
for death. Don't miss this chance." This flippant little
conceit allies him with Stephen, who at the end of Proteus
imagined an advertising pitch for
drowning: "beware of imitations. Just you give it a
fair trial. We enjoyed ourselves immensely."