Whooping cough

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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."