On 29 June 1904 the Chief Secretary to the Lord-Lieutenant of
Ireland fielded a hostile question from an Irish nationalist
M.P. about the "serious outbreak in the City of Belfast": was
the city doing enough to contain the spread and to alleviate
unsanitary conditions? The Chief Secretary, Mr. George
Wyndham, replied that "The total number of cases admitted to
the smallpox hospital is ninety-three. Two have died;
fifty-five have been discharged; and thirty-six remain under
treatment. The disease is supposed to have been introduced
from Scotland. The Belfast Corporation, in the opinion of the
Local Government Board, efficiently discharges the duties
devolving upon it as the sanitary authority. Every effort is
being made to prevent the further spread of the disease." The
disease did die out without becoming epidemic.
This is one of many instances in which Joyce, the former
medical student writing his "epic of the body," paid attention
to questions of public health. Research into microbial
infections had begun with the work of Louis Pasteur in the
1850s and 60s and Robert
Koch in the 1880s, and by the 1890s and early 1900s
individual strains of bacteria and viruses were beginning to
be identified. Immunization against smallpox was older.
Without knowing anything about viruses, English physician
Edward Jenner had demonstrated in 1796 that infecting human
beings with the relatively benign cowpox disease could give
them immunity from smallpox. ("Vaccination" was coined from
Latin vacca = cow.)
Smallpox was a horrible disease, responsible since medieval
times for many millions of cases of permanent disfigurement,
blindness, and death, and sometimes imperiling entire
societies. In some epidemics more than half the people
infected would die, and child mortality could reach 80
percent. In a 12 February 2021 article on IrishCentral.com,
Dr. Ciarán Wallace observes that "Among the many diseases that
could kill you in 19th-century Dublin smallpox was the most
feared." Compulsory vaccination of Irish children began in
1864 and the law was widely accepted, but the disease still
threatened, especially in port cities. Bloom's hyper-cautious
thought that perhaps Molly should "let herself be
vaccinated again" before going to Belfast may reflect
the fact that Dublin itself had very recently had a bad
smallpox scare.
In 1902, Wallace observes, from "an initial case of one
infected sailor arriving into a crowded tenement, smallpox
began spreading through the community, threatening the entire
city. Lethal outbreaks were claiming many lives in Liverpool
and Glasgow, port cities trading regularly with Dublin. Dr.
Charles Cameron, Dublin’s long-serving and renowned medical
superintendent of health, took very vigorous action. He
ordered the rapid construction of an isolated smallpox
hospital. Close contacts were placed in a municipal refuge,
their homes were disinfected and whitewashed, the clothing and
bedding incinerated. Vaccination and re-vaccination played
a key role. A poster campaign publicized new vaccination
centers that operated late into the night. The posters
also warned of fines for concealing cases of smallpox. By
autumn 1903, after 360 cases, 33 deaths, and no new
infections, Dublin could breathe a sigh of relief. The
medicine was unpleasant but it had worked."
In an interesting reflection of events today, there was
enormous pushback to compulsory vaccination in England, but
the movement never really caught on across the Irish Sea: "The
public response in Ireland seemed to be a mixture of amusement
and bemusement. The Southern Star newspaper in 1898
observed that: 'Englishmen sneer frequently at Irish
agitation, but to the Irish mind nothing could be more
ludicrous than the anti-vaccination crusade'."
In the United States, then as now, the suspicious libertarian
attitude took hold of many minds. The country was suffering a
severe epidemic—hundreds of thousands of cases of smallpox
from 1899 to 1904—and authorities mandated vaccination, with
certificates required for entry into public spaces. Those
measures were widely resented. According to Dave Roos' 9 April
2021 article on the History.com website, people forged papers
and, "Unable to tell if certificates were legitimate, health
officials fell back on physical evidence: they demanded to see
a vaccination scar." People who couldn't show a fresh scar
were "vaccinated on the spot."
As the 20th century wore on, rigorous programs of
inoculation, employing better vaccines, exterminated this
virus in the wild—the first (and, to date, only) such success
in human history. It represents perhaps the strongest possible
argument for compulsory vaccination.
