Medical Examination of Immigrants at Ellis Island

Abstract

SARS, avian flu, bioterrorism: such threats to national security at the dawn of the 21st century have renewed anxieties about controlling disease at the nation's borders.Control of infectious agents also provided the impetus for immigrant medical inspections along the U.S. coasts in the late 19th century, but, in practice, it was the weeding out of chronic disease and disability that actually motivated public health officers on "the line" at Ellis Island and other U.S. immigration stations during the first 30 years of federal control of the nation's borders.From the colonial era to the end of the 19th century, each state had borne responsibility for regulating immigration.But with the swelling numbers of immigrants in the 1880s and 1890s, an increasingly complex industrial economy, and mounting concern about the international spread of infectious diseases, the federal government took control of the nation's borders in 1891.While admission decisions were made by the Immigration Service (IS), the law required medical inspection of immigrants by the United States Public Health Service (PHS).When a PHS medical officer formally diagnosed an immigrant with a disease or defect, throwing his or her admissibility into question, that individual was considered "medically certified."The law required the PHS to issue a medical certificate to those who suffered from a "loathsome or a dangerous contagious disease" [1].Exclusion of those diagnosed with infectious diseases such as tuberculosis, venereal disease, trachoma, and favus was mandatory [2].The PHS defined its mission rather narrowly-preventing the entrance of disease to the nation-but PHS officers interpreted their job more broadly.In their eyes, the goal was to prevent the entrance of undesirable people-those "who would not make good citizens" [3].In the context of industrial-era America, immigrants who would wear out prematurely, requiring care and maintenance rather than supplying manpower, would not make "good" citizens.By 1903 the PHS had elaborated two major categories: "Class A" loathsome or dangerous contagious diseases and "Class B" diseases and conditions that would render an immigrant "likely to become a public charge."A subset of Class A conditions included mental conditions such as insanity and epilepsy. Inspection on the "Line"www.virtualmentor.org

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