THE MEDICAL SIDE OF IMMIGRATION 385 



the blindness in Syria and Eg}n^t Its contagious nature, together with 

 the resulting scarring of the lids and blindness, make its recognition 

 imperative. The hookworm {Uncinaria) has received much attention 

 lately since it has been found so widely distributed through the moun- 

 tains of the south, the mines of California, the middle west, etc. It is a 

 minute parasitic intestinal worm about three fifths of an inch long, 

 and under the microscope shows relatively enormous and powerful 

 chitinous jaws by means of which it attaches itself to the intestinal 

 walls. The saliva of the hookworm has the curious property of prevent- 

 ing coagulation of blood like leech extract, and when it is remembered 

 that the worms may vary in number from several hundred to a thousand 

 or more, and that each worm moves frequently from place to place on 

 the intestinal wall, it is apparent how excessive and continuous is the 

 drain on the blood and lymph juices. The result is an extreme anemia 

 which brings in its wake a varied multitude of bodily ills, and may 

 eventuate fatally, meanwhile having incapacitated the victim for mental 

 or physical work. Infection can spread rapidly from a single case. Not 

 many hookworm carriers have been discovered among immigrants, prob- 

 ably because the facilities for their detection are so meager. But the 

 heavy immigration from countries where uncinaria is abundant, as well 

 as the recent suggestive work of Dr. H. M. Manning at the Ellis Island 

 Immigrant Hospital, indicate that there is a constant stream of fresh 

 infection pouring in. Indisputably routine examination for hookworms 

 should be instituted. The same can be said of other intestinal parasites 

 as tapeworms, pin worms, whip worms, eel worms and others. One of 

 the tapeworms, the so-called fish worm (DibothriocepJialus latus) leads 

 to an anemia fully as severe as that from the hookworm. 



Many other diseases might be mentioned, but these are sufficient to 

 illustrate the importance of careful medical inspection of immigrants. 

 The total immigration into the United States through all ports of 

 entry for the year ending June 30, 1911, was 1,052,649. Of these 22,349 

 were debarred for various reasons, leaving a net increase of 1,030,300. 

 The chief port of entry is, of course. New York, where 749,642 aliens 

 were examined. Next in order of importance come Boston, Baltimore 

 and Philadelphia, and at a greater distance Galveston, Tampa, San 

 Francisco, Honolulu, Miami and Portland, Me. As the laws are uni- 

 form and the methods of inspection the same at all ports, consideration 

 of methods and results at Ellis Island, N. Y., will give a clear idea of 

 the entire subject. 



The medical inspecting service at Ellis Island is divided into three 

 branches, the hospital, the boarding division and the line. The hospital 

 division presents an excellently equipped and managed institution, and 

 an isolated set of buildings for contagious diseases. The hospital serv- 

 ice is limited exclusively to immigrants, and the patients are those 

 acutely ill upon arrival, those taken sick during their stay on the island. 



