IMMIGRATION AND THE PUBLIC HEALTH. 



233 



immigrant a public charge. When the physical defect or poor physique 

 is so marked that it seems to the medical inspector likely to make the 

 immigrant a public charge, the immigrant is detained, and a certificate 

 is made stating his disability, which certificate goes to the board of 

 special inquiry with the detained immigrant. About two thirds of the 

 immigrants so certified as likely to become a public charge are admitted 

 because of the latitude allowed by the phrase, 'likely to become a public 

 charge.' Under the present law, therefore, the immigrant certified 

 as sufi^ering from a loathsome or dangerous contagious disease, or as 

 being idiotic or insane, is deported. The immigrant recorded as 

 having a 'poor physique' or other j^hysical defect is usually admitted. 



Destination is scarcely less important than physique, and it is the 

 rule that aliens of a race having a low physical standard will invariably 

 herd together in the overcrowded insanitary tenement districts of our 

 great cities, while the sturdy races of unskilled laborers are scattered 

 over a wide territory and tend to establish little homes of their own in 

 the country or in the subur])s of manufacturing towns or cities. 



The following table indicates the relative physical strength of the 

 various races under discussion, and also the percentage of each race 

 giving New York as their destination. Statistics of the Irish and 

 Scandinavian races are given in this table for the purpose of comparison. 



The third factor to be considered is the presence of communicable 

 disease among immigrants. The ordinary quarantinable disease are 

 eliminated from the question by efficient quarantine methods, but cer- 

 tain communicable maladies, classed as loathsome or dangerous con- 

 tagious diseases, exist among immigrants, and constant vigilance and 

 considerable skill are necessary on the part of medical inspectors of 

 immigrants to detect these cases and separate them from the healthy 

 immigrants. 



The most important of these diseases, because of its frequency, is 

 trachoma. Of the total number of cases of loathsome or dangerous 

 contagious disease found in immigrants, 87 per cent, are due to 

 trachoma and 10 per cent, to favus. 



Several years ago the prevalence of trachoma in the poorer dis- 

 tricts of our large cities, and particularly among the foreign-born 

 population, caused numerous requests from medical men engaged in 



