IMMIGRATION AND THE PUBLIC HEALTH 121 



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 com- 

 municable disease among immigrants. The ordinary quar- 

 antinable diseases are eliminated from the question by efficient 

 quarantine methods, but certain communicable maladies, 

 classed as loathsome or dangerous contagious diseases, exist 

 among immigrants, and constant vigilance and considerable 

 skill are necessary on the part of medical inspectors of immi- 

 grants to detect these cases and separate them from the 

 healthy immigrants. 



The most important of these diseases, because of its fre- 

 quency, is trachoma. Of the total number of cases of loath- 

 some 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 

 districts of our large cities, and particularly among the foreign 

 bom population, caused numerous requests from medical men 

 engaged in eye work in various parts of the United States that 

 trachoma be placed in the list of excluded affections. This 

 was done in 1897, with the result that a great many suffering 

 with the disease were taken from among the steerage immi- 

 grants and deported. It was then discovered that ordinary 

 steerage aliens suffering from trachoma were being transferred 

 to the cabin, while en route, or after being refused passage in 

 the steerage at the port of departure, would be sold a cabin 

 passage, with the assurance that cabin passengers were not 

 inspected at the port of arrival. To check this practice and 

 to make the inspection of aliens complete, an inspection of 

 cabin passengers was instituted in the fall of 1898. The cabin 

 inspection has been very successful in preventing evasion of 

 the law, but many steamship companies were still apparently 

 careless of the diseased condition of immigrants to whom they 

 sold tickets. By the last immigration law (1903) a penalty 

 of $100 is imposed upon the steamship company for each dis- 

 eased alien brought to our ports, provided the disease evidently 

 existed at the time of the immigrant's taking passage, and 



