IMMIGRATION AND THE PUBLIC HEALTH 123 



Faviis has for several years been included in the list of 

 excluded diseases. If the disease has existed for any length 

 of time, it is, of course, easily detected by the loss of hair and 

 changed character of the individual hairs and the scalp ; but in 

 cases of recent origin detection is often difficult because of 

 shrewd efforts at concealment. The immigrants are often 

 prepared for inspection, the tell-tale yellow crusts carefully 

 removed and the scalp cleansed. 



Tuberculosis of the lungs is rarely found among immi- 

 grants on arrival. Thousands of immigrants are examined 

 whose poor physique suggests to the medical examiner the 

 possible existence of tuberculosis, but out of the many thou- 

 sands thus examined at Ellis island last year, only fifteen cases 

 were certified as suffering from tuberculosis of the lungs. 



This apparent freedom from tuberculosis is partly ex- 

 plained by the fact that tubercular diseases are notoriously 

 diseases of the cities, while the bulk of our immigration comes 

 from the agricultural communities and small towns. The 

 remarkable prevalence of tuberculosis among recently landed 

 immigrants is the effect of horrible over crowding in infected, 

 filthy tenements by immigrants whose poor physique makes 

 them ready prey for communicable disease. In addition to 

 the horrible congestion of the tenements, the insufficient food 

 and insufficient fuel and clothing, especially among immigrants 

 from Mediterranean countries, must be considered as factors 

 in the development of tuberculosis. 



The danger to the public health from immigrants suffering 

 from communicable disease is at present comparatively shght. 



