IMMIGRATION AND THE PUBLIC HEALTH 33* 



of every such examination those cases which later after landing develop 

 some definite psychosis or show positive mental impairment could have 

 this original examination reconsidered in the light of later develop- 

 ments. From a large number of such cases it would be possible to 

 formulate definite methods of original examination and to codify new 

 symptom complexes for different races and classes. Tabulation of such 

 symptom complexes and from them the establishment of definite stand- 

 ards of mental abnormality for the various races, would be in accord 

 with the same principle as that followed in formulating the Binet- Simon 

 measuring scale of intelligence, now used so widely in the diagnosis of 

 mental backwardness, which was codified from a large number of 

 mental examinations of French school children. 



A few illustrations have been picked at random to show the enor- 

 mous field of usefulness of Ellis Island as an experimental station of 

 methods and standards for the physical and mental examination of 

 immigrants. Of course there would be great gain incidentally to the 

 cause of science and scientific medicine, and this gain would be shared 

 directly by the public health conditions of the country. As a sugges- 

 tion of the opportunity for obtaining data on related topics, it would! 

 be feasible to make an exhaustive study of muscular anthropology, or 

 the racial and relative physical development of the living man. Abun- 

 dant material is available for this at Ellis Island from every race and 

 nation, and that, too, with no hardship and practically no delay to the- 

 immigrant. 



Space forbids more than a suggestive sketching of what Ellis Island 

 means for the best interests of the public health. Were a larger staff 

 of medical officers available, it would permit the fuller utilization of 

 observation wards in the immigrant hospital in the diagnosis of diseases 

 of the lungs, kidneys, heart, blood, intestinal tract, and others where 

 careful observation and laboratory examinations are essential. 



An efficient immigration station requires a staff of specially trained 

 interpreters. It is hard to overestimate the need for thoroughly trained 

 competent medical interpreters. Of course the ideal arrangement 

 would be for the examining physician to be able to address each immi- 

 grant in his own tongue, but this is manifestly impossible. It is hard 

 enough to discover mental symptoms ofttimes when the examiner can 

 converse fluently and sympathetically with the patient. Lacking a 

 skilled, intelligent and honest interpreter, his task is well-nigh hopeless. 



The medical examination is the only true examination of immi- 

 grants that is provided for under the law, or that is possible or even 

 necessary. The real center and necessary essential of an immigration 

 station is the medical division. If an immigrant is in a broad sense 

 the possessor of mental and physical health his entry is desirable. 

 Whether he shall sta}^, having once been admitted, could well be made 



