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Medical Inspection of Immigrants
First and second class passengers on steamships arriving in New York were examined in the privacy of their cabins, but the "huddled masses" in steerage disembarked at Ellis Island. Given the flood tide of immigrants in the late 19th and early 20th centuries, the medical examinations were necessarily brief and superficial. The medical inspection began as the immigrants ascended the stairs to the Registry Room in the main building, with PHS physicians at the top of the stairs watching for signs of heart trouble, difficulty in breathing, or physical disabilities.
The immigrants proceeded through the Registry Room in lines, with each newcomer's hands, eyes, throat, and scalp inspected by a uniformed physician at the head of the line. Each immigrant's eyelid was everted to check for trachoma, a contagious eye disease that could lead to blindness. Because no specialized instrument yet existed for this procedure, physicians employed conveniently shaped button-hooks, more commonly used to assist women in buttoning high-top shoes or long gloves. The scalp was probed for lice or scabs -- symptoms of favus, a contagious skin disorder. Leprosy, schistosomiasis, syphilis, and gonorrhea are other examples of "loathsome or dangerous" contagious diseases that could deny an immigrant entry into the country.
Although modern technology was increasing the doctor's diagnostic abilities, the speed with which physicians had to act during the line inspection made an experienced glance the best diagnostic instrument at hand. John Thill, a PHS physician who served on the Island, commented of one of his colleagues: "I can recall what a clever diagnostician and acute observer our chief medical officer was, Dr. Billings. A German lady was in the line and he took one look at her and he said, Nehmen Sie die Parucke Ab, meaning take off the wig, which we had not noticed, and were astounded to see a totally bald lady who had had favus."
-- The Office of Public Health and Science | Lister Hill National Center for Biomedical Communications | The Audio Visual Development Branch --