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Doctors at the Gate: PHS at Ellis Island

On January 1, 1892, a 15-year-old Irish girl named Annie Moore became the first immigrant to enter the United States through Ellis Island, the newly opened Federal immigration depot in New York Harbor. The Island opened for business at the beginning of the period of peak immigration in U. S. history. During its first year of operation, Ellis Island processed nearly half a million people, and the annual number of newcomers received there more than doubled within fifteen years. By 1924, when more restrictive laws greatly slowed the flow of immigrants to America, some twelve million people had already entered the country through the Island. Each of these immigrants passed under the watchful eyes of physicians of the U.S. Public Health Service (PHS) before being admitted to this country.

PHS evolved from the Marine Hospital Service, a Federal government program created in 1798 to provide health care to merchant seamen. A series of marine hospitals were established in port cities across the country to care for the mariners. An 1870 reorganization converted the loose network of local hospitals into a centrally controlled system headed by a Supervising Surgeon (later Surgeon General). The physicians of the Service were organized into a Commissioned Corps, with uniforms and ranks modeled after the military.

As public concerns about the spread of epidemic diseases intensified in the late 19th century, the Marine Hospital Service (renamed the Public Health Service in 1912) was given increasing responsibilities for quarantine inspection of ships arriving from foreign ports. Federal legislation in 1891 also mandated the medical inspection of all arriving immigrants, assigning this task to the Marine Hospital Service. The law stipulated the exclusion of "all idiots, insane persons, paupers or persons likely to become public charges, persons suffering from a loathsome or dangerous contagious disease" and criminals. The physicians who performed the medical inspections saw themselves, in the words of one of them, as "watchdogs at the gate."

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