Class Differences in Immigration and Disease
With regard to immigration and disease, steamship companies had to inspect their passengers. Before leaving the port, the companies had to vaccinate, disinfect, and determine the health of the ships occupants. But often these examinations were superficial.
A physician for the U.S. Marine Hospital Service inspected first and second-class passengers who arrived in New York in the privacy of their cabins. The government felt that these more affluent passengers would not end up in institutions, hospitals, or become a burden to the state. On occasion, first and second class passengers had to go to Ellis Island for further inspection because of illness or legal problems.
This experience of arriving in America was far different for steerage or third-class passengers. A cursory inspection on board to check for outbreaks of cholera, smallpox, typhus, or yellow fever occurred. Immigrants in steerage traveled in crowded and often unsanitary conditions near the bottom of steamships with few amenities. Rough Atlantic Ocean crossings, which could last up to two weeks, often left third-class passengers sea-sick. Arriving in New York City, ships would dock at the Hudson or East River piers.
First and second-class passengers would disembark, pass through Customs at the piers and then entered the U.S. But for steerage passengers, everyone would undergo a medical and legal inspection on Ellis Island.
Ships carrying passengers with contagious diseases were quarantined and flew a yellow flag at their masthead. Authorities then took those passengers to hospitals on Hoffman and Swinburne islands.
As a group, immigrants entered the main building where authorities inspected their bags. Then they walked up a stairway to the first in a series of medical inspections that took place. Public Health doctors watched as new arrivals climbed the stairs, looking for signs of health problems like wheezing, coughing, or limping.
In the Registry Hall, and inspector stamped the immigrant’s health inspection card and then watched. As the immigrant looked to see what was on the card, doctors looked to see if they revealed any eye problems.
“Beware of the eye man.” The second station, many immigrants knew about before leaving home. This painful exam checked for trachoma, a highly contagious disease that caused blindness. Anyone found with trachoma was immediately deported.
Men and women were segregated for inspection, and female doctors and nurses examined the women. By 1924, the Public Health Service had four female physicians on duty. After completing the exams, immigrants waited until their names were called so that they might leave or be taken to another facility.
Ellis Island had its own hospital, contagious disease ward, mental ward, autopsy theatre, morgue, and crematory. In 1911, physicians examined nearly 750,000 immigrants. Of these, almost 17,000 had physical or mental defects, which included 1,363 with loathsome or dangerous contagious diseases and 1,167 who had trachoma. Loathsome contagious diseases included favus (scalp and nail fungus), syphilis, gonorrhea, and leprosy. Dangerous contagious diseases included trachoma and pulmonary tuberculosis. During Ellis Island’s history, more than 3,500 immigrants died on the Island, including 1,400 children and more than 350 babies were born.
Michael L. Grace, “Ellis Island History: Immigration to America,” 2011.
Sharon DeBartolo Carmack, Guide to Finding Your Ellis Island Ancestors (Cincinnati: Family Tree Books, 2005).
Dr. Howard Markel, “Before Ebola, Ellis Island’s terrifying medical inspections,” PBS Newshour, October 15, 2014.
See also: Alan M. Kraut, Silent Travelers: Germs, Genes, and the ‘Immigrant Menace’ (New York: Basic Books, 1994).
Detail view of hydro-mechanical control panel in sanitary room on second floor – Ellis Island, Contagious Disease Hospital Measles Ward G, New York Harbor, New York County, NY.
Measles Ward G, constructed in 1907, is one of 11 individual treatment wards in the contagious disease hospital complex on Island 3. One of eight wards designated as measles treatment buildings, these buildings also housed patients with scarlet fever, diphtheria, pneumonia and whooping cough. Like the other seven measles wards in the contagious disease complex, Ward G was built from a single, standardized design and arranged in a pavilion plan – a wing and corridor form popular for hospitals since the nineteenth century. The plan isolated contagious patients from those in the main hospital. It also helped prevent the spread of disease among patients with other infectious illnesses.
Ward G’s architectural styling, along with its materials and finishes, integrates it with the other buildings within the hospital complex to form a cohesive design unit. Ward G and its sister wards are the largest and most significant group of buildings within the contagious disease hospital complex.
Child with measles in tent home of his migrant parents in Edinburg, Texas, 1939.
Photos courtesy of the Library of Congress.
Questions for Further Thought
- What was the examination procedure like for different classes of immigrants when they arrived at Ellis Island?
- Explain the thought behind the rigorous exams for steerage passengers. How does this compare to first-class and why would these passengers have less inspections?