Page 3 of 8

Women immigrants presented a particular challenge. For a women who had never been touched by a man other than her husband, being examined by a male physician could be a traumatic experience. In 1914, two women doctors were appointed to the medical staff. Before that, PHS rules required the presence of a matron during the examination of an immigrant woman by a male physician. Female nurses were also employed by the PHS on Ellis Island at an early date.

During the line inspection, whenever an immigrant's condition aroused concern, the doctor made a chalk mark on the right shoulder of the newcomer's garment to signal the need to detain the person for further examination. Letters symbolized the suspected condition, for example, "K" for hernia, "G" for goiter, "X" for mental deficiency. Most newcomers filed through the line medical inspection in less than an hour, and most passed. Trachoma was the most frequent medical cause of rejection.

The medical diagnoses made by Public Health Service doctors could determine the fate of an immigrant. However, as historian Alan Kraut has pointed out in Silent Travelers: Germs, Genes, and the "Immigrant Menace" (1994): "Physicians tried to keep their medical assessments separate from final decisions to admit or deport." The physician reported his or her findings and then left it to immigration officials to rule on admission. For this reason, physicians refused to sit on the boards of special inquiry, which made the final decisions on exclusions. Only about 2% of the arriving immigrants were refused admission into the U.S.

continue