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John L. Parascandola, Public Health Service, pp. 487-93 in ed. George Thomas Kurian, A Historical Guide to the U.S. Government. New York: Oxford University Press, 1998.

As immigration increased dramatically in the late nineteenth century, the Federal government also took over the processing of immigrants from the states, beginning in 1891. The Marine Hospital Service was assigned the responsibility for the medical inspection of arriving immigrants. Immigration legislation prohibited the admission of persons suffering from loathsome or dangerous contagious diseases, those who were insane or had serious mental deficiencies, and anyone who was likely to become a public charge (e.g., owing to a medical disability). Officers of the Marine Hospital Service were assigned to immigration depots to examine immigrants for medical fitness. The largest center of immigration was Ellis Island in New York, opened in 1892, and Service physicians could examine as many as five thousands immigrants on a busy day. Under such conditions the medical examination was necessarily brief and superficial, and the experienced eye of the physician was the best diagnostic instrument at hand. When an immigrants condition aroused concern, he or she was detained for further examination.

The newly emerging science of bacteriology was just beginning to make its impact felt on medicine in the late nineteenth century (e.g., by aiding in the diagnosis of infectious diseases). In 1887 the Service established a bacteriological laboratory at the Marine Hospital at Staten Island. Originally concerned mainly with practical problems related to the diagnosis of disease, the Hygienic Laboratory, as it was called, was later moved to Washington, D.C., and became a center for biomedical research, eventually known as the National Institutes of Health.

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