| The U.S. Congress mandated the medical inspection of immigrants in 1891. The new legislation required Public Health Service (PHS) physicians to certify (or diagnose) all immigrants suffering from a "loathsome or a dangerous contagious disease." The Immigration Service (IS), created in this immigration act, was responsible for making final decisions regarding immigrant exclusions on medical and other grounds. Beginning in 1903, in response to more sweeping federal legislation, the PHS began to issue medical certifications for diseases that rendered immigrants "likely to become a public charge.".;Key to understanding (or misunderstanding) the history of immigrant medical inspection has been the enormous gap that arose between the number of immigrants the PHS certified and the number the IS ultimately excluded. On average, 4.4 percent of all immigrants were certified annually from 1909 to 1930; only 11.5 percent were excluded. The national pattern, however, masks important regional variation. This dissertation, by taking a regional approach to the medical examination of immigrants and using previously untapped aggregate and archival data sources, finds that the immigration medical inspection was an expression of power that varied by regional labor conditions, historical social and economic circumstances, and predominant racial ideology. Thus, this dissertation tells several regional stories of science and power.;The dissertation also tells a story of science and power within the PHS. PHS officers worked at the limits of science and medicine: they forged a new philosophy of medical examination; they helped to construct disease in terms of threats not to the public health but to the national welfare. Yet they did so while constantly renegotiating their scientific authority. The story of immigrant medical inspection takes place at the intersection of the social construction of disease and the professional negotiation of scientific authority in the context of immigration. This analysis, then, takes place at the borders or fringes of science, medicine, and immigration. |
