Walking the Line on Ellis Island

Public Health Service officials subjected immigrants to the “physician’s gaze” and decided whether they were healthy or not 

By Kate Ferguson

Eye exam at Ellis Island.

During eye exams at Ellis Island, officials would use a buttonhook to pull back eyelids and check for trachoma. (Wikimedia Commons)

In 1929, nine-and-a-half-year-old Sura Meisler, her younger sister, Blanche, and her mother arrived on Ellis Island. They were just three of the roughly 12 million immigrants who arrived between 1892 and 1954, delivered to the small, 27.5-acre island that had been built by ships dropping their ballast of bricks and stones as they voyaged in and out of the harbor. Before Meisler and her family were free to leave Ellis Island and pursue their dreams of a better life, they had to walk “the line.”

The line was the set of techniques and procedures that medical officers in the U.S. Public Health Service used to quickly inspect thousands of immigrants. The recent arrivals would troop past the officers in single file to be visually examined for any serious or minor diseases or defects and then have their eyelids turned back with fingers or a buttonhook to check for trachoma. Trachoma, now known as granular conjunctivitis, was a dreaded and common disease in the late 19th and early 20th centuries brought to U.S. shores by infected immigrants. “The medical inspection was the first of various hurdles each immigrant had to pass in the bureaucratic maze that was Ellis Island,” observed Dr. Elizabeth Yew in a 1980 paper.

According to Yew, when legislators established the medical inspection of immigrants in 1891 they signaled a “startling change in United States medicine,” one reflecting America’s slow awakening to the plausibility of germ theory. European scientists such as Joseph Lister and Louis Pasteur had shown that minute microscopic organisms were the cause of much disease and suffering, and the physicians of the Public Health Services were among the first in the U.S. to enthusiastically support this theory. In so doing, these doctors became the standard-bearers for the public health movement of the late 1880s—just in time for them to become the eagle-eyed guardians of Ellis Island, “The Gateway to America” that was being crashed by a towering tidal wave of immigrants.

Sura’s Story

When the Meisler women first stepped on the White Star Line’s largest ship, the S.S. Majestic, in early December 1929, they all wore new clothes for their trip to America. Although the ocean liner was an elegantly appointed floating palace that sailed passengers from the charming port city of Cherbourg, France, to New York City, the Meisler family could only afford to book passage in steerage, the lower decks where steamship builders housed the steering mechanism. There, steamship agents could routinely jam as many as 2,000 men, women and families into the metal-framed berths piled three bunks high that lined the long, narrow compartments of the steerage dormitories.

But the Meislers were fortunate. They managed to secure private quarters: a small, separate room on steerage level. Even so, unlike their more affluent counterparts who traveled first- or second-class and were examined onboard the ship, the Meislers and their companions were hustled onto ferries and shuttled to Ellis Island for medical inspection. But not immediately. When they arrived, it was Christmas Day. And Sura, now age 94, says immigration officials wouldn’t let them leave the ship because there weren’t enough officers to examine everyone. A day or two later, they were allowed to disembark.

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The main building at Ellis Island. (Wikimedia Commons)

Inspectors pinned tags on their clothes with the ship’s passenger manifest page and line number on which the immigrant’s name appeared. Sura still clearly remembers being watched. This scrutiny was termed the “physician’s gaze.” It was the definitive test used by doctors reputedly armed with the keenest and most expert powers of observation to determine an immigrant’s health. Inspectors ushered the Meislers and others into the Main Registry Room or Great Hall, and pointed them to the examination line. “The hall was huge, crowded and noisy,” Sura says. “I was frightened and clung to my mother and I held my sister’s hand.” The doctors checked each person according to the Book of Instructions for the Medical Inspection of Immigrants, a Government Printing Office handbook published in 1903. Physicians looked for “diseased, abnormal, crippled and deformed aliens” that they divided into two general classes, A and B.

Under Class A, doctors grouped “undesirables” in four subdivisions, including people suffering from “dangerous contagious and loathesome diseases.” Under Class B, doctors placed those with “all diseases and deformities which are likely to render a person unable to earn a living.” Officers marked those who appeared sick or who suffered from a contagious disease with chalk marked letters, such as “EX,” for further examination needed; “C,” for a suspected eye condition; “S,” for senility; and “X,” for insanity.

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Chaya Fayga Appel and her children—Sura Meisler and her sister, Blanche—pose in new clothes made for their trip to New York. (Photo courtesy Sura Meisler)

These unfortunates were removed from the line and taken to either physical or mental examination rooms for calculated questioning or testing designed to determine whether or not they’d be given health clearance or a medical certificate that required they be confined to isolation units. Often, these unfortunate souls were quarantined in Ellis Island’s southernmost wing for several months, even years. Some immigrants whose health was questioned might be granted treatment on humanitarian grounds. Others might apply for hospitalization and hope they’d receive treatment, which most did. Those with Class A conditions, however, most often did not apply for treatment because if doctors granted the request, the immigrants faced a demand for payment of their medical expenses—many who did accept hospital treatment were deported because they were unable to pay their medical bills. Indeed, between 1891 and 1930 a disease or defect dashed the dreams of almost 80,000 immigrants who were barred from coming to America. Still, on average, less than 1 percent of the newcomers were sent home because of medical problems.

“The examination went well because I remember we went to the good line, thank God,” Sura says. “Some were put aside if they found some sort of sore or something, but we didn’t have any problem.” Like many other immigrants, Sura’s family braved the trip to reconnect with relatives who’d already voyaged to America. Sura’s father had left for New York when she was three-and-a-half years old and she hadn’t seen him in six years. When her papa appeared, she didn’t recognize him. After Sura’s family left Ellis Island, they stayed at her aunt’s house in Williamsburg to recuperate. Later, her father procured an apartment on East Houston Street in lower Manhattan. Gradually, life got back to normal and Sura started school in her new neighborhood.

Today, 83 years later, Sura’s memory of Ellis Island is sharp and clear. She remembers too that she eventually forgot her native Romanian tongue because her family never spoke the language at home. “People couldn’t get over how beautifully I spoke the language and how well,” Sura says with a sigh.

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