Quiet on the Third Inspections of Michigan

P U B L I C H E A L T H 0 S E R V ICE

HIS TO RICA L PER SP EC T IV ES ON P U B LI C HE ALT H IS SUES

timore, Boston, and New York. As an George M. Kesl, who served at Port All Quiet on inland port of entry buffered by Huron for more than 20 years. these Atlantic seaboard public Conditions at Michigan's immi- the Third health controls, Michigan was gration stations, howvever, were far unusually free of epidemics of dis- from ideal. Both the Detroit and Coast: Medical eases such as cholera, typhus, or Port Huron stations lacked basic plague. Second, an amicable rela- medical equipment until the 1920s. Inspections of tionship with Canada's immigration George W. Stoner, then Chief Med- in service which allowed PHS offi- ical Officer at Ellis Island, was Immigrants cials to maintain stations and board occasionally sent to investigate the trains in Winnipeg, Montreal, and status of Michigan's stations. In Michigan Vancouver prevented the kinds of 1903, he asked that Detroit be pro- ALEXANDRA MINNA STERN, MA political tensions that erupted along vided a "place of detention, where HOWARD MARKEL, MD PHD

D_ uring the decades that spanned the late 19th and early 20th centuries, between 2000 and 20,000 immigrants passed through Michi- gan ports of entry each year. Immi- grant inspection along the "third coast" in makeshift sites at Sault Ste. Marie, Detroit, and Port Huron was in many respects uneventful and undramatic. Newcomers certified as diseased wNere often held for weeks at Ellis Island on the east coast or Angel Island on the Nvest coast, and immi- the US-Nlexico border during the aliens might be held for observation, grants processed along the Mexican same time period, especially followv- long enough to determine accurate border were subjected to aggressive ing a PHS-mandated typhus quaran- diagnosis."3 Five years later, aware disinfection procedures. Yet immi- tine in 1917.' Last, during an era in that Detroit's inspector was forced grants passed from Canada into the which Russian, southern European, to carry slides and cultures two US through Michigan with relative Asian, and Mexican immigrants miles to the Public Health and ease. There are several reasons for Nwere often viewed through the lens Mlarine Hospital if he wvanted to use this. First, for the most part, immi- of prejudice and suspected of being a microscope, Stoner urged the Sur- grants crossing into Michigan had germ carriers, the immigrants who geon General to better equip the already undergone quarantine passed through Michigan's gates Detroit station due to the growving inspections when the steamships were principally "the more desirable Volume of immigrants entering that initially brought them to Amer- northern or wvestern European,"' in through the station.4 Assistant Sur- ica had docked at cities such as Bal- the words of Assistant Surgeon geon Erwin Eveleth repeatedly

I7/8 P1UB L I C HEALTH RE P OR TS * NI ARC, H/ APR IL 1 999 * XVOLUNM E II 4 wrote to Washington asking for the Surgeon General explaining that Xg s T Gt _ much-needed laboratory equipment; he had been unable to confirm a ]I in 1921 he was finally authorized to positive diagnosis of trachoma in a purchase a microscope, stethoscope, female immigrant because he had slides, and other materials.5 neither a microscope with which to to Port Huron from his post at Ellis Similar problems existed at the view tissue cultures nor adequate Island to survey the station, wrote Port Huron station. In March 1906, facilities for short-term hospitaliza- that "the physical facilities are poor, Assistant Surgeon Albert J. Nute tion. Instead of allocating funds for the officer being located in a small wrote to both his Senator and the the construction of a more modern wooden building which has been Surgeon General to "respectfully ask site, however, the Surgeon General condemned by the local health offi- that I may be transferred to some suggested that Schuster figure out cer as unsanitary. It is poorly station in a warmer climate that "some arrangements for the proper equipped. There is an unserviceable pays a living salary, in any of the detention and observation" of immi- stethoscope and no microscope."9 departments under your charge."6 grants and "borrow the use of some Williams applauded Assistant Sur- Nute claimed that he was frequently friendly physician's microscope" geon Kesl's heroic efforts to carry on duty for more than 12 hours a when bacteriological analysis was out his duties professionally despite day, including Sundays, and had to required.7 In the end, Schuster the dearth of equipment, need for travel back and forth between the offered to use his own microscope foreign language interpreters and a train depot, ferry station, and his as long as his station was sent a female attendant, and a subservient office to inspect immigrants. In modest amount of supplies.8 administrative relationship to some 1910, Acting Assistant Surgeon In a 1914 report, Surgeon Louis immigration officials. Despite these Bruno L. Schuster sent a letter to L. Williams, who had been directed interdepartmental tensions, four

This harbor scene depicts the bustling maritime activity along Detroit's riverfront in the 191 Os. PHS inspectors had to travel to several ferry docks along the Detroit River to examine immigrants.

PUBLIC HEALTH REPORTS * MARCH/APRIL 1999 * VOLUME 114 179 .ml

A w q .11 21-01- !IiwL -won years later, when the Surgeon Gen- eral decided to furnish all the essen- tial equipment for a bacteriology laboratory, the Immigration Service made arrangements for Kesl to occupy a small room in their building. 10 Immigration: the public health perspective. Beginning in the 1880s, Michigan's state medical authorities began to evince a con- cern that immigrants represented a public health threat, decreeing an anti-cholera and communicable diseases act in 1885," a detailed inspection law in 1892,12 and a stringent quarantine act in 1893-1894.13 (In 1894, all were declared unconstitutional, largely for semantic reasons, by the Michi- gan Supreme Court, which ruled that the State Board of Health was contravening the authority of the state legislature and executive.) But Michigan followed the pattern com- mon in most other parts of the country; responsibility for regulating immigrant inspection and quaran- tines shifted from state to Federal control by the turn of the century.'4 For the first several years of the 20th century, there was some collab- oration and overlap between state and Federal authority. For example, Built in 1929, the Ambassador Bridge symbolized the transition from rail or Federal public health officials sta- ferry passage to automobile transportation of immigrants and tourists. tioned in New York and Philadelphia alerted Michigan public health offi- medical establishment. The mem- admissions to state asylums and cials when immigrants who were bership of the Michigan State Med- indigent hospitals. The author, Dr. infected with measles, diphtheria, ical Society included such promi- Albert M. Barrett, Professor of chicken pox, typhoid, or scarlet nent physicians as Victor C. Neuropathology and Director of the fever intended to settle in Michigan. Vaughan, the Dean of the University Psychopathic Ward at the University This was also the policy of Canadian of Michigan, and John H. Kellogg, of Michigan, wrote that "in view of authorities, who quarantined ships founder of the Battle Creek Sanitar- the excessive amount which the for- at Grosse Isle, located at the outlet ium. From 1900 to 1930 only one eign population, in proportion to the of the Detroit River. article in the Society's journal ven- numbers in Michigan, contributes After PHS took control of tured an explicit association to the insane and mentally defective inspections and quarantine, interest between the growth in immigration class, it is urged that a more effec- in immigration as a public health and undesirable public health out- tive control and supervision be issue diminished among the state's comes, in this case the increase in maintained by state and Federal

180 PUBLIC HEALTIH REPORTS * NIARCH/APRIL 1999 * VOLUME I 14 authorities."'5 While many articles geon Kesl of the Port Huron station published in the Society's journal reported to the Surgeon General and in Public Health-the lay peri- that during that year, "especial effort odical of the State Department of was made by medical officers to Health-endorsed eugenic programs detect defects or disease designed tively large numbers of immigrants such as sterilization and marriage by the Immigration Act as inadmis- debarred for "mental defects" are laws, immigrants were not targeted sible."'8 To identify these abnormali- borne out by his annual reports: as the primary source of disease out- ties, Kesl relied on psychometric 10% of the 356 immigrants certified breaks. (Immigrants were most instruments. In 1924 he wrote that as deportable for health reasons in actively demonized by the Ku Klux "among the tests found to be most 1923-1924 were classified as "con- Klan, which was very active in valuable in the detection of mental stitutional psychopathic inferiors."20 Michigan during the 1920s and defects were construction puzzles, Other certifications were: 1 epilep- almost captured Detroit's mayoralty picture form boards, the cube test, tic, 10 feebleminded, 1 insane, 9 in 1924.16) counting forward and backward mentally defective, 7 neurasthenics, from one to twenty, store problems 1 psychasthenic, and 1 psycho- Screening for "mental defects." involving simple arithmetic, naming neurotic. Of 2404 immigrants Probably because fears of large- the days of the week forward and inspected at Port Huron in 1924- scale epidemics had diminished, backward, naming the months and 1925, 302 were certified as PHS officers devoted a lot of atten- seasons of the year and fixing holi- deportable; 28 of the 302 were tion to diagnosing cases of "feeble- days in the proper month of the classified as "constitutional psycho- mindedness" and other mental dis- year. A blackboard was installed in pathic inferiors." Following the orders as described in PHS's 1918 the medical examiners' quarters and implementation of the quota system Manual of the Mental Examination used in giving simple problems in mandated by the Johnson-Reed Act ofAliens.'7 In 1922, Assistant Sur- arithmetic to the alien."'9 The rela- of 1924, these numbers began to

Although PHS physicians' offices were located in the Post Office and Custom House Building in downtown Detroit, during the early 20th century doctors inspected immigrants at various sites throughout the city. Many newcomers arrived at Union Depot on trains from Canada. (c. 1905)

FrE

.! °; <

*N; .: :,t,, ,{

.: :.

PUBLIC HEALTH REPORTS * MARCH/APRIL 1999 * VOLUME 114 181 I flow of European and Asian immi- Printers and Binders; 1896. p. xciii-ciii. 13. Local quarantine regulations. In: 22nd annual gration, reversing earlier patterns of report of the Secretary of the State Board migration and settlement. of Health of the State of Michigan, for the Regional and geographic differ- fiscal year ending June 30, 1894. Lansing: decline, although almost 10 years ences shaped the historical experi- Robert Smith & Co., State Printers and Binders; 1896. p. lxxviii-lxxxvii. later Kesl continued to report that ence of immigrants and of PHS in 14. Marcus Al. Disease prevention in America: during his inspections, "at least the late 19th and early 20th cen- from a local to a national outlook, 1880- some clothing was removed and turies. Further research into PHS 1910. Bull Hist Med 1979;53:184-203. tests given to determine mental activities along the country's "third 15. Barrett AM. The extent of insanity and fee- will illuminate the blemindedness and their causes in Michigan. abnormality or asocial psychopathic coast" help history J Michigan State Medical Society tendencies."21 of the Progressive era, of immigra- 1915; 1 4(9):283-6. tion, and of public health in the US. 16. Dunbar WF, May GS. Michigan: a history of The automobile era. Between the Wolverine State, 3rd ed. Grand Rapids: William B. Eerdmans Publishing Co.; 1995. References 1910 and 1920, the major automo- 17. Public Health Service (US). Manual of the 1. Markel A, Stern A. Which face? whose bile companies such as General mental examination of aliens. Miscellaneous nation? immigration, public health, and the Pub. No. 18. Washington: Government Motors, Ford, and Chrysler began to construction of disease. Am Behavioral Sci- Printing Office; 1918. attract thousands of immigrants to entist. In press 1999. 18. Annual Report of Surgeon Kesl, July 8, 1922, 2. Annual report: medical inspection: aliens: the Detroit area. During this period PH, GSF, NC 34 EI0, USPHS, RG90, NACP. Port Huron. Mich. 1928, Domestic Stations: Polish and Finnish immigrant com- 19. Annual Report of Assistant Surgeon Kesl, Port Huron (PH), General Subject File NC 34 munities began to rival and in some (GSF), 1924-35, NC 34 EIO, General July 1924, PH, GSF, E10, USPHS, NACP. areas outnumber Michigan's well- Records of the United States Public Health RG90, of Aliens for Service (USPHS), Record Group 90 (RG90), 20. Report of Medical Inspection established German and Irish com- year ending June 30, 1924, PH, GSF, NC 34 National Archives at College Park, Maryland munities.'6 While many laborers EIO, USPHS, RG90, NACP. (NACP). 21. Annual Report, Medical Inspection, Arriving traveled from interior industrial 3. Surgeon George W. Stoner to the Surgeon Aliens, Port Huron, Mich.," PH, GSF, cities such as Toledo, Chicago, and General, July 31, 1903, File 3690: Detroit 1932, NC 34 E10, USPHS, RG90, NACP. (3690), Central File (CF), 1897-1923, Pittsburgh and did not pass through of USPHS, RG90, NACP. 22. Public Health Service (US). Annual report the Saute Ste. Marie, Detroit, or the Surgeon General of the Public Health 4. Surgeon George W. Stoner to the Surgeon Service of the United States. Port Huron stations, the rising num- General, September 10, 1908, 3690, CF, Washington: 1916. bers of immigrants is documented USPHS, RG90, NACP. Government Printing Office; X by PHS figures. In 1916, for exam- 5. Assistant Surgeon General to Acting Assis- ple, Acting Assistant Surgeon Ken- tant Surgeon Erwin Eveleth, March 18, 1921, Both authors are with the Historical 3690, CF, USPHS, RG90, NACP. Center for the Health Sciences and the neth L. Weber reported a total of 6. Acting Assistant Surgeon Albert J. Nute to Department of Pediatrics and 7784 immigrants processed at the Surgeon General, March 16, 1906, and Detroit, noting, "[T]his is an to Hon. J. H. Gallinger, US Senate, March Communicable Diseases, University of increase of 3429 examined at this 21, 1906, 460, CF, USPHS, RG90, NACP. Michigan Medical Center, Ann Arbor. Dr. 7. Assistant Surgeon General to Acting Assis- Markel is the Director of the Center, and port over the preceding fiscal year tant Surgeon Bruno L. Schuster, July 13, Ms. Stern is a Research Associate. and exceeds by 1019 the number 1910, File 460: Port Huron (460), CF, examined at this port during any USPHS, RG90, NACP. previous fiscal year."'22 8. Acting Assistant Surgeon Schuster to the Surgeon General, July 27, 1910, 460, CF, Adrscrepneco=' akt The popularization of the auto- USPHS, RG90, NACP. mobile and the emergence of car 9. Surgeon Louis L. Williams to the Surgeon tourism increased the flow of immi- General, August 12, 1914, 460, CF, USPHS, grants through both Detroit and Port RG90, NACP. 10. Public Health Service (US). Annual report of Huron. As railroads and ocean liners the Surgeon General of the Public Health gave way to freeways and airports, a Service of the United States. Washington: new era of immigrant inspection Government Printing Office; 1918. began. The completion of the 11. MacClure TR. The State Board of Health and a quarter century of public-health work Ambassador Bridge in 1929 and the in Michigan: supplement to the 1897 annual Detroit-Windsor tunnel in 1930 report. Lansing: Robert Smith Printing Co.; symbolized the beginning of this 1897. transition in Michigan. During this 12. Michigan-Canadian inspection of immigrants. In: 22nd annual report of the Secretary of same period, severe immigration the State Board of Health of the State of restriction laws enacted by the US Michigan, for the fiscal year ending June 30, Congress significantly reduced the 1894. Lansing: Robert Smith & Co., State

182 PUBLIC HEALTH REPORTS * NIARCH/APRIL 1999 * VOLUMNE I 14