Medicalizing the Mexican: Immigration, Race, and Disability in the Early-Twentieth-Century United States

Natalia Molina

Every few years, the debate over whether race is a social construction or a biological reality is rekindled.1 A recent example is a March 2005 New York Times op-ed piece by Armand Marie Leroi. In an editorial titled “A Family Tree in Every Gene,” Dr. Leroi, an evolutionary developmental biologist at Imperial College in London, contended that racial differences are biologically identifiable realities and asked readers to reconsider the idea that individuals share nearly as much genetic simi- larity across races as they do within them.2 The lively response to the piece, which included comments from those in both the natural and social sciences, demonstrates that the so-called race question remains unresolved. Historically, meanings of race have been understood in both biological and social terms. In the eighteenth and nineteenth centuries, much scientific effort was devoted to determining — and ranking — human racial groups.3 Contempo- rary scholars, however, especially those in the social sciences, tend to concur with Michael Omi and Howard Winant (authors of the leading U.S. text on race as a social construction), who argue that “as a result of prior efforts and struggles, we have now reached the point of fairly general agreement that race is not a biological given but rather a socially constructed way of differentiating human beings.”4 Many scholars in the social sciences who view race as a social construction explic- itly decouple concepts of race from biology. Their work shows how racial meanings

22 Molina | Medicalizing the Mexican 23 evolved and how these concepts shape social life, determining, for example, where people live and how they are perceived by others.5 Alas, this close attention to social construction may have exacted a price, shifting our focus from the corporeality of race so that important ways in which race is written (and continuously rewritten) on the body are sometimes overlooked. Cultural practices have written race on the body so indelibly that, as some scholars have shown, they are almost indistinguishable from biological inscription. In Stories in the Time of Cholera: Racial Profiling during a Medical Nightmare, Charles Briggs and Clara Mantini-Briggs argue that when a cholera epidemic broke out among indigenous persons in the delta region of the Orinoco River in eastern Venezuela in 1992 and 1993, cultural reasoning held the victims themselves accountable. Health and government officials blamed the cultural beliefs and practices of the region’s inhabitants and in the process “transformed individual bodies into natural bearers of disease.”6 Similarly, in his examination of hypertension and heart-disease studies and research on human genetic diversity, Troy Duster has demonstrated how scientists continue to use “a set of assumptions about race” to interpret their data, thereby ascribing disparities between groups to racial differences. As Duster convincingly argues, a methodology that privileges race as the main interpretive framework can lead investigators to miss or ignore other under- lying causes of disease.7 Both studies underscore the observation that Evelyn Ham- monds, a historian of race and science, recently made regarding the sizable amount of work that remains to be done in challenging “the power of biology as a natural- izing discourse.”8 A potentially useful step in mounting such a challenge is to initiate and sus- tain a conversation between historians investigating race and immigration and those conducting scholarship on disability. Our joint recognition of the body as a narrative site provides us with a shared border to use as a starting point: the modal subject. In the United States, the modal subject is neither raced nor disabled. Historically, race has provided a shorthand way to refer to difference, be it physical, cultural, or political, and thus also has been central in defining the modal subject (e.g., enfranchised/ disenfranchised; citizen/alien, slave owner/slave). Likewise, the modal subject historically has been assumed to be independent and, by extension, able-bodied as well. The provisions of the 1790 Naturalization Act, which allowed only those deemed legally white to become naturalized citizens, are a case in point. Members of groups denied citizenship could not vote, testify in court, initiate lawsuits, or own property. With the modal subject by definition independent and by default able- bodied, those with disabilities were legally incapable of representing themselves, regardless of their race. The concept of the modal subject draws attention to similarities in the ways in which race and disability have been used to exclude certain groups from the body politic. In each case, physical difference is identified and mobilized to figure specific 24 Radical History Review groups discursively as outside the bounds of social membership. Studies of race and immigration and of disability provide a unique opportunity to understand the fal- lacy of the modal subject. To make the most of that opportunity, though, we need to conduct a joint conversation, one that deliberately reaches across the separate, isolated spaces — academic, private, and public — that are and have been the typi- cal sites of discourse. We would be wise to remember that it was just such isolated discourse that shaped the Civil Rights Act of 1964, which for all its historic achieve- ment in redefining the legal meaning of race fails to even mention disability, though the act was amended nine years later in 1973 with the inclusion of section 504. This essay contributes to multidisciplinary perspectives in the academic field of disability studies by examining some of the social and political determinants of the status and role assigned to Mexican immigrants in early twentieth-century America. Because immigrants were considered advantageous only to the extent they filled critical gaps in the labor market, physical fitness was central to gauging a group’s desirability. One way immigration advocates positively constructed Mexicans was by emphasizing this group’s special affinity for manual labor. Mexicans, they argued, were uniquely able-bodied. They were capable of doing work whites could not do, as well as work that whites simply would not do. In contrast, when anti-immigrationists turned their attention to Mexican immigration in the aftermath of the 1924 Immi- gration Act, they emphasized how unfit Mexicans were, even as laborers. Calculat- ing the worthiness of a given group on the basis of its members’ perceived physical characteristics provided a way of calibrating racial difference as well. As a result, long after immigration legislation was passed (or, in some instances, was defeated), the arguments used to construct Mexicans as desirable or undesirable continued to resonate. Attributes, including corporeal characteristics, ascribed to Mexicans during immigration debates became central to the construction of the racial category Mexican. The practice of judging an immigrant group’s desirability based on their perceived physical abilities emerged well before the 1920s, of course. The 1882 Immi- gration Act legalized the exclusion of any immigrant deemed to be a “convict, luna- tic, idiot, or any person unable to take care of himself or herself without becoming a public charge.”9 Although Mexicans were not categorized as disabled, they were constructed as nonnormative, and discourses that emphasized the body constituted a main vehicle for achieving this construction. In American immigration policy, the specific grounds for exclusion were malleable; the crucial step was simply to establish difference. And in that regard, as Douglas Baynton points out, the concept of disability played a key role. He notes that “beyond the targeting of disabled people, the concept of disability was instrumental in crafting the image of the undesirable immigrant.”10 Conversely, even the arguments in favor of Mexican immigration that emphasized Mexicans’ physical capability as laborers became yet another way to mark them as racially distinct. Molina | Medicalizing the Mexican 25

Mexican immigrant workers, suspected by authorities of being likely typhus carriers. Published in the California State Board of Health Monthly Bulletin 12 (1916), 181. The original caption reads, “A gang of Mexican railroad section laborers in Los Angeles County. These men have but recently arrived from Mexico and are under the supervision of the railroad and health authorities.”

Mexican Immigration in Historical Context In the early twentieth century, large-scale employers, particularly those in the agricultural, railroad, and mining industries, supported immigration to facilitate development in many parts of the Southwest. Projects requiring an infusion of labor included the expansion of railroad lines, construction of federally funded irrigation, and support for the increase in agricultural exports made possible by refrigerated boxcars. During the 1910s, employers turned to Mexican immigrants as a source of low-skilled, low-wage labor.11 The number of Mexican employees grew steadily throughout the next few decades, assisted by an immigration policy that permitted a steady supply of low-cost Mexican labor.12 Although Southwestern capitalists generally welcomed Mexican immigration, not everyone else did. Labor unions, for example, opposed Mexican immigrants on the grounds that they competed with white laborers.13 Anti-immigrationists also cited various social and fiscal costs as reasons to restrict entry. One issue that immigration opponents did not raise in the 1910s and early 1920s, however, was the state of Mexicans’ health. This is a significant omission, as health factors 26 Radical History Review were an important component of the social costs attributed to the presence of other immigrant groups. The Immigration Act of 1882 set forth rules and regulations that required those coming into the United States to be in good physical health, to be of sound character, and to demonstrate they were unlikely to become public charges. The Immigration Act of 1917 added a head tax and literacy requirement to these existing regulations. Concern over the potential costs of immigrants who were not fit for immediate employment contributed to the development of standardized and rigorous physical inspections, including medical evaluations, of southern and eastern Europeans and Asians, particularly Chinese, at ports of entry. At Ellis Island, for example, immigration inspectors weeded out European immigrants based on what the inspectors considered telltale signs of physical unfitness, such as hunched shoulders.14 Chinese immigrants, who generally were processed at a facility located on Angel Island in the San Francisco Bay, underwent physical inspections much different from those conducted at Ellis Island. U.S. Public Health Service (USPHS) workers operated under the assumption that disease resided naturally in the Chinese. Health inspectors believed the Chinese were naturally prone to diseases such as leprosy and hookworm. In depicting Chinese bodies as more susceptible to disease, and specifically to diseases that differed from those that afflicted other immigrants, public health officials showed that they were not only screening to determine who would be good laborers but also to determine who were fit to be citizens.15 Meanwhile, until the mid-1920s, Mexican immigrants crossed the border with relative ease (the border patrol was not created until 1924), and their health status was an issue only sporadically.16 In Los Angeles, for instance, Mexicans (who represented the area’s largest immigrant group by 1920) were not characterized as tubercular, even though they died of tuberculosis (TB) at a rate two times higher than the rest of the population of Los Angeles County.17 County officials chose to define the high rate of TB among Mexican residents as a condition that did not threaten the general public. Thus health department staff did not compile and compare TB rates by race, as they did for birth- and infant-mortality rates (IMRs). Nor did they set up TB clinics. The Los Angeles County Health Department (LACHD) concentrated its outreach efforts on Americanization programs, such as well-baby clinics, rather than on tuberculosis treatment and prevention.18 The disproportionate emphasis on high IMRs and, more specifically, on Mexican women, shifted the focus away from TB, thus enabling health officials to sidestep responsibility for improving overall housing conditions to help eradicate TB. The gendered approach to racialized health problems also helped divert attention from a crucial fact: Southern California’s economy depended on Mexican immigrant labor. By focusing on high IMRs, health officials marked Mexican women as the source of health problems and, in so doing, helped male Mexican laborers escape further stigma.19 Downplaying the presence of TB in Mexican communities during the early twentieth century meant that the disease Molina | Medicalizing the Mexican 27 generally did not serve as an impetus for reform, but neither did it prompt warnings against open immigration for Mexicans. So, for instance, in 1916, when Dr. William Sawyer of the California State Board of Health testified before Congress on tuberculosis cases in the state, he made no reference to Mexicans.20 At the time, health officials took the position that Mexicans contracted tuberculosis after they arrived in the United States. During Congressional hearings on the admission of Mexican agricultural laborers in 1920, many who favored continued immigration from Mexico emphasized Mexican bodies, constructing an image of these immigrants as ideal laborers. Mexicans may not have been culturally suited for citizenship, but certainly they were physically fit for hard work. Mexicans were consistently described as better able to perform strenuous labor than other groups, based on their physical ability. Testify- ing before the Committee on Immigration and Naturalization, Texas congressman Carlos Bee argued, “The Mexican is adapted for that special character of labor; whether in the providence of God he has been so constituted I won’t say.”21 Judge Walter Timon, also of Corpus Christi, wrote, “The gathering of cotton is peculiar to the Mexicans and to the negro.”22 Of course, all of those who testified in this manner had a vested interest in the continued importation of Mexican labor because they lived in a region that relied on affordable casual labor. Perhaps not surprisingly, they increasingly described Mexicans as particularly well suited for physically demand- ing labor. Previously, pro-immigrationists had asserted that Mexicans would make good laborers because of their subordinate and docile natures, or they had focused on the idea that Mexicans were an especially good match for the seasonal nature of agricultural work —they were “birds of passage” who could be counted on to return to Mexico once their jobs were done.23 The emphasis on Mexicans’ physical ability that emerged during the 1920 congressional hearings was significant given the biological racialism of the time. During the opening decades of the century, eugenicists argued that immigrants, particularly southern and eastern Europeans, should be barred from the United States because they were of inferior genetic stock and could not assimilate.24 The anthropologist Franz Boas, now referred to as the father of American anthropology because of his enduring influence, tried to disprove these claims. He argued that racial characteristics once thought fixed were, in fact, mutable. Boas published his findings in 1911, in a study titled Changes in Bodily Form. After studying eighteen thousand children of European immigrants, Boas concluded that physical forms changed across generations. The types of physical features that marked immigrants as different, such as long skulls or round heads, physically morphed, becoming more “American” in as a little time as one generation. Boas’s work was included in a forty-two-volume report by the Dillingham Commission, published in 1912. The nine-member commission, appointed by Congress as part of the Immigration Act of 1907, assessed numerous aspects of the so-called immigrant problem in the United States. 28 Radical History Review

Prior to the passage of the 1924 Immigration Act, the times when links between Mexicans and disease did impact border-crossing policies coincided with outbreaks of serious illnesses that could spread to large (white) populations. In 1916, a typhus epidemic began in a Mexican laborers’ railroad camp in Los Angeles, infecting twenty-six people (twenty-two of whom were Mexican railroad workers). There were five fatalities, all Mexican. In the aftermath of the outbreak, health officials’ and municipal leaders’ desire to assure the public that Mexicans were a safe source of labor prompted the drafting of local measures to prevent any future outbreaks.25 In addition, officials encouraged the USPHS to establish inspection stations along the border in Texas.26 The need for stronger public health safeguards in border-crossing policy was underscored by an outbreak of typhus fever, also in 1916, which claimed four lives in El Paso, including that of W. C. Kluttz, a prominent local physician. In the aftermath of these deaths, Claude C. Pierce of the USPHS imple- mented much more detailed medical inspections at border-crossing stations. The new procedures, which were intensive and invasive, amounted to what the historian Alexandra Stern has termed an “iron-clad quarantine.”27 Because Mexicans were suspected of being “vermin infested,” they were required to strip naked for physical examinations and then bathed in a mixture of soap, kerosene, and water. In the meantime, their clothes were disinfected.28 Disease outbreaks legitimized the increased fortification of the border and stigmatized Mexicans as disease carriers. Still, the link between disease and race was not yet as all encompassing as it would become after the passage of the 1924 Immigration Act. In the aftermath of the typhus and typhoid fever incidents, the medicalized aspects of border-crossing procedures intensified for Mexicans, based on the notion that they could spread infectious diseases. They were not, however, marked as having or being prone to the kinds of exotic and/or disabling diseases associated with other immigrants, especially the Chinese. Nor, unlike southern and eastern Europeans processed on Ellis Island, were they routinely tested for mental deficiency, insanity, or feeblemindedness. Border agents might call Mexicans foolish or stupid, but these labels were not formalized in ways that might lead to exclusion.29 In sum, although there was an increase in the medical racialization of Mexi- can immigrants, the general construction of Mexicans as a fit workforce remained in place until after the 1924 Immigration Act. Mexicans, as I have argued, were not medically racialized in the same ways southern and eastern Europeans were. For them, however, there was no possibility of “becoming American,” culturally or physically. Mexicans’ physical form was not the subject of criticism, but the lack of criticism meant that they were biologically suited only for manual labor (and not much else), which did nothing for improving their position in the U.S. racial hierarchy. Molina | Medicalizing the Mexican 29

Medicalized Racial Exclusion after 1924 After the passage of the 1924 Immigration Act, attitudes toward Mexicans began to shift. The 1924 legislation established a national origins quota for southern and eastern Europeans, but it placed no such restrictions on immigrants from countries in the western hemisphere.30 Mexicans could continue immigrating with few limitations. Many supporters of the 1924 Immigration Act were outraged by this imbalance. Mexicans were seen as inferior to Europeans; permitting their continued immigration while excluding southern and eastern Europeans was an affront to the logic of racial ordering. That Mexicans should have been barred from immigrating seemed so patently obvious that the act’s lack of such prohibitions caught many Americans by surprise. Restrictionists’ feverish efforts to extend the quotas to include Mexicans resulted in legislation proposed by U.S. Representative John C. Box of Texas in 1926.31 Box attempted to show that Mexican “birds of passage” created various social and health problems while in the United States. Citing reports from Los Angeles – based institutions, he depicted Mexicans as responsible for over- burdening charity departments and hospital services. Not surprisingly, agricultural employers and others who relied on large numbers of Mexican workers fought the Box proposal. The debate grew so heated that the House Immigration and Natural- ization Committee chose not to act on the Box Bill.32 With the cessation of the flow of southern and eastern European immigrants, brownness came to signify the most important new threat to the racial hegemony of white native-born Americans. To ensure that Mexicans would be included in quota-based immigration legislation, it was imperative to depict them as dangerous. Anti-immigrationists began promoting an image of the racially inferior and diseased Mexican. Medicalized nativism proved central to this effort. Biologically based neg- ative representations intensified during the mid- to late twenties and served as a key justification for the deportation of Mexicans during the Depression. Health officials made unprecedented contributions to the new view of Mexicans as an undesirable immigrant group. Edythe Tate-Thompson, the director of California’s Bureau of Tuberculosis (a division of the State Board of Health), held views on Mexicans and TB that represented a sharp departure from the attitudes of public health officials in the first two decades of the century. She wrote a forceful response to the open immigration policy. In “A Statistical Study of Sickness among the Mexicans in the Los Angeles County Hospital,” she presented results of a study of Mexican TB rates and argued that Mexicans were a drain on municipal governments’ budgets.33 An important aim of the report’s attention on the social costs of Mexican immigration was to prove false arguments by agricultural and business leaders that Mexican labor was an asset to the country. Tate-Thompson’s contention that Mexican immigration should be limited was based on both biological and cultural grounds. She argued that Mexi- 30 Radical History Review cans were inherently less able-bodied and thus were more prone to be infected by and to become spreaders of tuberculosis. Mexicans’ biological makeup, she asserted, rendered them less able to fight off the progression of TB once infected. Her culture- based reasoning completed the picture: Mexicans ate poorly, lived in deplorable conditions, and, due to language barriers, were less likely to follow health codes. Combining these scientific and cultural arguments, Tate-Thompson arrived at a rep- resentation of Mexicans as irresponsible and diseased. This image also conveniently masked systemic inequalities (such as segregation and dual labor-market segmenta- tion) that were the actual basis for the conditions she observed and criticized. Tate-Thompson also used her tuberculosis report to advocate immigration policy reform. She called on the federal government to fortify national borders by placing physicians at United States – Mexico ports of entry.34 Health officials in El Paso, the site of the busiest of these entry points, had made similar requests during other disease outbreaks,35 but Tate-Thompson’s position was different. She argued for these reforms as a California state health official, based in Sacramento, twelve hundred miles from the El Paso port of entry. During the years following the publication of her study, Tate-Thompson continued to pursue her agenda of identifying Mexicans as health burdens. In 1929, she wrote to the Los Angeles Board of Supervisors, asking them to create more selective admissions policies for Olive View Sanitarium, the county’s tuberculosis facility. Her letter asserted that during 1925 and 1926 alone, Olive View had housed 374 tubercular Mexicans, at a cost of $300,000.36 The sanitarium’s official policy was to admit Mexicans who had established residency in California after living in the state for a year. The facility’s supervisor, W. H. Holland, reported that contrary to Tate-Thompson’s estimates, only 139 (23 percent) of Olive View patients were Mexican.37 The discrepancy between the two sets of figures (374 versus 139) may reflect an error in tabulation on Tate-Thompson’s part. It was common for patients with TB to be interned for several months. Thus Olive View patients who were counted as in residence in 1925 may have been counted again in the 1926 tally. In addition, Holland noted that 67 of those the report counted as Mexican were in fact U.S. citizens. In addition to these efforts to limit public health expenditures to non- immigrants, Tate-Thompson persisted in her explicit use of public health issues as a springboard to influence immigration policy. In the California Department of Pub- lic Health’s biennial report, she called for “shutting off the tide of [Mexican] immigration” in order to reduce California’s tuberculosis mortality rates and to lower the economic costs associated with the disease.38 She based her policy recommendation on the assumption that diseased Mexicans immigrated when their TB was in a latent stage; the infection moved into its more active and severe stages only after the carriers had settled in the United States.39 Tate-Thompson referred in passing to “activi- ties” that had begun “toward the restriction of migration of tubercular Mexicans Molina | Medicalizing the Mexican 31 into the United States,” but she did not describe any specific programs.40 She also noted that health authorities attempted to deport sick Mexican immigrants. When these attempts were unsuccessful, health departments would “care for [the ill] until the immigration authorities could deport them.”41 Tate-Thompson’s writings are especially important because they were widely used by those who supported restrictions on immigration from Mexico. For example, the editors of the Grizzly Bear magazine quoted her argument that Los Angeles County had become a dumping ground for poverty-stricken Mexicans. This development, the editors maintained, was part of a “carefully laid scheme to make the taxpayers of the county pay for the support and care of indigent foreigners.”42 Simi- larly, politicians who supported the 1928 Box-Harris Bill’s quotas for Mexico rallied behind images of Mexicans as disease carriers whose cheap labor was outweighed by the high cost to taxpayers in terms of public health and social services.43 “Not only do these people cause the county to spend thousands of dollars for relief, but they are compelling the expenditure of a great deal more public money in treating them for contagious diseases, including tuberculosis,” Congressman Box charged during hearings on the bill. He, like the Grizzly Bear editors, quoted Tate-Thompson’s assessment of Los Angeles County as a “dumping ground.”44 Other California public health officials also went on record as endorsing the claim that Mexicans imported TB and other diseases. In a weekly bulletin issued in February 1928, the state health department published an article that asserted just such a link. The article ran alongside another piece that described immigration legislation under consideration that would decrease or eliminate immigration from Mex- ico, including the Box-Harris Bill.45 In the bulletin, state health officials implored border officials to ensure that physical examinations at the United States – Mexico border were comparable to those conducted at stations with longer histories, such as those at Ellis Island and Angel Island.46 They also urged U.S. Public Health Ser- vice staff to equip border stations with all the necessary “machinery” (most likely a reference to x-ray machines to test for TB) to adequately examine Mexicans crossing the border. California state health officials were not convinced that long-standing federal restrictions prohibiting the entry of individuals deemed unable or unlikely to be able to care for themselves due to illness were sufficient.47 They expressed concern that Mexicans might pass the border inspections, but would later manifest signs of a chronic disease that had been in an inactive stage at the time they immigrated. Thus the officials called for the deportation of Mexicans who showed any sign of chronic illness within a year after being admitted to the United States. This, they hoped, would eliminate the possibility that these immigrants would seek state- funded services. Just as lawmakers relied on the racialized knowledge produced by health officials, well-known eugenicists also began to use medical and public health standards as a gauge with which to determine the deleterious effects of immigration. 32 Radical History Review

They still relied on the tried and true racial tropes they had used against southern and eastern Europeans, confidently declaring, in the words of one “very intelligent” female writer in California, “Mexican peons can never be assimilated with white Americans.”48 Others (also referring to Mexicans as “peons”) charged that Mexicans’ “Indian stock” would result in national decay.49 But eugenicists also began to rely on data public health officials had been amassing for over a decade. Birth- and disease rates became fundamental building blocks in the ongoing effort to construct Mexi- cans as dangerous. Opponents of open Mexican immigration, including self-described eugenicists like Madison Grant, wrote numerous articles in support of the passage of both the Box and Box-Harris Bills. Medicalized constructions of Mexicans emerged as a common theme across these publications. With titles such as “The Menace of Mexican Immigration,” “The Influx of Mexican Amerinds,” and “Mexicans or Ruin,” authors showcased their beliefs regarding the inferiority of Mexicans.50 Some articles were published in extremist journals such as Eugenics: A Journal of Race Betterment. Others made their way into more popular mainstream publications, including the Saturday Evening Post, which claimed a circulation of over 2 million, revealing the degree to which eugenics-based notions of a racial hierarchy were part of mainstream culture before and during the Depression. The use of public health information to advance eugenicist arguments also demonstrates how a grow- ing arsenal of knowledge in the field of public health gave eugenicists new ways of articulating their fears regarding immigrant bodies. The image of the racially inferior, tubercular Mexican often was used to rally support for the restriction of immigration. For example, the University of Califor- nia at Berkeley zoology professor and eugenicist Samuel Holmes, although perhaps best known for his preoccupation with birthrates as evidence of race suicide, also publicly advocated immigration limits. Holmes used tuberculosis statistics from the LACHD to support his position. He also quoted John Pomeroy, the county’s chief health officer, as stating that the LACHD had “found four thousand [Mexicans] to have been infected before they crossed the border.”51 (There is no indication of any such finding in LACHD records.) In the aftermath of the 1924 Immigration Act, attitudes toward Mexicans changed. Scientific racialism came to influence how people generally understood the category Mexican. Fears about southern and eastern European groups had often been expressed similarly — appearing, for example, in studies of craniotomy and treatises on race suicide. The post-1924 treatment of Mexicans, however, represents a significant break with the past. Mexicans go from typically receiving fairly casual medical scrutiny — relative to southern and eastern Europeans on the East Coast and Chinese immigrants on the West Coast —to being the objects of intense, nega- tive assessment and then exclusion. This dramatic redefinition was brought about Molina | Medicalizing the Mexican 33 by means of a focus on their bodies, demonstrating the general principles of anti- immigrant bias within political and medical discourses. Non-normative physical attributes, including disease and disability, have served historically as grounds for writing groups out of the notion of the modal subject. Visual and rhetorical representations of the modal subject have routinely and compulsively depicted an actor who is white, male, and able-bodied. The categories of exclusion applied to Mexicans, who were deemed less than able-bodied because of diseases like tuberculosis, continued to overlap and inform one another for years to come. For example, when institutionalized in juvenile detention centers, mental hospitals, or prisons, Mexicans (immigrants and citizens alike) were routinely given the same kinds of biased IQ tests immigration inspectors had administered to southern and eastern European immigrants before permitting their entry into the United States.52 Like the Europeans, Mexicans often scored poorly and were labeled fee- bleminded. That such a label could result in forcible sterilization provides another indication of how the discourses of race and disability reinforce one another.53 In fact, the history of sterilization in the United States cannot be understood apart from the category of disability. One need only consider the U.S. Supreme Court’s landmark ruling in Buck v. Bell (1927), in which the court supported a Virginia stat- ute authorizing the compulsory sterilization of the mentally retarded for the pur- pose of eugenics. Defending the high court’s ruling, Justice Oliver Wendell Holmes argued that “three generations of imbeciles [were] enough.”54 The question of “who may give birth to citizens” remains salient, as legislation such as California’s Proposition 187, passed in 1994 by an overwhelming majority and seeking to deny public services to undocumented immigrants, makes clear.55 Ostensibly, Proposition 187 was directed at all undocumented immigrants, but within California’s political and cultural climate, it was understood that the proposition’s primary target was Mexicans. The two public services most discussed were education and nonemergency medical care, specifically infant and mater- nal care. Thus Mexican women and children would have been disproportionately affected (state court rulings eventually voided the proposition). Voters’ endorsement of Proposition 187 starkly demonstrates the role race, like disability in Buck v. Bell, plays in marking groups against the modal subject.56 These examples indicate not only that race, immigration, and disability studies are intimately connected but also that often it is difficult to discern where one ends and the other begins. Inquiry in these fields is relational. Thus, if we are to understand larger processes of exclusion and inclusion, we should take historical practice as our guide and deliberately blur the boundaries between the categories of race and disability in our methodologies, studies, and categories of analysis. 34 Radical History Review

Notes I would like to thank David Serlin and Charles Briggs for helping me think through some of the conceptual links between race and disability. I would also like to thank Ian Fusselman for his editorial help and support and Kathy Mooney for her editorial help. Parts of this article are taken from my book Fit to Be Citizens? Public Health and Race in Los Angeles, 1879 – 1939 (University of California Press, forthcoming). 1. � Two notable examples of this ongoing cycle are Richard J. Herrnstein and Charles Murray, The Bell Curve: Intelligence and Class Structure in American Life (New York: Free Press, 1994); and Vincent Sarich and Frank Miele, Race: The Reality of Human Differences (Boulder, CO: Westview, 2004). 2. � Leroi cited a well-known 1972 article by Harvard geneticist Richard Lewontin that argued, “If one looked at genes rather than faces . . . the difference between an African and a European would be scarcely greater than the difference between any two Europeans.” Leroi goes on to counter Lewontin’s findings, arguing that “gentic variants that aren’t written on our faces, but that can be detected only in the genome, show similar correlations. It is these correlations that Dr. Lewontin seems to have ignored. In essence, he looked at one gene at a time and failed to see races. But if many —a few hundred —variable genes are considered simultaneously, then it is very easy to do so.” Richard C. Lewontin, “The Apportionment of Human Diversity,” Evolutionary Biology 6 (1972), 381–98. Armand Marie Leroi, “A Family Tree in Every Gene,” New York Times, March 14, 2005. 3. � See, for example, Matthew Frye Jacobson, Whiteness of a Different Color: European Immigrants and the Alchemy of Race (Cambridge, MA: Harvard University Press, 1998). 4. � Michael Omi and Howard Winant, Racial Formation in the United States from the 1960s to the 1980s (New York: Routledge, 1986), 65. 5. � Some notable examples of this scholarship include Keith Wailoo, Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health (Chapel Hill: University of North Carolina Press, 2001); Nayan Shah, Contagious Divides: Epidemics and Race in San Francisco’s Chinatown (Berkeley: University of California Press, 2001); Dorothy Roberts, Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (New York: Vintage, 1997); Julyan Peard, Race, Place, and Medicine: The Idea of the Tropics in Nineteenth-Century Brazilian Medicine (Durham, NC: Duke University Press, 1999); John McKiernan-Gonzalez, “Fevered Measures: Race, Contagious Disease, and Community Formation on the Texas-Mexico Border, 1880–1923” (PhD diss., University of Michigan, 2002); Judith Walzer Leavitt, Typhoid Mary: Captive to the Public’s Health (Boston: Beacon, 1996); Alan Kraut, Silent Travelers: Germs, Genes, and the “Immigrant Menace” (New York: Basic Books, 1994); Laura Briggs, Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in Puerto Rico (Berkeley: University of California Press, 2002); Alexandra Stern, Eugenic Nation (Berkeley: University of California Press, 2005); and Charles L. Briggs and Clara Mantini-Briggs, Stories in the Time of Cholera: Racial Profiling during a Medical Nightmare (Berkeley: University of California Press, 2003). 6. � Briggs and Mantini-Briggs, Stories in the Time of Cholera, 9. 7. � Troy Duster, “Enhanced: Race and Reification in Science,” Science 307 (2005): 1050–51. 8. � See the Web site “Is Race Real?” organized by the Social Science Research Council, raceandgenomics.ssrc.org (accessed May 31, 2005). 9. � Kraut, Silent Travelers, 70. 10. � Douglas Baynton, “Disability and the Justification of Inequality in American History,” in The New Disability History: American Perspectives, ed. Paul Longmore and Lauri Umansky (New York: New York University Press, 2001), 33. Molina | Medicalizing the Mexican 35

11. � U.S. employers had first recruited Chinese and then Japanese to work as low-skilled laborers. Chinese laborers were forced out through the 1882 Chinese Exclusion Act (and repeated ten-year extensions of its provisions); later, Japanese workers faced a similar form of exclusion, through the 1907 –8 Gentlemen’s Agreement and state laws passed in 1913 and 1920 restricting land ownership by “aliens.” 12. � According to the U.S. Bureau of the Census, the number of Mexican-born residents was 103,393 in 1900, 221,915 in 1910, and 486,418 in 1920. See Mark Reisler, By the Sweat of Their Brow: Mexican Immigrant Labor in the United States, 1900 –1940 (Westport, CT: Greenwood, 1976); David Gutiérrez, Walls and Mirrors: Mexican Americans, Mexican Immigrants, and the Politics of Identity (Berkeley: University of California Press, 1995); Camille Guerin-Gonzales, Mexican Workers and American Dreams: Immigration, Repatriation, and California Farm Labor, 1900 – 1939 (New Brunswick, NJ: Rutgers University Press, 1994). 13. � See Reisler, By the Sweat of Their Brow, esp. chap. 2. 14. � Kraut, Silent Travelers; see also Amy Fairchild, Science at the Borders: Immigrant Medical Inspection and the Shaping of the Modern Industrial Labor Force (Baltimore, MD: Johns Hopkins University Press, 2003). 15. � Shah, Contagious Divides; Erika Lee, At America’s Gates: Chinese Immigration during the Exclusion Era, 1882 –1943 (Chapel Hill: University of North Carolina Press, 2003). 16. � Mae M. Ngai, “The Strange Career of the Illegal Alien: Immigration Restriction and Deportation Policy in the United States, 1921 – 1965,” Law and History Review 21 (2003): 69–108; Kathleen Anne Lytle Hernandez, “Entangling Bodies and Borders: Racial Profiling and the U.S. Border Patrol, 1924 –1955” (PhD diss., University of California at Los Angeles, 2002); George Sánchez, Becoming Mexican American: Ethnicity, Culture, and Identity in Chicano Los Angeles, 1900 – 1945 (New York: Oxford University Press, 1993). 17. � “Mexicans in Los Angeles,” Survey 44 (1920): 715–16. The first Los Angeles County Health Department annual health report to mention Mexicans with TB was the one in 1920. The reports were usually brief and mainly qualitative. Annual Health Report 1920, Department of Health Services Library, Los Angeles, CA. 18. � Well Baby Clinics (WBCs) provided prenatal care to pregnant women and offered preventive medical care to babies and children under six. The clinics formed part of a national movement to improve children’s health and thus significantly lower infant mortality rates. Initially, public health departments had tried to combat early deaths through the establishment of pure milk stations. See Richard Meckel, Save the Babies: American Public Health Reform and the Prevention of Infant Mortality (Baltimore, MD: Johns Hopkins University Press, 1990). 19. � For a helpful discussion of gendered racism within the context of welfare, see Kenneth Neubeck and Noel Cazenave, Welfare Racism: Playing the Race Card against America’s Poor (New York: Routledge, 2001), 29 –35. 20. � U.S. Congress and Senate Committee on Public Health and National Quarantine, Standardization of Treatment of Tuberculosis: Hearings before the United States Senate Committee on Public Health and National Quarantine, 64th Cong., 1st sess., January 17, 1916 (Washington, DC: Government Printing Office, 1917). 21. � U.S. Congress and Senate Committee on Immigration and Naturalization, Hearings on Admission of Mexican Agricultural Laborers, 66th Cong., 2nd sess. (Washington, DC: Government Printing Office, 1920), 19. 22. � Ibid., 27. 36 Radical History Review

23. � Camille Guerin-Gonzales, Mexican Workers and American Dreams: Immigration, Repatriation, and California Farm Labor, 1900 – 1939 (New Brunswick, NJ: Rutgers University Press, 1994), ch. 2. 24. � See Thomas A. Guglielmo, White on Arrival: Italians, Race, Color, and Power in Chicago, 1890 – 1945 (New York: Oxford University Press, 2003); Jacobson, Whiteness of a Different Color. 25. � See Molina, Fit to Be Citizens? 26. � El Paso was the largest point of entry from Mexico into the United States during this period. See Sánchez, Becoming Mexican American, 39. 27. � For an insightful analysis of this event, see Alexandra Stern, “Buildings, Boundaries, and Blood: Medicalization and Nation-Building on the U.S.-Mexican Border, 1910 – 1930,” Hispanic American Historical Review 79 (1999): 41–81, esp. 45. 28. � Ibid. For more on disease and medicalization along the Texas-Mexico border, see McKiernan-Gonzalez, “Fevered Measures.” 29. � The historian George Sánchez gives a good example of miscommunication arising from language barriers between a border agent and a Mexican crossing into the United States. The border agent interprets the miscommunication as a sign of stupidity on the part of the Mexican. See Sánchez, Becoming Mexican American, 54–55. 30. � The 1921 Immigration Act had initiated a quota system that became known as the national origins principle. Immigration from eastern and southern Europe was limited to 3 percent of the population of each designated European country’s citizens already in the United States at the time of the 1890 census. That amount was reduced to 2 percent under the 1924 Immigration Act. 31. � The Box Bill, HR 6741, proposed extending the quota restrictions to countries in the western hemisphere. See Reisler, By the Sweat of Their Brow, 202 n. 19. 32. � Ibid., 202–4. 33. � Edythe Tate-Thompson, “A Statistical Study of Sickness among the Mexicans in the Los Angeles County Hospital, from July 1, 1922 to June 30, 1924” (Sacramento: Bureau of Tuberculosis, California State Board of Health, California State Printing Office, 1925). 34. � Ibid. 35. � El Paso health officials had called for more stringent standards of public health to fortify the border during the 1917 typhus epidemic. See Stern, “Buildings, Boundaries, and Blood.” 36. � Letter from Tate-Thompson to Board of Supervisors, April 24, 1929, Los Angeles County Board of Supervisors, Los Angeles, CA, hereafter cited as “B of S.” She also stated that she was concerned that migrants were coming to Los Angeles to seek free medical care at the facility, even though they had not resided in California for very long and thus had not yet paid taxes to the state. Among the patients Tate-Thompson used as an example of this reprehensible behavior were migrants from Iowa and Kansas. 37. � Letter to Board of Supervisors from Supervisor W. H. Holland of Olive View, Holland, 2/4/1927, B of S. 38. � Edythe Tate-Thompson, “Migration of Indigent Tuberculosis Is Serious Problem,” Weekly Bulletin of the California State Department of Public Health, June 15, 1929, 73–74. 39. � Ibid. 40. � July 1, 1928, to June 30, 1930 (Sacramento: California State Printing Office, 1931). 41. � Ibid. 42. � Grizzly Bear, December 1927, 3. Molina | Medicalizing the Mexican 37

43. � Like the 1926 Box Bill, the 1928 Box-Harris Bill would have extended the quota to all western hemisphere nations. Also like the Box Bill, Southwestern lobbyists helped defeat the bill in order to maintain a steady source of laborers from Mexico. 44. � House Committee on Immigration and Naturalization, United States Congress, Hearings before the Committee on Immigration and Naturalization, House of Representatives, 70th Cong., 1st. sess., February 21 to April 5, 1928 (Washington, DC: Government Printing Office, 1928). 45. � “For Control of Mexicans’ Health,” Weekly Bulletin of the California State Department of Public Health, February 11, 1928, 2 – 3. 46. � For a history of immigration to these ports of entry, see Howard Markel and Alexandra Stern, “ ‘Which Face? Whose Nation? Immigration, Public Health, and the Construction of Disease at America’s Ports and Borders, 1891 – 1928,” American Behavioral Scientist 42 (1999): 1314 – 31. See also Kraut, Silent Travelers; Shah, Contagious Divides; and Fairchild, Science at the Borders. 47. � Baynton, “Disability and the Justification of Inequality in American History,” 33 –57. 48. � Quoted in Remsen Crawford, “The Menace of Mexican Immigration,” Current History 31 (1930): 902–7, esp. 907. 49. � Madison Grant, “Editorial: Immigration,” Eugenics: A Journal of Race Betterment 3, no. 2 (1930): 74. 50. � Kenneth Roberts, “Wet and Other Mexicans,” Saturday Evening Post, February 4, 1928, 10 –11, 137 –38, 141–42, 146; Kenneth Roberts, “The Docile Mexican,” Saturday Evening Post, March 10, 1928, 40 –41, 165 –66; Kenneth Roberts, “Mexicans or Ruin,” Saturday Evening Post, February 18, 1928, 14 –15, 142, 145 –46, 149–50, 154; Remsen Crawford, “The Menace of Mexican Immigration”; C. M. Goethe, “The Influx of Mexican Amerinds,” Eugenics: A Journal of Race Betterment 2 (1929): 6-9. 51. � Samuel J. Holmes, “Perils of the Mexican Invasion,” North American Review 227 (1929): 615–23. There are no reports by the LACHD on how many Mexicans may have had tuberculosis before they entered the United States. 52. � See Kraut, Silent Travelers. 53. � See Molina, Fit to Be Citizens? See also Natalia Molina and Anne-Emanuelle Birn, “In the Name of Public Health,” American Journal of Public Health 95 (2005): 1095–97; Alexandra Minna Stern, “Sterilized in the Name of Public Health: Race, Immigration, and Reproductive Control in Modern California,” American Journal of Public Health 95 (2005): 1128-38; and Stern, Eugenic Nation. 54. � Buck v. Bell, 274 U.S. 200 (1927). 55. � The court, however, immediately barred implementation of the law, pending settlement of the legal challenges lodged against it. Dorothy Roberts, “Who May Give Birth to Citizens: Reproduction, Eugenics, and the Nation,” in Immigrants Out: The New Nativism and the Anti-immigrant Impulse in the United States, ed. Juan Perea (New York: New York University Press, 1997). 56. � Dorothy Roberts, “Who May Give Birth to Citizens: Reproduction, Eugenics, and the Nation,” in Immigrants Out: The New Nativism and the Anti-immigrant Impulse in the United States, ed. Juan Perea (New York: New York University Press, 1997); and Pierrette Hondagneu-Sotelo, “Women and Children First: New Directions in Anti-immigrant Politics,” Socialist Review 25 (1995): 169–90.