the blindness in Syria and Egypt. Its contagious nature, together with the resulting scarring of the lids and blindness, make its recognition imperative. The hookworm (Uncinaria) has received much attention lately since it has been found so widely distributed through the mountains of the south, the mines of California, the middle west, etc. It is a minute parasitic intestinal worm about three fifths of an inch long, and under the microscope shows relatively enormous and powerful chitinous jaws by means of which it attaches itself to the intestinal walls. The saliva of the hookworm has the curious property of preventing coagulation of blood like leech extract, and when it is remembered that the worms may vary in number from several hundred to a thousand or more, and that each worm moves frequently from place to place on the intestinal wall, it is apparent how excessive and continuous is the drain on the blood and lymph juices. The result is an extreme anemia which brings in its wake a varied multitude of bodily ills, and may eventuate fatally, meanwhile having incapacitated the victim for mental or physical work. Infection can spread rapidly from a single case. Not many hookworm carriers have been discovered among immigrants, probably because the facilities for their detection are so meager. But the heavy immigration from countries where uncinaria is abundant, as well as the recent suggestive work of Dr. H. M. Manning at the Ellis Island Immigrant Hospital, indicate that there is a constant stream of fresh infection pouring in. Indisputably routine examination for hookworms should be instituted. The same can be said of other intestinal parasites as tapeworms, pin worms, whip worms, eel worms and others. One of the tapeworms, the so-called fish worm (Dibothriocephalus latus) leads to an anemia fully as severe as that from the hookworm.
Many other diseases might be mentioned, but these are sufficient to illustrate the importance of careful medical inspection of immigrants.
The total immigration into the United States through all ports of entry for the year ending June 30, 1911, was 1,052,649. Of these 22,349 were debarred for various reasons, leaving a net increase of 1,030,300. The chief port of entry is, of course, New York, where 749,642 aliens were examined. Next in order of importance come Boston, Baltimore and Philadelphia, and at a greater distance Galveston, Tampa, San Francisco, Honolulu, Miami and Portland, Me. As the laws are uniform and the methods of inspection the same at all ports, consideration of methods and results at Ellis Island, N. Y., will give a clear idea of the entire subject.
The medical inspecting service at Ellis Island is divided into three branches, the hospital, the boarding division and the line. The hospital division presents an excellently equipped and managed institution, and an isolated set of buildings for contagious diseases. The hospital service is limited exclusively to immigrants, and the patients are those acutely ill upon arrival, those taken sick during their stay on the island.
