of every such examination those cases which later after landing develop some definite psychosis or show positive mental impairment could have this original examination reconsidered in the light of later developments. From a large number of such cases it would be possible to formulate definite methods of original examination and to codify new symptom complexes for different races and classes. Tabulation of such symptom complexes and from them the establishment of definite standards of mental abnormality for the various races, would be in accord with the same principle as that followed in formulating the Binet-Simon measuring scale of intelligence, now used so widely in the diagnosis of mental backwardness, which was codified from a large number of mental examinations of French school children.
A few illustrations have been picked at random to show the enormous field of usefulness of Ellis Island as an experimental station of methods and standards for the physical and mental examination of immigrants. Of course there would be great gain incidentally to the cause of science and scientific medicine, and this gain would be shared directly by the public health conditions of the country. As a suggestion of the opportunity for obtaining data on related topics, it would be feasible to make an exhaustive study of muscular anthropology, or the racial and relative physical development of the living man. Abundant material is available for this at Ellis Island from every race and nation, and that, too, with no hardship and practically no delay to the immigrant.
Space forbids more than a suggestive sketching of what Ellis Island means for the best interests of the public health. Were a larger staff of medical officers available, it would permit the fuller utilization of observation wards in the immigrant hospital in the diagnosis of diseases of the lungs, kidneys, heart, blood, intestinal tract, and others where careful observation and laboratory examinations are essential.
An efficient immigration station requires a staff of specially trained interpreters. It is hard to overestimate the need for thoroughly trained competent medical interpreters. Of course the ideal arrangement would be for the examining physician to be able to address each immigrant in his own tongue, but this is manifestly impossible. It is hard enough to discover mental symptoms ofttimes when the examiner can converse fluently and sympathetically with the patient. Lacking a skilled, intelligent and honest interpreter, his task is well-nigh hopeless.
The medical examination is the only true examination of immigrants that is provided for under the law, or that is possible or even necessary. The real center and necessary essential of an immigration station is the medical division. If an immigrant is in a broad sense the possessor of mental and physical health his entry is desirable. Whether he shall stay, having once been admitted, could well be made
