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Reviewed by:
  • Science at the Borders: Immigrant Medical Inspection and the Shaping of the Modern Industrial Labor Force
  • John Parascandola
Amy L. Fairchild . Science at the Borders: Immigrant Medical Inspection and the Shaping of the Modern Industrial Labor Force. Baltimore: Johns Hopkins University Press, 2003. xiii + 385 pp. Ill. $48.00 (0-8018-7080-1).

Amy Fairchild's book is a welcome addition to the literature on medicine and immigration. She goes beyond earlier works on the subject by providing much more detail about and analysis of the medical examination of immigrants arriving in the United States, and by devoting substantial attention to immigration at ports other than New York. Since Ellis Island was by far the largest immigration depot, and its history is relatively well documented, it is not surprising that it has received the lion's share of attention from scholars. Fairchild helps to redress the balance by discussing in some detail the medical examination of immigrants at the Canadian border, the Mexican border, the Gulf Coast, and the West Coast. The period covered, roughly from 1890 to 1930, was one of mass immigration to the United States.

Fairchild's main thesis in Science at the Borders is a novel one, namely, that "the immigrant medical examination was shaped by an industrial imperative to discipline the laboring force in accordance with industrial expectations" (p. 16). The medical examination, conducted by physicians of the Public Health Service, was subjected to various pressures, with tension always present between those (e.g., labor and nativists) emphasizing exclusion and those (e.g., industrialists) emphasizing inclusion in the immigration process. Capitalism required the immigrants for the labor force, and industrial interests saw the medical examination as a new technique to discipline arriving workers. Fairchild argues that in general the examination was meant to promote the adoption of core industrial values and to create a cadre of good industrial citizens.

According to Fairchild, the discipline involved in the process "represented immersion in a particular, routinized, ordered set of exercises or motions: waiting in line, moving in unison, stepping up to the medical inspector, moving forward, stepping up to the immigrant inspector, answering questions" (p. 66). The public nature of the examination, and the fact that it represented the power of enforcement because a certain number of immigrants were denied admission into the country, also played a role in communicating industrial values and norms. The immigrants were thus "taught the rules, the repetitive, monotonous habits of industrial order" (p. 67). Although there is certainly merit in this [End Page 913] argument, the question remains of how much socialization into the industrial order could have been accomplished in the course of an examination that for many took place in a matter of seconds, especially at Ellis Island. More research is needed to fully assess Fairchild's claim about the purpose of the medical examination.

The author herself argues that the examination was sometimes used for purposes of exclusion rather than discipline, and the second part of her book is devoted to this subject. This was particularly true in the case of Asian immigrants, the majority of whom arrived on the West Coast. The use of the medical examination in this context was tied to American racial attitudes toward Asians: "The function of the exam along the Pacific Coast was not discipline. Rather, consistent with other federal legislation, the goal was exclusion of a group of immigrants deemed wholly unsuited for either civic or industrial citizenship" (p. 134). Asian immigrants arriving on the West Coast, regardless of class, were generally subjected to primary physical examinations and the testing of stool samples for parasitic diseases. Parasitic infections, which were not even tested for at most immigration stations, were the major cause of exclusion on the Pacific Coast, whereas immigrants on the East Coast were usually excluded for conditions affecting economic potential (e.g., eye diseases, hernia, heart conditions).

Fairchild admits that the Public Health Service doctors did not explicitly articulate discipline as a primary purpose of the medical examination, but saw themselves as excluding dangerous diseases and undesirable immigrants. One would like to know whether these doctors, and the immigration inspectors, were to some extent specifically aware of...

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