Immigrant Fridays: The Insane Immigrant

Immigrant Fridays turned into Saturday.  I wrote too soon when I promised regular theme days.  The semester started and, as always, hijacked my life.

Toward the end of the 19th Century, examinations of immigrants began at places like Ellis Island.  To this day, immigrants with certain diseases like syphilis, tuberculosis, and HIV/AIDS [the last one until 2010 when Obama got rid of it--thanks Ben!] are barred from legal residency.  Back in the day, insanity and idiocy were also on the list ("insanity" differently defined is on the list now too) and I often wondered how officials determined the two.  I found a 1903 volume titled Book of instructions for the medical inspection of immigrants by the U.S. Public Health Service ("Prepared by Direction of the Surgeon-General"), which answered my questions not at all, but was entertaining enough especially since it contains a reference to "ignorant representatives of emotional races." This last one goes unexplained so I guess everyone knew who they were talking about.

Here are some of the instructions:

The medical examination should be made by daylight and never, except in an emergency, attempted in poorly lighted rooms or by artificial light. The preliminary line inspection should be conducted on an even, level surface, so that the passengers may not be tempted to look where they are stepping. ... Care should be taken to prevent crowding, to maintain a single file evenly spaced, with the individuals well separated (10 feet).

Good to know about the lighting.  You can't see crazy in the dark. 

Below are two of the document's subdivisions.  One on insanity and the other on "idiots."  Both of them pose ethical issues today, but how in the world did they determine these at the turn of the century (daylight notwithstanding)?  How could English-speaking officials, with few if any translators, keep an ear out for illusions or hallucinations?

Subdivision III.—Insane persons.

The following definition of insanity may be accepted for guidance: Insanity is a deranged and abnormal condition of the mental faculties, accompanied by delusions or hallucinations or illusions, or manifesting itself in homicidal or suicidal tendencies or persistent mental depression, or inability to distinguish between right and wrong.

In the case of immigrants, particularly the ignorant representatives of emotional races [!!!], due allowance should be made for temporary demonstrations of excitement, fear, or grief, and reliance chiefly placed upon absolute assurance of the existence of delusions or persistent refusal to talk or continued abstinence from eating.

Persons suffering from acute attacks of delirium tremens should be certified as insane. Those presenting less active evidence of alcoholism should be regarded as coming under the heading of likely to become public charges, as should also all cases of simple epilepsy or hysteria.

At least two officers should concur in a certificate of insanity, and when this is impracticable the medical officer should recommend the employment of a local physician in good standing, and they shall jointly sign the certificate.

The evidence on which a certificate of insanity is based should be made a matter of permanent record. It should always include, among other things, the physical appearance, character of hallucinations, delusions, or illusions, and a brief history of the peculiarities noted while the case was under observation.

Subdivision IV.—Idiots.

The following definition of an idiot may be accepted for guidance:

An idiot is a person exhibiting such a degree of mental defect, either inherited or developed during the early period of life, as incapacitates the individual for self-maintenance or ability to properly care for himself or his interests. (Richardson.)

Idiocy is a defect of mind which is either congenital or due to causes operating during the first few years of life, before there has been a development of the mental faculties, and may exist in different degrees. (Standard Dictionary, by Maudslev; Responsibility in Mental Diseases, chapter 3, p. 66.)

In case of persons of impaired mentality to whom the term " idiot" or " insane," as above defined, is inapplicable, certificates should be made in such terms as may be deemed best calculated to convey an idea of the degree of disability in each particular case.