Ellis Island Health Inspections
1891 U.S. immigration law required all immigrants to have a health inspection. Public Health Service physicians examined the immigrants for sixty health conditions; failing any one might require the immigrant to be detained until they were given a clean bill of health, or deported. Ellis Island historian Barry Moreno told the History Channel that doctors developed a coded system to communicate with each other by the peak years, around 1907. Inspectors used chalk to mark the immigrants on their clothing signaling medical conditions. Moreno explains, “‘H’ indicated heart trouble suspected; ‘L’ suspected lameness; ‘X’ suspected feeble-mindedness, and so on.” He further details how ‘marked’ immigrants, about 10% of the total immigrants undergoing health inspections, had to wait in the “doctor’s pen,” until they could undergo more intense examination. But doctors ‘passed’ some that would have otherwise failed inspection, as there wasn’t room enough to detain all afflicted immigrants.