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To protect Americans from disease, prospective immigrants stopped first at Ellis Island where doctors examined them. Hair, face, neck, and hands were checked. Those with eye disease trachoma were sent back. Sick children over age 12 were sent back. Persons were interrogated to determine if they were up to demands of living in US. Those unable to work were sent back-Ellis Island for Swedes

November 30, 2018

“Ellis Island-The Swedes foretaste of America”

Ellis Island (right)

Before a prospective immigrant was admitted to the US, each was examined by doctors at Ellis Island:

Medical examination”

After entering the main building you left your luggage below and was guided up to the second floor, to the Registry Room.

All ready at the first steps on the stairs up to second floor every immigrant was inspected by the doctors. The doctors viewed them from above to watch after weakness, heavy breathing (indication of hart problems) and other signs of mental disturbances.

When every immigrant passed, the doctor with the help of an interpreter, examined the hair, face, neck and hands of every person. The doctor had a chalk in his hand, when he noticed that some area needed to be checked more thoroughly, he wrote a letter on the immigrants clothes. About 2 of 10 persons got a letter on their clothes. This check became known as “the six second physicals”.

What did the letters mean?

X – high up at the frontside of right shoulder – mental defects.
X – further down on the right shoulder – disease or deformity.
X – within a circle – some definite disease.
B – back problems
G – struma
H – heart problems
Pg – pregnancy
Ct – eye disease

Next doctor was the “Eye doctor”

The Eyedoctor looks for trachoma

They searched for a disease in the eyes called trachoma. This eye disease cause blindness and it can also lead to death. Nearly 50% of those who had to be examined further before registration was due to this eye disease. The immigrant was mark with the letters Ct. If the doctors later on could determine the diagnosis trachoma the immigrant was sent back home again.

If they had other diseases and these were confirmed or if the immigrant was to sick and to weak to manage to work, they were not allowed to enter to the US.

Sick children from 12 years old or older were sent back by them selves to their home harbour. Children under 12 years old that were not allowed to stay in the US were forced to go back with one parent. Many tears were dropped when the parents should decide which parent that should stay and which parent that should bo back with the sick child.

Those who were approved by the doctor went on to Interrogation. »


After the check-up by the doctor the immigrant went on to the long queue were they must wait for the interrogation. In the Registry Room there could be waiting approx 5.000 people at the same time.

In the front sat the inspectors

After waiting in queue, the immigrant went forward one an one to the inspector who sat far front in the Registry Room on a high chair behind his desk. Beside himself he had an interpreter and in front he had the shiplists.

The check-up should be regarding the information that the immigrant have left of himself and that also was written in the ship records. Here they double checked the name, age, religion, last residence, sex, civil status and if the immigrant should met up with some relative etc.

2 minutes with every immigrant

Every inspector had approx 2 minutes per immigrant to determine that the information were correct and that the person could take care of himself and fulfill the demands to be able to stay in the US. They should also determine if the person was a danger to the society. Due to that the time was so short to do this check-up, it could happen that the spelling of their name could be wrong (this is not often common though), sometimes even the home country were wrong.

If their were any hesitations the immigrant had to stay at Ellis Island for further investigation.


Most immigrants passed the interrogation and got their “landing card” (the permit to leave and enter New York). Only 2% of all the immigrants who went to America had to return to their home country after the check-up at Ellis Island.

After approval they only had a few hours left on Ellis Island, before they could leave the island and continue their travel.” images from



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