for treatment at the expense of the United States until they may be safely deported. [Sec. 18, act Feb. 5, 1917.]

17. To render opinions when requested by the proper immigration officers as to the curability of a "contagious disorder" affecting the wife or minor children of a domiciled alien or certain minor children of a citizen. [Sec. 22, act Feb. 5, 1917.]

18. To give an opinion as to the age of an alien, when requested to do so by the proper immigration officers. [Sec. 3, act Feb. 5, 1917.]

19. To render opinions, when requested to do so by the proper immigration officers, as to whether an alien may be "physically capable of reading."

20. To designate to the proper immigration officers such aliens as may be in need of hospital care and treatment, as provided under the law and these instructions, and to recommend their transfer to hospital or other suitable place and there supervise or conduct such care and treatment as may be necessary. [Sec. 18, act Feb. 5, 1917.]

21. To designate to the proper immigration officers such arriving aliens as it may be necessary to transfer to hospitals for the purpose of completing their medical examination. [Sec. 16, act Feb. 5, 1917.]

22. Upon request of the proper immigration officers, and in accordance with such special departmental authority as may be necessary, to determine the physical and mental condition of aliens charged with being unlawfully in the United States, and who have been taken into custody by the immigration officers under departmental warrants of arrest. Also, when requested, to submit in writing for the information of the Secretary of Labor estimates as to the length of time that medical treatment may be needed in such cases. [U. S. Immigration Regulations.]

23. To conduct the physical and mental examination of aliens along the borders of Canada and Mexico, subject to such special rules and arrangements as the Commissioner General of Immigration, with the approval of the Secretary of Labor, may prescribe. [Secs. 10 and 23, act of Feb. 5, 1917.]

During the fiscal year 1921 physical and mental examinations of 2,004,410 immigrants and alien seamen were made

at seventy-four places in the continental United States, and at eight in Canada, one in Alaska and several in the insular possessions. The number of aliens certified for defects was 46,880. More than half of the examinations, 1,023,791, were made at New York; the second port in number of examinations being Boston with 95,976. The examinations made at the various ports are shown in the following table:

ALIENS EXAMINED AND CERTIFIED FOR DEFECTS, FISCAL YEARS

ALIENS EXAMINED AND CERTIFIED FOR DEFECTS, FISCAL YEARS 1920 AND 1921-Continued

The officers of the Bureau of Immigration are responsible for the designation of the persons subject to medical examination, and must provide adequate facilities for this work. The person to be examined passes before the examining surgeon who "first questions the alien as to his age, destination, etc., or propounds to him one or two simple 'sums' in addition. Immediately afterwards he carefully observes the alien's eyes, tests his pupillary light reflex, and everts the upper eyelids. He then makes an inspection of the alien's scalp, face, neck, and hands. The alien then turns at a right angle, and as he proceeds the medical officer observes the posterior aspect of his scalp as well as his posture and gait." If any abnormality is observed during this inspection the alien is detained for a thorough medical examination, which may include such laboratory tests as are necessary.

If an alien is certified for mental defects the act of February 5, 1917 (sec. 16) gives him the right to appeal to a board of medical officers of the Public Health Service, and he may introduce before this board, at his own expense, one expert medical witness. The regulations provide also that a reëxamination may be made at the request of the Secretary of Labor, the Commissioner General of Immigration, the Commissioner of Immigration, the immigration inspector in charge, or whenever the chief medical officer at the port deems such action advisable. A medical board may also be convened at the request of any of the officers mentioned above. However, the alien has no right to appeal to a board unless he is certified for mental defects.

Foreign Quarantine. The first real attempt to build up a truly national quarantine system was made by the act of April 29, 1878 (20 Stat. L., 37), by which the Marine Hospital Service was charged with the enforcement of quarantine regulations to be promulgated by the Secretary of the Treasury. As early as 1796 and later in 1799, 1832, and 1866 Congress had passed quarantine laws, but these earlier

laws merely extended federal aid in the enforcement of local regulations.

The act of April 29, 1878, gave the Supervising Surgeon General of the Marine Hospital Service power to make regulations governing the detention of vessels having contagious diseases aboard or coming from foreign ports in which contagious diseases existed, but it was expressly provided that these regulations must not "conflict with or impair any sanitary or quarantine laws or regulations of any state or municipal authorities." The Attorney General, however, held that this phrase meant that the local requirements were the minimum, and that additional federal requirements could be imposed upon the expiration of state action.10

The law provided also that consular officers in foreign countries should advise the Supervising Surgeon General regarding the appearance of contagious diseases in any foreign port or the departure of any vessel from such port to the United States. The duties and powers of the Marine Hospital Service in regard to quarantine conferred by the act of April 29, 1878, remained in force only to June 2, 1879 (21 Stat. L., 5), when they were transferred to the National Board of Health created by the act of March 3, 1879 (20 Stat. L., 484). The operations of the act of June 2, 1879, were limited to four years, and after April 2, 1883, the Marine Hospital Service again functioned as the government agency in quarantine regulations.

The desirability of more specific authority for federal control of quarantine resulted in the passage of the act of February 15, 1893 (27 Stat. L., 449), which is the organic act of the present quarantine system, supplemented in minor details by the acts of August 18, 1894 (28 Stat. L., 372), March 1901 (31 Stat. L., 1086), and June 19, 1906 (34 Stat. L., 299).

This act neither prohibited states or municipalities from maintaining quarantine stations, nor did it give the Marine Hospital Service general power to establish stations in 10 20 Op. Att. Gen., 468.