Immigrants and Disease

Charlotte Leszinske

Fear and Loathing: Ward’s Island as an Ill Immigrant’s Refuge

Sickness, though common to both native- and foreign-born residents of the United States, frequently acquires nativist overtones in the case of immigrants. Historian Alan M. Kraut comments, “Often, the native-born grudgingly welcomed immigrants contingent on their physical health and intellectual vitality, striving to admit only those most fit and able to compete for the material rewards of life in the United States.”[1] In fact, “[Americans] have feared that poor health and frail physiques might make of immigrants burdens rather than assets; might spread infectious diseases among the native-born, undermining the advantages of the very society that offered freedom and opportunity to those who could find it nowhere else.”[2] In an analysis of anti-immigration rhetoric, sociolinguist and critical discourse analyst Otto Santa Ana defines the association of immigrants and poor health as “the nation as body metaphor, [in which] the immigrant is characterized as a disease affecting the body or as a burden on the body.”[3] Some even extend the connection and brand immigrants as biologically inferior;[4] in the late 19th century, “immigrants were described alternatively as swarthy, squalid, pestilent, or of ‘bad stock.’”[5] Persistence of “loathsome or dangerous contagious disease” in a new immigrant could result in deportation,[6] ridding the body of the nation of a contaminated limb.

Anti-immigration rhetoric and disease survive intertwined into the contemporary era. Furthermore, when immigrants receive medical treatment, they are derided as “drain[s] on the welfare system”[7] and even accused of immigrating precisely to take advantage of, or let their children take advantage of, the financial assistance the United States offers the sick. President Clinton’s decision to rescind Supplemental Security Income for “nearly all non-citizen immigrants”[8] in 1996 was partially due to the testimony of those such as Norm Matloff, a professor of computer science, who “claimed that the recent increase in public assistance use by elderly Chinese was because their well-to-do, middle-class, naturalized-citizen children were scamming the welfare system by putting their parents on public assistance, and in some cases were profiting from their parents’ SSI cash payments.”[9] Most recently, some conservative media outlets have pointed to “the link between the massive influx of sick foreigners into the country and sick, paralyzed and potentially brain damaged children,”[10] capitalizing off of the nation as body metaphor to push a political agenda.[11]

In the mid-1800s, these problems came to a head in the face of mounting immigration to the United States, to New York in particular. “Manhattan’s 166,000 inhabitants in 1825 increased in twenty years to 371,000 and, during the period of largest immigration, expanded phenomenally to nearly 630,000 in 1855.”[12] Many of these foreigners, often fleeing miserable conditions in their home nations, fell ill before or during passage, the close quarters of packet ships facilitating communication of the disease: “Because shipmasters sought to maximize profits by cramming into their holds as many immigrants as possible, shipboard illness and even mortality was quite common. Typhus and diarrhea often ravaged tightly packed passengers to the New World.”[13] Friedrich Kapp, a former Commissioner of Emigration for New York, commented, “Ten deaths among one hundred passengers was nothing extraordinary twenty percent was not unheard of; and there were cases of 400 out of 1,200 passengers being buried before the ships left port.”[14]

The disease rates among immigrants were reasons for concern. “During the ten years from 1849 to 1859, of all persons admitted to Bellevue Hospital, a public institution, 83.9 per cent were foreign-born.”[15] Unfortunately, even after successfully clearing New York ports many immigrants carried disease: “The health inspection of immigrants was at best casual, and often acute symptoms did not develop until shortly after the passengers had landed.”[16] Physicians stationed at ports “freely admitted that emigrants were not stripped and that, beyond taking pulses and examining tongues, they closely scrutinized only hands in the search for symptoms of serious ailments.”[17] Adding another incentive to misperform their job, these physicians were paid per inspection – “a pound for every hundred persons inspected.”[18] These diseases, having passed through the gates to America, spread quickly amongst fellow immigrants in crowded tenement slums.[19]

Later, in May 1855, immigrant inspection techniques improved with the opening of Castle Garden, a former Manhattan fort. Going forward, “[E]very vessel bringing immigrants had to anchor at the Quarantine Station […]. There, a New York State emigration officer boarded to ascertain a count of passengers, deaths during the voyage, the degree and kind of illnesses suffered during the trip, and the overall cleanliness of the vessel.”[20] After the inspection, a Castle Garden-detailed police officer took authority over the ship and transferred the passengers through the Landing Department to the Castle Garden pier via barges and tugs: “There, passengers were examined by a state medical officer to discover ‘if any sick have passed the health authorities at Quarantine […].’”[21] Therefore, by the late 1850s, newcomers to the United States underwent at least two individual medical inspections and consequentially presented a significantly reduced health threat. Yet “many Americans continued to hold the foreign-born responsible for disease in general, not just cholera.”[22]

Though many foreigners suffered poor health, “[a]mong the immigrants, the Irish were the chief victims of disease,” likely because of the abject poverty of many Irish in comparison to wealthier (and thus, operating in cleaner, more comfortable quarters) German newcomers.[23] Furthermore, “many poor families bought impure food from hucksters and basement storekeepers,” along with favoring ineffective superstitious practices and home remedies rather than medical advice.[24] As a result, concentrated areas composed of primarily Irish immigrants fell ill en masse: “In discussing a small-scale epidemic of typhus in Bellevue Hospital during the spring and summer of 1862, Dr. A. L. Loomis stated that most of the cases came from Mott, Mulberry, and Baxter Streets,”[25] the locations of crowded tenements frequently populated by Irish immigrants.

Along with suffering disease more than other immigrants, ill Irish, frequently amongst the most destitute, also faced the greatest difficulty seeking healthcare. Though German physicians agreed to treat foreigners presenting statements of need from the German Society, “the relatively few Irish physicians faced an insuperable task of giving medical attention to the multitude of Irish immigrants who could not pay for it,” consequentially having to seek admission to public dispensaries and hospitals, “where they were nearly always in the majority. The only organized medical aid among the Irish was through their benevolent and fraternal associations.”[26] As a result of their visibility in public institutions, “distortions in the data [collected from these institutions] shed false light on the extent of the plight of the Irish, a in the case of mental illness.”[27] As a result, “Irish immigrants appeared to have the highest rates of illness in general, and the highest rates of insanity, according to published data of the era. […] Trying to account for these skewed figures, [Blackwell’s Island’s] resident physician speculated that ‘either the ratio of insane is very much less among the natives, or they are kept at their home.’”[28]

As a result of vast numbers in which they inhabited New York City and the popular perception of illness fostered by statistics available at the time, the Irish became a particular target of nativist outcry against immigrants on the basis of disease. Following an outbreak of cholera in the US in 1832, “many Americans believed that cholera was caused by the Irish.”[29] The reason for this was primarily the large numbers of Irishmen and women in New York: “[B]y 1860 there were 203,760 foreign-born Irish living in New York City; one of every four New Yorkers was Irish.”[30] The destitution of many Irish and the twin prejudices held by primarily Protestant Americans of English origin against both Irishness and Catholicism led many nativists to identify a lack of morality as the cause of Irish sickness:

“Living in run-down shanties and teenements, Irish immigrants felled during the 1832 cholera epidemic were believed by many of the native-born to have died of individual vices typical of their group, a punishment divinely determined that might be spread to those deserving of such retribution. […] Intemperance and a lack of cleanliness were the character flaws most responsible for the sickness suffered by the ‘low Irish’ who were crammed into city slums, according to a New York Board of Health report.”[31]

Forced to find treatment at public hospitals, the “sick and impoverished Irish [pouring] into the city” were described as “literally swamp[ing]” New York City’s Quarantine Station and other city health institutions.[32]

The Quarantine Station on Staten Island became a site of local anxiety and erupting nativist sentiment: “Since the word ‘quarantine’ was associated with epidemic disease, neighboring residents soon began to demand that the station be removed. Over and above this local pressure, the proximity of the quarantine grounds to New York made it virtually impossible to keep the friends and relatives of quarantined immigrants from flocking to visit them.”[33]

In 1848, 180 cases of yellow fever erupted amongst residents near the Staten Island Tompkinsville quarantine, escalating tensions towards foreigners.[34] After the quarantine was moved to Sequine’s Point in 1857, attempted construction on the new site faced arson by locals, who razed buildings even after the military began to patrol the site. Consequentially, the government attempted to reopen the old quarantine at Tompkinsville, only to face the wrath of residents: “On September 1, 1858, lawless islanders armed with fiery fagots of straw broke through the quarantine gates and burned the new buildings. The militia was called in to save what remained, but […] the mob returned, dragging patients onto the lawns and setting the last buildings ablaze.”[35] Later, leading figures of the mob were arrested,[36] but the problem remained.

As a result of public outcry, quarantine officials moved patients offshore to ships until they could be resettled on islands, existing and artificial.[37] Fear of disease and its perpetuation by new immigrants forced the foreign-born to seek treatment on islands, literally, land separated from New York City (itself primarily composed of islands) and thus become metaphorical islands, persons segregated from the rest of the city by detriment of their ill health.

Ward’s Island, one of these islands, received typhus patients from the Staten Island quarantine centers.[38] Health services on Ward’s Island began in the 1840s, when bondsmen created private hospitals to treat the destitute. However, these hospitals were so poorly maintained that in 1847 the New York City Commissioners of Emigration worked to create an Emigrant Refuge and Hospital on Ward’s Island, two intertwined complexes completed in 1849.[39] This hospital was so large that “[f]or a brief period, 1853-1855, the Ward’s Island hospital complex formed the largest hospital center in the world.”[40]

The success of the Emigrant Refuge and Hospital varied. Many Irish newspapers criticized overcrowded facilities and poor nutrition, even claiming doctors undertook medical experimentation on hapless immigrants.[41] Though these claims were baseless, it is true that the staff of Ward’s Island frequently faced internal division and therefore poor administration, as well as great personal risk – many personnel came down with typhus in the course of caring for patients.[42] After the greatest waves of immigration during the late 1840s and early 1850s resided, Ward’s Island residents enjoyed increasingly better facilities, the island planning new hospitals into the 1860s that promised to incorporate all ‘the greatest improvements in practical sanitary science.”[43]

Despite such progress, nativist sentiment decrying the rise of immigration as a cause of disease did not disappear. Most famously, Typhoid Mary (real name Mary Mallon), an Irishwoman forcibly confined by health officials for her asymptomatic carrying of typhoid fever, was stigmatized as unclean and became “the butt of jokes [and] cartoons” in the early 1900s.[44] “[D]eclared ‘unclean’ like a leper,”[45] “Mary’s case is a perfect example of how the Health Care system provokes social attitudes towards disease carriers, often associated with prejudice.”[46] Though the article does not touch upon Mary’s unique position as an Irish immigrant, her nationality and eventual confinement on North Brother Island share eerie parallels with the fate of fellow countrymen just a half-century before her.

[1] Alan M. Kraut, “Illness and Medical Care among Irish Immigrants inAntebellum New York,” in The New York Irish, eds. Ronald H. Bayer and Timothy J. Meagher (Baltimore: Johns Huopkins University Press, 1996), 154.

[2] Ibid.

[3] Otto Santa Ana, “’Like an Animal I Was Treated:’ Anti-Immigrant Metaphor in US Public Discourse,” Discourse & Society 10, no. 2 (1999), 199.

[4] Howard Markel and Alexandra Minna Stern, “The Foreignness of Germs: The Persistent Association of Immigrants and Disease in American Society,” The Milbank Quarterly 80, no. 4 (2002), 761.

[5] Ibid.

[6] Markel, 762.

[7] Referring to the stereotyping of undocumented Latino/a immigrants as taking advantage of government welfare in the 1990s. Lynn H. Fujiwara, “Immigrant Rights Are Human Rights: The Reframing of Immigrant Entitlement and Welfare,” Societal Problems 52, no. 1 (February 2005), 79-101.

[8] Ibid.

[9] Ibid.

[10] Tammy Bruce, “When Foreigners Bring Disease Across the Border,” The Washington Times (Washington, DC), January 25, 2016,

[11] Naturally, the article ignores the rising anti-vaccination movement that has permitted the rise of previously-long-unseen diseases. Jack Healy and Michael Paulson, “Vaccine Critics Turn Defensive Over Measles,” The New York Times (New York, NY), January 30, 2015,

[12] Robert Ernst, Immigrant Life in New York City, 1825-1863 (Syracuse: Syracuse University Press, 1994), 20.

[13] Kraut, 155.

[14] Friedrich Kapp, quoted in Kraut. Ibid.

[15] Ernst, 53.

[16] John Duffy, History of Public Health in New York City, 1625-1866 (New York: Russell Sage Foundation, 1968), 336.

[17] Kraut, 157.

[18] Ibid.

[19] Ibid.

[20] Kraut, 158.

[21] Ibid.

[22] Kraut, 159.

[23] Ernst, 54.

[24] Ernst, 55.

[25] Duffy, 453.

[26] Ernst, 56.

[27] Kraut, 159.

[28] Ibid.

[29] Kraut, 155.

[30] Kraut, 156.

[31] Ibid.

[32] Duffy, 337.

[33] Duffy, 338.

[34] Sharon Seltz and Stuart Miller, The Other Islands of New York City: A History and Guide, Third Edition (New York: The Countryman Press, 2011), 88.

[35] Ibid.

[36] “The Quarantine Arson.,” The New York Times (New York, NY), September 6, 1858,

[37] Seltz, 88-89.

[38] Seltz, 89.

[39] Duffy, 495-496.

[40] Duffy, 496.

[41] Ibid.

[42] Duffy, 495-496.

[43] Duffy, 498.

[44] Filio Marineli, Gregory Tsoucalas, Marianna Karamanou, and George Androutsos, “Mary Mallon (1869-1938) and the History of Typhoid Fever,” Annals of Gastroenterology 26, 2 (2013), 132-134,

[45] Ibid.

[46] Ibid.