Page:Popular Science Monthly Volume 83.djvu/339

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But the exclusion of unsound aliens includes more than a competent medical examination at entrance. Many cases of incipient disease both physical and mental are unrecognizable at the time of entry except by detailed and refined methods of diagnosis which are absolutely impracticable in the routine examination of large numbers of immigrants. Also the cleverness and cunning of defective aliens may easily conceal from the examiner some unobtrusive though important sign of defect or disease. Such cases are very apt to come to light sooner or later after landing, in hospitals or other public institutions. As Dr. Friedman says:

In addition it is impossible for an examination at the time of arrival to indicate how successfully a given immigrant will react to the stress and strain of American life, and whether some latent tendency or weakness may not be developed under the new conditions. In short the medical examination at entrance must be supplemented by examination at a period later in case some latent disease manifests itself.

The law takes cognizance of these circumstances by providing for the deportation of aliens who, within three years of landing, become public charges or develop any of the excludable diseases from causes existing prior to landing. An example of the need of this law and of its operation may be seen in the case of pulmonary tuberculosis, due to causes present when the alien landed but not appearing in definitely recognizable form until months later.

Even more striking is the value of this law in insanity, epilepsy and mental defectiveness. These conditions are excludable but often escape detection on the primary examination. Within the three-year limit, however, a large number of such cases develop. Many forms of insanity and epilepsy are known to be due to hereditary constitutional defect and psychopathic tendencies. Hence if one of these becomes apparent within three years after landing, the diagnosis shows that the causes must have existed prior to landing. Of course feeble-mindedness, idiocy and imbecility are congenital and one of these conditions found within three years is evidently under the law.

Feeblemindedness differs from imbecility only in degree, and in its lesser forms in turn shades off into simple backwardness of mental development. A case may have been given the benefit of the doubt on the primary examination, when later conditions indicate it to be feeble-minded. An infant or young child may show feeble-mindedness within